When Toddlers Are Picky Eaters

Dear Dr. Bill:

My 2-year-old daughter has recently decided she doesn't like food! She used to eat almost anything we put in front of her, but now she's slowly narrowing her list of acceptable meals. At 12 to 18 months, she loved pizza, pasta, grilled cheese, rice, mashed potatoes and more, but now she won't even touch them — unless it's throwing them to the ground. She will only eat snack-type things like pretzels, crackers, applesauce and yogurt. She'll also eat eggs, toast or cereal for breakfast, but that's about it.

My wife and I have tried everything. We've tried to force feed her, but that doesn't work. We've made her sit all night until she eats whatever we set before her. But we're afraid to let her go to bed hungry, and we're not sure when we should give in and let her eat something else, or whether we should stick it out. Please help before our daughter won't eat anything at all!

— Joe

Dear Joe:

Just about every parent can relate to your situation in one way or another. Most of us have had at least one child who was a picky eater at some point in their early childhood.

I wanted to get a pediatrician's perspective on your question, so I consulted with my friend Dr. Jennifer Shu of the American Academy of Pediatrics. Here's what she had to say:

Frequently after the first birthday, children begin to grow more slowly and typically need to eat less than before. This period coincides with their natural need to exert their independence. Parents often notice that their child's appetite has decreased. In addition, they'll start to hear the word "no" more often, and find that 2- and 3-year olds like making their own decisions whenever given the chance.

You can take advantage of this newfound independence by at first offering her a choice of 2 foods that you approve of. Bear in mind that snack-type item (such as pretzels or crackers) should not be a choice during dinnertime.

Allow your daughter a set amount of time to eat her meal rather than force her to sit too long; at age 2, a child's attention span is likely to be about 10 to 15 minutes. If she doesn't eat dinner during that time, continue with the rest of the evening routine. If she goes to bed without dinner, she'll just eat more breakfast the next day.

Be sure to offer her some healthy choices in the morning as well. (You don't have to limit the choices to typical "breakfast" food — leftovers from dinner work fine, too.) Once she sees that you won't cater to her food preferences, she'll willingly eat what you provide —or she can just wait until the next meal.

Whenever possible, eat meals together as a family and make sure that children eat the same food as adults. Parents should not have to be short-order cooks for their children. Healthy children who have been growing normally will not starve if they miss a meal here and there. If your daughter persists in refusing food, consult with your pediatrician for more ideas.

Our thanks to Dr. Jennifer Shu for that great advice. By the way, let me recommend a great book that Dr. Shu has written with her colleague Dr. Laura Jana — Food Fights: Winning the Nutritional Challenges of Parenthood Armed with Insight, Humor and a Bottle of Ketchup. You can order the book through most online book retailers.

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