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Many children have aversions to certain foods and this can be very challenging for parents. I have provided some helpful links below.

Mayo Clinic presents: Children’s Nutrition: 10 tips for picky eaters.

Children's nutrition doesn't have to be frustrating. Consider these strategies to avoid power struggles and help the picky eater in your family eat a balanced diet.

Has your preschooler refused to eat anything other than chicken nuggets for the past two days? Or would your toddler rather play than eat anything at all? If children's nutrition is a sore topic in your household, you're not alone. Many parents worry about what their children eat — and don't eat. However, most kids get plenty of variety and nutrition in their diets over the course of a week. Until your child's food preferences mature, consider these tips for preventing mealtime battles.

  • No. 1 Respect your child's appetite — or lack of one

    If your child isn't hungry, don't force a meal or snack. Likewise, don't bribe or force your child to eat certain foods or clean his or her plate. This might only ignite — or reinforce — a power struggle over food. In addition, your child might come to associate mealtime with anxiety and frustration. Serve small portions to avoid overwhelming your child and give him or her the opportunity to independently ask for more.

  • No. 2 Stick to the routine

    Serve meals and snacks at about the same times every day. Provide juice or milk with the food, and offer water between meals and snacks. Allowing your child to fill up on juice or milk throughout the day might decrease his or her appetite for meals.

  • No. 3 Be patient with new foods

    Young children often touch or smell new foods, and may even put tiny bits in their mouths and then take them back out again. Your child might need repeated exposure to a new food before he or she takes the first bite. Encourage your child by talking about a food's color, shape, aroma and texture — not whether it tastes good. Serve new foods along with your child's favorite foods.

  • No. 4 Make it fun

    Serve broccoli and other veggies with a favorite dip or sauce. Cut foods into various shapes with cookie cutters. Offer breakfast foods for dinner. Serve a variety of brightly colored foods.

  • No. 5 Recruit your child's help

    At the grocery store, ask your child to help you select fruits, vegetables and other healthy foods. Don't buy anything that you don't want your child to eat. At home, encourage your child to help you rinse veggies, stir batter or set the table.

  • No. 6 Set a good example

    If you eat a variety of healthy foods, your child is more likely to follow suit.

  • No. 7 Be creative

    Add chopped broccoli or green peppers to spaghetti sauce, top cereal with fruit slices, or mix grated zucchini and carrots into casseroles and soups.

  • No. 8 Minimize distractions

    Turn off the television and other electronic gadgets during meals. This will help your child focus on eating. Keep in mind that television advertising might also encourage your child to desire sugary foods.

  • No. 9 Don't offer dessert as a reward

    Withholding dessert sends the message that dessert is the best food, which might only increase your child's desire for sweets. You might select one or two nights a week as dessert nights, and skip dessert the rest of the week — or redefine dessert as fruit, yogurt or other healthy choices.

  • No. 10 Don't be a short-order cook

    Preparing a separate meal for your child after he or she rejects the original meal might promote picky eating. Encourage your child to stay at the table for the designated mealtime — even if he or she doesn't eat. Keep serving your child healthy choices until they become familiar and preferred.

If you're concerned that picky eating is compromising your child's growth and development, consult your child's doctor. In addition, consider recording the types and amounts of food your child eats for three days. The big picture might help ease your worries. A food log can also help your child's doctor determine any problems. In the meantime, remember that your child's eating habits won't likely change overnight — but the small steps you take each day can help promote a lifetime of healthy eating.

© 1998-2013 Mayo Foundation for Medical Education and Research. All rights reserved

Feeding Issues: Treating Severe Symptoms of food Aversion or Extreme Food Selectivity

Approximately 25% of average children will have mild feeding problems. However, between 40% and 70% of infants born prematurely or having chronic medical conditions will have feeding problems.

Signs and symptoms of severe food aversion or extreme food selectivity

  • Only accepting a narrow range of food choices
  • Extreme preference for certain brands of food
  • Anxiety when faced with a new food item
  • Inability to eat any foods, including foods regularly chosen within the home, when not at home
  • Preference toward avoiding food, often for an entire day, instead of trying something new
  • Failure to thrive
  • Difficulty chewing or swallowing
  • Recurrent pneumonia or chronic lung disease
  • Frequent vomiting
  • Frequent gagging when served certain foods
  • Prolonged mealtimes

The following recommendations may help in treating children with severe food aversions or extreme food selectivity.

  • Family involvement

    Treatment should involve the entire family.

  • Prechaining and food chaining

    Prechaining and food chaining therapies are used to treat children who have either feeding aversion or severe food selectivity.

    Prechaining is meant to keep the child on target with feeding developmental skills. For example, you might expose a child to minute amounts of food on a daily basis. You might introduce texture by dipping utensils into flavored purees. The goal during the first year of life is to maintain the tolerance of food taste and aroma until swallowing skills improve enough for the child’s diet to progress. Prechaining should take place during the child’s first year of life, and should begin as soon as the child displays signs of a feeding problem or the potential to develop one becomes clear.

    Food chaining begins with a therapist analyzing the child’s current feeding habits to determine which tastes, textures, and temperatures are most acceptable to him or her. Those foods that the child currently tolerates remain the base of the diet, while gradually offering other foods that are identified as possibly acceptable. Any food that is moderately approved becomes part of the foods that are regularly offered. The child is not overwhelmed with change, as this is a very gradual process, with the introduction of only one or two foods at a time.

  • Videotaping feedings

    Many therapists are asking parents to videotape feedings, so that they can closely analyze familial interaction, the pacing of the meal, the feeding environment, and the level of independence demonstrated by the child.

  • New foods

    Experts recommend combining new foods with preferred foods.

  • Positive reinforcement

    Some studies have shown that positive reinforcement of food progression, including rocking the child or allowing the child to play with a favorite toy, is effective.

  • Dysphagia

    If the problem is related to dysphagia, a change in positioning, textural desensitization, modification of food consistency, and/or use of special feeding devices sometimes is necessary.

  • Mealtime

    Initiation of a regular mealtime schedule and avoidance of force feeding is crucial. It is recommended that the entire family eat a varied and balanced diet, including many different types of food, and that meals are eaten together as a family, within the home as often as possible.

  • Texture sensitivity

    For children with texture sensitivity, “playing with” their food sometimes is helpful. Occupational therapists may recommend other exercises, such as rubbing the child’s gums, providing oral stimulation with a toothbrush or washcloth, etc.

  • Distractions

    Some children eat better when they are distracted, such as when caregivers recite stories or sing familiar songs.

References and suggested readings

Cambridge Center for Behavioral Studies. Severe food selectivity treated. Available at: http://www.behavior.org/journals_BAD/V3n3/digest_V3n3_food.cfm. Accessed November 6, 2008.

Clawson B, Purcell D, Elliott C. Picky eaters and how to help them. Available at: http://allaboutkidsmagazine.com/?p=3381. Accessed November 6, 2008.

Fishbein M, Cox S, Walbert L, Fraker C. Comprehensive treatment of feeding aversion in children. Available at: http://www.empoweredparents.com/pickyeating/pickyeating7.htm. Accessed November 6, 2008.

Shore BA, Babbitt RL, Williams KE, Coe DA, Snyder A. Use of texture fading in the treatment of food selectivity. J Appl Behav Anal [serial online]. 1998;31:621-633. Available at: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1284152&blobtype=pdf. Accessed November 6, 2008.

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