Pushing away the bowl of eggs I had just made for breakfast, my oldest daughter mimes gagging motions at the smell.
“Oh my gosh, Mom, that smells so bad,” she says, waving her hand frantically around the air, as it to dispel the atrocious scent. I sigh a little, busying myself with pouring sippy cups for her siblings.
“You know the rules,” I say. And she does. We have a try-it-once-and-then-you-can-choose-cereal rule in our family here because with four young kids, I’m under no illusions that every single meal is going to be loved and devoured by all. But one of my daughters takes the cake for picky eating and on this particular morning when she takes a bite of the chosen cereal and then wrinkles her nose, proclaiming that the milk now tastes “icky,” I admit I feel like giving up.
A new study claims there’s a link between picky eating and mental illness in children.
At first, this news made me feel a teensy bit better to think that there could be some “real” causes to picky eating besides my own failures as a parent. But then it made me terrified out of my mind because how on earth do you tell when there’s a medical problem or if your kid is just being stubborn?
I talked to a few experts to get the lowdown on what to do and when to worry when you have a child like mine who once gave me a list of her pre-approved food choices, which only included 5 items including steak, bacon, and chicken nuggets. (No, I’m not kidding.)
1. Determine whether or not it is impacting other areas of their life
“Typical picky eating, which all children [experience] to some degree, is inherently different from what we have called ‘extreme picky eating,’ ” explains Jenny H. McGlothlin, MS, CCC/SLP, a Speech-Language Pathologist and Faculty Associate at the Callier Center for Communication Disorders-Richardson in Texas.
Extreme picky eating, says McGlothin, encompasses food aversions, feeding disorders, and selective eating and is characterized when a child’s physical growth and health, social, or emotional development is negatively impacted.
“When the child can’t attend parties, is anxious about going to school, or can’t function in the social arena because of their extreme picky eating, then the social development will suffer,” she says. “If anxiety about eating causes major conflict at the table, gagging, tears, or tantrums, and the child becomes so upset by the suggestion that they eat something that they have a meltdown, then the emotional development of the child needs to be examined.”
2. Realize that it’s not just about the food
Picky eating, unfortunately, is usually not just about the food. “There are many ‘causes’ of extreme picky eating,” explains McGlothlin. “But when you rule out any other issues, you are left with temperament.”
After ruling out any medical, oral motor, or significant sensory issues, McGlothin explains that the children she sees who are “picky eating” often have temperaments that are similar: They are highly verbal and intelligent, have a strong desire to figure things out in their own time and in their own way are easily upset and frustrated, and feel and express intense emotions. (Side note: OMG does this describe my daughter!)
“Personality traits like shyness, emotionality, and irritability have also been linked in the research to food refusal,” adds McGlothlin. “All of these temperament characteristics set the child up for having anxiety about eating, which is a complicated and very personal experience.”
She explains that the problem with picky eating may start as early as 14 months to 4 years of age, when children through a typical phase of neophobia (fear of new food) and are met with pressure from well-meaning adults, it could cause the child may become highly anxious about food. “The cycle that ensues pulls parents into battles with the child and their eating gets worse,” she relates.
And lastly, children with extreme picky eating often struggle with severe anxiety in all areas of their life, says McGlothin. “We eat all the time, so anxiety can be pervasive for a child who struggles with eating,” she explains. “It may be on their mind all the time, interfering with other more positive thoughts and feelings. They may have a poor self-concept, which can be the start to depressive tendencies. If the adults in your life are constantly pushing you to eat more or differently, it tells you that you aren’t okay the way you are. But when the anxiety around food is decreased, they don’t have to spend so much energy worrying about food and more positive thoughts have room to grow. ”
3. Be aware of when to seek professional help
So if you’re the parent of a picky eater like me, how do you know when it’s time to actually seek professional help? According to McGlothlin, children that exhibit any of the following signs or symptoms will need a medical intervention:
- Inability to chew with their gums/molars by about 15 months
- Documented nutritional deficiencies and/or is falling off her own growth chart
- Gags or vomits frequently when eating
- Gets upset or cries often around food, feels bad about eating
- Can’t go to social gatherings
- Isolates themselves or the entire family because of menu limitations
- Is teased by peers or extreme attention is paid to her eating by adults (teachers, family)
4. Be willing to look beyond your child
The issue of having picky eaters might start closer to home than you would think. “Interestingly enough, many severely selective eaters have parents who are themselves battling mental health issues, such as eating disorders, substance abuse, depression, anxiety, and obsessive compulsion,” relates Houston psychologist Dr. Gail Gross, Ph.D., Ed.D., M.Ed.
Perhaps taking a good, hard look at yourself and your own relationship to food or mental health is a helpful place to start. “There can also be an issue with sensory processing and your highly picky eater may just be too sensitive to internal and external stimulation, such as smells, sight and texture,” adds Dr. Gross.
5. Don’t make it about you
That being said, it’s important to separate any of your own emotional baggage with food or mental health with your child’s diet. “Parents have to truly let go of their own anxieties about their child’s eating before they can help their child,” says McGlothlin. “Children can sense when we are worried or frustrated about their eating, and that can feel like pressure to the anxious child.”
She recommends the following strategies to reduce anxiety at meal time for the food-adverse child:
- Let the child know there will always be something he can eat.
- Reassure him that you won’t be disappointed if he doesn’t eat.
- Facilitate internal motivation rather than relying on external motivation. “Don’t praise!” McGlothin stresses. “Praising today communicates that you will be disappointed if she isn’t brave tomorrow.”
- Bolster the child’s self-confidence and feelings of capability through mealtime jobs and neutral exposure of a variety of foods.
- General anxiety should be addressed separately from food. “Anxiety management strategies can be particularly useful for a child who has difficulty with change or transitions,” says McGlothin.
6. Look at picky eating as a good thing
I know, right? I didn’t quite see how this could be a good thing either, but Dr. Gross maintains that picky eating can be a gift in disguise. “If your child is an extremely selective eater, she may be telling you that there are other problems afoot, which gives you a wonderful opportunity to support your child,” she explains. “This is a win-win situation. It’s a great opportunity for you to build a strong and healthy relationship and become a lifelong ally to your child.”
For more information on picky eating, check out Jenny H. McGlothlin’s book Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion, and Feeding Disorders