In my continuous search for solutions I discovered that we get four different types of picky eaters:

• The children who do not want to try new food
• Children who will only eat certain foods
• Children who spend a long time at the table without actually eating anything and
• Children who refuse certain colours or textures when it comes to eating food.

Shock,  horror – she falls into all four categories!  Jemma will not try anything new, she will only eat starchy food and meat, she will spend an inordinate amount of time at the table to just take two bites of her food and she definitely refuses anything green and crunchy.

Oral defensiveness is apparently the leading cause of being a picky eater at the dining room table. Children who are orally defensive often exhibit some of the following signs:

• They only eat a limited variety of food
• They are extremely reluctant to try new food types
• These children only eat soft or pureed food still after the age of two
• Children who are orally defensive often gag on their food
• They choke easily or have difficulty sucking, chewing or swallowing
• They often over stuff their mouths with food (which then can lead to gagging or choking)
• These children do not like brushing teeth and can have a fear of the dentist and any dental procedure
• They often prefer only hot food or only cold food
• They tend to dislike toothpaste and mouthwash
• They avoid seasoned, spicy, sweet, sour or salty food and would rather eat bland food.

If your child, like mine, seems to be orally defensive; here are some tips on how to overcome this sensitivity:

1. Forget what you learned as a child and allow your child to play with his food.
2. It might help to grind up the food that the rest of the family is having to get her used to different tastes without having to deal with different textures.
3. When you have found a favourite food, try to introduce similar foods.  If for example your little one likes cheese pizza expand his repertoire slowly by adding ham to the pizza.
4. Usually it would be seen as a bad thing, but with orally defensive children distractions like a toy or the television, can be helpful!  It draws his full attention away from what he is hesitant to do.
5. Bribery is a useful tool.  Agree beforehand that if he tastes, chews or swallow a bit of something new – he can receive an agreed upon reward. It is all in an effort to expose him to new tastes and textures.
6. A reward chart in a noticeable spot in the house can be helpful.  If he can see more and more stickers added on a chart on the fridge, he should become more confident and therefore more adventurous.
7. A limited choice will give your child a sense of control over what he puts into his mouth.
8. Try to include different textures on his plate of food, but remember to keep the portions of new foods small.
9. Give your child free reign of condiments – if he eats the peas only when covered in tomato sauce, so be it.
10. Praise, praise and praise your child even for the smallest effort. Do not scold him if he does not succeed, scolding will lead to negative associations with food.
11. Respect your child’s appetite – do not force him to eat if he is not hungry.
12. Stick to a routine where there are no snacks for at least an hour before mealtime
13. Have patience – only with repeated exposure  of new foods will you succeed.
14. Make mealtime fun! Use a cookie cutter do make different shapes, give dips with meals, or give breakfast for dinner.
15. Get your child involved in the shopping, let him choose something that he wants to try out.
16. It is important that you set the example of healthy eating habits – if you do not eat vegetables, you cannot expect it of him.
17. Sometimes healthy bits can be disguised in favourite food – who will notice the blend of carrots and baby marrow in spaghetti bolognaise?
18. Do not become a short order cook for your child.

Many parents with children that are picky eaters are worried about their child’s weight and whether they are getting in all the minerals and vitamins that they need to grow and function. A good target to set for your child is to try and cover all the food groups in one week and not in one day. If you are unsure of what a child should be having in a period of a week, here is a reminder:

• Bread, Cereal, Rice and Pasta (6 – 11 servings)
• Fruit (2 – 4 servings)
• Veg (2 – 4 servings)
• Milk, Yoghurt and Cheese (2-3 servings)
• Meat, Poultry, Fish, Dry Beans, Eggs and Nuts (2 -3 servings)
• Fats, Oils and Sweets (sparingly)

Giving a multi-vitamin, eases many parents’ worries.  If your child is growing and happy, generally there should not be anything to be worried about!

There are various problems found in children’s eating behavior:

• Sensory Integration Disorder: These children are either hypersensitive to the taste, texture, temperature or smell of food, or there is a lack of sensitivity which prevents them from eating.
• Motor Difficulties: Children with motor difficulties experience problems with chewing or swallowing of food.
• Attention Deficit Disorder: Children with ADD are too easily distracted at mealtimes to remain at the table and finish a meal.
• Overeating: Overeating in children can be due to growth spurts, a fast metabolism, hormonal problems or sometimes as a reaction to a stressor in their lives. This becomes a big concern if the overeating develops into a permanent behaviour pattern, seeing that it would lead to childhood obesity.

Some parents are worried that their children are not getting enough food into their systems. When all medical problems are eliminated, they realize that they have a "picky eater" .  Most children will at some stage go through a phase of being picky regarding what they want to eat.  Parents should only worry about the amount children eat when they are losing weight or have not gained any weight in six months, have other symptoms of an illness, gags on food or vomits, have thinning hair or develop fine, baby like hair on their bodies.

The battle of "I am not hungry" can become a struggle for control between parents and their child.  At mealtime the child claims not to be hungry, but whines in between meals for snacks.  Because the parent is worried that their slender child will not get enough nourishment, they resort to threats, bribes and catering to the will of the child. It takes patience to resolve this conflict.  Experts give the following tips to help in handling a "picky eater":

• Adjust your expectations of the portion size you want your child to eat.
• Offer small portions – a full plate can be daunting.
• Snacks are allowed if they are small.
• Limit the amount of juice and cold drinks as they are filling.
• Consider giving your child meals more often per day, but make it mini-meals.
• Plan ahead in order to make the running of mealtime smoother, a hungry child can get distracted if they have to wait too long for their food and then lose interest.
• Involve your child in making decisions of what is for dinner or allow him to help with the preparation of the food.
• Your child should feed himself.
• Refrain from forcing your child to eat. Force will lead to negative associations with food.
• Try to keep mealtimes as pleasant as possible.
• Never nag or praise your child when it concerns food. You do not want to connect an emotional association with food.
• Do not cook on demand. Your child should eat what is offered to him, but make sure that there is at least one thing that your child enjoys.
• Eliminate "gag" foods. If your child had a bout of vomiting after a certain type of food was eaten they may associate the food with feeling ill and feel sick at the prospect of having to eat it.
• Do not eliminate dessert, but keep it nutritious. If dessert is the only thing your child eats, at least you know it is not empty calories.
• Ease your own mind by giving vitamin supplements.
• Be sure to avoid distractions during mealtimes. Switch the TV off and remove all toys from the eating area.
• Take your child on a field trip to the supermarket. Let him push the trolley and make some purchasing decisions.
• Let your child play with plastic dinnerware and toy food. This will create familiarity and comfort with food.

Joan Price believes that both the parent and child share responsibility when it comes to eating behaviour. The parent is responsible for the what, when and where and the child is responsible for the how much or whether.  She stresses that if children are allowed to follow their own internal cues of hunger and fullness, obesity can be prevented.

Many picky eaters have a limited range of acceptable foods.  Familiarity is the key to acceptance, therefore keep on exposing your child to new foods even if they do not want to eat  it.  Eventually they might be willing to give it a try.  It is important though to reassure him that he is allowed to take it out of his mouth if he does not like it.

Help your child to develop a healthy relationship with food – seeing food for what it is and not what emotional need is fulfilled through it.