Food preferences in children, as with adults, are a normal phenomenon. Picky or selective eating in children and adults are not representative of simple food preferences, however, but of neurological hard wiring problems that could possibly indicate an autism spectrum syndrome, or certain types of non-verbal learning disabilities and sensory integration disorders. Children with sensory problems tend to be hypersensitive to tastes, smells, and textures in the mouth, and may refuse food, gag or vomit as a typical response. Picky eating could potentially foreshadow obsessive compulsive disorder, phobias or other extreme forms of anxiety. In some instances, these conditions may follow premature birth and early intubation, or other trauma around eating, digestion, and the functioning of the mouth.

Question: “Should I offer my child an alternative dinner if she doesn’t like what the family is eating?”
Response: Parents need to assess each situation for its unique quality, and to trust their instincts in response. An important element in instilling healthy eating habits is for the entire family to sit down together as often as possible for home-cooked meals.  Expect the child to eat what the family eats; children need to learn to tolerate a variety of nutritious foods as set out by parents… except in cases of extreme distaste or possibly a feeding disorder (selective eating) that marked by fear and discomfort.  In those cases, you might do well to have alternative options available. It helps if both parents give the child the same message by providing a “united front” about expectations for the child’s presence and cooperation at meals.



The following are a few guidelines to keep in mind in approaching this issue:

First, try to comprehend what your child’s request might signify.

The child who is generally a healthy, flexible eater who sits with a plateful of healthy course items but who has a particular dislike for one particular food served may occasionally substitute a protein for a protein, a complex carbohydrate for a complex carbohydrate, if only now and then. The exchange should be simple, easy and facilitated by the child (substituting a scoop of cottage cheese or tuna salad for the protein course.)

If this request resounds consistently during most mealtimes and if the child refuses to eat whatever the family is eating, this child may possibly be a picky eater. It might also be a control device or the child’s attempt to draw attention to herself, though it is important to understand that the child who cries, gags, and exhibits fear, or who refuses to eat even if he or she must go hungry as a result, this child is probably not just opinionated, stubborn and willful, but is most likely a picky eater.  

If the child is refusing foods that contain certain fats or sugars or that are calorie dense, that might lead a parent to consider whether this might be an early warning sign of the onset of food restriction or an eating dysfunction. It might be helpful to discuss with the child his or her motivation in demanding such a compromise.

If the child is not hungry at dinner because he or she has eaten a snack too close to dinner time, this is something that must be noted and avoided in future situations. This may be more a matter of eating lifestyle and food planning.

If you determine that your child might be a picky eater, you will need to solicit professional help for the child, and for yourself and family, in managing the condition and the anxiety that naturally arises from it around mealtimes.

If a child is a picky eater, the first priority is to provide nourishment upon which to grow. Beware that by offering only the child’s few food preferences, parents may be missing a prime opportunity to expand the diversity of the child’s palate, and food repertoire, all of which will have consequences later in life. Parents need to be teachers as well as mentors. 

To optimize a child’s palate, parents do well to expose their children to a wide variety of foods, tastes, smells and textures within the two years of life. Sometimes a parent might need to offer the same food as many as ten times before the child will consider trying it. If a child is deprived of important nutrients, parents need to supplement the child’s diet with Pediasure and vitamins.

Picky eating syndrome is a problem that is chemically and neurologically based. Anxiety and unpleasantness at mealtimes become givens in the case of the picky eating child.  Develop a system for recognizing and handling meal-time crises, making every effort to offset their effects while helping the child learn to overcome his or her fear of certain foods. Picky eating represents an eating life style.  When the child’s eating life style includes a regular diet of fear, alleviating that fear must become a first priority. Helping siblings deal with the chaos and discomfort is still another task for parents.

Parents can expect to discover in some cases that eating behaviors at dinner might be representative of similar responses in other life spheres. The child who cannot adjust to new foods may be generally unable to adjust to and accommodate change, unfamiliarity and discomfort in other contexts as well. Any behaviors that take on the quality of excess, rigidity, ritualism or compulsion are most likely rooted in anxiety.

As a rule of thumb, dysfunctional eating behaviors may in some ways represent the tip of a behavioral iceberg, a metaphor for how a child thinks, behaves, and views the world.