Health, Food & Nutrition

The Parent’s Guide to Mealtime with Picky Eaters

ADHD and sensory processing problems frequently coincide with feeding challenges. Pursuing professional guidance and feeding therapy can help mitigate your child’s problems with eating. In the meantime, use these strategies to improve mealtime with picky eaters.

illustration of a disgruntled child sitting at a table with a plate of broccoli and carrots. Picky eater not eating healthy dinner
illustration of a disgruntled child sitting at a table with a plate of broccoli and carrots. Picky eater not eating healthy dinner

Maintaining our sensory systems in a calm and regulated state can be challenging for anyone, and even more so for those with ADHD. Some of us process sensory input more efficiently than others, and almost all of us have some sensory quirks that are part of what makes us unique. Our senses lead us to seek out what keeps us feeling our best — clothing choices, exercise preferences, and what we eat for breakfast, lunch, and dinner.

Picky Eaters and Sensory Challenges

Sensory processing difficulty affects everything you do during the day, and it has a tremendous impact at mealtimes. Research suggests that children with sensory processing challenges frequently struggle to eat. And many children who don’t eat well often have sensory processing problems.

Eating is a complex sensory task. Each time we chew our food we must simultaneously integrate at least one new piece of information from each of our eight sensory systems. Each time you chew, your food feels different in your mouth, it sounds different in your head, and the taste changes. It even smells different as you chew (we have scent receptors in the back of our mouths), and you must use a different amount of chewing pressure. You also have to monitor several internal body signals that are indicators of hunger and fullness.

Understanding why a child has feeding challenges may be difficult. The website estimates that 1 in 37 children under the age of five has a pediatric feeding disorder.

A team approach to identify the problem can be beneficial. You know your child best and are a vital team member! Ideally, a feeding team would also include a pediatrician, a registered dietitian, a speech language pathologist or occupational therapist, and a psychologist to explore how a child thinks about food. These four parts of a feeding team’s evaluation make up the categories required to determine whether a child has a pediatric feeding disorder (PFD). When not addressed, young children with a PFD grow up to be teens and adults who still have deficits affecting their eating.

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Getting Picky Eaters Back on Track Developmentally

Early identification and therapy are vital for helping children with feeding challenges get back on track developmentally and improve their diet and growth. But feeding challenges are often brushed off by medical providers. Many pediatricians tell parents “all children are picky, and they will outgrow it.” However, this is not supported by research.

Studies show that 25 to 33 percent of children are picky eaters at some point in their lives, and only about one-third of these children will outgrow their picky eating without professional help. Research also shows that persistent feeding problems suggest that something about a child’s development is not progressing correctly. Children with developmental challenges frequently present first with feeding difficulties, usually within the first two years of life. If your child has struggled with eating for several years, you feel like mealtimes are a battleground, your child is having trouble following her growth curve, or her doctor is concerned about her, it would be worth seeking out a feeding assessment.

Working with a feeding team is the best way to determine if your child is a problem feeder, but there are many things you can do on your own.

Steps to Better Mealtimes with a Picky Eater

1. Build positive experiences with new foods and low-pressure exposure to them.

Pressuring your child to taste a new food often backfires. The likelihood of a child liking a new food when he is pushed to taste it is very low, and makes it increasingly hard for the child to taste that food in the future. Instead, focus on positive, low-stress experiences with unfamiliar foods.

2. Involve your child in meal preparations.

Age-appropriate cooking tasks help your child gain experience seeing, touching, smelling, and watching foods as they change in the preparation and cooking process. This opportunity to interact with food before it shows up on their plate at meals can significantly increase their comfort with that food, even if they aren’t ready to eat it yet. Kitchen gadgets can often help children engage with unfamiliar foods.

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3. Clean up together.

Putting away leftovers is an easy way to have your child interact with a food that he may not be ready to eat. Many children barely look at foods they don’t eat, and helping out in the kitchen lets them engage with that new food without the expectation of eating it yet.

Simplify the Task of Eating for a Picky Eater

1. Fix your child’s chair

Supporting your child’s posture at meals is critical, and this is often the first recommendation I give to families. Make sure that your child’s feet rest flat on the floor, that her knees fall over the front edge of the chair at a 90-degree angle, and that her back rests against the back of the chair.

The easiest option is usually an adjustable wooden chair, such as the Stokke Tripp Trapp. You can also adapt your regular kitchen chair for an older child by adding a footrest and a firm cushion behind his back to give him more support. I like to duct-tape old textbooks or phone books together to make the right-sized footrest. Benches and stools without back or foot support do not set your child up for success at mealtimes.

2. Let your child eat with their fingers.

Eating with fingers increases the mess during meals; however, the mess is a good thing and helps your child learn about the food. Understanding what food is going to feel like in your mouth decreases the stress of trying new foods, and when we eat with our fingers, we get a chance to figure some of that out!

3. Making the right cut.

The way we cut and cook food makes a big difference in how easy or hard it is to eat. Here are a few examples:

  • Cutting food into long, stick-shaped pieces helps your child place the food directly on the back molars for more efficient chewing. Peel apples, pears, and cucumbers, then slice them into thin sticks.
  • Slice meat against the grain, so that it quickly falls apart. Crockpot and instant pot recipes produce tender meat that is easier to manage.
  • Use cocktail forks to spear small cubes of hard-to-chew foods. With a cocktail fork, your child can place the cube directly on her back molars.

Presentation matters. We eat with our eyes first; children often decide whether or not they like a food based on how it looks.

4. Make it fun

You don’t have to be fancy, just thoughtful and a little creative. Small bowls or reusable cupcake liners can be a great way to contain condiments or separate different foods to help avoid the overload that sometimes comes when children look at a big plate full of food. Cookie cutters come in all sizes and themes and can be helpful as well.

5. Serve new foods in tiny portions

Offer familiar foods to your child at every meal, and when you offer a new food, make sure it is a small amount. Let everyone serve themselves, family-style, and encourage everyone to take at least a tiny bit of all the foods on the dinner table.

6. Keep meals simple

One-pot meals, soups, and casseroles are easy, but they may be off-putting to children because of their mixed textures. You may want to separate the different ingredients on your child’s plate to simplify things.

If your child needs more support than these strategies provide, know that many professionals specialize in feeding therapy. They can help your child develop the skills required to eat well. You can start at feeding websites such as Feeding Matters, which has a free Infant and Child Feeding Questionnaire, or the SOS Approach to Feeding website and read through the parent resources to help you start to understand how big of a problem eating might be for your child. You can take this information to your child’s physician and request a referral for a feeding assessment. The Feeding Matters and SOS websites have referral lists to help you find a qualified feeding specialist in your community.

With the right support and a team approach to solving feeding problems, you can improve your child’s relationship with food and lower everyone’s stress at mealtimes.

Picky Eaters with ADHD: Next Steps

Lindsay Beckerman, MOT, OTR/L, is an occupational therapist specializing in feeding therapy. She enjoys empowering children and teens to improve their relationship with food using the SOS Approach Feeding program. You can reach Lindsay at [email protected].

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