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Three-Year-Old Is a Picky Eater

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: I have a three-year-old who refuses to eat. We recently moved and that seems to be when it got really bad. He used to eat everything. Now he only eats a few things, like potatoes, any kind of pasta, eggs, and grapes. He has become very picky and I don't know how to get him to eat. He doesn't eat sweets, so I know that isn't the problem. Will he grow out of this? It has been going on for six months. He only weighs 32 pounds. His weight seems to be staying the same. Please give me advice on this -- thank you.

A: Kids around your son's age are notorious for being picky or even refusing to eat. Children's appetites and growth tend to increase and decrease as they experience normal growth spurts or slow-downs. Every child is unique but, in general, appetites are smaller while growth is slower between the ages of one and five years. The average toddler will also demonstrate various mealtime behaviors. He may not be interested in trying new foods and says "NO" to most of what you offer. He may prefer mildly flavored foods. He does not like casseroles because he doesn't want one food touching another and insists on being able to identify each food. He does not like extreme temperatures. He may prefer fruits to vegetables. He only eats a little at a meal, but shortly after asks for a snack.

As a toddler also struggles to assert his independence from his parents, he often wages battles over eating, sleeping, and toileting. While it is understandably frustrating, it is an important part of his development. Your son may be even more defiant in response to your recent move. He had no control over relocating, but he can exert enormous control over what goes into his mouth!

So what can you do? First, try to relax. Children are quite good at getting enough quality calories. Each meal may not be perfectly balanced, but over the course of a week, he'll do fine. Continue healthy, regularly scheduled meals and let your toddler choose what and how much he will eat. Offer nutritious snacks like milk, cheese, fruit, whole grain breads or crackers. Limit juice to one glass per day. The fact that he doesn't eat sweets is good. Candy, soda, and other sweets can ruin appetites and promote cavities. Do not use food as punishment or bribery and never force your child to eat.

Many parents share your worry about "picky eaters" not getting enough to eat or eating the right foods. It sounds like your son is eating some and at least he's not losing weight. If you are still concerned, a visit to his doctor may reveal that he has grown more than you thought and a physical exam can reassure you that there are no real medical concerns.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.


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