So, you think you have a picky eater? Does your child only want to eat just one food?

A mom recently shared her child’s picky eating habits with me. Her child will only eat a certain fast-food brand of fried chicken nuggets, only in the original box. When the restaurant changed packages, the mom raced out to buy all the old boxes she could find, in an effort to help her child continue to at least eat something.

A lot of young children are finicky about food. Many parents need to intervene on behalf of their child’s diet in order to ensure they are getting the right amount and variety of nutrients for healthy development. A child who only eats one type of food might seem OK initially, but poor nutrient intake will eventually take a toll. 

Up to one in four kids have an eating problem in early childhood. Some children will eat only certain types of food. Others will eat little or nothing at all. Many children go through phases where they will only eat certain foods – this is what we mean when we say picky eating. Problem eating is a different story, in which children eat 20 foods or less. Presenting problem eaters with new foods may lead to vomiting, gagging or temper tantrums.

While most kids soon outgrow that peanut butter-only phase, up to 1%-2% of children ultimately need professional assistance to improve their diets. Physical problems, such as food allergies, developmental delays or metabolic disorders, underlie some of these cases. Children sometimes refuse to eat to attract attention from their parents and exert control. Parents may observe that their picky eater eats much better at daycare or school. This is likely because no one is hovering over them.

Parents must be good role models for their kids and model good nutrition habits. They can do this by exposing children to new healthy foods again and again. With most children, just having healthy and nutritious foods on the table near them may help reverse any negative associations they have with the foods in question. Even well-meaning parents can promote bad behavior, for example, by letting kids end a meal by throwing a fit. Additionally, if junk food is easily accessible or clearly visible in the home, it may be just too tempting for children not to crave it. 

A parent’s duty is to offer healthy age-appropriate food in a pleasant atmosphere where the child does not feel forced to eat. The American Academy of Pediatrics offers the following tips for parents of picky eaters:

• Remain calm. In most cases, your child’s behavior is typical.
• Parents should discontinue bottle feeding soon after the child's first birthday. 
• Don’t force a child to clean his or her plate. If your child misses a meal, they will make it up later.
• Minimize juices and any sweet drinks, fast or processed foods and dessert foods. Dessert should follow a healthy meal, not replace one.
• Be on the lookout for potential food allergies that could be impacted the way children eat.
• Involve your child in the process of meal preparation. Children may be more apt to eat foods they helped to prepare.
• Ignore tantrums. Many kids will give them up in a few days.
• Make changes so gradual that your child doesn’t notice. If you know your child will balk after four bites, for example, stop after four bites. In a few days, try five or six.
• Praise good behavior, such as trying new foods.
• Be consistent. Make sure other caregivers follow your lead.
• Remember, children’s appetites fluctuate day-to-day.
• Encourage drinking plain water.
• Do not withhold food as a form of punishment.
• Seek help for weight loss or very slow growth in young children. 

There is some evidence that play has become a forgotten educator, and that making mealtime more fun by introducing creativity and games could help your child become less picky. Parents are encouraged to try anything from conducting a taste test of different foods with their children or decorating the table in a new and unique way to reduce mealtime stress or anxiety.

Food consumption and dental hygiene go hand-in-hand. It is very important that children learn to brush their teeth early, and they should have their first appointment with a pediatric dentist soon after the first year of life. Reach out to your child’s pediatrician if your child’s nutrition is becoming concerning, mealtime disruptions have worsened for months, progress has stalled—or if you’re overwhelmed.

Editor's note: This article was originally published on May 7th, 2014.