Study: Picky Eating Usually Normal, But Can Be a Sign of Bigger Issues

While most kids grow out of it, for others it could mean health issues

Boy eating with a fork and making a face
Got a picky eater? A new study says you might want to talk to your child's pediatrician to rule out health issues . Eric Audras/ONOKY/Getty Images

 If mealtimes are a battle with your picky-eating preschooler, you may chalk it up to a normal childhood behavior. And for most it is. But a new study finds that in some cases, kids who are fussy at the dinner table may have more serious problems and may require the help of a pediatrician.

Researchers at Duke University Medical Center observed over 3,400 children. They found that 20 percent of all kids in the 2 to 6 age group can be considered picky eaters.

Of that group, 18 percent are considered to be moderately picky eaters, and 3 percent are considered severe picky eaters. It is these two groups that researchers are most concerned about. Kids were what researchers considered to be moderate and severe picky eaters also displayed symptoms of anxiety and depression. Kids in these groups were twice as likely to have general anxiety. 

"These are children whose eating has become so limited or selective that it's starting to cause problems," said lead author Nancy Zucker, Ph.D., director of the Duke Center for Eating Disorders. "Impairment can take many different forms. It can affect the child's health, growth, social functioning, and the parent-child relationship. The child can feel like no one believes them, and parents can feel blamed for the problem."

Mealtime battles are often very common in households with these types of picky eaters, which causes stress for everyone.

But one of the keys is trying to figure out to what degree a child is selectively eating. 

"The question for many parents and physicians is: when is picky eating truly a problem?" said Zucker. "The children we're talking about are not just misbehaving kids who refuse to eat their broccoli."

Part of the problem of diagnosing picky eating is that it is so common, especially in young children.

And generally, the response to a parent who worries about a child who isn't eating enough is to take a "wait-and-see" approach. But when does a child cross the line and become a problem feeder?

The researchers suggest that pediatricians need to talk and probe further with parents who say their child is a picky eater. While for most, picky eating is a normal form of childhood, but for those who it isn't, talks like this may lead to the pediatrician getting involved sooner, and help parents who are most likely feeling overwhelmed. 

"There's no question that not all children go on to have chronic selective eating in adulthood," Zucker said. "But because these children are seeing impairment in their health and well-being now, we need to start developing ways to help these parents and doctors know when and how to intervene. What's hard for physicians is that they don't really have data to help predict which children will age out of the problem and which children won't, and so they're trying to do the best they can with limited information and interventions."

According to Zucker, kids who have issues with food may have "heightened senses, which can make the smell, texture and tastes of certain foods overwhelming, causing aversion and disgust. Some children may have had a bad experience with a certain food, and develop anxiety when trying another new food or being forced to try the offensive food again," she said.

The researchers suggest that therapy could help children who don't like eating, but that more needs to be done to address specific needs of children in different age ranges. 

"Psychological and Psychosocial Impairment in Preschoolers With Selective Eating," appears in the September 2015 issue of Pediatrics

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