Current Evidence on Picky Eating in Early Childhood
5 min read • By: Gerber Medical Hub
Quick Summary
Learn about the science behind food acceptance and picky eating.
Table of contents
Evidence Supporting Picky Eating
The science picky eating is complex and aims to understand the development and persistence of picky eating behaviors with a focus on how to help families support their children. Research in the field of picky eating is very active, as it remains an ongoing challenge for families. Recent areas being studied and some key conclusions that can help parents and caregivers are listed below:
Is Picky Eating a Phase or Outgrown?
Commonly, yes. Of 7,405 children ages 5.5-8.5-years-old with data on picky eating, 13% were classified as having picky eating behaviors when they were between the ages of 2.0-5.5-years-old. At 5.5, 7 and 8.5 years, the likelihood of picky eating behaviors declined with age. The families of children who have picky eating behaviors at the time of entering the school system should be offered reassurance that the feeding difficulties are likely to slowly resolve over time but also be provided with support to encourage food acceptance. (Dimantis 2023)
Does it Matter What Parents Say about Foods and Feeding?
Yes! What caregivers say when feeding children was associated with child rate of acceptance in filmed interactions of caregivers and their infants (46 infants aged 6-11 months and 60 toddlers aged 12-24 months). Supported and engaging prompts were found to be more helpful than unsupportive prompts, especially as children developed more advanced language capabilities (Barrett 2023). Check out the table below for examples. Table 1. Caregiver verbal prompts, definitions, and examples for 1-2-year-olds, adapted from Barrett 2023
Parental Supportive Prompts
check_circle Yum! Is it good?"
Verbal Prompts: Positive comments about food
Definition: Caregiver highlights the food positively
check_circle "It's like broccoli."
Verbal Prompts: Teaching
Definition: Comparison to known foods
check_circle "It's good for you."
Verbal Prompts: Reasoning
Definition: Caregiver uses reasons or rationales to get the child to accept a taste
check_circle "You tried the food. Thank you!"
Verbal Prompts: Process praise
Definition: Caregiver acknowledges the child did something good
check_circle "Are you all done?"
Verbal Prompts: Inquires about internal cues
Definition: Comments or questions about the child being hungry, full, done, etc.
check_circle "Let’s try it."
Verbal Prompts: Encouraging verbalizations
Definition: Comments or questions that promote eating in general
check_circle "Mmmm!"
Verbal Prompts: Encouraging vocalizations
Definition: Noises or sounds made by the caregiver to encourage eating (excludes sounds made during a game)
check_circle "Here are some options for lunch today. You can choose between the chicken and vegetables or the pasta and broccoli. Which one would you like to try?"
Verbal Prompts: Autonomy promotion
Definition: Comments or questions that offer the child the opportunity to make their own food choices within provided options, encourages food engagement, and allows child to express preferences
Engaging Prompts
check_circle "Do you want another bite?"
Verbal Prompts: More?
Definition: Direct questions about whether the child wants a taste of the food or more food
check_circle "This is green."
Verbal Prompts: Food description
Definition: Nonjudgmental descriptions of the food
check_circle "Big bite. What is this?"
Verbal Prompts: General comments
Definition: Comments about what is happening, including narrating what the caregiver is doing during feeding
check_circle Saying the child's name to get their attention
Verbal Prompts: Redirection
Definition: Comments that help the child focus on the food or eating
Unsupportive Prompts
cancel "Just a little bit. Please take a bite."
Verbal Prompts: Pressure
Definition: Caregiver uses persuasion or pleads to influence the child
cancel "As soon as we finish this, you can have more lunch."
Verbal Prompts: Instrumental feeding
Definition: Caregiver offers bribes or rewards to get the child to take a taste
cancel"Keep your feet still, please."
Verbal Prompts: Criticism/limit setting
Definition: Caregiver scolds or sets limits around behavior to get child to focus.
cancel"Eat. Take a bite."
Verbal Prompts: Commands
Definition: Caregiver directs or instructs the child to perform a desired action.
cancel "Let's see if you can eat all your vegetables before the timer runs out! Ready, set, go!"
Verbal Prompts: Game
Definition: Caregiver inappropriately turns feeding into a game that creates pressure or distraction around mealtime
cancel"Your food is getting cold."
Verbal Prompts: Hint
Definition: Caregiver uses indirect statements to get the child to take a taste
cancel"Good girl."
Verbal Prompts: Person praise
Definition: Caregiver makes positive comments about the child
Are there Factors that Favor the Development of Food Acceptance?
Yes! Factors that favor the development of food acceptance (Maier-Noth 2023) are:
- Offering a variety of foods from each food group during complementary feedingo Offering even initially disliked foods repeatedly until it becomes familiar and more likely to be accepted.
- Introduce solids at about 6 months of age (USDA 2020)
- Offer a variety of textures, tastes, and flavors to increase the range of nutrients consumed, increase the likelihood of achieving a well-balanced diet, and continue to mold food preferences and eating behaviors.
Does Picky Eating Have an Impact on Eating Behaviors Later in Life?
Potentially. When picky eating behaviors are transient and stay in the realm of normal development, unlikely. However, some studies have shown a significant negative association between picky eating around age 4–5 years and the frequency of fruit, vegetable, fish, and dairy consumption, but not snack, meat, egg and sweet drink consumption and weight status at age 17–20 years (Pereboom 2023). Therefore, it seems that some nutrition behaviors common in young children with picky eating behaviors may still be present years later. Timely interventions focused on support for parents, addressing parents’ handling of picky eating, can be used when working with children with picky eating behaviors, to improve children’s current as well as future dietary patterns (Pereboom 2023).
Future Research Advancements
Ongoing research continuously aims to unravel the complexities of food acceptance and picky eating, with the goal of promoting healthier eating habits and improving children’s overall well-being.
The following are recommended focus areas of focus for future research to further advance this field of study (Barrett 2023, Bourne 2023, Chilman 2023, Pereboom 2023):
- Further differentiate between picky eating behaviors and clinical features to establish clear indicators for parents regarding when to seek professional help.
- Better understand if picky eating is associated with adverse physical or mental health outcomes.
- Include more diverse populations.
- More comprehensively investigate perspectives from parents and siblings of children with picky eating behaviors.
- Investigate caregivers' perceptions of developing receptive language abilities in toddlers to understand when, what, and how frequently caregivers communicate with children.
- Verbal prompts:
- Explore the associations between caregivers' verbal prompts and children's food acceptance longitudinally.
- Explore which verbal prompts precede successful tastes of food among young children.
- Better understand how the food itself might influence what verbal prompts caregivers use/say.
