Understanding Picky Eaters

By Stefanie Sacks, MS, CNS, CDN

Around the turn of the millennium, three prominent books emerged as authoritative guides on the subject of nourishing children—Ellyn Satter's "Child of Mine" and "Secrets of Feeding a Healthy Family." Satter, a trailblazer in the field, delved into the realms of emotional well-being and fostering positive familial connections in the context of food, eating, and feeding. Furthermore, Walter Wilkoff's "Coping with a Picky Eater" provided a concise and pragmatic handbook, supplying practical solutions for both children and their caregivers in the realm of food.

As an emerging Culinary Nutritionist, these books became indispensable resources for me. Equipped with knowledge and expertise acquired from Teachers College, Columbia University, and guided by mentors within New York City's top-tier healthcare community, I felt empowered to assist those seeking my guidance. While my practice wasn't solely centered on addressing picky eating habits, I encountered my fair share of exasperated parents who wanted their children to eat more than pasta and chicken tenders.

Then in 2008, I gave birth to my younger son and everything I thought I knew about feeding children and picky eating was tossed out the window. Hunter was born tongue tied—a congenital oral anomaly that affected his ability to eat. More specifically, the membrane connecting the underside of his tongue with the floor of his mouth (frenulum) tightly fastened his tongue in a way that made drinking from the breast or bottle near impossible. At one week old, he had a frenulectomy—a surgical procedure that releases the lingual frenulum to improve tongue mobility and function. Although told that his feeding issues would now improve, Hunter still struggled. Upon evaluation by a speech pathologist, he was swiftly diagnosed with oral motor hypotonia , a condition that hindered his ability to coordinate sucking and swallowing. Thus began our journey, spending the initial nine months of his life immersed in intensive feeding therapy sessions multiple days per week. 

Imagine this: it took Hunter a staggering 90 minutes just to drink a measly 3 ounces from a bottle. At 8 months old, when he should have been eagerly exploring the world of pureed solids, he could barely keep them down, often vomiting shortly after each attempt. And when we dared to introduce small bites, he'd hurl his plate across the room in frustration. By that time, he mastered drinking from a bottle so that continued to be his main source of nutrients. 

Picky eating is not simply a matter of preferences, but a complex puzzle often rooted in very real challenges.

I was utterly shattered, a whirlwind of emotions swirling inside me as I grappled with the harsh reality—I couldn't even help my own child despite all my expertise (and successfully feeding my older son)! In a moment of raw frustration, I hurled my stack of cherished child nutrition books off the coffee table, the clatter echoing my feelings of defeat. But amidst the chaos, a flicker of insight emerged—a realization that the key lay not in textbooks but in truly listening to my child, forging a path forward together.

No child chooses to be a picky eater; circumstances beyond their control lead them down this path.

It was a challenging journey, requiring an extraordinary level of patience and gentle persistence that stretched beyond what I thought was humanly possible. I had to come to terms with the fact that my husband often had an easier time feeding our son than I did. Despite this, I never wavered in my commitment to meet Hunter where he was at. Through this process, I gradually learned that picky eating is not simply a matter of preferences, but a complex puzzle often rooted in very real challenges (just like my son had) that demand compassion, understanding and medical intervention, rather than judgment or criticism.

I’ve heard countless parents frustratingly say, "My child only eats a few things no matter what I try.”  But delve deeper, and you'll uncover a tapestry of challenges, both physical and emotional, driving their behavior. Remember this: no child chooses to be a picky eater; circumstances beyond their control lead them down this path.

While I consider myself a fairly knowledgeable food and nutrition expert, it’s my lived experience that has truly illuminated the complexities of picky eating. It isn't merely a culinary quirk but a multifaceted puzzle, requiring compassion and insight, not judgment or reproach. Often, it necessitates a collaborative effort involving a team of specialists. As parents, we wield the ability to turn our child's frustrations, as well as our own, into catalysts for growth. The key lies in listening, attentively and empathetically.

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