37 | From Yuck to Yum! Strategies to Conquer Picky Eating

Do parents ask you for advice for their picky eater? Do your patients say "yuck, I don't like that" when you suggest they try some broccoli? How would you answer a mom who says, "my child only eats 10 foods, what do I do?"  In this episode, Registered Dietitian, Veronica LaMarca, joins Colleen to discuss practical solutions for 5 of the most common nutrition challenges faced by parents and pediatricians dealing with picky eaters.

Key Takeaways:

• Responding to "Yuck": Discover effective ways for parents to respond when their child rejects a food with "yuck" and learn how to encourage food exploration.
• How to solve brand preference:  Learn how to gradually expand the child's food preferences through food chaining by making small changes to familiar foods.
• What to do when a child only eats 5-10 foods: Learn how to increase variety in a child's diet without pressuring or bribing.
• Family Meals and Environment: Understand the importance of family meals and creating a positive mealtime environment to promote healthy eating habits.
• What to do if a child refuses meat: Learn to reassure parents that kids need less protein than they think and they can meet those needs without eating meat. 

Whether you're a parent seeking mealtime harmony or a pediatrician looking for practical advice to share with your patients, this episode offers valuable insights and actionable strategies to help your picky eater transition from "yuck" to "yum"!

Connect with Veronica on Instagram: @feedingpickykids

Transcript

Colleen and Veronica

[00:00:00] all parents and pediatricians, this episode is for you. Are mealtimes a battle for you? Do your patients often ask you for help feeding their picky eaters? Saying, what do I do because she won't eat anything? Do you tell patients to just try it? Or say, come on, it's good for you, it makes you healthy. Well, how's that working for you?

Clearly not great because the majority of our pediatric population is coming to us saying that they have a picky eater. Welcome back to the exam room nutrition podcast where each week I'm giving you answers to common nutrition problems to help you become a more compassionate competent clinician. I'm your host Colleen Sloan I'm a registered dietitian and pediatric PA So today's episode is going to help you say goodbye to mealtime meltdowns and hello to practical insights that truly work. My guest today is a pediatric dietitian and together we're going to provide you with solutions to five common nutrition challenges.

 [00:01:00] I am thrilled to introduce to you Veronica LaMarca. She's a devoted mother of two and a seasoned registered dietitian with 12 years of experience. She excels in picky eating and diabetes management, and she owns a thriving counseling business, offering practical solutions through her program, the fight to bite method to help families alleviate mealtime stress and conquer picky eating. 

Veronica, I'm so excited for this episode. Welcome to the show.

Thanks, Colleen. I'm excited to be here.

I'm super excited for these five questions and stick around to the end because we might have a bonus question for you. All right, let's jump right into the first question.

So what do we do if a child says, Yuck. I don't like it. what can parents say in response to that?

Great question. so a lot of the times when kids see a food that they weren't expecting, or a food that they just don't. You know, feel like that evening. sometimes their initial reaction can be yuck, 

[00:02:00] Yuck. I don't like that. And that may be their way of expressing that. They don't feel like it tonight. They're not ready to eat that. even though they ate it yesterday or last week. They're not interested in eating it. It might not actually mean that they think that food is yucky. Us as parents, I am a parent.

I have a two girls, they're seven and four. And I think sometimes when we hear that word after preparing a beautiful meal, spending time planning and prepping and cooking and getting that meal on the table, we want our kids to eat. We hear that word and it just makes our. heart sink. So my advice is, I always tell parents, try to not let that word really get to you.

take that word with a grain of salt because, when we [00:03:00] hear that word, it might prompt parents to think I can't ever serve that again. My child doesn't like that. They're not going to eat it. But in reality. A way to help kids expand what they're eating and learn to like a variety offering these foods that they may have thought were yucky, or they may have, you know, refused in the past offering them over again is really, really important.

What would be just a kind of a simple one liner or statement that the clinician can tell the parents to say, backto their child when they say, yuck, I don't like it. What can the providers, tell their parents to respond with?

I always like to recommend leading with the words you can. So whether it's, you can leave it on your plate, you can eat it when you're ready, you can try it when you're ready, you can try it next time. I find, especially in the world of social media, there is a common, reaction to [00:04:00] say, you don't have to eat that.

But in reality, we want our kids to try. We want our kids to eat. So, saying, oh, you don't have to eat that may just take the pressure off completely, which is a good thing, but we do want them to eat it. So, saying something like. You can eat it when you're ready, or that's okay. If you don't want to eat it today, you can eat it next time, or you can try it next time.

So, leading with those 2 words, you can, is a good way to kind of keep that possibility open for kids to potentially try it or eat it in the future.

I love that. Super practical and very helpful. All right, let's move on to number two. What do we do if our patient or the child only eats one brand of food, be it one brand of nugget, one brand of rice, or they only want, you know, plain cheese quesadilla, plain white rice. How do we start to expand their diet?

Okay, so it's very common for [00:05:00] picky eaters to be brand specific. It's also common for kids that may not be picky, but to have preferences for certain brands. Same with adults. So, I think the first step if your child is already very brand specific, the first step may be to start serving food. Outside of their packages outside of their containers, and at 1st, they can watch the parents take that food.

So they know it is their favorite brand. We're not trying to trick kids. We're not trying to pull a fast 1 on them. 

Take that out of the package, serve it on a plate, serve that yogurt in a bowl. They can start. Not associating that brand with that food so often when they see, for example, my 4 year old when she sees the yogurt in the green container.

She knows it's the yogurt that she likes when I serve it to her in a bowl. Sometimes she's a little bit skeptical and this is normal. So the 1st step would be having all [00:06:00] brands out of sight and then there's different strategies that we can do to help kids move on to different brands.

So you can start with, you know, a different brand, but the same flavor. Of a food. So let's take yogurt. For example, you can start with a different brand of, let's say, vanilla yogurt, same type of yogurt. We don't want to change the texture too much. We don't want to go to, like, a Greek yogurt or Icelandic yogurt.

That's that sticker something with similar texture, but just a different brand serve it in a bowl. So it really is going in small steps and going at the pace of the child and how fast or slow they're able to tolerate these changes.

That's really helpful. And I love what you said in the beginning that we're not trying to trick our children because I think this used to be kind of an older, you know, method to kind of like sneak veggies and chop them up so they don't see them. But [00:07:00] really, I find that that just creates a lack of trust among the child and the parent.

 nobody likes to be tricked into eating something that's not fun. So I love that you recommended to not be, you know, being sneaky and tricky, but that's a really, really good place to start is taking the snack food out of the package.

Can we talk a little bit about. a method that's called food chaining and I know you have this on your Instagram page and I think it's fantastic. 

 So guys, if you, want to follow her, you can find her at feeding picky kids on Instagram and she's got some really, really helpful, useful tips for you guys too. So on your page, you use an example of white rice and how to get them away from just one brand, one flavor of white.

So what are some suggestions that the clinician can do to kind of branch out and broaden a mealtime food?

 Starting with changes to a meal time food could be. as small as just cutting a food that they love in a different way. So if you're used to serving sandwiches with the crust cut off and they are served in [00:08:00] triangles, you can start by serving them in squares, for example.

So making small changes can really allow children to feel comfortable with change we still want them to notice the change, but we want them to be comfortable with it. So, the change is not going to be so big that, you know, they push the food away and they completely refuse the meal that may happen.

Sometimes with toddlers, all stars need to be aligned in order for them, you know, to accept the food, but making small changes really does start with. a small change to a food that they already like. Sometimes with kids, it's even serving that food on a different plate or using a different placemat, using different cutlery, for example.

And then we can make small changes again with changing brands or perhaps mixing in. a different flavor or a different texture of a food and [00:09:00] slowly getting them used to that change before actually making a big change. Like going from, you know, white rice to brown may be too big of a change for some kids.

So it really is important to assess. That child where they're at what they're ready for because sometimes kids can also surprise us, you know, we offer food. We haven't offered for a long time and they happily accept it. And those surprises are great with the population of patients that I work with. A lot of times.

We really have to go step by step. So I always tell parents to start by making changes to their favorites 1st.

What a great piece of advice. I love that. and that's a really, really good place to start. And that leads us very beautifully into the next thing that clinicians might, be posed with in the office. And that's my child only eats Two to three foods. So what do I do? How do I increase the variety when they only stick with those two to three foods?[00:10:00] 

Okay. That's a great question. And I do hear that all the time, you know, my child only eats 5 things or 10 things. my first question to parents is, are you serving more than those 5 to 10 things? So often, as a mom, I understand that. Sometimes it's those foods that we serve our kids that we know are a sure thing.

 sometimes we get into a rut where we're only serving foods.

We know our kids will like, and we know our kids will eat. And those foods are our child's favorite foods. So, I always have a conversation with parents to encourage them to start serving. One new food, one new food per meal, for example, just to get our kids used to seeing something new on their plate.

So it's not such a shock when we do put something new on their plate and they say, what is this? I don't want to eat it. I don't eat that. Don't put that near me. So it's. It's increasing their comfort level with seeing [00:11:00] new foods around them. I also assess, you know, are parents eating with their kids?

Are there kids seeing different foods? Our kids smelling different foods 

 the sensory aspect is also very important. So seeing new foods, smelling new foods, watching family members enjoying different foods that they may not be eating. So it really starts with the food environment at home. And I often ask, how often are you offering new foods and offering might be putting that food on a plate.

In front of their child, maybe their child isn't ready for that new food on their plate yet, but it's in front of them. So that's where they can start. Have your child. Get used to some new foods being offered. in terms of giving choices at a meal, often we're in the kitchen and we're yelling. What do you want for dinner? what do you want for snack that open ended question can [00:12:00] leave parents feeling really frustrated because we might hear something that we don't want to hear we 

 will likely get the same response every single time, you know, oh, I want pizza or they're just going to ask for their favorites. So, often in terms of choice, I always encourage parents to take charge of the menu, take charge of deciding what they're going to offer. If they want to give their kids choice within that, that's fine.

Sometimes choice can be very overwhelming for picky eaters. So if a parent asks, you know, we're having chicken tonight, do you want mac and cheese or rice, for example, those options may be overwhelming. So it really depends on the child, but I always encourage parents to say, okay, tonight, this is what we're having.

They're always encouraged to offer an accepted food at each meal, so there is something for their child to eat at that meal. but all in all, it, it really is the parents decision to decide [00:13:00] what they're serving to offer a variety and to make sure that there's something that their picky eater is comfortable with has eaten at least a portion of before and will accept it about 75 percent of the time that it's offered.

All right.

I really like your tip for how we should respond as clinicians when the parent says my child only eats two to three foods. Because as a clinician, when you get that question, you kind of have so many things in your mind rolling around and you're like, I don't even know where to take this and like how to follow up.

And sometimes it's easy to just be like, Oh, it's okay. They'll grow out of it. And that's like the worst thing to say. And so I love that you had said, well, are you offering more than those two to three foods? Cause that's a really good follow up question to kind of get them thinking. Oh, you know what? I'm not.

And right there, that's kind of where you can stop with your recommendations of like, okay, this is step one, let's just start to offer something new. And maybe even just pick one meal at breakfast, instead of always saying here's cereal, let's try to, you know, switch it up and try to offer some eggs or something different.

So I think that's a really, really good place to start. And I'm [00:14:00] really thankful for that piece of advice. All right, let's move on to the fourth one, and that is, what do I do if my child doesn't eat meat? And I can tell you as a pediatric PA, I hear this every single day, probably at every checkup.

Parents are obsessed with their child's protein intake, and I think it's because adults are obsessed with their own protein intake. And so we really think kids need to be having, like, meat at every meal or a protein at every meal. So they're super, super worried about protein intake. So how do we respond if the child doesn't eat meat at all, because I know this is a big textural thing.

Absolutely. That's a great question. And protein is always top of mind for parents. It's a huge worry. Something I talk about all the time with the parents that I work with. I always reassure parents that a true protein deficiency. Is highly unlikely because protein is in so many different foods, but we are conditioned to think that kids need to eat animal protein [00:15:00] in order to meet their protein needs.

So a child that weighs 50 pounds that meets their protein needs for one day. And it consists of a peanut butter sandwich, a glass of milk and a cheese string. So none of these foods contain meat, 

 So, when I'm working with parents, I will look at 2 to 3 days or longer of a child's food intake and sort of assess, where that protein is coming from. if the child drinks milk, has yogurt.

Eats cheese, or even nut butters, edamame, things that parents might not count as protein really do add up. Kids don't need as much protein as we think they do.

And interestingly, to this point, exactly my daughter who's 13, she, she's a great eater, but I always like to offer her a variety of foods. And just recently she learned that she likes pumpkin seeds and seeds and nuts are a great source of protein. So don't give up on your kids and don't give up on your [00:16:00] patients just because they don't like something when they're younger or today doesn't mean they're not going to like it later on.

So again, kind of always going back to continue to offer the food, offer a variety, and they might at some point. Enjoy those foods. Let's, let's linger here a little bit longer and talk about meat.

Why do kids just kind of blanketly dislike meat, specifically chicken and steak? What's the deal with that?

I think it is a texture issue. Meats can be hard to chew. It really depends on how they're cooked. If they're dry and chewy, they're also sometimes unpredictable, right? So, if you're serving chicken, you can serve it so many different ways with the skin on, baked, fried, air fried. So, that sense of unpredictability may also throw children off.

 some children don't like a wet texture. So, even if parents are offering that meat with a sauce, or with a dip, or something that might be a little bit more [00:17:00] moist, they may not like that. So, meat is definitely a tough 1.

I often hear that kids, you know, do love foods like chicken nuggets. So I always encourage, you know, starting off with branching off to different brands or trying even like a homemade version of chicken nugget. Or if a childis into dips or does like meat that is soft and easier to chew, meats like. Meatloaf, meatballs, hamburgers, things like that, ground meat in tacos, that may be an easier meat to start with versus a dry grilled piece of chicken or a piece of steak that might be cooked too much and too chewy for a child.

I totally agree with you. Any of those crumbly meats are way easier to chew, even for us as adults. Right? Like it's a softer meat. It's much easier and much more, comfortable to chew and to swallow. So

 let's move on to number five. And [00:18:00] what do we do? If a patient is obsessed with sweets, this is a huge one when it comes to candies and cookies and desserts in general. So many parents are either afraid to offer the dessert altogether or they're like, well, they're not going to eat dinner and they only ask for the cookies or they're only going to eat the cookies.

So how do we handle sweets around our, families?

Great question. Sweets are definitely controversial. I believe that it really comes down to how the family views sweets or how parents view sweets in their home. Do they keep sweets in their home? Do they see sweets as foods that are really negative that are bad that we're not supposed to have? You know, I always have this deeper conversation with the families that I work with, and I always ask, how do you talk about sweets at home?

How often are you offering sweets? And when you offer sweets, do you let your child get their fill? Or do you say you can only have [00:19:00] one cookie because sugar is bad for you? Often with restriction, that fuels obsession. So if a child knows this food is Coveted. It's really special. Then that may cause them to, to want it more.

Or often we use sweets as a bribe. So, you know, we say you need to finish your vegetables and then you can have dessert. Of course, we want them to eat something more nutritious before having a food that is, you know, that's offering less nutrients. Also thinking as a dietician here, But that can also fuel a notion that sweets are way better than vegetables.

You know, we have to get through that yucky stuff before getting to the good stuff. So I believe it involves a deeper conversation and really assessing whether parents are offering sweets and allowing kids to Eat their fill, which they don't have [00:20:00] to do every day.

but maybe once a week at a snack time, we're sitting down and we have a plate of cookies, maybe other foods there, some milk, and we let our kids eat as many cookies as they want. And I always look for the parent's reaction. Does that make them feel uncomfortable? Right. And I always explain that one snack a week.

With your child eating potentially five cookies is not going to break their nutrition or make them unhealthy. It will actually teach them a lot about their body. It will teach them a lot about the access to sugar. That if this starts happening regularly, they can eat sweets. They don't have to 

 overeat the sweets when they get a chance. They can. Eat one cookie, two cookies or five cookies, depending on how hungry they are, but they can really start listening to their body because often if kids know I have [00:21:00] this cake, and this is only, you know, once in a blue moon where I get to eat it.

I'm going to eat a lot of it. I'm going to really get my fill because I don't know the next time that I'll have a chance to eat this again. So The topic of sweetss is always a big one. My kids love sweets. Adults love sweets. Sweetss taste good. I always say they fuel our soul, right?

They're good for our soul and they should be around for enjoyment. We shouldn't be scared of sugar for our kids. However, it is important to also have those boundaries. So if we aren't offering dessert one night, for example, it's okay to say, no, we're not having that tonight.

We can have that tomorrow. so again, it's back to the parents are in control of what they're serving, what they're offering. and that's okay. If you're not offering that sweet, and your child is asking for it, or if your child is begging for ice cream for breakfast, it's okay to hold those boundaries and say, we're not having ice cream for breakfast.

We can have it tomorrow. We can have it later.[00:22:00] But, you know, just kind of treat it like any other food. If your child is asking for pizza for breakfast or asking for pancakes, and you weren't planning on making pancakes, it's okay to say we're not having that right now. We can have it another time.

I can imagine the clinicians listening, telling their patients, yeah, you know, if you serve cookies, allow them to have their fill, their eyes are probably just like bugging out because they're probably like, what are you crazy? But what you're saying makes a lot of sense because if you keep it kind of this taboo, this really special type of food that we can only have on holidays or on birthdays or because you did really good today.

They associate that and that's of course going to lead to more binge eating. I love your follow up question to asking the parents about, what their thoughts are regarding dessert, because yes, we are working with the child, but really at the same time, you're kind of re educating and helping the parent work through any of their.

issues or relationships with food that they might be struggling with because, you know, the parent themselves might be a [00:23:00] binge eater or overweight and have struggled with sweet, you know, obsession themselves. So they're kind of putting that on to the child as well too. So it is really, you're kind of counseling and educating the entire family. What are your thoughts on offering the sweet with the meal? I've seen this a lot bouncing around on social media. People will put like some M& Ms with the, dinner or the cookie right on the plate with the dinner. What are your thoughts on that strategy?

I think it's a great strategy and it's definitely 1 option to try. I do feel like it can still promote scarcity because technically the recommendation is to have a smaller amount. of a sweet with the meal. So the sweet doesn't overpower the rest of the meal. So the child is not just eating M& M's for dinner, for example.

So the recommendation is to have a small child size portion of sweets alongside the meal. This can [00:24:00] work very well for parents who are used to using sweets as a bribe. Because it's no longer used as, well, you have to eat everything before you eat your M& M's, or you have to eat your vegetables before you eat your M& M's.

This is, your M& M's are there. You can choose to eat them before, during, or after the meal. and, and really it, can work very effectively for that. This strategy can also be very effective with helping sweets be on the same playing field as other foods.

So they get their sweet right away. It's not any better than the carrots on their plate. They don't have to eat their meal before they get their carrots. but as I said before, it can still promote scarcity because often younger toddlers may not understand. They want more. Well, I have three M and M's.

I want 10 M and M's. I want more of this. So if parents are trying this strategy, serving dessert with a meal, I always encourage them. To also [00:25:00] serve an unlimited portion of sweets at a snack time, perhaps starting once a week, once a week is fine, can really teach them how to control themselves around those sweets, how to, listen to their body around those sweets versus just have a restricted portion, which I find often can be the problem that leads to kids becoming obsessed.

And I think that's the ultimate goal, right? And us trying to teach our own kids, our patients, our families,how to have an appropriate with all foods, right? To not be overeating when the bread basket comes. To not be overeating when you've got, you know, your favorite pasta dish. To listen to your hunger and fullness cues.

To know when you've had enough. To know when you need a little bit more. And to know, I've had my full of sweets. So I think that is a really, really helpful tool. to really teach our patients just how to listen to their bodies and be able to regulate themselves. So I love that.

All right. As promised guys, you're going to get a bonus tip [00:26:00] today from Veronica. And this is one of my favorite tips to offer to you guys is the worst piece of advice that we as clinicians could say to a family of a picky eater. So I'd love to hear your thoughts on what we absolutely really shouldn't be saying.

That's more harmful than helpful.

Yes, so what I hear a lot from the parents that I work with is when a clinician tells them that they will just grow out of it. So don't worry. Keep doing what you're doing your child will grow out of it. parents tell me that it makes them feel dismissed, that their worries, that their stresses are not valid 

All children go through phases of picky eating, picky eating is, is a very normal part of development. However, if a parent is really struggling and they're cooking several meals and they're stressed and they're worried and there are battles at the table and it's [00:27:00] affecting their relationship with their child.

Maybe there's disagreements between spouses. These are all very real and something that parents have to face day to day. So just that blanket statement, Oh, don't worry, they'll grow out of it.

often clinically a child may be growing fine. You know, they're following their growth curve. There is no nutrient deficiency. So they medically, they, they look good, but it's the variety that they're lacking or their parents are so stressed. 

 So, as a clinician, I can tell you, you know, I've got this dichotomy of the dietician mind and the PA mind. And I'm in a very, very busy clinic. I see tons and tons of kids every day. And I can tell you why it would be easy or maybe why we say it's okay, they're going to grow out of it.

Because it's an easy answer, right? Like, it's just easy for us to kind of feel like we're answering their question, to address that one main issue, but at the same time, [00:28:00] okay, check we're done with that conversation. Because again, it's easy. It is hard to get into the details of, okay, well then what are they eating?

And right, like that is just, it's exhausting and it's burdensome when you know you have 30 plus patients to see, you're an hour behind. It's easy to just be like, don't worry about it. They're going to grow out of it. Their growth chart's fine. Next, you know, so can you, can you give us maybe one or two things that we could say that are still easy, right?

Because ultimately we should be referring to a dietitian to help with that picky eater and to really help with that family because, you know, this whole purpose of the podcast isn't to say, Oh, clinicians can be dietitians and we can solve all these problems in the checkup. No, it's to help the patients kind of on that next step on that journey.

So, Instead of saying, don't worry, they'll grow out of it, what could be like one or two other phrases or, suggestions or even questions that the clinician could say instead of that? 

That's a great question, [00:29:00] Colleen. Something that comes to mind is bringing back the whole point of family meals or raising our kids to, have a healthy relationship with food. So, one question could be how often are you eating with your kids as a family?

How often are you eating with your children without any distractions without any screens that includes parents putting phones away, putting tablets away. another question, maybe what we spoke about earlier, how often are you offering new foods? How often are your kids getting in the kitchen?

Doing some prep while you are cooking or teaching them important life skills about, you know, cooking and preparing. Even if it's taking frozen nuggets out of the bag and putting them on a baking sheet and teaching them, you know, this is how you turn on the oven. [00:30:00] Getting them involved. Or sometimes even giving kids special jobs, like setting the table.

You know, you can place all the napkins on the table, or you could be the one that walks around with the green beans and puts them on everyone's plate. Getting them involved in some way can also boost their interest in what's happening. It makes them feel special. Like, they have a part of the meal. They did something special.

So, I think perhaps bringing it back to that notion of family meal time eating together. Eating without distractions, offering kids new foods and helping them feel like they are more involved with either the prep or the cooking or some part of that process. I see this all the time that there's a disconnect, right?

There's a disconnect between kids eating alone, kids eating their own foods. that the rest of the family isn't eating. They're eating these foods maybe just with their siblings or by [00:31:00] themselves with a screen. Parents may be eating later. So, you know, time has changed. It's busy. , We live in such a fast paced world and it gets so easy, especially if we're frustrated with mealtimes. It can be so easy to just turn on a tablet, give our kids what they prefer, and we just call it a meal. But bringing it back to that family mealtime I think is very important.

I really love that recommendation too, because again, we're very limited to what we can do and say in a well check and nutrition is really just a very small part of the entire well check. And so I think that's a really important question to follow up with, becausethen as a clinician, you don't have to get into the nitty gritty of like, okay, well, what does breakfast look like?

What does lunch look like? And the kids are throwing food. And then the parents are telling you like 10 different issues going around with the mealtime. I think that I love that you Brought it back to just like, Hey, can you work on maybe having one or two family meals every week and then see me back in two or three weeks?

And then we can talk about those other concerns.but a [00:32:00] really good place to start is family meals.

And I love ending it there. So thank you so much for kind of bringing it back to that. that sense of family, that sense of home and so much happens around the family dinner table. You know, there's so many studies that show family meals are so important for the health and wellbeing of the child's whole body, their mental state, their emotional state.

So I'm a big proponent of family meals. So I love that you kind of reminded us of that. So super, super powerful last suggestion. if you found value in today's. content. I would love for you to follow me on Instagram at exam room nutrition. If you'd like to connect with Veronica, you can find her 

 at feeding picky kids. Veronica, thank you so much for the gift of your time. I know you're super busy as a mom and a full time dietitian. So I appreciate you just giving us some wisdom today.

Thank you so much for being here.

Thank you for having me, Colleen.

 All right, guys, now it's time for my nutrition notes. In this section, I will leave you with a nutrition tip, an encouraging quote, or an interesting case that I think might add [00:33:00] value to your day. Veronica and I had a really fun conversation off air after we just finished recording.

And I shared my experience as a pediatric PA and how, even for me, I have a nutrition background. I worked as a dietitian for five years, even me in the clinic, when a parent says my child is so picky, they only eat two or three foods and they throw foods and they only want milk. It's very overwhelming because my mind is running with all these different strategies, different solutions.

And then of course the medical side of things. Okay. Could there be a medical reason why they're picky? Do they have EOE? Do they have food allergies? Are they constipated? And then do I need to check labs? Could they be iron deficient? did I look at their growth curve, in enough detail?

Am I missing something? Right. All these things are packed into your mind when the parent says, my four year old, is very, very picky. And so that's why I think it's a difficult thing to answer and to provide a recommendation or a [00:34:00] solution, in a 10 minute visit, right?

So. I want to give you guys a few more pieces of advice and really just to, to kind of hammer down what Veronica had said, because I think her last piece of advice was so extremely useful and important to kind of calm your nerves and just to relax when you're providing a recommendation.

At least in the beginning. So if this is the first time the parent is coming to you saying my child is really picky.

So I'm going to give you three pieces of advice that I have found that have been really useful to help me not feel so overwhelmed and scatterbrained when I'm trying to provide some helpful solutions for this parent. Number one.

Know that you're not going to solve the child's picky eating today and that can be challenging, right? Because we are in medicine So we really like to give a treatment plan and to solve the problem and to say here use this cream It's gonna make the rash go away use this antibiotic. It's gonna make the ear infection go away We want to do the same with our nutrition recommendations.

[00:35:00] Like well if you just Increase their variety, the picky eating is going to go away. If you just serve it on this kind of plate, the picky eating is going to go away. And that's just not true with picky eaters. So I want you to pause and just remember, I'm not going to solve this in this one and only patient encounter, and that's okay.

All right, picky eating and learning to like new foods and developing new preferences is actually a lifelong journey. So as pediatricians, we need to set the guidelines for a healthy relationship with food, but you're not going to solve it in just one visit.

the second thing that I want you to do, and this is tip number two, is Ask that question that Veronica had said, ask about the mealtime environment. So are you eating family meals? Do you sit down together?

No screens, parents included. There's been tons of research that shows how important family meals are.

And you know, I'm a working mom. I get it. It's really hard to sometimes sit down and have a family meal, but it doesn't mean it has to be every single meal every single day. Maybe ask them, Hey, can you start doing [00:36:00] this on Sundays? So then you can start to talk about your week and maybe talk about their school.

You can talk about work and just have a very peaceful environment that's promoting a sense of togetherness. And it allows the to see their parents. Eating healthy foods, having a healthy relationship with their meal.

 If they're already eating family meals, the next thing that you can suggest is, Hey, can you get that child involved in the kitchen? Because the more that they are exposed to those foods and interact with those foods, the more likely they are to try it because it's not scary.

And then also they can take some ownership too. If they help to prepare that dish for dinner, They're really proud of that. And they're excited that they were involved and children as young as like. 3, 4, and 5 can be involved in the kitchen. 

So I really hope these suggestions were helpful for you in dealing with a parent who comes to you and says, my child's picky and kind of like unloads on you. Pause, take a minute and discuss the mealtime environment before you even recommend making any food changes, because sometimes if we just change the [00:37:00] environment.

The increase in variety will follow.

 well, that's it for today, guys. So as always, let's continue to make our patients healthier. One exam room. At a time. if you want to connect with me, you can find me on Instagram at exam room nutrition, and I would love to connect with you. I'll see you next time.