Growing up, like lots of kids, I was a picky eater.

Hi, I'm Jordan Nishkian, Managing Editor for The Daily Thrive! Nutrition is a major part of what we do, so it's a little embarrassing to hear my parents, to this day, tell stories of my unusual requests and what they had to do to get me to eat veggies, like hiding broccoli in the hollows of buttered penne pasta. Even just getting me to sit down long enough at the table with them was a struggle.

Thankfully, I’ve improved since then, and in a lot of ways, I eat more adventurously than my parents do. Most of my family members (adults and children) have their own particularities when it comes to food, so I always thought that picky eating as a child was simply a phase that we all grow out of.

But until I had a conversation with Alexia Hall, RDN, The Family Thrive's expert dietitian, I had no idea that picky eating could be a sign of bigger health issues. While picky eating could be connected to behavioral or sensory issues, two of the greater clinical health concerns Alexia looks for when working with a child who’s a picky eater are:

• Eosinophilic Esophagitis: this causes choking symptoms upon eating
• Gastroesophageal Reflux Disease: this causes pain in the chest upon eating

Finding that I was totally clueless to how potentially serious picky eating could be, I asked Alexia if I could team up with her to meet some of her patients and share their stories and progress (with permission, of course) with The Daily Thrive parents. Thus, our Picky Eating Series was born!

So . . . let’s get started!

Meet Our Picky Eater

Our first picky eater is a four-year-old kiddo named Lennox.

While he loves expressing his curiosity for math and dipping his dino chicken nuggets in honey, Lennox isn’t a big fan of vegetables, cheese, or meat.

Lennox comes from a happy, bustling household with one older brother and two older sisters. While he and his siblings were all born on the lighter end of the scale, Lennox’s mom, Suzannah, says she had picture-perfect pregnancies, and each baby was carried to term. Although completely healthy, they were all a little underweight.

Lennox is the youngest of his siblings, and Suzannah nursed him for 11 months before transitioning him to milk. “He didn’t have any problem latching,” Suzannah recalls. “I was one of those moms that, since [the kids’] weights were always under, doctors always thought I didn’t produce enough milk. So I was always nursing and pumping and feeding that to them; it was always a battle.”

Lennox was introduced to baby food at six months, and that’s where a few issues began. Suzannah and her husband Christopher tried to make food for him at home but found that he was only taking to the basics, like fruit and rice cereal. Even from the beginning, Lennox was refusing vegetables from the jar. But when it came to graduating to table foods, Lennox was about 10 months old, and started with little pieces of potato, chicken, broccoli, carrots—“pretty much anything and everything.”

Lennox’s Daily Routine

The Fraser Family always gathers around the table for dinner, but due to busy schedules, breakfast and lunch are more separate. While Suzannah works for her family’s restaurant by running the business end, Christopher is an MRI tech, and the rest of Lennox’s siblings have school.

Needless to say, mornings in the Fraser household consist of people leaving at different times, so Lennox typically eats breakfast by himself Monday through Friday.

Lennox’s typical morning routine includes enjoying a Chewy granola bar, a glass of milk, and an apple (skin-on) while in the family room watching TV. He usually spends the rest of the day with Suzannah, who can take him to work with her, and he’ll go to a tutoring center one day a week.

“He’s a snack man,” Suzannah says of Lennox’s midday meals. “Lately, we’ve been making these toddler trays where I put what he requests on the tray and then I’ll try and introduce some other things on the tray as well.” His favorite parts of the trays include pretzels, almonds, an apple, an orange, raisins, cucumbers—

“I don’t like cucumber,” Lennox chimes in.

“You used to like cucumber,” Suzannah responds.

“When I was a baby,” he says.

For the most part, Suzannah aims to offer him a variety on this tray, and he typically washes it all down with water, milk, or watered-down juice. And despite his family’s ownership of a Mexican restaurant, Lennox refuses to try beans, a quesadilla, or even a tortilla—but he has been known to enjoy tortilla chips. “Dry carbs? He’ll eat them,” Suzannah says.

Although Lennox used to eat things like peanut butter, chicken (not dino-shaped), black beans, and salmon mixed with rice, he no longer enjoys them. Suzannah and Christopher also note that he doesn’t like mixed food (food that’s touching other foods) or slimy textures like grapes.

A Dietitian’s Thoughts

Since one of the main things Alexia will keep an eye out for is Eosinophilic Esophagitis, she began to ask Lennox a few questions, like:

• When you eat do you feel a tightness in your chest?
• Do you feel like food gets stuck in your throat?

While Lennox may be too young to answer accurately, Suzannah let her know that she has Eosinophilic Esophagitis herself. She would experience choking when she ate certain foods.

“I’d have to make myself throw up, I had to go to the emergency room a couple of times to have them do an upper endoscopy,” she says. “It’s usually dry meat, tortillas—and oddly watermelon.”

“With Eosinophilic Esophagitis, that can cause some damage in your esophagus and can cause your esophagus to stiffen, and that makes different foods difficult,” Alexia explains. “So it’s not so much that you eat a food and that food is causing the reaction; it is the long-term, chronic damage that’s happened over time that’s made the esophagus stiff and not as flexible as it once was.”

Upon hearing this, Alexia recommends Suzannah to get Lennox checked out for Eosinophilic Esophagitis, as it may be affecting him as well. We’ll catch up with the family later to find out the results!

Tips From a Dietician

Concluding our discussion, Alexia created a comprehensive list of tips for Suzannah, Christopher, and Lennox to try before the follow-up call in a month. Here’s what that looked like:

Tip 1: Eat meals at the table and with family

Since Lennox mostly snacks on his own throughout the day, Alexia recommends that he phase-out snacking alone and start eating at a table with a family member.

This will not only allow for more nutrient-rich food and place an importance on mealtime routine and expectations, but it will also give him a positive, supportive environment that allows him to learn and mimic food behaviors from his family without distractions from the TV.

Tip 2: Set up dinnertime for success

Because Lennox likes to snack, readjusting his hunger drive will help create a more healthful routine, and she suggests doing this by avoiding sugary drinks (like juice) and not eating for two or three hours before dinner.

Then, while at dinner, Alexia recommends that Suzannah and Christopher choose the majority of the meal, but allow Lennox to choose one favorite food to be present in each meal.

Another great tip Alexia shares is to gradually get Lennox comfortable with certain foods—and this doesn’t have to be by eating it!

Throughout 15-20 trials per food, Lennox can get acquainted with the food being on his plate and get comfortable with it by touching, smelling, licking, having it in his mouth, then eventually swallowing.  The best part? Every stage is a win!

Tip 3: Get the kiddos involved

One of Alexia’s favorite ways to get kids more comfortable with trying new foods is by getting them involved!

She recommends that Suzannah take Lennox with her to the grocery store and try making it a game (we’ll hear lots about this in our next call!), and even getting the kids involved in preparing or making the food.

I can personally attest that this works, by the way. My 19-year-old brother said he didn’t like broccolini...until I had him help me prepare it for dinner. He ate all of it!

Tip 4: Tips for staying seated

Here’s where my parents really struggled with me a lot (I was a bit of a wiggle worm).

To help kids sit and stay seated more comfortably during meals, Alexia says that having a chair, booster seat, or a stool for under his feet will help Lennox feel more secure, and letting him play and run before having him sit still.

She also says that parents should establish four or five mealtime rules, ignore bad, attention-seeking behavior, and reward good behavior.

Tip 5: Use positive language around food

One of Alexia’s most helpful tips involving positive food language is this: rather than offering Lennox “yes or no” questions about food (ie: “Do you want this apple?”), offer him choices (ie: “Would you rather have an apple or a banana?”)

It’s also important to avoid labeling food with negative words like “smelly” or “bad.”

Tip 6: Nutrients, nutrients, nutrients!

Not only are nutrients important for immune health, but they’re also crucial for setting up proper taste functions!

For Lennox specifically, Alexia recommends that Suzannah and Christopher limit Lennox’s milk intake (to avoid the malabsorption of zinc and iron) and try to expand his diet with iron-rich foods that are similar to his current palate.

Check back in and see how Lennox is progressing!  

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