Super picky eating behavior in toddlers

Judy Converse MPH, RD, LD of Nutrition Care for Children, responded to my post about super picky eating behavior in toddlers:

"I saw your post on this topic and have to jump in.  I’m a licensedregistered dietitian in private practice who has specialized in
pediatrics since 1999.

Here’s the scoop:
Doctors always tell parents not to worry about this.  Partly true:
Some defiance around foods is normal at the toddler stage.  But,
toddlers are also naturally curious when they are developing
typically.  While they can have jags with a certain food for a bit,
these should pass, as should the tantrums that can come with presenting
new foods.  A natural curiosity to put things in the mouth and try them
normally extends to foods.  In my experience, kids who simply will not
do this usually have nutrition problems that need correcting.

What
is not normal is for kids to continue exceedingly rigid eating patterns
into school age years.  If a kid still eats five or fewer foods at age
four, that is a red flag for me.  While they may get enough total
calories to keep growing (sometimes they don’t), they pretty much can’t
eat a diet that adequately meets their needs for learning, developing,
sleeping, pooping, talking – all the things toddlers must learn to
do.  If a child is truly entrenched in this, a nutrition assessment can
find out if it really is cause for concern, or if all you need to do is
add a good multivitamin with minerals and wait it out.

A
big clue:  Kids currently get many, many more meds than prior to 1980.
Antibiotics in infancy and toddlerhood can change eating patterns.
Children with entrenched, rigid food preferences often have had
antibiotics either very often (five or more rounds) or very early (in
the first 8 weeks of life).  Adjusting the gut ecology back to normal
often triggers an abrupt change in food preferences in children.  So,
for parents really tearing their hair out, try antifungal therapy for
intestinal Candidiasis.  This can be prescription or naturopathic
(herbs and probiotics) – et voila – your picky eater suddenly picks up
fish, steak, and broccoli.  The hardest part is convincing your
pediatrician to try this – they are trained to believe this is only
relevant if thrush is foaming out of your child’s mouth or anus.  My
experience with this is that it does matter if there is intestinal
candidiasis without thrush, and that it responds very nicely to
treatment.  There are medications like Nystatin that are very safe for
infants and children for this.  Even Diflucan is now used in infants.   

Long
short, no need for parents and kids to struggle through this.  You can
find out whether it matters or not with a good nutrition assessment,
and fix it."

Great information. Thanks, Judy, for setting the record straight and for giving us more clues to start piecing things together for our own kids.

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