Rethinking Picky Eating: What’s Normal, What’s Not, and What Actually Helps

Today we’re diving into a topic so many of you are thinking about: picky eating.  And honestly, if you’ve ever found yourself saying “my kid is SO picky,” this episode is going to give you a totally new perspective.

I’m joined by pediatric PA and dietitian Colleen Sloan, who works with kids from birth through the teen years, and hears about picky eating in almost every visit. We’re unpacking what picky eating actually means (because it’s not as straightforward as you might think), why it happens, and how parents can shift their approach in a way that actually helps long-term. 

In this episode you’ll hear about:

 • Why “picky eating” means something different for every family
 • Common nutrient concerns (and why protein usually isn’t one of them)
 • How pressure, bribing, and labeling can backfire
 • Simple ways to create a more positive mealtime environment
 • Creative, low-pressure strategies to help kids explore new foods
 • What a “successful” meal can look like (hint: it might be smaller than you think)

Links & Resources:

Follow Colleen on Instagram at @examroomnutrition

Listen to Colleen's podcast: Exam Room Nutrition

Listen to Gather 'Round: How to Make Family Meals Doable for Busy Parents With Picky Kids - an episode from Colleen’s podcast that featured Sarah!

Want more content on picky eating? Listen to Sarah’s podcast episode with dietitian Sally Kuzemchak, Tips on Feeding Picky Eaters from a Former Picky Eater & Dietitian

Transcript

Sarah Schlichter (00:46)
Hey Colleen, welcome to the podcast. I think it's been a couple years since we last spoke on your podcast.

Colleen Sloan (00:54)
Yeah, thank you so much for having me on yours. I'm really excited that you launched a podcast. This is great information that is so needed for families. So I'm really excited to share my thoughts with you today.

Sarah Schlichter (01:02)
Yes, and we're so lucky to have you here today with your perspective. So why don't you go ahead and tell listeners a little bit about what you do, and then we'll get into the meat and potatoes of the conversation.

Colleen Sloan (01:14)
Well, I started my career as a registered dietitian and then about five years into that, I switched over and went back to school as a single mom of a kindergartener and became a PA, which is a physician assistant, very similar to nurse practitioner. I'm sure a lot of your audience visits a PA for their primary care visits or for their checkups. And so I've been a PA since 2017 and I've always and only will ever work in pediatrics. So I see kids from birth until 21 years old.

And I've loved the marriage between my two professions, nutrition and medicine, because it's a great blending of the two and helping parents, you know, help their kids thrive throughout, infancy, toddlerhood, all the way through the teen years. So it's a really, really fun job and I love what I get to do.

Sarah Schlichter (02:01)
Honestly, I think it's a great marriage too. I wish I lived near you because we would totally go to you. mean, hopefully this is something other medical providers will catch on to, but just curious what made you, after becoming a dietitian, become interested in medicine or were you already interested and then it just grew from there?

Colleen Sloan (02:19)
Yeah, it's a good question. I get that question a lot from a lot of dietitians who are like, like I've kind of capped out on what I can do in my profession. I'm itching for something more. PA looks like a great route. And so I didn't stop being a dietitian because I didn't like nutrition or anything like that. And I still have the credentials and still work day in and day out as a dietitian. I've just kind of merged the two. Why I did that was because I did feel like I had more to offer than just nutrition advice.

Dietitians are the nutrition experts, but our advice kind of stops there. And I was getting a little bit sick of just giving recommendations, right? We can't write orders. All dietitians listening will know this. And I was getting frustrated with that. I also wanted a louder voice on the medical team. So I wanted to be able to help with the medical management of patients, not just stop at the nutrition side of things. And a PA was a perfect...

credential for me to achieve that because schooling was 27 months. I already had all the prerequisites. I already had all the clinical practice from being a dietitian. So it was a really easy transition for me. I did not want to go into school to be a medical doctor. That's kind of a fallacy. A lot of people think like, oh, if you're a PA is the next step. Medical doctor? No. If you ask any PA, we don't want to be doctors. I became a PA because I want to be a PA. um, schooling was shorter. So that was

better for me at the time as a mom. I kind of wanted to be in there, get out there and work and not miss, you know, 10 years of my daughter's life if I were to go to medical school.

Sarah Schlichter (03:46)
Yes, yes, I love that. And I feel like being in the position you're at, you probably deal with, so our topic today is picky eating, and you are probably seeing that more than many dietitians, because I think a lot of people maybe don't necessarily know we're here still, but also maybe we're harder to access, whereas you see people coming.

to the pediatrician or coming for nurse visits and maybe hearing these concerns. So I'm really curious on your end, what are parents stressing about when it comes to picky eating? How are they describing it?

Colleen Sloan (04:20)
Yeah, I would say nine out of 10 of my visits of toddlerhood, school-aged children, when we get to the nutrition portion and I ask a very open-ended question, do you have any concerns about what or how much your child eats? When I say that, nine out of 10 times the answer is, yes, he is or she is so picky. Now, picky is a very subjective terminology. And my initial response,

if someone were to say that their child is picky as what do you mean by that? Because this could mean something different for 10 different parents and it's really important that you as the mom or the dad, if you say that your child is picky, that you explain what you mean to the clinician because our recommendations are gonna be very different based on what you mean. So I'll give you a few examples of what picky eating could be. It could be that the child does not eat the.

the quantity that you as mom or dad think is sufficient, meaning you don't think they eat enough. This may be true, but if I hear someone say that, it's important to then get into their developmental age. Sometimes they're not going through a rapid growth spurt and their intake might be sufficient for them or it might not. So that's a nuanced conversation. Another reason someone may say their child is picky is because they don't eat a wide variety, meaning,

they only eat one fruit or maybe one veggie or they don't like any meat besides chicken nuggets and so the parent is concerned with the variety in their diet which may or may not be sufficient or insufficient. Another one is that really they think that they're not eating enough but really that they are. So again getting back to that variety I think teasing that out can be important because

It's hard to remember, right? If you're a parent, you maybe have multiple kids, you might have a job, you've got a spouse. So you have so many things rolling around in your mind that when you think back to a day of your toddler's eating, it's hard to remember everything that the child eats. So when I hear, they don't eat anything, they only like five foods. Well, we really need to dig a little deeper and keep a journal and really track exactly how many foods because when you write it down and talk it through,

It's like, yeah, you know what? They will eat a carrot here and there and broccoli here and there. So they do eat some veggies. It's just not the variety in which that the parent wants.

Sarah Schlichter (06:37)
Those are such good points. And you're right. There's so much nuance. And I often feel like picky is kind of like a reflection of the parent, right? It's like, maybe they're not living up to the parents expectations, which maybe they are, they are not realistic. But to your point about maybe a kid's not eating a lot of dinner, but maybe lunch is their biggest meal, or they had a big afterschool snack and parents aren't putting that together. So.

probing and asking questions, it sounds like is so, so important.

Colleen Sloan (07:05)
Sarah, another thing, going back to the question you asked me, what am I seeing in clinic? Another thing most parents struggle with, and they tell me that they're concerned with the amount of protein their child eats. Very often they'll say, I don't think he eats enough protein. And I'm looking at a seven-year-old. So he needs like less than 20 grams in a day, right? Like that would be his max that he would need. And we as adults have this mindset and because of the culture that we're in,

that we need high protein. So it's about educating parents, like, no, actually protein is not the macronutrient that we need to prioritize in childhood. Like, let's focus on some other things, but kids can easily meet their protein, especially if they're dairy drinkers. If they eat any form of meat at all, it's really easy to meet protein needs. So that's another thing that I see in clinic.

Sarah Schlichter (07:52)
That's such a good point. mean, obviously, yes, as adults, our culture is very protein centric. And you're right. I hear that from parents. mean, even when I'm at family gatherings, eat the protein. You need protein. You're hungry because you need protein. And I think parents will be reassured to hear what you just said, like the dairy eating some meat helps you get there. Having brought that up, what are some of the nutrients that maybe you're most concerned about? It sounds like it's not necessarily protein.

Colleen Sloan (08:19)
Yeah, it's definitely not protein. Now it depends on the age. Iron deficiency anemia is the most common deficiency in children. So your pediatrician should screen for that. This universal screening guidelines are to do once at age one, we should do a hemoglobin and lead check to screen for iron deficiency and lead toxicity. And then again, somewhere between 18 months and two years old. If those are both normal, we don't have to continue checking that every year. The next time we check iron is gonna be for your menstruating daughter.

So iron deficiency is a big one. Now when parents talk to me about protein because they're really again worried that the child doesn't eat meat, And that's just sometimes due to chewing because it's hard to meat's tough right? It's a tougher texture for kids. Sometimes it's not prepared well or it's bland or maybe too seasoned with sauces. So we kind of tease that out why they're struggling with that. I don't say they need meat because of protein. We talk about meat because of iron.

It's viewing the importance of meat through a different lens. But we can get iron through beans, nuts and seeds if it's age appropriate for the child. Leafy greens are another really good source. Even iron fortified ⁓ cereals and grains can be a great source for children. So iron is a big one that we talk about often. Fiber is a huge one. Even as adults, like 90 % of Americans are not meeting their fiber intake recommendations. And this goes for kids too.

I almost always hear parents say, oh, he loves fruit, but he won't eat any veggies, like at all. And that's really common. And I provide a lot of reassurance because I say, hey, that's great if he likes fruit. Fruit has pretty much similar nutrients as vegetables. So really let's hone in on what he does like and add a little bit more there, or maybe he can eat a little bit more or add more variety in the fruit section as he's learning to appreciate different veggies.

Veggies that most kids will learn to like more quickly are going to be carrots because they're sweeter. So veggies are hard because they're bitter, right? And often if you're not really good at cooking, we can sometimes overcook the veggies so they get really soft and soggy and they usually stink, right? Broccoli smells bad, cauliflower smells bad, Brussels sprouts, stink. And so that can be challenging. So I like to start with carrots. I also like to offer broccoli because that is pretty bland and you can really

Sarah Schlichter (10:24)
Yeah.

Colleen Sloan (10:38)
⁓ add things to it like cheese or cheese sauce or even crunching cheese-its as just a way to kind of help them get through that flavor. Yeah, that's a fun one. So those are two veggies that I really like to start with. But fiber is a big one because what I see often is a common condition that children have is constipation. A lot of potty training kids, even school-age kids are constipated. And most of the time it's due to a lack of fiber or fluids in their diet. And fiber comes

Sarah Schlichter (10:45)
That's what we want.

Mm-hmm.

Colleen Sloan (11:05)
primarily from fruits and veggies, beans, and also whole grains can be helpful too, but most kids aren't eating their fruits and veggies. And along that line, when we're seeing some nutrient deficiencies, any of those vitamins that are rich in fruits and veggies, kids can become insufficient. I wouldn't necessarily say deficient, because they're pretty rare since we're in a developed country. A lot of our foods are fortified, things like vitamin A, vitamin K. But if we are extreme picky eaters, know,

less than 15, 20 different foods, they might have a deficiency in one of those, any of the vitamins A, D, E, K, even potassium can become a nutrient of concern if they're really limited with their produce intake.

Sarah Schlichter (11:46)
That's all very good to know. And before we delve into some of the strategies for picky eating, you mentioned before, it is kind of nuanced, right? There's really no clear definition of a picky eater. There's a lot to consider. In your practice or even in the research, how much of picky eating would you say is developmental? Is it behavioral? Is it environmental? Is it like a combination?

Colleen Sloan (12:09)
Yeah, you know, along the lines of what the definition of a picky eater is could be different for every family you talk to. The reason why a child is picky can be different for every child as well. I think most of the time it can be a combination, but it could be any of those three. Think of development, right? When we think of normal picky eating because there is some normal selectivity. Some kids...

just go through a phase in that honeymoon phase of your one-year-old who is the best eater, right? My one-year-old checkups, the parents are like, he eats great. That is not an issue at all for him. Like we have no questions. Everything we give him, eats. Then I see them at like 18 months, two year checkup and things have completely shifted. Their perfect eater is now a terrible eater and he won't eat anything but mac and cheese and chicken nuggets, right? Like that is a story I hear all the time.

that typically is developmentally appropriate. Kiddos around this age become autonomous. They wanna do things for themselves. mean, raise your hand if you wanna tie your child's shoes and they're like, no, I could do it. Or buckle their car seat, I could do it, right? And it's like pretty annoying, but pretty cute at the same time. They're getting independence. And this also comes out through food choices as well. They're also scared of new foods. So food neophobia, which is a fear of new foods.

You know, as adults, we just think like, food's here, eat it, put it in your mouth, you know, chew, swallow. It's complicated for kids. Other things, other factors affect their ability to want to eat something and think about the five senses, right? It's not just how something tastes, it's how it smells. It's how it looks. It's how it feels, whether it's on your hand or in your mouth. That could completely turn a child's appetite off and they don't want it. So again, it doesn't necessarily mean that they're just being picky or difficult. They might be struggling with something else.

So development is a big deal. Now, if you have a child who is on the spectrum, a lot of the picky eater suggestions and strategies we may talk about today or your pediatrician shares with you might not be appropriate or work for a child who is on the spectrum. They need specialized feeding therapy. They need to work with a speech pathologist or a feeding therapist to really help. often, these strategies take time, and I mean years, in order to get the child to feel safe around food.

So just know and give yourself and your child some grace if they are on the spectrum or have some other developmental disorder that some of these strategies may or may not work for them, but keep at it and be consistent. So development is one. Environment is a very big one. And when I think of environment, I think of the dining room table or your dinner table. What does that look like? What is the language around food?

What are you saying about the food? What are you telling the child? If you grew up in a family who was a clean plate club and your parent always said, there's kids in Africa who are starving, finish your food or you can't leave this table until your plate is clear. These types of language is very pushy to a child and can feel very assertive and scary to a child. So if there's that kind of language going on or there's any kind of forcing,

going on, so if you've forced a child, I've even seen, I mean, some horrendous TikTok videos where like a parent was plugging the child's nose, holding their head up and like spoon force feeding them. That is not appropriate and that will create PTSD essentially for a child and possibly a feeding disorder later on in life, because that's a traumatic event. So that type of environment is not conducive to feeling safe, to feeling comfortable, to try a new food that looks scary to the child.

Now even lesser things like, why don't you try your broccoli? Like look at Sarah, she's eating her broccoli. Look how good Sarah is doing. That can feel very shameful for the child and they can feel very embarrassed and have that guilt put on them of like, gosh, why can't I be like my sister? She's so much better than me, right? Those don't work either, nor does bribing a child. If you eat all your broccoli, we get to go to Legoland or you get to have dessert or whatever the bribe might be.

Although well intentional, that type of environment is not helpful either. What was the other one? Environment development behavioral. Yeah, so it kind of is along those lines. I think a lot of the time with behavior, what I find a lot of parents struggle with is actually having the child come to the table and sit and enjoy a dinner as you would as an adult with your loved ones. That can be really tough for kids, especially our wiggly little toddlers.

Sarah Schlichter (16:08)
behavioral.

Colleen Sloan (16:27)
sitting down for 10 minutes feels like an eternity. And so I find that the dinner table can be scary too if they've had a negative experience. So bringing it back to that environment, if they have been punished or anything like that, or if they're left alone at the table and everyone else is done or older brother gets to, he finishes food so he gets to go and then he's watching TV in the other room.

The toddler at the table feels so much FOMO. They don't wanna eat because they wanna go do what their brother is doing. It's not fair in their little minds. So I think a lot of it plays off of each other and is intertwined. But that's why having these nuanced discussions with your pediatrician is important. And I'm gonna pause because most of the time when I pick up patients, they might not have been with me since birth and I see them at like five or six, they've been dismissed.

Sarah Schlichter (17:01)
Mm-hmm.

Colleen Sloan (17:20)
by their pediatrician. Sometimes unintentionally, right? Maybe the doc thought it was normal, but often, yes, picky eating is normal and it's a phase and kids will grow out of it between like six and seven years old. However, not always. So if you really are concerned, if you're being dismissed by your pediatrician, either find a new one or ask to see another provider or push for a feeding therapy evaluation and really get...

into the details, sit with someone who might have the time because sometimes in clinic you don't have an hour to go through all of the details of what's going on in your home. We only have 10 or 15 minutes. So it can be really challenging for the pediatrician. But if you are listening and you're like, gosh, I'm dealing with all of this stuff, I would then push for further assistance outside of the pediatrician's office so that you can get a really thorough evaluation to determine what's going

Sarah Schlichter (18:11)
And it sounds like, the developmental part to what you're speaking of, on one hand, sounds like reassuring as the parent, like, this is normal development. They're going to go through this. They're becoming more autonomous. And on the other hand, it's almost like, well, if this is out of my hands, you you do want to take the steps to advocate for your child, see that feeding therapist.

I think today it's most helpful to focus on the environmental aspect because it seems like that's what we have the most control over as a parent. And we've talked about the division of responsibility on here from Ellen Satter. And as the parents, you you pick what served, you pick when and where. And speaking to that, as we get into some of these strategies, you mentioned the pressuring, right? Like the bribing, all of these things.

I'm sure all parents, myself included, have tried it. We've been there, right? We feel desperate. But can you speak more as to how does that backfire? I mean, you mentioned, yes, it could be shameful when you're comparing. I like to say, like with the bribing, it might work in the short term, but the long term, it's not. It's going to eventually lose its power, right? The kids are going to figure that out. But from your perspective, why is bribing something we want to stay away from?

Colleen Sloan (19:25)
You're right, you said that word power. It's a power struggle between you and the child. And that's really a lot of what parenting is, right? And we are the authority in so many areas, but how we approach that power is really, important. And bribing, I find, is just not effective. If it were, you would do it and it would work, right? So when I talk to families, I remind them that we are teaching kids how to eat for the long term.

It is a marathon. You've got 18-ish years with your kiddo to help them learn to like a variety of foods, right? That is our ultimate goal. No one's goal is to have an 18, 19, 20-year-old who has an eating disorder because their relationship with food and their body has been so distorted because they struggled when they were a child and they got yelled at or they were bribed or they were punished.

I have seen this happen and a lot of my colleagues who work in adult medicine, a person who has maybe body image issues or struggles themselves with an eating disorder can often pinpoint it back to a situation when they were a child and something was said or frequently said about how they're eating, how much they're eating or what their body looks like. no parent wants that for their child. So I like to remind them.

to look forward, look into the future of the type of child or really the type of adult you would like to raise. And how should we then parent or talk to them about their food choices and their body when they're kids? A lot of the time I find exploration is a better approach than bribing. Kids thrive with play. We forget that as adults, we kind of get so fuddy-duddy and we're get boring or we just want to get through the task because

You know, I'll be honest with you, I'm exhausted too. We're all tired parents. Dinner is usually the hardest meal because everybody's patience is thin. Everybody's pretty tired. We've all had a day and we just want the meal to be over with. But kids thrive when they can explore. So sometimes for parents, rather than bribing and really, putting such a focus on the food, I back it up and say, let's stop even trying to get them to eat broccoli at dinner, for example.

Or let's not even worry about how much they're eating at dinnertime. Like let's focus on things outside of this dinner table, because this is too stressful for everybody. So really we take a completely different approach. And we might now, if we're trying to get them to that broccoli, let's actually explore it in different areas. How about we play with it during playtime and we feed it to his dinosaur? Or if it's an older kid, how about they actually help you in the kitchen, cutting it or washing it or maybe sprinkling it with salt and pepper or whatever you're seasoning it with. So that when they finally do come to the table,

after weeks, months of playing with said food, it's not foreign to them. It's not something they've never seen. Now this is something that their dinosaur's eaten or their baby doll has eaten or they've towed it in their tractor trailer and dumped it into the construction site. They've washed it, they've prepared it in the kitchen, they've seen it so many times and that now it's not new on their plate. So I find those strategies are much more helpful than actually bribing because bribing, you're gonna lose the battle, I promise you.

Kids, we could learn something from kids about their persistence, right? They are the most persistent human beings I've ever met and they will wear you down and they will win. And so it's a battle you just don't even want to go to and you don't even want to show up to the fight for. there's other strategies that you can do that are more effective.

Sarah Schlichter (22:56)
Mm-hmm. 100 % with you on the curiosity aspect of it, the exploration, and our words matter. So thinking the long-term, what we're saying now, something can stick with kids. I'm curious about this idea of, parents saying, my child's picky, but maybe they've stopped offering certain foods, because they're not going to eat it anyway. What's the point? So maybe they're in this rut, like it's chicken fingers, mac and cheese, maybe pasta with butter.

you know, the plain things that they know their kids will eat because of course, as parents, we want our kids to eat. We want them to go to bed with a full belly and be nourished. Do you see that? it kind of like a what, how does that happen? And how do we go about reintroducing things? Or I know part of it, you just explained with the exploration, but I think parents can get really stuck up on just assuming kids won't eat something.

Colleen Sloan (23:47)
Yeah, parents are sometimes surprised when a child goes to school, a friend's house or maybe grandma's house, and they're like great eaters, or they did try like salmon. And you're like, what? I've been trying to get you to eat this forever. And sometimes it's just a new environment. It might've just been offered differently, right? Or who knows, it's just time. Preferences can change over time. Think back to yourself of foods you did not like when you were a child. I can list a handful of them that now I really enjoy as an adult.

So allowing a child and giving them permission to not like something today, but maybe liking it tomorrow in a few months, that is perfectly fine. And that's actually quite normal because our tastes also evolve over time. So they might have very limited taste acceptance when they're a toddler, but as they get a little bit older, they can accept things. So that's why it's really important to continue to offer it. Now, yes, kids get in these food jags where they are just like, nope, I want nothing but a chicken nugget.

My buttered noodles, you know, they've got their list of like five or so things. However, be consistent. I will promise you that over time, they may try it. And I say may because not every strategy works for every kid. I think exploration is key. I love when kids are curious about foods. That is probably the best because they might paint with a green bean, but if you tell them to put that green bean in their mouth, they're probably not. But painting is a very good skill to learn. They've touched it.

They're feeling what it feels like, the texture. They're feeling what it could possibly crunch like in their mouth. The smell is in the air, right? So don't dismiss how effective playing with your food actually is, even though our generation, like millennials, we grew up like, don't play with your food, right? So it's a little different nowadays.

Sometimes also what can be helpful is switching things up. So letting a snack be a meal and a meal being a snack because kids also come to expect certain things. So we've got to keep them on their toes and we had chicken nuggets and mac and cheese for lunch, know, for a snack. For dinner, we're actually going to be having, I don't know, rice and beans today or whatnot. I think that can be helpful. Another thing with kids who have brand preference.

changing it up with the brand, so the shape, so the dino nugget, get the circle nugget, get the tender, changing the shape up can be also very helpful because kids are, we are creatures of habit and sometimes we are our own worst enemy as parents and we just, we get the thing that we know they'll eat. But if you start early on by not buying the exact same thing every time and taking it out of the package, so the child doesn't really know, is this the green box with dino nuggets or is it the blue one that, you know, they might not know.

And so that could be a really helpful thing. Combining or switching up meals and snacks and taking things out of the package is another really helpful thing when kids get in food jags. But also I like to keep a list of foods that your child maybe once ate and doesn't eat anymore and go through that like once a week, once every other week and be like, you know what? I didn't realize, I have not offered oatmeal in a very long time, but he used to love oatmeal. So if it's been a month or two, let's bring it back. Let's try oatmeal again.

Another thing that kids can often get sick of is just the flavor of the food. So if you've always only given your child warm oatmeal with milk and a little brown sugar, change it up. Change the flavor, change the temperature. I did this with my daughter when she was younger. She got sick of oatmeal. And so I then gave it to her cold with a little sprinkle of salt. As wild as that sounds, she loved it. And she's continued to like it that way

So sometimes it's not necessarily the food. So it's not oatmeal that she didn't like. She just didn't like it being sweet and warm. She wanted it cold and salty. So sometimes you just need to be a little creative in your offering and how you're preparing the food if they do get stuck in like a cycle of only eating five to 10 foods.

Sarah Schlichter (27:33)
That's so key and switching the environment, making it a snack versus a meal. I think those are all great strategies because we're trying to make our kids more flexible and adaptable, right? We don't want it to be so rigid that it has to be this certain dino nugget every time or we're not going to eat it. I'm even thinking maybe we do a couple dino nuggets and pair it with a couple circle nuggets when we're starting.

or have different dips out there. I think I've said this on the podcast before, but I did a taste test one time with the kids and we had, baby carrots that are cold and crisp and I roasted some longer carrots and then I had little carrot chips and I was like, all right. I know my kids were kind of young at the time, but with older kids, you can do more advanced things like rate them what was different about each.

just to kind of show them, you know, we can prepare carrots in different ways and it's okay if you don't like this, but did you know it can transform into this? And I think it goes back to something you said earlier about we forget that it can be fun. Like these are kids, it doesn't have to be serious. They're not gonna eat every meal. I think we have to kind of have that expectation too. But that brings me to another question parents probably have

I've done the strategies you recommended. We sat down to eat together. Kids didn't touch anything. What do I do now? Do I go back to the comfortable mac and cheese? How would you handle those situations?

Colleen Sloan (28:59)
It's a really, really tough situation and it's gonna be like, we have to find out why. Why is the child not eating dinner? It can go back to a lot of the things. Is it development? Is it behavior? Is it the environment? I also like to look at the meal before and what is the child drinking beforehand? So did he have a really great big lunch at school or maybe you offer your child an after school snack? Did he just, he still on bottles and juice or milk?

Sometimes if they drank down 10 to 12 ounces of milk, and I see this often, they're not hungry if you just are trying to serve them dinner. So I really like to look back, are their bellies actually empty and are they ready to eat a meal? Because if it's been two to three hours since their last meal or snack, they might truly not be hungry. And kids can sometimes struggle with knowing if they're hungry. So, and also we kind of...

force them to ignore those signals, like, no, you need to eat more. Often they know when they're full. So yes, some kids can try to manipulate because they want a snack or they want ice cream or whatever afterwards. So they just say they're hungry to speed up the dinner process. But I think knowing your kid is really important. First of all, what do they eat? What are they drinking? If they had something recently, that's what's going on. They might not be hungry and it might be okay for them to...

skip dinner and you might need to adjust the timings of your meals or the timings of your snacks. Now, if it's not the case, if let's say they had lunch at like 11 o'clock at school and it's five o'clock, six o'clock and you know they should be or they probably are hungry, look at what you're serving them. Is every food on the table a new food or food that they don't really like? My daughter doesn't like spaghetti sauce and if I were to serve her spaghetti and meatballs with sauce slathered all over it, she'd probably take like two or three bites and be like, okay, I'm full.

Like my appetites turn up, I don't like this. So is there anything there for your child that they do like? I am a big fan of always having at the table something that they like, something that they will eat so they can come comfortably and say, ⁓ okay, I like this, whatever it is. And there might be something new that we're working on trying to eat, likely a vegetable or a protein. And there might be something that's

an okay food, something that they've eaten before. They like enough. I like having that structure to meals because having completely new foods at the table can be really scary for kids and they can feel really, really frustrated. Now, if they are just all out refusing the meal, again, it really depends on your child, but this is where that division of responsibility is very important. If you've checked all those boxes, yep, Colleen, they didn't have a snack, they didn't have a meal. There is something that they like.

and they're just refusing everything. And you you can then say, this is dinner. If it's early enough, maybe they can have a before bed snack. Like if you eat dinner at five, maybe you could say, this is dinner. There's nothing else until we have a bedtime snack. And that's going to be an orange or you can pick an apple or an orange before bed. Are you sure you don't want to eat any of this now? Giving them that autonomy and that choice.

is helpful and it upholds those standards in that role. What your role is is what, when and where the child eats. They can decide if and how much they eat. And that releasing control is really scary for parents. But if you uphold this, two or three nights go by, the child is like, huh, mom ain't playing around. I said, I was full. I wasn't really, I didn't really want an apple. So I went to bed. My tummy was kind of hungry.

And that is okay. It's okay for the child to feel hungry and feel a little bit of the consequence of their decision. Now again, this is a caveat. This is not for a child who is on the spectrum. ever agree with a physician who says they will eat when they're hungry. They often won't. Some kids who are not on the spectrum sometimes won't either. They may be that stubborn. But most of the time, if you have communicated this with a child,

and there is something there that they will eat, it is okay to uphold those standards, offer some form of a bedtime snack, again, that you are choosing. You can have oatmeal or yogurt. You can have a banana or a peanut butter and jelly sandwich. Make it something small that they're like, they'll take or leave. It's not their favorite. You're not offering them an ice cream bar or their favorite cereal. It should be something that is a little bit nutritious, something that's not that exciting.

That should be their dinnertime snack. If they don't want that either, they do need to learn that mom is serious. I need to eat when I'm told, otherwise I'm gonna be hungry. So I think a little tough love, but more importantly, consistency is really, important when it comes to that.

Sarah Schlichter (33:35)
Yeah, we're talking about setting boundaries here and it can be very hard to stick to that. mean, having your kid go to bed hungry or just giving in, right? But I think it's so important what you said, like do it three nights in a row. They're gonna learn. It doesn't feel very good to go to bed hungry. Like I just, it's annoying. This apple isn't filling me up. So I think as a parent, take comfort in knowing, you you.

If you going through the checklist that Colleen talked about, like have that safe food, something that you know they're going to like, make sure the snack beforehand wasn't too big. make sure it's not all new foods. if you're going through that and you checked those boxes, your job is done, right? We can't make a kid eat for all of the reasons we talked about earlier. long-term that's going to backfire and it's going to create trauma.

We've offered things, we've given them autonomy. Okay, if you're sure you're done now, we're not gonna eat again until maybe that orange or apple before bed. And it's kind of to your point, tough love, it's a lesson. This is something we want to teach them. We want to have them learn and sometimes get beyond their comfort zone. So I think those boundaries can be hard sometimes for parents.

Colleen Sloan (34:45)
kids thrive with routine. They thrive with a schedule. Think about school or daycare. When it is time to play or learn, it's time to play or learn. That's the only thing that kids are doing. When it is time to eat, if it's snack or lunch, that's what they're doing. They have very distinct lines between the two behaviors and kids actually fall in line pretty quickly. They learn like, I better eat now. Otherwise I don't have another opportunity.

Even infants, I've seen seven, eight month olds, they have this same structure. It's maybe more often feeding, but they have this structure too. And parents are always amazed. like, why on earth does he eat so well in daycare? But at home, he's just like grazing and snacking all the time. And it's because of that. In school, there is a structure and kids really, really do thrive with routines and structure so they know what's coming and they know what's expected of them.

Sarah Schlichter (35:40)
And I think having realistic expectations is really helpful. And everything you've lined up in this episode really can help parents say, okay, maybe it's not reasonable to expect my five-year-old to eat everything on his plate. Even though he used to do that, there's like seven new foods there that he's never tried before. So what would you say, you know, maybe it's starting slow, but what does a quote unquote successful meal look like for a picky eater?

just for a parent to start to gain some confidence in this process.

Colleen Sloan (36:12)
Yeah, I love that question. this has to be very individual. You have to answer this for yourself. I'll give you some examples, but just like what picky means for one person could be different, I think success would look differently for each family. And so in order for you to feel confident, I want you to choose the lowest lift. What's the easiest thing that you can do tomorrow, tonight, that would be a win? And it could be something.

really small. Like if your child does not sit at the table, maybe what we're going to do is we're going to have a 60 second dance party to their favorite song. We're going to blast it on your phone or your TV and dance like crazy to get the Wiggly's out of that Wiggly little four year old so that they can kind of prepare themselves. Okay, we got our Wiggles out. Now let's go sit down. Maybe that's your biggest win. That's a new thing you're going to build into your routine. And maybe they do that. And now can they sit at the table for two minutes?

Right? Or lower your expectations. Ten minutes is a long time for any toddler to sit at the table. Adults, we do. We want to enjoy the meal and sit and conversate, but it's not an appropriate expectation for a young child. So maybe two or three minutes is all that we expect. That would be successful to me. Now, if it comes to variety, if your goal is to get the child to put that food in their mouth, that might be too high of an expectation to start out with.

You probably aren't gonna be successful with that with two or three nights. Maybe we need to step back, lower the goalpost, and maybe we can just have them accept the food sitting on the table or on their plate. That might be a win for our child. Because I've known plenty of toddlers when they look down and they see a piece of broccoli, it's an all out panic mode and a temper tantrum, and now dinner is ruined and we're arguing with our spouse, and it's an unhappy environment for everybody. So that could be a win.

literally just having a new veggie on the plate. That would be success to me as well. Maybe it is trying a different variety. I really love this strategy where you go from a dino nugget and you make very, very small changes to its shape, texture or temperature. So dino nugget, maybe to a round nugget, maybe to then a tender.

to then a lightly breaded chicken breast. And then the goal is to get all the way to like grilled chicken, right? I love the concept of food chaining. So maybe that's your next goal is like, okay, kid only eats dino nuggets. Maybe successful to me is that he eats round nuggets, this week or next week. And then can hopefully get him to a plain old chicken breast. So I think I can't answer what success would look like for anybody, but think of those options. Kind of think about what the child is struggling with.

lower your expectation and choose something that's a very, very easy win for you and then that will be successful and then you kind of work from there and build from there.

Sarah Schlichter (38:56)
Mm-hmm. I love that. And one thing I want to say to parents, and this came from a conversation I had with a dietitian who was formerly a very picky eater. To this day, she still has very strong food preferences, but she talked about her experience and she said just hearing the word picky eater, like being described about her, almost gave her that identity. So kids hear you talking. So if

you say, you're so picky or, kids over here, you saying, my son's a picky eater. That can also play into that identity. So are there other words we could use or maybe parents just refrain from saying things like that altogether?

Colleen Sloan (39:36)
I am jumping up for joy that you just said that because I actually don't use the terminology picky eater and I know you are, you most dietitians like cringe at that terminology. So when a parent says my child's picky, my next question, what do you mean by that? After I hear that, I then educate and reframe, let's not label them picky because you're right.

100 % children will take on that identity and they will kind of say like huh well my mom thinks I'm picky like I Get there's no hope for me like I can't change it is what it is I am what I am and What I do as a provider when I I'm listening to the parent I'm watching that child out of the corner of my eye or directly looking at them when the mom or the dad is Describing or saying he's so picky. He doesn't eat anything the child

often their body language completely changes, their shoulders slump, you can visibly see how ashamed they are. Or I've seen a lot of kids say, no, I'm not. They get really upset at that. It's almost like you're calling them a bad word, right? They're offended that you labeled me as a picky eater. I'm not picky. Why would you say that?

Sarah Schlichter (40:42)
That's expensive.

Colleen Sloan (40:47)
So that's why having those conversations will like, let's back it up. What exactly will he eat? And through that, often the child's like, see mom, I like apples, I like grapes, I like watermelon, I like carrots, I like, and he's listing off a really good variety. So again, this is where having that conversation and really determining is this even picky eating? And Sarah, to answer your question.

What do I use instead of picky? I like a few things. I traditionally go with selective. That's a terminology we often use in children with autism. They are more selective eaters. But I've also liked the language curious or cautious eater. And I think of like a little kitty cat, right? Like they're really curious and they're like, wanna kinda play, but then they're a little bit nervous and then they run away, but they wanna come back to you. That's how kids are with food. Especially if you're over there having fun painting with.

know, broccoli florets are kind of like, hey, what's everybody doing? This looks so fun. So call your kid selective, cautious, or a curious eater and let them step into being curious, because that's really what we want. We want children to be curious about the food they're eating enough to explore it, try it, and maybe one day taste and eat it.

Sarah Schlichter (41:59)
I have loved this conversation so much. I feel like even myself, I've learned a ton and I hope the parents out there have found it helpful and will share it among their mom group, their friend group. Just to kind of recap, we've talked about a lot of different strategies. We've talked about kind of what causes it, how we can help it, feeding it to toys and dinosaurs, having kids being involved in the prep, trying different ways, different pairings, different temperatures.

I also say parents just eat it yourself in front of kids. you, you gotta be eating it too. They have to be modeling after you. Are there any other strategies parents can start implementing to try to increase variety?

Colleen Sloan (42:41)
Sarah, I'm laughing as you had said, like parents have to eat it too. And it's kind of like the old, recommendations, like parents have probably been told this or they know like, yes, I know I have to model good behavior. But I'm laughing because I've had multiple kids when the parent says he doesn't eat any veggies, the kid is like, but you don't eat any veggies either. You know, they kind of like call them out.

or sometimes what I really love doing because I'm always on the child's side. I'm there as the provider, as the advocate for the child. And so when the parent says, he doesn't eat any veggies and I can just feel the tension in the room, it feels very negative, I'll just calmly look at the child and say, hey, Jimmy, did your mom eat or did your dad eat any veggies? And

It's great because it's almost like permission for the child to like tell on their parent, right? Even me, even you, we're dietitians. I've actually had some days where like, hmm, I think I've had like not even any fruit or any veggie, right? Like there's probably been days like that. So yeah, we're not perfect. So the child can point and they will point that out. But again, it just brings it back down to like humaneness

But at the same time, we don't want to blame or shame or point our fingers at our child. We are teaming up with them. We're their partners with them. So yes, being a good example is so great. What I find parents often do wrong in trying it in front of the child is they take a bite. It's so good. You should have it. Well, just because you're eating it doesn't mean I'm going to like it.

Even now, like I have my own preferences. I hate mushrooms. I think they're slimy. I've tried them and I don't like them. So you could tell me until you're blue in the face, Colleen, they're so good, eat it. I still don't believe you. It's the same for kids. Telling them that it's good or it's good for you really doesn't convince them. But what you can do is again spark their curiosity. As you're chewing something, maybe you are eating carrots. Maybe like you said, you've got baby carrots and ranch. You can show them.

Look how crunchy it is. Look what I just did. How crunchy do you think my next bite could be? You know, asking things that are more about the senses and things that they can observe you doing with that food. They might say, man, that looks really fun. I kind of want a crunchy carrot now. And that's, that's the goal, right? Yes. Also to connect with your child. Like how fun is that to kind of play games with your child? I love taste tests like you do, Sarah. I think that is so fun.

Letting them be like a little food critic is just awesome. beyond that, beyond being a good role model, I love having dress up parties for dinner, letting it be a themed night. And it doesn't have to be complicated. We could have backwards night. Everybody throw your t-shirt on backwards, put your pants on backwards, or reverse day. Mommy's going to dress like daddy and daddy's going to dress like mommy and siblings can dress opposite.

If you've got a Halloween bin, we've always had a Halloween costume bin and pull that out. Let the kids pull through it. What girl doesn't love princess costumes? What boy doesn't want to dress like a superhero, right? Allow them to wear it to the dinner table. If you don't have time for that, maybe it's silly sock day or just sock day. Maybe it's tie day and everybody's going to put dad's tie on their head or on their neck. Dress up is so fun. And again, it's just doing something that's a little different and like, ⁓

This is fun, I kinda wanna come to the party for this. I also like making dinner special. As adults, why do you like to go out on a date with your spouse? Most of the time it's to a nicer restaurant, nicer than your house. The lights are dim, there's nice music, sometimes like a candle or a light. It feels special. Make the dinner special too. Dim the lights, throw on a candle or one of those fake candles if you've got young children.

throw on some music, maybe new placemats or have the child decorate the table can be really, really fun for them to get involved. So it feels like a special occasion. Another thing, I've got two more for your listeners. One is if you don't have dogs, eat dinner under the table. And this is so fun for kids because this is like, we're never allowed to do this. Like, what are we doing? This is so weird. Yeah, she's nuts.

Sarah Schlichter (46:42)
Yeah, what is mom suggesting? She's crazy.

Colleen Sloan (46:46)
Exactly. So under the table can be fun and I love tabletop dinners, meaning no plates at all, no bowls, nothing. This works great for like a taco night or nachos, even spaghetti or pasta night. And what I mean by this and my like clean freaks, this might be a little too much for you, but put either saran wrap or tin foil on your table, something to protect the table. Dump out, let's say plain noodles.

And then you can have sauce separately. Let's say you've got an Alfredo or a marinara or a butter sauce, because you've got different preferences in the house and that's okay. Everybody can grab some pasta. You can eat right on the table, pour whatever sauce you want. Same with nachos. Dump some nachos, put some toppings. It's really, really, really fun for kids. And I hope the take home message is make it fun. Because not only will the child be more willing to eat or try the food, but they're also going to connect with you.

on an emotional level. And this becomes very important in those teen years and young adult years when you really do need to have conversations about serious things, the table can sometimes be a beautiful place to have those serious conversations if you've created a safe space for them.

Sarah Schlichter (47:55)
Yeah, and you're taking the pressure away, right? Kids feel comfortable, it's fun. And to your point, thinking in the future, if we start these habits now, kids can feel comfortable talking to us, coming to the table. So those are such great suggestions. Thank you so, so much. I'm gonna, have one rapid fire question for you before we wrap up. And that is, you've worked a full day. I know you wear many hats. You've worked a full day.

You're exhausted. You have like 15, 20 minutes max in you to make dinner. What are you making?

Colleen Sloan (48:25)
Ooh, I love this question. Okay, what am I making? If I'm on a most exhausted day, I am probably making a sheet pan dinner. And I almost always have potatoes and chicken. It could be chicken breast or chicken thighs. So I'm gonna put some broccoli with potatoes and chicken breast and smother that with garlic parmesan sauce from

Buffalo Wild Wings, I think is the brand that I love their sauce. I'm gonna smother that, put it in the oven for like 20, 30 minutes and it is one pan and it is done. It's also great for different preferences. So I can not sauce half of it or sauce it differently. If one likes barbecue, I might throw barbecue on one side and my, you garlic Parmesan on the other side. So sheet pan dinners are probably my go-to if I'm exhausted and have nothing left in me.

at the end of the day.

Sarah Schlichter (49:18)
genius. mean, maybe it takes 30 minutes to cook, but it literally took like three minutes of effort to just put it on the sheet pan. So a good sauce can go a long way. I am 100 % with you on

Colleen Sloan (49:24)
Yep.

Yep, exactly.

Sarah Schlichter (49:29)
All right, Colleen, well, thank you so much for your time. Tell our listeners about your podcast and where they can find you if they want to learn more.

Colleen Sloan (49:36)
Yeah, so I have a podcast which Sarah has been on. We will link down to it in the show notes if you want to take a listen to our conversation. My podcast is called Exam Room Nutrition. It's on Apple and Spotify. Although I more target clinicians because as you may have experienced, your pediatrician might not be very well versed in nutrition and you might have gotten really bad advice. So my goal is to really educate my colleagues. However,

My content is very appropriate for anyone listening. It's not too sciencey or too confusing that you can't learn something from. I also am on Instagram at examroomnutrition. I often talk all about kids nutrition, but also weight management for adults. So if you're postpartum and looking to lose some weight, or if you're on a GLP-1, I've got a lot of great content on there as well.

Sarah Schlichter (50:21)
Thank you for all the work you do and working to merge these two important profession specialties I think is so amazing. So you all will find great content with Colleen and thank you for listening