Picky Eaters: Why Your Child Won’t Eat (And What Actually Works)

My child refuses to eat. Is this normal?

Fussy eating—also known as picky eating—is one of the most common concerns parents face. It can be frustrating, stressful, and sometimes worrying.

In this episode of Healthy Beginnings, Dr. Edgar Kalimba explains why some children become picky eaters, what is actually happening during this stage of development, and what parents can do to support healthy eating habits.

Many feeding struggles are not about the food itself—but about development, behavior, and environment. Understanding this can change how you respond.

In this episode we discuss:

•  Why children become picky or fussy eaters 
•  What is normal (and what is not) 
•  Common mistakes parents make during mealtimes 
•  Practical strategies to encourage healthy eating 
•  When to be concerned about your child’s nutrition 

Healthy Beginnings offers clear and evidence-based conversations about children’s health, family wellbeing, and the systems that shape our lives. 

New episodes every Monday 

Have a question? Email: healthybeginningspodcast@gmail.com

Produced by LF Media

Transcript

SPEAKER_01 0:01

My child used to eat carrots and vegetables and fruits and other healthy options without any difficulties. And yet today, they won't even look at them. Does that sound familiar? So, fussy eating is one of the most common concerns parents face. In fact, a lot of statistics say that anywhere between 10 and 50% of children, at least within the first three years of life, at some point in time struggle with refusal to eat or fussy eating as we call it. The question is how much is normal and when should you worry? I get this question all the time that, you know, doctor, my baby is not eating enough. And it's always a debate. Uh, why do you mean enough? Let's talk about this a bit more. And often, there's probably more concern and worry than necessary. So today I want to take the next 25 minutes to actually break it down and to discuss uh what could be done, if at all, and if it's even required, and when to worry and when to seek extra help. So fussy eating or peaky eating uh typically includes refusing certain food types. And if I broadly look at uh statistics, I think vegetables come up high on that list. Many kids are frequently not interested in eating vegetable options, vegetables and maybe legumes as well. And of course, this is a core and important part of the diet, and uh and vegetables provide much-needed nutrients. The other way to describe fussy eating could be eating only a limited number of foods. So I've heard often from parents uh saying that my child only wants to take dry white rice, or they want to take uh French fries, what we call chips. Or they want to snack on sugary snacks. But when it comes to food, like healthy cooked food, uh, my child just doesn't want to eat it. The other way that uh fast eaters could behave is uh changing preferences very frequently. So today they accept one thing and tomorrow they completely refuse it. And then, of course, eating very small amounts. I put that in courts because I often find that small amounts is uh debatable uh often than not. So it's very common, and I like to say that it's often a normal stage and not a failure in parenting. Um, the reason I say this is because if I take a step backwards and talk about growth and development, particularly the first two years from birth until the second birthday, uh, we all know that on average a newborn baby might weigh three kilograms uh at birth, and then by the time they are one year, they might weigh anywhere between nine and eleven kilograms. So they will often triple their birth weight. So the first year of life is really exponential. Babies grow very fast from small baby to a toddler one-year-old running around the house and often causing uh good chaos. So now when you look at the second year of life, which is from uh uh 12 months to 24 months, there is much slower growth. In fact, it's not uncommon for children to put on between one, 1.5 kilograms to two kilograms the entire second year of life. So if they weigh 10 kilograms at one year, they might weigh 12 or 12.5 kilograms at two years, completely normal. So there is slower growth, and this slower growth, particularly in the second year of life, uh is commonly associated with less appetite. They want to explore more, they're not as interested in food, and sometimes parents worry and become anxious and associate that with a big problem. And yet it's just part of the slower growth combined with a little bit of distraction. The second element that happens, particularly around that age, second year, third year of life, is uh toddlers particularly want control. They want to control, they want to assert control, they they challenge authority. Uh, that's why at two years we often uh talk about the terrific twos, or what many parents uh call temper tantrums. That is toddlers asserting themselves. And it's not uncommon for food to become one of the ways through which they actually assert themselves, you know, refusing this, wanting that, and and uh being a little bit difficult, so to speak. The third thing is that there are some children, although they're a minority that have what we call neophobia or a fear of new foods. It's a natural protective instinct. So some kids, every time they see something new, they're just very hesitant and they need time. They need time to actually warm up to it and uh be able to accept it. Then that also goes with uh sensory sensitivity. So the different foods have different textures and smells uh and appearance really matters. You know, one of my three kids, my daughter, when she was younger, she always made uh funny references. So when we would introduce things like oats, I remember her telling me that it's slimy, and when she takes it and tries to swallow it, she would gag, she would say, just the feel, the texture doesn't work for me. Um, or things like fish, fish or seafood sometimes has a strong scent, and some kids have some kind of aversion towards that. So there's all kinds of sensory sensitivities that could make it uh a bit difficult with certain food groups. So overall, I would say the vast majority is the fact that your child isn't being difficult, they are developing. So, how do you then handle uh fussy eating? Some practical steps. Very simple, but these are really uh common tips that parents could explore. One, um you should not give up, so you should keep offering the food group but without pressure. So it's not uh uncommon for some children to take 10 to 15 exposures before they actually accept something. Now, this is different from uh complete intolerance. You know, sometimes, especially, you know, in the first year of life, you feed something and your baby is throwing up or vomiting excessively or gagging vigorously, that could be something else. But if it just refusal and, you know, takes one or two or three or five spoons and then they're not interested, um, don't give up. Don't say, oh, they don't like this. You know, try again tomorrow, try again the next day. Keep the exposure. If there's no other alarm signs around that food, you have to keep offering, offering it without pressure. Second thing is structure. I think I spoke about uh routines in my previous podcast about winning foods when you're starting solids. Structure is very important. Children generally thrive on uh a routine, they love routines. Do not confuse them, do not mix things, you know. So if they are having three meals a day, maybe plus a snack or two snacks, try and fit in a routine and try to stick to it. This often creates uh a bit of ease and it also uh uh makes it easy for the child, they know what to expect. So stay regular and avoid constant grazing. You know, there's I've seen sometimes some parents who want to give something uh every other minute, you know, your child has had a good meal, after half an hour, you want to offer a snack. So avoid constant grazing because that actually creates bad eating habits. The other thing that is often not stressed enough is uh eating together as a family. Now, I know that parents are busy and often uh they are not available to have meals, sit around the table with the children. However, this is a time-tested behavior uh and routine. Sitting together, eating together as a family actually helps. You know, not only do the children learn by watching you, they see that you're putting vegetables and you know, putting healthy options and portions on your plate, but it actually builds uh a good habit with the children. So if you're as busy as myself and you're often not at home, at least choose one meal. It could be breakfast very early, it could be dinner at night, choose a meal that works for you as a family and sit together. Look at them, encourage them, and make it fun to sit together. The other practical tip is to offer choices, uh, but control choices, obviously. So, for example, if it was time for um a fruit snack, you could say, Do you want banana or you prefer yogurt today? So try and give options. Often that makes your your baby or your toddler think that they're in control, and it's it's a positive thing. And then um, you know, this has happened in my own house as well. The question around portions. Uh too big portions are not good, uh, large portions are actually kind of overwhelming. So you always have to really limit your portions, you know, keep portions small and age appropriate. Then I'd also say uh make it fun, you know, make it fun, be creative. Don't just have the same routine, the same boring, uh not very tasteful food offered every day, in and out. So be creative in terms of the colors, the shapes, the textures, try and come up with ideas that actually work for you and your baby. Um important is to make sure that you don't force or pressure, don't use food as a reward. And uh, you know, especially for babies who are one year and above, you don't need to cook separate meals every time. So I would like to briefly speak about when you should actually be concerned, or when is your worry and anxiety justified and you need to seek medical advice. First and importantly, is if they're not gaining weight or growing well. Now, again, uh, it happens to me very frequently when um parents are very worried about their child's growth and their weight gain. And in fact, they're actually gaining good weight. And often parents will tell me, but our friends or their cousins who have the child the same age, the child weighs three, four kilograms bigger. And more often than not, the other one who is weighing a lot more is where the problem is. Not your child who just eats enough sufficient amounts and has actually uh good weight on average, uh weight for age. But when they're genuinely not gaining weight or not growing well with clear signs of milestone delay, then that is definitely a cause for concern. Uh the other element is that if they refuse entire food groups, you know, if they completely refuse, let's say dairy, or they completely refuse uh red meats, or they completely refuse um uh fish or seafood, uh then there might be a problem. I've mentioned before in my prior podcast that sometimes refusing completely or behaving abnormally before in front of a certain food group, it might be sometimes a sign of being allergic or intolerant to that food. Now, if your baby also has difficulty chewing or swallowing, uh, that could also mean something in terms of how they coordinate. Maybe they have a neurological problem or they have um uh a coordination, chewing and swallowing, a coordination problem, that should also be uh checked out. There is some children that are a little bit spoiled. You make easy, you make life easy for them, you blend and you know, make food very easy, and you don't really allow them to grow or outgrow that. So sometimes difficulty to chew or swallow could just be that the fact that they have not been sort of gently pushed and encouraged to outgrow certain behaviors. But if it's genuinely uh very difficult, and this actually also goes with excessive gagging or vomiting frequently with food. You know, we have things like uh gastrosophageal reflux, you know, and that could be physiological or normal within the first year of life where they bring back the spit up when they're full. But every now and then there are some children that actually have something not just physiological, but also pathological, also like a disease, a medical condition that needs to be addressed appropriately. Uh, and just generally, if there is some developmental concerns, if it's not just about the food and the weight gain, but also developmentally in terms of the milestones, if there are concerns, uh, it's always good to consult and to discuss this. Of course, um, appetite varies day by day. If you look at yourself or myself as adults, uh, we don't eat the same way every day. So I often say, don't look at a pat one day, look at the trend. You know, let's say look at the intake over a week or over two weeks. In fact, I like one of my favorite things to do is to ask parents to write down what I call a food diary, where they take two weeks and then they document everything that their baby or their toddler is eating. Uh, what they ate, what they drank, what time, how much. And often when they come back to me after two weeks and they look at the intake and try to estimate the caloric intake, it's frequently quite good. So there is certainly frequent anxiety that is not always justified. And then also importantly to note is that, you know, if you have a fussy eater, uh, if the little that they eat, you should really focus on uh rich and nutritional dense options. So your uh iron-rich foods, the meat, the chicken, the fish, the plant-based, uh, fortified foods, healthy fats, and really have a variety over time to make sure you keep it fun. So before I wrap up the discussion today with regard to fussy and picky difficult eaters, um I just want to mention a couple of mistakes, so to speak. Mistakes that parents make. The first one, as I already mentioned or highlighted, forcing or pressuring your child to eat. Uh I see this quite a lot. You know, you always say, just one more bite, five more bites, and then we'll be done. So really pressure and push and push. And sometimes parents take it to the extreme and say, you won't leave the table until you finish that plate. And maybe it was a large portion. So this is not good, and it often backfires in a way that it not only creates anxiety around food and just makes it uh a bad environment, it creates a bad mood, and that actually further reduces appetite and leads to unnecessary power struggles. So, a better approach is to offer the food calmly, be encouraging, but let the child decide how much they want to eat. If they ate to uh five spoons or ten spoons, and they're really, really not interested in eating more, then take a break. Don't push, don't pressure, because pressure today is what will actually create resistance tomorrow. The other mistake is uh giving up too quickly on new foods. As I mentioned earlier, unless your child has particular alarm signs, signs of allergy or excessive vomiting or something really eventful or dramatic, then do not give up easily. You know, you might need to do 10 to 15 exposures, you know, today, tomorrow, you know, the next week, two weeks, by the time they actually completely accept that new taste. So keep offering without pressure, change the way you prepare it. For example, roasted versus mashed. So be creative, as I mentioned already about that. And familiarity does indeed build acceptance eventually. The other thing that I see frequently is that uh we often fall into the trap of cooking separately for our children, you know, especially when they are a bit younger. They have a separate dish and kids get bored very quickly. So instead of cooking separate meals, rather have them somehow eat the family meal. And this is particularly frequent when your baby's towards one year. They used to eat well between six, seven, eight, nine months, and all of a sudden they start losing interest. And some children will actually show and really show you that they want to eat from your plate. So this is a sign that you don't need to cook separate meals, you should actually have them eat part of the family meal. Um so uh again, this goes together with uh it Sitting around the table as a family and eating the same meal, and it actually does build a good habit. It builds good habit, it builds a good uh practice uh and exposure for your baby. One frequent mistake that cannot be uh emphasized enough is constant snacking or grazing. Uh, it often strikes me that parents don't count milk or juices as meals. So you find your baby or your child has been having juice or other sugary drinks, many of them, and maybe they have taken 500 ml or even more in the last couple of hours. Same with milk. Milk is even actually more dense. I frequently see three-year-olds, four-year-olds that still drink 500 ml or even one liter of milk. Uh, let's say inyanze milk or any other milks, and they drink this either during the night or as part of their day. And that is a lot of uh milk, a lot of nutrition already. So if a child has taken in plenty of dairy or a good amount of juice, they're not going to be that hungry. And we often fall in that trap. You give a lot of milk, then they refuse to eat, you give more milk, then they even refuse to eat the little that they were accepting, and so the vicious cycle continues. So avoid this and stick to uh discipline and routine as much as you can or reschedule. The last word on uh frequent mistakes is using food as a reward or as a punishment. So, for example, something like if you eat all your vegetables, you're gonna get dessert. So my personal observation is that this actually backfires in the sense that it makes unhealthy foods more desirable. It means that what you're offering as a reward is better or sweeter or something that should be earned. Uh, and indirectly it makes the unhealthy or the sweeter part of things more desirable. And it also enforces or promotes emotional eating patterns. So try to avoid that as much as possible. Every now and then that's fine, but if you make it a daily thing, this will often backfire. So treat all foods neutrally as much as you can and avoid laboring uh avoid labeling some foods as good and others as bad. So food is a nourishment, it's not a bargaining tool. So, in conclusion, I would like to say that uh raising a healthy eater is not about controlling every bite, it's about creating a calm, consistent environment where children can learn to enjoy food over time and to create healthy eating habits. Before we leave, I would like to answer some of the questions that were sent to us by the listeners.

SPEAKER_00 25:50

First question from Amina 27 from Kigali. I just had my first baby and everything scares me. Every cry and every small change. I'm constantly checking if I'm doing things right. How do new parents manage this level of anxiety?

SPEAKER_01 26:05

This is a very frequent scenario where mothers especially feel overwhelmed. You've just had a baby, first couple of days and weeks of life of your baby, you're trying to get used to each other, you're sleep-deprived, uh, probably everybody is on top of you, demanding for breast milk. And it can indeed be overwhelming. And at the same time, uh having a reassuring environment, getting some good rest is all important as part of your recovery and as part of your journey as a new parent. So the first thing I always say is if your baby was born full term, was born at the right time, and they're healthy, they were checked at birth, there's no health concerns, your baby is able to feed and do all the normal things that a newborn baby is doing, that should reassure you that you have a healthy baby. Now, uh I often prefer to have having a routine check is very important, uh, especially the first two weeks of life, because it helps us establish if your baby is actually adapting well, if they didn't lose too much weight in the first week of life, and if there's uh if the other common uh concerns are not there. So, and this is really a time to also reassure you that you are doing well and your baby is doing well. Now, if you're a naturally anxious person that wants to check everything and gets worried about everything, about every cry, I would say that you need to be patient with yourself. Make sure you have the right support around you, prioritize rest. So do the important things first. Make sure that you give them time. You rest enough, you hydrate, and use the support around you, whether it's your spouse or any other help. And this is a phase that usually goes away. We typically see uh, for example, infant colic where your baby is crying quite a lot uh for abdominal discomfort between the third week and maybe two, two and a half months. And that also often drains parents. But again, most of these anxiety-causing scenarios are actually pretty normal phases of growth. So I think um get routine checks so that you're reassured and use the support around you and be intentional with your rest and taking care of your health.

SPEAKER_00 28:58

Second question from Alan31, living in Nairobi. I switched from a very active job to an office job, and within a year, my body completely changed. Weight gain, back pain, and low energy. It feels like my body is deteriorating just from sitting. What's really happening?

SPEAKER_01 29:16

So you might have heard it say that prolonged sitting is the new smoking. So most people that have office jobs or jobs that keep them seated on the table for hours and hours and hours, or often in long meetings, it's very bad for your health. It's not a surprise that you start to feel pain because of posture and because of prolonged sitting, understandably. Uh, of course, weight gain because, you know, if you're taking calories and then you're sitting the whole day with minimal or no physical activity, that could also predispose to unusual weight gain. So we often say that at least every hour, and nowadays there's a lot of prompts. People put prompt in their phones, for example, that if you've been sitting for an hour, you get a prompt that actually reminds you to walk around the office, maybe walk around the block, stretch your legs, and get your blood circulating. I think simple intentional measures like that really do make a difference.

SPEAKER_00 30:26

Last question from Patrick38 from Kigali. It feels like kids today are surrounded by junk food, snacks, sodas, and fast food. Even when I try to control it at home, they're exposed outside. How much damage does this actually do long term?

SPEAKER_01 30:42

So unhealthy foods, um, highly sweetened drinks like sodas, uh, junk food in general are really an epidemic. And you know, if you look at uh countries like the United States, where more than 40% of the population are battling obesity, these are really at the heart of the problem. And a similar scenario is actually happening in our setup. In fact, my next podcast is going to be dedicated to infant and childhood obesity because it's a growing problem, particularly in the urban populations here, or in what we like to call middle class families. So we have an epidemic going on that should be addressed. This is a big problem because it actually rewires or changes the how the metabolism of your child works. And often the side effects or the outcomes of these bad choices have a lifelong consequence. So it's not something to be minimized. And it takes a lot of discipline, discipline from the parents and the family in general, how you cook your meals, what you buy. I can give an example of my house. You know, in my house, I think most of the people really love bread and pastries and things of that nature. So we got to a point where we decided that these will be bought once a week. We had that agreement. So, meaning it's not even there. If you work in my house on Monday or Tuesday or Wednesday, you won't find any pastries or any breads. And we had to find alternatives. So I think it's doable. You can build a routine, you need to inform yourself because the impacts of poor choices, especially in early childhood, really have a lasting negative impact. The good news is that it can be avoided and it can be controlled. Thank you for listening to Healthy Beginnings. If you have any questions you'd like answered in the next episode, you can submit them to our email, healthybeginningspodcast at gmail.com. You can also follow us on all social media platforms. You can find us on YouTube as well as the audio platforms of your choice. See you next week.

SPEAKER_00 33:17

This podcast is for general informational and educational purposes only. Do not make health decisions without consulting your doctor. This podcast is brought to you by LF Media, home of great African podcasts.