Picky Eating: A Toddler's Approach to Mealtime

Mary Cathey; Nan Gaylord

Pediatr Nurs. 2004;30(2) 

In This Article

The Role of Personal Preferences

In addition to the belief that picky eating is a developmental phase, research provides support for the fact that children demonstrate personal preferences, which will help determine the food choices they make. By reviewing the psychologic influences on dietary intake of children found within the literature and tying them in with her own ideas, Birch (1998) concluded that few food preferences are innate. Rather, they are found through trial and error of the child. When these preferences are determined, young children simply eat what they like with no regard to fat, cholesterol, or sodium content. She purports that these preferences, when considered in the context of family values, attitudes, and beliefs and with respect to emotional states, help determine future dietary and intake patterns (Birch, 1998).

Fisher and Birch (1995) provide further evidence on the importance of food preferences in the development of eating behaviors. The authors studied children aged 3 to 5 years old to determine the importance of food preferences in the development of dietary intake patterns. The researchers observed each participant's 24-hour food intake from prepared choices that consisted of healthy and unhealthy food options. Each child's actual intake was compared with the results of the Fat Preference Assessment obtained earlier in the study. The authors hypothesized that children with a strong preference for high fat foods were more likely to eat foods high in fat. This proved to be true as the measured fat intake ranged from 25% to 42% of total consumed energy. The higher percentages were observed in those children demonstrating a greater preference for high fat foods (Fisher & Birch, 1995). Understanding the role of preferences in dietary choices of toddlers is critical to identifying appropriate interventions to address neophobic food behaviors.

In examining the importance of personal preferences in toddlers' food choices, a brief discussion regarding the impact of exposure to novel flavors via mother's milk in breastfed infants is critical. Mennella, Jagnow, and Beauchamp (2001) hypothesized that exposure to a particular flavor in breast milk or amniotic fluid would modify an infant's response to and acceptance of that flavor when transitioned to solid foods. In a study of 46 mothers and their infants, the authors offered one group of pregnant women carrot juice 4 times per week during the last trimester of pregnancy and water during the first 2 months of lactation. The second group was given water during the pregnancy and carrot juice during lactation, while the third was offered water throughout both pregnancy and lactation. At about 6 months of age, the infants' diets were complemented with cereal. Approximately 4 weeks later, the flavor of carrot was added to assess responses. Each mother rated her child's enjoyment of the new food item according to a 9-point scale with 9 indicating the food was liked very much and 1 implying that the food was not liked at all. The researchers analyzed each infant's response based on facial expressions and negative responses including gaping, head turning, brow lowering, and nose wrinkling. These authors found that the infants exposed to the carrot flavor prenatally or in breast milk exhibited fewer negative responses and facial expressions when presented with it when weaning to solid foods, thus supporting their hypothesis (Mennella et al., 2001). This significant finding lends support to the idea that food exposures may play a pivotal role in acceptance of novel foods and unfamiliar flavors.

An earlier study examined the outcomes of garlic ingestion by nursing mothers on the odor of their breast milk and the subsequent suckling behaviors demonstrated by their infants. Mennella & Beauchamp (1991) found a significant increase in the odor of the mother's milk approximately 1 hour after ingestion, during which time each infant tended to nurse longer and suck more. These early breastfeeding experiences may play a significant role in the development of food preferences.


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