What to Do with a Picky Eater

By Dr. Karen Sadler

Q: My two-and-one-half-year-old daughter is a very picky eater. She has been since my wife stopped breastfeeding. She never liked baby food or anything that looked like baby food. Now she'll eat some breakfast (toast, bagels, cereal without milk), but won't eat meat (except hot dogs). She is still having two to three bottles a day. Is she getting enough nutrition from just pasta, cheese, fruit, cucumbers, and broccoli? I feel badly giving her the same things over and over.

A: Toddlers are notorious for being picky eaters. Instead of living to eat, like many of us, they eat to live, and even that may seem like an overstatement!

Simply put, a growing body that is deficient in the necessary building blocks won't grow well, so seeing the expected height and weight gains between child visits is the first way we reassure ourselves that picky eaters are healthy.

As for the limited variety, don't worry. It is more important that your daughter's intake covers the food groups, providing the required vitamins and minerals, proteins fats, and carbohydrates. The short list you provided does a pretty good job at that: Protein is provided by the milk and cheese; pasta gives her carbohydrates as well as some B vitamins; and fruit and broccoli provide even more vitamins.

The one pitfall in her diet, which you can, and should, do something about is the bottle. Toddlers allowed to continue on bottles tend to use them as a quick filler to take the edge off hunger, which then kills their appetites at the next meal. Bottle use also promotes tooth decay, even if she isn't sleeping with it. We recommend around 16 ounces of milk per day for two year olds. More tends to constipate them.

The only nutrient deficiency that is fairly common in picky eaters is iron, and this can be easily detected in a simple blood test. If found to be low, iron levels can be replenished with iron supplementation or sometimes just a multivitamin with iron.

So, don't worry about the limited variety for now. Encourage her to try new foods, but without pressure. Have her screened for iron deficiency and begin the process of taking her off the bottle.

Oh, and remember that there are millions of parents in the exact same boat as you who are raising normal, healthy children.

Dr. Karen Sadler

Pediatrics
Dr. Karen Sadler is a board certified pediatrician who has been working in the Boston area for thirteen years. She completed her medical studies at Harvard Medical School in 1988 and went on to her residency at Children's Hospital Medical Center in Boston. The mother of three, Dr. Sadler is committed to healthcare for the underprivileged, as well as medical education. She is an associate instructor of pediatrics at Boston University School of Medicine and sits on numerous committees including the Massachusetts State Women Infant Child Program.

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