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Listen to Portland based nutritionist Katharine Jeffcoat as she discusses the intricacies of dealing with picky eaters and talks about how she helps parents raise mindful and competent eaters.

How do taste and smell play into picky eating?

I am also so happy to hear Katharine talk about how letting a child skip a few meals till they are hungry just doesn’t work for all kids.

If you are interested in a free Ebook to get you started with powerful strategies to expand and reverse PICKY EATING, check out this free downloadable Ebook HERE.

 

Audio Transcription: 

Vaish:

A picky eater ever change their patterns. You’re listening to functional nutrition for kids. I’m your host Vaish and I’m super excited to bring you today’s guests an expert on picky eating Katharine. Katharine is a registered dietician nutritionist with 20 years of experience with a career focused on children. She believes that all children and teens are born to be intuitive eaters, and can be successful in self-regulating their own food intake to nourish their bodies. With the guidance and positive role modeling of their parents. katharine helps parents navigate the how, what and where of feeding in order to raise children who are mindful and competent eaters. Welcome, Welcome, Catherine, I just want to say that I’m so grateful to have been able to connect with you and how awesome that you’re based in Portland. And looking forward to tapping your vast experience and learning more about tips for picky eaters and their parents.

Katharine:

Thank you. Thanks for having me. Reach forward to your questions today.

Vaish:

Yes, me too. So I’m just going to jump in. And as you know, picky eating is so pervasive these days. And I scarcely know a parent who doesn’t describe their child as a picky eater. So my first question is, when do children typically become picky?

Katharine:

Great question. And certainly, there are several different when it starts to develop that picky eating behavior, I find it most often occurs around the time a child is development, Delve developmentally 14 months of age, they separate themselves from their parents and realize they are their own individual. And they’re starting to discover that No, has a response. And, and they, that’s the start of learning that whole cause and effect. So a lot of the children, like most children will go through that picky eating stage, around that time, and depending on how it’s managed, will either get worse or just get resolved very quickly.

Certainly, some children will have a stronger sense of taste and smell. And that is really blaming our evolution, for even becoming picky eaters, which is a good thing. We want our children to stay away from poisons and harmful chemicals. And so this is a survival mechanism for children to be able to smell and taste very bitter, and foods and substances. And so so for some children, this can cause them to start refusing more foods, and with his bitter, bitter, strong taste preference. So, so that’s why really sticking with exposures. And presenting children with new foods is important, not just assuming they turn their nose up at it, that it’s never going to go. And so really the parents response to how they act is going to make all the difference.

Vaish:

We know that sensory processing disorders are are increasing, and there are more children with with sensory integration issues with just overall sensory processing issues. So that makes sense from what I can. I mean, this isn’t a scientific study, but I’ve just seen that there are more picky eaters today than yesterday. Is that your experience homeschool?

Katharine:

I mean, the majority of my practice is made up of picky eaters I feel like I see a lot of them.

You know, it’s I think we’re getting better diagnosing. Because even now we have a new term arfid avoidant restrictive food intake disorder, which when I first started practicing, this wasn’t a diagnosis and arfid is usually a child that’s accepting 20 or less foods, there’s high anxiety at meal time. Just putting a new food on their plate may may cause a child to break into tears. So it’s really overwhelming. For a child versus a typical picky eater, who maybe has foods in every food group, a child with arfid is is often like the same texture.

They have a safe kinda food, you know, foods, maybe 10 or 15 foods that are safe for them and they’re really rigid about going beyond that and they are a child that will not eventually eat, as in the advice most doctors give parents as an Oh, they’ll eventually eat just right. Just just wait it out. Well, there are certain children that will not eventually eat if you wait it out. And good to know because

Vaish:

Because where common piece of advice is I mean, probably from people that are not very familiar with bit picky eating, or you said arfid is accurate. The name of the I guess

Katharine:

arfid ARFID. Yeah. So, yes.

Vaish:

Probably people are not familiar with that. It’s just, you know, if you starve the kid for a day, they’ll eventually eat when they’re hungry enough. And that doesn’t always happen. Right? Yeah.

Katharine:

Right. Because especially ARFID Kids have very high anxiety around new foods, that tactile feel of food in their mouth, it’s overwhelming they have a stronger taste, there’s a lot that goes into, we’re still just learning. I mean, there’s not a there’s still more that needs to be learned about managing our fib. But they are anxious at meals and anxious since the adrenaline up the fight or flight responds that meal and appetite. So these children will not be hungry. And they will just be glad that they don’t have to eat and they will gladly just not eat.

Vaish:

So is choosy or picky eating something that parents should be looking to address. I mean, I think you kind of answered that question I was going to ask it. But for example, I mean, most people are just waiting for it to pass on its own. But if there is something like, like arfid, or even if it’s not our fit, if it just severely chooses to eat, that’s restrictive, I think, I think what you’re saying is pretty obvious that you need a feeder or a parent that is constantly looking to address the situation, correct?

Katharine:

Yes, definitely encourage parents to seek help sooner versus later. If food and eating become really a negative experience, it can certainly get worse.

If they are identifying that their child is stressed that meals their food preferences is getting smaller and smaller. And it’s just making mealtime miserable. Yeah, then, and there have missing food groups than getting help. It could be more of a sensory concern. I mean, there are so many different levels of picky eating, it’s just like one big bucket. But there are so many, you know, there are some kids that I’ve seen with picky eating that we realized later they have more of an oral motor delay. And it’s tough for them to move food to the back of their mouth to chew and they’re just nibbling from the front. And so there are things that yes, get worked, get some help earlier with a feeding specialist and occupational therapists, speech-language pathologists who work with that beating at a young age. So there’s so much that can be done at a young age, your parents are noticing that beading is just not progressing.

Vaish:

Right? And what you said about oral motor sounds so much like my son, so it took years of oral motor therapy before he’s even able to, you know, choose some foods that other people would take for granted. But

Katharine:

yes, oh, yes. Yes, for sure. Yeah.

Vaish:

So that actually brings us right to the next question about confounding variables, because eating itself is is is a pretty complex thing to address in terms of working with the child, what happens when there are additional diagnoses? Like it could be a DD ADHD or it could be an autism diagnosis, but you could choose any or all of these? Does it complicate the situation further in terms of how you work with the child? Does it make anything different?

Katharine:

Well, most definitely, when I’m working with a family who has a child with a DD or ADHD, if they’re on medication, this makes a huge difference. A lot of children just don’t have an appetite. And they’re not going to eat one and afternoon with their medications peeking. And so working with them, we just make the most out of breakfast and dinner and we make sure that they get a bedtime snack and that the foods they’re getting at this time are just really nourishing foods. I really know for ADHD, I know all kids really just encouraged just trying to make the majority what they’re, they’re eating or moving to remove processed foods, make sure we’re getting foods in all the food groups and you know, ADHD, it’s certainly extra important.

I mean, there are some links with kids with ADHD that, you know, additional preservatives or preservatives or chemicals can certainly not make it easier for them to focus on things I really try with these kids. I have my own ADHD child so I really try to make what she’s eating. Just really nourishing, and whole grains, fruits, and vegetables. And when she does have a bigger appetite, it’s making sure that what she is getting in is helping her grow because a lot of these kids with ADHD, we’re just really worried about them getting enough and they’re still growing right. And they have enough to focus on because they’re oftentimes not eating lunch. And just eating enough is often the problem with some of those kids.

Vaish:

A lot of these kids, I mean, when especially when kids are super restricted in the foods they eat, let’s, let’s assume some of these kids, the restricted foods are like super processed, and that’s often the case. So how do you balance that in terms of when you remove if you’re trying to make the food less processed, and that just kind of throws them off? I mean, they do worry that introducing foods that are less processed, that are more wholesome and nourishing introduces a level of, you know, further restriction if you know what I mean.

Katharine:

Yes, and yes, by all means, we, if they need to gain weight, we work at what they’re eating, already getting enough calories too, to gain weight.

If we’re trying to work on making small changes, it’s looking at what they’re eating already. I do what’s called Food chaining with a lot of picky eaters is making one small change that may be the shape of the food, the temperature of the food, the color of the food, just such a small minute change that’s very similar such as, for example, Nutella, may be swapped out for Justine’s hazelnut spread, it just has a lot less, less sugar in it. So it’s using that for, you know, maybe you look like an equal, it looks the same, it smells the same but for the child and maybe a slight change in the texture of it, that may slightly notice that just trying to make little small changes that can give them more nutrition with what they’re eating that more likely to be accepted for picky eaters, that something that looks similar.

Vaish:

Before I asked you for your top three recommendations, there’s, there’s a question that usually pops up when people are talking about picky eating. And there was this really sad and unfortunate story about a teenager who I think lost his vision because he was in Britain, and he was on a very severely restrictive diet. And I am familiar with many kids who are on similar super restrictive diets, and it’s a little scary when you think about it like that. And given that when you’re on a restrictive diet.

Obviously new to nutrient deficiencies are likely parents will ask if child give children should be taking vitamins. And the flip side of that question is if taking multivitamins kind of negates the need to fix within quotes, the restrictive eating patterns. So can you just take multivitamins and be done with it? And the other part of the question is should you be just should be taking multivitamins anyway, if your child is a picky eater,

Katharine:

or whatever it was, with families, I do have them take like a three to four-day food log, and we’ll review foods in each food group. And so when I do identify that there are actually missing food groups, such as when a child is eating the white food diet only like white bread, crackers, milk, and cheese, they’re missing fruits, specials, and complete proteins. And so with them, you know, they’re missing out on antioxidants, B vitamins, iron, and zinc, and having a multivitamin can be very beneficial.

Every time I work with a new family with a child with ARFID, I always recommend doing micronutrient testing, something I offer at my office that’s looking at nutrients at the cell level of where six months span and we can really narrow in what supplements they benefit from. So yes, you know, certainly taking a multivitamin for your child if they’re missing food groups. But when it comes to things like iron, I always like to see first as in well, what’s missing. I mean, I certainly have had just the kids that eat a lot of meat. It’s like no, they don’t need a vitamin multivitamin that includes iron in it. Because there are certain nutrients we want with the minerals. We don’t want to give them too much. But yes, that can certainly help if they’re missing food groups.

But getting them not a substitute for not a substitute completely. We can’t get the phytochemicals from in vitamins from the fruits and vegetables that we’re eating. So make trying to work towards bringing some of these in is always a great goal.

Vaish:

Okay, so I’m super excited for my next question, which is I know you have a beautiful program for parents to help picky eating. So would you be willing to share your top three recommendations for parents? Now obviously, the top question usually is how do you get restricted vegetables and try new foods?

Katharine:

Yes, yes. Well, really a core piece that I have I work with families on is falling what it what is called the division of responsibility.

This is the gold standard of feeding that was coined the term was coined by Ellen Sattar. She’s a dietitian and feeding specialist that’s been around since really the late 80s researching feeding with children and their families. And so what the division of responsibility is, his parents decided the what, when and where, what are we eating? When are we eating, they’re having a schedule and whereas in, we’re sitting at the table, and it’s up to the child to decide how much and if they’re going to eat. So remembering that children were born to be intuitive eaters, they trust them to know what their appetite needs, really keeping the parent in their own lane, not for speeding, not getting out of that division of responsibility. Because when the parent gets out of the lane, that’s when problems start really occurring. So step two is serving family meals. And family meals is such a wonderful opportunity for children to observe, see, smell, touch new foods, you know, they don’t have to eat them to be learning about new foods, they’re watching their parents eating, maybe they’re watching their siblings eating, they’re seeing them passed around the table, they’re smelling them.

Families that don’t have family meals, and their child just eats by themselves, like the same favorite food all the time, they’re not going to have those wonderful exposures that are necessary to accept new foods, right? And the last one, which is being consistent, as soon as the parent like lets the child win, or okay, we’ll let you know, they decide they’re gonna be shorter to cook, what do you want instead, you know, the child will know, hey, if I hold out long enough, they’re going to give me what I want, because it usually works one out of three times. And so when a parent’s not consistent, then the child doesn’t know what to trust. So So those really are foundational principles of helping your child prevent picky eating or certainly helping your child move forward when they are a picky eater.

Vaish:

And I love that so much. And I especially have so much. I love the first step that you said about remembering that children are intuitive eaters and remembering to build trust and just to, you know, to trust them. And I think it is so hard to do that, to remember that children are intuitive eaters. I can remember many times that I haven’t done that myself.

I thought you said something very interesting about parents remembering to stay in their lane. What do you mean?

Katharine:

Well, when in the division, the responsibility of parents is either what, when, and where the child decides how much and if they’re going to eat. So when the parent requires a child to take bites, or they can’t leave the table to eat their dinner, or that’s them getting out of their lane, that’s them stepping across that boundary of that’s, that’s not there, that’s not their decision to decide how much the child’s going to eat. And if they’re going to eat, it’s up for them to put the food on the table. And when we’re doing dealing with really picky eaters, we’re working with them putting some food on the table, like one or two things they know their child will eat. So the child can come to the table and not be stressed and have been anxious. But it’s not a parent’s job to like, make them eat.

Vaish:

Yes. And so, therefore, that negates the most commonly used technique of force-feeding. Yes, look at this screen and just put food in your mouth when it’s open kind of stuff.

Katharine:

So exactly right, distracting them, making them like not realize it, and then sneaking food and that’s certainly

Vaish:

so that’s a big break of the trust factor right there.

Katharine:

I would say yes, definitely. Most definitely.

Vaish:

Wow, this is so illuminating. I love that. And  I totally love these points that you brought in. Where can listeners find you and how can they work with you, Katherine?

Katharine:

Well, they can follow me on Instagram that’s at PDX_nutrition. I have a Facebook group called Raising confident eaters. It’s all about preventing picky eating and raising children to have a healthy relationship with food and their bodies. And my website is Portlandpediatricnutrition.com. And I have there some more information. I do have a picky eaters program. I’m kind of in the midst of one right now. It’ll be another series that will start up in January 2020.

This is a six weeks program to help families walk through unpicking their picky eater.

Vaish:

Nice. So I will have Katherine’s information, the Instagram page or Facebook page on her website on my Facebook group which is facebook.com\, /probably so facebook.com/functionalnutritionforkids. Well, thank you so much for joining us, Katherine. I’m so grateful that we got to talk to you today.

Katharine:

Well, thank you. It’s good to talk to you.

Vaish:

You’re listening to the function of nutrition for kids. I will be back next Thursday with a brand new podcast. Thank you.