Question from a patient: Maddie (13 months) used to eat anything on her tray but we are now in a picky phase. She throws food and yells if she doesn’t like it. The other night the only thing she would eat for dinner were blueberries. She ate half a pint lol. She seems to still like fruits and veggies best, so I was thinking we should always serve these first…and if she fills up on these no big deal. What do you recommend for the other behavior and how should we handle the pickiness? I don’t mind giving her extra of healthy food, but I also don’t want her to think she can yell and then immediately get something different (healthy or not).
Answer: First, I’m thrilled that Maddie loves fruits and veggies best. So many babies by a year of age prefer starchy carbs and are rejecting veggies that I can tell you have really offered a great diet throughout her first year, and Maddie has an “accepting” palate.
At this age, several things are in play. Maddie’s growth rate is slowing down, so she doesn’t need to eat as much. From birth to the first birthday children will triple their birth weight but between ages 1 and 2 most babies will only gain another five pounds or so the whole year. At that slower rate, they surely don’t need to eat as much and that is why they will often start eating much less at meals and will be much choosier about what they eat. The problem is that parents worry when their children don’t eat as much as they think they should, and will resort to all sorts of things to get their children to eat out of worry.
Another thing happening at this age is that toddlers are often drinking more than they need either because they haven’t yet been weaned off the bottle or because they have large sippy cups or constant access to them. If toddlers are drinking a lot (whether it is during the day or at night), they won’t be as hungry at meals and will reject food.
The other major factor in play for toddlers is their growing independence. Even at the tender age of 1, babies are becoming individuals and expressing their own wants and preferences. They are trying to assert control and seeing where their influence can get them. If parents let them, toddlers can rule the roost and actually this makes for very unhappy toddlers and parents alike.
My advice for Maddie’s parents was to not offer fruits and veggies first, but rather offer a complete meal with protein, fruit, veggie, and carb all at once and let her go at it. If she throws the food on the floor right away, end the meal. No second chance. She will not starve to death and she will quickly learn that throwing food isn’t OK. If she eats the food provided, she can have unlimited seconds of fruits and veggies but it’s important to encourage a continued broad palate of proteins and healthy carbs too rather than just preferred foods, even if they are healthy.
If she learns that she can upend the tray and get her preferred foods (or even reject the meal more politely and get preferred foods), she will get pickier and pickier over time. If she’s hungry, she will eat what is provided and if she’s not, she may indeed eat a whole pint of blueberries but in the long run you may end up regretting the fact that you encouraged a picky eater. In Maddie’s case, I did suggest offering milk at the end of the meal since she would often drink all her milk and eat little, but by holding off she would still drink it even though she ate pretty well. That strategy often works. All a toddler needs is 4-6 ounces of milk with meals and one other cup of milk with a snack. Look at the bottom of your sippy cups to see how many ounces it holds and fill it accordingly.
All in all, Maddie is a great eater and her parents are doing a great job creating a healthy attitude toward food in their home. I’m glad, though, that she’s not going to feed the dog quite as much going forward!