Food, Glorious Food: How to get your picky toddler to eat healthfully

I recently received a joke about food. It essentially said that you cannot eat pork because of swine flu, you cannot eat chicken because of bird flu, no beef because of Mad Cow Disease, no fish because of mercury, no fruits and vegetables because of pesticides… You get the drift. The conclusion was that we should subsist on M&Ms. As a huge chocolate lover, I cannot disagree.

Underneath the joke is the push and pull we all feel on a daily basis about what is safe and healthy to eat. It is hard enough to figure out what we are going to eat that won’t make our cholesterol sky rocket and that won’t put us in the poorhouse. For parents trying to provide healthy choices for their children, the issue is even tougher.

Most toddlers and young children tend to gravitate to “white” foods: Cheese, pasta, macaroni, goldfish crackers, cookies, etc. So while it's fine to say, “place a well balanced meal in front of a child,” that does not mean he is going to eat it. I know many toddlers who seem to live on air. They literally seem not to take a morsel of food for days on end. On further questioning, many of these children are filling up on milk or juice, but they certainly don’t seem to care if food is available or not.

I tell parents who are trying so hard to provide healthy food for their recalcitrant toddlers not to worry. It has been said that no child ever voluntarily starved himself, and I agree, assuming food is available, and the child is not sick. I find that when I see these “starving” kids, they are usually growing just fine. Somehow they are getting enough calories to thrive despite their lack of interest in food. When looking at a toddler’s diet, it can be helpful to look at the whole week’s worth of food. I ask parents if in the course of a week, the child hits all the food groups and most say, “Yes,” with a possible exception of vegetables.

My advice is to provide a healthy choice of foods at meal times, with healthy snacks in between. If the child does not want the food, fine. Don’t make the mistake of chasing him around the house all day, trying to get him to eat. And don’t make special “white” food meals for him all the time. Once in a while, sure. Eventually, if you have family meal times, he will sample the goods and take an interest. Try not to get emotionally invested in your child eating, as he will pick up on it, and food can then become a tool of manipulation. Sometimes it becomes a weapon.

In this country, obesity is a far larger problem than failure to thrive or malnutrition, so if your pediatrician thinks your child is healthy, relax about his intake in terms of quantity. Too much milk is not good, as it can be constipating and cause a feeling of fullness. Three servings of milk or dairy per day are enough. Avoid juices except a little orange juice— 4 ounces is enough. And continue to offer healthy choices. If the rest of the family eats healthy foods, most likely your child will eventually, too.

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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