“Picky eating is an American problem. If children were not offered junk or fast food to begin with, they would have better palates for healthy food and they wouldn’t be so picky about what’s on their plate.”

This argument gets tiresome. With all due respect, there is so much more going on with picky and selective eating that simply cannot be solved by putting homemade and wholesome food in front of someone. If it were only that easy.

A recent meme using flags to show traditional foods of countries around the world paints the US as a nutritionally dismal place. A flag full of hot dogs? C’mon! Where are the Napa Valley orchards? The Boston clam chowder? The Florida oranges? Canada’s food flag doesn’t look much better, all that bacon and maple syrup arranged into a maple leaf. Not that I’m complaining.

Photo credit Huffington Post

Even in a stereotypical sense, America and her bountiful offerings of carbon-copied food served through a car’s driver-side window is not the limit, nor the cause of feeding issues. Mind you, it is comforting to know that when the homemade and wholesome stuff has been refused for the gazillionth time, there is that cardboard container of deep-fried french fries just a short car trip away. Unless you walk in these shoes, you cannot possibly understand the relief and comfort that comes from knowing your child has (finally) eaten. Something.

“Between 20% and 60% of parents state that their young children are not eating optimally, that is, that they are too selective or “picky,” eat too little, fail to advance to more complex food, or eat “junk food.” Whether these concerns are warranted or not, parents often resort to a variety of strategies, including using pressure or force, to try to improve matters. Yet the negative consequences that may flow from such attempts to change feeding behavior, especially the use of coercion, can broadly compromise parent-child interactions.” ~Dr. Benny Kerzner,  Department of Gastroenterology, Hepatology, and Nutrition, Children’s National Medical Center, Washington, DC.

Parents have similar mealtime frustrations not just in America, but all over the world. At a well baby clinic in Thailand, researchers sought to determine the prevalence, characteristics, and factors related to feeding problems in typically developing children. After excluding children with organic feeding problems, premature birth and developmental disability, 26.9% of the 402 children included in the study sample were identified as having some form of feeding problem.

A study conducted to determine the key aspects of picky eating and feeding difficulties among Singapore families reported 25% of parents feel their child (age 1 – 10 yrs.) is consistently picky about food, and 49.6% of parents report feeding difficulties occur all the time. 20% of families say feeding difficulties began around one year of age.

This Australian study says that preschool children’s everyday food preferences are strongly associated with food neophobia. This common stage in child development is associated with reduced preferences for all food groups, especially for vegetables, and a less varied range of food preferences. Food neophobia in children has also been studied in the United Kingdom, Finland, Canada and the United States, just to name a few. 

This small sampling of science should be enough to convince any skeptic that there really are children who won’t ever be hungry enough to eat the healthy, homemade casserole outside of America’s borders. As research from Duke University proves, issues with food can persist long after childhood.

Back to the study from Thailand…

As statistics for childhood feeding issues and food neophobia are fairly consistent across international studies, it is reasonable to conclude that the types of feeding issues should also follow suit. The researchers in this particular study identified four distinct categories of childhood feeding problems that have no underlying medical pathology.

Highly Selective Intake (57.4%)

This category describes children who are able to eat, but avoid food with certain sensory qualities (appearance, smell, texture or taste). Food refusal goes well beyond the typical resistance to a new food. Selective eating children often follow a consistent pattern of weight gain along low, middle and high percentiles. Selective eating can persist through adolescence and into adulthood.

Little Interest in Eating (25%)

These children are more interested in their environment than in eating. Feeding issues typically become noticeable during the transition from spoon to self feeding. Often referred to as Infantile Anorexia, these children do not communicate hunger and appear to lack interest in food, but show strong interest in exploration and interacting with parents. 

Limited Appetite (16.6%)

Parents expect their child to consume certain amounts of food, and misunderstand the child’s natural cues of hunger and satiety. The child appears to eat very little, yet continues to follow a consistent pattern of growth, often below the 25th percentile for weight.

Fear of Food (1%)

Children in this category typically have had a terrifying experience with food (choking) and refuse ALL food. In some cases, children will also refuse liquids, including their own saliva.

Just to make things more interesting, childhood feeding problems rarely present as simply as the above descriptions. It is not uncommon for a feeding challenged child to have characteristics from two or more of the above categories.

Back to the drive thru window…

It is extremely unlikely, not to mention dangerous, to attempt to fix a feeding problem by restricting access to food, as this can significantly diminish the dietary options that the child can eat. We are talking about children who will NOT eat for reasons that are far more powerful than hunger. We are also talking about children who need to know, despite a limited diet, that they WILL be fed. The nutritional quality of whatever trusted food your child eats, no matter how reprehensible it may be, is still better than not eating at all.

Because that very frightening fact IS the alternative.

The next time someone claims that picky and selective eating is the result of America’s dependence on fast food, you can confidently explain that childhood feeding issues have little to do with the quantity of drive thru queues or the quality of the food. Feeding issues are a global concern, and exist in any country that has children in it. 

Which one do you live in?