Parental Feeding Practices and Associations with Children’s Food Acceptance and Picky Eating
Lisa R. Fries and Klazine van der Horst
Many parents report that their children are picky eaters, with this behavior peaking at the age of 2–5 years. Some of the most common behaviors of picky eaters include limited dietary variety, neophobia, food refusals, less enjoyment of eating, and sensory sensitivities [Fries et al., unpubl. data], and this can be a source of stress for families during mealtimes.
Parents can influence their children’s mealtime behavior through the feeding practices they use when offering foods. This feeding relationship is a 2-way interaction, with children’s behaviors also affecting the parents’ feeding practices . It is important to evaluate how parents can effectively intervene when encountering difficult eating behaviors in their children and to give them useful alternatives to parenting practices that have been shown to be counterproductive in establishing healthy eating habits.
Parents often give up after a food is refused a few times, but they should be encouraged to keep trying, as children may need to be exposed to a food several times before it is accepted. Different preparation methods change the taste, texture, and appearance of foods, and certain variants may be better accepted by children. Children can also become more familiar with food by cooking together with the caregiver  or even playing with food products.
Coercive feeding practices such as the use of pressure to eat should be avoided, as this can create negative associations with the food or meals, and could lead to more food refusals [3, 4]. Instead, one of the most successful ways to convince a child to try a food is for another person to model eating and enjoying it . When families eat meals together and consume the same foods, this provides an excellent opportunity for modeling. Parents who give a reason why the child should taste something, such as by talking about the good taste of the food or its nutritional value, rather than simply telling them to eat it, may also help children be willing to taste a new food. This practice can also create intrinsic motivation for the child to eat the food in the future, as they will appreciate the food for its own properties (e.g., taste and health benefits), rather than only eating it when they expect an external reward.
Another practice to avoid is using one food as a reward for eating another food, as this can have negative short-  and long-term  consequences, such as food refusals and decreased liking of the target food. In contrast, non-food rewards, such as praise or stickers, can be used to encourage children to taste a food without creating these negative outcomes . It should be noted that such rewards should be reserved for encouraging children to taste a food, but the child should not be required to finish the food. Using any kind of extrinsic rewards for plate cleaning can override children’s internal satiety cues and lead to eventual overeating.
It may be tempting for parents to prepare separate meals for picky eaters, but providing an alternative meal for a child who refuses the food initially offered reinforces the food refusal behavior. Further, if children are regularly provided with a limited range of “accepted” foods, this reduces opportunities for the child to experience new tastes or to have additional exposures to foods that they have not previously accepted. Thus, this behavior can perpetuate the child’s limited diet. As some children refuse foods as a way of expressing independence, parents may be able to avoid rejections by providing choices between 2 healthy options, as this allows children to express a preference without saying “no” altogether.
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