Time to re-think picky eating?: a relational approach to understanding picky eating

Background: Estimates of picky eating are quite high among young children, with 14-50% of parents identifying their preschoolers as picky eaters. Dietary intake and preferences during the preschool years are characterized by slowing growth rates and children developing a sense of autonomy over their feeding and food selection. We argue that the current conceptualization of picky eating defines acts of resistance or expressions of preference (acts of autonomy) by a child as deviant behaviour. This conceptualization has guided research that uses a unidirectional, parent to child approach to understanding parent-child feeding interactions.

Objectives: By reviewing the current feeding literature and drawing parallels from the rich body of child socialization literature, we argue that there is a need to both re-examine the concept and parent/clinician perspectives on picky eating. Thus, the objective of this paper is two-fold: 1) We argue for a reconceptualization of picky eating whereby child agency is considered in terms of eating preferences rather than categorized as compliant or non-compliant behaviour, and 2) We advocate the use of bi-directional relational models of causality and appropriate methodology to understanding the parent-child feeding relationship.

Discussion: Researchers are often interested in understanding how members in the parent-child dyad affect one another. Although many tend to focus on the parent to child direction of these associations, findings from child socialization research suggest that influence is bidirectional and non-linear such that parents influence the actions and cognitions of children and children influence the actions and cognitions of parents. Bi-directional models of causality are needed to correctly understand parent-child feeding interactions.

Conclusions: A reconceptualization of picky eating may elucidate the influence that parental feeding practices and child eating habits have on each other. This may allow health professionals to more effectively support parents in developing healthy eating habits among children, reducing both stress around mealtimes and concerns of picky eating.

Keywords: Bi-directional research methods; Fussy eating; Parent-child relationship; Parental feeding practices; Picky eating.

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References

    1. Lumeng J: Picky eating. In Developmental and behavioral Pediatrics: a Handbook for primary care. Edited by Parker S ZB, Augustyn ME. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.
    1. Taylor CM, Wernimont SM, Northstone K, Emmett PM. Picky/fussy eating in children: review of definitions, assessment, prevalence and dietary intakes. Appetite. 2015;95:349–359. doi: 10.1016/j.appet.2015.07.026. - DOI - PubMed
    1. Dubois L, Farmer A, Girard M, Peterson K, Tatone-Tokuda F. Problem eating behaviors related to social factors and body weight in preschool children: a longitudinal study. Int J Behav Nutr Phys Act. 2007;4:9. doi: 10.1186/1479-5868-4-9. - DOI - PMC - PubMed
    1. Carruth BR, Ziegler PJ, Gordon A, Barr SI. Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food. J Am Diet Assoc. 2004;104:s57–s64. doi: 10.1016/j.jada.2003.10.024. - DOI - PubMed
    1. Needlman R. Growth and development. In: Behrman RE, JH KRM, editors. Nelson textbook of Pediatrics. 16th. Philadelphia: WB Saunders; 2000. pp. 23–50.