BABIES & NURSING

A Grandfather’s (and M.D.) Take on Nutrition for the Picky Eater

By: Michael Roizen, MD

October 6, 2016

My wife and I recently welcomed our first grandchild, a healthy baby girl named Julien. As a doctor, my wife always asked that I save my “practitioner” recommendations for my books and not push them on our children. The health and wellness research I read – and continue to reference today – was a big part of raising our children and giving them the best nutritional start we could. I am sharing a summary of the advice I would give my children (and my new granddaughter), if I were allowed.  These recommendations are based on scientific studies and experts, including the advice of pediatrician and co-author Ellen Rome of my book, YOU Raising Your Child.[1]

We have all seen kids who decide that the only thing worth eating is a chicken nugget or a bowl of pasta – and that is it.

Oh, the picky eater, the child who asserts that he likes only a few things and refuses to let his tongue touch anything else. In fact, after breast-feeding, almost no child (not even the perfect eaters) eats a balanced enough diet to ensure he or she gets 100 percent of the recommended daily value of all essential vitamins, minerals and essential fats.

Many breast-fed babies may be deficient in adequate levels of vitamin D2/3, unless you are supplementing with 6400 IU of vitamin D per day or more.  The only other way to get active vitamin D2/3 is through exposure to sunlight; however, infants should not be exposed directly to sunlight.[2] In accordance with the American Academy of Pediatrics (AAP), I recommend that all infants of mothers who are breast-feeding, supplement with vitamin D drops. The AAP recommends 400 IU of supplemental vitamin D per day beginning in the first days of life for all breastfed.

In addition to vitamin D2/3, infants and young children typically do not get enough of vitamins C and E, carotenoids (lutein and zeaxanthin) or the healthy fat, DHA omega-3. Vitamin C deficiency can lead to scurvy [3], while vitamin E, DHA, zeaxanthin and lutein are important nutrients for normal development of the brain and eyes. Many infants over six months of age and young children do not eat a variety of fruits and veggies to get very important nutrients. I look at vitamin supplements as an insurance policy from an inadequate diet for young children.

I conducted an informal survey of pediatricians who shared the real issue of picky eaters.

Of course, it is not one of taste, but it is one of control. To avoid raising a picky eater (or going to combat during a food war) try these meal-time strategies:

  • Provide lots of choices, and do not be afraid to parallel cook. If junior never eats fish, then have a different protein available and encourage eating fish when there is positive peer pressure to try it. For instance, when junior’s best buddy, who eats fish like a champ is coming over, plan to have fish for dinner. Observation of peers, older siblings or cousins can be a powerful motivator.
  • Food repetition is okay, as long as there is balance overall, or a multi-vitamin makes up the difference. Children may go for days, weeks or months wanting only peanut butter and jelly, or whatever the latest taste preference may be. While it may drive you nuts, look on the bright side: You have an easy meal that goes down without a fuss. Choose organic fresh peanut butter made from only ground peanuts, available at most health food stores; the emulsifiers in commercial peanut butters stimulate latent allergic tendencies.
  • Though we typically do not see eating disorders in children until about the age of seven, that doesn’t mean the groundwork is not established early. To avoid raising a child with an eating disorder, you can do a couple of things. For one, try not to obsessively talk about your own weight or your partner’s; the constant verbal barrage sinks in. Also, try to make meals fun: a time of communication, even of playing games (just not with food).

Thanks for reading. Feel free to send questions to youdocs@gmail.com and follow me on Twitter @YoungDrMike or subscribe to the YOU; The Owner’s Manual Podcast at RadioMD.com.

References

1.      Roizen MF, Oz MC.  You Raising Your Child.  New York: Free Press;  2010.

2.      Bruce W. Hollis, Carol L. Wagner, Cynthia R. Howard, Myla Ebeling, Judy R. Shary, Pamela G. Smith, Sarah N. Taylor, Kristen Morella, Ruth A. Lawrence, Thomas C. Hulsey. Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics, 2015; 136 (4), 626-634.

3.      Popovich D, McAlhany A, Adewumi AO, Barnes MM.  Scurvy:  Forgotten but definitely not gone.  J Pediatr Health Care 2009; 23:405-415.

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