Is Your Picky Eater at Risk of Underweight or Malnutrition
This article has been professionally reviewed by Dt Wen Ni Sin, a registered dietitian of Malaysian Dietitians Association (MDA).
As a parent, you’ve likely faced the challenge of a child who turns their nose up at anything that isn’t pasta, fries, or some other “kid-approved” food.
Picky eating is common, especially during the toddler and preschool years, but it can leave you wondering, especially when it persists until the preteen years: Is my child getting enough nutrition? Could this selective eating put them at risk of being underweight or even malnourished?
Picky Eating among Children
Picky eating usually peaks between the ages of 2 and 6, a time when children are developing independence and may assert control over their food choices. While many children outgrow this phase, some may continue to be selective eaters, which can cause concern for parents worried about their child’s nutritional intake (1, 2).
When Should You Worry?
Most picky eaters still manage to get enough nutrients to support their growth, even if their diet is limited.
However, it’s important to be vigilant if your child (2, 3 , 4):
- Is significantly underweight and/or has a much shorter height compared to their peers.
- Showing signs of deteriorating learning performances and mood swings.
- Frequently complains of being tired or appears less active than usual.
- Consistently avoids entire food groups, like vegetables or proteins.
- Shows little interest in eating or refuses meals altogether.
If any of these signs sound familiar, it might be time to take a closer look at their diet and consult a healthcare provider.
Contributing Factors to Nutritional Risks
Several factors can contribute to the risk of a child being underweight or malnourished (1, 4, 5):
- Protein Deficiency: A child who is picky about eating may not be consuming enough protein-rich foods like meat, dairy, or legumes, which could lead to protein deficiency.
- Protein helps to rebuild cells and tissues, and is crucial for growth, immune function, and overall health, so protein deficiency in children can significantly affect their growth development and overall health.
- Protein helps to rebuild cells and tissues, and is crucial for growth, immune function, and overall health, so protein deficiency in children can significantly affect their growth development and overall health.
- Limited Food Variety: Consistently avoiding entire food groups, such as vegetables or proteins, can result in a lack of essential nutrients, leading to deficiencies.
- Nutritional Imbalance: A diet that is high in sugars and refined carbohydrates but low in fruits, vegetables, and whole grains can lead to an imbalance in nutrient intake.
- Reduced Appetite: Some picky eaters may have a reduced appetite, making it difficult for them to consume enough calories and nutrients throughout the day.
If your child shows signs of being underweight or has slowed growth compared to their peers, it’s important to consider these factors. They might be indicative of deeper nutritional issues that need addressing.
The Risks of Being Underweight
Children who are underweight may not be getting enough calories, vitamins, and minerals necessary for their development. This can lead to:
- Delayed growth: Your child may have a shorter or smaller stature compared to their peers, as insufficient nutrients can slow down physical growth and bone development.
- Weakened immune system: A lack of proper nutrition can make it harder for your child’s body to fight off infections and illnesses, making them more susceptible to diseases.
- Cognitive and behavioral issues: Malnutrition can affect brain development, potentially leading to learning difficulties, mood swings and behavioral problems.
Tips to Support a Healthy Diet
Ensuring that your picky eater gets the nutrients they need doesn’t have to be a battle. Here are some strategies to help (2, 3, 5):
- Offer a variety of foods: Encourage trying new foods by offering them alongside familiar favorites. Even a small taste can help expand their palate.
- Make mealtime fun: Create a positive eating environment by involving your child in food preparation or turning meals into a fun activity.
- Focus on nutrient-rich options: Sneak in nutrients by adding pureed vegetables to sauces, smoothies, or baked goods. Consider fortified foods or age-appropriate supplements if necessary.
- Use nutritional supplements when needed: While whole foods are always the best source of nutrition, children with more severe picky eating habits may benefit from nutritional supplements to prevent further nutrient deficiencies. Consult a healthcare provider for guidance on appropriate supplements to ensure your child’s needs are met effectively.
When to Seek Help
If you’re concerned that your child’s picky eating is putting them at risk of being underweight or malnourished, don’t hesitate to consult with a paediatrician or dietitian.
They can assess your child’s growth and provide guidance tailored to their specific needs.
Remember, every child is different. While picky eating can be frustrating, with the right approach, you can help your child develop healthy eating habits that will set them up for a lifetime of good health.
References
- Gahagan, S. “Malnutrition.” Nelson Textbook of Pediatrics, edited by Robert M. Kliegman, et al., 21st ed., Elsevier, 2020, pp. 396-407.
- Taylor, Caroline M, and Pauline M Emmett. “Picky eating in children: causes and consequences.” The Proceedings of the Nutrition Society vol. 78,2 (2019): 161-169. doi: https://doi.org/10.1017/S0029665118002586
- Samuel, Tinu Mary et al. “A Narrative Review of Childhood Picky Eating and Its Relationship to Food Intakes, Nutritional Status, and Growth.” Nutrients vol. 10,12 1992. 15 Dec. 2018, doi: 10.3390/nu10121992
- Mok, Kai Ting, Serene En Hui Tung, and Satvinder Kaur. “Picky Eating Behaviour, Feeding Practices, Dietary Habits, Weight Status and Cognitive Function Among School Children in Kuala Lumpur, Malaysia.” Malaysian Journal of Medicine and Health Sciences, vol. 16, no. 2, 2020, pp. 91-102, eISSN 2636-9346. 10.47836/mjmhs.18.4.3.
- Scaglioni, S., et al. “Factors Influencing Children’s Eating Behaviors.” Nutrients, vol. 10, no. 6, 2018, p. 706. https://doi.org/10.3390/nu10060706.