What if my kid won’t eat vegetables?

When an infant starts experimenting with solid foods, their whole world expands. Like breast milk and formula, food is fuel for the body and a vehicle for love. But it is also a cornerstone of culture, and can define national identities. It provides entertainment and spreads joy. And it helps us understand the world and our place in it.

On this episode of Mayo Clinic Kids, we talk to Dr. Leslie Kummer, a primary care pediatrician with special interest in breastfeeding medicine, about beginning the weaning process, safely introducing kids to the wonderful world of food, and sharing the love.

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Dr. Angela Mattke: Hi, I’m Dr. Angela Mattke, a pediatrician with Mayo Clinic in Rochester, Minnesota, and I specialize in helping parents make sense of medical issues. On each episode of “Mayo Clinic Kids,” we talk to different medical experts to get the latest pediatric research and recommendations. This episode: nutrition.

My youngest was a challenge both with breastfeeding and with transitioning to food. He decided he wasn’t going to breastfeed anymore at like six to eight weeks of age and he quit and he wouldn’t breastfeed. When 12 months came around, I was really looking forward to it, being done pumping at that point. But the biggest challenge with my son was textures and different food groups.

I had to live on my own medicine because he would not eat, and he would not eat anything that was soft or pureed. I got to the point where I was like, “Oh my god, my child’s going to have scurvy. Like, what if he’s not getting enough vitamin C?” He would not eat any fruits, and he would not eat textures. I just kept giving it to him. That’s what we tell our patients.

Dr. Leslie Kummer: Yeah. Keep trying. Keep trying.

Dr. Angela Mattke: We tried, and we tried, and we kept trying. I remember the day that I came home and his nanny said he ate watermelon and he was two-and-a-half-years-old and it was like the very first real fruit that we got him to eat and we were ecstatic.

We were just like jumping up and down and stuff and now he won’t actually want to eat watermelon anymore, but he eats every other fruit and eats every vegetable known to man. I do believe if you keep exposing children and you eat them yourselves you can get them, even when they have severe sensitivities to textures and tastes and flavors, to try new things, but it’s challenging.

Dr. Leslie Kummer: I love that story because I think it just speaks to how common these challenges are. I tell my patients more and more, I think almost 100 percent of toddlers are picky eaters. It is something that can be a very developmentally normal thing. But there’s a range. It can be scary and frustrating as a parent, and you worry about, “Is my child going to get enough of what they need nutritionally?”

Dr. Angela Mattke: Are they going to get scurvy? When an infant starts experimenting with solid foods, their world expands. Solid food isn’t just fuel for your body. It’s a vehicle for love. It’s culture. It provides entertainment. It spreads joy, and it helps us understand the world and our place in it. But when you’re trying to build lifelong eating habits, there can be a lot of fear and pressure around this transition. Is my kid eating enough? Are they getting all the nutrients they need?

The classic question is: how do I get my kid to eat veggies? On top of that, some of the information about nutrition can also be confusing, or downright contradictory. How do we make sense of messy information and messy eating? How do we make sure our kids are building healthy bodies and appetites? Well, the voice you just heard affirming my own struggles was Dr. Leslie Kummer, a primary care pediatrician and international board certified lactation consultant, with a special interest in supporting families in the first few months and years of life. I’m talking to her about beginning the weaning process, the potential risks of picky eating, and how to get your kid to finally eat that kale.

Leslie, most of us who have little kids now grew up with the food pyramid as our main nutritional guide. But that food pyramid from 1992 has been tossed in the compost bin. What were the issues with that guide, and what do we use now specifically to help guide our discussions around what is good nutrition for children and adults?

Dr. Leslie Kummer:  I certainly remember a poster of the food pyramid, being in my classroom growing up and it was developed, like you said, in the 90s. It was really a public health effort to communicate to the public, what does a healthy diet look like or what are the recommendations from experts in nutrition. The intent was good, but the challenge with the food pyramid was probably too complex.

I remember it had information about the number of servings and how many cups or tablespoons and, I’m not going to keep track. It was challenging for people to follow and apply to their lives. Some experts feel that there was maybe a little bit of overemphasis on the breads, pastas, rices, and starch, the carbohydrates, but the more we learn about nutrition and the science of it and how it impacts our health, the more we recognize that most of us, as Americans, need to be eating more fruits and vegetables than we are currently and reducing some of our intake of things like, higher fat meats, oils, sugars, and processed carbohydrates.

In 2011, the USDA developed a different infographic, which was much more appealing, much easier to read and interpret. That one is called “My Plate.”

And I love it because it’s very simple. You can literally be like, “Okay, this is what my plate should look like when I sit down for a meal. You start by splitting it in half, and half of that plate should be covered with fruits and vegetables. Then the other half is going to be split roughly between some type of lean protein, and a whole grain carbohydrate with a serving of milk or other dairy on the side.

It’s nice because it’s not overly prescriptive where you’re worrying about amounts, but it’s really just communicating the main message that we want most of the foods that we’re eating to be coming from those fruits and vegetables for really optimal nutrition.

Dr. Angela Mattke: This new “My Plate” recommendation for how we approach food and different food groups, is it different for children or does it apply across the age spectrum?

Dr. Leslie Kummer: It really does apply across the age spectrum. I will say with my families in the clinic, I do emphasize even more the importance of some additional things that aren’t necessarily called out on “My Plate.” Things like limiting sugar-sweetened beverages. Then the other thing I think to consider for a child is just the size of the plate, right? Our portion sizes for a child, for a toddler versus a school-aged child versus an adolescent are going to be different than they would be for an adult.

Dr. Angela Mattke: One of the great things that I learned in working with the dietitians is the serving sizes for fruits and vegetables for kids is the size of their fist. That’s a really good way that you can use their fist to figure out as you’re plating things up for them and if they have enough, whether they are getting one serving or two serving or not enough.

Dr. Leslie Kummer: I love that, too. Often families come in and we ask them every time, “How many servings of fruits and vegetables is your child eating?” And they might be thinking, “Well, gosh, an adult serving. No way does my child eat that.” But actually, we don’t expect them to be eating an adult-sized serving.

That fist, that’s a great reference for families to use to know what amount would be appropriate. Another tool that I’ve heard is, about one tablespoon of fruits or vegetables for each year of life. Again, those portion sizes are just very small and it’s more about variety.

Dr. Angela Mattke: What’s different for the nutritional requirements for an infant or a baby? And why?

Dr. Leslie Kummer: When I’m talking with families in my clinic about transition to solids, particularly for babies that have been exclusively breastfed, one of the most important nutrients for them to start getting is iron. Basically, infants in the first four to six months are kind of coasting off of the iron that they got from the last three months of the parent’s pregnancy, but by the time they get to four to six months, they’ve really used up that supply of iron, which is critical for healthy brain development and growth. They need to start getting their iron from other foods.

Infant formula is iron-fortified. Breast milk is relatively low in iron, but it does have an extra substance in it that helps babies absorb the iron that’s in it. But, because we do expect that those iron levels are going to start to taper down around six months, it’s really important to start, those iron rich foods. We want to be very clear that children should not get cows milk or honey until they’re at least a year of age and that’s because their digestive tract is not mature enough yet to digest that milk and that can lead to health issues.

Dr. Angela Mattke: What are some of the signs that your kid is ready for real table food?

Dr. Leslie Kummer: The main thing is we really want babies to be able to sit well with support. If they’re in a high-chair or on the parent’s lap, I’d like them to really have that good head and neck control, be able to keep their head up, turn towards in a way to indicate when they want more, when they’re done.

Really the most important thing about that is being able to protect their airway. Because it’s a big, developmental step for them to be transitioning from that liquid diet to coordinating swallowing those more thick consistencies of food. We want them to be able to sit well.

Typically we’ll see them looking really interested in food, really eager, maybe the whole family sitting around the table and baby is eyes wide open, watching, and mouth opens as they look at the food the other family members are eating, that’s a great sign. Then generally babies will have reached about 13 pounds or they will have about doubled their birth weight at the point that they’re ready to start solids.

Dr. Angela Mattke: Okay, so my baby’s ready, and I’m ready. But how do I start this transition to food?

Dr. Leslie Kummer: I typically recommend starting with an iron-fortified, single ingredient infant cereal, like an oatmeal cereal or barley or rice. That’s number one for the iron and two because it’s generally easy to digest and pretty palatable for babies, and it’s easy to mix with formula or breast milk or a little bit of water. Then you can introduce one single-ingredient food every couple of days.

If you’re purchasing store-bought baby food, these are going to be the ones that are listed as stage one foods. It’s just one ingredient, they’re pureed to a nice, thin consistency, so easy for babies to handle.

The best part about this phase of the parenting journey is just how fun it is to watch babies expressions and their reactions as they explore. I often encourage parents to really not worry so much about the amount of food that the baby is getting, but have fun with it. It’s a time of learning and exploration. Get the baby undressed down to the diaper. Let them get messy. And let them just explore those different tastes, flavors, and textures.

Dr. Angela Mattke: That’s a really good point because sometimes I see families being a little hesitant to let their kids try and feed themselves. But that’s a really fundamentally important part of their fine motor development. And you don’t need to wait until they’re nine months to let them start trying to feed themselves.

They can start to do that at six months as they’re starting to develop that pincer grasp and being able to transfer things into their mouth and all those other skills that are really important that build on other skills later on. It’s okay! The mess can get cleaned up. I think parents just need to take a deep breath about that.

Dr. Leslie Kummer: Yes! Put a big mat down on the floor.

Dr. Angela Mattke: How should I introduce my kids to foods that might be really highly allergenic? For example, peanuts. Peanut allergy is really prevalent in Western society.

Dr. Leslie Kummer: The pendulum has really swung on this over the last five to ten years. When we were kids, our parents were told to wait until we were two or three years old to introduce these things.

But we actually have some really good studies now that have shown that there is really an optimal, almost like a window period, from about four to six months or when we start introducing solids, in which, if we start those potential allergy foods, which the most common ones are, peanut, eggs, tree nuts, fish, shellfish, wheat, soy, and milk, those children are less likely to develop allergies to those foods compared to those children that get them later in life.

There are some specific scenarios depending on your child’s medical history, so I would recommend discussing with your child’s pediatrician or family doctor what they recommend for your child.

Dr. Angela Mattke: Exactly, and those situations mostly pertain to eczema.

Families might have another sibling or relative living in that home who also has a food allergy, and that doesn’t mean we shouldn’t introduce it to that child, because actually those studies were done in children who had siblings who had peanut allergies specifically, and it reduced their incidence of developing peanut allergy. Talk to your physician and develop situations and plans to go ahead and introduce these foods if they deem it safe.

To reiterate, the goal here, we want about half our kid’s plate to be veggies and fruits, and the other half whole grain carbs and lean protein. When we say plate, we mean a kid-sized plate. For infants specifically, we also want to make sure they’re getting enough iron starting around four to six months of age. When we move to solid foods at six months, we want to start with single-ingredient foods.

But the most important thing: have fun with it. Let your kid get messy and explore.

Leslie, as I talked about earlier, my youngest did not like fruit. We also had problems with other things, and one of those was avocados. I remember the very first time I gave my oldest son avocado, he made the most disgusted face you can possibly imagine, and spit it out.

Of course, the good pediatrician I am, I kept offering it to him and offering it to him. Fast forward like 7, 8 years, he still doesn’t like guacamole, but I still offer it to him.

Many times in our office, we hear the question, “My kid won’t eat veggies.” Families are worried bad things are going to happen to their child. Is their child going to die from this?

Dr. Leslie Kummer: No.

Dr. Angela Mattke: Okay, good. But what do you tell these families? Like what happens, truly, if children don’t eat enough vegetables?

Dr. Leslie Kummer: It is really hard. We’re kind of hardwired to like sweet things, and it takes time and patience and more time and more patience. But it’s worth the time and it’s worth the effort to keep at it because vegetables have a lot of really important nutrients in them.

Some nutrients kids can get from fruits and from other foods, but there are certain nutrients that really only come in vegetables. It is important for us to get those particular things like fiber, potassium, Vitamin A — which is one of the most common nutrient deficiencies in the world — Vitamin C, antioxidants — they’re important for tooth and skin and hair development and development of our intestinal tract.

It’s worth the effort to keep working at it and find strategies. Sometimes that means sneaking things into food in clever ways. One of the things that my parents in my clinic often rave about are the pouches that have blends of apple and kale or pear and spinach because you know what? They’re getting those foods in, and we’ll work there. Baby step by baby step. We’ll get to those whole foods.

Dr. Angela Mattke: What about constipation? I see that as being a consequence for a lot of kids who are not getting enough vegetables specifically because they tend to have a lot more of that insoluble fiber sometimes than the fruits do.

Dr. Leslie Kummer: Yes, absolutely. I definitely see that too. I think, unfortunately what you could kind of characterize as the toddler diet like Goldfish, cheese, bananas is terribly constipating, especially during those potty training years, where really keeping the bowel movements comfortable and soft is so important for kids during that phase of their growth.

Dr. Angela Mattke: There’s a line between, “It would be good if they had some more peas with dinner, but they’ll be fine” and “Yeah, we’re seriously looking at the consequences.” How do you walk that line as a parent between fighting a battle or not?

Dr. Leslie Kummer: Again, it’s kind of a spectrum. Children especially, in years one, two, and three, they’ve got that emerging independence, they really want to have some control over their lives and this is one of the few areas where they do have some say in what they eat.

If we’re talking about there are some things that they’ll eat, but it’s maybe not as much variety as the parents would like, I don’t worry about that as much if the child is generally getting a range of fruits and vegetables, and is getting calcium and vitamin D from dairy, and getting iron and protein from the foods that they eat.

But, if you’re in a situation where your child is not eating any vegetables in any form whatsoever despite multiple attempts, or certainly if you’re starting to see physical signs or symptoms in your child, or if a child has a condition that makes absorption of nutrients more difficult, those are definitely situations where we want to pay closer attention.

Dr. Angela Mattke: Someone once taught me that kids have to pay the rent at the end of the week, meaning like some days they might eat a bunch of fruits and some days they might eat a bunch of vegetables, and other days it’s only grains. Then one day, all they wanted was protein and stuff like that.

If, in the course of a week, they pay the rent to kind of get a variety of different foods, then you’re doing okay. But some days and some meals are just complete hit or miss.

Dr. Leslie Kummer: I also tell families, especially in those toddler years, it’s very normal to go through phases like, last week we were all about raspberries, this week we want nothing to do with raspberries. Eventually they will circle back to them. Parents should keep in mind some kind of division of responsibility. Parents are in charge of what is being served, when and where it’s being served, and then the child is in charge of how much they’re eating at a given meal.

The caveat to that is that there’s a lot of kids that will snack throughout the day, and they’re just not as hungry when mealtime comes around, so of course they’re not as interested in eating the chicken or the veggies that you’ve prepared for them. Finding that balance, parents really focusing more on the quality, and letting children learn to regulate their own appetite based on their hunger and fullness cues is important.

Dr. Angela Mattke: Now zooming out, when you think about the big picture that those everyday efforts add up to, what’s the official or technical definition of malnutrition in kids?

Dr. Leslie Kummer: It refers to basically either deficiencies or excesses, or an imbalance in somebody’s intake of energy and nutrients. We think of it as three different categories. One would be under nutrition, and this would be things like if a child is underweight, is kind of stunted, has a very low height for their age.

You can also have nutrient deficiencies, so a lack of or limited vitamins and minerals.

I would say in the United States, the things that we see most commonly are iron deficiency, we see that a lot here. Especially in Minnesota and the Northern latitudes, we see a fair amount of vitamin D deficiency.

I don’t necessarily check it regularly, but I do talk with my adolescent patients quite a bit about making sure they’re getting enough calcium intake as well, just because of the huge amount of growth that’s going on and promoting healthy bone development.

Then we also think about malnutrition as including overweight and obesity and some of the diseases that are related to that, like heart disease, stroke, and diabetes.

Dr. Angela Mattke: You mentioned vitamin D deficiency, low amounts of iron or iron deficiency as being the most common things that we see in our practices. How would those present and what would parents know to look for?

Dr. Leslie Kummer: Often we will pick up on iron deficiency actually with our routine screening that we do in infants, which is typically done around 9 to 12 months of age. We screen at that time particularly for kids that we think are at higher risk for having low iron because that’s the point where we expect they’re going to be at their lowest.

Some of those kids may — if it’s iron deficiency, but that hasn’t gotten to the point where it’s affecting their red blood cells and their body’s capacity to carry oxygen around the body — they might not have any symptoms at all, but sometimes they might show signs like fatigue, sometimes sleep disruption, being really restless at night.

If it progresses to the point of anemia where their hemoglobin is low, if that goes on for an extended period of time, untreated, that can actually have very significant consequences for children’s brain development and cognitive development.

I will check vitamin D levels for kids if there’s certain risk factors for low vitamin D. Children that are darker and have higher melanin levels in their skin are at more risk for vitamin D deficiency, so I might check them particularly if I have concerns about dietary intake of vitamin D-rich foods. Children that are struggling with obesity, children that are struggling with disordered eating, and also sometimes children that are experiencing depression symptoms I will check as well.

When we think about signs of undernutrition, we might look for things like if you’re noticing weight loss, like “my child’s clothes are fitting much looser than previously,” potentially changes in hair, brittle nails, fatigue that seems like it’s gradually coming on and worsening, mood changes — often kids that are experiencing nutrient deficiencies will be more irritable. They might experience other mood changes like anxiety or low mood.

Dr. Angela Mattke: How can I tell the difference between my kid being picky or it actually being like a medical biological issue? You’ll sometimes hear people talking about food sensitivities or even some types of eating disorders. Is there a way to sort this out?

Dr. Leslie Kummer: This is where a conversation with your child’s doctor is really helpful. But again we’re looking at a case of extremes. If you’re starting to see any physical signs or symptoms — that fatigue or just loss of energy, if a child is having diarrhea, stomach aches, nausea, weight loss, they’re showing difficulty with their growth — those are all definitely red flags that this child may actually be having difficulty digesting or absorbing nutrients or is having a reaction to the food.

Dr. Angela Mattke: Sometimes as an eating disorder doctor, I’ll see kids with really distinct food preferences and sometimes back themselves into an eating disorder where it truly affects their growth in a harmful way where we’re not seeing them gain weight, but then also seeing their length being affected, we’re seeing their puberty be delayed.

That gets into a category of a specific type of eating disorder called avoidant restrictive food intake disorder, or those in the news like to call it ARFID. But these kids have a prevalent pervasive pattern of either having some type of associations with foods, such as fear of choking, gagging, inability to eat them, that causes them to avoid foods and then not grow because of it and affect their physical and emotional health, or sometimes they’re just kind of extreme pervasive pickiness.

These are the kids that we see in our office that’ll have like five foods they eat, and  it’s like they only eat a certain type of french fries, a certain type of chicken nuggets, shaped a certain way, prepared a certain way, one type of yogurt, and like bananas or something like that.

Those can be really concerning, but we as pediatricians don’t know what’s going on unless you share with us what the foods your kids are eating and tell us about your concerns so we can help sort out whether this is just like picky eating or you’re onto something here. I’m concerned too. Let’s talk more about it.

Good news! If your kid’s picky, odds are they’re just being a typical kid, and not every mealtime needs to be Instagram-worthy, perfectly balanced. Just make sure they’re getting everything they need over the course of a week or so.

Severe nutritional issues are rare, but if you notice any problems with your kid’s weight, growth, digestion, or mood, that would be a good time to talk with your doctor.

Now, my oldest son did eventually learn to love avocados! After years of offering and him rejecting it, one day he got a cookbook from my family and in it was a recipe for avocado toast. And he picks that as his first recipe. Avocado toast! And so he made it and thought it was the next best thing. That was his journey, but there’s lots of different paths. Let’s talk about day-to-day tips and techniques for healthy eating.

Leslie, what can we do to make sure our kids are healthy and growing and getting all the good stuff from their food that they really need?

Dr. Leslie Kummer: As a parent, kind of day to day, some of the big things are just having patience. This is a process. Children, when they start taking those first early steps, they kind of wobble and fall, and we don’t give up on them right away.

We get them back up. We encourage them, we cheer them on, we keep giving them opportunities to practice. It’s the same thing with encouraging healthy eating. Then the importance of modeling.

We are our children’s most important role models in life, and so the more that we are able to eat those healthy foods sitting at the table as a family, staying active as a family, getting those kind of behaviors ingrained as just part of regular everyday life, that goes a long way because children want to emulate their parents. When they see us trying new things, then they’ll be more likely to try new things too.

Dr. Angela Mattke: In some cases we’re not just talking about food preferences and picky eaters, but we’re talking about kids that have real medical concerns like allergies or maybe families that practice as vegetarian or vegan. How do we help accommodate and make sure the children are getting appropriate nutrition in these situations?

Dr. Leslie Kummer: For things like food allergies, I think parents educating themselves, learning as much as they can about how to maintain an allergen-free environment at home, communicating with friends and family members, communicating with the school, having an anaphylaxis action plan at home and at school so that family members know what to do in case there was an emergency that happened.

Sometimes, it’s like, it was cupcake day at school or a child’s birthday and they aren’t able to have the same food as the rest and that’s hard. It’s really hard. But, planning ahead as much as possible, sending the child with an alternative snack that is fun for them and that helps them celebrate with the rest of the group can help.

When it comes to other dietary preferences like keeping a vegetarian or a vegan diet, I think about it in terms of we just need to make sure that we’re getting all the nutrients that our body needs.

It is okay if they’re not coming from animal sources. We just need to make sure that you’re getting a plant-based source of protein, iron, B vitamins, zinc, some of those other minerals.

Dr. Angela Mattke: When families practice a strict plant-based diet, meaning vegan specifically, I usually say, if you’re concerned about it, these are situations to start a multivitamin to make sure they are getting enough of those B vitamins, folate, iron, those kinds of things. It takes the pressure off of you worrying that your child’s not getting enough, but you can still find vegan or vegetarian-based multivitamins to supplement those situations.

For families that are eating a vegetarian diet, if they are incorporating eggs they have good amounts of essential amino acids in them, as well as protein. But there are other vegetarian foods such as tofu, seitan, beans, legumes, and nuts. You can get all of the essential nutrients from these things, but kids need to eat them. If they’re not eating them, then they might not be getting enough protein specifically.

Same with a vegan-based diet. In American society, a lot of kids’ early protein and fat does come from cow’s milk-based dairy and we need to make sure that if you are giving them some type of alternative, it’s not one that has zero grams of protein in it.

I usually recommend soy or pea because they have the highest amount of protein, and then an oat-based one would be kind of a step down. Now, let’s talk about picky eating. What can we do for kids that are picky eaters? What are some solutions and tangible things that parents can do?

Dr. Leslie Kummer: I talk with families and some of the things that I’ve tried with my own kids as well are things like changing up the way you’re preparing food. Maybe they don’t like it in those mashed potatoes, but they love a baked potato and getting to add some things on top of it. Maybe trying something with a dip that’s kind of fun, like a hummus or ranch dip that might encourage a child to try something that maybe they weren’t willing to previously.

Sometimes combining a food that they like with something that’s more of a challenge that can help encourage them. A couple of things that I’ve enjoyed really trying with my own kids is engaging them in the process of meal planning and meal prep.

I’ll bring my 12-year-old along shopping with me and he’s in charge of planning one meal, and he has to choose a veggie and a fruit and a main part of the meal as well.

We have a cookbook and I love seeing them page through it and find things that they want to try. Then we also have just a small garden out on our deck, so some tomato plants and some kale and some peppers, and I’ve found that can help them to be more excited about trying things that they might not otherwise try because they grew it themselves.

Dr. Angela Mattke: One other thing I would add is that sometimes as parents, we try not to do any harm, but when our kid doesn’t eat things and they’re picky, we stop trying to serve them things and we only give them things they’re going to eat because we’re so concerned they’re not going to grow and they’re not going to have any nutrients, but I think the best thing I can say to you is just don’t only give your child things that you know that they’re going to eat because that’s how they get pickier.

Because if they know you’re just going to give them X, Y, and Z food, they won’t even try the other things, but you have to be willing to take chances. Kids will eventually eat when they’re hungry. I promise you no kid is going to starve themselves if they don’t have an eating disorder. If they’re just normal children, they will eat when they’re hungry, so stick to it.

Do you have any specifics about when and how often we should be trying new things with our kids or asking our kids to try new things?

Dr. Leslie Kummer: I don’t know if I have a one-size-fits-all answer. When they’re sort of hangry or when they’re overtired, that might not be the time to try something new. Honestly, once or twice a week, there’s a balance that we just have to strike. I often encourage families to present the child at any given meal with a couple of things that they know that they’ll eat fairly consistently and maybe one new kind of challenge food, so it maintains that expectation that “yep, we’re gonna try this.”

If you’re starting to get to the point where mealtimes are a battle, if you’re feeling a lot of resistance or tension, or it’s just not pleasant anymore, that’s the point to take a step back, take a break and talk with your child’s pediatrician or family doctor if you have concerns and then re-engage with some support.

Dr. Angela Mattke: Absolutely. If you’re a parent who has not introduced the new things before and you are ready to take that step, sometimes it can be really challenging, especially if the expectation from your child previously has always been like, “I don’t like what mom’s making so she’ll make me something different.”

There’s going to be a lot of initial push back, and we call that an extinction burst in behavioral terms. They’re going to resist a lot and there might be some big feelings and big behaviors, but that should be expected. There’s ways that you can counterbalance these by getting kids involved with making some of those choices of the new things they are going to try.

Do you want to try this or that this week? When do you want to do it? Bringing them involved with some of those acceptable choices can really help them try to engage in the things that they’re going to do.

Kids are going to be really wanting to engage but also knowing that, “yeah, we’re going to try things” and maybe the expectation is that you don’t eat all of it the first time, but maybe you like to put it in your mouth and you chew up a little tiny piece.

Dr. Leslie Kummer: It kind of goes back to baby steps. Our colleagues who are amazing in occupational therapy that work in the feeding clinic, they will often, with those kids that are just really resistant and have maybe even a lot of anxiety around trying new foods, they might just start with, “let’s look at the food, let’s smell the food” and just kind of getting used to that, tolerating that. Then we advance, like, “we’re going to give the food a kiss, we’re gonna lick it,” and again, it’s just baby steps.

These are all interactions, and it’s all progress, it’s practice, and it sometimes can feel really slow, but just with a lot of patience and some good support around you, you can make progress.

Dr. Angela Mattke: Absolutely. I keep going back to my son not wanting to taste anything that was soft or squishy or anything that was fruitlike, and we were celebrating anytime he would touch it, he’d put it to his mouth, anything. It was like he hit a home run. We were yelling, hooting, hollering.

The feeding clinic people taught me you should be able to hear them in the next room because kids thrive on positive attention. If you’re only giving them negative attention for when they’re trying those things, they’re not going to be really willing to try it or engage in that, so give them all that positivity. You got to make a really big deal about even those tiny moments, like you were saying, those baby steps.

Dr. Leslie Kummer: Fill that cup.

Dr. Angela Mattke: Fill the cup! Awesome. Dr. Kummer, thank you so much for joining us. This was such a great discussion. I just really enjoyed hearing how you speak about it too, because I can take some of these nuggets from you and incorporate them into my interactions with patients and families so, thank you.

Dr. Leslie Kummer: Yes. I feel the same way. Thank you so much for the opportunity to join you. This was a lot of fun and I hope we can do it again sometime.

Dr. Angela Mattke: If your kid’s hesitant to try new things, it’s time to get creative. Prepare foods in a new or fun way. Get them involved! Bring kids into meal planning, prep, and even buying or growing foods to give them a sense of control and connection to what they eat. But regardless of what tips or tricks you use, the most important thing is don’t give up. While it can be a struggle to get kids to eat, patience and persistence are the best tools you can have as a parent. Don’t forget to have fun! Celebrate those wins, no matter how small.

That’s all for“Mayo Clinic Kids.” But if your kid has something else going on… or you have a topic suggestion, send us an email at [email protected] or leave us a voicemail at 507-538-6272, and we’ll see if we can help you out.

Please remember, this podcast cannot provide individual medical advice and the discussion presented here cannot replace a one-on-one consultation with a medical professional. If you act now, you can take home your very own, one-of-a-kind jumbo-size popsicle stick absolutely free. Okay, thanks for listening!