Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food

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Abstract

Objectives

To determine the prevalence of infants and toddlers who were considered picky eaters, the predictors of picky eater status and its association with energy and nutrient intakes, food group use, and the number of times that caregivers offered a new food before deciding their child disliked it.

Design

Cross-sectional survey of households with infants and toddlers (ages four to 24 months) was conducted.

Subjects/setting

National random sample of 3,022 infants and toddlers.

Methods

Data included caregiver’s socioeconomic and demographic information, infants’ and toddlers’ food intake (24-hour recall), ethnicity, and caregivers’ reports of specified times that new foods were offered before deciding the child disliked it.

Statistical analyses

For picky and nonpicky eaters, t tests were used to determine significant mean differences in energy and nutrient intakes. Logistic regression was used to predict picky eater status, and χ2 tests were used for differences in the specified number of times that new foods were offered.

Results

The percentage of children identified as picky eaters by their caregivers increased from 19% to 50% from four to 24 months. Picky eaters were reported at all ages for both sexes, all ethnicities, and all ranges of household incomes. On a day, both picky and nonpicky eaters met or exceeded current age-appropriate energy and dietary recommendations. Older children were more likely to be picky. Those in the higher weight-for-age percentiles were less likely to be picky. The highest number of times that caregivers offered a new food before deciding the child disliked it was three to five.

Applications/conclusions

Dietetics professionals need to be aware that caregivers who perceive their child as a picky eater are evident across gender, ethnicity, and household incomes. When offering a new food, mothers need to provide many more repeated exposures (eg, eight to 15 times) to enhance acceptance of that food than they currently do.

Section snippets

Sample

Caregivers who had children four to 24 months of age were recruited for the Feeding Infants and Toddler Study (FITS). Methodology for the cross-sectional survey of 3,022 infants and toddlers has been published (34).

Data collection

Telephone interviews were conducted with the primary caregiver residing in an identified household. For all participants, data included one 24-hour recall (with nutritional supplements) of the child’s food intake, ethnicity, weight and height, and the primary caregiver’s

Sample

Of the sample, 51% were males and 49% females. Ethnicity was 77% white, 7% non-Hispanic black, 10% Hispanic, and 6% “other” or multiracial groups. The mothers ranged in age from younger than 15 years to 40 years or older, with a majority of mothers aged 20 to 34 years when their study children were born. Participants represented mostly urban and suburban households, with about two-thirds of the sample reporting household incomes ranging from $25,000 to $99,999.

Frequency and prediction of picky eater status

The primary caregivers who

Discussion

The FITS provides the first national data on the prevalence of caregivers who perceived their infants and toddlers as picky eaters. Unlike the FITS, most studies about food acceptance involve mostly white children who were older than 24 months of age 13, 15, 16, 17, 18, 19, 22, 25, 26, 27, 28, 29, 30, 31, 32, 33. We found that the prevalence of picky eater groups was reported for both sexes and among children from families with varying household incomes. Furthermore, all ethnic groups in the

Applications

  • Dietetics professionals need to be aware that the prevalence of children perceived as picky eaters was evident in both sexes and all ages, ethnicities, and household incomes.

  • When new foods are introduced, caregivers should provide tasting opportunities more frequently than they do at the present; between eight to 15 repeated exposures to a new food may be required to enhance the child’s acceptance.

References (47)

  • L.L. Birch et al.

    I don’t like it; I never tried itEffects of exposure on two-year-old children’s food preferences

    Appetite

    (1982)
  • L.L. Birch et al.

    Infants’ consumption of a new food enhances acceptance of similar foods

    Appetite

    (1998)
  • L.V. Harper et al.

    The effect of adults’ eating on young children’s acceptance of unfamiliar foods

    J Exp Child Psychol

    (1975)
  • A.T. Galloway et al.

    Predictors and consequences of food neophobia and pickiness in young girls

    J Am Diet Assoc

    (2003)
  • S.F. Schakel et al.

    Sources of data for developing and maintaining a nutrient data base

    J Am Diet Assoc

    (1988)
  • G.A. Falciglia et al.

    Food neophobia in childhood affects dietary variety

    J Am Diet Assoc

    (2000)
  • P. Pliner

    Development of measures in food neophobia in children

    Appetite

    (1994)
  • H.M. Hendy et al.

    Effectiveness of teacher modeling to encourage food acceptance in preschool children

    Appetite

    (2000)
  • J.D. Skinner et al.

    Do food-related experiences in the first 2 years of life predict dietary variety in school-aged children?

    J Nutr Educ Behav

    (2002)
  • E.S. Weigley

    Changing patterns in offering solids to infants

    Pediatr Nurs

    (1990)
  • H.P. Sarett et al.

    Decisions on breast-feeding or formula feeding and trends in infant feeding practices

    Am J Dis Child

    (1983)
  • A.L. Wright et al.

    Infant-feeding practices among middle-class Anglos and Hispanics

    Pediatrics

    (1988)
  • M.A. Lauver et al.

    Infant feeding practicesThe effect on six-month weights

    J Kansas Med Soc

    (1981)
  • Cited by (0)

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