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picky eaters

Nutrition Experts Podcast Episode 09 Dealing with Picky Eaters with Sharon Somekh

July 2, 2018 by matheaford Leave a Comment

Sharon Somekh is a general pediatrician, loving wife and mother to 4 daughters.

After a decade of practicing general pediatrics and working with families, she realized that what she enjoyed most was helping parents with parenting concerns, and felt this is what would be most helpful in shaping their children’s futures. There often wasn’t enough time, however, while tending to children’s medical needs to address these concerns in the office.

She developed Raiseology to help parents with their parenting struggles and teach them how to raise resilient children in a modern world.  As a parenting consultant she hopes to make a difference for parents today while affecting the future of their children in a positive way.

Mathea Ford: [00:00:27] Hi there! It’s Mathea. Welcome back to the Nutrition Expert Podcast. The podcast featuring nutrition experts who are leading the way using food starts today. Right now with our next guest it’s great to have Sheron Somekh on the show today. Sharon welcome to Nutrition Experts. I’m excited to have you on the show and share your expertise with my tribe.

Sharon Somekh: [00:00:49] Thank you so much. I’m so excited to be here.

Mathea Ford: [00:00:52] We’re going to talk a little bit about picky eaters today. So, tell my listeners a little more about you and what you do.

Sharon Somekh: [00:01:13] Though, I am a General Pediatrician who currently is focusing on Parent Consulting and I help parents with their daily parenting struggles and focusing on how to decrease the anxiety that they’re experiencing surrounding parenting and allow them to really enjoy their children more. We do a lot of work on how to create more independence in their children. Even from a very young age and why that’s important and how that allows them to have a more peaceful home and how that prepares their children for the future.

Mathea Ford: [00:01:53] So what made you interested in the topic of picky eating?

Sharon Somekh: [00:01:57] So as a pediatrician in the office I found that I saw many many many families struggling with picky eating and not even in the office they see all around me with even children of friends of mine and family members that are very particular about how much variety they have in their diet and what types of foods that they’re willing to eat. I guess it surprises me sometimes how much parents are willing to roll with that and to what extent children are able to really dictate what they’re eating and for me as a pediatrician I found that that actually was detrimental to their nutrition and really led to a lot of failure to thrive and kids that had very little variety in their diet and sometimes really didn’t eat very much at all. I just feel that it’s an important issue to teach parents about and really help parents prevent or eliminate picky eating as early as possible.

Mathea Ford: [00:03:02] How do you identify a picky eater? Can you can give a description of a child that would be you know a picky eater? What would you say would be the signs of that?

Sharon Somekh: [00:03:14] Oftentimes, they have a list of maybe three or four things that they’re willing to eat. Many times it’s the same three or four things across many many children. So, you know French fries, chicken fingers, grilled cheese and macaroni and cheese tend to be for big ones but sometimes they are willing to eat what we would consider more nutritious foods. But there are just so few of them that the parents find themselves really needing to cater to a very specific diet that has no medical reason for it and that I think is one of the telltale signs.

Sharon Somekh: [00:03:50] So when I find I have a parent in front of me that is telling me they have to cook several different meals if they have more than one child. Just to please everyone or that she and her you know the mom and her spouse are eating different meals than their children. That always is sort of a red flag for me to make sure I’m asking the right questions to find out why that’s happening.

Mathea Ford: [00:04:16] How does it evolve in your experience that children get to a limited range of foods that they want to consume?

Sharon Somekh: [00:04:27] I have seen and believe that most children will go through a picky eating phase. Usually happens sometime between 15 months and 20 months or 24 months where suddenly foods they used to love or even foods they loved yesterday they no longer are really interested in not really sure why that happens but it does tend to happen pretty much across the board and I think that while most children go through a picky phase it’s really our response to that phase as parents that will help dictate whether or not it’s a phase or becomes a true behavior pattern. And so I think that picky eaters in a sense are created by our response to a picky phase. And what that means is basically if you have a toddler who is you see eating all sorts of foods and today you presented them with chicken and broccoli and they threw it on the floor they weren’t interested. If that jars you as a parent and causes you to then offer an alternative – a yoghurt from the fridge or something else that you think your child might prefer to eat – then you’re teaching your child in a sense that you know if you don’t want what I’ve prepared I will prepare you something different. Children are very smart. They learn very quickly. How you respond to these behaviors and they will behave accordingly next time. And so any time something served doesn’t look right to them or doesn’t feel right to them and they don’t want to eat it. If the parent is willing to offer an alternative then suddenly we end up with a list of very few items that they are willing to eat because they just keep asking for an alternative whenever food is offered to them.

Mathea Ford: [00:06:27] I’m thinking that the parent is obviously concerned with their child eating make sure they have enough food for the day that they’re not hungry and that would be a reason to offer an alternative. What is the philosophy that you would propose to kind of change that behavior? I mean…

Sharon Somekh: [00:06:45] Many of the things that we struggle with us parents and challenges we face as parents tend to be symptoms of sort of a bigger parenting philosophy. And often kids who are picky eaters are also children who present challenges with sleep because they’re just not as much attention to boundaries or consistency with boundaries in many of those homes. And so it becomes challenging. Whereas picky eating does fall into that category. I think the motivation for the parents behind that is very different. I think that there really is a true fear or worry when your child doesn’t eat, that they aren’t going to grow well. And sometimes it’s short sided and we think that if we give children food in the moment it will just help and they will eventually choose different foods in the future. But the reality is that that’s often not what happens and when I actually found in the office was that kids who were catered to and given a lot of sort of freedom as to what they were going to eat were actually children who didn’t grow as well. I think that there are two main ways that we sort of create bad food habits in our children. And one of them is force feeding or creating so much attention around feeding that children start use feeding time as attention seeking time. And then they don’t eat even on purpose just to get attention because they find they get attention when they don’t eat. And so that is one way that parents can sort of perpetuate a picky eating behavior. And then the offering of alternatives is another way because we’re so worried that if our child doesn’t eat dinner or lunch that they will be hungry. And then what might happen if they’re hungry they might not sleep well, they might misbehave and all that sort of causes us to think that if we offer the alternative at least they won’t be hungry. And so it’s usually not until later on when they really find that they’ve created a habit of picky eating in their children that parents seek help with it and really find that they need to backtrack in and fix it. And the way to fix it is really to be firm in what you’re offering. Right?

Sharon Somekh: [00:09:24] And I think a lot of it is has to do with mindset surrounding feeding and mindset is a huge factor here because if parents can really find it in themselves to change their mindset surrounding the worry about if their child has eaten then they will feel more comfortable presenting a plate of food and saying this is what there is. Take it or leave it.

Mathea Ford: [00:09:49] If you’re offering your child a plate of food that’s ahealthy plate of food and everybody’s at the table the child refuses to eat. How do you address that? Because that seems like another way around eating the healthy meal.

Sharon Somekh: [00:10:03] The first thing I would say is eliminate snacks even if it’s temporary you should eliminate snacks and if you have a hard time eliminating snacks then don’t buy them. So, don’t have things available that you don’t want your child to eat or that you think that you might cave with. The idea is really for your child to arrive at meal time hungry. Okay? If you’re tired eat a snack at 11:00 o’clock and lunch is at 12:00. Then they’re not hungry. And even if you put something that you want them to eat infront of them they may not eat it because they’re not that hungry. The idea is really to eliminate snacks until they’ve shown that they can increase their palate and eat more variety of food in a more structured way the way you want them to right? So, the way I see it is we as parents should be the ones to decide what and when our children are going to eat. And they should decide if they’re going to eat it and how much. And if your child is hungry they will eat. The second thing I would say is offer what you want them to eat.

Sharon Somekh: [00:12:35] And the third thing I would say is pay no attention to what they’ve even once you’ve set that plate in front of them. Feeding time should not be a source of attention for them. And basically what that means is you have to look of your mindset that it matters what they do. Right? And I set a plate in front of my child and you know for all eating together I’m eating with them but we’re not talking about food and we’re not talking about the specifics of what they’re eating or how much they’re eating. If my kids are eating and I am not eating with them for whatever reason I put a plate of food infront of them and I really do walk away and I don’t even pay attention. Now, they also don’t get anything after the meal if they haven’t eaten while so even if dessert is fruit they’re not getting any of they haven’t eaten their meal right? And then, if they’re they haven’t eaten their meal and an hour or two hours later they’re hungry. You really have a choice here. You either can say well you know you can eat at the next meal and then they’ll really be hungry at that next meal and you can offer whatever it is you want or you can offer them that same plate of food that they did not eat. Right? And so at least it gives them the opportunity to eat that food that you had already offered them. And it’s not always easy to do. Kids will have tantrums and you know sometimes they really do get frustrated. But if we give in to those tantrums then we’re perpetuating the behavior.

Mathea Ford: [00:13:57] So the attention they’re getting at meal time is related to maybe you know just having a discussion with the family about how their day went? What they’re doing and activities that type of thing and not about if you don’t eat your meat loaf you’re not going to get a dessert?

Sharon Somekh: [00:14:14] It’s just that way.

Mathea Ford: [00:14:14] Okay.

Sharon Somekh: [00:14:14] We Assume that dinner time or you know what was the best thing that happened to today? And what are you grateful for today? Not you know can you take one more bite of your chicken. Right? And if I did start the meal would say like “Okay, you have three bites” and I’m counting their bites. Then suddenly that becomes the focus of the meal and they learn that if they don’t eat those bites they’re going to get more attention because I’m going to do is say “hey, did you eat your rice. Right? And so it’s important because kids are smarter than we give them credit for. And they really do notice. I have a 3 year old and she tries. I mean she has her picky moments for sure where she doesn’t want to eat something and she happens to be a very very good eater. But she even has learned that there really is no other option and there are times where I’ll set a plate of food in front of her and she’s not interested. And she’ll say “I don’t like that” and I’ll say okay that’s great. You don’t have to eat it. You don’t have to eat anything I put in front of you. But there will be nothing else to eat.

Sharon Somekh: [00:15:11] And she’s only three and I will turn my back and within 60 seconds probably less she’s eating that same plate of food she just told me she didn’t like. Now, granted she told me she didn’t like it before she even tried it. Okay? But she does like it she just didn’t feel like eating in at that moment. Right? And once she realizes that there isn’t another option, suddenly she’s eating it and she’s eating it beautifully.

Mathea Ford: [00:15:33] Are there any conditions like medical conditions that you see that tend to lead to more picky eating? Or is there a way to kind of identify that a little earlier?

Sharon Somekh: [00:15:44] I do think that there are food sensitivities that we may not sort of notice right at first that could contribute to pickier eating. I know that there are kids for example that have gluten sensitivity or food allergies such as nut allergies or dairy allergies that may not have a true visual reaction that you might notice right away. And there have been times where we will discover a a nut allergy in a child. And then the parent will say “you know that’s interesting. They really tend to not like foods that have nuts in them and it may not be a severe allergy but it’s enough to make them feel uncomfortable when they’re eating it.” You know with those foods I think children will avoid them.

Sharon Somekh: [00:16:29] People are smart as kids are smart and they will avoid those foods and you may get frustrated until you do realize that there is a true sensitivity and if there is a food that you’re noticing specifically that your child is avoiding it would make sense to have them tested and maybe see your physician and talk about it and have that discussion. But I don’t recommend necessarily only offering one type of food in in every meal. You want every meal to be balanced. And so for me I offer my children a plate that seems more balanced where I’m offering the protein and you know vegetable and sometimes after a carb or starch to go with it and I let them decide what they’re going to eat. So, in the event that one of them had [my kids don’t] if one of them had a gluten sensitivity and every time the pasta they noticed that they were having bellyaches and they maybe couldn’t put their finger on it but they just they just don’t like it for that reason then they don’t have to eat the pasta. They can eat whatever it is that I’ve put on their plate besides the pasta.

Mathea Ford: [00:17:29] So, that makes me think do you allow them then to get seconds of when you obviously aren’t paying attention to specifically you know did they eat their whole plate? If they’re able to go back and get seconds for it if they want it more broccoli or something else instead of eating maybe the three things that you put on their plate they just ate one?

Sharon Somekh: [00:17:47] Yeah I think it depends on what they’ve eaten and how I feel about it. So, you know I do want them to have some sort of balance and so if I give that same plate with pasta, chicken and broccoli and all they ate was the pasta, I probably would not allow them to have more pasta without eating some of their chicken and some of their broccoli.

Sharon Somekh: [00:18:05] And I have had situations where I have to wait to offer vegetables in my house because my kids really are very good as vegetable eaters and sometimes they will get full on broccoli and not eat any protein. Right? And so I am a little bit more attentive to that I would say. And I try not to let them just eat one type of food. Although, I also feel that what they they’ve you know across the course of the day is equally important. And if I know that you know we had lunch and my child ate a big piece of grilled chicken for lunch I might not be as picky about how much protein they had at dinner.

Mathea Ford: [00:18:40] Okay that makes sense. You mentioned a few nutrition problems like failure to thrive or delayed growth. Are there any other nutrition problems that you see with picky eaters?

Sharon Somekh: [00:18:49] Specific nutrition problems. I mean certainly you know what picky eaters you can get certain vitamin deficiencies but we don’t really tend to test for those very often in kids specifically. And I would say the focus for better or for worse tends to be on their weight gain or weight loss or rate of growth. And there have been times where we’ve seen you know height delay like growth delays in terms of length and height as a result of poor nutrition but I would say the majority of kids don’t have such severe nutritional deficiencies. It’s not something that we tend to see all that often in practice.

Mathea Ford: [00:19:27] What kinds of things do parents say that lead to the recognition of a picky eater?

Sharon Somekh: [00:19:32] I think that it’s important to ask the questions so I usually ask you know how is your child’s diet? What kind of foods do they eat? Do you eat meals together as a family? It’s really more to get a sense I think when you ask those questions they start to open up about other things that may or may not be frustrating them about mealtime. And I think that most parents who are sort of cooking multiple meals for multiple people in the same meal time do get a little bit frustrated by that and I think parents who have picky eaters tend to get frustrated by the fact that their children are so particular. And so if you start asking questions even if they didn’t bring it up themselves they will open up and start talking about it.

Mathea Ford: [00:20:17] One thing that people sometimes say to me is I feel like a short order cook.

Sharon Somekh: [00:20:20] Yes.

Mathea Ford: [00:20:21] And that’s a big find like “Okay, you shouldn’t feel that way you should feel like you can cook one meal and have people eat it.”

Sharon Somekh: [00:20:28] And the other thing is sometimes parents are really picky eaters. It makes it hard because if you are not modelling sort of a variety in your diet it makes it a little bit more challenging to encourage your children to have variety in their diet. And I would encourage parents to be willing to try new foods just the same way that they’re expecting that their children are going to try and foods.

Mathea Ford: [00:20:55] That cracks me up a little bit because my father who is 86 years old lives with our family and he grew up in a time when you know he was on a farm and you ate what was put in front of you and you were hungry at the end of the day. He basically said I played him from him and he eats everything. It doesn’t matter what it is. He doesn’t ask anything he’s just like thank you for the food you know I’m going to eat.

Sharon Somekh: [00:21:21] That’s awesome!

Mathea Ford: [00:21:22] It is good because then the kids can’t say “grandpa doesn’t want it. It’s like grandpa’s like Mikee. He eats everything.”

Sharon Somekh: [00:21:28] Yes.

Mathea Ford: [00:21:29] So would you say that there’s any cultural changes related to families in eating that seems to be affecting the youth and and parenting that you’ve noticed?

Sharon Somekh: [00:21:43] So I think that there are a lot of cultural influences that affects picky eating. I find that it becomes a very big barrier to healthy eating habits. When grandparents are really emotionally invested in how much their grandchildren are eating and I see this a lot when grandparents tend to be more have more of a role in the day to day caregiving. Often there are cultural influences that cause a little bit of like force feeding. And when a child is sort of forced to eat that creates a very negative relationship with food and then it does start that cycle of getting attention for not eating and sort of not feeling comfortable around mealtime. It’s you know sometimes parents don’t realize how much of an impact that has and then to be honest they think that the current trends that we’re seeing in parenting, many parents are not creating strict boundaries or not saying consistent when they do create boundaries. And that can exacerbate picky eating behaviors because a lot of what we’re talking about is boundary setting sort of we’re being a little bit more authoritative. And if we are not authoritative in our parenting that lends to more freedom and choice in terms of food choices and often kids who don’t have the same experience that we do are not going to make the food choices that we want them to. And while I think that we should involve children in certain decisions and certainly hear their opinion and value that they have an opinion. Our experience really is valuable as well and we should be teaching them that we have more experience in certain ways and why we’re going to make certain choices for them.

Mathea Ford: [00:23:52] My mother-in-law when my kids were younger when they would visit she would say “you need to make a happy plate and a happy plate is a clean plate.” And I would say “no, we’re not going there because they need to eat you know if they’re hungry and full.” So, is it is that I do see that cultural difference with that. So that’s very interesting and I do. My children are a little older they’re 12 and 13 and we do when we make the menu plan say “you know you get to pick a meal one night” and my son gets to pick a meal one night and that way you know they’re learning the value of planning and preparing food and even being involved in making the food. But yes you’re right kind of it’s I do give them choices though. They know it’s a limited kind of you’ve got to pick a vegetable and a starch and meat. You know protein source type thing so…

Sharon Somekh: [00:24:50] Yeah. And I think that’s great! I mean I think it is great to involve them if you can in the planning and preparation and even cook meals with them because the even younger kids do tend to eat more variety if they have been involved in the preparation of a meal. I recognize that especially with older kids sometimes there are foods that they have tried many many times and they simply don’t have a taste for and I can appreciate that. I mean I’m an adult and there you know I don’t like cheese and nobody’s forcing me to eat blue cheese right? And for example, my 12 year old is not a fish eater. She just does not like fish and she has eaten it many many times and you know it’s one of the favorite foods of one of my other children. So, it’s interesting because when I make fish for dinner I am sort of faced with a little bit of a conundrum. Like my 12 year old really doesn’t eat fish. And is it something that I should be forcing her to eat? Well I don’t force them to eat anything. Right? But if she really wants to eat a protein and I’ve made fish I’ll allow her to prepare herself something that was left over in the refrigerator or something like that. And it’s really on a case by case basis and only if there is nothing else at the meal that I think she should be able to have as an alternative. I wouldn’t give my 3 year old that same courtesy. You know because she doesn’t have the same experience and call it you know not be fair or whatever it is. I think you have to give each child what they really need. And again I probably wouldn’t even give her that courtesy if she wasn’t already a pretty good eater and open to pretty much every other flavor.

Mathea Ford: [00:26:41] That’s kind of a little different in my mind because they’ve tried the foods as they get older they do develop their preferences but it’s also like they’re not eliminating entire food groups. Their preferences to not eat fish and that I can see that and especially as they get older allowing them that choice and freedom and the responsibility too. So…

Sharon Somekh: [00:27:04] I will say if I’ve prepared fish in a new way I do ask her to try it even if I know she doesn’t like fish and she knows she doesn’t really like fish. You never know. Right? So, I may make a Tilapia with pesto sauce or a salmon you know with olive oil and lemon. And she might have not had that before and she might think she hates salmon but she likes it prepared in this way and so I do ask her to try everything I make and I’m hoping that one day she’ll try and actually like it and sometimes she does eat it you know. So, I think we just have to be more persistent as parents and not sort of allow them to link it eliminate full food groups from their diet.

Mathea Ford: [00:27:47] So what are some simple changes a dietitian or a doctor could recommend to a family or mom or dad or whoever is the responsible caregiver to reduce some of that picky eating?

Sharon Somekh: [00:28:01] So I think that that recommending the elimination or significant decrease in the amount of snacks that are available is a big one right? So recommending that a child gets to the table hungry for a meal time is already going to increase the chances that they’re going to try new foods. I think that with you can recommend for parents what we talked about sort of having the children help with planning a mealtime and really being firm on the idea that there aren’t going to be alternatives at mealtime. With older children I think you can recommend something that I do with my kids sometimes and I just call it a “no, thank you” bite where even if there is a food that doesn’t look right to them or they don’t think it’s going to taste good they do have to try at least one bite before they could say “no thank you I don’t like that.” I think that more times that they will try a food then the more likely it is that one of those times they’re going to take more than one bite.

Mathea Ford: [00:29:08] That’s an excellent idea. So, thinking about this so as the process of changing if you currently now act like a short order cook and you want to switch to being more consistent getting your kids to try different foods and kind of stand your ground a little there’s going to be a transition time. There’s going to be times when your child refuses to eat at the table and maybe goes to bed hungry and you’re you said kind of that mindset change about not putting so much value on whether they ate or not type thing. You want to develop independence in your children as well so you want them to obviously grow up to be adults that can take care of themselves. So how do you balance that? And during that transition time what kind of advice would you give to parents?

Sharon Somekh: [00:29:57] Sure. In general, whenever you’re making major changes in your home and I do think this would qualify as a major change for your home if you’re currently offering everyone in the home what they want to eat and you’re going to start preparing one meals for everyone, I think it’s important to have a conversation with everyone in the home and say “listen, I’m currently cooking different meals for all of you. After a long day that’s exhausting. I need to make things a little bit easier. And I think that you guys need to have a healthier diet in general. Let’s work together to make that happen. And this is how it’s going to be from now on.” Right? I think you need to give your children the expectation that we’re going to have this discussion. This is what we’re going to do. You will not get any more alternatives and then stick to it. And there will be challenges. There are often when you’re trying to change behaviors there are moments where children will intentionally challenge whether you really truly mean it or not and you have to stay firm especially in that first week that you’re trying something new like this because that’s when they will learn that when you say something you mean it and that this is really the way things are going to go moving forward. And then certainly saying okay let’s write a list of 10 meals that you guys eat like. And let’s try to put those into the rotation.

Sharon Somekh: [00:31:29] You don’t want to offer your first week that you’re saying “okay, there’s no alternatives and then there’s meal set.” One of our children never likes fish and everyday you’re eating fish for dinner. Right? So, you have to be reasonable and you have to also insert things that they do like to eat. But take the opportunity and introduce new foods and foods that you know maybe they like less but there’s not really a good reason for them to like less. Right? And really just see what works best for your family but have the conversation, set up realistic expectations and then really stick to them.

Mathea Ford: [00:32:08] That is great advice. So, do you have any recommended good parenting books for our listeners that might help them?

Sharon Somekh: [00:32:16] I know the American Academy of Pediatrics has a book called Food Fights which is pretty good. And then I am trying to think I recently read a book called If I have to Tell You One More Time by Amy McCready. That was pretty good as well.



 

Mathea Ford: [00:32:37] Okay. Sharon, what’s your favorite food?

Sharon Somekh: [00:32:39] For me my favorite food is Tacos. I love tacos because you could turn anything into a taco. And I happened to be a pretty well-rounded eater. I mean I did mention that I don’t like blue cheese particularly but it probably is one of the very few foods that is on my do not put on my plate lists. I love all things food. I think tacos are fun because you can put any type of cuisine into a taco I think except maybe Chinese food and even I think they’ve found ways to do that. So that’s my favorite.

Mathea Ford: [00:33:17] I love tacos too. I love chips and salsa though.

Sharon Somekh: [00:33:23] Always burritos is never a bad thing.

Mathea Ford: [00:33:27] Okay. Sharon, thank you so much for being on the podcast today. It was a pleasure to have you on the show. I know my listeners have learned a lot about picky eating, parenting, establishing boundaries. Just getting started with that. So if listeners want to connect with you what is the best way to do that?

Sharon Somekh: [00:33:46] Thank you so much for having me. The best way to connect with me is at www.raiseology.com. I do have a Raiseology Parenting Facebook group and would love to see you guys there and there will be a Raiseology podcast coming this summer. Launching July 31st.

Mathea Ford: [00:34:07] Oh those are great and I’m sure if they’re interested in more about that topic, it’d be awesome to listen to the podcasts. So, guys thanks. It’s been another great episode of the Nutrition Experts Podcast. The podcast that is all about learning more. So you can do more with nutrition in your life.

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