Episode 009: The Real Cause of Picky Eating (It’s Likely NOT Parenting) with Dr. Kay Toomey

Dr. Kay Toomey, PhD is a Pediatric Psychologist who focuses on picky  eaters and problem feeders. 

Plenty of parents complain about their kids being “so darn picky!” (including me, even though I know I shouldn’t use that word!).

But what IS a picky eater, really?

Did you know:

• Only about 1/3 of kids are actually picky, although 50% struggle age 2-3.
• Only about 25% of kids outgrow it.
• 5-10% are problem feeders and need professional help.

Dr. Kay Toomey explains how parents can determine if their “severity” meter is accurate when it comes to their kids eating. Do you have a problem feeder who is truly extreme? Or just a picky eater? These questions will help you determine!

And the craziest part — it might not all be in your child’s head, even if they are having trouble accepting a wide variety of foods.

It turns out that what matters is how much it takes to chew, physically, and what food feels/looks/tastes/sounds like etc. to the child. Some picky eaters just never learned to chew properly! 😮 #mindblown

I’m humbled to admit that I’ve had to change my own “Raising Adventurous Eaters” presentation in FOUR different places because of what I learned from this 30-year expert pediatric psychologist.

When someone takes kids who literally won’t eat and consistently has success turning them around, I sit up and listen!

In part 2 of the interview (you’ll hear both in the podcast, but they’re two separate videos below), you’ll get help understanding WHY your kids are so wiggly at dinner, the special chair that could make all the difference, and more practical tips and picky eater solutions.

According to Dr. Toomey, it takes real intentionality to help your kids expand their palates — most kids won’t just “grow out of it” like we secretly hope!

From the extra little plate you’ll now set on the table to the way in which food is served, to your rules about who moves (the food or the kid), your routines are about to be turned upside down! But if your kids eat better with fewer power struggles…isn’t it worth it?

Can’t see the video? Watch Picky Eaters with Dr. Kay Toomey on YouTube.

Watch Picky Eater Solutions on YouTube. 

No time to watch the whole video? Here are the notes!

These timestamps align with the videos, not the audio podcast (although they’ll be fairly close).

Time Stamps for First Video, “The Real Cause of Picky Eating”

• 0:12: Today I’m here with Dr. Kay Toomey, a 30 year expert with picky eaters. We’re going to talk about the real cause of picky eating and the difference between picky eaters and problem feeders.
• 1:38: Dr. Toomey has her own clinic teaching practitioners and parents her SOS approach to feeding kids. She actually reached out to me about recommending the Kids Cook Real Food^™ course to her families!
• 2:36: People tend to think it’s a behavioral problem when kids don’t eat. When a child doesn’t eat, it’s because something in their body isn’t functioning properly. Dr. Toomey shares some fascinating information about child development and eating.

When kids don’t eat well it’s all in their bodies, it’s not all in their heads. -Dr. Kay Toomey

• 4:35: The research shows that parents cause a child’s picky eating only about 5-10% of the time. It’s much more complicated than many people assume.
• 5:19: If the issue is in the body, then our solutions for picky eaters will be focused on the body and not behavior.

Developmental Stages and Feeding

• 5:38: The first developmental stage is only the first 4-6 weeks of life. This stage is the only time that your appetite instinct is the primary driver behind eating. 😮
• 6:09: After the first developmental transition, reflexes become the primary driver. You’re probably familiar with the rooting reflex and grasping reflex in babies.
• 6:51: Around 4-6 months of age, you get voluntary control of these reflexes. At this age, eating becomes a learned skill. A child can learn to eat, learn to not eat or learn to kindof sortof eat.

• 7:18: The first transition from appetite to reflexes is driven by the baby’s body. As long as their reflexes are solid, you don’t need to do anything to facilitate the transition. If your baby was premature their reflexes may not be what they should be and you could have difficulties.

Eating is a learned behavior after 6 months of age, so we need to understand what we’re teaching our children. -Dr. Kay Toomey

• 8:26: As parents, many of us approach feeding as dieticians. We look at what our kids are eating and count up whether or not they got enough calcium, protein, zinc, etc. We need to approach feeding as teachers.

• 8:46: While parents don’t often cause a feeding difficulty, they can contribute to making it worse.

Root Causes of Picky Eating

• 9:22: When a child is experiencing picky eating, they often have specific parameters for how they will eat things. For example, they won’t eat “real” meat but will eat processed meat because it’s easier to chew. Notice how this is a sensory issue or a case where the child may have difficulty chewing. The root of the issue is in their body.
• 10:26: Any sensory difficulties can lead to eating difficulties. The way things taste, feel in the mouth, smell, even how things look or sound can affect a child’s comfort eating them.
• 11:03: Many vegetables have a bitter flavor and a stringy or fibrous texture. There are two sensory hits against them. Add a chewing difficulty and no wonder kids shy away from them!

• 11:52: When a child rejects a food ask, “what is it about the food that’s the problem?” Look at the food before looking at the child as the issue. Listen in to this part to hear more about how to avoid the power struggle and figure out why a food is offensive to your child.
• 12:43: The next developmental stage is 12-14 months. At this point, kids become self-aware and realize they can express an opinion.
• 13:12: The rest of the developmental stages happen around ages 2-3, 5-6 and 9-10.

How Common Is Picky Eating?

• 13:40: Not all kids are picky. Only about 1/3 of children develop picky eating habits. The numbers rise to 50% of kids during the 2-3 year developmental stage.
• 14:18. About 25% of kids grow out of picky eating. Parents assume their child will naturally outgrow picky eating and without an understanding of what’s driving it (something not functioning correctly in the body), they are unable to help their child move past it.
• 14:37: 5-10% of kids are problem feeders. These are the kids who have bigger developmental issues. You might consider them extreme picky eaters.

Picky Eaters Versus Problem Feeders

• 17:15: We get into the specific differences between problem feeders and picky eaters.
• 17:24: An exercise you might find helpful is to take a piece of paper and make three columns: proteins, starches and fruits/vegetables. Write down every food your child eats regularly on the list. Be very specific.

• 17:53: Parents think about foods being the same or different based on the name. Kids consider foods to be the same or different based on the oral motor skills needed to consume it and the sensory aspects of the food. Dr. Toomey gives several examples.
• 22:33: For a typical picky eater, you’ll have about 30 foods on the list. A problem feeder will have less than 20.
• 23:17: When a child’s sensory systems aren’t working well they tend to have food jags. That’s when they want to eat the same exact food, the same exact way over and over. These are common during developmental transitions.

• 25:17: Dr. Toomey describes the long-term problems with food jags and how they worsen problem feeding.
• 27:06: Picky eaters will eat at least one food from every nutrition and texture group. They may only eat one fruit or one starch, but at least they have one. Problem feeders will avoid entire groups.

Most parents think their kids eat less than they actually do. -Dr. Kay Toomey

• 28:04: A picky eater will fuss about a new food, but they’ll eventually settle down even if they don’t eat it. They may be willing to have it on their plate, or even lick it. A problem feeder will have a huge meltdown when introduced to a new food or food they don’t like.
• 28:41: Picky eaters are willing to eat with others, but they may want different foods. They’ll eat the same spaghetti but don’t want the sauce everyone else has. Problem feeders have a hard time even eating at the table and don’t like eating with other people.
• 29:39: Letting kids play on a screen or watch TV while they eat is a short-term fix that creates more of a long-term problem. If your child is already used to this, it will take time to wean them off, don’t just cut them off cold turkey.
• 31:53: Picky eaters fluctuate from month to month whether they will eat or not and what they eat. Problem feeders have constant struggles that can even get consistently worse over time.
• 32:38: Learning to eat new foods is much more complicated than many people think. The more difficulty a child has with eating, the harder it will be for them to learn to eat a new food.

There are 32 steps in learning to eat a new food. -Dr. Kay Toomey

• 33:39: If your child is a problem feeder, they need to be in feeding therapy. We as parents can benefit from the therapy as well as we learn to help our children learn to eat.

Time stamps for Video 2, “Solutions for Picky Eaters” 

• 1:18: We jump right in with the most important thing you can do to help your picky eater!

Any breathing issue can impact how kids eat. -Dr. Kay Toomey

• 1:44: People often think that eating is your body’s number one priority. That is not the case! Breathing is your number one priority. Think back to the last time you had a cold and how your difficulty breathing impacted your eating.
• 3:17: Turns out eating isn’t even your second priority! This is so fascinating and mindblowing!

The Picky Eater Solution Unrelated to Food

• 4:36: The correct seated position for everyone is a “90-90-90 position.” This means you’re at 90 degrees at the hips, knees, and ankles. Kids are usually expected to sit with no foot support in chairs that are too big for them for meals and doing homework.

• 5:15: Dr. Toomey describes how you can get your child in the correct position in an adult chair.
• 7:01: They make adjustable wooden chairs that can be easily adjusted as your child grows. You want to make sure that the seat and footrest are both adjustable forwards and backward and up and down.

• 7:56: The correct height for a child at the table is for the table surface to hit halfway between their belly button and nipples. If you’re making adjustments on an adult chair, don’t use a soft cushion like a pillow, use a firm surface. You can purchase couch foam from craft stores to make back cushions and seat elevators. Just be aware that you’ll need to make new ones as your kid grows.

• 9:13: To clarify: these seating recommendations are not just for picky eaters. All kids (and adults!) should be sitting this way!
• 9:36: Dr. Toomey recommends that you don’t bother with a highchair. An adjustable chair can be used as a highchair from about 7 months old with added straps and you can keep using it until your child is about 10 years old.
• 10:36: We talk about child-sized tables and whether that’s a good substitute.

Model Healthy Eating for Your Child

• 11:32: The second best thing you can do to establish healthy eating habits is to eat with your children and model healthy eating for them. Research shows that kids are far more likely to try a new food when the parent is sitting with them and eating the same food.

The only time kids eat new foods is when you are sitting and eating the new food with them. -Dr. Kay Toomey

• 13:00: If you want to take action today, at a minimum put a step stool under your kids’ feet to ground their feet. That’s a good start if you aren’t ready to get an adjustable chair and can’t do everything to make an adult chair child-compatible today.
• 13:39: Some kids like to stand at the table to ground themselves and adjust their height to the table. Sitting is better than standing.  The correct seated position helps them feel grounded and keeps them at the table.
• 14:40: The top reasons why kids leave the table are because they aren’t posturally grounded and because they aren’t sure they can handle the oral motor or sensory aspects of the food being served.

The Importance of a Mealtime Routine to Solve Picky Eating

• 15:07: The third most important thing we can do is structure our mealtimes with a routine.

• 15:32: Many of us don’t have a routine for meals. Dr. Toomey gives some practical ideas of what this could look like.
• 17:18: You can even set the table to facilitate better eating habits. Who knew these seemingly small details could have such a big impact!?

Family style serving is key to teaching kids to learn to eat new foods. -Dr. Kay Toomey

• 18:18: If you hand a child a new food and that triggers a fight or flight response, their adrenalin gets turned on which shuts down their digestive system and suppresses appetite.
• 19:11: Start serving the food by giving the child their favorite food at the table first. If the child is reluctant to accept any foods, Dr. Toomey has several options that will give your child exposure to new foods without them even putting them on their plate.
• 21:23: Including kids in the kitchen (which we love here at Kids Cook Real Food^™ of course!) helps them learn the sights, smells, and feel of different foods with no pressure to eat them. There’s a new component of expectation when you introduce a food at the table.
• 22:16: After everyone’s done eating, a cleanup routine is an important way to end the meal.

We’re keeping the kids at the table by letting them move the food away from themselves if they’re not ready for it versus moving themselves away from the food. -Dr. Kay Toomey

• 24:03: It takes about 2 weeks to learn new routines so it might be a bit chaotic at first, but stick with it!

Picky Eater Solution: Education

• 25:29: Dr. Toomey explains what the “learning plate” is. This comes into play when you’re serving something that you know will be tough for your kid to eat.
• 26:49: When you’re cooking the meal, that’s when you can think like a dietician. Once you approach the table you need to come as a teacher.

You need to teach them how to eat. You are the professor, your child is the student, the food is the subject and every meal is a class. -Dr. Kay Toomey

• 30:05: When we’re acting as dieticians we focus on questions like: Has he eaten enough protein? Is she getting enough vitamin C? How much volume have they eaten? Instead of being the observer tallying up how much they eat, you need to engage and explain why you choose certain foods and what they can do for your body.
• 31:39: Try to keep mealtime conversations positive and pleasant. We don’t want to talk about negative emotions or scary news that will spike adrenaline while we’re eating.
• 32:27: The same goes for rushing and hurrying through a meal. This can raise adrenaline as well and lead to stress which impairs digestion.

• 34:15: Be a fun teacher! If you’re not enjoying the meal your kids won’t enjoy it either.
• 34:27: When I hear “family-style serving” I see dirty dishes piling up! If you have a super picky eater it’s worth some extra dishes to help them, but what if your kids aren’t picky? Is that still good practice?

Practical Encouragement to Solve Picky Eating

• 36:20: We’ve been talking about what’s ideal here. Let’s talk about what’s realistic to do in a day.
• 37:30: We use lots of phrases here at Kids Cook Real Food^™ to help people remember concepts. One I like to use to help little kids at mealtime is “Do you want a serving or a taste?”
• 38:00: Some families have a “no thank you plate” or “no thank you bite.” Dr. Toomey explains the problem with these.
• 39:06: If a child truly can’t handle taking a bite of a new food I recommend that you offer them the option to smell, lick or taste it. This method gets Dr. Toomey’s seal of approval! Phew!
• 39:42: When we make children taste something when they can’t handle it, they’re likely to have a negative experience and then they’re averse to that food. You need to let them take it at their own pace.

Smell is an introductory way to get a taste. -Dr. Kay Toomey

• 41:52: Dr. Toomey shares her encouragement to help you get started making changes today.

Here at Kids Cook Real Food^™, we teach kids to cook so they can build connection, confidence, and creativity in the kitchen. Dr. Kay Toomey shared how connecting with your kids over your food can go a long way towards building confident eaters!

Thanks to her for so much great actionable advice today! I think any parent can learn something from this interview and apply her advice regardless of whether you have a picky eater or not!

Resources We Mention to Help Picky Eaters

• Find Dr. Kay Toomey online here
• Download the Picky Eaters vs Problem Feeders PDF
• My interview with Melanie Potock about how all 8 senses affect eating
• Another interview with Melanie about how speech can impact picky eating
• My interview with Margie Bissinger about how posture affects overall health
• My interview with Juliet Starrett about the benefits of standing desks for kids
• My interview with Shannon Miller about the gold medal mindset
• The importance of family dinners
• How to teach your kids to clean up after a meal
• The importance of letting kids play with their food
• 10 Ways to prepare vegetables for picky eaters
• Big encouragement for kids to try new foods
• Recipe for picky eaters: blended green soup
• The magic of the tiny salad
• The Tripp Trapp Chair by Stokey
• Tripp Trapp baby harness
• Keekaroo Height Right Chair by Special Tomato
• Keekaroo infant insert

Unless otherwise credited, photos are owned by the author or used with a license from Canva or Deposit Photos.