Picky eating in toddlers means a nutrient deficiency

What the research found

Australian and UK health guidance describes fussy eating as a normal part of development. Up to half of toddlers refuse new foods at least half the time. If a child is active, gaining weight and seems well, they are getting enough to eat.

Nutrient problems appear in the extreme end of restricted eating. A 2021 study of 20 children and teens with avoidant/restrictive food intake disorder (ARFID) found they met only 20 to 30 per cent of recommended intake for most vitamins and minerals, well below matched healthy children.

A 2021 systematic review of case reports found 76 cases of severe deficiency disease in children and teens with autism symptoms and self-imposed dietary restrictions. A 2015 review found children with autism often have a very limited food range, but results on the extent of nutrient gaps were inconsistent.

What it doesn’t mean

• This does not mean extreme food restriction is harmless. A very narrow diet, a tiny amount of food, or foods dropped from whole food groups deserves attention.
• The deficiency studies involved ARFID or autism, not typical toddlers. They are small or case-based, so they cannot show how often ordinary picky eaters become deficient.
• See a GP or child health nurse if your child's growth is slowing, they seem unwell or tired, they eat very few foods, or mealtimes cause intense distress. Growth charts can give reassurance.