The preschool and elementary school years are an important time for starting to establish healthy eating habits in children. But many kids are picky eaters at that age. They are often reluctant to try unfamiliar foods, and their food preferences are constantly changing.

A recent poll by investigators from C.S. Mott Children's Hospital at the University of Michigan asked parents about the challenges they face when it comes to providing kids with healthy meals.

“Nutrition is so vital to children's health. Knowing this is an area that is sometimes a struggle for parents, we were interested to get their perspective on this topic,” Susan Woolford, co-director of the poll, told TheDoctor. The current report reflected a nationally representative sample of more than 1,000 parents of children between the ages of three and 10 who were surveyed in February 2024.

More than 12 percent of parents said they required their child to finish everything on their plate, a strategy that can backfire.

A majority — 60 percent — of the parents surveyed said they often play short order cook and have customized their child's meal if he or she did not like what was served. Woolford, a pediatrician at C. S. Mott Children's Hospital, said that in her clinical experience, a fear their child is not getting enough of the right foods is what tends to motivate parents to do this — they worry that skipping a meal will affect their child's health. “When a child doesn't want to eat what has been prepared, quite often these concerns will make parents offer something else the child is willing to eat.”

More than 12 percent of parents said they required their child to finish everything on their plate, a strategy that can backfire, according to Woolford. Rather than forcing their child to eat large amounts of vegetables they don't like, ask them to try a small morsel along with something else they do like. Using this approach, she explained, children often become more accepting of different vegetables over time.

Parents know what a healthy diet is, but they often decide to avoid the conflict and give in. Only 32 percent of parents considered the typical American diet a healthy option, compared to 47 percent who thought the Mediterranean diet was healthy. They may not realize how damaging the high levels of saturated fat, sugar and salt in the American diet are to children's health. “It is not just as one gets older that these things are not good for us. They are not good for us even when we are young,” said Woolford.

Few parents said they had tried offering their children healthier foods, however. They may worry whether a diet such as the Mediterranean diet or a mostly plant-based diet lacks enough protein for a developing child, Woolford said. They may also be unaware that there are healthy options that accompany these diets. She suggested that families who want to try these diets, but worry about their children getting enough protein, research alternative sources such as plant-based meat substitutes, beans and legumes.

Have your child help select vegetables in the grocery store. Ask them what they might like to try.

Many experts recommend the approach of “the parent provides and the child decides”. This means parents provide healthy options at a meal, Woolford explained, then the child decides which of those things and how much of them they will eat.

A good way to encourage kids to eat what is served is to have them participate in grocery shopping and food preparation. This works best if you have your child help select vegetables in the grocery store and ask them what they might like to try.

“Spend most of the time in the produce section and try to make it fun by maybe selecting new options from different parts of the world that they haven't tried before,” Woolford advises. More than 40 percent of parents surveyed said they involve children in grocery runs, and about 25 percent of parents said they have their children help in food preparation.

For help figuring out what foods are best for children and what portion sizes are appropriate, Woolford recommends parents visit MyPlate.gov. Another good resource is HealthyChildren.org.

C.S. Mott Children's Hospital is part of the University of Michigan Health System. The C.S. Mott National Poll on Children's Health is published monthly and covers a variety of topics related to children's health and well-being.