Parents desperate to get a little food into a picky eater may encourage a child to graze constantly, which is not a good pattern. Instead, offer food every three to four hours, with three meals and two snacks built into the day. Take advantage of children’s interest in dipping, but keep the food as nutritious as possible (dipping vegetables into yogurt or hummus, for example). Expect it to be messy, Ms. Lipner said, and give them the illusion of choice: Which vegetable do you want today?

Provide exposure

“We sit down and come up with three to five foods parents would like to see them eat, something that comes up in their home,” Ms. Lipner said. Meals involve three or four foods, one new, and the new foods get rotated through every few days, becoming familiar. The only rule, she said, is no throwing: “Food stays on the table.” They can manipulate it, but they don’t have to eat it. Consistent repeated exposure is the key.

Tracking Pickiness

In an abstract presented in May at the Pediatric Academic Societies meeting in Toronto, researchers looked more closely at whether picky eaters coming out of those toddler years stay picky, and at how they grow. The study used a cohort of low-income families in Michigan, tracking 189 children from the age of 4 to 8 and a half, looking at feeding and eating behaviors, and at the children’s growth.

Dr. Megan Pesch, a clinical lecturer in developmental and behavioral pediatrics at the University of Michigan Medical School C.S. Mott Children’s Hospital, who was the senior author on the abstract, said that in her training as a pediatrician, she was taught mostly to reassure parents of picky eaters that their children would grow out of it.

Instead, “we found three stable trajectories,” she said, the children who scored as high, medium and low on the picky eating scale. And the children stayed in their groups. “By 4 years, the parent perception of picky eating was established, and did not change over the next four and a half years.”

The children were given two kinds of vegetables, one familiar (string beans), one less familiar (artichokes), and their reactions were videotaped — how much they ate, whether they made negative comments, how they rated the foods on a yummy-yucky scale. And it turned out that the parent reports “were totally valid,” Dr. Pesch said. “This is not just moms overreacting.”

As other studies have found, there were certain attributes that were associated with a higher likelihood of being in the high-picky-eater group: firstborn children, older mothers, families with fewer routines around mealtime, which includes everything from a specific time and place and even such practices as saying grace or having a specific seat for the child and a habitual way of serving food. On the other hand, being female, having a younger mother, and having more mealtime routines was associated with a higher probability of being in the low-picky-eating group.