Is My Child Just a Picky Eater or Is It More Serious?

Children with feeding disorders aren’t just picky eaters. These disorders can signal the presence of underlying medical and developmental issues.

For parents who are wondering whether their child is merely going through a temperamental phase, or may be experiencing something more serious, it’s important to be able to recognize the signs of feeding disorders. That way, infants and children with potential feeding difficulties can receive the help they need to eat without pain, discomfort or fear.

Up to 80 percent of children with developmental disabilities or medical and behavioral difficulties display feeding disorders, according to a study from World Psychiatry. Feeding disorders can progress to increased developmental delays, behavioral disorders, feeding difficulties and poor growth. Difficulties with psychosocial issues also can develop, interfering with family dynamics during mealtimes and with socialization with peers.

Picky Eaters

Parents often ask about the differences between children who are picky eaters and children who have a feeding disorder. Observing your child in various situations can help you determine that. Picky eaters often are characterized in the following ways:

• Eats a self-limited number of foods, but will still consume foods with a variety of textures and consistencies from all food groups
• Able to eat in different public environments, such as school and restaurants
• Refuses to eat a previously accepted food, only to re-accept it after a short period of time
• Accepts new or less-preferred foods with prompting, rewards or punishments
• Accepts preferred foods despite brands or how the food looks

Signs of a Feeding Disorder

For those concerned that their child may have a feeding disorder, here are the more serious signs to look for:

• Accepts a very limited number of foods and liquids
• Refuses different groups, textures, brands, shapes or colors of foods and liquids (aka food selectivity)
• Experiences difficulty eating outside the home environment
• Exhibits tantrums at meals and snacks in response to offered foods, with behavioral outbursts persisting after food is removed or meal is completed
• Chokes, gags or vomits when offered particular foods and liquids
• Has varied chewing skills with different consistencies and textures of foods
• Unable to tolerate different foods’ smells and/or watching meal preparation
• Refuses a previously preferred food and will not re-accept it

Infants also can display symptoms of feeding and swallowing issues. These additional signs may be observed during mealtime:

• Difficulty breastfeeding or drinking from a bottle or cup
• Difficulty remaining latched to the nipple
• Requires an increased amount of time to eat or drink
• Displays signs of physical discomfort, including restlessness, arching of the back and/or becoming fussy or crying
• Becomes increasingly congested or hoarse as a meal progresses
• Regularly spits up or vomits
• Poor weight gain

Diagnosing Feeding Disorders

Parents are often the first to recognize that their infant or child is struggling to consume food or liquids. If you notice that your child doesn’t seem to be eating like other children, it’s best to schedule an appointment with your primary care physician. From there, you may be referred to a specialist.

Difficulties with eating could be due to physical, oral-motor or behavioral issues — or a combination of these issues. The causes of feeding and swallowing disorders can include:

• Anatomical or structural abnormalities
• Autism
• Failure to thrive
• Food allergies
• Gastrointestinal disorders
• Genetic disorders
• Heart disease
• Medications that can interfere with alertness or hunger
• Neurological disorders, such as traumatic birth or brain injuries, or cerebral palsy
• Premature birth
• Respiratory disorders

If left untreated, feeding disorders can progress to increased developmental delays, behavioral disorders and poor growth. These problems can continue into adulthood. By working with a team of specialized providers and incorporating learned strategies at home, parents can help ensure their child receives the assistance they need to develop healthy habits and routines with eating.