Is Your Child a Picky Eater? How to Know When there is a Problem.
by Laura Austin
All children evidence periods when they are picky eaters. Toddlers in particular are notorious for loving a food one day and refusing it on their plate the next. How then are parents to know when pickiness becomes a problem?
In general, food selectivity becomes a problem when (1) it impacts growth or nutritional status, or (2) it causes disruption at home, school or with socialization. If a child is not growing well or medical testing has identified nutritional deficits, then action should be taken to improve the volume and/or variety of foods accepted. However, physical status is not the only consideration when evaluating food selectivity. Food preferences can be disruptive at home or school. This may be more evident as children get older and show difficulty participating in social events such as birthday parties and sleepovers.
If your child exhibits food selectivity that interferes with physical or social development, the next step is to attempt to determine the source of the resistance. One of the first questions to ask is whether or not certain classes of foods are avoided. For example, does your child eat only pureed or smooth foods but rejects anything solid that must be chewed? Or, in contrast, does your child prefer chewing foods, but resists any smooth or pureed texture? Perhaps your child will only eat carbohydrates or food of only one color? Patterns in the types of foods accepted or avoided can provide clues as to whether or not a true problem exists.
There are a variety of factors that can lead a child to be a picky eater. Medical issues such as reflux or food allergies can lead to irritation in the esophagus and/or stomach which can make kids reluctant to eat. Oral motor weaknesses such as difficulties with strength or coordination in the mouth can make eating certain types of foods difficult or scary for kids. Oral sensitivities lead children to avoid certain types of foods because of the way the food feels inside of the mouth. These children often have global sensory processing problems as evidenced by resistance to activities such as getting their hands or face messy, resistance to having their hair washed or fingernails cut, and reluctance to walk barefoot in grass or sand. Finally, when children refuse foods parents often resort to the “Whatever they’ll eat. Whenever they’ll eat. However, they’ll eat” approach. As such, refusal behaviors can become ingrained making forward progress with eating difficult.
Fortunately there are a variety of professionals who can help provide insight into the sources of food refusal and treatment for kids. North Texas is fortunate to have one of the nation’s few multidisciplinary feeding programs –Our Children’s House at Baylor. This facility provides multidisciplinary assessment and treatment for children ages birth to 18 with food selectivity or food refusal. Parents should also seek medical advice from the child’s pediatrician or from a pediatric gastroenterologist to rule out any underlying medical factors that could be impacting oral intake.
Laura Austin, PhD is a Pediatric Psychologist
For more information about the services offered at Our Children’s House at Baylor, visit www.BaylorHealth.com/OCH or call 1-800-4BAYLOR.