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Is Your Child a Picky Eater? How to Know When there is a Problem.

Submitted by on November 18, 2017 – 8:00 am2 Comments

Picky Eater

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 or call 1-800-4BAYLOR.



  • Kristy Gregory says:

    My son will be 4 years old in March and has the exact issues listed above. He has had the issues since day one. He was born at 31 weeks weighing only 1 pound 14 ounces. Even getting him to drink a bottle was a struggle. He has been in therapy most of his life for this issue. We started out with ECI then decided to go to Our Children’s House at Baylor in Frisco up to 4 days a week with not much progress in a year. We decided to take a more drastic approach and put him in the 30 day inpatient treatment program that Our Children’s House of Baylor offers in Dallas. That was huge mistake!!! They seemed to think it was a behavior problem and going into the program his therapist from Frisco along with myself and husband made it very clear that he did not have a behavior problem. I would talk to them daily about this and then they were not even feeding him as much as I was feeding him at home. He even lost weight while there. They would try to push him to eat cookies and I thought that was ridiculous and made sure they never did that again. He was in the program for 10 days when we decided to pull him out. For us the program was like a step back not a step forward. They are extremely unsanitary. When you first start the program they do not want the parents there during the day. I would come back right before he was done with this last feeding of the day to stay the night with him and his hands were filthy. It was not from food it was from dirt and activates like finger painting they had done with him that day. They never washed nor at least sanitized the children’s hands before feeding them. Needless to say by the time we pulled him out every single child that was in the program was very sick and was getting breathing treatments. My child was so sick they quarantined him. My child could not breathe one night and I asked the nurses for a breathing treatment and one nurse said he does not sound that bad and would not do anything. If he would have been at home I would have given him a breathing treatment and if he still sounded like that after the treatment he would have been in the emergency room. Once they realized we were about to walk out and take him home they called the respiratory therapist and said he does sound bad. They then said they would be back in 4 hours for another treatment. After 6 hours and them not showing up at 2:00 AM to give him one, I again had to demand he get one. The program might work for a child that has a behavior problem but outpatient therapy would also work. I would not recommend this place. Do not waste your time, sanity, health or money. Is NTKIDS getting a cut to post this artical?

  • I have two very picky eaters and they both refuse to eat their vegetables. I am worried because I know that they are in the critical stages of their lives where they need those vitamins and minerals to be able to learn and grow correctly. I did not know that oral sensitivities can lead to pickiness. I will try to prepare the vegetables differently this week and see if that helps them eat it.

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