My Child is a Picky Eater: Part 2
What is a Picky Eater
There are many terms floating around—and if you do an internet search—terms like “fussy eaters”, “picky eaters”, “problem feeders”, “selective eaters”, and “extreme picky eater” are quick to populate. These terms are often used interchangeably with typically developing children, to children with moderate to severe eating challenges. It is quite helpful to define the term you are using when discussing your situation with friends or professionals.
Picky eaters usually have a food repertoire of approximately 15 to 30 foods and there is variety within those foods. They might drop a food, but will come back to eat it again. The behavior of the child at the table is typically within what is considered to be normal for children.
It is also important to know that picky eating is typical in young children. Take toddlers for example. They are all about testing limits and quite inconsistent. They might reject a food they liked previously, and then quite happily eat it when offered at a different time. If you have a toddler who is doing this, know that this is quite normal behavior—and if you let the behavior slide for that particular food at that particular time—you will avoid limit testing, power struggles, and control issues that are common during this stage of development.
Problem feeders or extreme picky eaters are those who are severely limited in the foods eaten. Often the child self-selects one or two foods only, and will only drink milk. I have observed some children self-select to only eating a certain color of food within a select few options. You might observe gagging, choking, meltdowns, and other unhappy behaviors when a food outside the child’s repertoire of food is offered. At well-child visits, the topic of conversation is always about your child not eating.
Problem feeders often have significant medical issues and/or developmental delays—either clearly diagnosed at birth, or yet-to-be diagnosed. Children who have undiagnosed autism spectrum disorder frequently fall in the problem feeder category and parental concerns are not often fully addressed by front-line medical professionals during routine office visits. Any one of these issues compound the challenges revolving around consuming food and drink successfully.
If you have, or suspect you have a problem feeder, please get professional help as soon as possible. There are many caring people who are specifically trained in this area. For example, a qualified in-home or clinic-based occupational therapist or speech language pathologist is a great place to start. If your child is under three years old, contact the early intervention program in your area. Here is a link: https://www2.ed.gov/programs/osepeip/index.html. For more significant or severe eating disorders, there are teams of feeding specialists housed in hospitals across the United States that evaluate: postural concerns, sensory integration issues, motor challenges, behavioral components with ability to learn, nutritional factors and medical history.
Up until about the age of five or six, children are in the learning stage about food. Taste, texture, variety and exposure all play their roles and children develop food preferences. It typically takes 12-25 exposures to a new food for a child to accept it. Exposure means any time a child is in contact with the food through looking at it, listening to caregivers talk about eating it, helping prepare it, shopping for it, tasting it or actually eating it. Picky eaters may take even more exposures, and problem feeders may take hundreds of exposures before they accept the food.
Caregivers also have a significant role at the dinner table (or high chair). If caregivers place a lot of pressure on the child to eat a food the first time and it doesn’t go well, the following exposures will certainly not go well.
How can you expect your child to consume and learn about food if you, as a caregiver, do not enjoy a wide variety of food or expose your child to a wide variety of food? I have repeatedly experienced this in my work with families. A surprising number of caregivers I have worked with had their own issues with food from buying it, to preparing it, to eating it. Please remember your child has no “experience” with food—from touching it to tasting it to actually eating it. Variety truly is the spice of life and food exposure certainly is no exception.
My next article will discuss the emotional toll on caregivers and increasing personal awareness to the seemingly never-ending dialogue in our minds.
Rosemary Slade, PLLC, OTR, NC is a practicing occupational therapist and mineral-nutritional practitioner. She can be reached on this website. This article is not in any manner, shape or form intended to be considered or construed as medical advice or providing a medical diagnosis. This article is for entertainment purposes only. Please see your medical doctor for medical diagnoses.