Picky Eaters & Problem Feeders

Picky Eaters

Why would your child be a picky eater?  Once you have ruled out any digestive or other medical concerns, consider your child's food aversion to be possibly sensory based.

 

Signs or Symptoms of Sensory Based Food Intolerance:

Texture – child may avoid touch to hands or mouth smooth, moist, creamy; but may crave crunchy, sour, spicy

Visual – many children are 'yellow food' eaters; French fries, pasta chicken nuggets               

Oral Motor – low oral muscle tone, weak lip, cheek, or jaw muscles

Smell – some food smells

Temperature – avoidance or preference for hot, warm, room temperature, cold

Regulation – difficulty accepting new food based on taste, texture, what it looks like, rigid temperament; children that find what they like and it works for them so they figure why change it  

Behavioral – some children who are sensory defensive in other aspects of their lives learn secondary behaviors in order to cope.  They are control seekers so they can manage their environments and not have to be faced with unexpected challenges.  This behavior may carry over to meal time.

 


Why Do Children Avoid Foods?   

Sensory sensitivities can put a child in a fight or flight response.  They perceive the stimulus as noxious or dangerous.  Then their learned behavioral coping strategies kick in.

 

Why Do Children Crave Certain Foods, Textures, or Tastes?

Some food textures or tastes don't provide enough sensory information.  Foods with strong tastes, textures can give good sensory feedback.  Warm, creamy foods can be calming and comforting, hence comfort foods.

 

What You Can Do

Maintain firm rules around mealtime and at the dinner table – as mentioned above, there are often undesirable behaviors that can be associated with picky eaters.  Eliminate talk about what the child doesn't like and won't eat.  Rules of the house can be that everyone helps prepare meal, sets table, and sits for a minimum of 10 minutes.  This has nothing to do with eating the meal.  Do not hold a grudge if your child won't try something new.  They should feel good about their participation in the meal time event.   Once you are working with your child to try new foods you won't also be working at mealtime rules and behaviors.

 

Prepare by desensitizing with a damp wash cloth to lips with firm pressure, a tooth brush or other tool firmly rubbing inner cheeks and tongue, and jaw compressions by applying pressure to top and low molars.

 

Use a plate divided into 3 sections.  Put 2 foods that your child loves and is really motivated to eat:   pieces of cheese, pieces of apple, or pieces of mini M&Ms.  In the 3rd compartment put a new food.  He needs to go around the plate taking a bite of each item before moving onto next item.  New food can be touching it to lips a few times.  Don't forget to praise.  Then proceed to touching tongue with new food item before moving to next item.  After tongue, have him hold it in his mouth; do not allow spitting it out.  Instruct him to remove it and put back in plate or napkin if he has to.  It may take a few meals before ready to chew or swallow.  Respect that he gave the old college try and truly does not like the food item.  Move onto another food item next time and have him tell you what he would like to try.  Make a list together.   I can't emphasize enough the importance of not getting mad or carrying a grudge.  Praise your child for his efforts.  In addition to the reward of moving onto the food he likes, you can also use a token board, sticker chart, or marble jar to reward as you go; good table manners, following rules for 3 sectioned plate, smelling it, licking it, etc.

 

These strategies and others are not easy to implement alone.  A pediatric occupational therapist or pediatric speech-language pathologist specializing in sensory processing and feeding disorders would be the professional(s) to get help from.


Lori Frommer, OTR/L
Home Therapy Solutions, LLC
Occupational Therapy and Parenting Foundations




If your child only eats certain foods and often refuses to try new types of food, you may be wondering if your child is a picky eater or has a feeding problem. Here are a few ways to know the difference. Typically, the majority of children who are picky eaters and do not have a more serious feeding problem demonstrate a normal growth pattern [1]. Normal growth and development as well as the absence of physical symptoms (e.g. trouble swallowing) are factors that healthcare professionals often look for when determining whether a child is a demonstrating picky eating or problem feeding [1].

Common signs of picky eating include [2-4]:

Eating a limited amount and type of foods
Refusing certain foods, especially fruits and vegetables
An unwillingness to try new foods
A strong preference for specific foods
Preferring to drink milk or juice instead of eating
Snacking instead of eating proper meals
Preferring fatty foods and sweets
Feeding problems, on the other hand, may be due to an underlying medical problem and it may also be linked to malnutrition [1, 5]. Signs of a feeding problem include:
Difficulty swallowing
Painful swallowing
Choking or coughing while swallowing
Complaining of pain while eating
Diarrhea and/or vomiting
Food allergies or sensitivities
Failure to thrive
Certain disorders (e.g. autism)
 
Overall, normal growth and the absence of physical symptoms are often observed for picky eaters, while significant symptoms as well as medical conditions are often associated with feeding problems. A physician can help you accurately determine which may be the case.



7 tips for trying to get a picky eater to try new foods

Introduce foods with a flavor or texture similar to a favorite food. Mimicking favorite food recipes, but perhaps swapping out just part of the recipe for a different seasoning, veggie, or protein source.

Try just placing a new food on the table for the first few times, then after a couple of introductions perhaps put the food on their plate without expecting them to try the food.

Expose your child to new foods gradually, making sure not to overwhelm him with adding multiple new foods at once.

Do not force your child to eat all of a new food, allow experimentation. Allow only tastes, touch, or smell during introduction periods if needed.

Mirror desired behavior by eating new food as a family, talk about a new food positively.

Make food fun. Allow your child to pick a new food item at the store or pick from the garden.

Perhaps have them help you pick out a recipe. Once again, no pressure to eat it.

Try to be creative with presentation. Sometimes just making a fun shape or presenting the new food on a fun plate or bowl works great. 


Denise Voight, MS is a Clinical Nutritionist with a Masters of Science in Human Nutrition and Functional Medicine specializing in Nutritional Intervention for autism spectrum disorders and ADHD.  https://www.denisevoight.com/blog/picky-eating-vs-problem-feeding

My Spectrum Heroes™ was created to provide a trusted resource for support, education, and empowerment of parents, caregivers, clinicians, and anyone who serves a loved one with autism, ADHD, and/or neurocognitive challenges.

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