Picky Eater or a Feeding Disorder?

Most kids are picky eaters at one time or another—but determining if their finicky behavior is severe enough to be classified a pediatric “feeding disorder” involves an expert’s diagnosis. According to the September 2011 National Institutes of Health (NIH) report, “Up to 10 percent of infants and children have a pediatric feeding disorder;” however, many children are missed in this study.

Symptoms

“Professionals working with children with feeding difficulties sometimes classify children as ‘picky eaters’ rather than a ‘problem eater’ or a child with a ‘feeding disorder,’” says Marci Chmielewski, M.S., OTR/L, and clinical coordinator of the Occupational Therapy Department at Children's Mercy Hospitals & Clinics.

“A picky eater is a child that does not have a wide variety of foods, but will typically eat 30 or more foods,” reports Chmielewski. “The picky eater may also have times in which he won’t want to eat that food, but will generally add it back into his food repertoire after a couple weeks.”           

These kids usually are able to touch, look at or taste new foods, even if they refuse to eat them. They also will try one food from each food group.     

“The ‘problem feeders’ are the children we treat in occupational therapy and typically have 20 or fewer foods they eat,” says Chmielewski. “A child with a feeding disorder will often never eat a food once they have “burned out” on that food—even after a break from it. These children may cry, try to get away from the table, be unable to tolerate smells of food or become very upset when a new food is presented. The problem feeder also often eats foods in only one or two of the food groups.”

Treatment modalities

“The treatments vary depending upon the underlying causes of the child’s problem or picky eating,” Chmielewski says. “A feeding  therapist will typically take a history to help determine if there are underlying physiological problems causing discomfort with eating, as well as evaluate for oral motor problems (inability to properly chew or move food in the mouth), swallowing problems or oral sensory problems (difficulty with tolerating various textures of foods).”

Working along with the parents, caregivers and treatment team, a goal-oriented plan will be initiated for improving eating and feeding techniques for the child. The NIH recommends the earlier the diagnosis and beginning of treatment, the better the results. If left untreated, feeding disorders can become more complex.

Stacey Hatton is a pediatric RN and Overland Park freelance writer.