Picky Eaters vs. Problem Feeders – Do You Know the Difference?

Unlike picky eating, problem feeding is not a normal part of child development. Children who are problem feeders often have inadequate caloric intake, poor weight gain and growth, as well as vitamin and mineral deficiencies. If left untreated, children who are problem feeders can suffer from malnutrition, dehydration, and impaired intellectual, emotional and academic development.

The incidence of feeding disorders in typically developing children has been reported as 6-40%, while the incidence of feeding disorders in children with disabilities has been reported to be much higher at 18-80% (Kyong-Mee Chung, Sung Woo Khang, 2006).

Prolonged, untreated feeding disorders can also result in the disruption of positive mealtime routines, which can lead to a disruption in parent-child interactions where less cuddling and positive interactions occur (Budd, et al 1992).

Problem feeders typically:

Eat less than 20 foods
Eat fewer and fewer foods over time until they are limited to about 5-10 foods they will eat
Refuse foods of certain textures altogether
Will eat one food over and over, but unlike picky eaters they will eventually burn out and not go back to eating that food again
Will not accept new foods on their plate and will not tolerate even touching or tasting a new food
Cry, scream and tantrum when new foods are placed on their plate
Are unwilling to try a new food even after 10 exposures
Have a rigidity and need for routine/sameness during meals
Are inflexible about certain foods

Problem feeders will often need extensive therapy from a multi-disciplinary feeding team (occupational therapist, speech therapist, nutritionist, psychologist/behavioralist, physician) of which the parents are an integral part, in order to overcome their feeding problems.

Studies have shown that treatment success and gains at home were largely due to parental compliance in implementing and following through with clinicians suggestions and protocols for treatment (Kennedy Krieger Institute).

Identify if Your Child is a Picky Eater

Picky eaters commonly:

Will eat less than 30 different foods
Will eat one or more foods from each type of food texture
Will have one favorite food that they will eat consistently, then may burn out and not eat that food, but after 2 weeks will resume eating that food again
Will accept new foods on their plate and willingly touch or try new foods
Will eat a new food after being exposed to it at least 10 times

Most picky eaters get enough calories per day to maintain healthy weight and growth. Picky eaters can be managed at home without too much difficulty.

Dealing with a Picky Eater at Home

The majority of picky eaters will gradually expand their diet to include a greater variety of foods if these suggestions are implemented.

Offer the child a variety of different foods each day
Offer consistent set meal times for your child each day
Make mealtimes pleasant
Limit the child’s juice intake to 4-6 ounces per day
Limit the child’s snacks to 2 or 3 healthy snacks per day

Sources include: Autism and Feeding Problems by Elizabeth Strickland, RD, LD; Pediatric Feeding Disorders by Kyong-Mee Chung and Sung Woo Khang; Treating Eating Problems of Children with Autism Spectrum Disorders and Developmental Delays by Keith E. Williams and Richard M. Foxx