This topic is long over due around here. Many parents consider one or more of their kids to be a so called "picky eater". But what does that really mean? If you scroll the comments on this blog, you will see a whole spectrum of picky eaters, from parents looking for advice for a child that is refusing several vegetables, to one that is gagging at the site of food. Do they all fall into the same category? Hardly. Moreover, a few well-intentioned, but vastly incorrect comments about how parents need to just give their kids some tough love when it comes to eating. That may work for some kids that fall on the picky eating spectrum, but for others it could be disastrous - leading to a feeding tube. That may sound dramatic, and although it is unlikely, it is possible. So how does a parent know when they need to be concerned? When does picky eating go too far?
The SOS Approach to Feeding, by Kay A. Toomey, has clearly defined when a child falls into picky eating and when they are problem feeders. The term, "problem feeders", is one that few have heard of, but the distinction is important. Generally speaking, picky eating can be a normal part of childhood, albeit annoying and frustrating. Problem feeders are beyond picky eating and usually need the help of a feeding therapist to make progress eating new foods. In these cases, eating is actually a problem for the child and the family, general feeding advice often doesn't apply to these kids, I'll elaborate more on that in a minute. I have used these guidelines for years to determine just how serious a child's picky-ness is.
- Have at least 20 foods in their diet.
- Eats at least a few fruits/vegetables, carbs, and proteins.
- Can be coaxed to occasionally try new foods.
- Usually will eat foods similar to preferred foods. For example, will eat a variety of chicken nuggets or pizza, they will typically not reject different brands or styles.
- Sometimes eats foods different than the rest of the family.
- Will suddenly refuse a food they have preferred, but will eat it again in the future.
- Eats less than 15 foods consistently.
- May gag or vomit at the site or taste of foods.
- May become emotionally upset when a they are encouraged to interact with non preferred foods.
- Refuses large categories of foods (i.e.: vegetables, meat, etc.)
- May insist on foods being preferred in specific ways or will only eat a specific brand/style of food.
- Almost always eats food different than the rest of the family.
- Will suddenly refuse a food they previously preferred and never eat it again.
SOS has a .pdf form here of the differences between picky eaters and problem feeders, if you would like to print one out. Keep in mind that the lists above are just guidelines and if you aren't sure where your child falls or you feel confident they are a problem feeder, consider having a feeding evaluation. Usually, that is completed by an occupational therapist, like myself, or a speech therapist. If your child is under 3 and in the states, you should qualify for a free evaluation. More info on that here. I also offer consultation services via phone, skype, or facetime. Get details by clicking the link or the tab in the menu bar at the top.
I mentioned above that problem feeders typically don't usually respond to general feeding advice - which isn't the advice I am giving here. All of the strategies and tips I share can work for picky eaters and problem feeders, BUT problem feeders likely will need some additional strategies that need to be determined on an individual basis. Also, the one piece of advice that will not work on a problem feeder and that you will never see here on Your Kid's Table is to: serve your kid what your eating and they will eventually get hungry and eat. This is a huge myth and many well meaning people love to dispense this advice: Moms, Grandpa's, neighbors, and friends that haven't had a problem feeder. Many problem feeders will NOT eventually eat, they will end up in the hospital because they are starving. Fortunately, parental instincts tell moms and dads this and they usually don't try or give up on this approach quickly. That isn't to say that the problem feeder should be allowed to rule the roost, either. I address some of these key points in Basic Strategies to Improve Eating- a great place for a parent of a problem feeder or picky eater to start.
If you think you do have just a picky eater, it doesn't mean that eating can't or shouldn't be improved. A consultation may be beneficial, and perusing the article index in the menu bar, because it lists all of the picky eating articles - and there are a lot! If you have more questions about a consult, don't hesitate to contact me at YourKidsTable@gmail.com