Is it more than just Picky Eating? Problem Feeding explained

Surface-level observations are easy. And honestly, true “picky eating” can be a very normal phasebut what if it isn’t?

There are some of the underlying reasons that contribute to “picky eating”

Normal reasons kids can struggle to eat are:
🔹Teething
🔹Improper/Unsupportive Seating
🔹Lack of Routine
🔹Constipation
🔹Change in Growth Rate from Baby to Toddler
🔹No “Safe/Familiar” Food

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Most of these we are able to “self-troubleshoot” at home and what I’m here to help with!

However, at a point, it is no longer “picky eating” and more accurately defined as “problem feeding“.

Some deeper underlying reasons kids can struggle to eat:
🚩Sensory Issues
🚩Anxiety
🚩Oral Motor Skill Difficulties
🚩Tongue Ties
🚩Gross/Fine Motor Skill Difficulties

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While problem feeding is an issue in itself, problem feeding can cause many other issues down the road. Eating fewer foods can lead to consuming fewer nutrients, which can cause other issues such as:

  • Nutrient Deficiencies
  • Chronic Constipation
  • Underweight/Malnutrition AND Overweight/Obesity

These reasons are typically problems that need some individualized assistance to address.

But the thing about “problems” is that they almost always have “SOLUTIONS” – and in cases of true “problem feeding”, that solution is working with a Feeding Therapist!

Having a trained professional assess your child as an INDIVIDUAL and then create a customized plan to start working WITH them!

Not only do Feeding Therapists help children, but they also help adult caregivers to gain new skills and “tools” for feeding their children. These skills help US feel more confident and then create an environment where our child(ren) can learn and grow.

If you are concerned that your child might fall more into the “problem feeding” category rather than just picky eating, seek professional help by discussing with your pediatrician about finding a local Feeding Therapist. Or you can find Tele-Health options like virtually working with a Feeding Therapist.

Now the “eats less than 20 foods” DOESN’T really apply to babies (6-12 months) and younger toddlers, who are still learning and being introduced to new foods.

But if your child is 2yo+ and this applies (or they are younger but you feel they are still really struggling such as excessive vomiting or tongue ties) it is a great idea to consult your pediatrician for a referral to a local feeding therapist.

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What to Expect at Feeding Therapy

During feeding therapy, therapists work with children to provide them with the skills they need to make mealtime more enjoyable and nutritious. The skills taught to each child are determined based on the patient’s needs and may differ from those below. According to Children’s Health Orange County, the most common skills taught include:

  • Oral skills: Some children may lack the skills needed to eat and/or drink due to developmental delays, illness, allergies and a variety of other factors. When this is the case, therapists work with patients to teach them how to control and coordinate chewing, sipping, sucking swallowing and the like while eating and drinking. Therapists also work with patients to increase each child’s oral strength and range of motion.
  • Food orientation: Due to illness, allergies, sensory aversion or developmental delays, some children may need assistance broadening the amount and type of foods they eat. This is very important and will allow the child to better enjoy meals and eat a more balanced, healthy diet. Therapists work with patients and their families to increase the amount and types of foods the child is willing to eat. Many patients, especially those with sensory aversion or those who have had limited exposure to a variety of foods, maybe taught skills on how to reduce their sensitivities to foods and their textures.
  • Improve the overall eating experience: Whether a child has struggled to eat because of illness or allergies, a sensory aversion to food, and/or reduced oral skills, he or she may have developed negative feelings toward eating and mealtime in the process. As a result of many children, and their families, benefit from learning how to create positive eating and drinking experiences. Therapists work with patients and their families to improve the child’s overall mealtime routine and create positive associations with food. Therapists also work with patients to help them gain the self-feeding independence that many of them crave by teaching skills like drinking from a cup, eating with a spoon or fork or drinking from a straw. By teaching the child how to enjoy mealtime and retraining the child’s caregiver on how to create a positive mealtime experience, meals and snacks may become easier for the entire family.
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Role of Adult Caregivers in Feeding Therapy

Adult caregivers play an important role in feeding therapy.

While the child is learning skills in order to become a better eater, adult caregivers must learn the skills and strategies they can use at home in order to help the child progress and become a better eater and/or drinker.

The child’s caregivers and therapist are a team, working together to make sure the child receives the therapeutic, physical, social and emotional support to improve his or her feeding skills and habits. In order to provide patients what they need at home, therapists teach the child’s caregivers:

  • Feeding strategies and general advice for eating at home.
  • Tactics for addressing negative mealtime behaviors.
  • How to continue encouraging the child to eat the new foods introduced during therapy at home.
  • To keep a food log of what the child eats and how he or she acts at mealtime and reacts to foods.

Working as a team, the caregivers and therapist decide which foods to introduce or target during the therapy. This decision includes many factors including the child’s oral skill level (what he or she is able to chew, sip or swallow), the family’s culture and lifestyle choices, the child’s specific nutritional needs and any sensory or food texture experiences the overall therapy is addressing.

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How long will Feeding Therapy take?

The length and frequency of therapy depends upon each child’s needs. The child’s therapy team will work with the child and his or her caregivers to make sure the child gets the right amount of therapy so that he or she can progress without feeling too overwhelmed.

References:

Brittyn Coleman, M. S. (2021, April 30). The difference between picky eating & problem feeding. Autism Dietitian. Retrieved December 3, 2021, from https://www.autismdietitian.com/blog/picky-eating-problem-feeding. 

Feeding therapy. Children’s Health Orange County. (2021, April 8). Retrieved December 3, 2021, from https://www.choc.org/programs-services/rehabilitation/frequently-asked-questions-feeding-therapy/

Geoghagan, S. (2020, December 28). Kids and mealtimes: Problem feeders vs. picky eaters. Children’s Therapy Concepts. Retrieved December 3, 2021, from https://childrenstherapyconcepts.com/2020/05/kids-and-mealtimes-problem-feeders-vs-picky-eaters/. 

**The author of this site encourages you to consult a doctor before making any health changes, especially any changes related to a specific diagnosis or condition. No information on this site should be relied upon to determine diet, make a medical diagnosis, or determine treatment for a medical condition. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. For more information please read our full disclaimer here.**

Published by snackswithjax

Sarah is the creator and mom behind "Snacks with Jax", a social media community of over 85,000 parents/caregivers, where she shares her son's meals, nutrition information, and evidence-based tips for feeding children. She is a Certified Health Education Specialist with a Bachelor's degree in Nutrition emphasizing in Wellness from Texas Woman's University and years of experience as a culinary instructor working with ages 2+. She has coached hundreds of parents & caregivers through the journey introducing solids to babies and also navigating picky eating with toddlers and older children. Her focus is on establishing a life-long healthy relationship with food for children while also empowering, encouraging, and educating their adult caregivers.

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