How To Tell If It's Picky Eating Or Something More

by Wendy Wisner
Originally Published: 
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If you are like me, and just about every parent out there, feeding your kids can be a total shit-show. You may have thought you’d be the glorious exception, and you’d raise a kid who will eat anything you put in front of them. But the reality is that most kids at least have one annoying phase of picky eating.

Picky eating can run the gamut from the kid who will only eat his sandwich if you take off the crust, to the kid who will not eat anything green—even that speck of oregano in his tomato sauce. For some kids, picky eating is just part of the terrible twos (and threes, and fours…the fun never ends). Other kids just don’t like anything too flavorful, smelly, or weird looking.

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These sort of things can be annoying as all hell, especially if your kid is especially stubborn about it. But generally, despite what Susie Q Perfect Parent might tell you, picky eaters are common, normal, and just one of the joys of raising kids.

Some of us with extremely picky kids might have wondered, however, if maybe there was something actually “wrong” with our child. I mean, there’s picky, and then there’s P-I-C-K-Y as fucking hell. You know, the kid who is healthy and growing, but who will literally eat only about 20 things, and only prepared in a very particular way.

Case in point: I have two sons. One is what I think of as a pretty normal picky eater. He’ll turn his nose up at certain foods, but will usually eat them with a little cajoling. My other son, however, is really, really freaking picky.

He was the kid who would only eat about 20 different things when he was a toddler. And God forbid you put his food on the wrong colored plate, or cut his sandwich into halves when he asked for fourths. There was no convincing him that a particular food was okay or could be tried, and there were times when the smell of unwanted foods made him gag.

The thing is, there were always healthy foods like broccoli and hummus on his “yes” list, and he grew well and thrived otherwise, so I never really pushed the issue of his picky eating. And now, as a tween, it has mostly resolved, although he is still much pickier than his peers.

At the time, though, like countless other worried parents, I wondered if his pickiness may have bordered on something more problematic. But according to Carrie Becher — a pediatric occupational therapist from ATI Physical Therapy in Grand Blanc, Michigan — in most cases, picky eating is just a developmentally normal phase, especially for toddlers.

“With picky eating, a child might become oppositional or have a typical ‘toddler tantrum’ over being asked to eat green beans, having chicken for dinner vs. their favorite chicken nuggets, or being offered a new dinner such a meat loaf,” she tells Scary Mommy. “They have their preferences and will test the limits in an effort to have their preferred meals offered daily.”

Oh yes, that sounds extremely familiar. And it’s so frustrating!

Becher specializes in infant and toddler “feeding aversion,” a term I didn’t even know existed when my son was young. To distinguish normal pickiness from “feeding aversion,” Becher says that children with true feeding aversions typically have the following symptoms/characteristics:

– Usually have an accepted food items list of less than 20

– Reject or eliminate entire categories of food

– Experience recurrent gagging, vomiting, or persistently choke on food

– Have trouble gaining weight or developing properly; feeding tube may be discussed

And what causes disorders like these?

Well, they don’t manifest from thin air, says Becher. They usually have an underlying cause. There may be a medical cause like prematurity, anatomical or functional challenges, neurological disorders like infantile spasms or cerebral palsy, or sensory processing disorder.

At other times, the feeding disorder can stem from a negative experience a child may have had with the food that becomes stamped in their psyche. For example, your child may have accidentally choked on a food, or been sick after eating a food, and will therefore refuse it on a long-term basis.

Becher noted that true feeding disorders most often start in infancy. So again, having a toddler who suddenly shuns everything green is usually normal. But if you had a baby who was difficult to feed, gagged persistently while trying to latch onto breast or bottle, or who couldn’t coordinate the “suck, swallow, breathe” pattern, you may have a child with a feeding disorder, especially if these patterns continue into toddlerhood or beyond.

So what should you do if all signs point to a feeding disorder–or if you simply have concerns about your child’s eating?

Taking your worries to your pediatrician is the first step, says Becher. If it’s a minor issue, your child’s pediatrician might be able to help you solve the problem on your own. But if that doesn’t resolve things for you, your pediatrician will refer you to an occupational therapist, speech therapist, or other feeding specialist professional who will be able to assess your child and come up with a plan to help them overcome their disorder or aversion.

Bottom line: Your picky eater is probably normal. However, if they have any signs that concern you—even a little bit—it is always wise to take them to the doctor to get evaluated. It’s always better to be safe than sorry, especially when it comes to the wellbeing of our kids.

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