Written By: Victoria Wood, OTR/L

Thirty years ago, this would not have been a popular topic.  Children ate what was provided, like it or not.  Sometimes parents would spare the child and leave the offending objects off of the plate.  More often than not, children over the age of four were expected to eat what everyone else was eating. Fast forward to 2022.  There has been a huge rise in allergens, picky eaters, and problem feeders, and this has become the forefront of many therapy sessions and referrals.

Why?  Some of the change is due to parenting expectations, electronics, processed foods, and “free will”.  There has been a marked rise in sensitivities/allergens to certain foods.  This goes hand in hand with the rise of anxiety, illness, ADHD, autism, and poor immune response.  Children are just not as hearty as they were 20-30 years ago. 

It is not productive to get stuck in the “why”, but move forward to “what can I do about this”.  I am not just an experienced feeding therapist, I too had two picky eaters who survived on 3-4 different foods in their second and third year of development.  In order to help my daughters, I had to remove my parenting/worry/anxiety/they are starving hat, and put on my therapist hat.  I am happy to report they are thriving adults who eat a huge variety of foods!

Picky Eating

• Selective eating habits
• Eats 10-20 different foods
• Will often eat more if hungry
• Not missing entire groups of food groups
• Can often be bribed or rewarded for good eating
• Can be distracted into eating
• Adds and subtracts foods from diet

Problem Feeding

• Refusal to eat
• Rigid eating habits (no food touching, specific brand, same plate, cut a certain way)
• Eats less than 10 different foods
• Will starve before they eat unwanted foods
• Missing entire food groups
• Behavioral reactions: gagging, vomiting, crying, anxiety, refusal to sit at the table
• Increased sensitivity to the taste and/or texture of foods
• No amount of rewards, bribing, punishing will magically make this go away
• Does not recognize hunger
• Food jags, will lose foods once eaten regularly

What is the big deal?  The picky eater will survive.  They are likely to consume at least one meat, fruit, and vegetable and a bunch of carbs.  Continue to put out expected foods on the plate and encourage tasting of new foods.  The problem feeder on the other hand, is not consuming enough calories, or getting the right nutrition.  A person surviving on four foods, often gets tired of one of them, eating only three foods now.  This is more of a dire situation and the treatment is complicated.

If you have a problem feeder, seek treatment from a therapist who is certified or has attended classes in feeding therapy.  There is a lot that can go wrong working with problem feeders.  The Sequential Oral Sensory course, Beckmann Oral Motor Therapy, and Mealtime Miseries are popular courses.

For more information on this topic, Summit is offering my webinar on Sensory-Based Feeding Strategies.  I have also published a helpful resource book for different environments that may be impacting the eating habits of your child/clients, including the cafeteria, kitchen, restaurants, and more.  Click here to check it out on Amazon.

Feeding and toileting are two of the most frustrating, anxiety producing stages of childhood. Children start to exert their free will at this stage and can no longer be forced to do certain things. Encourage parents, educate yourself on this topic, and spread the word, so problem feeding does not continue to rise along with other scary diagnoses.