All kids can be picky, but when should a parent worry? In my article Early Signs That Baby is Picky — and What to Do About It, I highlighted red flags that may indicate a pediatric feeding delay or disorder.
What’s the difference between a delay and a disorder?
Delay refers to a gap in development. Learning to eat is a developmental process because it’s a fine motor skill. When kids are delayed in any skill, if the gap is mild, they may just need a little boost or a few ideas from a professional to catch up with peers. If children’s skills are lagging enough to cause concern, they may need a formal feeding evaluation. Kids have a feeding disorder when the assessment shows that they are not progressing through feeding skills like biting, chewing and swallowing a variety of age-appropriate foods in a safe and effective manner. Thus, if the delay or gap is widening, it may indicate a feeding disorder and require treatment. Extreme picky or fussy eating is also considered a feeding disorder.
What causes a pediatric feeding disorder?
Picture three blocks stacked on top of each other. The first block is physiology, which includes our sensory system. Medical or physiological reasons that make eating challenging include (but are not limited to) a cleft palate, gastroesophageal reflux disease (GERD) and a disorganized sensory system.
The second block represents motor skills. Examples of gross motor skills include baby sitting up on his own by 6 months of age, walking shortly after 12 months of age and learning to skip in preschool. Fine motor skills include handwriting, picking up small objects or foods with the pincer grasp, and oral motor skills like chewing, just to name a few. When kids are delayed in gross motor skills, like sitting up independently, it will have a direct impact on fine motor development, too. Sitting up with good head control is essential for safe introduction of finger foods, as well as purees.
The third block represents learned behaviors. If baby often turns away from the spoon, refuses certain textures or cries consistently when put into the high chair, it’s because he has learned that eating is hard. We want baby to enjoy all kinds of food, and getting help from a feeding professional can ensure that a stall in feeding development doesn’t impact a child’s nutritional health. It has been reported that at least 25 percent of typically developing kids will develop a feeding disorder and that at least 70 percent of kids with special needs have a feeding disorder.
Where to find help:
Talk to your child’s pediatrician and insist on a feeding evaluation that looks at the whole child — physiology, motor skills and learned behaviors. Resources vary state to state but may include a free to low-cost evaluation via Early Intervention Services in the United States. There are a wide variety of support systems for parents in other countries, and a pediatrician can guide parents to resources. Many insurance companies cover medical testing and feeding assessments at local hospitals and clinics. Most importantly, don’t wait for your child to “just grow out of it.” The wait-and-see approach allows the gap to widen over time. Picky eating isn’t always a stage and may indicate something that needs professional intervention in order to bring back happy, stress-free mealtimes for the entire family.
Melanie Potock, MA, CCC-SLP, is an international speaker on the topic of feeding babies, toddlers, and school-age kids. She is the co-author of the award-winning Raising a Healthy Happy Eater: A Stage-by-Stage Guide to Setting Your Child on the Path to Adventurous Eating (2015) and Baby Self-Feeding: Solutions for Introducing Purees and Solids to Create Lifelong Healthy Eating Habits (2016). The tips in her latest book, Adventures in Veggieland: Help Your Kids Learn to Love Vegetables with 100 Easy Activities and Recipes (2018) are based on the latest research and Melanie’s 20 years of success as a pediatric feeding therapist. Melanie’s advice has been shared in a variety of television and print media, including The New York Times, CNN.com, Huffington Post and Parents Magazine. Visit her at www.MelaniePotock.com for more articles, professional tips, and helpful videos to raise your adventurous eater!
The content provided in this article is intended for informational purposes only. It is not recommended as a substitute for professional medical advice, diagnosis or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem without consulting a qualified healthcare professional. Always seek the advice of a qualified healthcare professional regarding any medical questions or concerns. See additional information.