Does your child have a feeding disorder or is he just picky?


Picky eating among young children is so commonplace, it often is a topic at cocktail parties and playgrounds: "My child won't eat anything green," or, "My child eats only white foods."

Most children outgrow this stage between 5 and 7. Yet for a large percentage of developmentally delayed children, such as those born prematurely, and 5 percent of the rest of the population of toddlers and children, picky eating is a serious health problem.

What's wrong?

Some children are so picky or feeding averse they will consume only a few foods, such as crackers and certain types of juice.

How do you know what type of feeder your child is? A picky eater may reject certain foods, but still has a nourishing diet. Children with a pediatric feeding disorder may consume only three to four types of foods and reject entire food groups, resulting in too few calories and nutrients for healthy growth and development.

"Most kids experience food jags. A child with a feeding disorder will start omitting foods out of their repertoire instead of adding them," says early intervention nutrition specialist Jennine Sidler, RD, of Primary Nutrition Specialists in Frankfort. "Often the first sign of an eating disorder is they can't look at the food."

She points to numerous physical reasons a child rejects certain foods, including pain, malaise, immature motor skills, behavior or emotional problems, and parental or environmental factors. "Most of the time it's physical-some type of surgery, reflux, GI pain or negative reinforcement. Or they have autism, Asperger's syndrome, Down syndrome or some type of development delay."

Kay Toomey, Ph.D., a pediatric psychologist, developed the SOS (sequential oral sensory) Approach to Feeding, a program for assessing and treating children with feeding problems. She distinguishes picky eaters from problem eaters by the variety of food accepted. If the child accepts more than 20 foods, he is a picky eater. A problem eater eats fewer than 20 food items.

When new foods frighten

Studies at the University of Pennsylvania's Monell Chemical Senses Center found that many times children have aversions to food textures.

"Generally it's the wet plant foods such as the fruit and vegetable group that the sensory kids avoid," says Sidler, a mother of three, one of whom is picky due to allergies.

Feeding problems are increasing due to the rise of disorders such as autism, sensory integration, and even prematurity.

"A feeding problem is often the first clue a developmental disorder exists," she says.

"Most of the kids crave crunchy and eat a lot of the starch group. They're completely omitting the fruit and vegetable group. A lot of times it feels like they're eating a grasshopper. They can't even touch it."


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