Picky Eating – When should I be concerned?
How many times have you heard the term ‘picky eater’? The term is common and one which most of us are familiar with. It is often used as a general term to describe children and adults who are more selective about which foods they are and are not willing to eat.
The definition and therefore estimates of prevalence of ‘Picky Eating’ vary across the literature, however approximately 25% of children are reported to suffer with some form of eating difficulty, and in children with developmental delay, 80% are estimated to have a feeding disorder.
Whilst a certain amount of fussy eating is developmentally acceptable and to be expected (more to follow in a separate blog article), when should parents start to become more concerned about Picky Eating and when should they seek help?
The word ‘picky’ may sometimes have negative connotations, suggestive of a voluntary or ‘behavioural’ decision to restrict eating to certain foods. However, having worked in this field for over two decades, while some picky eating can certainly be described as behavioural, in my clinical experience, in the great majority of cases this is not the case.
Many factors may contribute to picky eating, including gut issues or a history of this, underlying medical conditions and/or oral-motor delays. These may not be immediately obvious, and that is where an expert assessment is invaluable.
When children are eating a sufficiently limited range of foods, are significantly restricted in the food tastes and/or textures they will accept with sometimes entire food groups excluded and/or mealtimes are sufficiently disrupted and protracted, ‘picky eating’ can then be more aptly described as a feeding disorder. Some children who can be initially described as ‘picky’ or ‘fussy’ eaters can sometimes also progress to have more disordered feeding, particularly if the underlying cause of the eating difficulty has not been identified.
Feeding Disorders can lead to faltering growth and macro- and micronutrient deficiencies as well as delayed oral-motor (biting and chewing) skills. Infants are born with the suck reflex; however, the development of oral-motor skills is a function of experience. Selective eating can be one reason that some children can develop delayed oral-motor skills as in some cases they are not eating a sufficiently wide range of foods to afford them the possibility to practice and refine their biting and chewing skills. This in turn can impact on growth and compromise macro- and micronutrient requirements as an insufficient range of foods is accepted and/or in insufficient volumes. Mealtimes can then in turn become more protracted, challenging and stressful for both the child and the family.
If your child’s picky eating is causing you concern, please get in touch today and let me help you to determine whether your child’s picky eating is appropriate for his/her age and stage of feeding development, and if not, what may be driving the feeding/ eating difficulties.
Following a comprehensive assessment, I will be able to support you to progress your child’s feeding development with a structured and bespoke individual programme informed by my assessment findings.
Reference for this article:
Manikam, Ramasamy, and Jay A. Perman. “Pediatric feeding disorders.” Journal of clinical gastroenterology 30, no. 1 (2000): 34-46.