Many children — especially toddlers — go through phases of picky eating when they only eat a small range of foods. Most children eventually outgrow their finicky approach to food.
There are children, however, whose very limited food repertoire, reluctance to eat, refusal of entire categories of food textures, and tremendous aversion to new foods is beyond typical picky eating behaviour. According to Dr. Kay Toomey, a Pediatric Psychologist who specializes in feeding problems, these children are not picky eaters, they are problem feeders.
Parents should consider taking a problem feeder to a specialist if any one of the following is present (from www.sosapproach-conferences.com):
- Ongoing poor weight gain (rate re: percentiles falling) or weight loss
- Ongoing choking, gagging or coughing during meals
- Ongoing problems with vomiting
- More than once incident of nasal reflux
- History of a traumatic choking incident
- History of eating and breathing coordination problems, with ongoing respiratory issues
- Inability to transition to baby food purees by 10 months of age
- Inability to accept any table food solids by 12 months of age
- Inability to transition from breast/bottle to a cup by 16 months of age
- Has not weaned off baby foods by 16 months of age
- Aversion or avoidance of all foods in specific texture or nutrition group
- Food range of less than 20 foods, especially if foods are being dropped over time with no new foods replacing those lost
- An infant who cries and/or arches at most meals
- Parent repeatedly reports that the child is difficult for everyone to feed
- Family is fighting about food and feeding (ie. meals are battles)
- Parents reporting child as being “picky” at 2 or more well child checks
- Parental history of an eating disorder, with a child not meeting weight goals (parents not causing the problem, but may be more stressed and in need of extra supports)
The SOS (Sequential Oral Sensory) Approach to Feeding program was developed by Dr. Toomey and is an effective way to address problematic feeding behaviors.