When your child struggles with food refusal, impaired oral intake, or picky eating tendencies it can be challenging to know if you should seek help. In this blog I will highlight the differences between picky eating and a pediatric feeding disorder.

Picky Eating: Many parents tell me that their child is a picky eater. Unfortunately, the term ‘picky eating’ seems to be a catch-all phrase that parents (and therapists) use to explain a spectrum of feeding issues. This can be very confusing when the same term (picky eating) is used to describe a child that only eats buttered noodles and a child who will eat anything (including green veggies) as long as there is nacho cheese dip. My colleague and feeding researcher, Dr. Kay Toomey, describes Picky Eaters as children with the following characteristics:

• Has a decreased range or variety of foods (but typically has 30 or more food in their food range)
• Has foods lost due to “burn out” from food jagging (but are usually eaten after a 2-week break)
• Eats at least one food from nutrition categories (carbs, proteins, fruits, vegetables)
• Eats a least one food from texture groups (e.g., purees, meltable foods)
• Can tolerate new foods on their plate (and is able to touch or taste the new food)
• Frequently eats a different set of foods at a meal than other family members
• Typically eats at the same time + same table as other family members
• Sometimes reported by the parent as a “picky eater” at a well-child check up

Pediatric Feeding Disorder (PFD): Did you know that pediatric feeding disorder impacts millions of children worldwide each year? Research has found that 1 in 37 children under the age of 5 years has PFD. A pediatric feeding disorder is not picky eating. It is defined as impaired oral intake that is not age appropriate. And it is commonly associated with medical, nutritional, feeding skills and/or psychosocial dysfunction. Some signs of a PFD are:

• Medical Concerns: impaired structures or function, additional medical diagnosis, or aspiration
• Choking, gagging or coughing while eating or drinking
• Vomiting
• Poor or excessive weight gain
• Suboptimal growth
• Fatigue during or following feeding
• Nutritional Concerns: difficulties with a variety of beverages and foods consumed
• Lack of energy
• Poor weight gain or excessive weight gain
• Dehydration
• Feeding Concerns: difficulties using feeding utensils, delays in self-feeding skills or prolonged mealtimes
• Difficulty chewing or swallowing
• Getting tired during feedings
• Limited food choices
• Dependence of a feeding tube
• Psychosocial Concerns: difficult mealtime interactions, problematic mealtime communication or caregiver stress
• Child refusing to eat or drink
• Difficulty eating in certain situations
• Difficult behaviors, such as tantrums during mealtime
• Parents and caregivers feeling stressed or overwhelmed

Feeding Therapy: If you are struggling with picky eating tendencies or you suspect a PFD, fill out the 6-Question Screener by Feeding Matters. This screener can help you (and your feeding therapist) differentiate between picky eating and a PFD. Then, seek out a qualified Speech Language Pathologist or Occupational Therapist that specializes in feeding and swallowing to help your family with mealtime milestones. Oftentimes families only need a few sessions of feeding therapy to work on self-feeding skills or overcoming psychosocial concerns.

Feeding Support: Pediatric feeding disorder is a common diagnosis, yet parents are oftentimes dismissed by medical professionals and family when voicing their struggles and concerns. Team ezpz is a proud partner of Feeding Matters, a non-profit that works year-round to raise awareness of PFD and support families struggling with PFD. If you are feeling isolated or overwhelmed with mealtime, sign up for their parent mentor program for support.

Do you have a child with a pediatric feeding disorder? Are you using ezpz products to help with their self-feeding and swallowing skills? If so, be sure to tag us with our hashtag #ezpzfun.