Following my last post about picky eaters, parents should know that there is a more severe level of picky eating, which has been termed problem feeding. In the medical community, it is often diagnosed as “feeding difficulties”.
Problem feeders have the following behaviors:
- Young infants who refuse bottle or breast, or drink a small amount then refuse. This results in a decreased overall volume consumed, and eventually weight loss and dehydration.
- Toddlers and children who eat less than 20 foods.
- Kids who “lose” foods that they once ate, and do not resume eating them even after a few weeks break. Eventually they may be down to 5-10 foods.
- Kids who refuse certain textures altogether.
- Kids who scream, cry, and panic over touching, smelling, or tasting a new food.
- Kids who are unwilling to try almost any new food even after 10+ exposures.
Why do some kids become problem feeders?
- Gastroesophageal reflux disease (GERD), chronic constipation, delayed gastric emptying, dysphagia
- Food allergies
- Sensory processing disorders, autism
- Complications related to premature birth, including history of intubation and/or feeding tube
In these cases, the child forms “oral aversion” associated with the pain and discomfort they feel/felt as a result of eating or swallowing. This association is made very strongly in the young developing brain, and in the case of problem feeders, overrides hunger. Oral aversion becomes a protective mechanism, which is why they panic over eating new foods. Problem feeders can be underweight or overweight as a result of their rigid food choices, depending on what type and how much food they eat.
The big difference between picky eaters and problem feeders:
Eventually, a picky eater will come around to eat some type of food they are presented with outside of their usual repertoire, if they are hungry enough. A problem feeder will not respond to hunger cues to meet their needs with the food options presented to them if it is outside of their “accepted” foods. Problem feeders will go on a food “strike”, even if it results in dehydration and malnutrition.
Problem feeders need assessment and feeding therapy, which can be effectively achieved with a multidisciplinary team, such as at North Shore Pediatric Therapy. NSPT has occupational therapists, speech therapists, and dietitians to work through sensory, oral-motor, and nutritional deficits as well as mealtime behaviors. We also have social workers for additional support and behavior guidance. If you are concerned that your child is a problem feeder or a picky eater, contact our facility for an evaluation.