Why won’t my kid eat?
Making sense of picky eating and finding solutions
More than 50% of parents of young children report that they are concerned about their child’s eating habits. While some picky eating habits are a normal developmental stage, others have deep roots. When we invest time in figuring out root causes, it’s easier to find strategies that will work best for your child.
You, as parents, are often the most concerned about your child’s nutrition, growth, and health. Those are all valid concerns. As a pediatric occupational therapist and feeding specialist, I look beyond the surface to reasons that also include developmental, medical, oral motor, social/emotional and sensory concerns.
Neophobia: Around the age of 18 months, toddlers develop neophobia, the fear of something new. This fear can include new experiences and being hesitant around new people. We generally see toddlers wanting the same foods over and over again because it feels familiar and safe to them.
Autonomy: Preschoolers are on a search for autonomy and independence. They can become rigid and inflexible and want foods served the same way every time.
Reflux or pain while eating: Children who have experienced reflux or pain while eating become protective of their food choices.
Sensory sensitivities: We often think of textures when we think of food sensitivities, but children may also have reactions to strong smells and flavors.
Previous negative experiences: If a child became sick after eating a certain food, they could develop aversions specific to that food and other foods with similar characteristics.
Oral motor: If a child has always had a limited diet, they haven’t had the opportunity to develop age-appropriate oral motor skills for chewing and swallowing foods with different textures.
Limited role models: If children often eat their meals alone or have a parent or caregiver who has their own food issues, their relationship with food becomes compromised.
Recognizing the difference between a normal phase of picky eating and a situation that requires help can be confusing, especially when other health professionals wrongly assume that picky eating is just a phase. We’ll help to break the signs down so you can get the help you need as early as possible.
Duration and severity
Normal: Temporary developmental stage that results in mild picky eating, is sporadic, and isn’t affecting your child’s growth or health
Seek help: If picky eating persists for an extended period, becomes more severe, leads to noticeable weight loss, lack of energy, developmental issues, or nutritional deficits.
Limited food variety
Normal: Preferences and certain food dislikes are normal. Children also often go through phases of preferring one brand over another, sometimes due to recognizing favorite characters on the packages. However, they will still be eating foods of different colors, textures, flavors, and from each food group.
Seek help: If your child has fewer than 10-20 safe foods, eliminates foods from entire food group categories, and they are becoming more rigid about the brand or presentation of the foods they will eat.
Behavioral changes
Normal: Mild resistance to trying new foods is common. Expressing preferences for foods is often a normal part of development.
Seek help: Extreme anxiety, fear, or distress during meals will lead to even more power struggles and may damage the family relationship.
Underlying medical conditions
Normal: Occasional refusal of foods due to constipation or stomach issues
Seek help: If chronic constipation is inhibiting regular food intake. Other stomach problems such as reflux often result in bad habits that lead to poor weight gain.
Parental concern and stress
Normal: Mild stress, frustration, and concern about your child’s weight, nutrition, and food intake
Seek help: If your stress is overwhelming, there is likely a reason for it. Your child is able to feel your stress, leading to more complicated food relationships.
When deciding whether to seek help for your family, the key takeaway is to trust your instincts. If you think there’s an issue, it’s always best to err on the side of caution and get help for your child as soon as possible. Early intervention helps children become more flexible. At That Makes Sense OT, our mission is to share evidence-based, practical tips and strategies with parents and children to give them the confidence and skills to create harmonious mealtimes that last a lifetime.
If something on this list resonated with you, and you’re inclined to seek help as a result, trust that instinct. We’re here to help. We’ll discuss steps you can take to start you along the path toward successful and peaceful mealtimes.
