Picky Eater or Feeding Disorder? By Dawn Cuglietto, Psy.D.
If your children are like mine, you’ve experienced your fair share of mealtime tantrums and picky eating. While hard to believe, periods of mealtime struggles are part of normal development – even if it means requests for chicken nuggets at every meal.
But what happens when a child can’t eat, won’t eat or severely restricts the foods he’ll consume? It’s estimated that 1 in 4 children exhibit feeding difficulties at some point during their development.
In the populations with physical disabilities, prematurity, developmental delays and/or chronic illness, the rate skyrockets to as high as 80 percent. Over a prolonged period of time, this is indicative of a much more serious, but less talked about condition called a feeding disorder.
A feeding disorder is suspected when a child can’t consume enough nutrition by mouth to sustain weight and proper development. The cause often stems from a complex combination of underlying medical conditions coupled with behavioral and emotional aspects. Medical factors may include digestive disorders, genetic conditions, severe food allergies, neurological conditions, respiratory conditions, chronic pain and structural anomalies.
Feeding disorders may present very differently for each child. A child with severe reflux may try to protect himself from pain by refusing to eat. Another may lack the neurological coordination to move food through the mouth, chew effectively and propel it to the back of the tongue for swallowing. A preemie who has been tube-fed may not recognize the feeling of hunger. These kids don’t have the skills and motivation that we take for granted. Eating is a complex process and they frequently miss one or more developmental stages in which they should begin learning to accept changes in feeding methods, tastes and textures – making mealtime a stressful experience.
Many parents describe months or even years of trying to fix feeding difficulties with little progress. They feel judged by family, friends and even medical professionals who may not be well informed about feeding disorders. It’s important to know that you’re not alone and there are professionals who can help.
Dawn Cuglietto, Psy.D., is a clinical psychologist and director of the Cindy and Tod Johnson Center for Pediatric Feeding Disorders at St. Mary’s Hospital for Children in Bayside. Call 718-281-8541. For related programs at St. Mary’s Kids at Roslyn, call 516-621-2681.
IF YOU SUSPECT YOUR CHILD HAS A FEEDING DISORDER
Speak with your child’s pediatrician.
Keep track of your child’s food/fluid consumption, bowel habits, symptoms and behaviors.
A consultation with a GI (gastrointestinal) specialist may be warranted to assess for underlying medical conditions.
A developmental specialist may prove helpful in assessing for developmental delays and/or neurological conditions.
Highly trained speech therapists can assess and provide interventions for chewing and swallowing problems; occupational therapists can assist with factors such as poor postural control during eating.
If your child’s condition is considered severe and/or doesn’t respond to individual interventions, seek a comprehensive assessment from a multi-disciplinary program.
Promoting Healthy Eating Habits
Expose your child to a variety of foods
Be a role model - children’s food preferences may be shaped by what parents eat themselves
Try to avoid the natural pull to use bribery to get your child to eat
