"Picky Eating" & Feeding Disorders
Approximately 25 percent of otherwise normally developing children experience feeding difficulties. This percent goes up to approximately 80% when we include the special needs population including children who are on the Autism spectrum.
These feeding difficulties, often perceived as "picky eating" by frustrated and discouraged parents, may result in intense parent-child conflict during meal times, as well as a decreased ability to participate in age appropriate and socially engaging activities like birthday parties, dining out, and special holiday meals, all of which may negatively impact the child's physical and emotional development.
While "picky eating" is a term that is bandied about freely by parents and on social media, many kids who are given this label, like our hero Tyler, have underlying oral motor delays, anxiety, gastrointestinal issues presently or historically, and/or sensory issues that severely impact their ability to safely and willing participate in an age appropriate diet. For these children, professional feeding therapy is recommended.
So, how does a family get help? The first thing to understand is that Pediatric Feeding Disorders require medical intervention. Feeding professionals such as Speech Language Pathologists and Occupational Therapists, are medically trained. Therefore, for most patients and their families, the first stop needs to be your pediatrician to talk about your child's challenges and to request a referral to see a feeding specialist.
"But they say, 'He'll grow out of it!'"
"I'm always told, 'You're just not trying hard enough/are too permissive/let your kid run your household"
"Everyone tells me, 'He'll eat when he's hungry. Children won't starve themselves!' but I'm not so sure..."
Feeding therapists hear things like this from parents all the time. Sometimes, we even hear it from other medical professionals (ouch!). When it comes to eating and drinking and kids, EVERYONE seems to have an opinion and be more than happy to share, and with the advent of social media, its become even tougher to parent children that aren't eating the beautiful meals presented on cartoon character plates displayed everywhere.
It makes meal times miserable.
It makes it impossible to participate in all the wonderful "fun" stuff peers and siblings are doing like having cake and ice cream at birthday parties, going to the county fair and trying some wonderful new concoction, dining out somewhere new and different, sitting down with extended family for special holiday meals.
"So," you ask, "how do I start?"
As I said before, the first stop is your pediatrician's or family doctor's clinic.
These days, medical professionals have a very limited amount of time they can spend with each patient, so when you go to the appointment, make sure you are prepared. What do I mean by prepared? Well, "picky eating' is a term that can encompass a whole range of "pickiness". For example, I know one child who came to me only eating one brand of cereal, dry, "blue box" macaroni and cheese, canned green beans and a pediatric liquid supplement drink. Some days, she'd accept chocolate milk, too. But only the pre-made stuff from the grocery store AND only ONE brand. That's an extremely limited diet! Her mom had struggled to get help because the child was not underweight and was following a growth curve... So, what to do?
Mom brought along a "food diary" with her to the next well-child appointment. What is a food diary? Mom wrote down everything her daughter ate and drank, at meals, snack times, grazing (walking and snacking) and before bed, for three days. Everything. And when she showed the list to the healthcare provider, it quickly became apparent that even though the child was growing, she had a severely limited diet and was not getting the kind of nutrition a young body and brain needs to grow and thrive.
Another approach, and one that's a bit easier for some: Take a picture of the child's plate at each meal and snack. Take both a picture at the beginning and at the end of the meal.
A food diary (whether picture or written) is one of the easiest ways to get a real handle on what and how much your child is eating and drinking. It is invaluable to you as a parent as you move forward seeking help. Not only can a food diary help educate healthcare providers about the limitations of a child's diet, but they can also help someone like myself, a pediatric feeding therapist, get an insight into what is and isn't working for your child.
Where should we go for therapy? Should we see a Speech Pathologist, an Occupational Therapist, or someone who is ABA trained and offers feeding therapy? Are groups best or private sessions? Should therapy take place in the home or at a clinic? The answer to all these questions is, "It depends." it depends on your child and what is best for them as well as what is and isn't available in your particular area.
As you can see, this is a rather complex topic. Please check my resource page for websites that can give you more help in these areas. In the future, I'll probably add a blog page, but for now, my goal is to help you find the help you and your family need by providing resources that include some amazing therapists.