When a child won’t eat the meal you offer him or her, it can be frustrating and worrisome for any parent. It’s common for young children to be picky eaters from time to time. But how do you know the difference between normal childhood pickiness and a true feeding disorder?
Childhood feeding disorders involve problems gathering food and sucking, chewing, or swallowing it. They occur when a child does not consume enough food or liquid to receive appropriate nutrition, calories, or hydration. In contrast to typical childhood pickiness, a child with a feeding disorder will likely refuse entire food groups or may be willing to eat only a few types of food. This can result in weight loss and eventually malnutrition.
Symptoms of feeding disorders can vary greatly from child to child. Children with feeding disorders may demonstrate the following signs:
- Arch their body or demonstrate irritable behavior while feeding
- Frequently cough, gag, spit up, or vomit during meals
- Spit out food
- Take a long time to feed—the amount of time to complete one feeding/meal will often exceed 30 minutes
- Act as if they are not hungry
- Refuse different food textures (e.g., a child may eat only pureed foods or only accept crunchy textures)
- Refuse to open mouth during feeding
- Hold food or liquid inside the mouth
- Only accept food or liquid from a bottle (this applies to toddlers)
Treatment of childhood feeding disorders can be a complex undertaking, often requiring a team of professionals. Depending on the underlying cause of the feeding problem, a feeding team may consist of a physician, a speech-language pathologist, an occupational therapist, a physical therapist, a nutritionist / dietician, and a psychologist / developmental specialist. Oftentimes feeding disorders are due to an underlying medical condition, so it is imperative to consult your pediatrician first and foremost.
Once any potential medical issues have been managed, feeding therapy from a trained speech-language pathologist may be implemented if feeding problems persist. In these cases, treatment may focus on improving strength and coordination of the muscles of the mouth and increasing acceptance of different foods and liquids.
- Having a picky eater does not necessarily mean your child has a feeding disorder.
- If your child spits out food or oftentimes takes a long time to feed, they may have a feeding disorder.
- Treatment may include feeding therapy from a trained speech-language pathologist.
Feeding disorder or eating disorder? Is there a difference? If so what are these differences?
For infants and young children, “feeding disorder” (from a speech-language perspective) refers to problems handling food in the mouth. For example, they may have a problem closing their lips all the way to keep food or liquid from spilling out. Or the may have trouble using the muscles of the mouth correctly to properly suck or chew food. Or they may have trouble swallowing food. Or they may have sensory issues, where they have a hard time accepting the feeling of certain textures in their mouth.
“Eating disorder” involves a psychological problem, usually in adolescence (although it can sometimes start in childhood too), where there are often issues with low self-esteem, a preoccupation with weight / body image, and an unhealthy relationship with food (e.g. binging or restricting).
Thank you for helping me to understand the difference. I now feel comfortable on my decision on how to help my child.
Very helpful article! I hate to say it but I am almost positive at this point one of my children have an eating disorder and it almost breaks my heart. I am just not exactly sure how to deal with it at this point. I am going to go into diligent prayer to find my next step but amazing article! Thanks bundoo! !!!
Definitely consult your pediatrician if you haven’t already– knowing how to deal with it will involve first finding out the root of the problem (e.g. a medical problem such as reflux?, sensory issues?, problems with the strength or movement of mouth muscles?, psychological / behavioral issues?, etc). Then a treatment plan can be developed. Good luck!