“My child is such a picky eater!” We’ve all heard it and most of us have said it. 

We’d be hard-pressed to find a parent that hasn’t struggled to get veggies into little tummies or had a 3-year-old (or 8-year-old…) crying over a sandwich cut into squares instead of triangles. Picky eating is pretty normal – but when does it go beyond picky eating to a feeding aversion? And, what about infants – when should we be concerned with our baby’s lack of interest in breastfeeding or taking a bottle?

It’s normal for a child to be particular about the way food is presented or prepared. It’s normal for children to avoid new foods. It’s perfectly normal for there to be foods that your child just won’t eat. But, what if it goes beyond just being picky? What if we’ve tried some strategies to make eating fun and appealing to kids and it’s not working? (Stay tuned – we’ll get to some strategies below). A feeding aversion could be the cause and therapy with specialists at EIRMC could be the answer. 

Alix Buchanan is the Pediatric Therapy Supervisor at Eastern Idaho Regional Medical Center and is an expert when it comes to helping kids and families overcome a feeding aversion. She has shared some valuable information and tips for any parent with a picky eater! 

What is a feeding aversion? 

A feeding aversion is when a baby or child, who is capable of feeding or eating, avoids and/or refuses to do so. 

For an infant, this means they are having trouble or refusing to nurse or take a bottle and some signs could include: 

• Should be hungry but refuses to eat
• Only eats with distractions such as loud music or TV or only when sleeping
• Poor growth or sudden weight loss 

For children, a feeding aversion is the most significant form of picky eating and signs include: 

• Eats less than 20 different foods
• The list of foods the child does eat gets smaller and smaller over time
• Foods they do eat must be prepared a certain way
• Regular strategies to encourage kids to eat don’t work
• Child may gag or throw up around food
• Child has an intense physical reaction to eating beyond whining and saying no
• Poor growth, sudden weight loss or gain
• Child avoids public and social situations in which food is involved (for example: not wanting to eat in the cafeteria at school, not wanting to attend birthday parties or get-togethers where food is involved) 

It’s normal for children to have foods they won’t eat and avoid new things. However, if they are not responding to normal strategies to help with this it may be time to chat with your pediatrician. Let’s talk about some things we can do to help our picky eaters! 

Strategies for picky eaters: 

• Offer very small portions at mealtimes – both foods they like and may not like. 

A child’s appropriate serving size is 1tbsp per year (3 yr old serving = 3 tablespoons of peas). So, you can imagine how a 3-year-old might respond to a large serving of a new food – they don’t particularly like it and they can’t eat that much anyway. 

• Get kids involved with food prep. 

If a child helps to wash vegetables or sprinkle them with seasoning they will be less likely to refuse it.

• Present food in a fun way. 

Use divided plates, bento boxes or small bowls for dipping. Have kids pick out their favorite dishes or give them special dishes as gifts for birthdays and holidays. Serve food in fun shapes or faces. 

• Have patience. 

It can take a child up to 15-20 interactions with a type of food before a child will be comfortable and eat it without whining or coaxing. 

• Only offer water between meals. 

Juice and milk can be filling for kids. If a child has a tummy full of milk they won’t be hungry at mealtime. Try to limit snacks between meals as well – a hungry kiddo is more likely to try new foods and not avoid mealtime. 

• Avoid using food as a reward. 

Encouraging kids to finish their meal so they can have dessert is enticing – we’ve ALL been there. However, their tummies are small and encouraging healthy habits is best. Maybe start a sticker chart for trying everything on their plate and pick a toy or special activity when they’d hit the goal. 

These are great tips for any kid! But, if you’ve tried these and your child’s list of foods they eat is dwindling and foods lead to intense reactions from your child it may be time to talk with your doctor about therapy. 

What if I suspect my child has a feeding aversion? 

If an infant at any time displays the signs above talk with your pediatrician and ask for a referral to a feeding therapist. Preterm babies, those with excessive reflux, or with a history of hospitalization requiring intubation may be at a higher risk for developing a feeding aversion. 

If your child is showing some of these signs keep a 3-day food journal. Write down all of the things your child eats and drinks for 3 days. Take notes about times and reactions to foods. Then take that journal with you to talk with your pediatrician, and ask for a referral to a feeding therapist. 

Speech and occupational therapists at EIRMC are specially trained to identify and treat children for these conditions. They will meet with you and your child to take an in-depth feeding history. They will essentially “play detective” to figure out what is causing the aversion, and then create a detailed plan for therapy. 

A typical therapy session happens once a week and includes washing hands, a sensory activity, prepping food, serving themselves or with help, and practicing strategies that meet each child’s individual needs. Parents are involved every step of the way so that practice can be carried out at home as well. 

It is completely normal for picky eaters to be an annoyance to us as parents. But if you find a lot of anxiety and intense reactions around foods or a very small list of food prepared a certain way – you may have a child with a feeding aversion.

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