Demystifying "It's Just a Phase" in Picky Eating

Signs That Call for Intervention

Lately, I've been receiving numerous calls from concerned parents wondering if their picky eater needs feeding support. Despite reassurances from healthcare providers that it's just a passing phase, these parents are still worried—and they have good reason to be. As a feeding therapist, I've witnessed firsthand how picky eating can sometimes indicate deeper underlying issues that require professional attention. Let's explore the signs that may suggest it's time to seek feeding intervention.

Understanding Picky Eating: It’s Not Always So Simple

Picky eating is a common part of childhood. Many children go through phases where they refuse vegetables or insist on eating the same food repeatedly. However, when these behaviors persist or intensify, they may reflect more than just developmental normalcy.

Picky eating is multifaceted, influenced by genetics, environment, and sensory sensitivities. Research published in Pediatrics suggests that picky eating affects up to 50% of children, underscoring how prevalent it is among families (Birch & Fisher, 1998). That said, it's essential to distinguish between typical picky eating and feeding behaviors that indicate deeper concerns.

Signs That Catch My Attention

Oral Motor Struggles

Children who consistently struggle with biting, chewing, or overstuffing their mouths may be exhibiting signs of oral motor dysfunction. These difficulties often extend beyond simple pickiness and can be signs of feeding disorders requiring therapy. The Journal of Pediatric Gastroenterology and Nutrition highlights the importance of addressing oral motor issues in children with feeding difficulties (Kerzner et al., 2015).

Weight Worries

It's important to monitor growth in picky eaters. If a child is not gaining weight appropriately or is losing weight, this could be a red flag. The American Academy of Pediatrics emphasizes that failure to thrive is a serious concern that often warrants clinical intervention (Manikam & Perman, 2000).

Emotional Rollercoaster

Frequent tears, tantrums, and anxiety around meals are not just behavioral challenges—they may reflect a child's discomfort or negative association with eating. Emotional responses during mealtime should be taken seriously. Research shows that mealtime emotional distress is associated with problematic feeding behaviors (Dovey et al., 2008).

Food Group Fiascos

If your child avoids entire food groups—like fruits, vegetables, or proteins—it could lead to nutritional deficiencies. This behavior may point to sensory sensitivities or learned aversions. Interventions that support food variety are vital to preventing long-term nutritional issues (Bandini et al., 2010).

Mealtime Mismatch

When a child regularly eats different foods than the rest of the family or refuses to sit at the table, it could be more than a preference. This behavior may signal sensory or behavioral issues. Research emphasizes the importance of inclusive mealtimes and structured routines to support healthy eating habits (Jacobi et al., 2003).

Limited Variety

If a child's food repertoire can fit on a post-it note, it likely indicates restricted eating patterns. Children with limited variety may miss key nutrients necessary for growth and development. Early intervention is key, as children's willingness to try new foods tends to decrease with age (Nicklaus, 2009).

Food Fickleness

Rapid or frequent changes in food preferences can sometimes indicate underlying anxiety or disordered feeding patterns. For example, a child who previously loved apples but suddenly refuses all fruits may be exhibiting signs of sensory-based aversion. Unpredictable eating behaviors have been well documented in children with feeding disorders (Chatoor & Ganiban, 2009).

While picky eating is common, it is important to recognize when it crosses the line into something that may need intervention. Signs like oral motor challenges, limited variety, emotional distress at meals, and poor weight gain should not be overlooked. As a feeding therapist, I encourage parents to trust their instincts and seek support when something feels off. Early intervention can make a significant difference—helping children develop a healthier relationship with food and making mealtime a more joyful experience for the whole family.

References

Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., ... & Must, A. (2010). Food selectivity in children with autism spectrum disorders and typically developing children. Journal of the Academy of Nutrition and Dietetics, 110(2), 238–246. https://doi.org/10.1016/j.jada.2009.10.032

Birch, L. L., & Fisher, J. O. (1998). Development of eating behaviors among children and adolescents. Pediatrics, 101(3 Pt 2), 539–549.

Chatoor, I., & Ganiban, J. (2009). Feeding disorders in infants and toddlers: Diagnosis and treatment. Journal of Pediatric Gastroenterology and Nutrition, 48(Suppl 1), S1–S9. https://doi.org/10.1097/MPG.0b013e318193c6c2

Dovey, T. M., Staples, P. A., Gibson, E. L., & Halford, J. C. G. (2008). Food neophobia and 'picky/fussy' eating in children: A review. Appetite, 50(2-3), 181–193. https://doi.org/10.1016/j.appet.2007.09.009

Jacobi, C., Agras, W. S., Bryson, S., & Hammer, L. D. (2003). Behavioral validation, precursors, and concomitants of picky eating in childhood. Journal of the American Academy of Child & Adolescent Psychiatry, 42(1), 76–84. https://doi.org/10.1097/00004583-200301000-00014

Kerzner, B., Milano, K., MacLean, W. C., Berall, G., Stuart, S., & Chatoor, I. (2015). A practical approach to classifying and managing feeding difficulties. Pediatrics, 135(2), 344–353. https://doi.org/10.1542/peds.2014-1630

Manikam, R., & Perman, J. A. (2000). Pediatric feeding disorders. Journal of Clinical Gastroenterology, 30(1), 34–46. https://doi.org/10.1097/00004836-200001000-00010

Nicklaus, S. (2009). Children's acceptance of new foods at weaning. Role of practices of weaning and of food sensory properties. Appetite, 52(2), 78–84. https://doi.org/10.1016/j.appet.2008.09.004