Thanksgiving puts every family’s eating habits on display. The table is full, relatives are watching, and your child eats two bites of a roll and asks to be excused. Across the table, a cousin the same age is working through turkey and green beans.
It’s natural to compare, and natural to wonder whether something is wrong. Most of the time, picky eating is a phase. Sometimes it’s more. Here’s how to tell the difference, how to get through the holiday meal without a standoff, and when to ask about feeding therapy.
Picky eating is common
Babies grow fast in their first year, then growth slows down. Appetite slows down with it. The American Academy of Pediatrics says a toddler may eat only one or two favorite foods for weeks at a time. A new food can take 10 or more tastes before a child accepts it.
Kids also go through stages where they become more opinionated, including about food. Melissa Harrell, a speech-language pathologist and APT’s speech therapy discipline advisor, sees this often. That pickier stretch “should resolve really, really quickly,” she says, and kids should go back to eating a variety of foods.
When picky eating doesn’t go away
The children Melissa sees in feeding therapy are the ones where it never resolves. She looks for:
- A very limited diet
- Whole food groups gone, like zero vegetables, zero fruit or zero meat
- Meals that take a very long time
- Trouble touching food
- Gagging while eating
- Not gaining weight, not growing as expected, or losing weight
When eating isn’t on track for a child’s age and affects their health, nutrition or daily life, doctors call it a pediatric feeding disorder. It’s more common than most parents think. According to Feeding Matters, it affects more than 1 in 37 children under 5 in the United States.
What’s usually behind it
Feeding problems rarely come down to stubbornness. There’s often a reason a child can’t eat certain foods yet.
- Sensory reasons. Some textures, smells or messy hands feel overwhelming. A child may need to feel calm before they can sit near the food. “A lot of feeding is just getting that child’s body to be calm so that they can eat,” says Meredith Doyle, APT’s occupational therapy advisor.
- Motor reasons. Chewing, moving food around the mouth and swallowing are skills. When they’re hard, a child sticks to foods that feel safe, like crackers or purees.
- Medical history. Kids born with cleft lip or palate, kids with Down syndrome, and kids who had a hard start with eating in the hospital often need extra help.
Speech therapists focus on chewing and swallowing. Occupational therapists focus on the sensory side. At APT, they often work together. Learn more about feeding therapy at APT.
Getting through the holiday meal
These tips won’t fix a feeding problem, but they can make the day calmer for everyone.
- Put one food your child already eats on the plate. A safe food makes it easier to sit at the table with everything else.
- Let new foods sit there. Skip “just one bite.” The AAP notes that pressuring kids to eat can make them dislike foods they might otherwise like.
- Skip bribes and the clean-plate rule. Dessert as a prize turns the other food into a chore.
- Give relatives a line. Try “We’re keeping dinner low-key this year.” Most people will follow your lead.
- Keep meals near your usual times. A child who is hungry, but not starving, comes to the table more ready to eat.
- Count a calm meal as a win. If your child leaves the table in a good mood, that’s progress.
Use the holiday table to notice
A big family meal is a good chance to see patterns. Which foods does your child reach for? Which do they push away? Do they gag, or take much longer than everyone else? Write down what you see. Those notes help your pediatrician and a feeding therapist.
When to ask about feeding therapy
If you recognized your child in the list above, it’s worth a conversation now. Melissa puts it plainly:
“There are going to be those children who are just a little bit behind and they will catch up on their own. The problem is we don’t know who those children are.”
An evaluation either puts your mind at ease or gets your child help early. Both are good outcomes.
Here’s how to start:
- Talk to your child’s pediatrician. A pediatrician’s referral is required before your child can be seen at APT.
- Start your registration while the referral is on its way.
- Come to the evaluation. You stay with your child the whole time.
It’s not only for little kids
Most children start feeding therapy young, but older kids and teens come in too. At that age, progress depends on the child wanting to make the change. If your teen is ready, we’re ready to help.
Read more about pediatric feeding therapy at APT, or reach out to get started.
Si su hijo presenta con estos síntomas, es importante de visitar su pediatra y seguir con una evaluación de alimento. Viste https://www.feedingmatters.org/ para mas información.