There are many causes of picky eating and understanding how your child got to be such a picky eater can often help solve issues getting them to accept new foods. Below are the 5 most common reasons behind picky eating I see in my clients. You may be able to identify one of these factors in your child and this may help you guide them towards the acceptance of new foods.
1. A medical reason – Common medical reasons that can affect a child’s desire to eat include food allergy, EoE, (Eosinophilic Esophagitis, inflammation of the esophagus, caused by an allergic reaction), constipation, reflux, GERD (Gastroesophageal Reflux Disease) and celiac. In all of these situations, food makes them feel bad and they’ll have little desire to eat. Once the medical issue is addressed, these kids typical improve their food intake. Speak with your child’s doctor about your concerns and make sure none of these issues could be the cause.
2 Oral delay or tongue tie– Oral skills issues and lack of ability to move the food in the mouth could result in your child not advancing with textures and avoiding certain types of food. If food is falling out of your child’s mouth when they eat or you notice they are primarily biting and chewing in the front of the mouth, this could be the cause of their limited diet. Another red flag is children who never put anything in their mouth as a baby, never mouthed chew toys or had a chance to push back their gag reflex. They likely are adapting their diet to easy to chew foods because eating is exhausting, resulting in hunger cues that can be turned off due to lack of oral skills. If you suspect an oral delay, its best to have them evaluated by an OT or SLP who specializes in feeding.
3. A negative past experience – A bad illness, vomiting or choking episode can result in an oral aversion. The trauma and fear of that experience can be imprinted in kids brains, even if can’t consciously recall it. For some children with strong sensory aversions, the meal experience itself can provide negative reinforcements to want to eat, such as wiping the face during the meal and getting their hands messy.
4. Sensory overload – If your child is a Sensory over responder, eating can be overwhelming and extra challenging. Eating is the biggest sensory overload experience a child will have and if they struggle in this area with smells, touch, sight, and taste of new foods, this can overwhelm them, (this also ties in with #3 above, a negative experience). A sensory under responder can have challenges as well. If you suspect a struggle in this area, it would be ideal to have them evaluated by an OT for sensory processing disorder.
5. Behavioral – For some children, their picky eating is a learned behavior. They may have learned from a young age they can get what they want if they wait it out or have a tantrum. This can be common in a child with a strong personality who isn’t making it easy on you. Perhaps they have turned you into a short-order cook and haven’t branched out from a handful of their favorites and haven’t been exposed to new options? Children with this problem will require the most consistency being firm with the “how” of feeding.
Sometimes picky eating is a combination of a few of these factors or holds a strong genetic link. Regardless of the reason why your child is a picky eater, helping them accept new foods begins with the “how” of feeding; consistency at mealtime and multiple exposure opportunities to new foods.
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