"Picky Eating": What's Developmentally Appropriate & How to Know When it's a More Complex Issue

 
 
 

Would you describe your child as a “picky eater”? Many parents of young children do!

How do you know when it’s developmentally appropriate vs. when is it a more complex issue to investigate and seek support? I’m here to help you understand this distinction and determine the answer for your child (and/or clients).

As an integrative Speech-Language Pathologist and pediatric feeding specialist, in addition to being a Functional Nutritional Therapy Practitioner and Documenting Hope Certified Health Coach, my passion is working with parents who are navigating complex picky eating and/or neurodevelopmental conditions (often overlapping but not always).

The term “picky eating” is so broad and often overused for kids who really do have a more complex issue, like a pediatric feeding disorder. Most pediatric and family health, wellness, and developmental providers are not properly trained to understand the full scope of “picky eating” (like knowing when it’s a real problem for families, how to help, and where to refer them based on the issue).

 

Let’s take a look at what’s considered developmentally appropriate vs. what would be considered a more complex issue…

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Please note: The following lists of “picky eating” criteria were largely inspired by, and some contents were adapted directly from, S.O.S. Approach to Feeding, "Picky Eaters versus Problem Feeders", by Dr. Kay A. Toomey.

Developmentally Appropriate “Picky Eating”:

  • Child is within toddler to preschool age and…[see below]

  • Will eat at least 30 different foods

  • Eats at least one food from most food textures and/or nutrition groups

  • May really enjoy a certain food for a while then "burn out" on it, then re-introduce in a couple weeks

  • Is able to emotionally tolerate the sight of new foods on the table and on their plate most of the time

  • Will usually, sometimes hesitantly, touch or taste a new food

  • Typically eats with the family but not uncommon for them to sometimes have a different meal or different variations of the family meal

  • “Picky eating” seems to come and go (it’s not every single meal, every single day)

  • Sometimes reported as a "picky eater" to health providers

 

 
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When I use the term complex picky eating, I’m referring to when a child's picky eating / self-restricted eating habits are not developmentally appropriate and are persistently & consistently causing quality of life issues for the child and/or family.

Some synonymous or sometimes co-occurring terms could also be: Pediatric Feeding Disorders, problem feeders, extreme picky eating, severe picky eating, etc.

Note: These terms listed above are not always exactly synonymous and/or co-occurring with what I’m describing as complex picky eating. Ex: There are some children who have Pediatric Feeding Disorders (PFD) who I would not consider complex picky eaters, but sometimes children with complex picky eating have a presence and/or history of a Pediatric Feeding Disorder.

 

 

Complex Picky Eating:

  • Child’s “picky eating” consistently creates a quality of life issue for the child and/or family (unpleasant mealtimes and feelings of stress, overwhelm, defeat, etc.)

  • If your child has a developmental delay(s), neurodevelopmental condition(s), or other special need(s) as well as the presence of “picky eating” that impacts your child and/or family’s quality of life

  • If your child has a diagnosed chronic health condition or the persistent unwanted chronic health symptoms as well as the presence of “picky eating” that impacts your child and/or family’s quality of life

  • Child is outside of those toddler to preschool age years and still has regular persistent “picky eating” tendencies

  • If in toddler to preschool years and...[see below]

  • Typically self-limited down to eating less than 20 different foods

  • May really love a food, eat it often and consistently, then seems to "burn out" on it

    • For these kids, foods that become "food jags" are generally not easily reintroduced once they’re lost or “burnt out” on them (at least not for a long, long, time)

  • Child has a very difficult time emotionally tolerating the sight of new and/or unpreferred foods on their plate

    • May whine, cry, protest, push away plate, take the new or unpreferred food off right away, etc. Full refusal of the new or unpreferred food(s)

    • Child's reaction to new or unpreferred foods causes an emotional disruption in the mealtime

  • Refuses certain food textures or nutritional groups entirely

  • Almost always eats a different meal than the rest of the family and often doesn't eat with the family during mealtimes (sometimes because the family’s food bothers the child)

  • Consistently reported as a "picky eater" to health providers

 
 

Pediatric Feeding Disorder:

Pediatric Feeding Disorder is the official diagnostic term that some of the children with what I’m often referring to as complex picky eating could potentially qualify for. Typically I choose to use “complex picky eating” more often in my content because it’s more “parent friendly” / what parents are internet searching, at least initially.

It is estimated that 1 in 37 children in the United States under the age of 5 has a Pediatric Feeding Disorder.

According to Manikam & Perman (2000), “Pediatric feeding disorders are common: 25% of children are reported to present with some form of feeding disorder. This number increases to 80% in developmentally delayed children. Consequences of feeding disorders can be severe, including growth failure, susceptibility to chronic illness, and even death. Feeding disorders occur in children who are healthy, who have gastrointestinal disorders, and in those with special needs.”

Raising awareness and identification are the first steps!

I hope that this information helps clarify what is developmentally appropriate vs. what’s a more complex picky eating issue.

I encourage you to explore the contents of the site further and/or listen in to Speaking of Health & Wellness: The Podcast where I dive much deeper into this topic and give action steps that you can use at home! You can find the podcast here on the site and on major podcast platforms.

This podcast episode pairs well with this blog:


Are you ready to learn how to help your child overcome complex picky eating and bring more ease and joy to mealtimes?

Enroll today in Naturally Navigating Picky Eating, a self-paced online course + guide for parents and caregivers of children with complex picky eating, with and without developmental conditions…

Autism & Complex Picky Eating: Underlying Causes and Strategies for Support

 
Whatever it is, the way you tell your story online can make all the difference.
 
 

In this final episode of Season 1 of Speaking of Health & Wellness: The Podcast, I'm covering autism and complex picky eating using my signature © Complex Picky Eating Paradigm as a framework to help guide your understanding of the underlying causes of complex picky eating.

We'll explore the overlapping nature of these five domain categories as they relate to autism and complex picky eating:

  • Behavioral / Environmental,

  • Trauma,

  • Biochemical / Nutritional,

  • Structural / Functional,

  • and Medical

Listen in to hear concrete examples, solutions, tips, and insights related to the potential root causes of your child's (and/or client's) complex picky eating, with a special emphasis focus on autism!

Mentioned in the Show:

 

Are you ready to learn how to help your child overcome complex picky eating and bring more ease and joy to mealtimes?

Enroll today in Naturally Navigating Picky Eating, a self-paced online course + guide for parents and caregivers of children with complex picky eating, with and without developmental conditions…

Autism Awareness, Acceptance, and Action: It's Okay to Have Mixed Feelings

 
 
 

Autism Awareness, Acceptance, and Action...Can they coexist? I believe so!

In Episode 14, I'm covering the diagnostic criteria and rising rates of autism spectrum disorders, as well as the changes in formal diagnostic criteria in the DSM-5.

I'll be exploring various subtypes of autism, and the "communities" within the overall larger community of autism spectrum disorders (specifically the biomedical community, the neurodiversity community, and the traditional behaviorist community).

We'll talk about the difference between person-first language and identity-first language, and how the language we're using within the autism community really does matter... but it might matter differently to different communities within the larger autism community.

I share my own mixed feelings about Autism Awareness Month / day, and offer validation that it's okay for you to have mixed feelings too, if you do.

While there may be differences among the autism communities, I think everyone within the autism community really wants the same thing: For individuals with autism or autistic people, whichever that individual’s preference, to be able to live their best lives and be fully respected and loved.

Let's raise awareness. Let's teach love and acceptance of individuals where they are - always! But let's not forget: There's action to be taken for their individual health needs, and to move this conversation forward as a collective whole.

Push play below and listen in to Episode 14 to learn more!

Mentioned in the show:

BLOG: “Exploring Autism and Other Neurodevelopmental Disorders as Whole Body Conditions”

Episode 5: “Exploring Autism and Other Neurodevelopmental Disorders as Whole Body Conditions”

TACA Autism Statistics

 

Three Skills All Kids Need Before Developing Language: "Prelinguistic Skills"

 
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In Episode 13 I'm covering 3 prelinguistic skills that all children need to develop before developing language:

1. JOINT ATTENTION; 2. IMITATION; & 3. SYMBOLIC PLAY

This list is not exhaustive of these prelinguistic / pre-language skills but we're highlighting 3 very important ones that you can easily incorporate into your daily routines with your child!

This podcast is for parents of children who are typically developing, have developmental delays, or children who have symptoms or a diagnosis of a known neurodevelopmental condition like autism.

Not only are these skills foundational to language development, they also support social communication skills as well!

Listen in to learn these prelinguistic skills and a variety of examples of how you can naturally weave these strategies into your child's day. Enjoy!

 

Five Nutrients for a Healthy Brain & Which Foods to Find Them in

 
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As the title shares, Episode 12 covers 5 nutrients for a healthy brain, not just for development and but also for general brain health! I share which foods to find these nutrients in and a variety of ways to incorporate these whole foods into your child's diet. I’m sharing insights and creative ways to improve your child's willingness to tolerate and try these new or even non-preferred foods. Hope you enjoy it!


Mentioned in the show: 

Michelle Hoover from Unboundwellness.com - GFCF (AIP) Recipes - Salmon Cakes

Tony Mitra's work regarding organic chickpeas in North America containing glyphosate

 

Traumatic Brain Injuries, Leaky Brain-Leaky Gut, and Picky Eating...What's the Connection?

 
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You may have heard of "leaky gut - leaky brain" but have you heard it the other way around? "Leaky brain- Leaky gut"?

In this episode, we're covering "leaky brain - leaky gut", primary and secondary brain injuries, a brief overview of the nervous system and the gut-brain connection, as well as the biochemical and neurobiological ways that complex picky eating can develop following a traumatic brain injury or even after a concussion that doesn't seem too significant or traumatic in nature.

We'll explore some beginning nutrition and lifestyle tips and strategies you may want to consider, regardless of how long it's been since the traumatic brain injury took place (although, the sooner the better of course). We'll cover how and why individuals with TBIs develop food and environmental sensitivities and what you can do to help support them, especially when it comes to complex picky eating.

If you're brand new to these topics of "gut health" and the gut brain connection, please visit Episode 6 titled, "How "Gut Health" Impacts Your Child's Health and Development" and then come back to this one. Episodes 6-10 are absolutely relevant to listen into if this resonates with you!

Do you know someone who could benefit from this information?

Please help spread this information to those who need it most by sharing this episode with them. Thank you so much for helping Speaking of Health & Wellness support more families and providers!

Enjoy the episode!

 

Could Your Child’s Physical and Behavioral Symptoms Be Caused By the Food They’re Eating?

 
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Could your child’s physical and behavioral symptoms be caused by the food they’re eating? There are a number of ways that foods can impact children's health, physically and bio-behaviorally.

If your child struggles with complex picky eating, this one is for you!

If your child has developmental delays or a known neurodevelopmental condition, like autism spectrum disorders, ADHDs, speech-language disorders, sensory processing disorders, etc. then this one is for you!

If your child is struggling with a host of chronic health issue symptoms, this one is for you!

Did you know that over half of American children and millennials today have a diagnosable chronic health issue? Food and environmental reactions are very much involved here...

In this episode, I'm sharing an overview of the difference between food allergies, food sensitivities, and food intolerances. We'll cover the most common food allergies and sensitivities, as well as what physical and behavioral symptoms are seen in children with food reactions.

I share what to do if you think your child is experiencing negative reactions to their foods, starting with "cleaning up the diet overall", then navigating food sensitivity testing, and guidance around food elimination/reintroduction diets for food reactions.

Enjoy the episode! I hope that it's insightful and supportive for where you are on your journey!

Mentioned in the show:

Dr. Doris Rapp on The Phil Donahue Show (1989)

 

Gluten Free, Casein Free Diets (GFCF) For Kids with Complex Picky Eating and/or Developmental Conditions - Answering FAQs

 
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Episode 9 builds onto the information shared in previous episodes re: complex picky eating and neurodevelopmental delays and disorders being whole body conditions, as well as holistic nutrition, gut health, gluten free/casein free (GFCF) Diets... If you're new to the podcast and these topics, please go to earlier episodes in this Season 1.

I'm answering frequently asked questions that parents of these children often ask me when they're considering or starting the GFCF diet trial...

How do you know if they're getting or not getting the nutrients that they need? Can GFCF diets create deficiencies?

We specifically explore zinc and calcium and related factors to think about with these nutrients when implementing a GFCF diet.

Is the GFCF diet a lifelong change or temporary? How long until you see results? What would those results and improvements look like?

And lastly, I offer some guidelines and general habits for families to consider embracing during their transition to a GFCF diet with the child(ren) and/or family.

I'm answering all these questions and more. Enjoy the episode and don't forget to check out the resources linked below that I mention in the show!


Mentioned in the show:

My Accompanying Blog: "GFCF Diets, Picky Eating, Autism, & Other Neurodevelopmental Disorders...What's the Connection?"

Organic Olivia Herbal Supplements Line - For Kids & Adults - I use these products personally and with clients for support!

 

Is the Gluten Free, Casein Free Diet (GFCF) "All or Nothing?" What Happens if They Eat a Little Bit?

 
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Episode 8 builds onto the information shared in previous episodes re: complex picky eating and neurodevelopmental delays and disorders being whole body conditions, as well as holistic nutrition, gut health, gluten free/casein free (GFCF) diets...If you're new to the podcast and these topics, please go to earlier episodes in this Season 1.

I'm answering frequently asked questions that parents often ask me when they're considering or starting the GFCF diet trial...

Is it "all or nothing?" What happens if they eat a little?

How long will it take to see results? What results could you expect to see?

Why do some people still say there's not enough evidence to support the GFCF Diet for these demographics of children and individuals?

What guidelines should be implemented to see the maximum benefit and potential of this transition, especially for families of children with complex picky eating?

I'm answering all these questions and more. I hope you enjoy the episode!


Mentioned in the show:

My Accompanying Blog: "GFCF Diets, Picky Eating, Autism, & Other Neurodevelopmental Disorders...What's the Connection?"

Organic Olivia Herbal Supplements Line - For Kids & Adults - I use these products personally and with clients for support!

 

GFCF Diets, Picky Eating, Autism, & Other Neurodevelopmental Disorders...What's the Connection? [Podcast]

 
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We're covering the basics like what gluten and casein are exactly, the gluten free / casein free (GFCF) diet and exploring some of the research around it, as well as some thoughts you may want to consider before taking on a special diet for your child.

I'm covering 5 connections to consider when thinking about GFCF diets for children with complex picky eating, developmental delays, autism, and/or other neurodevelopmental conditions.


Mentioned in the show:

My accompanying blog: GFCF Diets, Picky Eating, Autism, & Other Neurodevelopmental Disorders...What's the Connection?

 

Are you ready to learn how to help your child overcome complex picky eating and bring more ease and joy to mealtimes?

Enroll today in Naturally Navigating Picky Eating, a self-paced online course + guide for parents and caregivers of children with complex picky eating, with and without developmental conditions…