Hailee Truelove, MA, CCC-SLP  
Lead Speech-Language Pathologist

What is a picky eater? 

A picky eater is a child with a decreased range of foods, meaning they will eat less than 30 foods and at least 1 food from each food group or texture group. A picky eater is someone who tolerates new foods on their plate and will even touch or taste the food. They typically eat meals with their family but eat different foods than their family. It’s the situation where mom or dad prepares a meal but often prepares the usual PB&J or chicken nuggets for Johnny who doesn’t really like anything that mom or dad has prepared. 


What is a problem feeder?

Just like a picky eater, a problem feeder has a reduced range of foods but has a restricted range of less than 20 foods. When a problem feeder burns out on a food they do not re-acquire it later on. A problem feeder has melt downs when new foods are introduced and refuses entire categories of food groups or textures. In addition, a problem feeder will eat different foods than their family and will often eat alone.

When should a parent(s) see their child’s pediatrician?

It is time to talk to your pediatrician when your child experiences one or more of the following:

  • Repeatedly reported as a picky eater across multiple well-child visits
  • Has poor weight gain
  • Weight loss
  • Ongoing problems with vomiting or reflux
  • Inability to transition to baby food, solid food, or cup
  • Has difficulty transitioning off a feeding tube
  • Has aversion to all foods in a specific nutrition group or texture group
  • Consumes less than 20 foods
  • Family is fighting about eating
  • Child cries at most meals


What can a parent(s) do? 

There are two ways to get a referral for a feeding evaluation. Parents can notify their pediatrician regarding their concerns with feeding and request a referral for a feeding evaluation. The other option is to call the Special Kids Therapy Center and ask to speak to a Family Resource Coordinator about your concerns and they can request a referral from the doctor for you. Parents should seek an evaluation and treatment from a speech language pathologist or occupational therapist trained to treat sensory-based feeding problems.   


What is the outlook and treatment for a problem feeder?

During treatment, parents are allowed to observe treatment sessions to learn practical treatment strategies to use during family meals at home to help their child. Therapy focuses on nutrition, texture, and sensory properties (i.e. color, shape, size, texture, temperature, consistency, etc.) of food. Therapists systematically desensitize children to food and create new positive experiences in a fun and non-threatening manner. They learn a mealtime routine and ways to reinforce desired behavior using positive means.


What is the benefit of group feeding therapy?

Eating is a common social activity for us in our society, right? Why is that? Perhaps it is the social aspects of having conversation over a meal, sharing a recipe, or talking about how something tastes. The same is true for children. Social situations can enhance a child’s willingness to touch broccoli or taste papaya when they observe their peers doing the same. Group therapy may be appropriate if your child is at the developmental age to watch and imitate others. 


Eating is a learned behavior.

Most people don’t realize that eating is a learned behavior and it doesn’t come easy for some kids. Children who have experienced pain, discomfort, or negative outcomes from eating have more to overcome in order to become what we would consider a “good eater”.


To learn more, below are recommended references:

o   For additional information on parent support groups for children with feeding difficulties or to learn more, please visit www.childrensdisabilities.info/feeding/groups-feeding-children.html

o   For additional information on Special Kids Feeding Therapy, please visit www.specialkidstn.com/feeding-therapy

o   Read more on “Getting Started” with Special Kids by visiting www.specialkidstn.com/getting-started


Always consult your child’s physician first if you think your child may be a problem feeder. References are for informational purposes only and they are not intended to replace physician and/or feeding therapy treatment(s). Information included by Kay Tommey, PhD, and Erin Sundeth Ross, PhD, CCC-SLP. “Picky Eaters vs. Problem Feeders: The SOS Approach to Feeding”, Conference, Le Bonheur Children’s Hospital, Memphis, TN, January 16-18, 2014.