Holy Name Medical Center Blog

Picky Eating: When Is It Time to Seek Help?

Posted by Hayley Riker, MS, CCC-SLP
Speech-Language Pathologist
Creamer Family Physical Rehabilitation Center
Holy Name Medical Center on May 21, 2021
Hayley Riker, MS, CCC-SLP

Are you worried that your child wants to eat the same foods every day? Does your child seem to be eating less and losing weight? Does your baby spit out certain foods?

If you are concerned that your child might be more than a picky eater, an evaluation with a speech-language pathologist will help determine whether he/she would benefit from therapy for a feeding disorder.

Holy Name Medical Center’s speech-language pathologists work with individuals across the lifespan to prevent, assess, and treat speech, language, social communication, cognitive communication, and swallowing disorders (dysphagia).

One specialty area within the scope of speech-language pathology that warrants much attention is the assessment and treatment of feeding disorders in children. Pediatric feeding disorders encompass a range of eating activities that may or may not include problems with swallowing. Characterized by suboptimal intake and/or lack of age-appropriate eating habits, feeding disorders are common and may be seen in up to 25 to 40 percent of children.

Feeding disorders are a significant concern to both the child’s family members and to the providers who treat him/her. Left untreated, a child with a pediatric feeding disorder may not thrive physically, emotionally, cognitively, or socially.

Myth Buster

Many individuals believe that eating is instinctual and that if a child is hungry, he/she will eventually eat. However, this is in fact a myth. In reality, eating is a learned behavior that children with feeding difficulties frequently recognize as an undesired and sometimes painful experience. Through establishing this negative connection with food, children will often come to us with avoidant and/or aversive behaviors while in the presence of food.

Picky vs Problematic Eater

In today’s world, it is very common to hear an adult describe their child as a picky eater. However, there is much uncertainty around what even qualifies a “picky eater” as a picky eater. In many cases, a child may require additional support to learn to consume a more assorted diet.

An essential first step for parents who believe this to be true is to determine if their child is at risk for becoming a problematic eater. If your child demonstrates some of these difficulties, a consultation with a speech-language pathologist should be considered:

  • inadequate weight gain or ongoing weight loss
  • ongoing problems with vomiting, choking, or coughing during mealtime
  • history of a traumatic choking incident
  • inability to transition to baby food purees by 10 months of age
  • inability to accept table food solids by 12 months of age
  • inability to transition from breast/bottle to a cup by 16 months of age
  • food range of less than 20 foods
  • oral motor weakness
  • mealtime tantrums
  • ritualistic behaviors during mealtime
  • extreme pickiness based on food type and/or texture
  • an infant who cries and/or arches at most meals
  • parent reports that the child is difficult for everyone to feed

Next Steps to Healthy Eating

If you or your child’s pediatrician believes that your child is experiencing ongoing difficulties with feeding, we are here to help.

Speech-language pathologists who have specialized training in pediatric feeding work with children and their families toward making mealtime both a positive and enjoyable experience.

The Sequential Oral Sensory (SOS) approach to feeding is primarily utilized during a child’s initial evaluation and treatment to address all factors involved in feeding difficulties. This program integrates posture; sensory, motor, behavior/learning; and medical and nutritional factors to comprehensively evaluate and manage children with feeding problems.

The SOS approach is particularly helpful in treating children with sensory-feeding disorders. These children have a sensory system that does not support the complex process of eating and drinking. They have difficulty modulating and integrating the sensory input that they receive during mealtime, such as what a food tastes like, how it smells, and/or whether it is hot or cold.

Our goals for most patients involve weight gain and growth, obtaining age-appropriate oral motor skills, and acceptance of a wide range of foods across all food groups for healthy eating.

We treat children with all types of complex feeding problems and work toward building healthy feeding patterns that your child and family can continue to use at home and in the community.

Hayley Riker, MS, SLP-CCC, treats adults and children, both inpatients and outpatients, for a range of swallowing, speech, language, and cognitive-linguistic disorders. She received her bachelor of science in communication sciences and disorders from James Madison University and her master of science in speech-language pathology from New York Medical College. Ms. Riker completed specialized training in fiberoptic endoscopic evaluation of swallowing (FEES) and modified barium swallow impairment profile (MBSImP). She also attended the SOS Approach to Feeding Conference.

For more information regarding Holy Name Medical Center’s feeding and swallowing services, or to schedule a feeding evaluation, please contact Hayley Riker, MS, CCC-SLP, at 201-833-3000 x6172.