Picky or selective eating can be characterized by any one or more of these characteristics:

• Fear of trying new foods (food neophobia)

• Having few food choices: liking a very limited range of food and being rigid about the brand or how the food is cooked, prepared, or presented

• Difficulty eating in a variety of settings (e.g., school or restaurants) or in social situations

• Low or diminished appetite 

• Difficulty knowing when truly hungry or full  

 

Most kids are picky eaters to some degree. In fact, limited food preferences and fear of trying new foods is a normal adaptation for human survival!  

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Selective eating is a continuum of traits, preferences, and behaviors. At one end of the spectrum, we find ‘adventurous eaters.' In the middle of the spectrum is ‘normal selective eaters,’ and on the other end of the spectrum are ‘extreme selective eaters' or ARFID (Avoidant/restrictive food intake disorder). 

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So when is selective eating a problem? It depends. Selective eating and associated food rituals can help children eat an adequate quantity of food. This is good because eating enough food is a bigger priority than food variety. Narrow food choices may be perfectly okay and pose little to no health threat. If you're worried about your child's intake we recommend talking to us. A thorough nutrition assessment with us can help determine whether or not you or your child’s selective eating is a problem. 

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Why typical strategies don't work: Selective eating is involuntary. Parents, have you noticed that pressuring your kids to try new foods, bribing them, or hiding new foods into familiar foods rarely helps? Typical strategies parents use to get their kids to try new foods tends to evoke MORE anxiety and eating resistance from children. This is because food decisioning occurs mostly in the limbic system of the brain, or, our 'lizard brain', not in the prefrontal cortex, where we make rational and logical decisions! The limbic system is our feeding center (it is also where we process fear and sensory inputs). Due to a lack of information and the plethora of conflicting and bad advice regarding picky eating that exists, it’s quite understandable that many parents and caregivers start down the road of counterproductive feeding strategies.  

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If your child is struggling with very selective eating (too few food choices) and/or low appetite, our nutritional, neuro-sensory, and behavioral recommendations with our specialized pediatric dietitians are effective interventions! 

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What to expect: 

During the initial 90-minute, parent-only appointment, we will: 

- Discuss your child's food likes and dislikes, eating patterns and habits, medical history, and look at growth charts.

- Talk about the factors that may be inhibiting your child's readiness to try new foods and/or contribute to low appetite or interest in food. 

- Assess your child's nutrition status and provide you with immediate nutritional and behavioral recommendations.

- Determine whether or not sensory-based occupational therapy or other interventions would be a helpful next step. We have a wide referral network if a team approach is needed.

- Meet for one or more 45-minute follow-up appointments to adjust the plan and monitor progress. We typically work with children 10y and older for 1:1 feeding interventions if appropriate (this is discussed during the parent-only initial appointment). 

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Models we use:

• CBT-AR (cognitive behavior therapy for ARFID)

• Sequential Oral Sensory (SOS) therapy 

• Food Exposure Protocol for Selective Eating and ARFID

• Responsive Feeding Techniques for parents of picky eaters

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Parents, if you're worried about your child's eating, it's a good idea to seek support. Together, we will re-establish harmony and trust in the feeding relationship and ensure that your child's eating will help them grow well and thrive!

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