Kids can be tricky. Kids can be picky. Mealtime can be sticky. Is your picky eater going through a phase or is it time to get help?
ALPHA- Your child may turn her nose up at dinner when you scoop something new on her plate, but she will at least take “one bite.” She allows the food to stay on the plate and may or may not eat more of it, but certainly doesn’t make a federal case out of it. You are able to serve everyone in your family the same meal and your child doesn’t expect you to be a “short order cook” and make something separate for her. She may pull the “it’s gross” or “I don’t like it” number, but the drama is usually kept to a minimum. The mood surrounding family meals is usually somewhere in the range of fine to pretty good.
BRAVO- Keep an eye on your picky eater. He may be going through a phase, but it’s possible he will turn a corner and end up at the Charlie level. This is the child who is starting to restrict what he will eat and would rather feel hungry than lose the battle surrounding food. It’s becoming harder to tell if he’s being stubborn or if he really can’t handle certain foods. He seems to be trending toward only wanting certain things, such as mac and cheese, hot dogs and chicken nuggets, but will often surprise you and have a big bowl of homemade vegetable stew or will down a whole pile of strawberries. It’s still “hit or miss” and fruits and vegetables are still in the game.
CHARLIE- Picky eating is now at the level of requiring intervention. There may be an underlying sensory processing issue that is affecting your child’s ability to eat a variety of healthy foods, such as sensory defensiveness or an oral aversion. She may be unwilling to touch, smell or even look at certain foods. Foods that used to be staples are now a “no go.” If you put something unwelcome on her plate, she may actually gag at the sight of it and truly appears distressed or is in that “fight-flight-fright” state. All of the bribing and negotiating in the world will not convince her to take a bite of a non-preferred food. When she is willing to try something new, she seems to panic and may only take the tiniest crumb of a bite with her very front teeth. She may complain that things smell yucky or feel slimy or food is too “bumpy.” Watching you eat something unwelcome may even set her off. Her mouth generally seems sensitive and toothbrushing might be an issue. Tears at mealtime are a daily occurrence and there is daily stress surrounding eating.
DELTA- This is the level of a potential medical problem and you should speak with your child’s pediatrician as soon as possible. Any number of these indicators may be symptomatic of a more severe medical issue, such as reflux, bowel impaction, a metabolic disorder or any number of food allergies. Examples of when to be very concerned include: * Your child is so picky that he is starting to look thin and / or is in on the lowest end of his growth curve for weight * Your child vomits frequently after eating and/ or has a wet, raspy sounding voice * Your child has frequent diarrhea, constipation and/ or frequently complains of tummy aches * Your child has dizziness, lightheadedness or fainting * Your child seems lethargic and drinks a lot as well as pees a lot * Your child complains of pain when swallowing or complains of any kind of pain after meals
If your child is at the Charlie level, there are various therapies that can help. A provider who is certified in Sequential Oral Sensory feeding therapy is a good place to start. If you are at Delta or even if you aren’t sure about your child’s level, please ask your pediatrician for guidance.
Author’s profile: Lisa has been an Occupational Therapist since 1996 and has specialized in Pediatrics for 23 of those years. She has worked in New York, Massachusetts, Connecticut and New Mexico in early intervention, school therapy and at the Center for Development and Disability at the University of New Mexico School of Medicine. She also spent the past 10 years working in Germany for the EDIS program in the Kaiserslautern and Stuttgart areas. She is now an OT at GrowingUp Therapy in Kaiserslautern.