When is it more than just being a picky eater?

This is a guest blog post by Courtney Joesel MA, CCC-SLP from Building Blocks Therapy Services. Building Blocks Therapy Services offer speech, language and feeding therapy for infants through adults. Please visit www.buildingblocksgr.com or call (616) 570-0925 to learn more.

When is it more than just being a picky eater?

Recently, I (Courtney Joesel, speech therapist) was able to sit down and discuss the common threads between pediatric speech therapy and pediatric bladder and bowel disorders with the team at Purple Mountain PT.   It is an interesting exploration of how our two fields intersect because both speech and language require oral-motor control and chewing and eating impact bladder, bowel function and digestion.  One topic of discussion that we shared was feeding disorders and the impact that digestion and motility can have on the body. Building Blocks Therapy Services offers feeding therapy throughout the lifespan.

We often hear the phrase “picky eater” being used as children grow up for those that tend to prefer certain foods and/or in specific ways. Maybe you know of or have a heard of a child only eating certain brands of yogurt or only eating certain colors or shapes of fruit snacks. Mealtimes may be stressful, but when is this just a phase versus a disorder that needs intervention?

How prevalent are feeding disorders?

According to various studies, parents report “picky eating” at a prevalence rate of up to 50%! (The definition of picky eating varied across studies). Additionally, only about on third to one half of these children will “outgrow” their picky eating in a 2-3 year time span.

 Surprisingly, 1 in 4 children are reported to have some sort of feeding disorder in their childhood. This is also reported to be of higher prevalence for children with developmental disabilities.

Signs of more than picking eating

Picky eating is a very common phase that children will go through anywhere during the 2-5 year old range. This “phase” should not extend a lengthy period of time. If the child was an adventurous eater and did not present with any mealtime difficulties prior, the child will likely increase their food repertoire. Here are some red flags of feeding concerns that may warrant a referral to a feeding specialist:

  • Coughing throughout meal or when drinking
  • Abnormal bowel movements
  • Eats less than 20-30 different foods at 2.5 years of age
  • Gags with new or no nonpreferred foods
  • Limited variety of textures
  • Eating only easy to swallow foods
  • Food refusal

Influences of gut problems

There are many developmental stages that are important for a child to experience to build their feeding skills. Influence on early feeding experiences can have an impact on the children’s feeding development. Such as a history of reflux during infancy, their body experienced an adverse reaction to feeding. Additionally, if the child is not completely emptying their digestive system, this can impact their hunger drive.

Feeding disorders can have a basis in different area such as oral skills, sensory, or behavioral. It is important for the skilled clinician to assess and determine the individual plan of care for the best approach for the child.

Ways to tackle mealtimes with a picky eater

Children who are going through a period of picky eating can make mealtimes stressful for them and their families. Creating a structure to mealtime is extremely important. An example of this could be

  1. Washing hands before the meal
  2. Sitting in a well supported chair with feet supported
  3. Presenting all foods to child on the plate without pressure to eat. Can use an “all done” bowl
  4. Do not have distractions such as tv or toys. Have conversations and engage with child
  5. Expect the child to stay at the table
  6. Signal end of meal by washing hands or wiping area clean

How we can help

Building Blocks Therapy Services is a speech therapy clinic in Grand Rapids, Michigan. Our clinicians treat infants through adults with speech, language and feeding disorders. We are highly trained in oral function and looking to treat the foundational deficits to improve the symptoms. Many families are dismissed regarding their concerns with their child’s food intake or symptoms. Our therapy programs are individualized to the child and families needs. Often, after initiating treatment, families report increases in willingness to try foods, calmer mealtimes, and increased food intake. If you are interested in learning more please visit www.buildingblocksgr.com or call (616) 570-0925.

Purple Mountain Physical Therapy is a specialty PT clinic in Grand Rapids, Michigan that serves adults and children who have bladder, bowel or pelvic conditions.

We also treat chronic back pain, TMJ pain and neck pain.  The children we treat commonly have bladder or bowel control problems.  In particular, we find constipation is a driving cause for many bladder control issues in kids, including bedwetting.  Our physical therapists are routinely talking to our pediatric patients about optimizing digestion and bowel regularity and one important piece of that is chewing their food effectively.  If the child has any oral-motor issues impairing their ability to chew food, they may experience constipation and bladder control problems.  If you are interested in learning more about our physical therapy to help kids, you can contact us here or call us at 616-516-4334.  

Peace,

Dr. Maureen O’Keefe, DPT founder of Purple Mountain Physical Therapy.

You may be interested in reading this articles we have written about our pediatric physical therapy:

Why is My Child’s Poop So Big?

Physical Therapy Can Stop Bedwetting!

Why Does My Child Keep Wetting Their Pants?

Why Does My Ten Year Old Wet The Bed?