This Is More Than Picky Eating: Now What Do I Do?

Always A Food Fight

You’re finally in bed and running a mental checklist of how your day went.  The kids had a good day at school, errands went quick, even work was easy. So why do you feel so wrung out?  Then it hits you: it took FOUR hours to make and eat dinner…that’s right, four hours. It took thirty minutes to shop for groceries, another hour and a half to cook the entree and all the sides.  Your family spent an hour enjoying your delicious food.

Wait…that’s only three hours.  So why did you think four? Oh that’s right; it took ten minutes to make a separate dinner for your youngest kiddo.  Then you spent at least fifty minutes trying to feed it to her. She happily ate the parts that she liked as she always does.  But then you tried to get her to eat something new and she fought and cried until you gave up.

Picky Eater Or Problem Eater

Maybe the issue is no longer about picky eating.  Maybe you have a kiddo who is a problem eater. How can you be sure?  There are several criteria you can use to figure out whether you have a picky or a problem eater, that are the same for both.  Often the only difference is the severity of the issue. Some of these are the numbers of foods a kiddo will eat, the response to a food jag, their ability to eat the same food as the family, and how often they have problems with picky eating.  Let’s go into more detail.

If you think your child is a picky eater bring them to a speech therapist or occupational therapist who specializes in feeding therapy and they will conduct a feeding evaluation.  According to Dr. Kay Toomey (2000), these are some characteristics that distinguish a picky eater from a problem eater:

  • A picky eater will usually eat 30 or more foods, while a problem eater will eat 20 or less.
  • A picky eater will go on a food jag (a food jag is when you eat the same food over and over again until you get sick of it), stop eating that food, and then eat it again after about two weeks.  A problem eater will go on a food jag and may never eat it again. This makes the number of foods they eat that much lower.
  • A picky eater will often eat different foods than the rest of the family.  However, they will still eat at the same time as the rest of the family, in the same area.  A problem eater will almost always eat a different meal than the rest of the family, at a different time and away from the family.  
  • The parents of picky eaters will often, but not always, report picky eating at health checkups.  The parents of a problem eater will almost always give a report of picky eating at those same checkups.  

What You Can Do

The differences between picky eating versus problem eating are very clear.  So is there anything that you can do if you have a problem eater? As a matter of fact, there are several things you can do for your kiddo who is a problem eater.  But first things first, find out if there are perfectly valid reasons why she has a problem eating certain foods or just eating and feeding in general.

Feeding Therapist

Contact an occupational therapist or speech therapist with a specialty in feeding therapy so they can rule out other circumstances.  Your child may have a medical condition like gastrointestinal issues or food allergies(i.e. nuts or strawberries). Your kiddo’s medical conditions would have to be dealt with before you start feeding therapy.  As far as food allergies, obviously your kiddo would never be able to eat those foods.

Perhaps your kiddo is facing an oral motor skills problem, a sensory processing disorder or behavioral issues.  You and your feeding therapist will have to work with these conditions in tandem with taking steps to transform problem eating.

Goal Setting

Working with your problem eater is a long and difficult process even with a professional feeding therapist.  It’s essential to focus on the goals you want to accomplish in feeding therapy. Is there something you want him to eat because your family eats it?  Is there a food group or texture that he’s not eating? Get very specific about it.

Steps To Eating Hierarchy

There are two incredibly effective tools for problem eating: Steps To Eating Hierarchy by Dr. Kay Toomey and Food Chaining by Fraker, Fishbein, Cox and Walbert (2007).  The Steps To Eating Hierarchy is slowly and patiently exposing your kiddo to food. There are more than twenty small steps, but the main steps are:

  • Tolerates (i.e. the child at the table with the food on the other side)
  • Interacts with (i.e. child uses her fork and spoon to grab food)
  • Smells (i.e. odor at table)
  • Touch (i.e. one finger tip)
  • Taste (i.e. bites off piece and spits out immediately)
  • Last step would be Eating

There are many other steps, but that’s the general gist.  You sensitize your kiddo to food until hopefully they are willing to eat it.

Food Chaining

The other method is Food Chaining.  Food Chaining is not as easy to follow as the Steps, but it can prove to be just as if not more effective if done right.  The basic rules are as follows:

  • Analyze what your child likes to eat and find a theme that ties them together (Smells the same?  Salty? Crunchy? Same color?)
  • Introduce a food that you want them to try that is different but may follow that theme (cinnamon crackers, pretzels, celery, spaghetti squash)

If this approach works, and they eat that new food then use the food chain again to add more foods.  

Picky Eater Tips

A lot of the same “rules” or suggestions that help with picky eating can also help with problem eating.  Keep a firm schedule for mealtimes where the family eats together. Limit distractions by banning screens during meals.  If your kiddo isn’t motivated to try new foods because he’s usually not hungry during meals, limit or completely do away with snacking or grazing.

Stay Strong And Positive

No two kids are alike, so what may work for one may not work for another.  Also, even if there is progress, it may take a long time…weeks, months, maybe even years.  At times the process will become incredibly frustrating.

Your kiddo may be more willing to change if she sees knows you’ll remain calm and patient no matter what she does.  Try to keep your cool and don’t give in to the stress. If that means you feel like you have to walk away then walk away.  Do some deep breathing. For some meals just let it go and let her be. In other words, save your energy. Stay consistent, keep to the course you and your feeding therapist create.  Eventually you will find success.

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