Picky eater or feeding disorder?

Do you have a toddler who only eats foods of a certain color? Or refuses anything crunchy? How about an infant who constantly spits food back out?

Many parents wonder if their child is just a picky eater or if a more serious condition might be involved.

It may be difficult to tell, but if your child is not gaining adequate weight or is still losing weight, an evaluation is recommended. They may have a pediatric feeding disorder, which involves the child avoiding eating or limiting what or how much they eat.

Surprisingly, experts estimate that about 20% of all children have some type of pediatric feeding disorder. However, determining the prevalence of the condition is complicated because there is no universally accepted definition or classification system. But there is help available.

Specially trained speech-language pathologists at Holy Name Medical Center can assess and treat children with feeding disorders. They use the Sequential Oral Sensory approach, which focuses on increasing a child’s comfort level with food.

“The connection between a child’s experience with food and their ability to eat can be complicated,” said Hayley Riker, a speech-language pathologist at Holy Name. “We approach this by looking at the whole child — from their behavior to their motor skills, their posture to their medical history and more.”

Hayley Riker, a speech-language pathologist at Holy Name Medical Center, specializes in helping children with pediatric feeding disorders. (Holy Name)

Eating is a complex process. Just to swallow, 26 muscles and six cranial nerves must work together. For some infants and children, many factors can prevent this process from starting naturally or disrupt it as they age. These youngsters may then scream at the sight of certain foods, tantrum when brought to the dinner table or show any number of ways they are distressed about feeding.

Using the SOS approach, speech pathologists start slow, often just getting the children used to being in the same room as the specific food or food type. They slowly graduate to touching the food, rolling it perhaps, or finding other ways to play with it. Riker said she sometimes gets the children to kiss the food, enabling them to tolerate having the food near their mouth.

“The children actually enjoy this therapy — we make it a game, and they get to play with food,” Riker said. “We go from tolerance to smell, touch and then taste. It’s a lot of fun for them.”

Treatment for children with feeding disorders doesn’t stop with the therapy sessions. The speech pathologists create a plan for parents to follow at home and often speak with parents on a daily basis, Riker said.

“I’ll work with the parents to start a new routine at home, including how frequently to introduce a new food, what food should be presented to the child and how long meals should last,” Riker said. “We also talk about the posture of the child — they need to be in a position of 90-degree angles — which is the best posture for chewing and swallowing.”

The length of therapy most often depends on the child’s age, the degree of how restrictive their diet had become and whether a structural problem is involved. Typically, most issues occur because of a breakdown in the sensory system, which the SOS targets.

“This approach is sensory-based and is really very effective,” Riker said. “I’ve seen kids who will only drink out of a bottle at 3 years old move to a regular diet within a couple of months, but, of course, each child is different, and the length of time varies.”

For more information on pediatric feeding disorders, visit holyname.org/PhysicalTherapy/specialized-therapies.aspx or call 201-833-3085.