Picky Eater vs. Problem Eater…When to Seek Help

As we have mentioned before, we are blessed to be surrounded by so many talented colleagues.  They have so much knowledge to share and we enjoy inviting them to share some of their expertise with you!  Today we are featuring Kelly Benson-Vogt, MA CCC/SLP, owner of Pediatric Feeding & Speech Solutions, PLLC in Leesburg, VA.  Kelly specializes in treating pediatric feeding disorders and shares with us today how we can discriminate a picky eater from a problem eater.


Picky Eater vs. Problem Eater:

When is help Needed?

Kelly Benson-Vogt, MA CCC/SLP, owner Pediatric Feeding & Speech Solutions, PLLC

Do you have a picky eater in your house?  Are you frustrated?  Do you dread mealtimes?  Is there tension when trying to get your child to try new foods?  Gaining an understanding of toddler eating patterns and their nutritional needs may help ease this tension and worry.  It will also help to determine what is considered “typical” toddler behavior vs. what constitutes a real problem that requires further intervention.

Most young children eat only when they are hungry.  Infants gain weight at an average of one to two pounds a month from one to six months of age and one pound a month from six to 12 months of age.   Toddlers on the other hand, gain an average of four pounds from the ages of 24 months to 36 months.  Therefore the calories needed for a toddler to maintain appropriate growth is less than it is for infants.  Also, as toddlers begin to walk they become more interested in the world around them and they have less time and attention for sit down activities like mealtimes.

In cases of “typical picky eating” children often want to eat a favorite food (i.e. applesauce) everyday and sometimes with every meal.  Occasionally this favorite food is exchanged for another and the favorite (applesauce) is no longer accepted when offered.  These “food jags” are normal behaviors in most cases if the foods continue to rotate through the list of accepted foods, and are accepted again at a later date.  If however the child begins to regularly refuse foods and those foods cannot be added back into the child’s diet due to continued refusal, concern should be raised.  When familiar foods are not re-accepted by the child after a break (i.e. two weeks), the child’s diet and nutritional status may suffer as the number and variety of accepted foods gradually decrease.

In addition to food jags, toddlers may also skip meals or only eat small amounts during certain parts of the day.  Usually this is not alarming because when children eat small amounts for one or two meals out of the day, they will usually “make it up” at a later meal.  We must remember that as adults we are not always hungry for every meal and sometimes we are too busy to eat meals or we may be distracted and not eat our “usual” amount.  Just as our activity levels and energy expenditure varies throughout the day and from day to day, so do our children’s.  Because of these variations, it is a good idea to look at a child’s intake on a weekly basis rather than a daily basis, keeping in mind that illness usually has a negative impact on food intake as well.

If your child has “favorite” foods that they seem to be stuck on, and then they may start to refuse them, but you are able to successfully re-introduce them at a later date, he/she is probably demonstrating picky eating behaviors of a typical toddler.  If however, you are not able to re-introduce once accepted foods and/or their repertoire of accepted foods begin to decrease over several weeks, further evaluation may be needed.

Behaviors that indicate a child may be demonstrating a feeding problem that needs more attention include the following but are not limited to:

  • restricted range or variety of foods
  •  eats fewer than 20 foods
  •  does not return to favorite binge foods lost to burnout
  •  cries and acts out when presented with new foods
  •  refuses certain food textures like soft cheeses, wet foods or cereals
  •  has a heightened awareness of foods (i.e. seeds, dry spots, bumps, cracks, colors, lumps)
  •  may have oral motor problems that lead to specific food choices
  •  hypersensitive gag/ vomit response
  •  appear to really want the food, but just can’t eat it or requests food but refuses to eat it
  •  demonstrates extreme behavioral reactions when presented with non-preferred foods.


If you are concerned that your child may need assistance to progress with his/her feeding, seek a feeding evaluation with an experienced feeding therapist.

Kelly Benson-Vogt is a speech and language pathologist who specializes in pediatric feeding and speech and language disorders.   She is the owner of Pediatric Feeding & Speech Solutions, PLLC in Leesburg, VA.  She can be reached via email at www.pediatricfeedingandspeech.com or by phone 703-771-2200.


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