Is mealtime more like meltdown time in your home? Do you struggle to get your child to eat more than a few select foods? Are you wondering if your is child a picky eater or a problem eater?

If so, you’re not alone. Experts estimate that feeding disorders affect up to 80% of children with developmental disabilities and 35% of typically developing children. Additionally, roughly 70% of children with autism spectrum disorder (ASD) struggle with food selectivity. This can lead to medical, social, cognitive, and behavior concerns, and in the worst cases, a doctor-ordered gastrostomy (g-tube) or naso-gastric (ng-tube) for nutrition.

It’s no wonder that parents feel stressed out! Time to take a breather. When it comes to issues around food, MeBe’s certified Occupational Therapists, Speech and Language Pathologists (SLPs) and Board Certified Behavior Analysts (BCBAs) are here to help. We’re breaking down the differences between a picky eater and a problem eater so you can decide when your family needs a little professional help.

“Feeding disorders affect more than 1 in 4 typically developing children and up to 8 in 10 children with developmental disabilities.”
– Abigail Bunt, Co-Founder and Executive Director of MeBe

Picky Eaters vs. Problem Eaters: What’s the Difference?

A lot of kids go through stages of picky eating. How can you tell when picky eating becomes a problem? Feeding disorders can come in a lot of shapes and sizes:

  • Refusing to eat many foods because of texture, taste, color, or previous unpleasant experiences
  • Only eating a few foods
  • Pocketing food in cheeks or behind gums rather than chewing and swallowing
  • Choking, gagging, vomiting, or aspirating (breathing foreign objects into the lungs) while eating
  • Not having the oral motor skills to eat correctly
  • Consistent stress and meltdowns around eating or even coming to the table

Click here to watch the recorded MeBe Learning webinar on Feeding Disorders to learn more about pediatric feeding disorders and feeding therapy.

Child picky eater


Picky eating, on the other hand, is much more common and less severe. “A lot of children go through stages of picky eating,” explains Nikki Rosner, M.A., CCC-SLP, MeBe’s Clinical Director of Speech Language Pathology. “It’s pretty typical for children to not want to eat green vegetables. Problem eating is more than that; we often find that children who have feeding issues will eat fewer than 10 foods, usually only carbohydrates and bland or pre-mashed foods like chicken nuggets, which don’t really require chewing.

Because they eat the same, say, five foods all the time, they’ll often hit what we call a food jag—they’ll get sick of one or two items and then they’re down to three or four approved foods. This can spiral and lead to the kiddo needing medical attention because they can’t get enough nutrients or caloric intake.”

What Causes Feeding Issues?

To some children, certain tastes and textures can be almost traumatic. They’ll have such a strong sensory aversion to wet foods, for instance, that it’s nearly a phobia. Upsetting experiences can also trigger feeding issues and food aversion. Choking on a piece of cheddar cheese or experiencing acid reflux after eating an orange could cause a child to avoid all orange-colored foods in the future.

Sometimes the reason behind feeding issues may not even involve the food itself, according to Nikki. “If your child has a feeding disorder, it may be because they don’t have the oral motor skills to eat most foods correctly, so their body naturally avoids them. A lot of parents don’t realize that feeding disorders are a combination of medical, oral-motor, sensory, and behavioral factors.

That’s why MeBe’s OTs, SLPs and BCBAs use a collaborative approach to feeding therapy, incorporating play-based, child-led, and sensory-focused strategies as well as Applied Behavioral Analysis (ABA). It’s all about working together to customize a feeding program for your child. Using a multi-disciplinary approach created specifically for your kiddo is the most effective way to address a feeding disorder and make positive, lasting progress.”

“A lot of parents don’t realize that feeding disorders are a combination of medical, oral-motor, sensory, and behavioral factors. They require a multi-disciplinary approach to assessment and treatment”

Looks like we’ve got a problem eater. What can we do to fix it?

If you suspect that your child may have a feeding disorder, MeBe recommends reaching out to your pediatrician first. They can assess whether your child is a safe oral feeder and can connect you with a nutritionist if necessary. They can also refer you to experts that specialize in feeding therapy, speech and language therapy, occupational therapy, and ABA, like MeBe’s SLPs, OTs, and BCBAs.

In the meantime, find tips for tackling feeding issues at home and learn more about our collaborative approach to feeding therapy —which incorporates play-based, child-led, and sensory-focused strategies as well as ABA— in our Feeding Therapy videos on the MeBe Family YouTube channel.

Or, contact us with your feeding therapy questions or concerns!