Beyond Picky Eating: Understanding Pediatric Feeding Disorder
Pediatric feeding disorders (PFD) are more prevalent than commonly believed, affecting approximately 45% of children. That’s more than one out of 37 children in the United States under the age of five. Contrary to popular misconceptions about eating disorders, these disorders are not limited to teenagers and women. Feeding disorders are often misunderstood. Treatment options, support, and guidance are available for parents and caregivers.
Feeding disorders in children
Feeding disorders are more than just a matter of personal choice or stubbornness. They involve a range of challenges beyond selective eating or the decision not to eat. Often referred to as “picky eating,” there is almost always more involved. Feeding disorders commonly occur between the ages of one and three, and the underlying cause might be hard to determine.
Feeding disorders have multiple causes that prevent effective eating, nutrition, or absorption of nutrients from food. Structural issues, developmental delays, neurological problems, psychological factors, sensory issues, and cultural or behavioral influences can all contribute to feeding difficulties in children.
We often think of malnutrition as low calorie intake or poor nutrition, but poor nutrition can also be overeating and high-calorie intake that leads to obesity or unhealthy weight.
Pediatric Feeding Disorder
Pediatric feeding disorder refers to a broad range of challenges related to eating, swallowing, and feeding difficulties in children. It can manifest in various forms that lead to inadequate nutrition and impaired growth:
Selective eating
Food aversions
Refusing to eat
Limited food intake
Impaired oral intake, not appropriate for age, related to a medical, psychological, feeding, or nutritional dysfunction.
PFD is a term used to cover multiple feeding disorders in children. Each is broken down further based on more specific criteria. PFD is generally an ongoing problem (chronic) and can lead to further problems as children get older. PFD is linked to bulimia nervosa and anorexia nervosa found later in teens.
The Impact and Signs of Pediatric Feeding Disorders
PFD can negatively impact a child's nutrition, development, and growth. A feeding disorder places a child at risk of malnutrition, dehydration, or obesity, and poses immediate and long-term health concerns. Symptoms may vary among children but can include:
Difficulty swallowing or chewing
Coughing or gagging during meals
Vomiting or spitting up
Behavioral issues during feeding
Failure to thrive
Poor appetite
Food refusal
Tantrums or meltdowns during mealtime.
Symptoms must be present for a minimum of two weeks and may last three months (acute) or longer. Many of the underlying causes aren’t easily treated resulting in chronic PFD.
Understand the causes
While the exact causes of pediatric feeding disorders may not always be clear, certain risk factors have been identified that may lead to PFD:
Gastrointestinal disorders
Sensory processing disorders
Psychological factors
Remember, it’s potentially a combination of reasons – medical, psychological, feeding skills, and/or nutritional.
If you suspect pediatric feeding disorder…
Suppose you have concerns that your child might be experiencing a pediatric feeding disorder. In that case, it's important to reach out to healthcare professionals who specialize in this area for an accurate diagnosis. A thorough evaluation by a team of experts, including a pediatrician, speech therapist, occupational therapist, and psychologist, can address the underlying causes.
They will create a personalized treatment plan for your child with treatments like behavioral interventions, sensory-based therapies, oral-motor therapy, and parent education. In some cases, medical interventions might be required to ensure your child receives the necessary nutrition.
Pediatric feeding disorders are a complex challenge that requires a holistic approach from medical professionals, therapists, and families. While the journey may seem daunting, don’t lose hope, support is available. Parents and caregivers play a vital role in helping their children overcome feeding challenges and achieve optimal health and well-being.
So, where do I fit in?
You might be familiar with my story, maybe you aren’t. But, several years ago now, PFD came crashing into my life when my oldest daughter, then not yet two and a half, stopped eating.
Now, I know what you’re thinking, “That’s awfully dramatic – stopped eating…” But it's the honest truth. My toddler who had eaten normally up to that point, aside from some health issues as an infant, started refusing nearly all foods. To the point we were down to approximately five safe foods. Just 5.
And while that sounds scary, that was only the beginning. I spent YEARS trying to find help for her. I was told repeatedly, “It’s just a phase, it’ll pass.” It took MONTHS of pestering the doctor about her eating. It did not pass. We finally got a referral.
We were sent to a lovely speech therapist who had no idea what to do with a kid like her. She wasn’t a “typical speech problem.” So, they added occupational therapy, same answer.
Many more months went by. We tried a few other therapy modalities. No answers, no improvements.
Finally, I made the right connection with the right team at the children’s hospital two hours from our home. They have a team of specialists for children with feeding and eating disorders. She was evaluated and placed in the proper therapy. At this point, she was just shy of her 6th birthday.
I drove her to the therapy appointments every week for a year and a half. An hour and a half one way, to a satellite facility of that hospital. We did our “homework” and made our best effort at home despite the resistance around us (I’ll save that for another story). But, she improved enough to gain weight and graduate from the program.
Best of all, we could eat a meal like a family, even if it was customized. It wasn’t Cheerios!
This is where my journey began. Fighting for years to get answers for my child. A child I just wanted to be happy and healthy. I had no idea what PFD was – Hell, then, that diagnosis didn’t even exist yet. All I knew was something wasn’t right and I had to do something about it even if I did it alone.
Remember, you're not alone in this journey. With the right support, reliable resources, and a commitment to your child's well-being, together we can navigate the challenges of pediatric feeding disorders and pave the way for a brighter future.
If you’re looking for support or answers for the struggles you and your child are facing, my free parent group is always open. I’m providing support so parents like us don’t have to do this alone. If you need more guidance or deeper support, my group membership and personalized 1-on-1 coaching might be right for you.
I’m here, waiting to support you!
