When you need more support

When children’s natural caution with new foods affects their growth

A small percentage (around 2-3%) of children will experience significant feeding difficulties, affecting family mealtimes and can affect their growth. This known as paediatric feeding disorder (PFD) and it can require more support and outlast usual picky eating. PFD can be characterised by limited amounts and variety of food. It often involves one or more medical, nutritional, feeding skill or psychosocial issues.

PFD needs assessment and treatment from a team of specialists like dietitians, speech therapists, or occupational therapists. A GP appointment is a good starting point to explore individual treatment options. The feeding tips and tools on this site will still assist and apply. 

The points below will help determine if you are dealing with a picky eater or paediatric feeding disorder.   

Picky Eater  

• Eats at least 30 different foods in total.  
• Foods lost due to ‘burn out’ (eating the same thing repeatedly over time) are usually accepted again with a 2-week break and food being re-offered. 
• Tolerates new foods being presented. 
• Eats at least one food from each food group and texture type.  
• Reported as a fussy eater by family. 
• No skill deficit present.  

 Paediatric Feeding Disorder 

• Eats less than 10-15 different foods in total. 
• Foods lost due to ‘burn out’ (eating the same thing repeatedly over time) are NOT regained when they are re-offered. This further reduces the variety in the child’s diet. 
• Child gets distressed or significantly upset when presented with new foods. 
• Refuses an entire food group or texture type e.g. wet textured foods, or vegetables. 
• Always eats differently from the family. 
• Usually there is a skill deficit present e.g. oral, motor. 

The PICNIC team can help provide the referral pathways for specialised feeding support.   

Awareness of differences in feeding traits and mealtime behaviours among neurodivergent children can assist with family support and referral pathways. 

Autism Spectrum Disorder (ASD)

Children on the autism spectrum may demonstrate some of these feeding and eating patterns:

• Prefer one texture type, one food group, or same colour (beige) foods. 
• Has a strong need to eat the same salty, crunchy foods. 
• Has a strong need for a set mealtime routine such as a specific colour of utensils, specific lunchbox, or the person feeding them at mealtimes. 
• Has a strong sensory reaction to aromas such as specific food smells.
• May feel unease when touching specific textures like playdough, or when eating and getting textures on their fingers, lips or face. 
• Prefers specific routines and may find it hard to eat at school, at playgroup, or anywhere outside familiar environment such as home.
• Prefers to use distractions like an iPad or phone whilst eating to feel at ease. 

Avoidant Restrictive Food Intake Disorder (ARFID) 

ARFID is an eating disorder characterised by restrictive or avoidant eating behaviour, unrelated to concerns about weight or body image. Food restriction may be due to:

• low appetite or lack of interest in food.
• sensory sensitivity or avoidance.
• fear of unpleasant consequences, e.g. choking.

ARFID’s severity can lead to growth issues, weight loss, malnutrition and sometimes reliance on nutritional supplements. It can cause significant challenges during family mealtimes.

Contact us

If you would like to talk further about the need for further feeding support please go to our contact page