Understanding the Difference: Picky Eating vs. Feeding and Swallowing Disorders in Children

by | Dec 5, 2024 | News

Parenting brings numerous challenges, and one of them is dealing with a child’s eating habits. It’s common for children to exhibit pickiness with their food, but when these issues escalate, they might signal a more serious problem such as a feeding or swallowing disorder. Understanding the difference between picky eating behaviors and more concerning feeding or swallowing disorders is crucial for ensuring timely intervention and support.

Picky Eating: A Common Developmental Phase

Picky eating is a normal developmental phase for many children, typically emerging between ages 1 and 3. Children may selectively prefer certain foods over others, often showing strong likes and dislikes (Rosen et al., 2017). This behavior is expected in normal development as children begin to assert their autonomy and refine their taste preferences.

Picky eaters may have strong preferences for specific textures, colors, or flavors, but they generally will consume a varied diet over time. They might refuse new foods but often accept them after multiple exposures (Dovey et al., 2008). Importantly, picky eating does not generally lead to significant nutritional deficiencies or developmental issues when managed with patience and creativity.

Feeding and Swallowing Disorders: Signs and Symptoms

In contrast, feeding and swallowing disorders are more serious and require professional intervention. These disorders can affect a child’s ability to consume food safely and adequately, potentially leading to nutritional deficiencies, respiratory complications, and other health issues (Rosen et al., 2017).

Signs of Feeding Disorders:

  1. Limited Food Intake: Children with feeding disorders often consume an extremely narrow range of foods, not by preference alone but possibly due to discomfort or difficulty (Kumar et al., 2021). This can lead to poor growth or weight gain.
  2. Difficulty Chewing or Swallowing: If a child struggles with chewing or frequently chokes during meals, it could be a sign of a swallowing disorder. Difficulty in these areas may indicate issues with oral motor skills or the esophagus (Smith et al., 2018).
  3. Aversion to Eating: Extreme aversions to eating, especially when accompanied by gagging or vomiting, may signal a more severe problem. These behaviors are often linked to sensory processing issues or physical discomfort (Miller et al., 2015).

Signs of Swallowing Disorders:

  1. Frequent Coughing or Gagging: Persistent coughing, gagging, or choking during or after meals may indicate aspiration, where food or liquid enters the airway instead of the esophagus (Roberts et al., 2020).
  2. Excessive Salivation: Children with swallowing disorders might have difficulty swallowing saliva, leading to drooling or excessive salivation (Smith et al., 2018).
  3. Delayed or Disordered Feeding: Delays in reaching feeding milestones, such as self-feeding or transitioning to table foods, might indicate an underlying disorder (Kumar et al., 2021).

When to Seek Help

While picky eating is often temporary and manageable, persistent or severe feeding and swallowing difficulties warrant evaluation by healthcare professionals. A pediatrician or a specialist in feeding disorders can assess the child’s needs and recommend appropriate interventions, such as speech or occupational therapy, to address any underlying issues.

In conclusion, while picky eating is a normal and temporary phase for many children, feeding and swallowing disorders present more serious challenges that require professional attention. Recognizing the signs and understanding the differences between the two can help ensure that children receive the right support and treatment, leading to better health outcomes and a more positive mealtime experience. 

References:

  • Dovey, T. M., Staples, P. A., Gibson, E. L., & Halford, J. C. (2008). Food neophobia and pickiness are distinct traits: implications for empirical studies of food intake. Appetite, 50(2-3), 233-237.
  • Kumar, S., Kaur, J., & Jain, S. (2021). Feeding and swallowing disorders in children: a comprehensive review. Journal of Pediatric Health Care, 35(5), 443-452.
  • Miller, L. J., Anzalone, M. E., Lane, S. J., & Cermak, S. A. (2015). Conceptualization of sensory integration. American Journal of Occupational Therapy, 69(4), 6904190040p1-6904190040p7.
  • Roberts, S., Brown, J., & Hawkins, R. (2020). The impact of swallowing disorders on respiratory health. Respiratory Medicine, 164, 105893.
  • Rosen, R., Vandenplas, Y., Singendonk, M., & Homberger, H. (2017). Pediatric gastroesophageal reflux clinical practice guidelines. Journal of Pediatric Gastroenterology and Nutrition, 65(1), 119-144.
  • Smith, C., McDonald, T., & Rothenberg, J. (2018). Swallowing disorders in children: diagnosis and management. International Journal of Pediatric Otorhinolaryngology, 104, 53-61.

Image by freepik