What does it really mean for a child to be a picky eater? Find out when it becomes a food aversion disorder, extreme picky eating, or a food phobia and get tips to help turn it around.
Many parents consider one or more of their kids to be a so called “picky eater”. It’s a term we hear EVERYWHERE, spoken on the lips of parents around the globe. But, sometimes the picky eating seems to be more extreme. Like when your child has a sensitive gag reflex when tasting, touching, or even looking at new foods. Or, when they tantrum and even totally meltdown at the suggestion of eating something new. And, when they only have a handful of foods in their diet, that leaves the looming question, “When picky eating becomes more serious, does a child have a food phobia, selective eating, picky eating or food aversion disorder?”
Parents that are living in this extreme stress are often wondering what to do to help their child eat, and a solution seems unattainable. But, there is hope. I know because as a feeding therapist (and mom), I’ve seen many extreme picky eaters overcome it and grow to have a healthy relationship with food.
To understand why a child may be a selective eater, we’ve got to dive a bit deeper into the meaning of picky eating…
What Does Picky Eating Mean, Anyways?
What does it really mean to be a picky eater? If you scroll through the comments on various articles on this site, you will find a range of picky eaters from parents looking for advice for a child that is refusing several vegetables, to one that has a seemingly overactive gag reflex every time they even look at some foods. Surely, all of these kids can’t all just be picky eaters, or can they?
Hardly. It’s actually more accurate to think of picky eating as a spectrum. On one end of this spectrum is the average picky eater, that eats a decent variety of food, but can be particular at times. Most families don’t really notice a disruption to their lives with this mild version of picky eating, even though it can be annoying at times.
On the other end of the spectrum is extreme picky eaters or children with a “picky eating or food aversion disorder”. I’ve seen both in my own home! When my second son was born, as soon as foods were introduced, he gagged and didn’t show an interest. While that can be normal, it persisted. He seemed to have no interest in eating. He definitely fell on the more extreme end of picky eating. I had to use some more targeted strategies and a lot of consistency to turn him around. He had underlying sensory issues with food, and this picky eating thing just wasn’t going to go away on it’s own. You can read about how I got him to go from being a child that won’t eat to one that has a healthy relationship with food.
Totally on the other side of the picky eating spectrum, I’ve watched both of my other two kids go through what I like to call “normal” picky eating. In fact, my 2 year old picky eater is in it right now. This morning he came down for breakfast and hardly ate any oatmeal, his favorite breakfast. A few months ago, he stopped eating yogurt, but for the most part, he has a well rounded diet.
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When Does a Child Actually Have Some Type of Food Aversion Disorder?
There a lot of different terms coined by different researchers and practitioners to describe a child that eats very small variety of foods.
The SOS Approach to Feeding, by Kay A. Toomey, uses the term problem feeders. And, authors Rowell and McGlothlin, in one of my favorite picky eating books, Helping Your Child with Extreme Picky Eating, use the phrase extreme picky eaters to describe these kiddos. You’ll also hear, picky eating disorder, food aversion disorder, food phobia, neophobia, selective eating disorder, and well, the list goes on and on.
To be honest, whatever word you use, there isn’t consistency among professionals like pediatricians and feeding therapists using a diagnosis, even though Avoidant/Restrictive Food Intake Disorder (ARFID) was added to the DSM-V (that’s the guide doc’s use to give diagnoses).
Even though you may have never heard of any of these terms, the distinction between average picky eating and the more extreme food aversion is important. Generally speaking, picky eating can be a normal part of childhood, albeit annoying and frustrating. Selective eaters are beyond picky eating and usually need the help of a feeding therapist to make progress eating new foods. In these cases, eating is actually a serious problem for the child and can have a big impact on family life.
On top of that, general feeding advice often doesn’t apply to these kids! Besides parents feeling frustrated by that, they often have to deal with well-intentioned, but vastly incorrect, comments about how they just need to give their kids some tough love when it comes to eating. Have you heard the advice, “Just feed them what you’re eating and they’ll eat eventually, when they get hungry!”???
That may work for some kids that fall on the milder side of the picky eating spectrum, but for kids with food aversions, it could be disastrous, even leading to a feeding tube. That may sound dramatic, and although it’s unlikely, it is possible.
I want to get really clear about the definition of an average picky eater and one of a child with more extreme picky eating. My hope is that it gives you some peace of mind, and answers the ever nagging question of your child needing more help!
These are some of the characteristics of Average Picky Eaters:
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- Eats 20- 25 foods on a regular basis. Eats at least a few fruits/vegetables, carbs, and proteins
- Can be coaxed to occasionally try new foods
- Bribes, rewards, and punishment will often work
- Usually will eat foods similar to their favorites. For example, will eat a variety of chicken nuggets or pizza, they will typically not reject different brands or styles
- Sometimes eats foods different than the rest of the family
- Will suddenly refuse a food they have preferred, but will eat it again in the future (Just like my youngest son and the oatmeal)
These are some characteristics of Kids with Food Aversion Disorders/Selective Eating/Extreme Picky Eaters:
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- Eat less than 15 foods consistently, maybe as few as 1-3
- May gag, shudder, or vomit at the site or taste of foods (Just like my second son when he started eating)
- Common picky eating strategies like the “try a bite” rule and punishment often don’t help them to eat more or new foods
- May become emotionally upset when they are encouraged to interact with non-preferred foods
- Refuses large categories of foods (vegetables, meat, etc.)
- Might lose weight or have growth concerns
- Seems to have a sensory issues with the food (the way it smells, looks, feels, etc.)
- May insist on foods being preferred in specific ways or will only eat a specific brand/style of food
- Almost always eats food different than the rest of the family
- Will suddenly refuse a food they previously preferred and never eat it again
- May only eat with distractions like a tablet, TV, or toys
The SOS feeding approach has a great printable here of the differences between picky eaters and problem feeders, and it includes some of the characteristics on this list.
How to Help Children With Food Aversions or Extreme Picky Eating
Please keep in mind that the lists above are just guidelines and if you aren’t sure where your child falls or you feel confident they are an extreme picky eater, consider having a feeding evaluation (click that link for how to set it up in your area). Usually, that is completed by an occupational therapist, like myself, or a speech therapist. If your child is under 3 and in the states, you should qualify for a free evaluation.
I will say this, the one piece of advice that will not work with an extreme picky eater and that you will never see here on Your Kid’s Table is to serve your kid what you’re eating and they will eventually get hungry and eat. This is a huge myth and many well meaning people love to dispense this advice: Moms, Grandpa’s, neighbors, and friends that haven’t had a child with sensory food aversions or extreme picky eating. Many kids with picky eating disorders will NOT eventually eat, they will end up in the hospital because they are starving.
Fortunately, parental instincts tell moms and dads this and they usually don’t try or give up on this approach quickly. That isn’t to say that picky eaters should be allowed to rule the roost, either. In fact, I believe there’s a few keys to create a balance between parents setting up healthy boundaries and kids being treated respectfully, all while helping them to eat more foods!
Want to know what they are? Then, grab a free spot in my free picky eating workshop for parents right here!
It’s perfect for helping you with the average or extreme picky eater!
More for Kids with Food Aversion Disorders and Extreme Picky Eating
What You Need to Know About Sensory Issues with Food
10 Extreme Picky Eating Red Flags that You Need to Know
The Most Amazing Healthy Snacks for Picky Eaters
Alisha Grogan is a licensed occupational therapist and founder of Your Kid’s Table. She has over 15 years experience with expertise in sensory processing and feeding development in babies, toddlers, and children. Alisha also has 3 boys of her own at home. Learn more about her here.
My son is about to be 5 and will not try any new foods. He literally only eats/drinks donuts, marshmallows, danimal yogurts, protein shakes, and milk. We tried to get him to eat what we eat, but he gags and throws up. He also holds his mouth and says that what we eat is nasty. We have no clue what to do! Any advice would be helpful.
He did have a tongue tie, two cheek ties, and a lip tie. We got those fixed two years ago and was told that’s why he wasn’t eating good, but he still won’t try anything new.
Hi Jeralyn! Thanks for reaching out! So sorry to hear that your son has difficulties with eating- we understand how stressful it can be. First, we would recommend discussing this further with your pediatrician, who could potentially refer you to a feeding therapist for some hands-on help. It definitely sounds like he has some sensory sensitivities, especially with the gagging/vomiting issue. Try some sensory and oral motor exercises, like sensory bins, food play, making silly faces, and using a toothbrush to brush the insides of his mouth. All of these things will help strengthen his oral muscles and desensitize his gag reflex/sensory sensitivities. We have a post that talks more about all of this. Check it out here!
Best,
Kalyn
My child used to be such a great eater. He would eat steak, chicken, turkey, ground beef, pork chops, etc. He would also eat white rice, Mexican rice and fried rice. He ate fruits and vegetables with no problem at all. He’s witness a divorce in parents and his biological mother would constantly and consistently provide frozen meals and fast food, every day. This is still occurring. When at home, she would not cook and would allow the kids to eat chips and candy for breakfast, lunch, dinner, snacks, whatever was convenient. The biological father would make different meals on a daily basis when they were in his care. The child never had any issues until recently. Child will now ask for an alternative meal and will not eat what’s made or provided. Now, he does not even eat turkey sandwiches. He has limited his foods to; tuna, fried foods(fast food), eggs, some breakfast foods and the obvious, junk foods(chips, candy). The divorce has been almost 3 years now and the biological mother has been trying to save money so she no longer purchases fast food items daily. She does still have frozen items available. We are all struggling to motivate him to expand his diet or his interest in food items. Today he had a doctors appointment and was advised to stay away from fried and greasy foods, chips, soda, juices. He is considered “obese.” Any advice, please?
Hi Melissa! Thanks for reaching out- we understand your concerns. It’s hard when a child has different routines and different foods from different households. Consistency is key! We like to encourage promoting a no-pressure environment. This means, not pressuring the child and allowing him to eat as much or as little as he chooses. The food, however, will be your choice. Serve him the same meals as everyone else and have him sit at the table for the entire duration of mealtime. You can always start by offering one of his preferred foods in addition to the meal, so that he feels more comfortable with the food on his plate. We also have a post that talks about encouraging healthy eating the right way. Check it out here!
Best,
Kalyn
I don’t have any toddlers but I do have a teenage daughter who only eats soup for breakfast (ramen noodles with ALL the salt included) we suggest she eat other breakfast foods but she refuses and doesn’t eat most things. She doesn’t eat lunch at school and when she does take lunch it’s the same Nutella sandwich and nothing else. Although she does manage to eat dinner when I cook she prefers to eat frozen food. I’m at a loss here because my two youngest daughters (6,8) have a very healthy diet. -Signed a worried Stepmom
Hi Tahereh! Thanks for reaching out. Picky eating is very frustrating, especially when it continues into teenage years. Try meal planning with her in preparation for the week- even if it’s for just one meal out of the day. Having her help you in the kitchen to prepare these meals will also help expose her to more food variety. For more tips and information, check out this blog post to help with your teen.
Best,
Desiree
My nephew will not eat food all he eats is bacon ,french fries, chips, popcorn, sometimes he will eat bread bananas and apples but very rare when he does. Thats his meal plan every day it’s been the same for the las 3 to 4 years he will no try no food at all
Hi Jennifer! We’ve definitely heard all of this before and know how stressful it can be! We have a free picky eating workshop that may help with your nephew’s eating habits. Let us know if we can help with anything. Save your seat here!
Best,
Kalyn
I finally feel seen – thank you for this wonderful resource!
You are so welcome! So glad this was helpful for you! Thanks so much for the feedback!
Best,
Desiree
My almost 3 year old eats basically nothing all day. When he does it’s either goldfish, dry cereal, french fries, shortbread cookies, and sometimes popcorn. He is still drinking lots of milk and water. He doesn’t even like juice or Gatorade (diluted or not). He used to eat more at a younger age like meats, beans, yogurt, and oatmeal. He will not eat off a spoon or fork anymore. He’ll turn his head away or say no. I know picky eating is common, but I feel like this has gone too far.
Hi Erin! Thanks for reaching out! We would recommend continuing to offer food in a variety of ways, without any force or pressure- making sure to serve him the same food as everyone else. Try including one of his preferred foods at mealtime- this might make him feel more comfortable to try the other foods on his plate. Keep exposing him to different things, including him in the cooking process, involving him, getting him hands-on with food, etc. Try using dips, fun spears or shapes to see if this makes him more interested! Dips can be helpful since they tend to mask the flavor of most foods. Aside from consistency and patience, getting to the root of his picky eating would be most beneficial. We have a free picky eating workshop that can help with this, check it out here!
Best,
Kalyn
I have a almost 3 year old she’ll turn 3 in September, when she was a baby she ate everything we gave her after she was about 10 month old would go trough phases that she would only eat avocado for every meal and it would last about a week or two. When she turned 1 she started being picky would sometimes eat everything and sometimes wouldn’t eat for days only drank milk. The dr said she is doing fine hight and waight wise so there’s no worry anyway long story short now she only has 5 foods and that’s it nothing more but if I give her chiken nuggets that she likes but will not have it again for afew days, some days she eats nothing at all she can go up to a week with only water and some milk
And refuses to eat at all. The dr doesn’t do anything and says she’s fine even though she has lost so much waight now she is the same waight as my 9 month old son.
I would appreciate you help
Hi Nora,
I’m so sorry to hear that you’re daughter is having these struggles. We know it can be concerning for parents! It can be helpful to provide a preferred food and milk with meals, so they is more inclined to sit down with the family and engage a little. Our free picky eating workshop would be a helpful place to start. You can save your seat HERE.
Best,
Andrea
Hi, My toddler is almost 3 years old and when I started to feed him on his 6 month he kept gagging and I had a problem feeding him since then. I breastfed him until 2 years of age and had to force him to drink formula milk to substitute, he doesn’t eat much. I have to cook soup and mushed rice to feed him. I’ve tried introducing new food but he kept gagging or sometimes cry when I ask him to eat. I also tried to stop feeding him formula milk to give way to solid foods but it didn’t work. He’s sensitive to texture, color or smell. I’ve been feeding him same food everyday. I’ve been trying to feed him vegetables but I need to mush every thing before he eats it but not always. I’m lucky if he eats what i’ve prepared. Now that he is 3 his weight is only 14kg. I’ve been so stressed ever since. What should I do? I really need your advice
Thanks for reaching out! It can be really stressful when our little ones don’t get the hand of eating solid foods. It can be helpful to try to start with dissolvable solids (such as graham crackers or Gerber baby puffs). They are great for learning to chew. We also have a post about teaching children to chew that might be a helpful place for you to start! I hope that helps get you started!
Best,
Andrea
You have a typo there. it’s “ARFID” not “AFRID”
Thanks so much for pointing out this typo! We have updated it 🙂
I think my son is more on the side of food aversion…. he is almost 9. and 43 lbs. His 7 year old sister is catching up to him in height and they weigh the exact same. (she is the polar opposite of him. She will eat anything… requests salads and devours pretty much any meal I make with little to no complaints. She’ll ask for hummus crackers and cheese for lunch, lobster in the summer… salmon and shushi. She’s got a very grown up taste)
He has always been afraid to try new things although I have gotten him to eat different kinds of chicken (fried, baked, roasted, grilled) but if I make a chicken pot pie for example he’ll only eat the chicken… no veggies. The One and only veggie he will touch/consider eating is corn. He’ll begrudgingly eat steak…but wont touch beef stew. He’ll eat pork in various ways but never pulled pork….Italian sausages he’ll eat too. He’ll spit out any meat that is chewy, charred, imperfect in looks.
BUT everything MUST be covered in Ketchup. Like unhealthy/disgusting amounts of ketchup. Even pasta with sauce or macaroni and cheese… ketchup. Grilled cheese.. dipped in ketchup… tacos drizzled in ketchup. It is his one major vice. If we run out of ketchup I panic.
He also eats only toddler sized portions…except when it comes to pizza.. then he can down 3-4 slices easy. This by the way is the one and only food he doesnt need ketchup on. (other than fruit which by the way he does like thank god)
His older brother was ultra picky too…but at about this age finally started opening up to trying new foods and now I dont generally have an issue with him. He is 12. But I legit remember training him to eat more foods before he went to his first summer of over night Boy Scout Camp 1/2 week at just the age his brother is now (or will be next summer… the summer before 4th grade). After that camp is where he turned around his habits.
PLEASE HELP!!! I am so over it all.
Hey Stephanie!
We get it!! It can be so hard and frustrating watching how picky they can be! I’d try to get him involved in the kitchen with helping with any meals as best as you can. This can help them get exposed to the other foods and make them more comfortable. We do also have a free workshop that is a great start at working on picky eating. If you haven’t seen it yet, save your seat here
Best,
Desiree
Thank you! I need all the help I can with this one
Hi, my son in 5 years old and hasn’t eaten a vegetable or anything ‘new’ in a year. He eats a few different cereals, cheese, salami, yoghurt, pears, saladas and corn chips. For dinner he will eat sausages, plain rice, plain pasta, or chicken nuggets.
That is it!
He will not try anything new despite bribes etc. if I so much a place something new on his plate (the other day I put one pea, one corn, one carrot) and he lost it, he wouldn’t eat until it was removed from his plate.
This has been going on for year. He won’t even get close enough to the food smell, touch or taste it.
I thought it would be a faze but it doesn’t seem to be.
It doesn’t apply to just veg etc, he won’t eat a corn chip if it is a different flour or shape, won’t try pizza despite loving cheese and salami, he doesn’t eat chips or even ‘junk food’ if he hasn’t had it before. Unless it’s sweets, he will almost always try new sweets.
Hey Natalie,
Thanks for reaching out to share your story with us! I’d try to start to remove all pressure from the table, this can be a big step for picky eaters to feel more comfortable within their home. You can learn all about how to remove pressure in our free workshop! Save your seat here
Best,
Desiree
Hi, I have 4 years old boy who is a extreme picky eater. Till the age of 1 year and half he was a good eater he used to eat everything. Since then he is drifting away and became picky eater. And now he is at the stage where he just drink pediasure 2 times a day and milk three times a day. And sometime he eats little rice, he doesn’t eat fruit or vegetables or any meat. I m very worried, don’t know what to do. Help would be highly appreciated
Hi, I have 4 years old boy who is a extreme picky eater. Till the age of 1 year and half he was a good eater he used to eat everything. Since then he is drifting away and became picky eater. And now he is at the stage where he just drink pediasure 2 times a day and milk three times a day. And sometime he eats little rice, he downs tear fruit or vegetables or any meat. I m very worried, don’t know what to eat.
Thanks for reaching out! We totally understand how difficult this can be. I’d first try to work on getting him involved with helping in the kitchen to get him touching and engaging with the foods. This can be a really helpful step in moving forward. We do also have a free workshop that is a really good first step towards opening him up to picky eating. You can save your seat here
Best,
Desiree
My 9 year old nephew does not eat veggies or fruits. The only meat is chicken nuggets. He only eats items like pb and j. Pancakes, cereal, etc. He has gained alot of weight in the past year and a half. What options do my sister in law have? She just lets him eat this way and it is out of hand.
Hi there!
We recommend working on the underlying cause of the picky eating and then work on expanding the foods that he’s eating. It does take some time, but this workshop can be a great place to start! You can save your seat HERE.
Best,
Desiree
My 5 yr old had gotten sick a while back and ever since then he has not wanted to eat like he use to he will take little bites of some things and that’s it he will just want to drink milk I ask him are you hungry and always says no Im not sure what else to do besides take him to the doctor he needs to eat more
Hey Caitlin,
So sorry you are dealing with this, we get how hard it is! I’d try to make sure there is a no pressure environment for him, this can be extremely helpful in getting kids to eat. We do have a free workshop on how to do that, as well as other tips and items to try. You can save your seat HERE
Best,
Desiree
Well this is more about my self I am 14 years old almost 15 years old and I have always been a picky eater but it’s getting worse like now I won’t eat some foods that I used to like so I’m having the same meal as I hate a lot of thing or haven’t tried them for instance I’ve never tried pizza cause I’m afraid to the same as a burger etc. So what should I do a she now my parents are sick of my being very picky and saying I must now try new stuff but I mm afraid what should I do and what would u call that I have like is it a picky eating disorder or something please resond with a answer
Hey Charly,
Thanks for reaching out to us, we know that it’s not easy being a picky eater. Check out this article for teen picky eaters and I’d share with your parents as well. There are some tips in there to work through as well as a link for describing “extreme picky eating” which is what we term the more severe picky eaters. You can read it here
Best,
Desiree
Hi! I have a 2yo who is extremely picky eater with chronic constipation and also egg & milk allergy.
I am honestly at my wits end cause he dont eat proper food at all.
He basically eat something today only once and will refuse anything alr after. He only likes banana. And will refuse the next few days. He was once a very VERY good eater before this.. but everything just change as he grow and now he is getting skinnier everyday. It worries me alot and its been going on for quite some time now. What should i do. 😔😔
We understand how hard this can be! I’d try to make meals a positive experience with making sure there is no pressure put on him at mealtimes to eat. We are just going to be starting our free picky eating video series today, where you will learn all about this and other strategies to help you picky eater. You can save your seat HERE
Best,
Desiree
I have a 4 year old who has suffered with chronic dairy allergy and reflux since he was born. The reflux controlled with some degree of success but at other times not at all. It’s now under control but I think it’s left a severe anxiety around eating. He will eat dry cereal, ready brek (kind of like porridge) plain pasta, plain rice, occasionally bread or toast. Mini sweetcorn peas and sweetcorn but no other veg and
Absolutely no meat or fish unless chicken nuggets or fish cake. Mash and potato letters. He’ll drink fruit smoothies but that’s the only way I get fruit and veg in him.
He’ll declare he doesn’t like food or just throw it. I put new things on his plate but if he doesn’t want them then the plate can get thrown. I don’t ask
Him to eat them and try and remove any pressure. I just don’t know what to do anymore I’m exhausted. Can you help? Thanks Clare
Hey Clare,
We know how hard this is! But we are here for you! You mentioned removing pressure this is a HUGE first step! I’d also be working on getting him involved in the kitchen with helping prep some meals or cooking fun, as this can help them relax around mealtimes as well. We do have a free workshop that is full of tips for where to start and getting them to move forward. You can save your seat here
Best,
Desiree
Hi there,
I have a 31/2 year old who can eat quite well on his own and likes all foods. He refuses to eat himself unless we tell him 100 x then he’ll take one bite then be completely distracted until we tell him again and again. If we spoon feed him he eats much quicker which is of course as two working parents has been our solution.
Hey Liane,
We understand how hard all these situations can be. I would try to remove all pressure from eating (it can be hard as parents, but once they feel that pressure removed, it can have a huge impact). We are starting our free video series soon, which will walk you through some great information and where to go with your child, even though he eats/likes all food, being able to remove the distractions and him feeding himself could be helpful. I think this workshop can help get you there. Save your seat HERE
Best,
Desiree
I have a 16 month old, I tried the messy plays, introducing with gerber luffs and some other meltable food.. but for some reason we are stacked on that step. For 4 weeks now, when we introduced other meltable food, he doesn’t like the other yoghurt melts and puffs. Now he just wants sweet biscuits. I can’t move with some other step as he is refusing the other puffs from which he seems to like before. I tried giving small pieces of soft bread but he will take 3-5 bites only. Also, we can only feed him whilst playing or having a tablet to watch. If he doesn’t have anything he’d play on his hands, it’s so tough for us to feed him. We think he has a big sensory Defensiveness and will only eat/pick Food he likes. I tried reaching out to my pedia but the only advise I got is to wait it out. He’s very slow in his growth and below than the regular weight for his age. I’m not sure how can we reach or get evaluated or reach for a feeding therapist. Coz I really need some advice on what to do.
Hey Frances,
So glad you are working with the meltables and moving your ways up, so great job with that. I would continue to do the playing with food/messy play outside of mealtimes, but including the new foods that you are going to want him to play with to get exposure and work on him touching it and getting used to it. Also, if you have not seen our free workshop it is full of great information on setting up mealtimes for this age. Save your seat HERE
Best,
Desiree