5 Signs That It’s More than “Picky Eating”

At some point in time, most children will exhibit behavior that falls into the “picky eating” category. It is common for toddlers to only like a few foods, to reject foods they used to like, or to be hesitant to try new foods. This process is all a part of typical development, and parents should not be alarmed. However, if your child exhibits the following signs, especially if they show more than one, there may be more to your child’s “picky eating.” In these cases, a feeding therapy evaluation may be warranted. 

1. Your child’s diet is extremely limited, often to only one or two food groups or one or two textures.

We all have our preferences, and it is NOT expected that children will accept every food that is presented to them. However, if their chosen or “safe” foods are extremely limited (for example, only eating mac and cheese for dinner every day, and refusing any other options), it may be a sign that their feeding difficulties are more than simply preference. It is also concerning if a child eliminates entire food groups from their diet, such as ALL fruits, ALL vegetables, and/or ALL proteins. A certain level of variety in their diet is important for nutrition, growth, and development. Similarly, limiting foods to only those that are soft (pancakes, bananas, and yogurt, for example), may indicate sensory processing difficulties or difficulties with oral-motor skills.

Girl covering mouth with plate of food in front of her

2. Your child has frequent, explosive meltdowns or extreme distress when asked to eat a food they don't like.

Just like the first point, this one is also a matter of degree. “Tantrums” are a typical part of development, and occur when children experience emotions bigger than what their young brains can handle. It is not uncommon, for example, for a child to be so disappointed at the thought that there isn’t any more of their favorite fruit pouch left in the house that they experience a meltdown. These should not occur regularly around food. If, on a regular basis, your child has an extreme reaction to eating a food that they don’t typically like, it may be a sign that there is more to their challenges than simple preference.

3. Your child has extreme physical reactions to foods that they don’t like.

child gagging at food

What does your child do when there is a food that they don’t like on the table, or on their plate? Some children gag or even vomit at just the sight of a non-preferred food. This makes it impossible for them to even be at the dinner table while the family is eating. Other children may be able to tolerate the presence of different foods, but become tense or gag when they touch or taste that new food. These strong physical reactions move beyond “I don’t like it” or “Yuck.”

4. Your child insists that foods be prepared a certain way, or will only accept a specific brand/type of their “safe” foods.

Maybe your child eats chicken strips, mashed potatoes, applesauce, and broccoli regularly. While there is at least some variety in these foods, the picture becomes more challenging when your child’s selectivity goes further. They’ll only accept chicken strips from one fast food restaurant (not just one chain, but one actual, physical restaurant’s drive thru). Mashed potatoes can only come from the pouch, with absolutely no lumps. The applesauce needs to be the one with the white lid. And the broccoli has to be raw, only the tops, and cut into the right-sized pieces. If presented with any slight variation of their favorite foods, they are unable to eat it and exhibit the reactions we talked about in earlier points.

5. Your child is experiencing slow growth or difficulty chewing/swallowing.

This is the biggest red flag on this list. If your child isn’t growing as expected, it is a sign that their selectiveness is more than “picky eating.” The second piece of this red flag occurs if you notice that your child coughs, chokes, gets watery eyes, or turns red when eating. If either or both of these situations is present, we recommend an immediate call to your pediatrician. There are a variety of medical conditions that may be contributing to your child’s difficulties with eating and digestion.

Next steps

Children who are experiencing feeding challenges will typically not respond to traditional approaches, such as incentives or consequences. The idea that “they will eat when they’re hungry” often does not hold true, which may result in slowed growth and development. Luckily, through feeding therapy and potential medical intervention, there is help available.


Does your child exhibit one or more of these red flags? Are you unsure if your child’s picky eating is typical or problematic? Schedule a free consultation with one of our occupational therapists. We will listen to your concerns and provide recommendations for next steps.

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