At some point or another, nearly every kid will exhibit behavior that falls into the "picky eating" category — and if you've ever had a toddler who refuses to eat anything not served in her Peppa Pig bowl or a preschooler who insists on dipping literally everything in ketchup, then you know what I'm talking about. As insanely frustrating as this can be, it's usually a normal and temporary part of your child's development. But in some cases, it's not so normal. So what are some red flags that could mean your child is more than just a picky eater?
From underlying physical conditions to eating disorders such as Avoidant/Restrictive Food Intake Disorder (ARFID), also known as "extreme picky eating," there are a number of reasons why your child might be refusing to eat an appropriate variety of foods — and some of those reasons, which include gagging and weight loss, could require the attention of a medical professional. In some ways, it comes down to a matter of degrees: It's one thing if your kid makes a fuss over finishing his broccoli; it's another if he dissolves into hysterics at the mere mention of any green food, ever.
"The common denominator in all of these scenarios is the stress that having a hesitant, selective, or picky eater brings to the child, the parents, and the entire family," pediatric feeding specialist and author of kid-friendly cookbook Adventures in Veggieland Melanie Potock, MA, CCC-SLP tells Romper.
"Just that level of stress in a household warrants getting help," she adds. "Feeding disorders can impact at least 25 percent of typically developing children, impacting both body and brain growth. Eighty percent of children with special needs have difficulty eating and may be diagnosed with a feeding disorder."
Worried that your reluctant eater might have something more serious going on? Watch out for the following warning signs, but remember: None of these are a guarantee that what your child is going through isn't just a relatively harmless phase; still, it's always a good idea to bring up any concerns with your pediatrician.
It's completely normal for a child (or an adult, for that matter) to just plain not like certain foods. But if your little one emphatically and consistently avoids foods based on how they look, feel or smell, a sensory processing disorder might be to blame.
"A large issue I see is avoiding foods based on certain textures, smell, or even brands of food," Krisitna Zufall, M.Ed., a psychologist who specializes in eating disorders, tells Romper.
"When this severely limits a child’s food intake, I usually raise the alarm," she says. This type of avoidance can sometimes occur along side other disorders including Autism spectrum disorder or obsessive compulsive disorder, she adds.
Again, it's not so strange for a kid to have a tough time deciding what he wants for breakfast. It is cause for concern, however, if his indecisiveness happens at every meal, every day, and is starting to interfere with your daily life, as pediatric occupational therapist Alisha Grogan pointed out on her website Your Kid's Table.
If your child gags every time she tries a bite of a particular item, don't assume she's being dramatic (or just really, really hates the taste). As Rallie McAllister M.D. noted in Parents, there are a number of reasons that kids might have frequent gagging (or even vomiting) issues, from a hypersensitive gag reflex to gastroesophageal reflux. So it's definitely important to bring this up with your pediatrician.
While it's fairly common for a kid to turn up her nose at a meal she's never tried before, if "your child is not able to take a taste of new foods without significant stress," says Potock, then you might want to pay attention. And again, the occasional meltdown over an unfamiliar side dish isn't unheard of — but if your kid can't even entertain the idea of sampling something outside of her usual repertoire without getting seriously upset, that's a different story.
Another potential symptom of sensory processing problems, an unwillingness (or maybe even inability) to properly chew food that's "crunchy" or "hard" can lead to some very limited choices.
"Even if a child seems to eat enough food, they may be eating the same texture — for example, yogurt, banana and oatmeal," certified nutritionist Bess Berger, RDN, CDN, CLT, tells Romper.
"It seems like a healthy, decent diet, but all those foods are soft (texture) and do not require much chewing."
Of course, the main reason why we're concerned about our kids getting adequate nutrition is so that they can "grow up big and strong," as the saying goes. So naturally, "In children, a large red flag is weight loss or failure to meet expected weight gains as they mature," says Zufall.
"Limited food intake and weight loss can cause malnutrition which may be evident in lab work conducted at physicals. When physical causes are ruled out, ARFID may be a cause."
If you find that your child's regular diet revolves around a handful of "safe" and/or "inoffensive" foods (as in, he's existing on a steady intake of mac and cheese and applesauce and you can't go to any restaurant that doesn't have chicken fingers), this could be a sign of food-related anxieties — or it could be a sign that other foods are causing your child physical discomfort.
"Often, the root cause of disordered eating behaviors can be digestive ailments, food intolerances, and leaky gut/intestinal permeability," board certified holistic family nutritionist Sara Peternell tells Romper.
"I use IgG and antigen methods of testing, and results help us get to the bottom of why a child may avoid certain foods, even in children who are non-symptomatic. Testing, interviews with the family and child, a food journal, sometimes communication with the pediatrician, and other labs facilitate the healing program."
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