All children have food preferences, but extreme food refusal or texture avoidance can point to deeper sensory or oral motor challenges.
These signs are often misunderstood or dismissed as just being “picky.” But sometimes, they’re signs of something bigger at play, like a Pediatric Feeding Disorder, which affects 1 in 37 American kids.
The good news? Early intervention and proper support make a big difference. So if you think your child might be struggling with sensory or motor feeding challenges, or you’re concerned that their picky eating might not be something they’ll just grow out of, you’re in the right place. And you’re doing exactly the right thing by learning more!
| Hi! I’m Danielle Mondesir (M.S., CCC-SLP) I’m an ASHA-certified Speech-Language Pathologist, Feeding Therapist, and the founder and CEO of Desired Pediatric Therapy Services. My experience includes evaluating and treating children in various settings, including schools, daycare centers, teletherapy facilities, pediatric facilities, private clinics, and homes. I’ve worked with clients ranging from 0 to 16 years old, addressing pragmatics, language, articulation, fluency, feeding, and developmental delays. My goal is to empower families, bridge communication gaps, and make therapy a truly impactful experience from the very start. Because when therapy is fun, children do better. And when caregivers are supported, everyone thrives. Let’s get into it! |
Sensory Processing in Feeding
Feeding is an incredibly sensory experience! It involves all sensory systems—mouth feel, smell, sight, and sound. Sensory processing in feeding refers to how the brain interprets input from those systems (including taste, smell, touch, sight, and texture) while we eat.
Because food is such a sensory thing, feeding can be a very intense experience for some kids. Sometimes, this is a positive thing. (Like when you eat the juiciest raspberry ever in the peak of summer, and you swear it changes your life!) But for kids with sensory sensitivities, who already experience sensations at a “higher volume,” it can be distressing and overwhelming. These kids often struggle to eat comfortably, even if they’re hungry. This can make eating a negative experience that they want to avoid, which can snowball into other nutritional and health concerns.
Motor Development in Feeding
Feeding is also an incredibly intricate skill from a motor developmental perspective. (It’s actually the single most demanding physical task a baby will master in the first months of their life!)
According to Feeding Matters, “a single swallow requires the use of 26 muscles and six nerves working in perfect harmony to move food and liquid through the body.” If even one doesn’t work as it should, the whole feeding experience can be disrupted. Sometimes, this can lead to (or stem from) a Pediatric Feeding Disorder (PFD).
This is important to know because for kids with PFDs, every swallow can be painful, uncomfortable, or a struggle.
Related: Feeding and Swallowing Milestones Broken Down by Age
5 Sensory and Motor Red Flags in Feeding
If you’re concerned about your child’s extreme pickiness or food avoidance, but you’re not sure if it’s “bad enough” to reach out for help, this list will help you decide what your next steps should be.
(But on a side note, if you’re concerned, it’s always a good time to reach out for help. Your intuition as a parent or caregiver is a valid enough reason!)
#1 Gagging Or Vomiting With Certain Textures
If your child often or sometimes gags on soft, mushy, or mixed textures (like yogurt with fruit) or vomits when trying new foods (or even watching others eat), this could be a sign of oral hypersensitivity. I would recommend consulting a pediatric feeding therapist who knows how to help them navigate through it.
#2 Extreme Food Selectivity
This goes beyond your run-of-the-mill toddler pickiness! If your child eats fewer than 10 or even 15 foods in total, or refuses entire food groups or textures (like “no wet foods” or “no crunchy foods”), it may indicate something called “oral defensiveness,” which also merits a conversation with a feeding therapist.
#3 Refusal to Touch or Interact with New Foods
If your child won’t touch food with their hands, avoid foods on their plate altogether, or asks for separate dishes, it could be because they’re avoiding the visual or tactile input food gives them. This is something a feeding therapist is trained to help with.
#4 Overreactions to Smells and Messes
If your child “overreacts” to food-related smells by covering their nose, gagging, or leaving the table, or if they melt down if their hands or face get messy, they may have a strong tactile aversion and need support to work through it.
#5 Meal Time Anxiety or Meltdowns
Some kids dread meals, cry, or even run away when food is served. Some avoid sitting at the table altogether because they don’t want to have another negative experience. Either way, this is an indication that feeding no longer feels safe or enjoyable to them.
If this describes your child, reach out to a feeding therapist. We can help your whole family navigate the situation while helping your child feel more secure around food again.
Worried About Your Child? Here’s What To Do.
If you’re a parent or caregiver and you’re concerned about your child’s extreme pickiness or food refusal, first of all, remember that this is not your fault. And that by simply reading this article, you’re taking a significant step toward getting them the help they need.
Here are the next steps I’d recommend taking:
- Don’t ignore the signs! Feeding challenges are valid and deserve attention.
- Seek support from your pediatrician, an occupational therapist, or a feeding therapist as soon as possible. Early intervention helps prevent long-term struggles.
Then, while you’re on a waitlist (or just waiting for your appointment), get started at home by:
- Reducing pressure at the table. We all learn and do better when we feel safe and have fun!
- Focusing on exploration, not consumption. Shift the goal posts in your mind. A “win” isn’t them eating all their broccoli. It’s touching, smelling, or even tolerating broccoli at the table.
- Use play-based approaches, such as sensory bins, to help your child become more comfortable with various smells, sensations, and textures.
Remember, sensory red flags in feeding aren’t just picky eating—they’re a sign that your child may need extra support at mealtime. When your child avoids food, they’re not being difficult; they’re communicating discomfort in the only way they know how. Trust their experience and your gut by seeking help early, and know that progress is possible with the right support.
References
- What Is a Pediatric Feeding Disorder? by Feeding Matters
- Eating and Swallowing Milestones from the American Speech-Language-Hearing Association (ASHA)
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