Picky Eaters vs. Problem Feeders: A Physical Therapist's Perspective

Feeding, next to breathing, is one of the most life dependable activities of daily living. For many of us, sitting down at the table with our loved ones and enjoying a meal is a pleasant experience. In contrast, it can be frustrating and stressful for many parents. Children who refuse to eat or are picky eaters can be a nightmare and cause worry to many parents. This issue will briefly discuss how a transdisciplinary therapeutic approach can have an impact on feeding.

The Difference Between Picky Eaters & Problem Feeders

Picky Eaters:

  • Poor food variety (30 or more)
  • Burns out on preferred foods but will try them again
  • Will attempt to try new foods with use of touch & taste
  • Will eat with the family but eats different foods sometimes

Problem Feeders:picky eaters

  • Poor food variety (20 or less)
  • Burns out on preferred foods & not attempted again
  • Will tantrum or melt down with new foods
  • Refuses particular group of food
  • Will always eat different foods than the family

*List provided by Dr. Kay Toomey, Pediatric Psychologist

Posture is Important

By Erin Lublow, DPT

Physical Therapy plays an important part in creating the foundation of the feeding process: Posture! We need to be able to sit upright and maintain overall postural control against gravity to complete the activity of feeding. Correct postural alignment is a critical element for the overall feeding/swallowing process to be safe and functional. Our base of support begins with pelvic stability and trunk alignment. We need to have both of these components to promote neck and head control. If the child has a poor basis of control, head and over all jaw stability for biting, chewing, and swallowing is affected. Aspiration is a risk factor without proper posture! When developmentally appropriate (around 5-8 months) children should be sitting upright in a high chair.

Proper sitting positioning and alignment in the chair begins with the feet. Feet should be supported firmly on the ground (or high chair foothold), knees should be bent at 90 degrees, and hips should be bent at 90 degrees and parallel with the shoulder joint. Below are some key muscular issues that can cause problems with feeding that should be addressed if they are apparent:

Muscular issues that can cause problems with feeding include:

  • Cervical hyper-extension due to weakness or increased tone
  • Poor head control in sitting
  • Spine asymmetries
  • Muscular asymmetry of trunk or pelvis
  • Muscular instability of pelvis and trunk

Intervention for children with muscular issues is evaluated and treated with a variety of gross motor exercises and activities. Tummy time, core strengthening using an exercise ball, half kneel positioning, and hip strengthening are some of the key areas physical therapists would address during treatment. These therapeutic interventions would help with cervical and trunk control, encouraging static control, and postural control against moving through gravity.

Discover more information on physical therapy in Sandusky, Ohio from the experts at Firelands Regional Medical Center today.