The difference between picky eating and feeding disorders in children

The difference between picky eating and feeding disorders in children

A simple screening test identifies pediatric feeding disorders (PFD)

Picky child or child with feeding disorder refusing to eat

Feeding disorders in young children can delay and lessen a child's mental, physical, emotional and social development. That's because feeding is a complex skill that develops over time. Finding and treating these feeding disorders as early as possible has the potential to prevent these developmental delays, and the problems that can come from a difficult relationship between the children and their parents or other caregivers.  

Feeding Matters, an organization that works with children who have or are at risk for pediatric feeding disorders (PFD), created the Infant and Child Feeding Questionnaire® (ICFQ©). The ICFQ© is designed to identify potential feeding concerns and alert a child's healthcare team. Based on caregiver responses to 6 specific questions, the ICFQ© has been able to identify pediatric feeding disorders (PFD) and tell the difference between those disorders and picky eating in children between 0-4 years of age. This 6-question quick screener continues to undergo research as Feeding Matters strives to promote the early identification of PFD. 

The ICFQ©  Screen for feeding disorders in those under 4 years of age

Does your baby/child let you know when he is hungry?

YES           NO

Do you think your baby/child eats enough?

YES           NO

How many minutes does it usually take to feed your baby/child?

5 – 30———Over 30

Do you have to do anything special to help your baby/child eat?

YES           NO

Does your baby/child let you know when he is full?

YES           NO

Based on these questions, do you have concerns about your baby/child's feeding?

YES           NO

Red flag answers are in Red. If 2 or more of your answers are red, please contact your pediatrician.

Older kids can have feeding challenges too 

Up to 20% of kids under 8 years old may have feeding difficulties, and even kids up to 12 can have them too. Some of these older kids have some of the same symptoms as the younger ones. Like taking a long time to eat, not knowing when they are hungry or full.

Signs of feeding difficulties in older kids: 

  • struggle to try new foods
  • eat less than 10 foods
  • not like getting messy
  • only eat specific textures
  • very sensitive to foods touching their skin or lips
  • gag when seeing or smelling certain foods
  • fussiness at mealtimes
  • unable to swallow certain foods 
  • pocket the foods in their cheeks

If your child has any or several of these problems, you should discuss them with your primary care provider, who may refer you on to a specialist or a clinic that works with these problems frequently.

Note: it is important to know that feeding disorders are different from eating disorders which can affect older kids and adults. Read more in our article about the warning sings of eating disorders to compare the difference between disordered eating and disordered feeding behaviors.

Bottom line

The ICFQ questionnaire can help you determine if your child's feeding difficulties need to be addressed by your pediatrician.