when to seek OT for picky eating

[Anonymous]

When is it appropriate to seek an evaluation or even talk to pediatrician about picky eating? I will have to count how many foods my child eats, but if it is under 20, is this the time to see specialists? Or is the fact that the foods eaten include only one vegetable and one fruit enough ground to seek intervention? Child is 6 and we've had this problem for the past three years. No official disability or special need, except speech delay in the past. Right now, only a few articulation problems remain.

[Anonymous]

I don’t know but I’m curious to see what others say, I have a very picky eater too, also 6.

[Anonymous]

As long as your child gets a good balance of different food groups and is within normal range for weight, there is probably no need. I have a picky eater who’s been eating the same lunch for years now. Rotates 3 fruits. Eats 1 vegetable. Slowly starting now to venture and try different foods. But check with the child’s pediatrician who could advise based on your child’s specifics.

[Anonymous]

If your kid eats a fruit and a vegetable, I personally wouldn’t. We went for a year when we were down to only a few dairy products - no meat, no fruit, no veggies, not even pasta.

We went an hour a week for a year and he learned to eat NutriGrain bars and Cheerios. End of list. Not a clear success!

[Anonymous]

I think if your child is healthy and you are managing ok with weight gain and no nutritional deficiency you probably could wait and see. My child could not even be around certain foods without a strong disgust reaction so they needed help to manage socially even though they had enough or close to enough foods. They also developed anemia- those gummy vitamins don’t have iron! So watch out for those. But I don’t think it ever hurts to talk to your pediatrician.

[Anonymous]

OP: my child does not take any vitamins.Should I do it? Thinking of asking pediatrician for blood tests. About two years ago our tests actually showed abnormally high iron and hemoglohin

[Anonymous]

What did the ped say about the abnormal blood tests?

[Anonymous]

I have a 12 yo whose only fruit or vegetable is a particular brand of applesauce squeezer.

We give him two flintstone vitamins with iron daily. He's 5'6 and his bloodwork is normal.

Like pp, we spent a fortune on an OT to helo with feeding and it was useless. He is just grossed out by many things.

[Anonymous]

Similarly spent thousands on OT with no new foods added. It simply doesn’t always help.

[Anonymous]

Also did not find OT helpful in increasing the variety of foods my kid would eat. There was a time due to mouth muscle weakness that he was unable to eat certain foods. Speech therapy helped with that.

The other thing about feeding therapy is that it is the most miserable thing ever. My kid’s weight fluctuated between the 0.05 and 0.03 percentile so we didn’t feel like we had a choice.

[Anonymous]

OT was a life-saver for us. The programs that are most successful have the family see borth an OT and a social worker/therapist at every appointment. Very rare to find. We aren’t in the DMV. Couldn’t hurt to ask your pediatrician if they know of any programs like this and what the Dr. thinks about your child in particular.

[Anonymous]

Some OTs specialize in feeding or have a feeding group. Many have done training in something called the SOS approach. I used to do this and had other specific training in feeding. I felt (and feel) a bit disgusted by my fellow OTs who don’t really specialize in feeding but still see kids who have this area of need. I feel like some are just kind of trying different things, hoping something works. The difference in outcomes among people who’ve tried OT for picky eating might just be a matter of which OT they chose. I used to recommend that parents read the book Just Take a Bite. You can find it on Amazon. It does offer some great strategies, but more importantly, it can help you take a closer look at your child’s eating and may help you decide whether professional help is a good idea. It’s not just about the number of foods he eats or even the nutritional intake. Does he go on food jags? How are his oral motor skills? Are there related behaviors? The book is very parent friendly. If you do choose to seek out an OT— be selective and do your research.

[Anonymous]

thank you! I got disparaged by the initial responses, but now I understand I need to look for the right specialist. I'll start with the book. Thanks so much!

[Anonymous]

I'd recommend a consult with a pediatric dietician. My already tiny 11yo actually lost weight during 6th grade (not a lot, but enough for his growth curve to plummet alarmingly), due to a combo of picky eating, loss of appetite, and stress/anxiety. Our pediatrician initially said she wasn't worried yet, but that if it didn't turn around quickly, it could become a real problem.

So I met with the dietician and she was SO helpful. Reassuring mostly, that any calories are better than no calories, so if he was eating something, not to stress about the pickiness yet, and also assurance and suggestions regarding macro and micro nutrients. We did discuss OT, but have tabled it for the moment until some of the contributing factors are more under control. We were able to turn the growth curve around in less than 6 months and he's doing much better now.

I do think its important to understand where the pickiness is coming from - an OT will be helpful for some reasons but not for others.

(The dietician I saw was Lauren Wenderoth: https://www.drdaisy.com/lauren-wenderoth.)

[Anonymous]

If bloodwork shows they are anemic.