Provider Tips on Identifying Pediatric Feeding Disorders

How to Identify When A Child’s Feeding Issues Go Beyond Picky Eating

Use the following questions to help identify if a child’s food sensitivity impacts nutrition, development or family functioning.

• Are caregivers reporting that a child has few accepted foods?
• Has the child stopped eating formerly accepted foods after a packaging or appearance change?
• Is the child’s food refusal escalating or limiting participation in school, activities or family meals?
• Does food-related stress appear to impact family dynamics?
• Is the child at risk of nutritional deficiencies, slow growth or psychosocial stress?

Additional signs to assess when determining a feeding disorder diagnosis:

• Over-reliance on specific brands, containers or food packaging
• High distress in response to food variation such as color, shape or plating
• Avoiding entire food groups or textures
• Rigidity about how food is served, such as only eating from a red bowl
• Negative physical reactions like gagging or vomiting to new or altered foods
• Delayed self-feeding skills or inability to transition from breast/bottle to solid foods or purees to table foods

Questions to explore with parents or caregivers to support assessment and identification of a pediatric feeding disorder:

• What happens if a safe food comes in a different package or is changed in some way?
• Does your child refuse foods they once accepted?
• Have you changed your family’s meals or routines to accommodate your child’s food preferences?
• Do you avoid restaurants, social events, or travel because of feeding concerns?
• How much stress does feeding cause in your day-to-day life?

If you suspect PFD or ARFID:

• Assess for PFD using the Feeding Matters Infantopen_in_new and Childopen_in_new Feeding Screening Tool
• Ask the parent or caregiver to complete the full Feeding Matters Infant and Child Feeding Questionnaireopen_in_new to identify challenges with nutrition, feeding and growth.
• Access the Feeding Matters PFD ICD-10 Toolkitopen_in_new for education, identification, and advocacy tools for professionals and families.