Selective Feeding-An Under-Recognised Contributor to Picky Eating

Area of Science:

• Pediatric Nutrition
• Child Psychology
• Feeding Disorders

Background:

• Picky eating is a common concern in children presenting to interdisciplinary clinics.
• Understanding the underlying causes and implications of picky eating is essential for effective management.
• Selective feeding, a specific type of picky eating, requires further investigation.

Purpose of the Study:

• To determine the proportion of children with picky eating who exhibit selective feeding.
• To describe the nutritional and growth implications of selective feeding in children.
• To understand parental coping mechanisms and feeding styles associated with picky eating.

Main Methods:

• Retrospective chart review of 152 children referred for picky eating from January 2020 to July 2022.
• Assessment of feeding behaviors using the Caregiver's Feeding Styles Questionnaire (CFSQ) and direct observation.
• Evaluation of caloric intake, oromotor skills, and medical concerns by dietitians, speech therapists, and doctors.

Main Results:

• 84.2% of children with picky eating were diagnosed with selective eating.
• Selective eating was frequently associated with comorbidities like autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD).
• Among 'otherwise well' selective eaters, 47.5% had inadequate caloric intake and 31% experienced failure to thrive, with authoritarian feeding styles and caregiver helplessness being common.

Conclusions:

• Picky eating is a symptom with diverse underlying causes, necessitating a thorough evaluation.
• Selective feeding significantly impacts child nutrition and growth, alongside causing considerable caregiver distress.
• Early recognition and multidisciplinary management are vital for addressing picky eating and its associated challenges.