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A Treatment Package without Escape Extinction to Address Food Selectivity
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Selective Feeding-An Under-Recognised Contributor to Picky Eating.

Terri X B Chiong1, Michelle L N Tan1,2, Tammy S H Lim1,2

  • 1Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore 119228, Singapore.

Nutrients
|November 9, 2024
PubMed
Summary

Picky eating in children often indicates selective feeding, impacting growth and causing parental stress. Early identification and multidisciplinary intervention are crucial for better outcomes.

Keywords:
caregiver feeding stylefeeding difficultiesgrowth and nutritionpicky eatingselectivity

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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.