Picky Eating and Selective Eating: When to Seek Support

Is this just picky eating... or something more?

Many children have strong food preferences, sensitivities, or challenges around eating. While this is often called picky eating, the term, selective eating, can better reflect the child’s unique needs and experiences. Whatever you call it, you’re not alone - and there are supportive, non-judgmental ways to help.

Questions to Ask Yourself:

1. Is my child getting the nutrition they need?
Are they growing well and staying healthy, according to their healthcare provider? A pediatrician is a great place to start. This is also a good time to ask about any food allergies or sensitivities as well ​​- sometimes kids avoid certain foods because those foods don’t feel good in their bodies. It’s helpful to rule out any medical reasons early on.

2. Are there any signs of swallowing difficulties?
Things like gagging, frequent coughing, choking, food or drink coming back up, a wet or gurgly-sounding voice, or even changes in facial color (like turning red) during or after eating can be signs that something might not be working quite right with swallowing. If you notice any of these, check in with your pediatrician- they can help guide you on what to look into next and connect you with the right support if needed.

3. Do mealtimes feel calm and positive?
Is eating together generally low-stress for your child - and for you? A peaceful mealtime environment is important for building a healthy relationship with food.

4. Can your child express what they like and don’t like?
Do they feel safe saying “no” to a food or describing why they don’t want it? Can they spit something out without feeling embarrassed or pressured? Can they describe what they like about a favorite food, like the taste, texture, and smell? 

5. Does your child notice when they’re hungry or full?
This is called interoception awareness - being able to notice internal body cues. You might see it when your child gets themselves a snack when they’re hungry or turns their head away when they’re full.

6. Does your child feel pressure to eat?
Pressure can show up in many ways- like offering rewards, encouraging “just one more bite,” or even gentle nudging. Most caregivers (and even professionals!) use these strategies without meaning to. Supporting a child’s relationship with food is complex and takes ongoing practice. If you’ve noticed this happening, you’re not alone- and there’s no reason to feel bad. What matters most is becoming aware and trying to shift toward a more relaxed, responsive approach over time.

7. Are there emotional or sensory needs at play?

Some kids feel overwhelmed by certain smells, textures, tastes, or even background sounds during meals. Others might have big emotions or difficulty focusing in a way that makes eating harder. These are all valid experiences. Do you feel confident in supporting your child with those needs at the table? If not, that’s okay!

8. What are your instincts telling you?
You know your child best. If something doesn’t feel right, it’s okay to trust your gut and reach out for help.

When to Seek Support

If you answered “no” to questions 1-7, or if your instincts are telling you that something doesn’t feel right, it might be time to talk to your pediatrician or connect with an occupational therapist or speech language pathologist who specializing in feeding/eating. Look for someone who takes a gentle, whole-child approach to feeding - one that respects body autonomy, builds safety, and removes pressure.

You're not alone. Help is available, and with the right support, your child can learn to enjoy food in a way that feels safe and empowering.

By Nicole Raisin, OTR/L

About the Author
Nicole Raisin, OTR/L, is a board-certified occupational therapist and the founder of Raisin Joy Occupational Therapy, a pediatric OT clinic dedicated to creating a safe and supportive space for children and their families. Nicole is passionate about building trust, honoring each child’s unique needs, and helping families feel empowered every step of the way.

To learn more or schedule a consultation, visit RaisinJoyOT.com