Parents with young children often wonder if their child’s eating habits are typical picky eating or if it’s something more. Picky eating is often a common phase of development that many children naturally outgrow. However, some children experience severe food aversions and restrictive eating habits that parents feel is more than typical picky eating.
In this article you will learn about causes of extreme picky eating in children and strategies to improve extreme picky eating.
This article will discuss
- Typical picky eating
- The differences between tradition picky eating and extreme picky eating
- 5 factors that contribute to extreme picky eating
- How to improve extreme picky eating
What is picky eating?
Ask any pediatrician or parent – picky eating is normal. Most children experience a change in their eating habits and food preferences. Starting anywhere from approximately 15 months to two years of age, children may begin to eat smaller quantities at mealtimes and might become more selective in the range and variety of food that they eat.
Often parents become frustrated when toddlers who used to eat everything start rejecting formerly preferred foods (often vegetables) and begin to show a preference for bland foods and sweets. Many children also begin to assert a preference for certain foods and preparations and may also experience cycles of preferring certain foods.
This sort of picky eating is common during adolescence and is often regarded as a typical stage of child development that coincides with a change in children’s appetite, growth, and increasing maturity. During picky eating, children can develop strong preferences for foods and specific preparations and can experience cycles of preferring one food over another.
Even though it may be a large departure from a child’s earlier eating habits, traditional picky eating does not usually have a negative impact on a child’s growth, health, or development. Importantly, typical picky eating is also temporary. Most children will outgrow their pickiness and independently begin to welcome a wider variety of foods.
How is extreme picky eating different from typical picky eating?
Extreme picky eating may present at the same time as typical picky eating – around one and a half years or age. Though extreme picky eating may initially appear to be the typical developmental phase, it differs from traditional picky eating in several ways.
Often extreme picky eaters have an even more severely restricted diet that might result from strong food aversions, sensory and oral motor impairments and subsequent inability to eat certain flavors and textures. This can affect physical growth, as well as emotional and social development.
Though it may seem that an extreme picky eater is rebelling or acting out, extreme picky eating is not a choice. Extreme picky eating is often associated with underlying developmental delays or medical challenges. Therefore, it tends not to spontaneously resolve.
5 Factors that Contribute to Extreme Picky Eating
There is no formal definition of extreme picky eating or even diagnosing criteria. Every child’s eating challenges may present differently and may have different causes. There are, however, several factors that can contribute to extreme picky eating.
Sensory impairments and extreme picky eating
Do you notice any patterns among your child’s preferred foods? Maybe they’re primarily a certain texture or flavor? This might have to do with a child’s sensory system.
Many extremely picky eaters have oral or tactile sensory challenges that impact food preferences. Research suggests that children with higher sensitivity to taste and texture can translate to a higher rate of disliked foods and increased picky eating behaviors [1,2,]. Sensory challenges may influence a child to prefer certain foods and avoid others.
Sensory impairments that affect eating are especially common in neurodivergent children and children with autism .
Medical challenges and extreme picky eating
Past and current medical conditions can influence a child’s eating habits, preferences, and abilities.
Conditions like allergies, chronic reflux, gastroparesis, and esophagitis can make it painful or difficult for children to eat. This can lead to eating refusal, loss of appetite, and increased fear and anxiety around food and eating.
It is also possible that being sick – not feeling well or throwing up after eating – can cause children to fear eating specific foods or eating in general.
Children with developmental delays are at increased risk for eating challenges.
Oral motor delays and extreme picky eating
Like sensory challenges and medical conditions, oral motor delays can make it difficult or even painful for a child to eat. When eating is uncomfortable a child will learn to avoid it as much as possible.
Challenges, such as an inability to orally manipulate, chew, or swallow certain foods can also lead to diet restrictions and food aversions.
Fine motor skills and extreme picky eating
Impairment of fine motor skills that impact a child’s ability to self feed can also contribute to extreme picky eating.
A struggle with certain food types or textures can cause a child to gravitate towards particular foods and avoid others.
Genetics and extreme picky eating
While children do tend to take on their parents’ eating habits, picky eating may not run in the family in a genetic sense. Genetics can play a role in picky eating, though. Children who are supertasters or non-tasters might experience a strong taste reaction to certain foods, particularly vegetables and other bitter tasting foods .
Strategies to improve extreme picky eating
There are many possible solutions and strategies that can improve extreme picky eating. The best solution likely depends on a child’s age and the reasons behind their food aversions and eating habits.
Still, the following articles can help to create an eating environment that supports extreme picky eaters and can provide parents with helpful tips as they begin to help their child learn to eat new foods.
- 4 Things to Do When You First Spot Picky Eating
- 5 Mealtime Musts to Improve Picky Eating
- 9 Ways to Improve a Picky Eater’s Diet
- 7 Things to Expect When Introducing New Food to a Picky Eater
There are many factors that can contribute to extreme picky eating. Taking all possible factors into account can help determine the best ways to help improve extreme picky eating.
 Smith AM, Roux S, Naidoo NT, Venter DJ. Food choice of tactile defensive children. Nutrition. 2005 Jan;21(1):14-9. doi: 10.1016/j.nut.2004.09.004
 Coulthard H, Thakker D. Enjoyment of tactile play is associated with lower food neophobia in preschool children. J Acad Nutr Diet. 2015 Jul;115(7):1134-40. doi: 10.1016/j.jand.2015.02.020
 Bandini LG, Anderson SE, Curtin C, Cermak S, Evans EW, Scampini R, Maslin M, Must A. Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr. 2010 Aug;157(2):259-64. doi: 10.1016/j.jpeds.2010.02.013
 Skinner JD, Carruth BR, Wendy B, Ziegler PJ. Children’s food preferences: a longitudinal analysis. J Am Diet Assoc. 2002 Nov;102(11):1638-47. doi: 10.1016/s0002-8223(02)90349-4