Feeding Red Flags Every Parent Should Know

From an OT perspective

Picky eating isn’t just a phase and it’s not just about being “difficult.” For many children, feeding challenges stem from a complex mix of sensory processing differences, developmental readiness, and nervous system regulation. I’ve walked this path from both sides of the table. What I’ve learned is this: we simply need more understanding.

What’s Developmentally Normal?

It’s completely normal for toddlers and preschoolers to show strong preferences or go through food jags (eating only one food for days or weeks). According to the American Academy of Pediatrics (AAP), it’s typical for young children to:

• Eat small portions (their stomach is about the size of their fist)
• Be wary of new foods (called neophobia)
• Exhibit inconsistent eating patterns from day to day

Normal picky eating typically peaks between ages 2–6 and gradually improves with exposure and trust.

Red Flags That Go Beyond Typical Picky Eating

While some pickiness is developmentally normal, there are certain signs that may signal a deeper feeding challenge, the kind that OT is trained to support.

Watch for these red flags:

• Gagging or vomiting from food textures
• Extreme sensitivity to smells, sounds, or food temperatures
• Limited diet (less than 20 foods)
• Refusal to eat entire food groups
• Emotional meltdowns or anxiety around mealtime
• Poor weight gain or nutritional deficiencies

If you’re seeing these signs, you’re not overreacting. Your child may be experiencing sensory processing difficulties, oral motor delays, or interoception challenges that impact hunger and fullness cues.

Why OT? What We Bring to the Table (Literally)

Occupational therapy looks at the whole child, not just what’s on the plate. We address:

• Sensory processing: Is the child avoiding food textures, overwhelmed by smells, or craving intense flavors for regulation?
• Oral-motor coordination: Are they struggling with chewing, swallowing, or tongue movement that makes eating exhausting or scary?
• Postural support: Are they wiggling constantly because their core isn’t stable enough for sitting?
• Feeding routines: Do transitions, timing, or environmental distractions make it harder to engage at meals?

In OT, the goal isn’t to get a child to eat more broccoli. It’s to create safety, predictability, and trust at mealtimes so that feeding becomes less about power struggles and more about self-regulation.

Practical Tools You Can Start Using Today

1. Offer structure — not pressure
   • Use a consistent mealtime routine with visual cues
   • Avoid bribes, threats, or rewards
2. Serve one “safe” food at every meal
   • This gives your child confidence without sacrificing variety
3. Use sensory regulation before meals
   • Heavy work (jumping, wall pushes, bear crawls) before mealtime can help kids sit and focus
4. Ditch distractions, not connection
   • Turn off screens but stay emotionally available — talk, connect, and model eating
5. Build tolerance through exposure, not force
   • Let them touch, smell, or play with new foods without the expectation to eat

Final Thought:

Feeding isn’t just nutritional, it’s relational. When a child feels safe, supported, and understood, the nervous system can shift from defense to exploration. That’s where true feeding progress begins.

Once you identify if the issue is normal or potential red flags, you can begin to come up with a plan. Consult with your pediatrician if you have concerns. Check out my free Picky Eating Checklist and read my next blog —->The Secret to Getting Picky Eaters to Try Just One Bite

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Free Resource:

✅ Download my Picky Eating OT Checklist

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Citations:

1. Carruth, B.R., et al. (2004). “Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food.” Journal of the American Dietetic Association
2. American Occupational Therapy Association (AOTA). (2022). Occupational therapy’s role in feeding and eating.
3. Chatoor, I. (2009). Diagnosis and Treatment of Feeding Disorders in Infants, Toddlers, and Young Children.