A Functional Approach to Feeding Difficulties in Children

Curr Gastroenterol Rep. 2019 Aug 23;21(10):51. doi: 10.1007/s11894-019-0719-0.


Purpose of review: This review provides an approach for resolving a variety of feeding difficulties in children, ranging from normal eating behavior that is misperceived as a problem to substantial feeding disorders.

Recent findings: Criteria to identify pediatric feeding disorders have been thoroughly addressed in the newly established designations of avoidant restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD). These diagnostic criteria improve the accuracy of identifying, classifying, and managing significant feeding disorders in young children. While recent definitions of feeding difficulties are particularly appropriate in multidisciplinary settings, in this paper, we advocate for a progressive approach of managing feeding problems in all clinical settings. It begins by identifying red flags indicative of serious threats to the child, screening for oral motor dysfunction, stabilizing nutrient intake, and eliminating aversive feeding practices. The next step, if eating behavior does not improve, involves strategies that target specific eating behaviors and parental feeding styles. In severe or resistant cases, referral to specialists or interdisciplinary feeding teams is advised.

Keywords: Fear of feeding; Feeding disorder; Food selectivity; Picky eating; Poor appetite.

Publication types

  • Review

MeSH terms

  • Appetite
  • Appetite Stimulants / therapeutic use
  • Avoidant Restrictive Food Intake Disorder
  • Child
  • Fear
  • Feeding and Eating Disorders / diagnosis*
  • Feeding and Eating Disorders / therapy
  • Food Fussiness
  • Food Preferences
  • Humans
  • Parenting
  • Patient Care Team / organization & administration


  • Appetite Stimulants