Picky Eating, Pediatric Feeding Disorder, or ARFID? How to Tell the Difference

If mealtimes feel like a battle in your home, you’re not alone. As a Certified Pediatric Feeding Therapist, I often meet families who aren’t sure if their child’s eating habits are “just picky eating” or if something more is going on. The truth is, there’s a spectrum — from typical developmental phases to clinical feeding disorders that need specialized support.

Let’s break it down together :) 

1. Picky Eating

• What it is: A common phase, especially between ages 2–5, when kids may decline certain foods or prefer familiar favorites.

• Why it happens: Developmental independence, changes in taste perception, and even a little power-testing at the dinner table.

• Signs it’s typical picky eating:

  • Child eats from all major food groups (even if the variety is limited)

  • Growth is on track

  • They try new foods occasionally — even if reluctantly

  • Mealtimes aren’t causing significant stress or anxiety for the child

• To help improvement: With patience, repeated exposure, and positive mealtime routines, most kids grow out of it. This is when picky eating is typical!

2. Pediatric Feeding Disorder (PFD)

• What it is: A Pediatric Feeding Disorder (PFD) is defined as a medical, nutritional, feeding skill, or psychosocial challenge that impacts a child’s ability to eat safely, effectively, or comfortably.

• How it’s different from picky eating: It’s not just preference — it’s a disruption in ability.

• Possible causes: Premature birth, medical conditions, sensory-motor delays, structural differences (e.g., cleft palate), or negative feeding experiences.

• Signs of PFD:

  • Coughing, choking, gagging during meals

  • Trouble chewing or swallowing

  • Limited diet that’s causing growth or nutrition concerns

  • Prolonged mealtimes (over 30–40 minutes)

  • High stress for child and caregivers around eating

• Why early help matters: PFD can affect growth, development, and the child’s relationship with food. Support from a feeding specialist, dietitian, and/or medical team can make a big difference.

3.ARFID (Avoidant/Restrictive Food Intake Disorder)

What it is:
ARFID is a diagnosis used when a child’s eating is extremely limited or avoidant in a way that impacts nutrition, growth, or daily life — and it’s not related to body image concerns.

It’s often rooted in anxiety, sensory sensitivity, or past difficult food experiences.

Common drivers:

• Strong sensory sensitivities to taste, texture, temperature, or smell

• Fear after a choking or vomiting experience

• Very low appetite or limited interest in eating

Signs a child may need specialized support:

• A very small number of accepted foods

• Nutritional deficiencies or growth concerns

• Significant anxiety or distress around new or unfamiliar foods

• Avoidance that impacts school, social events, or family life

A gentle reminder:
ARFID is not about willpower or parenting. It’s a complex interaction between the nervous system, sensory processing, medical history, and emotional experience.

Support often includes a team approach, which may involve a feeding therapist, dietitian, mental health professional, and medical provider working together.

The Takeaway for Parents

• Picky eating is common and often temporary.

• PFD involves challenges with the skills or comfort of eating.

• ARFID reflects deeper patterns of avoidance that may need more structured support.

Most importantly: if mealtimes feel overwhelming, you don’t have to figure it out alone.

My goal as a Certified Pediatric Feeding Therapist is to help children feel safe, regulated, and confident around food — and to help families move from stress to connection at the table.

If you're unsure where your child falls, or if you want support surrounding meal times, contact us here.