Feeding & Nutrition
Picky Eating and Feeding Difficulties
When food is a daily battle, there is usually more going on. We look at the medical, sensory, and behavioral pieces together.
Many kids go through picky phases, but some children develop persistent food refusal that affects growth, family meals, and quality of life. There is often an overlap of sensory, behavioral, and medical factors driving the pattern.
Dr. Mendez evaluates feeding difficulties with the time and patience they actually need. We rule out medical contributors like reflux, eosinophilic esophagitis, constipation, and food allergies, and we coordinate with feeding therapists when helpful.
Signs and symptoms
- Very limited food list (under 20 foods)
- Strong reactions to new foods or textures
- Slow weight gain or weight loss
- Gagging, choking, or vomiting at meals
- Mealtime distress for child or family
- Vitamin or iron deficiencies on labs
- Avoidance of entire food groups
- Eating only specific brands or presentations
How we treat it
- Full medical workup to rule out reflux, EoE, constipation, and food allergy contributors.
- Growth and nutrition review with personalized recommendations.
- Screening for ARFID and other feeding patterns that need a team approach.
- Coordination with feeding therapists, OT, and dietitians when appropriate.
- Family-friendly mealtime strategies that lower the stress without lowering the bar.
When to call a pediatric GI
- Food refusal that affects growth or weight gain.
- A child who eats fewer than 20 foods or drops foods over time.
- Mealtime distress that disrupts the family every day.
- Choking, gagging, or vomiting episodes at meals.
- Concern that picky eating is more than a phase.
Frequently asked
Is this just a phase, or is it something more?
True picky eating phases usually do not affect growth and resolve over months. When the list keeps shrinking, growth slows, or meals become traumatic, it is time for a real evaluation.
What is ARFID and could my child have it?
ARFID is Avoidant Restrictive Food Intake Disorder. It looks like extreme picky eating but is driven by sensory aversion, fear, or low interest in food rather than body image. We screen for it and connect families with the right team.
Do you work with feeding therapists?
Yes. The best results often come from a coordinated team: pediatric GI for the medical workup, dietitian for nutrition, and a feeding therapist for skills and behavior.
Ready to talk it through?
Concierge access means we have the time to listen, evaluate carefully, and stay with your family through every step.