Peer-reviewed article
Decoding Picky Eating in Children: A Temporary Phase or a Hidden Health Concern?
Dorina Pjetraj, Amarildo Pjetraj, Dalia Sayed, Michele Severini, Ludovica Falcioni et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This review examines picky eating in children aged 0-18 years, which affects 13-50% of children with peak incidence between ages 2-6. While often a temporary developmental phase, persistent picky eating can lead to nutritional deficiencies, growth problems, and psychosocial difficulties. The review identifies contributing factors including genetics, sensory sensitivities, temperament, and family feeding practices, and distinguishes picky eating from more serious conditions like ARFID and pediatric feeding disorder. Effective management involves parental education, repeated food exposure, responsive feeding strategies, and in some cases nutritional supplementation or specialist referral.
Key points
- Prevalence of picky eating ranges from 13-50% with peak incidence between ages 2-6 years
- Persistent or severe food selectivity may lead to nutritional deficiencies, growth impairment, and psychosocial consequences
- Contributing factors include genetic predisposition, sensory sensitivities, temperament, family feeding practices, and adverse feeding experiences
- Distinction from ARFID and pediatric feeding disorder is essential as these carry greater risk of nutritional and psychosocial impairment
- Effective management includes parental education, responsive feeding strategies, repeated exposure to novel foods, and sensory-based or behavioral interventions
Limitations
This is a narrative review synthesising existing literature, not a primary study, so it does not present original data or test specific interventions with controlled designs. The document does not specify which countries' data are included, limiting understanding of geographic applicability of prevalence estimates and management recommendations.
Abstract
Background: Picky eating (PE), also termed food selectivity, is one of the most common feeding concerns in childhood. Although often a transient developmental stage, persistent or severe selectivity may lead to nutritional deficiencies, growth impairment, and psychosocial consequences. Methods: This narrative review is based on literature searches conducted in April 2025 across PubMed, Web of Science, Embase, Medline, and Google Scholar. Articles published between 2015 and 2025 were included if they addressed the epidemiology, etiology, assessment, or management of PE in children aged 0-18 years. Additional seminal references predating this period were also considered. Results: Prevalence estimates of PE vary widely (13-50%), with peak incidence between ages two and six. Contributing factors include genetic predisposition, sensory sensitivities, temperament, family feeding practices, environmental influences, and adverse feeding experiences. Distinction from avoidant/restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD) is essential, as these conditions carry greater risk of nutritional and psychosocial impairment. Assessment relies on caregiver-report instruments, clinical observation, growth monitoring, and targeted nutritional evaluation. Effective management integrates parental education, responsive feeding strategies, repeated exposure to novel foods, and, when indicated, nutritional supplementation or referral to multidisciplinary teams. Sensory-based therapies, behavioral interventions, and psychoeducational programs show particular benefit in persistent cases. Conclusions: While most children outgrow PE without adverse outcomes, a subset remains at risk of long-term nutritional compromise and psychosocial difficulties. Early recognition, family-centered guidance, and evidence-based interventions are essential. Future research should refine diagnostic criteria, develop culturally sensitive assessment tools, and evaluate innovative therapies to improve outcomes.