Feeding Milestones: Helping Toddlers Who Won’t Eat, Only Eat Certain Foods & Sensory Food Aversion

Have you ever sat at the dinner table thinking, “I already spend so much energy planning meals and grocery shopping — how can I deal with a toddler who refuses to eat anything?” You are not alone. 

Parents and caregivers often worry when their child eats only a handful of foods or pushes their plate away. Are they getting enough to eat? Could this be a sign of something more — like sensory food aversion or a developmental delay?

This struggle is more common than many parents realize: 25% to 35% of toddlers are described by their parents as “picky eaters.”

Pediatric occupational therapist Nicole Akerson, OTR/L, works with families to make mealtimes less stressful, tackling issues from sensory aversions to developmental delays. In this article, Nicole will help you:

• Learn gentle strategies to make mealtimes less stressful
• Recognize what’s typical versus what may require extra help
• Understand what feeding therapy entails

The first two years are key for building healthy eating habits

You can help your child start building healthy eating habits as early as they start eating solids. Your child’s first two years are when sensory systems are rapidly developing and when children are most open to new experiences. Introducing a wide variety of tastes, textures and smells during this period can help prevent sensory food aversion later on. 

By ages four and five, children have more ingrained habits — and stronger wills. “They talk back and say no, so changing routines becomes a little bit harder,” says Nicole. But don’t be discouraged — whatever age your child is now, Nicole’s tips can help you make mealtime more enjoyable for your family.

1. Don’t take toddler food preferences too seriously

It’s tempting to panic when your child only eats certain foods — maybe crackers and yogurt one week and then only bread and cheese the next. Nicole wants parents to know that this is often part of normal sensory development, not a sign that something is wrong. 

“Sensory development in the first few years of life changes so rapidly that their palates have major shifts during that time,” she explains. “They might eat a fruit all the time, then reject it a month later.” 

It might seem like their favorite foods are always changing — because they are. “As certain areas of their tongue are popping up, they might desire sweet less, savory more. They might go through periods of only eating one thing at a time.”

It can take 15–20 exposures for a child to accept a new food. So don’t give up on green beans after your toddler throws them one time. Keep bringing them to the plate for repeat performances (even if they get mixed reviews).

2. Take pressure off of mealtime

Parents often ask Nicole how to “get their child to eat.” Her answer? Don’t pressure them. “I encourage parents to pull back some force and pressure they put around mealtimes. Have the kids feel safe at the table. If the kids don’t feel safe, they’re not going to try a new food,” she says. 

Feeling safe means:

• Children can eat foods in whatever order they choose.
• Children can eat the amount they want, not necessarily finishing their whole plate.
• They only eat foods they’re interested in — though those foods may still appear on the plate for exposure.
• They have a physical bubble of space — no one is shoving a spoon into their mouth or policing every bite.
• The table environment stays calm — there’s pleasant conversation, not yelling, bribing or policing table manners. 

The CDC reinforces this no‑pressure approach, advising parents to let children decide how much to eat and that toddlers do not have to finish everything on their plate. Children may eat different amounts on different days. Forcing them to clean their plate can override their internal hunger cues and turn mealtime into a power struggle.

3.  Avoid games or ultimatums

Many of us grew up with the “clean plate club” or being told we couldn’t have dessert unless we ate our vegetables. Nicole explains that these tactics usually backfire. 

“Kids will naturally go through periods where they need more or less food,” she says. Children are masters at intuitive eating if we let them tune into their bodies.

Using dessert as a reward is equally problematic. Bribery or punishment to make children eat certain foods can worsen their responses. Instead of “earn your ice cream by eating broccoli,” try presenting all foods — including dessert — together on the plate and let your child decide what to taste first. You may be surprised by how much more they eat when dessert isn’t held hostage.

4. Offer variety and repeat exposure

Given that preferences are still developing and exposures matter, the best thing you can do is continually offer variety. 

• Always include a winner: Present at least one food your child already likes alongside one or two new items. 
• Encourage exploration rather than consumption: Touching, smelling or licking a food counts as exposure.
• Lead by example: Make the most of your child’s copycat tendencies by having the same food on your plate. They may be more willing to try it if they see it’s a normal part of the meal.
• Explore textures: Children with sensory food aversion often avoid slimy foods like yogurt or mashed potatoes and may gag at mixed textures. Try offering crunchy veggies, soft fruits, and mixed dishes in tiny portions so your child can gradually build comfort.

Feeding milestones that could indicate a developmental delay

While pickiness and food jags are common, certain signs suggest you should consult your pediatrician. Nicole recommends keeping an eye on three main areas:

1. Fine motor skill development – By around age one, children should be able to feed themselves with their hands and move food around their mouth using their tongue. Chewing should not be labored, and choking episodes should be rare. Frequent choking or a child taking an unusually long time to chew soft foods may indicate oral‑motor issues.
2. Sensory processing challenges – Some toddlers refuse to touch food, insist on having their hands washed immediately, or will only eat if spoon‑fed by an adult. Others tolerate only one texture (e.g., exclusively smooth purées or only crunchy snacks). Hypersensitive children may grimace, gag or vomit in response to certain textures. Gagging is a protective reflex to keep food from entering the airway, but persistent gagging at every new food should be evaluated.
3. Distress at mealtimes – Watch for extreme anxiety, crying, meltdowns or refusal to come to the table. If your child isn’t gaining weight, seems lethargic, or you’re constantly pulling food out of their mouth due to gagging, it’s time to seek professional advice.

What to expect from pediatric feeding therapy

If home strategies aren’t enough, pediatric feeding therapy can be a game‑changer. Nicole describes her clinic sessions as “food school” where the emphasis is on play rather than pressure. 

Therapy combines guided play with parent coaching so that families know what to do at home. “We sit at the table with parents and kids, and we play with our food,” she says. “Kids feel more empowered to explore foods if they’re having fun.”

Feeding therapy can involve occupational and/or speech therapists. It begins with an evaluation to observe how your child reacts to different foods and to assess their oral‑motor skills. 

The therapist tailors treatment to their specific needs and challenges. For some children, therapy may focus on strengthening oral‑motor skills to improve chewing and swallowing; for others, it’s about desensitisation and building trust at the table.

Nicole emphasizes that parents play a huge role: “Parents also need to commit to making changes. That’s why it’s harder when children are four years or older — because parents have habits they’ve formed over that time, too.”

Make mealtimes less stressful

Feeding a toddler can feel like a roller coaster. One day they devour strawberries; the next day they throw them on the floor.

It’s easy to worry that your toddler won’t eat anything, or to feel defeated when your child only eats certain foods. But remember: a lot of this is normal developmental exploration.

By understanding that sensory systems are evolving, offering consistent variety, avoiding pressure and watching for milestones, you can make mealtimes more enjoyable for everyone. 

If you suspect your child has a sensory food aversion or you are dealing with frequent toddler tantrums at mealtime, reach out to your pediatrician. Pediatric feeding therapy provides play‑based strategies and parent support that can transform your family’s relationship with food. With patience, empathy and the right resources, you and your child can build a foundation for lifelong healthy eating — and maybe even have some fun along the way.