Podcast Transcript: Hidden Medical Reasons Behind Picky Eating
Host: Christine Miroddi Yoder
Date: July 21, 2025
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Christine:
So—you’ve probably tried everything. Exposure, schedules, maybe even feeding therapy. But nothing’s working, and you're still stuck. If that’s the case, this episode is for you. I’d be willing to bet there’s something deeper going on—and today, I’m going to walk you through five hidden medical reasons your child might be struggling with picky eating. These are the ones that often get overlooked, even by providers.
I’m Christine Miroddi Yoder, pediatric holistic feeding therapist and creator of the Unlocking Mealtimes method. And in this episode, we’re going beyond behavior—because feeding is not just about compliance or trying new foods. It’s biological. It’s medical. And the sooner we start treating it that way, the better progress we’ll see.
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Reason #1: Oral Motor Issues
Let’s start with the most common issue I see—oral motor delays. These might include:
* Low muscle tone
* Weak jaw or tongue strength
* Tongue ties
I’d estimate that over 80% of the kids I work with have some oral motor component affecting their eating.
Think about it: if a child can’t chew properly or coordinate food in their mouth, eating becomes exhausting. It doesn’t feel safe or comfortable. And children often can't explain why—it just feels wrong. So they refuse.
Here’s an example: I once worked with an adult client who had been a picky eater her whole life. She wanted to eat better but didn’t know why certain foods felt so hard to tolerate. After doing an oral motor assessment and working on her skills, she realized just how physically difficult eating had been for her. She’d never known it was a mechanical issue.
So imagine how hard this is for a child who doesn’t have the words or awareness to describe what they’re feeling.
Red Flags for Oral Motor Issues:
* Gagging or spitting out food
* Pocketing food in their cheeks like a chipmunk
* Preferring purees or meltable solids (like puffs or Cheetos)
* Meals dragging on for 45+ minutes
* Avoiding fibrous foods like meat or vegetables
* Missed or undiagnosed tongue ties, especially posterior ties
If you see these signs, your child likely needs an oral motor evaluation by someone trained to assess feeding, not just speech sounds. Dietitians, for example, typically aren’t trained in this unless they’ve taken extra coursework.
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Reason #2: Breathing Issues
Next, let’s talk about the airway. Breathing problems—like enlarged tonsils, adenoids, or chronic mouth breathing—can be a major block to eating.
Here’s why: breathing always takes priority over eating. You can’t chew and swallow while breathing through your mouth. So if your child can't breathe easily through their nose, food becomes a threat. Their brain is forced to choose: Do I eat, or do I breathe? And breathing always wins.
Red Flags for Airway Issues:
* Mouth breathing
* Snoring or restless sleep
* Teeth grinding
* Fatigue or irritability
* Grazing throughout the day instead of eating full meals
* Preference for soft, bland foods
If you suspect this could be an issue, consult an airway-focused dentist—not all dentists are trained in this. Chronic mouth breathing and undiagnosed sleep apnea can seriously affect mood, behavior, and appetite. We often spot these patterns before any other provider does.
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Reason #3: Gut Issues (Reflux, Constipation, Dysbiosis)
Gut discomfort is a huge hidden driver of food refusal. If a child experiences even mild pain or bloating with eating, their body will naturally begin to avoid food.
Sometimes this is reflux. Sometimes it’s constipation. Sometimes it’s a gut imbalance (called dysbiosis). Regardless, you can’t make real progress in feeding therapy until you address gut discomfort.
We’ve worked with children who were later diagnosed with celiac—even though they never complained about stomach pain. Why? Because to them, that discomfort was just normal. It had always been there. So they didn’t know to say anything.
Red Flags for Gut Issues:
* Bloating or gassiness
* Belly aches or constipation
* Mood swings or irritability
* Preference for carbs and processed snacks
* Skin rashes or failure to gain weight
In our Premium Roadmap program, we include gut testing through a functional stool analysis. Our holistic practitioner reviews it to identify:
* Imbalances in gut bacteria
* Poor digestion or absorption
* Food sensitivities or enzyme issues
This type of testing gives you real answers—not just a list of “safe” or “unsafe” foods, but a plan to heal the gut and restore appetite.
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Reason #4: Food Sensitivities & Allergies
Even minor immune responses to food can trigger discomfort and food refusal.
These aren’t always full-blown allergic reactions like hives or throat swelling. Sometimes, it’s subtle: inflammation that disrupts the nervous system or causes mood changes.
And the reactions can be delayed—happening hours or days after the food is eaten—which makes it even harder to spot the connection.
Red Flags for Sensitivities:
* Red cheeks or ears after eating
* Rashes, eczema, or mucus in the stool
* Loose stools or diarrhea
* Meltdowns or hyperactivity after meals
* Strong aversions to entire food categories
You can try keeping a food and behavior log to look for patterns. But elimination diets are hard to do with kids, especially if the food in question is one of their only safe foods.
That’s why testing often makes more sense—it gives you answers without playing a guessing game.
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Bonus Reason #5: Toxic Load
This one’s often overlooked but incredibly important: chemical and environmental toxin exposure.
From the food they eat to the products they touch, today’s kids are surrounded by synthetic additives, preservatives, and pesticides. These can overwhelm their nervous system and gut, leading to food refusal as a protective mechanism.
Red Flags for Toxic Load:
* Hyperactivity after snacks or candy
* Rashes, eczema, or dark under-eye circles (aka allergic shiners)
* Sensory overwhelm in public places
* Chronic congestion or ear infections
* History of antibiotic use or developmental regression
Common culprits include:
* Red 40 and artificial dyes
* MSG, BHT, and sodium benzoate
* Soybean oil (often pesticide-laden)
* Fluoride in water or toothpaste
* Plastics, aluminum, and synthetic fragrances
The body is designed to heal—but it can’t detox properly if it’s constantly being bombarded. Support detox naturally by using:
* Filtered water and air
* Real, whole foods
* Stainless steel or glass containers
* Sulfur-rich foods like broccoli, garlic, and onions
Small changes add up. Use apps like Yuka or Think Dirty to check for safer swaps. And remember, even one product switch at a time makes a difference.
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What to Ask Your Doctor
If this episode resonates with you, bring some of these questions to your provider:
1. Could there be an oral motor or sensory issue making it hard to eat?
2. Can I get a referral to a feeding therapist who takes a holistic, root-cause approach?
3. Could we evaluate the airway or gut function—not just growth charts?
And if you’re hitting a wall, consider a full feeding evaluation—one that looks at oral motor skills, gut health, breathing, and sensory-motor development. That’s exactly what we do through our Unlocking Mealtimes Roadmap. It’s personalized, comprehensive, and focused on lasting change.
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Let’s Recap: 5 Hidden Medical Reasons for Picky Eating
1. Oral Motor Issues – Gagging, pocketing, puree preference
2. Breathing Problems – Mouth breathing, snoring, fatigue
3. Gut Imbalances – Bloating, constipation, food avoidance
4. Food Sensitivities – Rashes, meltdowns, diarrhea
5. Toxic Load – Sensory overload, mood shifts, chronic congestion
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If any of these red flags sound familiar, you are not alone—and you have not failed.
You may just be addressing the wrong root. No sticker chart or exposure strategy will work when the true issue is biological. Take our free quiz at thepickyeaterquiz.com to find your child’s eating level and discover the next best step.
We hope this episode was eye-opening—and we’ll see you next week!
