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Picky Eating or ARFID?

Charting Pediatrics

Release Date: 05/05/2026

The Health Benefits of Recess for Kids show art The Health Benefits of Recess for Kids

Charting Pediatrics

When adults look back on school, they often remember more than lessons and worksheets. They remember recess — the playground, movement, friendships, laughter and freedom. Yet in many schools today, recess can be one of the most negotiable parts of the school day. It may be shortened, delayed or withheld in favor of academics, structure or behavior management. But research continues to show that recess is far more than a break. Regular opportunities for play and movement support children’s physical health, mental well-being, social development, and ability to learn. Pediatricians are...

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Charting Pediatrics

Some of the most serious diagnoses in pediatrics begin with common pediatric symptoms. A child comes in looking pale or with a febrile illness. They’ve been more tired than usual. Maybe they’re bruising easily or complaining their legs hurt. Individually, none of these symptoms are unusual. Together, or with persistence, they can tell a different story. Leukemia is the most common childhood cancer, but it’s earliest signs often resemble everyday illnesses.   The episode introduces , a pediatric oncologist at Children's Hospital Colorado and faculty member at the University...

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Charting Pediatrics

Tick bites used to be a seasonal nuisance, something you might mention briefly at a well visit in late spring. But that’s no longer the reality. With emergency department visits for tick bites climbing to their highest levels in nearly a decade and tick populations expanding into new regions, pediatricians are now seeing the ripple effects of a changing environment in real time. In this episode, we break down what’s driving this surge, how to approach tick bites in clinic, and what’s new in our understanding of tick-borne illness — including important updates on alpha-gal syndrome...

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Charting Pediatrics

Puberty doesn’t always follow the expected timeline. What happens when it shows up ahead of schedule? For pediatricians, the early appearance of breast development, pubic hair or accelerated growth can trigger a cascade of questions. Is this a normal variant? Should we investigate further? When is it time to refer? In this episode, we unpack the complexities of precocious puberty and explore how timely identification and thoughtful management can make a lasting difference for kids and their families.  To create clarity, we are joined by , and Clare Parker, MD. Dr. Hsu specializes in...

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Charting Pediatrics

A child’s future begins long before the first words, first steps or even the first smile. In the span of just 1,000 days, billions of neural connections are formed, and the foundation for lifelong health, learning, and resilience quietly takes shape. Pediatricians understand the critical nature of early development, and they translate that message to parents, helping guide, nurture, recognize risk and shape outcomes that can last decades.   To explore this fascinating time in a child’s life, we are joined by two experts. , and , both specialize in developmental and behavioral...

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Charting Pediatrics

The human spine is designed to support, balance and adapt through a lifetime of growth. But what happens when that growth starts to bend in an unexpected direction? Scoliosis often emerges during periods of rapid development, turning what should be a normal growth spurt into a race against progression. The challenge isn’t just finding the curve. It’s predicting what that curve will do next.  To explore the latest in scoliosis care, we are joined by . He specializes in orthopedic surgery and is the Medical Director of the spine center at Children’s Hospital Colorado. He is a...

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Charting Pediatrics

When most people hear the word “discipline”, they think consequences, punishments or stopping bad behavior in the moment. But what if we’ve been thinking about discipline too narrowly? We are reframing discipline in toddlers through a completely different lens. One rooted in connection, development and emotional regulation. Because toddler “misbehavior” isn’t usually about manipulation or defiance. More often, it’s communication.  To help us create developmentally appropriate expectations, we are joined by two experts. , specializes in child psychology here at...

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Charting Pediatrics

It’s one of the most unsettling calls a pediatrician can get: a baby who turned blue, stopped breathing or suddenly went limp, only to appear completely normal moments later. Welcome to the clinical gray zone of BRUE (Brief Resolved Unexplained Event). It sits at the intersection of alarm and ambiguity, where the history is often dramatic, but your clinical exam is reassuring. We are going to go beyond the definition and into real-life decisions that you have to make on the phone and in the office. From risk stratification to avoiding unnecessary testing, we break down what actually matters...

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Charting Pediatrics

For many families, water represents joy, summer afternoons, swimming lessons, beach vacations, backyard pools and time spent together. But in pediatrics, we also know that water can become dangerous in seconds, often quietly and without warning. Drowning remains one of the leading causes of preventable death in children, and recent updates from the American Academy of Pediatrics reinforce that prevention must be layered, proactive and tailored. In this episode, we explore how pediatricians can support drowning prevention, because some of the...

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Charting Pediatrics

What if the patient you’re least worried about is the one most at risk? In pediatrics, we’re trained to look for red flags such as low weight, failing growth curves and visible signs of malnutrition. But atypical anorexia challenges that instinct. These patients may sit comfortably on the growth chart, or even above it, while experiencing the same dangerous behaviors and medical instability as those with classic anorexia. In this episode, we rethink what we’ve been taught to look for. We explore how...

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More Episodes

“Picky eater” is one of the most common labels in pediatrics and one of the easiest to overlook. But when a child’s diet is shrinking instead of expanding, when meals are a source of stress instead of routine, or when growth and nutrition start to feel like a question mark, it’s worth taking a second look. In this episode, we’re discussing ARFID: what it looks like in clinic, how to spot the difference from typical picky eating, and how to approach these patients with a sharper clinical lens.

In this episode, we are joined by Kimberly Sheffield, PhD. She is an eating disorders psychologist at Children’s Hospital Colorado, as well as the Clinical Director of Pediatric Mental Health Institute (PMHI) day programs, and the Associate Training Director for Psychology Training. 

Some highlights from this episode include:

  • Specific growth or nutrition patterns that should raise suspicion of ARFID
  • Treatment options pediatricians can manage in clinic 
  • Overlap between ARFID and neurodiversity  
  • Patterns to look for in certain age groups 

This episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado. Ent is Colorado's largest credit union serving more than 550,000 members at 60 service centers across the Front Range. Ent generously responded to Children’s Colorado’s State of Emergency for pediatric mental health in 2021 and is pleased to support this episode. Visit ent.com, insured by NCUA. 

For more information on Children’s Colorado, visit: childrenscolorado.org.