The mitochondria produce the energy of life and impact the functioning of every organ, especially the skeletal muscles. Subtle mitochondriopathies can disrupt energy production and result in low muscle tone and capacity within the muscles of mastication, and this disrupted function can significantly impact a child’s ability to eat. Simple treatments with compounds like CoQ10 and carnitine can dramatically increase muscle tone, and therefore improve a child’s ability to eat. Mitochondriopathies should be considered as part of the evaluation for every child who presents with feeding problems.