PICKY EATERS: TIPS FROM A FEEDING THERAPIST

Is my kiddo just picky or do they need feeding therapy?

 

 Below are some tips for picky eaters. If you feel stuck or like everything you try is in vain, reach out to your local occupational or speech therapist to discuss if feeding therapy is appropriate. 

 

 

 

 

Picky eating, ARFID, Pediatric Feeding Disorder… there are many names used to describe difficulties with eating for children. For any parent, this can be an overwhelming issue. With meals and snacks occurring 3-5+ times a day, it’s no wonder that parents become overwhelmed! I want to provide you some ideas for your toolbox to help manage the overwhelm. These general tips are not meant to replace the guidance of your pediatrician or feeding therapist.

***Before walking through these tips, I’d like to start with an important caveat. Never, never, never force your child to eat. That means no holding broccoli in front of their faces until they accept, no standing behind them and sneaking a scoop into their mouths, no hand over hand to force food into the mouth, no demanding that your child stay at the table until they eat a certain food, and no punishments for not eating. Additionally, I do not recommend hiding things in their food. Even if you get away with it for a while, in the end this will create a more hyper vigilante child with more anxiety around eating. I say this without judgment. I know parents end up trying desperate things to get their child to eat and that this is borne out of concern for their well-being. However, these methods will only backfire long-term. Our goal should be positive relationships and experiences built around mealtimes. The tips below are an effort to help you do this. However, if things start to feel desperate or your caregiver/dad/mom-gut is telling you something isn’t right, talk to your pediatrician and ask about your child being evaluated by a feeding therapist (often speech language pathologists or occupational therapists).

Slow down, take a breath. If you’ve found this post then you are likely feeling stressed, worried, and/or at your wit’s end with finding foods for your little one to consistently eat. That’s understandable! However, this can often be palpable and add stress to the mealtime for both you and your kiddo. Not only is that unpleasant for all involved, but the stress response releases a hormone called epinephrine (also known as adrenaline) which is an appetite suppressant – see where I’m going with this? So my advice is to slow down and take a breath. You can even practice taking big belly breaths together! Try blowing bubbles at the table before you present food. Pretend to smell some beautiful flowers and then pretend to blow out birthday candles. You can help each other lower your heart rate and release endorphins (your “feel good” hormones)! What a great way to start a meal!

Recruit a sous chef. Give your kiddo developmentally appropriate jobs. Can they throw tomatoes into the salad bowl? What about stirring the pancake mix? This gives your kiddo more neutral or positive interactions and exposure to foods and their ingredients. Explain what the ingredients are and their changing properties as they are cooked. “The pasta started out crunchy but the hot water made it squishy!”. You can also explain what the different ingredients do and how they provide energy to our bodies. For example, proteins give our body energy for longer periods of time and starches give us energy for shorter periods of time. Proteins help us build strong muscles while vegetables help our bodies work better (like carrots keep our eyes healthy to see). Even setting the table can help your child feel a sense of predictable structure which helps with managing the transitions associated with mealtime.

Be a model. Kiddos love to imitate their parents! Use that to your advantage and show your kiddo what they can do with their food. You can also narrate your actions with food. “I’m going to have a small taste of this yogurt…the yogurt is cold and has a tart taste”, “I wonder what these carrots smell like…I’m going to sniff and find out…oh, they have a sweet smell! What do you think?!”. When you are chewing your food, make exaggerated chewing movements. Allow your kiddo to feed you (this is usually a huge hit!) or even take turns feeding a preferred toy.

Be mindful of your language. Instead of describing your food as “gross, yummy, good, or bad”, try describing the sensory properties. This helps children put facts with food and helps prevent internalizing negative feelings with food. Words like, squishy, crunchy, salty, juicy, smooth, purple, round, shiny, hard, big, small are good starting points!

Learning plate. Try serving meals “family style”. Everyone passes a dish and takes a serving. For foods that might be particularly difficult, place them on a saucer next to the dinner plate and designate it “the learning plate”. Explain that this is where the new foods go if they aren’t ready to eat it. Use the tip above to increase engagement and exposure!

Check kiddo’s seating situation. Good feeding skills start with good postural stability. Is your little one slouching or leaning to one side? Make sure your child is sitting upright and is not leaning left or right. Good posture ensures that the airway is in a safe position for swallowing. If maintaining this posture seems to be fatiguing for your child (pay attention to how they are breathing, does it seem more involved or faster-paced?), use towels to support them on either side. Eating is not the time to work on core strength – we need the muscles to focus on eating and breathing. Ensure that your kiddo’s feet are supported so that ankles, knees, and hips are at about 90 degrees. Also look at your child’s pelvis and make sure the pelvis is tilted more forward instead of backward with their booty scooted toward the back of the seat, all of which helps with the postural alignment. You can use towels, pool noodles, and even cardboard boxes to add support to any highchair or dinner chair! Consult your OT for specific suggestions for your kiddo’s proper postural alignment.

Play, play, play! Yes, PLAY with your food! Research shows that kids learn the best through play, but many of us forget that includes learning about food, too! Get goofy! Make green bean mustaches or pepperoni noses. Bite your biscuit and make it a crescent moon! Use fun utensils or small toys to engage with the foods. Use different animal licks: how does a lizard lick versus a puppy? Try chew challenges! Who can break the food into the smallest pieces or make the loudest crunchy sounds?! GET MESSY! Encourage your little one to engage in foods with their hands. Dump purees on the highchair table, let them splat and smear their hearts out! Encourage building structures or happy faces with foods. Tactile bins are great for sensory enrichment.

All in all, focus on building positive experiences with and around food. Change your mindset to increasing exposure to different foods rather than focusing on what actually goes in their mouth. Research indicates that on average, it can take a kiddo up to 10 times of tasting a new food before they will eat it consistently. Hopefully knowing this, in addition to the above tips, will ease some of the overwhelm related to “picky eating”. Remember to continue to take care of yourself, too. And if you need more answers, never hesitate to ask your child’s pediatrician. You know your child best!

Caitlin Sanschagrin, M.S., OTR/L

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