I have been seeing a lot of kids with feeding issues lately, which I why I have been writing a lot about them! About half of the inquiries I get are from parents who can’t get their kids to eat table foods, or who accept a very limited number of foods. One thing all these kids seem to have in common is that they have a lot of anxiety towards food and mealtimes.
Here is hypothetical scenario based on a few real-life clients I have seen.
Sarah is 18 months old. She is healthy and typically-developing. Her mom, Emily, reports that Sara is bottle-fed, and started solids at around 5.5 months of age. Her mom started by giving her purees and soft solids like rice, pasta and bread. However, she quickly noticed that Sarah was gagging a lot while feeding, and often spat food out. Her mom persisted with solid feeding, but Sarah continued to gag or spit out food, and was eating very little. After a while, Sarah was only accepting a few table foods, and began to dread mealtime. She would resist sitting in her high-chair and refuse to have any food on her tray. Her mom began playing cartoons and videos on her phone while feeding Sarah, and even then Sarah only accepted soft purees.
Emily is frustrated and says mealtimes have become very difficult and unenjoyable.
Many well-meaning parents find themselves in the same position as Emily, above. Parents will face hurdles in trying to introduce solids. Sometimes, this is related to history of a certain health issue like reflux. However, a lot of kids have no history of any health issues. In any case, the child appears to become very sensitive to any new textures and flavours, more resistant to feeding, and pickier about the foods that they eat over time. Back in January, I wrote a post about establishing healthy feeding habits with your toddler. Today, I discuss three starting point to try and help your child if they are anxious around food and resist mealtime
Allow safe exposure to food
A lot of these kids have terrible experiences with food. Whether they were force-fed by well-meaning parents, had bad reflux or had very heightened oral sensitivity and adverse reactions to food texture (like vomiting, gagging), at some point they associated food with pain or another negative experience. This association can be so strong that some kids will begin to cry right when they sit in their high-chair or see their parents prepare food. In the most severe case I have personally seen, a child began to scream when they saw their mom open the fridge.
In these cases, I always begin by asking parents to expose their kids to foods in a safe way. There are a few ways I suggest to parents to do this:
- leaving snack’s and fruit out on the coffee table
- asking kids to help pick out fruits and veggies and grocery stores or put them away at home
- watching parents eat food.
In any case, the child is not being asked to eat nor is he or she being force-fed. The idea is to minimize negative reactions kids are having from the mere sight of food.
Let them play with food!
Once a child feels safe around food, you can try more interactive play with food. For example, I will often get kids to squeeze juicy fruits like cherry tomatoes, blueberries or grapes between their fingers. We will use sauce and smear it to draw things on their feeding trays or plates. We also pretend play with any food and feed it to a doll or a stuffed animal. I get kids to also feed their parents and let their parents reciprocate (if they agree). All the while, I try to engage the child and talk about the food’s colour or texture.
I ask parents to try and do this at home regularly. When I feel a child is ready, I may ask them to touch a food on their lip, or even lick it and I will also always demonstrate it. However, I never force it. I will wait for kids to do it at their own terms.
These first two steps are so important and can really help change your child attitude towards food. It not only gives you an opportunity to model to them how you can enjoy together, but it also allows the child to learn about foods through sensory play in a safe, stress-free way.
Ditch the tech.
The third step is to really try and get rid of any technology your using during mealtimes. This is essential to let your child be more interactive with you during meals, and be more mindful and present during mealtimes. The reason iPhones and TVs work is because they shift your child’s focus away from food. Not only is it preventing you from working issues your child is having around feeding, but some research shows that distracted eating may also lead to over-eating in the long-term. Imagine if you were eating a bag chips while watching a movie. You probably aren’t being very mindful of how much you are consuming, and before you know it, you are done the entire bag. Some parents find this difficult to do immediately, and that’s OK. This is a process, and you can pick and chose the battles you want to fight at each stage.
Gradual solid transition for very orally-sensitive children
Despite parents’ best efforts, some kids will continue to have low tolerance to certain textures or tastes. In these cases, we try a very gradual textural transition, and go with the pace of the child. This is a very child-specific process that your and your OT can work on together.
Finally…remember that it is very typical for toddlers to be resistant, especially to change. In fact, it’s part of their development. But it is up to parents to set clear limits and to be consistent.
Feeding issues put a lot of stress on parents and families. It takes away from the joy of family mealtimes. If you find that you are facing similar struggles an OT assessment can help. I have worked with many kids as young as 6 months to 3 and 4 year olds with various feeding issues. Contact me to book a free 20-minute phone consult with me today.