Picky Eaters or Problem Feeders??
Picky Eaters or Problem Feeders??
As a parent there is nothing more frustrating than spending time cooking a delicious and nutritious meal only to be met with “I don’t like that!”, “That’s yuck!”. And, if you’re anything like me, I’m guessing you will refuse to prepare separate meals or allow your kids to eat noodles every night of the week….after all they are just being picky eaters right??
When to seek help
But…..when is it time to seek help? When are they just being picky eaters? How do you know when you have a problem feeder? We all expect our little ones to go through ‘fussy periods’ with that ‘yuck’ food turning into a favourite. Unfortunately, this is not the case with all children and that fussiness can persist far beyond what is considered to be “normal”.
Eating is very complex
Eating is an incredibly complex process. For most of us, we don’t give it a second thought… we sit down, we eat. Eating requires body awareness and balance, and involves all of our senses… touch, hearing, vision, and most obviously, smell and taste. It also requires a lot of fine movement coordination to bite, chew and eventually swallow. Next time you have something to eat, stop and think of all the movements taking place in your mouth. For little ones with movement coordination breakdowns or sensitivities in any or all of these areas, problems inevitably arise.
How do I know if my child is just a picky eater or whether there’s a problem? Here is a guide…
|Picky Eaters||Problem Feeders|
|– eat a decreased range but will eat at least 30 different foods|
– able to tolerate new foods on their plate and can usually touch or even taste a new food (albeit reluctantly)
– eats at least one food from most food textures or nutrition groups (eg purees, crunchy foods, proteins, fruits)
– frequently eats a different set of foods at a meal than the rest of the family (typically eats with the family)
– sometimes reported by a parent as a ‘picky eater’ at health checks.
|– restricted range or variety to usually less than 20 different foods|
– cries or ‘falls apart’ when presented with new foods; complete refusal
– refuses entire categories of food textures or nutrition groups (eg meats, vegetables, soft cubes)
– almost always eats different foods at a meal than the rest of the family (often doesn’t eat with the family)
– persistently reported by parents as a ‘picky eater’ across multiple health checks
‘Red Flags’ indicating you may need support…
- ongoing poor weight gain or weight loss
- ongoing choking, gagging or coughing during meals
- ongoing problems with vomiting
- history of a traumatic choking incident
- history of eating and breathing coordination problems
- not transitioning to baby food purees by 10 months of age
- not accepting any table food solids by 12 months of age
- unable to drink from a cup by 16 months of age
- unable to progress from baby foods by 16 months of age
Important to remember… If your little one is coughing, he is not choking. Coughing when eating is a reflex to dislodge any foods entering the trachea (windpipe) instead of the oesophagus (food pipe). When someone is choking, they are unable to cough as the food is totally blocking their trachea… ie they can’t get any air in to cough (or breathe).
What to do if you have a problem feeder?
Get help! A speech pathologist or occupational therapist who work with children who have eating difficulties can assist. I particularly like the SOS (Sequential –Oral – Sensory) approach to feeding and have seen some fantastic results. A dietician is also an important person to consult, they will ensure that your little one’s food intake is meeting their nutritional needs.
Please, please, please never force your child to eat. There are numerous reasons why a little one may be refusing to eat including pain due to reflux or constipation, sensory difficulties, immature motor, oral-motor or swallowing skills. Whatever the reason, making a little one eat will do nothing to foster a positive experience with food!
What can I do to create a positive feeding experience for my child?
Eat at the table as a family… mealtimes are an opportunity to model! Model how to eat, how to try new things (be careful of your own facial expressions), how to use cutlery, not to mention an opportunity to catch up on everyone’s day!
Let your child play with their food… little ones learn almost everything through play, but often we draw the line at ‘playing’ with food. Let them discover how it feels, what is sounds like when smashed with a spoon, what happens when it’s pulled apart, and it’s suitability for use as a hair gel… let them experience food before worrying about manners.
Offer sweet tastes at the end of a meal… sweet tastes suppress appetite quicker than other tastes. Offer ‘sweets’ as a part of the meal, rather than as a reward for eating or tasting the rest of the meal.
Change ‘Can you…?’ to ‘You can…’ questions interrupt a child’s eating and exploring and gives them the opportunity to say ‘no’. ‘You can…’ implies that you are confident your little one can manage what is being shown to them. Make sure not to interrupt what they’re doing. I’m trying to use this strategy throughout the day with my two boys, with everything, and it’s proving to be really effective!
When your little one persistently refuses to eat it can be a stressful time for the entire family, but rest assured help is available… if you have any concerns, please ask!
My name is Alison Marsh and I’m a speech pathologist. I am super passionate about empowering families with picky eaters and working closely with those families who have problem feeders.
(information adapted from text prepared by Dr Kay Toomey, SOS Approach to Feeding)