“My child won’t eat anything but Goldfish crackers or pasta and butter.”
“I’m trying to get my child to eat, but he refuses and chokes and gags when he tries to eat.”
It’s natural to be worried when your child isn’t eating or his food preferences are extremely limited. You want your child to be well nourished, but you also don’t want to battle with him at every meal and every snack. How do you find a balance, and what are the signs of a more serious issue? Here are 3 perspectives from occupational therapists at Children’s Health Council:
from Domenique Embrey, MS, OTR/L:
- Give your child space. If feeding problems are mild, sometimes the best thing you can do is stop hovering. Ellen Slater, author of Feeding with Love and Good Sense, says that a parent’s job is to present nutritious food multiple times during the day, and the child’s job is to eat it. This approach can be a good place to start. Present the food, knowing that you are doing your job, and let go of the outcome. Trust your child.
- Establish good meal routines. Eating is not only about nourishing our bodies, but it also should be fun and social. Even if it’s not a priority for you and your partner to sit down to meals, you may be depriving your child of the opportunity to learn table manners and mealtime social skills that later become critical to social and professional success. What are your aspirations for your child? Will mealtime skills be important? If so, use these goals as your motivation. While we often take these skills for granted, they are developed one meal at a time and over a long period of time.
from Elizabeth Zias, MEd, OTR/L:
- Give your child a sense of control. For example, offer him 4 options for dinner. Consider his suggestions for modifying one of your options. Some children enjoy cooking and will be more interested in trying new foods if they are involved in the process. Eating is one of the few things children have ultimate control over. Find ways to give your child some control while also maintaining your job as his parent.
Relax. If your child is gaining weight and is following typical developmental progressions, you don’t need to worry about whether she is getting enough food. However, if you think your child’s food preferences are so limited that it may impact her health, check with your pediatrician.
Consider whether it could be a developmental issue. If your child constantly gags, chokes or drools when he tries to eat, he may be deficient in oral motor control skills. These are skills that control the muscles of the tongue, lips and jaw and enable us to eat. If a child doesn’t have enough control, food or liquid can slide back into his mouth too quickly, startle him, or cause him to choke or cough. To develop his chewing and eating muscles, give him a straw to chew on, but give it to him without a liquid.
from Winifred Schultz-Krohn, PhD, OTR/L, BCP, SWC, FAOTA:
- Expand your child’s repertoire. Children can have sensitivities in their mouth that can cause them to overreact. Try introducing similar foods, especially those that have comparable flavors, textures or temperatures. For example, introduce Ritz Bits to a Goldfish lover or pudding to a yogurt lover. Also consider sensitivities to seasoning in new foods you are introducing. Children with sensory issues often have strong reactions to food seasonings, too. Even ketchup may be too spicy.
- Use a fresh approach. At mealtime, serve a food your child likes and also offer a new food. To create positive anticipation of mealtime, talk to your child about the food he likes before arriving at the table. A good time for this discussion is while your child is washing his hands for the meal. At the dinner table, say nothing about the food your child doesn’t like. Instead, quietly model eating the food.
- Compare and model. The next time you have the same new food at the table, talk about the similarities of the new food to the food your child likes, and also express how much you like the new food. Children learn best by watching others; showing your interest is a powerful teacher to help your child develop his interest in new foods.
- Use your sense of smell. At another meal ask your child to smell the new food. Comment on how it smells similar to food he likes, or talk about what you like about the new food (e.g., texture, taste, temperature).
These incremental steps allow your child to make connections between the food he likes and a new food and eventually build his openness to trying something new.
Feeding problems range from mild to severe. An occupational therapist can help you evaluate the severity of the problem and offer a multitude of additional strategies to build a child’s acceptance of eating. Every child is different. The key is finding solutions that work for your child.
Domenique Embrey, MS, OTR/L, Elizabeth Zias, MEd, OTR/L, and Winifred Schultz-Krohn, PhD, OTR/L work with a team of occupational therapists and psychologists at Children’s Health Council to help children with feeding problems. Dr. Schultz-Krohn is also a professor of occupational therapy at San Jose State University.