Mealtimes aren’t always easy. While some degree of picky eating is normal in childhood, there are times when it may point to deeper sensory, behavioral, or developmental challenges. Feeding therapy can help children build a healthier relationship with food in a supportive, play-based environment. In this blog, we’ll walk through some of the most common signs your child might benefit from feeding therapy, and what support can look like for both kids and their families.
What are the most common signs a child might benefit from feeding therapy?
Common signs your child might benefit from feeding therapy, include:
- You have referred to your child as a “picky” eater to your pediatrician in the last 2 or more well-visits
- Poor weight gain
- Your child has ongoing problems with gagging, choking, or coughing during meals
- Your child has fewer than 20 foods they eat consistently, especially if they stop eating a certain food entirely, but then don’t add a new one to replace the dropped food
- Your child avoids all foods in a specific texture (wet, squishy, crunchy, etc.) or nutrition category (meat, vegetable, starch, fruits, etc.)
- You feel like meal times are stressful for everyone, fighting over how much and what your child eats
- Your child has a G-tube or NG-tube
How do sensory issues impact a child’s relationship with food and mealtimes?
We all experience food with various parts of our sensory system, and you may not think of it this way, but there are many steps involved in eating. First, we tolerate how a food looks, smells, and feels, either on our skin or in our mouths. Then we process how it tastes with our tongues, and last, we chew. If any one of these steps is a challenge for our bodies and sensory system, it makes what we eat and how we eat more challenging.
Our body positioning and posture are additional factors impacting how we can attend to a meal.
What’s the difference between typical picky eating and something that may require feeding therapy?
If you were to make a list of all the foods your child eats, how long would it be? Picky eaters generally have around 30 or more foods in their regular diet. Children who may benefit from feeding therapy—often called “problem feeders”—typically have 20 or fewer. It’s not just about the number of foods, though. Pay attention to whether your child replaces foods they’ve stopped eating with new ones. If the list keeps shrinking over time without new foods being added, it may be time to explore feeding therapy as a supportive next step.
What happens when you put something new on your child’s plate? A picky eater might tolerate it being there, even touch or taste it, although they are not enthusiastic about it being there. A problem feeder has a more pronounced reaction: crying, tantrums and being unable to tolerate the new food on the plate.
Another helpful sign to consider: is your child joining the family at mealtimes? A picky eater may have different foods on their plate, but they typically sit at the table and eat with the rest of the family. In contrast, a problem feeder often requires entirely separate meals and may eat at a different time or even in another room altogether.
How can feeding therapy help children expand their diet and become more comfortable with new foods?
We know children learn best when they play and explore, and in order to do this, they need to feel safe and comfortable in their environment. At Puzzle Pieces, we use the SOS Approach to Feeding, which focuses on increasing a child’s comfort level by exploring and learning about the different properties of food. The program allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her, then moving on to managing the smell of the foods, learning about how foods feel on the body and in their mouth, and then enjoying tasting and eating new foods. It’s called playing with purpose!
Through this therapeutic relationship and play-based learning, children get to explore food at their own pace. Therapists are trained to acknowledge and work with each child’s individual differences in order to create a safe and fun environment to explore new foods.
How can parents support progress at home between feeding therapy sessions?
When a child is a problem feeder, it can be stressful for the whole family, but as parents you are one of the main players on your child’s feeding team, along with a feeding therapist, pediatricians, and dieticians. You are the models at home of how to eat and what to eat and should be involved in all aspects of feeding therapy, working with the feeding team to build a happy and healthy eater. This may sound daunting, but the team is here to help you! Through feeding therapy, parents always gain more resources and support to help at home.
When should parents seek professional support rather than waiting for their child to “grow out of” picky eating?
The sooner the better! It is much easier to address feeding problems at 2 years old than it is at 12 years old. That being said, it is never too late to address issues around feeding.
If you are noticing signs your child might benefit from feeding therapy, contact the Puzzle Pieces team today. Our multidisciplinary team will conduct evaluations and develop a personalized, family-centered treatment plan to help your child build positive eating habits at home and in social settings.