Hey y'all! I am SO excited to bring you this post! After months of research, my own experience and interviewing experts in the field I have FINALLY put together a post for y'all about tips and tricks for extremely picky kiddos.
Food is great, I love food! But my kids? Nope, not at all. It's always a CONSTANT battle anytime meal-time rolls around. Imagine fighting off two hungry bears with a stick...not easy my friends. The meltdowns that ensue when I don't give them the EXACT type of cereal they want are nuclear. So what's a mama to do? Fear not! I've gathered some amazing info for you!
What better way to get great advice than to interview the professionals themselves? So that's exactly what I did for y'all! Stay with me, there's a lot of info here so I'll break it up into a two part series!
First up, the Sensory Project Interview with Jessica Hill and Rachel Harrington. Jessica is a Certified Occupational Therapy Assistant, Licensed (COTA/L) and co-host of one of my favorite podcasts: The Sensory Project Show. I HIGHLY recommend this podcast to any mamas (or dads!) out there who have kiddos with sensory needs, special needs, or just want to understand your kiddos better. The information I've learned from their show alone is SO valuable in our everyday life. She's also a co-creator of the membership site, The Sensory Project Club which you can check out here! Her partner in crime, Rachel Harrington, is also a COTA/L, AC and creator and owner of The Sensory Project. Rachel also offers distance coaching for any families who are either on the waitlist for services OR who need a little extra help. Check out her distance coaching here!
Now let's dive in!
‣ What made y'all want to work in this field?
I think I speak for both of us when I say that we both have a desire, nay passion, for helping people! With what we do, we are not only able to help families but also children - the future generation - to lead healthy, successful, happy lives.
‣ A lot of people I talk to are unfamiliar with what occupational therapy is, what is OT?
For what we do, working with children, our goal is to help children lead successful, happy, and healthy lives. This includes creating independence with daily life tasks including play, school/homework, and all the things we do daily such as eat, get dressed, and enjoy the community.
We also strive to help the families of the children we work with. We want the family to feel confident that they can also help their child become successful!
‣ How does occupational therapy help with feeding specifically?
Well because feeding is a life skill, it falls within our scope of practice. We address sensory concerns - things like not liking certain textures or avoiding touching certain items (this relates to the tactile and proprioceptive senses) - as well as children with low tone - so this would be a child who struggles to latch as an infant and therefore will likely struggle to chew effectively, move their tongue effectively, and build endurance to eat a full meal.
There is so much that goes into feeding - postural control and proximal stability are huge components (core strength, the ability to sit upright with good posture, not fall over / out of the chair, and strength throughout the shoulders and neck). We also work with fine motor skills - so this is where self-feeding with a fork or a spoon come into play.
‣ Are there any other professionals or resources that can help with feeding?
One of our favorite resources for feeding is the company ARK Therapeutic. They create and sell a variety of oral motor tools as well as have an amazing archive of blog posts to help not only therapists, but also families!
Speech therapy is also another great avenue. Speech Language Pathologists also address feeding from a structural standpoint and can also work with children who experience swallowing deficits.
‣ What are some reasons kiddos may be picky eaters or have problems feeding?
Well first we want to look at their postural control and overall muscle strength / tone. Many of our kiddos have low tone and this will affect their ability to sit upright, use good control with their arms and their hands, and to chew their food efficiently (and safely!).
We also look at the sensory system - as I mentioned before, we look at the tactile system because many of our kiddos do not like certain textures, they don’t like to be touched by others, they don’t like to get messy, etc. Other sensory systems can also affect feeding in more indirect ways. For instance, if a child struggles to process auditory input, they may struggle with feeding because they don’t like the sounds that certain foods make.
‣ What is the difference between picky eating and problem feeding, are they the same thing? I often hear them used interchangeably.
Well that probably depends on who you talk to! They can be used interchangeably due to the nature of the beast - if a child has a problem feeding (due to low muscle tone, challenges with fine motor skills, challenges with tactile input, etc.) then they will most likely become a picky eater.
However, all children go through picky eating phases as they grow and become more independent! So not every picky eater has those challenges I mentioned - we really have to look at the whole picture, the whole child!
‣ What are some red flags parents and caregivers should look out for to help determine if their kiddo is just a typical picky eater OR if it’s something more?
The biggest red flags show up in infancy and will continue through toddler-hood:
- Trouble latching during breast / bottle feeding
- Poor digestion / challenges with digesting milk / formula
- Low muscle tone resulting in open mouth posture, decreased tolerance of tummy time, delayed milestones for sitting up, crawling, walking, etc.
- Delayed speech
- Excessive gagging
- Over-stuffing
- Tactile hyper-sensitivity
‣ What are some ways to help introduce new foods to kiddos who have a very limited diet?
- Play with the food at times other than meal time!
- Exposure is key! The more they see it, the more familiar it will become.
- Allow your child to help with grocery shopping and meal planning as well as cooking!
- Talk about the food - is it crunchy or soft? Is it salty or sweet?
- Prepare food in new ways so it looks like something else
- A good progression to improve food rapport:
- Having the food at the table regularly (daily if possible)
- Having the food on the child’s plate (even if they don’t eat it)
- Touching the food (even just 1 time and increase from there)
- Smelling the food
- Licking the food (again, start with 1 time then increase)
- Holding a small bite in mouth (even if it’s not swallowed)
- Then -- taking a bite, chewing, and swallowing!
‣ What are your top 5 tips on getting kiddos to eat new foods or expand their limited diet?
- Patience!
- Exposure!
- Repetition!
- Make mealtime FUN!
- Consistent expectations!
‣ What are some of your ideas for making mealtime fun?
- Use fun dishes! There are a lot of different plates and silverware - check out Amazon!
- Play games! There are so many different ways to play games with the family at mealtime!
- Decrease the amount of screen time during mealtime - increase interaction and conversation!
- Make your food into silly faces / shapes / designs.
- Allowing the child to participate in the meal prep will increase confidence and motivation to then sit down and participate in meatime.
‣ What are the most common mistakes you see parents make when trying to get their picky eaters to eat?
The biggest one is taking a food away the moment a child shows distaste. “My child doesn’t like it, so I won’t try again.” Exposure is key! Most of us don’t like new things at first, and our kiddos are no different! But the more we see / smell / taste it, the more we like it (or at least tolerate it).
Another mistake is inconsistent expectations. This can be challenging if the child is in different environments for different meals but you can make it work! Start by requiring a specific amount of time to remain at the table. Then work on taking a certain number of bites before leaving the table. There are a lot of different tricks but being consistent is key -- our kiddos are so smart! If they get away with something just one time, they will try it again!
‣ Do you have any advice for parents and caregivers during meal times to make it more successful?
Lead by example. Show your child how you want them to sit at the table, how you want them to serve their food, how you want them to clean up, etc. Children learn by watching and then by doing. If you want your child to eat broccoli, then you’re gonna have to eat it too!
‣ As a mama with two sensory kiddos I hear all the time that it’s normal for toddlers to be picky eaters and that they will just “grow out of it”, what are your thoughts about this?
I think this can potentially be true. I also have a son - he’s 5 ½ years old. He has gone through some picky eating phases for sure! But again, I think it’s so dependent on the child, on the family, on routine, on expectations, on exposure … there are SO MANY variables that there’s no way for us to say that a child will “grow out of” picky eating, sensory challenges or not.
‣ To follow up with the last question, will kiddos with sensory issues ever “get over it” or “grow out of it”?
Ooooooo tricky question! My answer is NO - not without intervention. My other answer is YES - with intervention and with carryover from the family!
Now take this into consideration - our children don’t necessarily “get over” or “grow out” of sensory challenges. It’s more that their bodies and their brains learn techniques and strategies. Their muscles tone develops and increases. They learn how to be more flexible with situations and with thinking patterns. They learn how to increase frustration tolerance. The list goes on and on.
‣ What advice do you have for exhausted parents and caregivers who feel like meal time is always a CONSTANT battle?
Take a step back. Write down your priorities. What’s the one most important aspect of the feeding / mealtime for YOU? And work on that one thing first. Habits are hard to change so if your child is in the habit of something you don’t like, it will take time and consistency. But journaling and breaking it down so you’re working on one thing at a time and you can look back to see your progress - that’s huge! Also being able to show your child the progress they’ve made!
And get help! Seek out therapies and make sure you communicate with your child’s therapists! If they don’t hear you voice your biggest concerns, they can’t help. And get help from family, friends, your community, even online support groups. You’re not alone!
‣ What is the most important thing to remember when dealing with a picky kiddo?
Your child does not want this to be hard. They just don’t know how to make it easier. That’s your job - to help them become successful. So remember - even if your child is having negative / unexpected behaviors, there’s a reason and chances are, they are not “trying to be bad.” Empathize!
I also like to remind families - there are likely foods that YOU don’t like to eat. Some if your child has tried a food item over multiple occasions (we like to say try a food at least 20 times before making a final decision!) and still doesn't like it, that’s ok!
‣ Can you give an example of what you, as a COTA/L, do during feeding therapy?
We would start with a movement activity! We want to get the muscles moving, the sensory systems going, and make it fun and motivating as well! We would include an oral motor activity with this - something with blowing bubbles, blowing through a straw to move pom poms - to get the oral musculature “warmed up.” Then, depending on the kiddo and the goals, we would work on some specific feeding activities. Using oral motor tools such as the Z-vibe (from ARK Therapeutic), sour spray, making silly faces with a mirror … as well as completing activities with real food. We might do some messy play with applesauce or pudding, we might do “experiments” with mixing food items together, and we might even work on tolerating a food item on the table while we completed a preferred table task. We might even incorporate it all into one big obstacle course! Again, it’s all dependent on the kiddo but ALWAYS start with movement to get the muscles and the brain activated!
‣ What are some helpful tools or gadgets that you use during feeding therapy?
Vibration! There are different types of “teethers” that vibrate as well as products from ARK such as the Z-vibe.
Mirrors! Using mirror feedback is so beneficial to increase awareness and registration!
Any toys that can be used during messy play!
Straws!
‣ What do parents and caregivers do if feeding therapy doesn’t seem to work? What is the next step?
Oh tricky question! I gotta say, feeding therapy DOES work! (Hello, research!)
From a therapist’s perspective - it’s all about training! We need to take courses and learn from our peers and practice practice practice! As well as work with the child and the family - build rapport so the child and family trust us! And try new things, introduce new ideas and games; if you keep treatment the same every session, then it probably won’t work! The kiddo WILL get bored! So change it up!
From a parent’s perspective - you gotta be ready to make changes at home! Occupational Therapy / feeding therapy is not a quick fix! You HAVE to follow through with suggestions, stay consistent, stay positive, modify as needed … carryover is hard but it’s definitely one of the most important pieces to the puzzle!
Now, some kiddos might not make the progress that we want. They might hit a plateau or they might just reach their end point and that’s as far as they get because of whatever reason. That’s when, as a therapist, we find adaptations - different types of silverware (example: weighted spoons and forks), different types of cups and plates (example: nosey cups, suction plates), and different types of seating arrangements. Even changing the types of foods for safety. But ultimately, there WILL be progress!
Well that wraps up the first interview of this series, and a HUGE thank you to Jessica and Rachel for sharing their insight on this topic!
I'd love to hear from you guys about your experiences with picky eating. What tips and tricks do you have? What are your experiences with this topic? Stay tuned for the second part of this series where I interview my good friend and Pediatric/NICU Registered Dietitian, Laura Andersen!
