Category: Feeding

The Best Ways Any Caregiver Can Support a Picky Eater

Mom is stressed, Dad’s frustrated, Grandma is worried… and a few more recognize that this little one should be eating more or have a wider variety in his diet. So, what can the village who loves this child do to help?

Every child is different and when I treat children with feeding difficulties, each child’s treatment plan looks different also. But, there are a few things that can be put in place with anyone, in any home and for almost every child that can support more individualized strategies used later.

I hear concerns about children with limited diets from parents, but also grandparents, aunts, uncles, daycare providers… The strategies recommended here are simple enough they can be implemented by anyone feeding the child. If all caregivers are working together to support the child, the positive outcomes will be seen quicker and with better staying power!

VIDEO: See Tera talk about how caregivers can help picky eaters with FOX 13 The Place here.

Make mealtimes enjoyable, fun and stress-free!

This point is absolutely the number one strategy! No other strategies will be effective without a pleasant mealtime environment and trusting relationships established between the child and her caregivers.  

Each one of us creates strong emotional memories when we eat. Think of your favorite foods and what that reminds you of… My husband absolutely loves sugared cereal… Froot Loops, Lucky Charms, Apple Jacks… Growing up, his dad had a long commute to work, so left early in the morning and came home late at night. As a boy, my husband wanted to see his dad during the day, so he would set his alarm early in the dark morning hours and eat breakfast (sugared cereal) with his dad before he left for his long drive. He’d then go back to bed to sleep a bit longer. My husband has fond memories of those early morning talks with his dad and has associated the food that he was eating with that fondness.

Now think of foods you can’t stand to eat or won’t even touch… My husband hates bananas and doesn’t even like them on the counter in our house. When he was young, he had a babysitter who was determined that he would finish all the food on his plate. He has memories of being force-fed bananas, with it squishing between his teeth as he was fighting it. He’s a grown man and still has definite strong aversions to even the thought of touching bananas.

So what emotions are swirling around your food being served at your house with your children? What’s the stress level with the adults and children? Children pick up on our adult stress level so quickly and profoundly, so it’s important that caregivers come to the table able to enjoy the meal also.

Eat together and enjoy social interactions around nourishing foods. Have fun! Create a mealtime environment that makes your child smile and feel at ease as you’re eating together. This means you may have to relax traditional table etiquette and that’s perfectly fine. Because in the long-term, we would rather have our child be able to independently eat a healthy, balanced, nourishing diet. Table etiquette rules can be implemented more fully at a slower pace after they’ve learned to acquire a taste for a well-balanced diet.

Creating a pleasant environment also means you are avoiding power struggles and stressful pressure on the child during the meal. Absolutely never, ever force feed a child! Don’t make them sit pouting at the table alone until they eat every last bite of food. Don’t require they stop eating a favorite food served with dinner because you feel they have already had too much. Part of enjoying a meal means the child feels a sense of control over their body, hunger cues and what enters their mouth. (If you’d like to learn more about this philosophy of feeding children, called The Division of Responsibility, The Ellyn Satter Institute is a great resource.)

Remember that the swirling smells and tastes of food and emotions at the table will mix together to form strong emotional memories during mealtimes. Caregivers have control over the mixture that will create a lifetime of emotional memories and food preferences.

Offer both preferred and non-preferred foods at meals and snacks. 

First off, I want to emphasize the word offer. The definition of offer is to present or proffer (something) for (someone) to accept or reject as so desired. Yes, in offering food you are presenting it to your child with the option to either accept or reject. That’s ok.

Tell your child that placing the food on the table or on their plate is not a requirement for them to eat it. In fact, don’t even ask your child to eat it, just tell them that this is what you’ve prepared and are offering them for their meal. If asking or requiring them to eat it creates too much stress, we’ve destroyed step number one of creating an enjoyable environment necessary for any other strategies to work.

A caregiver’s responsibility is to choose what foods to buy, prepare and present to nourish your child. Your child’s responsibility is to decide what and how much of that food to eat.

Make a list of safe foods your child will almost always eat. When planning your meals and snacks, be sure that at least one of those foods is always served with the family meal (not separate from the family meal). So, your family meal on the table may include goldfish crackers with spaghetti and salad for dinner or chicken nuggets with scrambled eggs, toast and orange juice for breakfast.

Now, make a list of foods your child won’t eat consistently, but you’d like them to incorporate into their diets. Be sure to include at least one of these foods at meals and snacks. I recommend offering foods everyone else is eating at the meal or snack. It’s convenient to offer a small spoonful and if it’s not eaten, it’s a such small amount that it’s not a worry when it’s thrown away.

Remember that caregivers decide what is offered, not the child. The child give some input, but the caregiver has the responsibility to make the ultimate decision. Caregivers will want to choose foods for a balanced meal with starches, proteins, fruits and vegetables. Include at least one food the child feels safe with and will almost always eat. Also include a non-preferred food that you’d like them to eat, even if you’re sure it will be rejected.

Yes, food may go in the garbage because we will allow the child to eat the food or not. That’s ok. Because food has been thrown away is NOT a reason to be a short order cook or hurry and make a second meal. The important recipe here is exposing the food to the child in an enjoyable mealtime environment. Caregivers and children will have another chance in a few hours to perform their jobs again at the next meal or snack and again after that… You can always load up on safe foods and only include one non-preferred food if the child didn’t eat much at the last meal.

Encourage interaction (not necessarily eating) with non-preferred foods. 

So far, we’ve created a pleasant mealtime environment without stress and have offered and introduced non-preferred foods into that safe environment.

For some children, just presenting a non-preferred food at mealtime, such as setting it on the table or serving it on their plate may be where you start with this step. They may not tolerate more than this. If that’s the case, don’t push any farther until they are comfortable with this minimal interaction of seeing it close by. Realize with the food even this close, they will be seeing what it looks like and smelling it, and really are interacting with some of the food’s sensory properties

From this point, you can slowly start to encourage and challenge the child to interact with the sensory properties of the food, while maintaining a safe and enjoyable environment. Look, smell, touch, listen to and finally taste the food. Ideally, interaction with the food should gradually get a little closer to the face and mouth until it is finally eaten.

Remember again that this step is where the child’s responsibility comes in to decide what and how much food they will eat. Every caregiver should absolutely respect the decision of the child. You can continue to encourage while maintaining a trusting relationship.

Support other caregivers without judgemental attitudes, especially the primary caregiver (usually Mom).

Feeding a child with feeding concerns is SOOOOO stressful! It’s hard to hide a caregiver’s stress from the child during mealtimes.

In my feeding therapy and my own mama experience, moms especially seem to carry a heavier load of guilt and worry if their child isn’t eating how they feel like they should. They also seem to hear and receive feedback and opinions from others sensitively, especially when they are already stressed.

Be supportive of the child and all caregivers. Share small successes. “She really liked helping me pass out carrots to the other children.” Or, “He seemed to enjoy making a smiley face out of his apple slices and even tasted it to his lips!”

Avoid pointing blame towards other caregivers. “If you were more strict, he’d eat more.” Or, “Well, he eats that at my house.”

Don’t sabotage mealtimes with treats, like unexpectedly showing up with a box full of donuts to eat just before dinner is being served. Ask the caregiver preparing the meal when an appropriate time would be to give treats and present it towards the end of the meal.

One caregiver can destroy a safe mealtime environment in every setting by force feeding. Never, ever force feed a child!

Seek out professional support sooner than later if these suggestions don’t help. 

Talk with your pediatrician or seek out an experienced pediatric occupational or speech therapist who specializes in feeding therapy. They can help screen for and identify underlying conditions or delays that may be hindering progress with your child’s eating and give more individualized treatment ideas. Don’t wait to seek out more support. Children who receive treatment earlier have better outcomes and often times need less professional support because they’ve avoided further complications. If you’re trying to decide if your child needs more help, this earlier post I’ve written, “When Does Picky Eating Become a Problem?”, may be helpful.

I’d love to be able to help in your northern Utah home with any feeding concerns. Happy eating!

How a Simple Teal Pumpkin on Your Porch Can Make a Difference for a Child on Halloween

Halloween celebrations always include dressing up in a costume and candy! I have so many little friends who excitedly anticipate Halloween night and trick-or-treating, including my little friends who have severe food allergies, are on special diets for medical reasons or are unable to eat food by mouth and are supported by tube feedings. The parents of these children work tirelessly to provide and support typical childhood experiences as much as possible. As children get older, they learn about childhood cultural traditions that siblings, cousins and friends do and they want to join in the excitement also.

A fun-filled Halloween night of trick-or-treating can turn into pure disappointment when candy buckets are dumped and sorted upon returning home… Only to realize that from the large loot gathered, you can only safely eat or keep a few of the treats or none at all! Everything else must be thrown away or worse, given to your siblings to eat!

You can help with some very simple things to make some of these children have an enjoyable Halloween and minimize the disappointment. Join the Teal Pumpkin Project!

Set a teal pumpkin on your porch! A teal pumpkin is a sign to families of children with food allergies and feeding difficulties that your house will be handing out non-food treats… stickers, pencils, small toys, glow sticks, temporary tattoos, etc. Many of you are already doing this, but let those families know with your teal pumpkin so they can add another house to their route of safe houses they plan to visit with their children.

My friend, Ryder, loves to dress up in theme with his parents every Halloween. Last year, he dressed up as Toothless from How to Train Your Dragon. His mom and dad dressed up as Vikings. He loves walking the neighborhood and joining in the Halloween fun. Ryder has an extensive list of food allergies and sensitivities that prohibit him from eating all but a very short list of foods. So, it comes to the point that he cannot safely eat ANY Halloween candy. How a Simple Teal Pumpkin on Your Porch Can Make a Difference for a Child on Halloween

His mom, Kim, loves the Teal Pumpkin Project and puts a teal pumpkin on their porch every year. She makes sure she has non-food treats to hand out to trick-or-treaters. When they went trick-or-treating last year in Morgan, Utah, they didn’t see any teal pumpkins in the neighborhoods they were in. Kim wishes more people handed out non-food treats. Ryder loves stickers, little toys and bubbles. Fortunately, Ryder has a sweet grandma that prepares a special non-food treat package for him every Halloween.

Confession: Several years ago I decided to plan ahead for Halloween and buy bulk bags of candy (mostly chocolate since that’s my favorite), but I ate almost all of the candy before Halloween came! Now I buy my non-food treats early and and candy last-minute to avoid my chocolate addictive behaviors! Win-win for any candy addicts like me!

My daughter loves painting a teal pumpkin and insists on adding her own artistic flair. She is excited to paint another this year to set out on the porch to signal anyone who prefers non-food treats. My sons make sure we still hand out candy for anyone else (or eat it themselves before any trick-or-treaters arrive). How a Simple Teal Pumpkin on Your Porch Can Make a Difference for a Child on Halloween

A few tips to keep in mind:

  • Set your teal pumpkin out before Halloween night so families can plan to make it to your house.
  • Keep food and non-food items in separate containers to avoid allergens touching the non-food items.
  • Avoid non-food items with latex or wheat. Some clays contain wheat.
  • If you don’t have time to paint a teal pumpkin, click on this link to download and print out a free sign at foodallergy.org.
  • You can also add your house address to the Crowd Sourced Fever Map on food allergy.org to let others in your area know you will be participating in the Teal Pumpkin Project.

For more information on the Teal Pumpkin Project, visit foodallergy.org.

Teal and orange compliment each other well, so use both colors for front-porch pumpkin decorating! You can make such a difference for a child who struggles with feeding difficulties with this simple change in your Halloween decorations and treats handed out on Halloween night!

Helping Your Child with Extreme Picky Eating Book Review

Parents of children with feeding difficulties need to take advantage of this book, Helping Your Child with Extreme Picky Eating by Katja Rowell, MD (family doctor and feeding specialist) and Jenny McGlothlin, MS, SLP (speech language pathologist specializing in pediatric feeding disorders). I’m a reader and reading is a preferred learning method for me personally. Repetition in learning feeding therapy strategies is always beneficial for parents. I’ve not seen a book so appropriately written, specifically for parents, to address feeding difficulties for children before. This book would be a great addition to participating in feeding therapy with your child. Really, I feel like this is a great summary of what I teach parents during a 3-4 month period of weekly feeding therapy.

Often, I remind parents of recommendations I’ve given in the past and they have forgotten. This book would be great to read before, during or after a child has received feeding therapy. It would really solidify the information given and parents could refer back to it easily.

If your child hasn’t started feeding therapy, I suggest reading this book one chapter at a time. Remember that I said it’s a good summary of what I teach parents over 3-4 months at a time? It is a large amount of information and could possibly be overwhelming all at once. Read a chapter, then take a week or two to really think and start applying the suggestions at home. Then go on through chapter by chapter like this until you’ve finished the book.

The philosophy of feeding therapy presented in this book addresses the importance of decreasing anxiety around food first, then to encourage and facilitate building skills in a trusting and safe mealtime environment. It mirrors my own feeding therapy philosophy. Towards the end of the book, the authors also discuss finding a feeding therapist and program that is a good fit for your child and family.

The book is written with a compassionate and realistic understanding of what children and parents go through when a child isn’t eating well. The authors structure the book around Jenny McGlothin’s STEPS+ feeding therapy approach.

STEP 1: Decrease Anxiety, Stress and Power Struggles.

STEP 2: Establish a Structured Routine

STEP 3: Have Family Meals

STEP 4: Know What to Serve and How to Serve It

STEP 5: Build Skills

Buy this book! Here is the Amazon link: Helping Your Child with Extreme Picky Eating. The book’s publisher, New Harbinger Publications even has digital downloads to help implement book suggestions.

I provide feeding therapy services in children’s homes in Davis, Morgan and Weber counties in Utah. If I am not in your area, Feeding Matters has compiled an extensive list of international feeding professionals. I’d love to help your family!

 

*I am part of the Amazon Associates Program. If you choose to buy this book from Amazon, I’d love for you to purchase it through the link on my website to help support the work I do with Yums Theraplay! Thank you!

 

Dylbug Products for Creative and Fun Food Exploration During Mealtimes

Mealtimes are meant for shared fun, enjoyment and exploration! Is this true in your household? Or are your children plugging their noses, turning their heads, covering their mouths and hiding under the table? I’ve seen the entire spectrum of refusal-to-eat behaviors in my 15 years of experience as an occupational therapist specializing in treating children with feeding difficulties.

When I first see a child for feeding therapy, my first step and recommendation to parents is to create a stress-free, enjoyable, engaging mealtime environment where their child can explore and interact with all types of food. Each child is unique in their temperament and abilities and parents should work to build a relationship of trust with their child to create a safe and nurturing place to eat.

With my own children, after coming home to dishes piled in the sink from yesterday’s meals, backpacks and homework scattered across the kitchen, dirty lunchboxes, basketballs bouncing on the tile floor, begging for piano practicing to be finished, trying to put together dinner with my own growling tummy, my patience and creativity are pretty well depleted. Once I’ve finally gotten the food prepared and on the table to eat, it’s time to make the meal stress-free, enjoyable, engaging and fun through exploring and interacting with food and children who aren’t too impressed or excited with the green things in their pasta. Does this sound vaguely familiar? Compared to families of children who struggle to eat, I know I have nothing to complain about because this scenario would be a dream come true for their child to turn their head at only the green things!  

Recently, a friend sent me a video clip of Leslie Mingo showing her Dylbug children’s mealtime products. I especially love her plates, food cutters and placemats! These plates, bowls, cups, cutters and placemats encourage food exploration and interaction in a fun, enjoyable, engaging way without mustering up large quantities of your own creative energy as you sit down to the table. Sometimes parents and children just need a starting point for creativity to encourage food exploration. Dylbug’s products could be one of those creative starting points!

During food exploration and interaction that I use during my feeding therapy sessions, I encourage looking at the colors and shapes of food, smelling the food as it slowly gets closer to the face and touching the food with hands, arms, face and lips to help children ease into being comfortable with the sensory properties of a challenging food before eating it. Dylbug’s products can be a great addition to feeding therapy tools for feeding therapists and families encouraging their children to eat at home.  

In addition to allowing your child to help use the food cutters and placing food on the plate to decorate it, they could try to recreate it again, such as holding the food “hat” up to their own head to encourage touching closer to their face. The placemats have fun designs and places to draw on it. I would encourage drawing with food for more interaction, using dipping sauces, food pieces or crumbs to “color” in the blank spaces. Those are just some beginning ideas to start off the creativity and exploration with your children. (But, please remember that you are creating an environment of trust, so be sure to read your child’s cues and not push too far.)

Leslie is a mother of three, including one that she describes as a picky eater. She wanted to make healthy eating fun, so used her artistic background and love for creativity to do just that. Her children will eat new foods with the playful way they are displayed on her plates. She’s also heard that other children are doing the same thing with her products. “Parents are amazed at how excited their children are to eat what is on their plate. It just makes mealtime happy,” says Leslie. Dylbug has an Instagram feed of photos of ideas from Leslie and other parents who are using Dylbug’s products. Leslie said, “Parents are so proud of what healthy ideas they create. It’s a great way for everyone (including me) to get ideas and support on how to feed our children.”

Dylbug is a Utah-based company that started about a year ago. Dylbug products are currently only sold online at dylbug.com, but Leslie is hoping that in the near future she can start selling in local boutiques. You definitely need to check out all the fun and creative dress-up designs that can be customized with hair, skin color, names and the car or train designs with matching food cutters and placements. At least follow dylbug on Instagram to be inspired for food exploration to make mealtimes enjoyable and fun for everyone!

If your child continues to struggle to eat, please read my blog post, “When Does Picky Eating Become a Problem?” to determine if your child may benefit from feeding therapy or further professional intervention. I offer feeding therapy services in children’s homes in Utah in Weber-Davis-Morgan counties. Happy exploring, creating and eating!                

When Does Picky Eating Become a Problem?

I’ve been preparing for a feeding presentation I’ve given for the past few years to early childhood professionals in Utah. My good friend, Melissa Willes, who is also an awesome feeding and speech therapist, presents with me. We will be at the Utah Early Childhood Education Conference this Saturday, March 5, 2016! I wanted to share some thoughts from our presentation that may be helpful. Many parents don’t realize that help is available for children with feeding difficulties.

VIDEO: See Tera talk about when to be concerned about a picky eater with FOX 13 The Place here.

Feeding your children is a never-ending task. Believe me, I understand as a mother of 3 children! I’m not a great cook, so mealtimes are stressful for me with just my typical eaters. In my many years of feeding therapy, of all the different kinds of treatment, I think feeding difficulties create the most stress for parents. You can’t ever forget it or set it aside. If your child isn’t eating, it is an all-consuming stress. First, you must plan what you’re going to give your child to eat. Then, you must prepare it (if you remembered to buy it all at the grocery store beforehand). Now, create the right environment and provide the right encouragement so your child will eat without all-out battles! You may end up arguing with your spouse about the best way to feed your child. Finally, you are left to clean up the mess… and the cycle starts over again… And this happens several times a day! Oh, and don’t forget the times your own mom or a friend stops by and tells you how she would do it to make sure your child eats!

It is common for children to go through picky eating stages and have days where they don’t eat as much as you think is enough. But, when should you be worried and stop waiting for her to outgrow it? Melissa and I have created this list with inspiration from Kay Toomey, PhD, about when you should seek professional intervention for your child’s feeding difficulties. Talk with your child’s doctor about seeking out help. The earlier feeding issues are addressed, the better the outcomes!

I’ve also recently found a great new resource on the Feeding Matters website. They have an age-based feeding questionnaire that you can fill out for your child. They offer suggestions and also talk about age-appropriate feeding behaviors based upon the results.

If you are interested in individual feeding therapy in your home in the Weber, Davis and Morgan County area in Utah, I’d love to help!

When Does Picky Eating Become a Problem?

  • Ongoing coughing, choking or gagging while eating or drinking
  • Throwing up frequently
  • Consistent crying, arching or signs of pain or discomfort while eating
  • Difficulty breathing while eating
  • Falling off his growth curve
  • Hasn’t started eating baby food purees by 10 months old
  • Not accepting table foods by 12 months old
  • Not using a cup by 16 months old
  • Hasn’t transitioned to table foods from baby food purees by 16 months old
  • When older than 12 months old, eats 20 or less total different foods
  • “Burns out” on favorite foods and doesn’t pick up new ones to replace the dropped foods
  • Refuses entire food groups or food textures
  • Can’t tolerate new food on her plate
  • Doesn’t tolerate small changes to his favorite foods
  • Almost always refuses to eat the same food the family is eating
  • Mealtimes are battles: stressful and miserable for everyone, including caregiver and child