Does Your Child Need a Feeding Therapist (Part 2)

When people learn that I work with parents, teachers and kids about issues related to food and cooking, they ALWAYS ask about picky eaters and problem feeders.  One question I hear all the time is, “is this ___ normal?”  Thank goodness, over the years, I have met some amazing people who are knowledgeable and are willing to help answer some of these questions when I come calling.  My What’s Cooking with Kids Facebook community had some questions for my friend Dawn, a feeding therapist after my first post about Feeding Therapy.  I won’t dilly dally with further introductions – Let’s get to it…

Forcing Food on Kids – Yay or Nay?

This is an area that is so dear to my heart. I see way too many families force-feeding their children. Unfortunately, a lot of therapists teach parents to force-feed, trick them by sneaking foods in their meals and bribe them with candy/desserts in order to try new foods. This is counter-intuitive to what we really want to accomplish, which is a lifetime of good eating habits!

When we force new foods upon children we are setting them up for motor and sensory challenges they may not be ready for. In addition, they are usually more resistant to those foods that are most important- fruits and vegetables! On top of that, parents lose the trust of their child when they force foods, so they start ‘trusting’ the “McDonald’s guy” in the drive-thru window instead.

I prefer to teach children about a new food. The way children learn is through play, so we play with food. We cover ourselves in it (literally), write stories about it, make songs and games about it, we explore the texture properties of it, we smash it, make water balloons out of it and most importantly the child chooses the path of exploration.

sensory play with food - Feeding Therapist advice

I perform child-directed feeding therapy, not clinician or parent-directed. We suggest, the child chooses. We guide them through the fears of a particular food but they choose how far they are willing to go. Through this process we learn about novel foods and the child eats the new foods.

How should a parent handle a child that eats very slowly?

Tehra, from Pediatric Speech and Swallowing Services in Florida, says that typical mealtimes last 20-30 minutes.  Lengthy mealtimes can often be an indicator of a feeding problem.  Eating, chewing and swallowing are work for the child, and the longer it takes, the greater the risk of malnutrition.  The child should not expend more energy eating than the amount of calories consumed.   If mealtimes are taking longer than 30 minutes, I would investigate why (is the child chewing for a long time, is the child getting up and down from the table?) and what is causing it (poor oral motor skills, poor respiratory and swallow coordination, etc).

Dawn, from Spectrum Speech, says that there are so many reasons for slow eating. Children sometimes have a certain meal of the day that they eat a bit faster than other meals. For example, Johnny may be a faster eater in the morning because he is fresh, had a lot of sleep and his oral musculature is strong. By the time dinner rolls around, he might be too tired to chew harder textures thereby slowing him down.  One solution for this would be to have him eat harder foods that require more time, like meat, for breakfast. If you want Johnny to eat chicken for dinner, give it to him for breakfast instead. See if you notice a difference in speed by switching meals around.

Another tip is to explore beans with your child! Beans are a great protein, easy to chew and manage from an oral standpoint.  Also, they can be consumed with a spoon, which is usually the utensil of choice for slow-eaters, so they will perform faster!

Speaking of utensils, sometimes slow-eaters are just poor hand-to-mouth feeders. Is the spoon/fork to heavy for them? Too big? Does the spoon have too deep of a bowl for your child? Try different utensils and observe their feeding skills and speed with them.

What might be some reasons that I child resists coming to the table at mealtime?

Kids that do not sit at the table to eat usually eat fewer calories and lose focus while eating. This can actually be dangerous, because this is when a lot of choking occurs. If you are eating while walking, your body is not focused on the chewing process and you are not building memories of how to effectively eat that particular food. If a child chokes on that food, they usually lose the food from their repertoire because the child only remembers the negative experience with that food and may not try it again.

Some suggestions to parents include having predictable mealtimes so that your child will know when the meal will occur and will want to sit with you. Also, focus on socialization at the table.  Talking about your day, funny stories, jokes, etc. will keep your child’s interest on the table and the food presented. Try to improve table-time activities and have some one-on-one time. For example, play a game that your child is successful with at the table before the meal. This positively reinforces the use of the table before the meal even starts!

Finally, if you have any additional concerns please seek out a qualified Speech Language Pathologist or Occupational Therapist that specializes in Feeding Therapy. Make sure to interview your therapist and ask them how many feeding approaches they are certified in, how much experience they have with feeding and swallowing disorders and most importantly, if they allow parents to be in the therapy sessions for family training.

I would love to talk to Dawn again to answer more of your questions.  If you are experiencing any challenges feeding your children, please leave questions in the comments section below. Thanks!

Many thanks to Dawn, the Owner and Clinical Director of Spectrum Speech and Feeding, LLC. For more information about Dawn Winkelmann, M.S, CCC-SLP check out www.SpectrumSpeech.com.  You can also follow her on Twitter (@SpectrumSpeech) and on Facebook (www.facebook.com/SpectrumSpeech).

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