When it comes to feeding concerns in little ones……I definelty could spend a significant amount of time talking about eating and not eating in reference to toddlers and preschoolers. This post is not only in reference to toddlers…..it is also in reference to eating and not eating in preschoolers.
Doing many many feeding evaluations I spend a lot of time talking to parents, caregivers and teachers about overall feeding skills and abilities in little ones. There are some children that have the ability to eat a variety of textures and foods. This means that the structures and functions of their lips, mouth, tongue, cheeks, teeth, and throat are capable of biting, chewing and swallowing….they do not have an anatomical or physiological reason that would cause them to not eat. However………the concern expressed by many parents (myself included in reference to my oldest when he was two and my Andrew now at ten)……the concern is…..WHY…..WHY do they refuse to eat certain foods???? Some kids can not even stand the sight of certain foods….the sight of the food may even make them gag…..sometimes it is the smell…..for me it is Beets…..I despise how they smell….and I gag a bit when I do smell them. But for the little ones that have feeding aversions…it is to many many foods.
In my experience there is a certain texture that is not tolerated by children with feeding aversions. These are children that I would say have a hypersensitivity to certain textures. Hyper-sensitivity means that they can not tolerate the texture…they are more sensitive to it-hypersensitive.
Children with oral motor feeding-sensory concerns typically are NOT hyper-sensitive to soft pureed foods that do NOT require any chewing at all. These foods are easily cleared from a spoon with the top lip….they do not need to be moved to the side by the tongue…they do not need to be chewed with the molars….you just swallow them. These foods include: Stage 1 and Stage 2 (no chunks) baby food, yogurt (no pieces of fruit inside), ice-cream, pudding, shakes, smoothies, thin not too thick mashed potatoes-NO chunks………. and many other pureed foods that do not contain any chunks or smaller pieces of food. This type of food is like a thickened liquid. Children with sensory feeding issues….in my experience…..can tolerate this texture. Please remember there are ALWAYS exceptions to the rule. However, my experience has been that children with oral motor feeding issues-when it comes to a sensory difficulty….they CAN tolerate this pureed texture….remember this consistency DOES NOT have any pieces or chunks of a different texture in it…..it is completely pureed.
Children with sensory feeding issues usually CAN tolerate a hard crunchy food such as the following: cheese doodle, Gerber puff, Gerber wagon wheels, veggie sticks, pretzels, chips, french fries (but must be well done), chicken nuggets (only if well done…can not be mushy or cooked in the microwave), Oreos, graham crackers, hard crunchy cookies, pancakes cooked in toaster oven or toaster…not in microwave, same rule for waffles………basically all hard crunchy foods. Now keep in mind…with this texture….they need to bite with their front teeth, lateralize to the side of mouth, chew with molars, then swallow. Little ones with sensory issues CAN tolerate this texture…they are not getting negative sensory information.
Sooooo…..what CAN’T they tolerate? They can not tolerate those in-between foods…the semi-solids….the foods that need your front teeth for biting (like a solid), the foods that need your molars for chewing (like a solid)…. they are not pureed and are not hard crunchy solids…they are the in-between…….the semi-solids….or as my oldest called them when he was three and could not tolerate…..they are the SWERBELIE foods. These semi-solids require the biting and chewing like a solid….but do not have the hard crunchy consistency as a solid does….so when your little one is biting through this “swerbelie” food…her sensory neurons are receiving a lot of negative information….because it is the texture of the food that she can not tolerate…remember it is not an inability to bite or chew this food type….it is the actual texture of the food that she can not tolerate. The in-between….semi-solid texture that gives their sensory neurons negative information.
And what are these foods: cheeses, deli meat, steak, chicken cutlet, pasta (unless cooked Al Dente….and that’s a maybe that your little one would eat the pasta if they have sensory issues…maybe they will eat it Al Dente), fruits, vegetables, eggs, oatmeal, cereal with milk (why because the milk made the cereal too mushy), soft pancakes, soft waffles, sandwiches, cold cuts…..and the list can really go on.
It is important to remember that we all eat because we need to and like to……we eat what we like. Have you really ever made yourself something that you do not like to eat…and then forced yourself to eat it? Probably no…..so why do that to your little one. Forcing your little one to eat foods she can not tolerate due to sensory issues will make feeding a very negative experience. She may start to refuse to sit in her high chair…or in her booster seat at the table…or where ever meal-time is for her. Remember that when introducing new foods it is best to try at snack time when there is less pressure on your little one. Make snack time in a different place from where she eats her three staple meals….try following this hierarchy when introducing new foods:
LOOK, SMELL, TOUCH, TASTE
This means that you are asking your little one to first just look at the new food…..if she is willing ask her to smell it….then ask her to touch…and then if she CAN ask her to taste. I have had little ones that remain in the LOOK stage for a few weeks before they are willing to SMELL the new food.
Also remember children with sensory feeding issues typically like foods with heightened flavor….foods that are saltier…sweetier even spicier….WHY….because their sensory neurons are hypo-sensitive….this means that they need more information when it comes to eating…..so…….when trying a new food you may add a little more garlic powder or onion powder….some salt…. a little pepper. Changing this one variable may help her to try the new softer food that she was not willing to try.
Most importantly….and often times the hardest for parents…(and I know two of my four children have had sensory feeding issues…and Andrew still has)……remember to be PATIENT! Do not pressure your little one….expand by offering new foods at snack time…let your little one know that she is working through the Look, Smell, Touch, Taste hierarchy so that she does not feel the stress to try new foods…we want her to want to eat….and to enjoy eating.
Make a menu of the new foods she has tried…..put them in categories…..list foods according to where she is in the hierarchy. For example if she looked at and smelled the hamburger…put a picture of a hamburger on her menu and show a picture of eyes to represent that she looked at the new food….and a picture of a nose to show that she smelled the new food.
Try hard crunchy snacks such as dried fruits….veggie stix are great….dip them in various condiments…kids with sensory feeding issues typically like condiments…they are saltier…and increase flavor….try hard cheeses not soft cheeses.
Click on this link for more information regarding foods to choose and why: Feeding plan
I hope this post was helpful….I have more to add and will continue to post regarding feeding concerns.