For many families, mealtime can be a source of stress and frustration rather than a time to unwind and share each other's company. For children that are very selective about the foods they eat, this could be for a variety of reasons. In order to find the source of the problem, it might take a little detective work. The good news is, whatever the reason that your little one is throwing fits during meals: it will get better!
Where to Begin?
Often these issues with mealtime did not just pop up all of the sudden. In fact, your family may be slugging through many months or even years of struggling to get through meals. You might feel as though getting your child to eat enough calories is a daily challenge, let alone eating healthy. As frustration builds, you might feel overwhelmed and hope someday they'll grow out of it without knowing how to help them. While, perhaps, we can hope eventually they will overcome their mealtime tantrums on their own, there might be a better way.
Follow the steps below and you may find yourself having some pleasant dinner dates with your children in the near future:
1. Check with your doctor and dentist
First, we want to eliminate any possible causes for food aversions that might be related to digestive or dental health such as a food allergy/sensitivity, acid reflex, constipation or a gum sensitivity. Any of these issues might cause pain and discomfort for a child and make mealtimes a source of anxiety or stress. Addressing these issues with a doctor may yield quick improvements.
2. The doctor said everything's clear, now what?
Well, it is wonderful news that he/she has a clean bill of health, but you may still be wondering where to go from here. This is when an Occupational Therapist and/or a Speech Language Pathologist may be of great service. Depending on the child, some of his/her food preferences may have developed over time due to either a hyper-awareness of oral sensations (when things come in contact with the lips, tongue, cheeks or gums) or a lack of oral awareness. An OT or SLP can help you to evaluate these potential issues and address them through a variety of therapeutic techniques.
3. What are signs that my child may have poor oral awareness causing oral defensiveness?
Sometimes sensory defensiveness might occur if a child had limited sensory experiences in and around their mouths as they developed oral-motor control/awareness in infancy and as a toddler. In this case, the child's oral awareness did not develop on-time. We can call this oral hypo-sensitivity. Some signs that a child has oral hypo-sensitivity might include:
In these cases, a child may simply be overwhelmed by trying to process sensory input they were not exposed to before. This child can then become defensive to any unusual textures or foods. An OT or SLP uses activities that slowly introduce textures, temperatures and tastes to the child's mouth in a way that is not overwhelming. These activities are directed by the child at his/her own pace. Sometimes these signs might also indicate a lack of coordination or strength in the child's cheeks, tongue or jaw. An OT or SLP can help you to sort out if this is the cause. Often in the case with certain conditions like cerebral palsy, premature birth or a traumatic brain injury, an individual may be dealing with more than one of these issues.
4. What are the signs that my child might be experiencing high oral sensitivity causing oral defensiveness?
A child with sensory defensiveness caused by an oral hyper-sensitivity might be seen retracting or pulling their tongue back in their mouth to avoid touching the food. Perhaps even touching their gums, lips or cheeks may seem painful or difficult. In these cases, an OT and/or SLP can slowly introduce activities related to touch and texture that are tolerable to the child and create a safe environment for the child to trial new sensory experiences. Eventually, this will translate to mealtimes and the child will gain the confidence to try new foods in the family setting without discomfort.
5. My child is starting to try new foods, how can I continue to encourage them?
Congratulations! (1) You and your child have identified the issue(s) that is causing your family stress during mealtime, (2) you followed through with your action plan to get help and (3) you are ready to incorporate what you learned at home. To continue to encourage your child during mealtimes, here are some additional tips to keep making meals a positive experience:
Be patient! It is important to let the child explore new foods on his/her own terms. It may take several trials of the same food for him/her to develop a new food preference.
Try cutting the foods into different shapes/sizes to see what your child prefers.
Give your child choices, two or three options. Let the child choose what he/she prefers to eat.
Get the child involved in preparing the food. As you give your child new and exciting challenges at mealtime, your child will begin to blossom with confidence and a sense of mastery in their new skills. Letting your child prepare parts of the meal will promote this.
Try new seating. Posture can have an impact on the meal experience. If the child has poor posture, head or neck control, this may be impacting mealtime. Allow your child to try different seating positions to promote a comfortable and safe experience. Ask your OT for more information on what seating positions are best.
Case-Smith, O'Brien. Occupational Therapy for Children. Sixth Edition. Sixth Edition. 2010.