A few months ago, I wrote a piece about picky eating. My son was subsisting on mainly pasta, grilled cheese, pizza, and chicken nuggets. A vegetable was not allowed to touch his plate and fruit was an iffy proposition. I am pleased to report that things have improved slightly since then and his palate has broadened. However, it got me thinking about children where it goes beyond pickiness – children who for a variety of reasons have significant feeding challenges.
Wanting to explore this topic further, I contacted a former colleague, Heather Noyes-Fredette MS, OTR/L Occupational Therapist, who currently works for the Central Falls School Department. She has extensive experience working with kids who have sensory disorders related to feeding and shared with me some of the causes, some of the signs that a problem may exist and some available resources.
Every one of us has food preferences. Even a hearty eater may dislike asparagus, applesauce, or arugula. However, Noyes-Fredette noted there are children that will only eat things that are a certain color or certain temperature. They may stay away from some foods that have a particular texture. Some foods may cause them to vomit or gag, or they may just be refusing to eat in general. Any of these could be signs of a deeper issue.
The root causes of these issues are as varied as the children themselves. It can be something physical, psychological, or a combination of the two. Some children may have experienced trauma as an infant – surgery, a stay in the Neonatal Intensive Care Unit (NICU), or severe reflux resulting in hypersensitivity. Others begin exhibiting problems when they transition to solid foods. It can happen after a child has a severe stomach bug and they associate the illness with specific foods. In others, it could be a symptom of a sensory or motor skills disorder. Sometimes the issue cannot be pinpointed.
According to Noyes-Fredette, there are some things you can attempt that may help your child. Don’t make eating a negative experience since forcing them to eat something could cause distress. Another tool used in food therapy is to start slow. First, see if the child can tolerate just having the food on the table or on their plate. Then you work up to touching the food, licking it, putting teeth marks in it, or biting it and spitting it out. In addition, it is important to seek therapeutic support for your child. Very often the key to success is to have a different person driving the change. If your child starts these challenges with a therapist then the parent is simply following what was already started and the child is “practicing.”
Noyes-Fredette says your best asset is a trained occupational therapist or speech-language pathologist at a feeding team or clinic. An Early Intervention provider or pediatrician would have the names of local experts. She also recommends the work of Dr. Kay Toomey who trains people on the Sensory Oral Feeding Protocol or Cheri Fraker. Hasbro Children’s Hospital has a feeding program as well. The key is to seek out a trained professional both to diagnose your child and develop a care plan. There are resources such as the ones listed above and hope that the situation can improve.
