As caregivers, therapists and physicians we encounter kids who we usually call “fussy eaters” and “picky eaters”. In these cases, parents may be advised to force-feed their children, starve them until they’d accept to eat effortlessly, or even feed them while they’re engaged in other activities, like watching their favorite cartoon show on the TV. However, these methods may only frustrate us and the kids more. Some caregivers may still complain that their child is losing weight or is still sticking to a few numbers of food items that are non-variant in nutritional benefits. But have we ever tried to have a look at these specific items that the child is sticking to?

When a child is a “picky eater” he usually picks items that have at least one common feature, it may be the texture, the size, the flavor, or even the manner this food is presented (juice with a straw, big chunks of meat, mashed potato). Let’s assume a child that picks only puree like food (pudding, yogurt), and whenever he tries vegetables, he prefers them boiled or mashed. In addition to that, when he eats fruits, he chooses the softest fruits like bananas and soft mangoes. In this case, the child may seem picky, but in fact, he always chooses soft food that does not require a lot of mastication (chewing) in the process. If you look further, you may also find this child drinking in a sippy cup rather than a straw cup, choosing fish over beef, or even mashed food over whole foods.

In the case that I’ve mentioned above, the child exhibits weak oral muscles which are the tongue, cheeks, lips, and jaw and that’s the reason he avoids any types of food that will oblige him to chew more and thus move his oral muscles more. He might –in some cases- also exhibit tactile hypersensitivity which is an overresponse to tactile input, and here I’m talking about a normally developed child apart from any developmental disorder.

Dealing with such cases is not easy, but it’s manageable if it is done the right way. First of all, you should let your child/client play with food before you introduce new textures/items on his plate. It has been proved that sensory play especially with food helps motivate the child to try out new textures/experiences as it’s very challenging for the child to put something in his oral cavity that he never touched especially in this crucial time when he starts exploring food or is being transferred from milk to purees and from purees to solid/chewy food. As the first step during mealtime, you can put a plate with no distractions in front of the child, preferably together with the family members at the mealtime with items that the family is also having (if you’re eating spaghetti put a handful of spaghetti on the child’s plate) and leave him to play with it at first without forcing him to eat it. You can also introduce a teeth-brushing routine during this time, trying different flavors of toothpaste and exposing him to the new texture of a toothbrush also without forcing him to do it. Brushing teeth early at this time will stimulate the sensations and the muscles in the oral cavity which will create a fertile ground for us to introduce more and more textures in the future and make him settle in a comfort level other than stressing out over food and mealtimes. As for strengthening the oral muscles, it is necessary to start with daily exercises such as biting on soft chewers or teethers and then gradually increase the hardness of the chewers until the child reaches an optimal jaw muscles strength where it allows him to effortlessly chew harder types of food. Other fun exercises can be as simple as putting a little bit of peanut butter/paste-like sweets inside the mouth and ask the child to lick the insides of his cheeks, the hard palate, and his lips, and of course, rewarding him after accomplishing that.

In the following articles, I will write about other types of kids with different eating habits. Moreover, I will describe the relationship between eating patterns and language development.

Written by Ne’mah Nabeel Assaf BA, SLP

References:

Treatment of children with speech oral placement disorders (OPDs): A paradigm emerges by Bahr, D., & Rosenfeld-Johnson, S. (May 2010)

Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review by Kent, Ray D., American Journal of Speech-Language Pathology (November 2015)