You’ve slipped sprouts onto their pizza. Blended spinach into ‘alien mash’. Held the ice cream hostage. But mostly you just try to believe kids can survive until college on cheesy pasta after all.
One in three children under five has feeding difficulties at some point. Feeding concerns are the second most common problem left unresolved by GPs and paediatricians.
It stresses the hell out of parents. But at what point does a normal fussy toddler cross the line into a child with feeding problems?
Mel Street is a feeding therapist from Small Talk Therapy in Auckland. She says: “Around the age of two, it is very common for children to become ‘neophobic’. They don’t like anything new or different. This can particularly apply to new foods.
“The challenge is to stay calm and keep offering new foods and new experiences with food. At this stage food refusal can also be about control and independence. As a two-year-old, there is very little in a child’s world that they can control. Food, and the reaction they get from you around food, is a biggie. Kids this age have erratic appetites. Some days they will eat what seems like their own body weight in food and the next day hardly a scrap. Children tend not to need as much to eat as we think they do.”
But some children have or can develop a real aversion to a wide range of foods. There can be many reasons for this.
Does my child need feeding therapy?
Is your child so fussy it's harming their health, making them unhappy and frazzling the family? It could be time to call in the professionals.
Some speech and language therapists, occupational therapists, dieticians and psychologists have specialist training in feeding problems. They work like food coaches. They work with parents to help kids learn how to eat or help inspire them to want to eat.
It can involve developing the skills to manage different textures. It can mean helping kids overcome sensory and emotional difficulties around new foods.
Jenni Lyons runs The Mess Hall feeding clinic in Wellington. She says “I often work with children with oral-motor, sensory or behavioural areas of need. They can have become limited in the range of foods that they eat. We work to establish regular, nutritious family meals that the whole family can enjoy.”
Lila is 16 months old and in full time day care. She had little interest in food. She would only snack and ask for her bottle. She had particular difficulty with harder to chew foods like apple, banana and carrot. She seemed to put food in her mouth but didn’t bite bits off.
Feeding therapy focused on chewing skills and gradually decreasing Lila’s milk intake. After 12 weeks Lila accepted a range of age appropriate solids and had family meals at home. At ‘Fruit Break’ at day care, she was able to bite, chew, and swallow all raw fruits.
Polly was five when she first saw a feeding therapist. She was withdrawing from sitting with peers at school lunch time and refusing to eat at the family table. Her mother was increasingly concerned. Polly would only accept five foods. Those were starch based – things that dissolved easily in the mouth. These didn’t include any raw fruit and vegetables - only pureed fruit from a baby food pouch. She would refuse to go to play dates and parties. She was anxious about having to be around new or unfamiliar foods.
She saw a feeding therapist weekly for 14 weeks, working on strategies for interacting with food. She was given small steps to achieve, with no pressure to chew and swallow. Smelling, tasting, and touching were practiced until Polly felt safe to make bite marks, then chew small pieces, then swallow.
Polly’s ‘accepted foods’ increased to 22 different items. Her mother says this may seem like only small steps, but they were huge for her and her family. Six months later Polly has more than 30 foods, including raw fruit and vegetables.
Jenni Lyons tells us: “If you are concerned about your child’s feeding, it’s worth getting it checked out. We can save a lot of stress and heartache with some simple strategies. We can also refer families on to other medical services if needed.”
10 Signs your child may need feeding therapy
The following may mean your child needs some professional help to develop healthy eating skills:
- Lack of mouthing toys as an infant
- Difficulties accepting or moving between different textures of food
- Frequent coughing and/or gagging when eating
- Less than 30 foods eaten or only eating specific brands or colours of foods
- Avoidance of touch around the face
- Irritability and anxiety around snack/meal times
- History of reflux or vomiting during or after foods
- Loss of food or liquid from the mouth or nose when eating/drinking
- Grimacing or odd facial expression when eating
- Tongue tie or history of tongue tie
Where to find a feeding therapist
Contact your local Speech Therapy department to see if they offer a feeding service. It will be run through the Child Development Team, Ministry of Health or Ministry of Education.
You may find you are not eligible for funded therapy. Or you may prefer not to wait. There are private speech and language therapy feeding clinics in several places around the country.
Auckland: Small Talk Therapy: clinics in Greenlane and Clevedon
Wellington: The Mess Hall