Picky Eaters/Problem Feeders and Related Activities

Some children develop very picky eating habits that may affect their weight, diet, and overall health. These children may be more than just picky eaters, but instead problem-feeders. These limited diets can also be difficult for families to afford or accommodate, and/or may also cause digestive issues and difficulties with bowel movements. Some children also demonstrate difficulty with fluid intake and with drinking water.

Picky Eaters versus Problem-Feeders:

Picky Eaters:

◦ Refuse to eat certain foods (typically vegetables)

◦ Maintain healthy weight

◦ Eat a variety of food groups

◦ No sensory aversions present

◦ No gagging with eating

◦ Eating is typically not difficult for the child besides being picky

Problem or Resistant Feeders:

◦ May be underweight

◦ Refuses to eat many foods and/or food groups

◦ May gag when eating or trying new foods

◦ May throw up while eating or shortly after

◦ May demonstrate significant emotional distress during mealtimes, when asked to try non-preferred foods, if non-preferred food is on their plate, when family is cooking, etc.

◦ Oversensitive to smells

◦ May not want to be in the same room as certain foods

◦ Limited food selection – may only eat 10-20 foods total

◦ Typically only eats:

◦ Eggs

◦ Sweet foods

◦ Certain fruits and fruit snacks

◦ Only drinks juice

◦ Hawaiian sweet rolls

◦ McDonalds

◦ Meat

◦ Steak

◦ Bacon

◦ Chicken nuggets

◦ Crackers (goldfish, but may not eat other types of goldfish or brands)

◦ Chips

◦ Only certain types of certain foods

◦ Examples:

◦ Only eats honey crisp apples and will not eat or try other types of apples

◦ Will only eat certain brands of food (Kraft brand box mac and cheese, not Annie’s brand box mac and cheese)

What can you do?

Structured family mealtimes together to take the time to eat together:

◦ Not eating in front of the TV, in the car, only fast food

◦ Provide opportunities to be around non-preferred foods that other family members may eat instead of just the child

◦ Eating and drinking is only done at the table

Provide opportunities to safely introduce new foods and try to not stick to only what the child with eat:

◦ Put new foods on the table or their plate during mealtimes, but do not force child to eat it

◦ Change brands or buy different types of preferred foods (colored goldfish)

◦ Change small things in each recipe (e.g., different noodles, different types of bread)

◦ Add food coloring

Scheduling structured mealtimes and snack times

◦ Same times everyday

Do not force or punish child if they do not eat

◦ Force feeding leads to fight or flight response and a distrustful relationship with the family and with feeding – this will be more hurtful than helpful

Allow child to play with food to become more used to it

Provide small amount of dessert with the meal regardless if the child has eaten the resistant food

◦ Try: they can have more if they try new foods

Let go of the ”clean plate club”

Play around with what foods you have at lunch versus dinner (can have breakfast food with dinner)

Encourage child to smell or lick new foods during mealtimes

Explore oral motor activities

◦ Ark Therapeutic Website

◦ https://www.arktherapeutic.com/blog/easy-oral-motor-exercises-to-try-today/

◦ Blowing Bubbles

◦ Blow Toys/Whistles

◦ Drinking with a straw

Explore oral sensory activities

◦ Try using an electric toothbrush

Include the child in cooking and presenting the meals

◦ Try to make it fun and engaging for the child

◦ Experience new textures and smells

◦ Learn life skills – include them with cleaning up as well (as tolerated)

Explore feeding therapy options within the community environment

During Mealtimes:

◦ Include at least one preferred item with each meal/snack

◦ Smaller portions

◦ Give them more if they ask

◦ A teaspoon of carrots is appropriate when trying new foods

◦ Role play and demonstrate eating techniques – with peers/siblings or adults

◦ Do not discuss eating habits or how much the child did or did not eat during mealtimes

◦ Discuss taste, texture, and smell of foods

◦ Age appropriately sized plate and utensils

◦ Use a timer when eating for 15-30 minutes

◦ Set timer between meals

◦ Select food that is child-friendly and only one menu per meal for the family

◦ Set routines during mealtimes and around mealtimes – same routine for all meals

◦ Stress-free routines

◦ Remove child if they demonstrate poor behaviors

◦ This means they are done with the meal and the family will finish the meal without them

◦ If they leave the table, they cannot return to the table – will be able to eat at next meal time

◦ They must clean up thrown or destroyed food

◦ Use a mirror to help child understand where their mouth is and what feeding looks like

◦ Try adaptive seating if child moves around a lot during mealtimes (e.g., wiggle seat)

◦ Always have preferred foods with non-preferred foods

Sensory/Feeding Therapy Activity:

Items needed:

1. Food items that your child likes

2. Food items your child does not like (e.g., raw carrot, raw broccoli, etc.)

3. A sensory bin (e.g., tray of shaving cream, bowl of flour and water, bowl of bubbly water, bin or dried rice or beans or noodles, etc.)

4. Preferred toys or any other preferred object

Directions:

1. Put non-preferred foods and preferred foods in sensory bin with toys and promote play with the food.

2. Make the food fun to play with!

- Have a toy eat the food, have child smell the food, have child touch and play with the food

- For example, broccoli can be trees for dinosaurs…..

References:

Ernsperger, Lori, and Tania Stegen-Hanson. Just Take a Bite: Easy, Effective Answers to Food Aversions and Eating Challenges. Future Horizons, Inc., 2004.

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