Feeding Therapy / Picky Eaters

If your child only eats certain foods or dislikes trying new foods he/she may be considered a picky eater.

The sensory sensitive child may be hypersensitive to the smell, sight, or texture of certain foods which limits their overall diet and nutrition.

A speech therapist and/or occupational therapist can work with your child on integrating more food choices to their diet.

Some strategies that you can try at home may include:

Eat dinner as a family
Do not allow your child to graze all day
Remove distractions from dinnertime – turn off TV and put away phones
Only introduce 1 new food at a time in small portions
Introduce the new food at the beginning of the meal when the child is hungry
Give choices – do you want 3 or 5 green beans?
Do not require a clean plate

Strategies to increase sensory tolerance for new foods:

Allow touching of non-preferred foods with fingers
Discuss food properties, varieties, preparation and preferences
Try variations of foods (cooked vs raw carrots)
Try changing the temperature of the food (frozen, cold, or room temperature grapes)
Try different dips or sauces that the child prefers
Read books about trying new foods, from your local library

The following are red flags that could be a sign that your child may need professional help with their feeding. Talk to your child’s doctor!

Inappropriate weight gain (under/overweight)
Choking, gagging, coughing, or vomiting with eating
Difficulty with accepting different textures of foods
Not accepting an entire food groups (i.e. fruits, vegetables, meats…)
Food range less than 20 foods
Child fights with parent about foods or mealtime

Not All Chicken is the Same

Chicken nuggets require a lot less jaw strength to chew that a chicken breast because they are mushy. This is why some kids eat chicken nuggets but refuse the chicken breast you cook at home. Try cutting it up into smaller pieces.

Common Feeding Questions from Parents

When should children start eating table foods? And what food should I start with?

Most children start eating solid foods between 10 months to 12 months. It is best to start with a really soft food (i.e. heavily steamed carrots) or food that melts readily (i.e. puffs or melts).

How should I give my child their first solid?

We like to present a solid food for the first time on the side on the mouth, or encourage them to place it there. By placing a small piece of the puff on the side of their mouth, you are making it easier for them (they don’t have to move the piece of food from the center of the mouth to the side). This allows them to get used to the feeling and focus on chewing.

How many foods should my child be eating?

A good rule of thumb is between 15-20 foods by ages 3. You also want to make sure they have 2-3 in each food group (breads/grains, fruits, vegetables, meats) and aren’t specific to brand or color.

At what age should I try using straws and open cups?

Your child should start using straws and open cups between 10-12 months.

What cup should I start with?

Every cup is made a little differently. For development of the mouth muscles, straws and the 360 cups are the best, however sippy cups are functional. If you give your kiddo a sippy cup try to drink out of it once yourself to make sure it isn’t too hard to get liquid out of (cups with stoppers can be difficult and can cause a child to use and overdevelop movements that are more immature)

How do I get my child to tolerate a non-preferred food to sit on their plate?

Using a timer or using a reward chart can give children a visual incentive and an achievable goal. Starting small and building the length of time and slowly increasing interaction with the food is best so children don’t shut down.

Why won’t my child try any vegetables?

Sometimes if we present the food with a preferred food, the child will interact more. For example, do they like any condiments that the child can dip the vegetables into? Or can you make it look more fun by adding sprinkles? A reward system can sometimes make all the difference and gets the child from hyper-focusing on the food item they are dreading.

5 Interesting Picky Eater Facts

Children don’t only eat what they like: children’s diets can be greatly influenced by what others around them eat. If mom and dad don’t eat the vegetables, they might not want to as well. Try eating the foods with your child so they see what a positive experience it is.

Just because they don’t like a food one time, doesn’t mean they won’t ever eat that food: A child needs to try a food multiple times before they can truly say they don’t like it. If a child doesn’t want a food once or says they don’t like it, take a few meals off, then try presenting it again.

A child can get sick of a food. Try to make sure to mix up meal choices enough so that they don’t get sick of a food and kick it out of their diet.

Making a child try a food is not always the best option. This can cause them to be fearful or anxious during meal time, if they aren’t willing to try a food, see if they will do something else with it: touch, kiss or lick.

The environment for eating is very important: sitting down together as a family is the best way as often as you can. If they see their parents and/or siblings eating a food, they have a more positive association. Sitting in front of the TV or iPad or being watched while the eat makes mealtime more stressful and makes them a less active participant.

How do I know if my child may benefit from feeding therapy?

Aversion, avoidance, and/or refusal of food textures or entire food groups
Coughing, gagging, and/or vomiting during or around eating or drinking
Self-limiting (<20 foods) or restrictive diets
Dropping foods from diet that your child previously ate and not bringing it back
Difficulty biting, chewing, or managing food in his/her mouth
Difficulty drinking from cup
Difficulty transitioning between developmental stages of eating
Ongoing weight loss or poor weight gain with growth
History of eating and breathing coordination problems

Delayed exposure to foods and textures
Difficulty using utensils and manipulating food/packaging in hands
Eats fewer foods over time and may end up with less than 8-10 foods
Avoids sitting at table, participating in meals, eats separately or leaves room
Difficult for everyone to feed or cries, yells, avoids, or tantrums around meals
Rigidity and inflexibility related to meal routine or foods specifically
Medical diagnoses (gastric reflux, motility disorders, failure to thrive,
Gastronomy (G-tube) or naso-gastric tube (NG tube) dependence
Anatomical or structural issues with jaw, palate, etc.