Tonya Rich, OT, Feeding Specialist at Gillette

Last week, we asked you to submit questions about your child’s mealtime challenges for Tonya Rich, OT, feeding specialist at Gillette. Today, we’re sharing Tonya’s responses and advice. Have a question we didn’t answer?  Leave a comment here.  Or, contact Gillette’s Feeding Clinic directly. By working to resolve feeding issues that children may struggle with, our clinic’s goal is to make mealtimes a positive experience for kids and their parents.

Q. My 8 y.o. rarely eats anything other than rice noodles, rice or tortilla shell with sour cream and cheese for dinner. If the noodles aren’t over cooked, or she feels a crunchy (or what she perceives to be crunchy) noodle, she spits it out and leaves the table crying. Same thing with any crunchy part she might find on a soft, flour tortilla shell. She’s allergic to eggs, pork, chicken, turkey, strawberries and cashews. Is there something that could help her deal with these texture aversions?

A. It sounds like you’ve really worked hard to manage your daughter’s allergies while continuing to expand her food choices. You might want to think about trying a  new food at snack time. That would allow you to maintain a more positive mealtime experience. Depending on how many flavors your daughter is able to tolerate, you might want to start by expanding the flavors that she’ll eat (noodles with a new sauce, cheese, or new red sauce).

Q. My 9 year old autistic boy is all about texture and color. He had a bad experience as a preschooler. They were righting letters with shaving cream and wont eat anything like it, mashed potatoes, cool whip. Wont eat lunch meat. No veggies. He only likes chicken nuggets, p.b. & jelly sands, most fruit (not strawberries or watermelon tho)any suggestions besides bribery?

A. Oftentimes we will start with what the child is most comfortable and then build towards stretching the child to new foods/experiences. You might want to start with changing the safe and less emotional parts of the meal such as the plates, tablecloths, utensils or having music on during the meal. It’s the same food but the environment has changed slightly. As your child is able to tolerate those changes, you can build towards tolerating having less desired foods on the table. I would also encourage safe non-food interactions with having your child look at pictures of food (google images works well) or read books about food/eating.

Q. My daughter who has Rett, has a hard time with pooling food in her mouth before swallowing, if she swallows it at all. We usually try mushy foods, or pasta, but have been trying pureed food too. Feeding time is for sure the most streeful time at our house.

A. Our therapists are able to help child learn how to manage food safely in their mouth. This could be by alternating a bite of pasta with a drink or some puree or placing the bite of food on the side of the mouth can be helpful for a child who is learning to eat as well.

Q. Five year old Naomi will eat noodles, tortillas and PB and honey, chicken nuggets with ketchup or honey mac and cheese and the occasional red sauce with pizza or spaghetti. Juice is the only was we can get any fruits or veggies. We thought she may have some allergies – but nope – just picky! She’s BASICALLY healthy weight wise and energy wise…but i long to give her a good salad or piece of fruit…..then again, not many kids dive on those I guess. In contrast her 2 year old sister eats Nori (seaweed) and hummus and peppers and oranges like she’s eating her last meal.

A. Family meals are one way to allow children to be exposed to a variety of sights, smells, and foods. Related to family meals, one strategy that can be helpful is encouraging children to participate in preparing meals and exploring food. This helps families to redefine what they mean when they say “try it” for their child. This could mean “trying it” is your daughter just starts out with looking at the other foods, helping to prepare them, tolerating them at the table or passing the dish to another person in the family. You can build up to her touching the food, having it on her plate, and hopefully steadily move towards her trying a new food.

Q. I’m having trouble getting my almost-two-year-old to eat squishy or wet foods. He is all about the crunchy. I really want him to eat more fruits and vegetables that aren’t pureed in a squeezable pouch. He has recently decided that cooked pasta is OK, so I have hope. Fresh or canned fruit is just out of the question, though.

A. It’s great that he will take the pureed fruits and vegetables! Now we can build off of that…Veggie sticks can be helpful for kids who like the crunchy. Sometimes engaging the child in making “food faces” on their plate with over-steamed vegetables can encourage a child to try a new food. That way they can touch a new food but it’s not too squishy or wet. Keep encouraging your child in play to explore wet/messy play (i.e. water table, in the bathtub, pudding painting, or finger painting).

Q. Any advice for parents whose kiddos overload on their preferred foods and then won’t eat them again for long periods of time? 

A. Slow and steady wins the race. Keep offering a wide variety of foods. Children often need a significant number of exposures to foods and this can be done in a way to minimize anxiety (putting foods in the grocery cart, helping with cooking, helping with menu planning, all the way to using a divided plate.