Picky Eaters Club — June 2008 Edition

For this edition, share a success story from the past month, a new tip or trick you’ve picked up… or feel free to make a desperate plea for help.

(For information about Picky Eater’s Club, click here.)

Well, our house has not exactly been a model of progress in this realm over the past month, so this is going to be a bit of a rough post for me. We have been floundering our way through assorted head colds, ear infections, and this week I added pneumonia to the mix. But in the midst of all this, children still need be fed — and unfortunately, mine don’t tend to come along willingly.

So here are my tips for the month — one for kiddos with extra medical challenges and one for the standard picky eater:

For The Picky Eater With Medical Challenges:

One of the biggest things I learned about feeding issues with a child with medical challenges is that you have to get really comfortable with the idea that progress is likely to be slow. And by slow, I mean S…L….O…..W…….. You need to initially measure success in terms of your own persistence — “I didn’t give up this week… I kept going!” And really, that’s what it all comes down to with any child — never giving up.

Kiddos that have had a lot of negative oral sensory input early in life, such as time spent on a ventilator, will often have very low tolerance for anything near their mouths. Last month I shared about the importance of maintaining the s*ckling reflex (sorry — had to be edited to avoid attracting undesirables), and this month, I thought I would share some possible next steps:

When medical challenges come into play with feeding, it is always a good idea to learn everything you possibly can about your child’s unique circumstances. Find out if there are any concerns about your child’s ability to eat orally — will they need to have a swallowing study completed first? Are they at risk for aspiration? Can your child qualify for assistance with an Occupational Therapist, a Physical Therapist, or for a Feeding Therapy program, Early Intervention? These folks can be invaluable along the path of teaching your child to eat and you don’t want to miss out on any resources available to you.

Once feeding safety issues have been established and you have located all your available resources, you’re ready to start — but remember it’s not going to happen overnight. Initially, Jacqui would not allow anything near her face except her pacifier or the finger-cot toothbrush I massaged her gums with throughout her NICU stay. These became my first tools for re-introducing her to food.

As a baby, Jacqui had severe reflux and some pronounced gross motor issues that made it difficult to properly position her for feeding. I found that her car-seat worked the best for feeding sessions — I just covered it in towels and had a catch bowl ready for those inevitable gags and pukes. Ideally, the time to work on oral feedings is before a scheduled tube feeding to help your child associate eating orally with the sensation of alleviating hunger. That isn’t always possible though. It wasn’t with Jacqui. You just work with whatever you have.

Your goal is to make feeding sessions into a non-threatening opportunity for your child to explore and learn. Make it a game, let it be messy. First steps for Jacqui involved dunking her pacifier and finger-cot toothbrush in formula and thin purees to interest her in flavors and slowly expand her level of tolerance for flavors and textures. Watch your child as they play. What do they willingly put in their mouth? Certain toys? Fingers? Toes? Encourage that curiosity any way you can. While holding Jacqui throughout the day I would play games with her involving her pacifier and her finger-cot toothbush, letting her become accustomed to and confident with the way they felt on her lips, her tongue, the insides of her cheeks. As weeks and months went on, I added “new toys” to the game: a Nuk brush, teethers, feeding spoons, straws, cups. Many of her favorite infant ‘toys’ were eating utensils.

Early feeding sessions with Jacqui were often nothing more than sitting her in her towel-covered car seat, dipping her fingers or a favorite toy in pureed pears and just letting her play. Making sure that every day she had opportunities for forward progress. Sometimes she took those opportunities, sometimes she ignored them, sometimes she flung them defiantly across the room. But we never gave up, neither of us. And five years later, I can tell you that it was worth it. Watch your child and learn what their main feeding issues are. Some children need to even go slower than we did — an older child might first need to be encouraged and rewarded for allowing food to be placed in front of them, or sometimes for even tolerating food in the same room. Set your child up for positive experiences and attainable successes, and then build on them. Slowly. And never give up!

Surviving Sick Days With Your Typical Picky Eater:

Mealtimes are a challenge at our house. And that’s on a good day. On sick days — well, the word ‘disaster’ quickly comes to mind. But at least nobody starves. Here are my survival tips for sick days with a picky eater:

Throw all your mealtime rules promptly out the nearest window. This is survival we’re talking about — rules are not our friends right now.

Look at the big picture. Go for caloric intake and worry about nutritional content sometime next week when the mention of ‘lunch’ doesn’t illicit shrieks and uncontrolled sobbing.

Develop a repertoire of sick day comfort foods for your kiddos — ones that make them feel cozy and cared for and that you can count on to be downed with minimal fuss. During sick days at our house, favorites include warm fruit juice with honey for sore throats, gluten-fee casein-free versions of warm chocolate pudding, hot cocoa with marshmallows, macaroni soup, pancakes with whip cream at any meal, and cheese and crackers on demand.

There is no shame in resorting to McDonalds. (Note: This can be tricky with the gluten-free crowd. We have a Happy Meal box reserved for such occasions which I then fill at home with gluten-free fries and gluten-free chicken nuggets heated up from our freezer. We top it off with a Hi-C juice box and a toy from my stash of recycled fast-food toys. Voilà — The ‘Happy Meal’ experience with none of the gluten.)

If you have a reward system for encouraging eating with your child, pull out all the stops — reward every chance you get! Our ‘Eating Jar/Good Job Jar’ typically makes a lot of progress during sick days.

Perk up interest in mealtimes by breaking even more rules: Try a breakfast tray complete with flower vase, spread a blanket on the living room floor and have a pajama party picnic, have ‘dinner and a movie’ night — the movie keeps rolling as long as the kiddos keep eating, if you’re good with story telling, make up a ‘five bites story’ — tell portion of a story for every five bites and finish the tale off with flourish and fanfare once they finish their meal. Basically, try anything you can think of to distract them from remembering that they feel miserable.

Pat yourself on the back once you have them all in bed and reward yourself with a nice cup of tea, a good book, and an early bedtime.

Remind yourself that it WILL get better… someday.

What About You? What picky eater tips or questions do you have? I’m looking forward to hearing them!

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