Eating is hard! It uses our whole body and it is something that we need to learn- it doesn’t come automatically and we certainly won’t suddenly learn to start feeding even if we are starving. It has a huge impact on families- it is something that we need to do multiple times each day, continually bringing up the stressors of having a limited food range- at home, school or out and about.
Statistically, very few ‘picky eaters’ outgrow being a ‘picky eater’. There are many underlying factors that could be making eating and drinking hard, which we need to be able to build on to feel comfortable to try and eat a greater range of foods. ‘Picky eating’ can be a ‘red flag’ for something else that may be going on for your child- children can control what goes in, and what goes out, so something may not feeling right for them- within their body, or something that may be going on around them.
3 ways OTs can work with children who are ‘picky eaters’
Is the child regulated? Does the child difficulty regulating and staying calm? This is one of the first things we look at for any child who we work with.
If the child does have challenges regulating, this forms our starting point, looking into why the child may have trouble regulating, and what we can do to support learning this skill. Sometimes we see supporting a child to be more regulated means that eating and feeding doesn’t become as big a challenge for them before we even start to talk about food!
What sensory input does the child seek? What do they avoid?
Our whole sensory system is involved in feeding including smell, touch, taste, sight, balance and movement (from vestibular system), body awareness (proprioceptive input). We need this information to come in so it doesn’t overwhelm us, and to be processed by our brain and body, so it can then be used to help us navigate the world and our food!
3. Posture, positioning and motor movements
Feeding uses lots of different movements which are complex and take time to learn. If someone is having difficulty with these movement and being able to plan and organise these, it can make eating challenging. This includes chewing, how our tongue moves, and for using tools to eat and drink.
But first, we need a good base of support, stability and good breathing before we can move more freely and confidently. This includes how we are sitting at meal times, or even if we can sit in a position that allows us to eat and drink.
Who else could help? Finding your team
There are many health professionals who could support, the right combination can depend on the underlying reasons behind why someone has a limited food range. In addition to identifying the underlying reasons and with intervention, the following health professionals may be able to support by:
- GP or Paediatrician: Referrals to link to specialists and other health professionals who could support. It’s important to rule out underlying medical reasons why someone may be a ‘picky eater’
- Child health nurse: To rule out or manage underlying medical concerns and monitor health and growth curves to ensure the child is within weight and growth ranges.
- Occupational therapists: Feeding is a daily living skill that OTs can support around. They can help to identify the underlying reasons behind ‘picky eating’ and build on these skills, or address factors that may be impacting such as regulation and sensory processing.
- Speech pathologist: Speech pathologists can assess for swallowing difficulties, and underlying reasons- especially with muscle use and movement and swallowing, then support with intervention.
- Psychologists: Support for underlying thought patterns and processes, with anxiety or worries around food and drink.
- Dieticians and Nutritionists: Ensuring the child has enough/right amount of calories and nutrient levels. To monitor dietary intake to ensure their health and growth is on track.
- Physiotherapists: To support with posture, movement, strength to help have a solid base of support.
Feeding Matters is an online support group and resource for parents and caregivers of children who are ‘picky eaters’ or ‘problem feeders’. They also have a questionnaire parents can fill in prior to meeting with their GP which helps to capture information about the child’s current feeding challenges https://www.feedingmatters.org
If you would like to speak to one of our OTs about supporting your child to build their feeding skills, please contact us at firstname.lastname@example.org or 0430 645 086