Jacki Walczak is an occupational therapist, avid gardener, and aspiring haiku writer. She grew up in the rolling hills of the driftless region of southwest Wisconsin, a product of many generations of farmers. Jacki moved to New Orleans in 2012 and calls Algiers Point home, where she lives with her two little dudes and precious pittie, Ruby.
While this columnist is a licensed professional, the following is not a substitute for personalized health care or advice provided by a licensed medical or health care professional.
Food Fight
As a pediatric occupational therapist (OT), I work with children and their families to reach for independence and fulfillment within the roles and routines of their daily lives. In the world of a child, that means I help them learn to take care of themselves, play, eat, use the bathroom, access education in school, and make friends, among other things. I’ve observed many small clients and their families struggle with issues in feeding and eating. “Feeding problems” captures a large spectrum of functioning that can range from some pickiness in refusing certain vegetables (i.e., most kids), to extremely restricted eating and oral aversions where a child only eats a handful of foods, which puts them in danger of malnourishment. For the sake of this column, I am referring to the kiddos who fall on the spectrum of generally mild to moderate “picky eaters.” Using an OT lens, there are some ways to help our kids feel more comfortable with choosing a variety of tasty things to consume.
Disclaimer: there are days where my own smalls survive on a diet of cheese crackers and smoothies, because life. It’s pretty much a dumpster fire. However, when resources and energy allow, here are some practical considerations to help your developing offspring eat in a (hopefully) pleasurable and empowering way.
1. Encourage your kiddos to play with their food
Build a car, animals, faces (anything!) with fruits and veggies, using dips as glue—to a piece of bread, for example. Eating is a multi-sensory experience. The more a child interacts with the smell, texture, and other properties of a food, the more likely they are to get used to it. In turn, they just might put it in their mouth. New sensations and textures can be very overwhelming and feel scary, so desensitization and exposure, without pressure to eat, is essential to feeling comfortable with novel food. For a baby that is just exploring new textures, a mesh or silicone baby feeder with any kind of food can help with early experience and exposure to tastes, smells, and textures. Here is one I used with my own kids. There are also some “pre-spoon” options designed for exposure in mind such as this one. Some OTs and parents follow a “baby-led weaning” approach for introduction of solid foods and trying new things to eat. For the child who is eating solid foods, aim for five things on their plate, and try not to have them all be the same type of food. If you are able, serve several different color foods at any given meal. Anything you are eating as a family, put a little on your child’s plate without any pressure to eat it. You are not your children’s short order cook. Change up the way foods are presented to a kid—like cucumber sticks one day, round slices another—to develop flexibility. And then play!
2. Cultivate an intentional environment for mealtime
In regards to body positioning, OTs often sit children at a table with 90 degree angles at their hip, knee, and ankle joints, an ideal positioning for eating. Sometimes that will help children feel at ease during mealtime. My children, however, like to stand to eat, and I allow it. But we all eat together around the kitchen island each night around the same time. Mealtime is a routine that we share and use to take time to connect, even though it is often loud and chaotic. Having an expected routine can also help picky eaters relax and feel more comfortable in trying new things.
3. Allow for choice
Feeding ourselves is one of the first ways we learn to have agency over our bodies. From the moment we emerge into our waking life, eating is a multi-sensory experience laden with subconscious connection to cellular memories; and it’s central to our conscious learning about our preferences, consent, and self-advocacy. In my experience, in situations where my child is digging his heels in for the sake of taking a stance, allowing for choice is helpful to everyone. He is learning to say “no” and “yes,” but I can give him choices that will still encourage an expansion in his diet. For example, I will offer carrots or potatoes by asking, “Which one would you like to help me cook? Fresh carrots, or soft potatoes?” The question is not “Will you eat this?” but rather, “Which one of these foods are WE going to make today?” Another (sneaky) way I help my kids feel as though their eating choices are speaking to their preferences is by relating a new food to one I know that they like. For example, if my kiddo loves steak, but doesn’t want to try chicken, I might say, “I made white steak for dinner.” A lie? Perhaps. But sometimes connecting something unknown and scary can be made approachable by building a bridge to something familiar, however convoluted.
4. Strengthen those little hands and mouths
Eating, drinking, and talking are fine motor movements. Let your child help you cook. The process will be messy and imperfect, but you’ll bond, the kiddo will work on their coordination and hand strength, and they’ll have fun handling food. My three-year-old loves to help take grapes off the stems and chop cheese. My five-year-old waits to spread peanut butter on the toast in the morning. Look for thick-handled and short forks, spoons, and knives to help kids use tools early. Early grip development with adapted spoon/fork. Or a silicone set that soothes teething. Or some for older toddlers. There are also “lipped” plates and bowls (example) that will help your child manipulate and scoop food early on with greater independence and less spillage. There are many “kid-safe” knives on the interwebs, or you can use plastic knives or butter knives for softer foods. (My favorite “dog” knives that won’t cut kids skin but will chop veggies.) My three- and five-year-olds both help chop zucchini before I sauté, and slice fruits for fruit salads. In the end, they feel pumped to have contributed to our meal together, and are motivated to enjoy the “fruits” of their labor. Teach your baby to drink from a straw to strengthen their lips and other oral motor muscles. Another way to encourage mouth strengthening and lip closure is to help your child learn to drink from an open cup, instead of a bottle or sippy cup, as early as possible. Mardi Gras cups are perfect for this. (I used this cup for my own kids.) The combined action of using their hands to carefully hold, gradually modulating the angle of the cup, and curling their lips around the edge helps their little brains forge a lot of pathways that will set the stage for further oral motor development that is essential to eating, drinking, and talking.
You’ll notice that most of these tips will likely result in a few (OK, tons of) messes. Life is messy. Learning is messy. By allowing our kids to make messes while they learn, we help them to feel confident about trying new things in general, without feeling like they need to be perfect. It should feel like play—because it is! The true work of a child is to play. But I understand that sometimes the energy or cost of cleaning up spilled food is just too much. When you have the capacity, though, allow for exploration and creativity. Most importantly, make it fun.
With all that said, there are children on the far end of the spectrum with feeding difficulties that result in significant disruption to (or limitation of) a family’s mealtime routine due to their aversions. If your child gags, vomits, or is severely inflexible when it comes to eating, talk to a pediatrician to request a referral to an occupational therapist. You can also visit Feedingmatters.org for resources and a survey to help guide you.
New Orleans metro area parents! Want to share your experience with ANTIGRAVITY readers? We’re always looking for a wide variety of parenting voices and circumstances to explore each month. If you’re interested, please get in touch with Erin Hall or head to our About page to fill out a contributor form.
