10 signs your child may need feeding therapy

You’ve slipped sprouts onto their pizza, blended spinach into ‘alien mash' and held the ice cream hostage. But you're still baffled: what is it about certain foods that some kids just don't like?

Statistics show that one in three children under five-years old will have feeding difficulties at some point, and that feeding concerns are the second most common problem left unresolved by GPs and paediatricians.

It stresses the heck out of parents! But at what point does a normal fussy toddler cross the line into a child with feeding problems? Mel Street, a feeding therapist from Small Talk Therapy in Auckland, explains.

“Around the age of two, it is very common for children to become ‘neophobic’. They don’t like anything new or different. This can particularly apply to new foods,” Mel says.

“The challenge is to stay calm and keep offering new foods and new experiences with food. At this stage food refusal can also be about control and independence. As a two-year-old, there is very little in a child’s world that they can control. Food, and the reaction they get from you around food, is a biggie. Kids this age have erratic appetites. Some days they will eat what seems like their own body weight in food and the next day hardly a scrap. Children tend not to need as much to eat as we think they do."

10 signs your child may need feeding therapy

The following may mean your child needs some professional help to develop healthy eating skills:

1. Lack of mouthing toys as an infant

2. Difficulties accepting or moving between different textures of food

3. Frequent coughing and/or gagging when eating

4. Less than 30 foods eaten or only eating specific brands or colours of foods

5. Avoidance of touch around the face

6. Irritability and anxiety around snack/meal times

7. History of reflux or vomiting during or after foods

8. Loss of food or liquid from the mouth or nose when eating/drinking

9. Grimacing or odd facial expression when eating

10. Tongue tie or history of tongue tie

All you can't eat: feeding therapy success stories

Jenni Lyons runs The Mess Hall feeding clinic in Wellington, and works with children with oral-motor, sensory or behavioural areas of need. These children can have become limited in the range of foods that they eat, so Jenni and her team work to establish regular, nutritious family meals that the whole family can enjoy. The following case studies are supplied by The Mess Hall.

Lila* is 16 months old and in full time day care. She had little interest in food. She would only snack and ask for her bottle. She had particular difficulty with harder to chew foods like apple, banana and carrot. She seemed to put food in her mouth but didn’t bite bits off.

Feeding therapy focused on chewing skills and gradually decreasing Lila’s milk intake. After 12 weeks Lila accepted a range of age appropriate solids and had family meals at home. At ‘Fruit Break’ at day care, she was able to bite, chew, and swallow all raw fruits.

Polly* was five when she first saw a feeding therapist. She was withdrawing from sitting with peers at school lunch time and refusing to eat at the family table. Her mother was increasingly concerned. Polly would only accept five foods. Those were starch based – things that dissolved easily in the mouth. These didn’t include any raw fruit and vegetables - only puréed fruit from a baby food pouch.  She would refuse to go to play dates and parties. She was anxious about having to be around new or unfamiliar foods.

She saw a feeding therapist weekly for 14 weeks, working on strategies for interacting with food. She was given small steps to achieve, with no pressure to chew and swallow. Smelling, tasting, and touching were practiced until Polly felt safe to make bite marks, then chew small pieces, then swallow.

Polly’s ‘accepted foods’ increased to 22 different items. Her mother says this may seem like only small steps, but they were huge for her and her family. Six months later Polly has more than 30 foods, including raw fruit and vegetables.           

*The names of the children in the case studies have been changed to protect their identities