Boundaries for Mealtime: Picky/Selective Eating Tips

04/14/2013

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Picture
Look familiar?

If you have a picky, selective or finicky eater I'm sure it looks ALL too familiar. Rest assured, you are not alone. 

One of the most important things I do as a feeding therapist is to help families bring peace back to the table while we are working on whatever issues are causing the picky eating. 

No matter the reason for the picky eating, we must begin to repair the damage that has been done from months or years of mealtime battles. 

So, how do we even begin to bring the trust and peace back to the table? 


By setting boundaries for both the child AND the parent. 


Boundaries, when used appropriately, are very effective with picky eaters because they allow the picky eater to learn what will be expected of them at the table {which will be very different than the past} AND it allows the parent to relax and focus on something other than how many bites their child is taking at the table. After some time {it will vary for each individual child/family} there will be far fewer battles at the table and the child will be adding to their food acceptance list. 

So, how do we set boundaries?

First, we always make sure that there is a food or two on the table that the child WILL eat
~YES, this means that it may only be crackers, bread, milk or water. 

Next, we are NOT ALLOWED to say "take a bite, try this, smell this, just two more bites" etc...we do not comment on each other's plates or choices. We simply enjoy the meal. 
~YES, this WILL be difficult. Go with it. TRUST the new boundaries. EVERYONE in the household or at the mealtime should be respecting these boundaries. 

Next, when/if the child begins to say "I won't eat that. I don't want that" you are firm and clear in your answer without giving too much attention to it. Say "That's fine. Choose something you'd like." {because there is ALWAYS something on the table they like}. Let me be clear here...you are NOT becoming a short order cook and fixing whatever the child likes that day. You are simply always having something on the table they WILL eat. Something as easy as milk, crackers, bread etc.. The picky eater must learn that it is fine to not want or try something on the table , but they will not be indulged with whatever they want {short order cooking}. Further, they will learn that there will not be a battle at the table because there IS something they like on the table. It is recommended that you are on a consistent meal/snack schedule so the child has an opportunity to eat again within a reasonable amount of time.

Finally, you follow these boundaries for EVERY meal. You follow these boundaries even when you don't see changes immediately. Trust takes time and many children and families have had such a horrendous experience with food and mealtime that it will take time to rebuild trust and repair their relationship with food. 

Be patient. 

THIS is where we must begin. We can not move forward with treating picky eating if we can not rebuild the trust around food. The only way to do this is by setting respectful and clear boundaries for both the child and the parents. 

If you need more information on learning how to set clear and respectful boundaries at your table, please contact me. 

Jen



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Finicky Eaters Stoplight Rating Scale

01/30/2013

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One of the things that I love about the Food Chaining philosophy is the concept of a rating scale for picky eaters to use when exploring new foods. It empowers them and gives them a say in what goes into their mouth and, eventually, onto their accepted food list. 

What I have found with these ratings scales, however, is that it can be hard for many of my picky eaters to conceptualize. I find myself cutting down the ratings for many of them and drawing {I always have crayons with me} a stoplight to give them a more real world example of how to use it. 

What do I mean? 

Most children KNOW what red means on a stop light. STOP! 
Most children KNOW what yellow means on a stop light. Go Slow, caution.
Most children KNOW what green means on a stop light. GO! 


How does this translate to food?  Like this...


I'll present this, or something very similar, to my kiddos and explain how we will use it as we try tastes of new foods. 
  • Green = GO! "Yes, I enjoyed that food. I will eat it again. Go ahead and put that on my food list. "
  • Yellow =Proceed with caution. "That food was O.K. I might eat it again but I'm not ready to put it on my food list and I want to try it again sometime."
  • Red = "No. I did not enjoy that food. I don't want to try it again in the near future. Don't put it on my food list." 

The kids really enjoy this rating scale and we often will make a corresponding list of red, yellow and green light foods {depending upon the developmental ability and age of the child}. 

How about you? Have you found a way for your picky eating kids to rate their foods in a unique and meaningful way? I'd love for you to share it with me. 


As always, thank you for reading and until next time...keep helping your kiddos BLOOM!


Jen
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Neowhat? Neophobia...fear of new foods.

04/11/2011

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As I sit here waiting to return to a week of work (had a nice week off with my kids), I am reviewing several conversations that I have had over the past week and find myself coming back to the same conclusion about our picky and problem eaters.  That conclusion is that it seems, no matter the cause (medical, structural, sensory), Neophobia plays a HUGE part in the development of  picky or problem eating.  I think sometimes, as clinicians, we forget to look at the big picture. We are so busy with treating the symptoms that we forget the cause and for me, that sometimes is the key to excellent treatment outcomes.

When I meet a new client for a feeding evaluation, invariably one or more of the following things will be mentioned as we discuss the case history; difficulty with bottle feedings, frequent ear infections or URI's, REFLUX/GERD, food allergies, sensitivity with getting hands dirty(tactile sensitivity), prematurity, difficulty with table food or lumpy purees when an infant, "grazing", sensory delays, sleep problems, distress at mealtimes, ONE choking episode, breathing problems, trouble gaining weight...the list goes on and on and on but these, for me, are some of the most common things I hear.  When you look at the list, you realize that some are medical, some are behavioral, some are functional but the result is the same...the child or adult doesn't want to eat.

Let's explore this for a moment. When you eat something and several minutes later your chest burns, you feel nauseous or you can taste a "sourness" in your mouth does it make you want to eat the food again?  Before you would choose to eat that food again would you remember how you felt the last time you ate it and would you want to recreate that feeling?  How about if you took a BIG bite of a new food and it was difficult to move around and keep together in your mouth?  Some of it stayed on the middle of your tongue but some of it slid back toward your throat and you gagged and it felt like you were going to choke. Would you choose that food again?  Would you say you had a positive experience with the food?  Do you see where I'm going here?  No matter the "source" of the picky or problem eating the outcome in my opinion, is the same....Neophobia....being fearful or anxious about food. 

I believe that one of the MAJOR pieces of the puzzle that most feeding therapists and feeding programs miss is the underlying issue of Neophobia. We can, in most cases, treat the oral/motor, functional or medical issues but STILL our children stay picky or problem eaters. We stand scratching our heads. Why are they not eating? Their tongue moves fine now..etc...etc...the reason is that we never addressed the ANXIETY that resulted from the condition that was treated.

I am exited that my "light bulb" moment came about a year ago when I attended a course entitled Food Chaining.  It just made sense to me.  I like that the program moved slowly and respected the client's feelings (no matter how young or old). I LOVED that it was FUN and clients seemed to "magically" try new foods once they realized no one was going to ask them to "take a bite" or "try it."  I LOVED that it dealt with ALL of the issues surrounding food..most importantly the Neophobia.

Stay tuned for my next blog post for some ideas on how to deal with Neophobia.  As always, please feel free to leave your comments and please visit our website and check out our new Skype consultation services for feeding AND speech/language issues.

Until next time...


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