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Helping children with feeding challenges

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We don’t usually think of eating as a ‘skill’, but it is. It can be stressful when a child has difficulty eating. Eating problems usually begin because of physical differences that make learning to manage and enjoy food more difficult. Parents don’t cause feeding problems. But there are many things parents can do to help their child learn eating skills.

Tips for mealtimes

  1. Stick to a routine for meals and snacks. This will encourage hunger in your child. Stay with this schedule, even if your child does not eat a meal.
  2. Have your child sit at the table or in a highchair for all meals and snacks.
  3. Eat with your child. If you’re not ready for your own meal, have a small snack like carrot sticks.
  4. Notice positive mealtime behaviours, like:
    • Coming to the table;
    • Sitting at the table;
    • Taking tastes of food.
  5. Don’t express any feelingsof frustration or disappointment during a meal or snack if your child doesn’t eat.
  6. Limit mealtime to 10-30 minutes. If your child is not cooperating at the table, thank him for coming to the table, and pleasantly take the meal away.
  7. Keep portions small. Always offer a small serving of a food your child likes as you introduce new foods on her plate.
  8. Schedule a time for drinks. Offer liquids during snack time or mealtime.
  9. Keep meals simple. Too many choices can be confusing for your child.

Strategic adult attention

The stress of having a child who has difficulty eating can cause parents to focus a lot of attention on food refusal behaviour. Children may even increase this kind of behaviour, because it gets quite a bit of attention from parents. Parents’ attention and reactions to food refusal become a kind of ‘reward’ to the child. Children will do things more often when these actions are ‘rewarded’ by parents’ attention.

  1. Pay positive attention to the behavioursyou want, and don’t pay attention to food refusal behaviours. It is important to notice when your child is doing something positive at meal or snack time. This could be sitting calmly in the highchair, holding a spoon or picking up a piece of food. Just describe what you see in a positive tone (with a smile!).
    • I see you’re holding your spoon already!  
    • You’ve got a piece of apple.
    • I like it when you’re sitting in your chair.
  2. Don’t respond to or ‘reward’ behaviours that get in the way of eating. This is hard. If your child says "yuck!", spits or throws food, take care that you don’t ‘accidentally’ reward him by expressing your frustration. Any expression of emotion from you (worry, irritation, disgust) may cause your child to repeat these unwanted behaviours. Instead, try to:
    • Keep your face calm;
    • Act as if the behaviour is of no interest to you;
    • Continue your meal;
    • Keep chatting with another family member.
  3. Stay quiet when your child is not eating. It’s best not to say anything at all, because your voice carries emotion, and your words show interest. Do not coax your child to eat-this just gives attention to not eating. While your child sits staring at her plate, try to busy yourself with something else, but be ready to show interest in eating related behaviours. For example, if your child picks up a spoon, you could say, "We’re using our spoons and forks".
  4. Keep calm and carry on if your child gags or coughs. This is difficult, but very important. Many children will gag or cough on new textures. To help prevent choking, avoid round, smooth foods like hotdogs or whole grapes. Your child will be looking to you for emotional guidance. Have a few phrases ready that you can repeat with confidence:
    • "It’s OK."
    • "It’s going down."
    • "You did it"
    • "You swallowed!"
  5. Be authoritative. When you talk to your child about food and eating, keep your attitude warm and positive, but ‘in charge’. Say what needs to happen in a clear, confident voice. This will keep things simple, but convey your authority.
    • "Time to eat"
    • "Food first, then play"
    • "Food first, then milk"


CHEO Occupational Therapy 613-737-7600 extension 2702 Monday-Friday 8:00am-4:00pm 

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