I Do Not Like Green Eggs and Ham! Picky Eating Strategies

It’s theme week at APT! What better way to tie in what we do here at APT with Dr. Seuss’s popular book Green Eggs and Ham! In the book, the main character is offered a plate of green eggs and ham over and over in different ways, different locations, and even with a mouse and a fox! He refuses the food until the very end when he decides, “I will show you.” He tries the meal and much to his surprise likes it. If only it were that easy right? So, let’s discuss our picky eaters and how we can help.

WHAT IS A PICKY EATER?

Did you know that Speech Language Pathologists and Occupational Therapists can provide therapy for children who are picky eaters? We can! So how do you know if your child is going through a normal phase asserting his/her ability to choose foods or if he/she is struggling with an eating disorder?

Listed below are criteria provided by Dr. Kay Toomey (the founder of a sensory based, trans-disciplinary approach to feeding issues) that help us to determine if your child’s eating issues are truly a “phase” or if he/she could benefit from feeding therapy services.

Does your child:

have ongoing poor weight gain (dropping percentiles on the growth curve) or weight loss?
have ongoing choking, gagging, or coughing during meals?
have ongoing problems with vomiting?
avoid all foods in a specific texture (wet, squishy, crunchy, etc.) or nutritional group (meat, vegetables, starches, fruits, etc.)?
have less than 20 foods that he/she is able to consistently eat? Especially if foods are being dropped over time with no new foods replacing those that were lost.

Has your child had:

more than one incident of nasal reflux (vomiting or spitting up out his/her nose)?
a traumatic choking incident, where he/she choked on something and then subsequently stopped eating certain foods?
a history of eating and breathing coordination problems, with ongoing respiratory issues?

Was your child unable to:

transition to baby food purees by 10 months of age?
accept any table food solids by 12 months of age?
transition from the breast/bottle to a cup by 16 months of age?
wean off of baby foods by 16 months of age?

Have you (as a parent or caregiver)

reported your child as being “picky” at 2 or more well child checks?
reported that your infant cries and/or arches at most meals?
felt like mealtimes are a battle, and that you are always fighting about food with your child?
reported that your child is difficult for everyone to feed?
had a history of an eating disorder, in addition to having a child who is not meeting weight gain goals? (Please note – parents are not viewed as causing the feeding problem in their child, however, they may be more stressed around meals and need extra supports.)

If you answered “yes” to any of these questions, then your child may benefit from services to address his/her feeding difficulties. Your SLP/OT can assess your child further to determine if there are skill deficits or underlying sensory issues causing his/her eating issues. Your pediatrician can help to refer you to a trained SLP/OT in the area of feeding.

SO WHAT SHOULD I DO?

Your SLP/OT will give you a variety of tips and strategies to do at home based on your child’s evaluation results. If there are specific skill deficits, those are things that will likely need to be addressed first before working on adding new foods.

As a pediatric feeding therapist for the past five years, I almost always will recommend the following:

Eat together at the table. This doesn’t have to mean that you prepared a full course meal yourself. This can easily be take out/fast food or something simple you tossed in the oven. Sitting at the table together allows your child (who normally doesn’t eat what you eat) to see your plate and see the foods you are eating. You know the phrase “monkey see, monkey do?” How many times have you been eating a snack as a parent and your child wanted some? It happens all of the time! Our children trust us as parents, so if they see us eating a food regularly then they know it likely is “safe” and are more likely to want to try it.
Expose your child to as much of a variety of foods as you can. The easiest way to do this is to get your child in the kitchen. Children of all ages can benefit from being in the kitchen with their parents when they are preparing meals. Little ones get exposed to the smells and visual presentation of the food itself. Children who are older can help with stirring, pouring, and getting materials for the meal. The great part about helping is that the child is being exposed to the food preparation and variety of materials, and the anxiety and pressure to eat it is removed. Often when you remove the pressure and anxiety of “please eat your dinner,” your child will likely try more foods.
Have fun with the foods! I know, I know, we all have been told a time or two “don’t play with your foods.” For a child who experiences anxiety around eating and new foods, exploration is a MUST. Your child is not going to just place a food item in his/her mouth without feeling it, deconstructing it, smelling it, and maybe tasting. Allowing your child to use fun cookie cutters and cool utensils to make things out of the food on the plate are creative ways to make meals fun that will in turn relieve pressure and anxiety. If your child is too young, perhaps you could do some creative food sculpting for him/her!

Ready to give these suggestions a try? I want to share with you with some fun recipes that you can try at home this week to join in with us and celebrate Dr. Seuss and Read Across America Week. These recipes will not only help get your child in the kitchen and expose him/her to some healthy options, but will be a fun, creative way to spend some time together! You might even discover a like for green eggs and ham!

By Amanda Crawford, MS CCC-SLP