Feeding & Mealtime Challenges

As a parent, feeding your child a variable healthy meal packed with all the nutrients and vitamins to support growth and development is one of our biggest jobs.   There is so much information out on the internet on how, what, and when to feed your child at various stages, even information on how to “hide” foods within food for picky eaters.  Yet despite all the information, good intentions, and delicious meals prepared for your child, your child is still not transitioning as expected or is even flat out refusing entire food groups.  Naturally, this leads to worry and stress for the parent and at times anxiety and stress for the child. As occupational therapists we are here to help, but before you call us, please read on, as there are some major principles about feeding that are important to understand:

Feeding Is Complex

Eating is an important skill for children to learn, so that they can get the nutrition needed for their growth and development.  As we introduce solids to our babies, a parent will quickly realize that feeding requires the seamless integration of a child’s oral, gross, and fine motor skills, sensory processing and enthusiasm for food. In addition, a child’s environment has to be conducive to supporting all these skills.  It is no wonder that feeding our kids can be so challenging!

Some common challenges that parent’s face include difficulties with infant food transitions,  introducing new food textures, picky eating, and food refusal.  Some of these feeding challenges can start during the infant or toddler stage and persist into childhood.

When should I be concerned about my child’s feeding?

Generally, children’s feeding behaviors and patterns can vary from time to time, and this should not be concerning. It is time to seek professional support when the feeding issues are affecting your child’s growth, nutrition, or development. For example, if your child is missing an entire food group in their diet or they will only tolerate certain textures. Another time to seek professional support is when mealtimes are really stressful for the family or the child becomes overly anxious during or before meals. The pressures around mealtimes can be overwhelming and frustrating, but feeding challenges can be resolved and addressing the issues early can establish healthy long-lasting eating habits.

How can an Occupational Therapist help?

During an assessment, the occupational therapist (OT) would gather information about your child’s health and medical background, sensory processing skills, and cognitive skills through an interview and parent completion of a detailed questionnaire. Following this, the occupational therapist would observe your child eat in their natural environment at home, via an in-person home visit or virtually.  The therapist will be analyzing your child’s feeding skills (oral motor, fine motor, posture), in the context of their sensory profile and environment. All of these skills and components are considered to determine what may be impacting your child’s eating or feeding experience.

Once the assessment is complete, your therapist will provide you with education on “why” your child is having difficulty with mealtime and explain the steps involved to move forward with mealtime goals.  Essentially, your occupational therapist would be your mealtime coach.  As the home chef, a daily routine that implements the OT’s recommendations often leads to success with mealtime. Some children would require direct therapy with an occupational therapist in order to support their feeding skills, particularly if the challenges are oral motor or sensory in nature. If direct therapy sessions are needed, a weekly treatment session will be discussed to address the skills to be developed. The treatment plan will be tailored to your family lifestyle, goals, and specific challenges.

As occupational therapists we support children at all stages and ages of their development from infancy to their teen age years.