How to tackle your child’s feeding issues

By Katherine Granich, Source Kids Health Contributor

Does your child have issues with food, eating, and getting enough appropriate nutrition? Helping them to thrive in the face of feeding challenges is often a matter of perseverance, creativity, and good old-fashioned trial-and-error.

Eating issues are a huge source of frustration and stress for parents of children with disabilities, and there’s no one- size-fits-all approach to solving them – in fact, “solve” is a word you might have abandoned long ago, as often it’s a matter of finding what works for your child and your family. With medical professionals, dieticians, and nutritionists eager to weigh in (and track your child’s weight), it’s all too easy to get fixated on the numbers on the scale, the kilojoules in each morsel they take in, and the amount of untouched food you’re scraping into the compost bucket.

Why is my child having such a hard time?
There are myriad reasons why your child might have difficulties with eating and nutrition.

For some disabled children, physical conditions such as a slow-moving digestive system (dysmotility), issues with nutrient absorption, reflux, chronic vomiting, or swallowing difficulties (dysphagia) might make taking in food feel unpleasant or painful.

Children may also lack the oral skills necessary to successfully eat. Eating involves not only the ability to know how to “move” food around, but also the development of skills to know how to handle its specific textures and qualities. For those who have been tube-fed from a very young age, sucking and swallowing skills may need to be re-learned with the help of a speech pathologist before your child can move on to chewing.

If your child is tube-fed, it can be challenging to find the appropriate rate and volume of food they can tolerate, and balancing this with their nutritional needs is like walking a tightrope at times. Also, if your child is on a continuous feed or tube-fed for many hours each day, they may not ever feel hunger cues – or might not realise what hunger feels like when they do experience it.

Sensory issues around food can also limit what children will eat. Many medically fragile and neurodiverse children have genuine sensory issues that can affect what they are willing to eat – they may refuse certain textures (wet, crunchy, soft), avoid certain colours or foods that “look” a particular way, or be unable to eat mixed textures, such as pasta with sauce or salad with dressing.

Children with allergies or intolerances may have a very restricted range of foods they are able to eat, which can cause difficulties in ensuring they are receiving enough of the right kinds of nutrients for their growth and development.

The myth of “They’ll eat when they’re hungry!”
Parents of children with disabilities are used to hearing the well-meant, but ultimately unhelpful, assertions from other adults that their child won’t starve themselves, and will, in fact, eat when they get hungry enough. But when it comes to a child with a disability or exceptional needs, “hungry” is not the primary consideration.

We may make jokes about the “autism food pyramid” (hint: It’s nothing but chicken nuggets) and roll our eyes at celebrity chefs who suggest hiding grated carrots in pasta sauce (our kids can find the smallest shred, and there goes the whole meal). But if you’ve ever scoured the shelves of every supermarket in a 10km radius for a very specific food you know your child will eat, or got frustrated when a manufacturer decided to “rebrand” their product and now your child won’t touch it even though it’s exactly the same (but in a different packet), you’ll know that getting something – anything – into your child is the real goal.

Ideas to try

If you’re struggling with your child’s feeding and eating, you may be unsure about what you can try that may help them. Here are five simple strategies to work on at home together with your child.

• Play with food. If your culture permits it, letting children experience sensory play with food without any pressure or expectation to eat it can be a good start toward becoming familiar with new foods. Set up a bin with dried rice or pasta shapes and let your child sift, scoop, shovel, drive toy vehicles through, or just move around with their fingers or hands. String macaroni elbows to make a necklace. Make play dough together with natural ingredients.

Take the stress away by keeping the activity low-key.

• Try food chaining. The idea with food chaining is to introduce new foods to your child’s repertoire by building on foods they already accept. It’s based on the principle that children will eat what they like to eat. So if you know your child will reliably eat chicken nuggets, you may be able to offer them crumbed rather than battered nuggets, then similar-sized pieces of chicken that you’ve crumbed yourself at home, then reduce the amount of crumbs but keep the size and shape the same, then try chicken with no crumbs.

• Consider quality over quantity. Hiding vegetables in mince might not work for your child, but what about using Dairy Farmers A2 Goodness + prebiotic milk in place of regular milk? Fortified bread or flour? Cereal with added vitamins or minerals? Check the labels on the foods you’re buying, and if there’s an easy option that has more healthy ingredients or added helpful nutrients, this is an easy way to ensure your child is getting more of the good stuff. Choose high-quality ingredients to make the food your child will eat as nutritious as possible.

• Keep mouth-related interactions pleasant. Gentle, kind, fun touches on the face and mouth may help children who have oral aversion to start to become more desensitised to having things near their mouth. Stroke your child’s cheek gently, offer safe toys they can “mouth” in order to explore with their tongue and lips, and practise blowing bubbles together. If you’re washing your child’s face, do so gently. In fact, give them a wet face cloth of their own to play with and chew on while you carefully clean them up.

• Seek feeding therapy. Consulting a professional, like a speech pathologist or occupational therapist, to find out whether feeding therapy might help your child doesn’t have to be a last resort. Often these professionals can give you some good ideas and advice in a consultation appointment, and there’s real value in having them assessed by someone who has seen feeding problems before and can identify what might help your child at the stage they’re at. They may share some exercises or strategies you can practise at home that you may not have even thought of.

Above all, know that you aren’t alone in dealing with this – even though having a child with feeding and eating issues can feel isolating, there are many others across the country who are in a similar boat. Joining an online forum might give you some relief (and a safe place to vent if you’re frustrated).

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