Refusal to eat, gagging before a food, when the child has difficulties to eat, the meals become moments of great tension in family. The advice of the speech therapist to break this vicious circle.
Up to 25% of children are affected by pediatric eating disorders. Also known as oral eating disorders or sensory dysorality, they are likely to manifest themselves particularly at the time of the two major transitional phases in feeding: the passage from liquid to purees and from purees to pieces. A piece, a taste, an odor, or even the simple sight of food can cause the child to refuse to put it in his mouth, to retch or even to vomit. The child may become very selective, refusing to eat anything other than milk or eating only pureed food for example. Meals become a living hell, dragging on and on. The main difference with neophobia, that phase of development where the child refuses new foods? This period is not transitory, pediatric eating disorders last over time.
Oral eating disorders: what are the causes?
There are many reasons for this disorder. It can be a sensitivity disorder, such as sensory hypersensitivity. This is for example the case of children who have been fed by tube and who can keep an exacerbated sensitivity at the level of the mouth, once the tube is removed.
This can come instead from a hyposensitivity “We easily recognize these children: they often have the reflex to form a large ball on one side of their mouth, which they end up swallowing”, notes Lucie Briatte, speech therapist. “In this case, the meal can last a very long time”. But the causes of this pediatric eating disorder can be other. Difficulties in chewing, organic malformation such as a velopalatine cleft, the origin can be linked to a motor disorder.
Blackmail, screens… reflexes to avoid
In families, the meal quickly turns into a confrontation. “When the child blocks, it’s not that he doesn’t want to, it’s that he can’t”, says the speech therapist.
However, in order for the child to have a minimum nutritional intake, parents are obliged to resort to strategies that can be counterproductive. Be careful not to force it. “The pleasure of discovery is lost”, warns Lucie Briatte.
It is also best to avoid blackmailing the child to eat, as the child will permanently link eating to a reward. Putting a screen to distract him is not a lasting solution, “we are in the circumvention of the difficulty.” Lucie Briatte and Lauriane Barreau-Drouin give us some tips to improve meals.
My child eats badly: 10 tips to help him
Letting go of the rules at the table
Becoming familiar with tastes and textures is already a learning process. Let the child manipulate the food, eat with his hands, even if it means he gets it everywhere. “You have to let go of the educational side during the phase of food re-education”, explains Lucie Briatte. Touching is already a first step.
Integrate the child in the preparation of the meals
Suggest that your child accompany you to the market, let him participate in the choice of food. At home, he can help peel the food or, if he is small, transfer it from the basket to the refrigerator. This visual and olfactory contact with food is important. “Put words on what you see together: ‘It’s hard’, ‘there is dirt’…”, says the speech therapist.
Give small amounts
A full plate can dissuade the child before he or she has even started eating. Prefer small quantities in adapted containers. Don’t hesitate to place the starter, main course and dessert on the table and let him choose the order in which he wants to eat them. “By choosing a food he likes, he will feel more confident about the meal,” says Lucie Briatte. There are also plates with several compartments. This can help a child who has difficulty with “double textures”. Use colored cutlery, let him choose a plate with the effigy of his favorite character. Does he have a favorite one that he wants to keep for every meal? Let him do it. Adults also have their favorite mug to drink their coffee!
Choose the right moment
In the morning rush, in the evening after a hard day, it is obviously not the right time to start new flavors. Choose to introduce new foods when you are more available, on weekends or vacations for example.
Try industrial foods
No matter how much parents who like organic and homemade food may dislike it, industrial food can be good when it comes to broadening the food palette, as the textures are more homogenous and therefore reassuring for children who have difficulty eating. Crunchy, crispy, flaky, melting, industrialists are redoubling their creativity to seduce our children’s taste buds. Curly, Pik’n Croq, breakfast cereals, mini-pizzas, the child can try to tame different textures.
From one brand to another, for the same food, there are slight differences in taste. If your child only eats Camembert, try offering the same Camembert in another brand to gently broaden his range of possibilities.
Use a timer
With children who have difficulty eating, meals drag on. To avoid finishing lunch at snack time, use an hourglass or a time timer and time the meal. “After 30 minutes, the child is tired. There’s no point in continuing, because you’ll go into a confrontational phase,” says the speech therapist.
Organize a picnic
When meals go wrong, it’s helpful to get out of the usual setting. Pack a picnic and have a meal out.
Practice mouth exercises
Blow bubbles in the bathtub, blow up balloons, drink through a straw, make faces, play with whistles, sing nursery rhymes. All these little games help to tone up the muscles of the mouth, which may not have been sufficiently used. They also allow to become aware of this part of the body, to realize how the organs change their state according to the positions. This is why it is important to verbalize: “I see that you inflate the muscles of your cheeks”, “your tongue comes out”, “your teeth clench”…
Pay attention to the position during the meal
If the child is badly installed, it requires a double effort for him: eating and holding himself well. It is therefore important to monitor his position. “Some children sit in a high chair with their feet dangling in the air. You have to make sure they have something to stand on. Also be careful not to present the child with a spoon that is too high, which forces him to lean his head back,” notes the speech therapist
If the problems persist
If the difficulties persist, talk to your doctor. He must first eliminate organic causes (reflux…) that may be at the origin of his difficulties. If there are no other causes, the doctor can refer him to a speech therapy assessment. It can be completed by a check-up with a dietician, an occupational therapist, a psychomotor therapist…