The term feeding difficulties is a broad term used to describe a variety of feeding or mealtime behaviors perceived as problematic for a child or family. Some of the common issues presented in feeding are mealtime fuss always or sometimes, not readily accepting new types of food, limited chewing or biting, limited jaw movements, keeping food in cheek pockets, choking, gagging, strong preferences to certain textures, following a list of food items. When a child refuses to eat their food, it can be a source of frustration and worry for parents or caregivers. Underlying reasons for not having proper mealtime can be limited interest, limited hunger, difficulty in chewing, weak muscles, sensory issues, and behavioral presentations like the sight of food may create some sort of distress, demanding screentime, and trigger tantrums.
For specific issues, it is suggested to get children assessed by an occupational therapist, feeding therapist, or speech therapist and follow the treatment.Some of the generalized strategies for feeding difficulties are as follows.
Stay calm and patient: The first and foremost thing is not to treat the dining table as a battlefield. Reacting with anger or frustration may further turn the situation into a power struggle. Stay calm and maintain a positive attitude.
Proper set up: There should be a consistent place to eat, it can be a center table, dining table, or in the Indian context even sitting on the floor. Discourage mealtimes in bedrooms, playrooms or the child is roaming and the mother is running after him.
Food Play: For Young Children, engagement or playing with food items that are raw or cooked, creates awareness and readiness to accept different textures and different smells. It mostly helps in sensory regulation.
Mealtime Preparation:Depending on the age of the child, he should be engaged in mealtime activities like washing vegetables or food material, cutting and chopping, dough making, batter making, serving food, and setting up the table. These activities not only create a sense of responsibility but also prepare the child for food intake.
Respect their appetite: Children have varying appetites, and their hunger levels can fluctuate from day to day. Encourage them to eat, but avoid forcing or pressuring them. Trust their internal hunger cues.
Set mealtime routines: Establish regular meal and snack times. This creates a predictable schedule and helps the child become aware of when they can expect their next meal.
Be a good role model: Children are more likely to eat what they see their caregivers eating. Sit together at mealtimes and demonstrate healthy eating habits. Habits like eating a wholesome diet, eating everything on the plate, not being choosy about selective items, and not wasting food. Habits like maintaining hand hygiene, setting up the table, serving and sharing food, keeping dishes in the kitchen and sometimes even doing the dishes, keeping leftovers in boxes, and cleaning the mess or trash on the table.
Offer a variety of nutritious options: A balanced diet needs to be given to children with a variety of healthy foods. Food plates should have a variety of pulses, rice, Chapati, vegetables, salads, curd, and some crunch. The food bowl should be discouraged in children as it is boring and does not offer variety in color, texture, Flavors, and most importantly nutrients.
Make mealtimes enjoyable: Create a pleasant atmosphere by eating together as a family, engaging in conversations, and avoiding distractions like screens or toys. Keep mealtime conversations positive and supportive.
Seek professional help if needed:If a child shows certain preferences towards textures and flavors, shows limited chewing, is always cranky during mealtime, or is inconsistent with appetite, he needs to seek professional help. The therapist suggests therapeutic activities like Z vibes, chew tubes, bite blocks, tongue depressors, strengthening exercises for oral structures, and games that can be played using toys for oral stimulation. These recommendations differ from child to child,no one formula works for everyone.
Remember, it's important not to force or bribe children to eat. Building a positive relationship with food and encouraging a healthy eating pattern is a gradual process that requires patience and persistence.
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