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Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

As a mother of four kids, meal times can be stressful. While I raised in the era of “finish everything on your plate”, I realized early that this is not an approach that would work for my family. I think the first time I tried the “eat everything approach” it went something like this:

ME: “Abby, you can eat everything on your plate, or you can go to bed”.

ABBY: “Well, that’s a goodnight” as she pushed her plate away and went to bed at 5pm.

Okay, mission failed. But this and other experiments with Abby over time made me realize that she has some texture sensitivities and what I will call “visual food distortions” that absolutely impact her eating. She cannot manage the texture of most meat (unless greasy) and won’t eat anything that looks like a dog’s breakfast (most casseroles, soups and even lasagna included). She likes some pasta shapes but not others, and most days refuses her favorite omelette because it is…not cooked enough, cooked too much, too golden brown, not flipped properly…yes, some days I think Abby survives on air.

However, while I don’t have the time, patience, or cooking knowledge to cater to the specific food preferences of each of my children, I have developed ways to ensure they are getting their nutrition while making meals slightly different. For example, I can still make pasta, sandwiches, and even meat and vegetables while remembering that within these meals each child is more likely to eat what I have prepared if I make some concessions. Some don’t want sauce so I prepare an extra vegetable, some won’t have cheese so I put yogurt on the side, and some need gravy to manage the texture of their potatoes while others leave them plain. The point is that I know the importance of nutrition, and recognize that if I am willing to be flexible, creative, and marginally accommodating, meal time is more enjoyable for us all.

In keeping with the National Child Day on November 20, I wanted to focus on this important parenting topic of picky eating. With the help of pediatric Occupational Therapist Jana Maich, we wanted to provide education and tools for parents on this important topic as follows:

The act of eating is an important part of the daily routine for both children and adults. In addition to being critical for healthy growth and development, eating is also a social activity and often an important part of the family routine. While it is normal for kids to have certain food preferences and dislikes, having a child who is a picky eater can be very concerning for parents, especially when this “pickiness” leads to food refusal, tantrums, or other behaviours. For these families, preparing meals, enjoying dinner as a family, or going out to eat can be unenjoyable due to the very specific preferences of their picky eaters.

There are varying degrees of severity when it comes to picky eating, ranging from an avoidance of certain textures (e.g. not liking “mushy” foods like bananas) to refusal of entire food groups. In addition to working with a pediatrician and nutritionist, occupational therapists can help to address this common issue. In this blog post I will talk about some of the strategies occupational therapists use to help expand a child’s food repertoire and make mealtime enjoyable again.

First and foremost, remove the pressure! A child should never be forced to eat anything. Forcing a child to consume a certain food item reinforces a negative association with meal time and with food. All meal time experiences should be kept positive to allow for the development of a positive association with food. Keep meal time playful and fun with no coercion or pressure to consume anything. Role model exploration of new foods and talk about foods as you eat them (e.g. “wow this apple is so crunchy and sweet!”) A positive meal time environment creates the necessary foundation for food exploration.

Allow your child to explore new foods on his or her own terms. You know the expression “never play with your food?” Ignore it! Exploring the sensory properties of food is a critical component to becoming comfortable with eating. In fact, a children’s comfort with food follows a sequential progression of sensory acceptance. Broadly, this continuum goes as follows: accepting/tolerating the food on their plate, exploring the food with a utensil (e.g. touching with a fork but not with their hand), smelling the food, touching the food with their hand (or allowing you to touch them with the food), bringing the food to their lips, tasting the food, putting the new food item in their mouth (they may spit it out at this point… that is ok!), chewing the food, and finally swallowing a bite. It can take multiple exposures at each level before a child feels ready to move on to the next step. An occupational therapist can help determine where your child is on this sequence and develop fun, play-based activities to move your child along the continuum.

Set a consistent meal-time routine. A predictable routine prior to and during meals can help ease anxiety about mealtime and positively prepare your child for a meal. For example, set a timer prior to the meal where your child will wash their hands, help set the table, and sit down. Make the routine work for you and your family. Involve your child as much as possible in the preparation and serving of meals as this helps increase exposure and comfort with food.

Introduce changes slowly. Start with your child’s preferred foods and gradually make changes to those. For example, if your child likes pizza try adding a small amount of a vegetable to the sauce. When considering what new food items to try, think about keeping the properties of the new food similar to a preferred food. For example, if your child loves peas, try green beans as they are similar in colour and texture. If presenting something new, don’t overwhelm your child with a large portion of a new or non-preferred food – ensure to always have a preferred food on the plate with the new, non-preferred food to make it less overwhelming. Remember – even if your child doesn’t eat it, the fact that it is on the plate counts as EXPOSURE and is a step in the right direction. If tolerated by your child, try and present a new food with a preferred food at all meals to increase exposure and encourage exploration of new foods.

Most importantly, check your expectations. Expanding a child’s food repertoire is a slow process, as the thought of new foods can actually be very overwhelming and scary for some children. Take it day by day, keep it positive, and take pride in small victories while making sure your child feels proud too!

We hope you find this post helpful!  For more insightful parenting tips check out some of our past articles on Children’s Health.