Are you having a tough time feeding your child? Are you having an everyday struggle
during mealtime with your child?

Feeding or Eating issues in children may be evident as difficulty in accepting
variety of food/new food textures, prolonged meal time, food refusal making
mealtime really difficult for the child as well as for the caregiver.

Feeding problems can range from mild form of picky eaters to severe food
refusals affecting a child’s food intake.

Is it something that you should worry about? What are the signs that you should
consider?

•Child is picky about food textures, the smell of food, and food temperature
•Child Prefers only certain taste of foods
•Does not accept any new food or takes time to accept new food
•Does not chew the food well and just swallows or gulps it.
•May keep the food in the mouth for long and may need reminders to chew the
food
•May gag, chock, vomit or spit out the food
•Puts non-edible items in the mouth/ Chews on toys or clothes

Few more things that you can notice in your child:

•Cries or arches away at most meals
•Unable to accept table food solids by 12 months of age, difficulty progressing to
table food
•Not weed off baby foods by 16 months of age
•Eats less than 20 foods by age of 2 years
•Not able to blow
•Not able to suck through a straw

If you see any symptoms in your child then you must consider. Screening and
feeding evaluation also may be required to understand medical, oral sensory
motor issues in the child affecting eating/feeding skills.

Many times we may feel that child is being moody and may think that it’s just a
behavior of the child. But many of the times the feeding issues are due to Oral
sensory and Oral motor issues.

Oral sensory issues are differences in regulating texture, smell, taste in the
mouth.

Oral motor issues are related to the strength and coordination of muscles of
cheeks, lips, and tongue.

For the optimal functioning of feeding and speech there need to be good
functioning of oral sensory structures and well developed oral motor skills.

Oral sensory integration, strength, range of movement, and coordination between
all the oral structures are crucial for the proper functioning of the oral motor
structures that impact feeding as well as speech clarity.

STRATEGIES TO IMPROVE FEEDING SKILLS

Here are few simple strategies that you can use for your child to improve feeding
and eating.

1. Proper Feeding Position

The optimal seating position is very important for mealtime. A child should be
sitting on a chair with a lap tray or table in front. Start with 5 to 7 minutes of
sitting and slowly progress it to 15-20 minutes as a child would need that much time
minimum to finish the meal.

For your young toddlers, you can also use the high chair. If a child does not want to sit
on the chair, start with some play activities while sitting.

Make it a routine and practice sitting on a chair with your child not only during mealtime but also for play. You can develop the habit of sitting by using play
activities with the child. That will improve the child’s sitting tolerance.

2. Food Exploration

Do not force your child to eat food that they don’t want to eat. Negative
associations with food can lead to food aversions and then it may become even
more difficult for the child to accept the food.

Let the child explore the food. A lot of food exploration activities can be done with
the child. By exploring/playing with the food help the child to feel the texture of
the food and the child can smell the food.

Touching, smelling, peeling, smashing, and interacting with food can be a great
start for the child to accept the food. Eventually, it can be progressed to eat it.

You can do the activities like

•Peel the skin of the orange and take out the slices
•Peel banana activity
•Peel a boiled potato and mash it
•Washing fruits and raw vegetables can be again great activity for the childlike wash the apple, cucumber, tomato, etc

Have patience and go slow with the child as a child may just refuse to touch the
food. Help the child in peeling the skin. Children are great imitators. You can take
out the initial part of the skin and then help the child to peel the rest of it.

You can do some more fun activities like chop the veggies in small pieces and tell
the child to make a shape by using the chopped foods like making a smiley or
writing alphabet by using small chopped vegetables or fruits.

3. Oral Sensory Awareness:

Its equally important that child able to manage and becomes aware about the
sensations (like touch, texture, temperature and taste) inside the mouth.
Child may present with different oral sensory challenges. Oral sensory
challenges can be of major three types.

Few children may be too sensitive to these sensations and may feel too much
inside the mouth. They may have a gag, vomit out of hypersensitivity and it limits
their food acceptance.

On the other hand, few children may have poor awareness inside the mouth and
do not feel it much. They may have poor feeding skills, keeps food in the mouth
for long.

The third type can be, where children crave excessively for these sensations and tries
to put everything in the mouth to fulfill their sensory needs.

You can use variety of activities to improve oral sensory awareness.

• Eat crunchy snack like raw veggies, biscuits, chips, nuts
• Vibrating oral toys
• Chewing toys
• Flavored sour sticks, candies
• Licking on lollipop

4. Oral Motor Exercises:

Oral motor exercises are to strengthen the muscles to cheeks, tongue, and lips
and it also improves oral sensory awareness as the child uses these muscles during
the activities.

• Straw Drinking:

Drinking from a straw is a very simple and effective activity that
parents can try at home.
You can start with the straight straw and slowly progress to long and spiral
straws.
You can start with simple liquids like water and milk and slowly progress it to
thick liquids like shakes, smoothies, etc.

• Blowing activities:

Blowing is again a very good activity for children to improve
oral muscle strength. Children love playing with bubbles, teach them to blow
bubbles.

1. Blowing whistles, flute, hooters can be again fun activity for the child.
2. Playing kissing games, blow the kiss
3. Kiss the food with lips
4. Smack the lips.
5. Pick up a small pom pom ball by using start by sucking the air u

Mealtime should not be torture for the child as that may create more stress to the
child every time he tries something new.

Do not be in rush and go slow as per the child’s acceptance. Try to do all these
activities in a fun learning environment.

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