Summer Mealtime Struggles: From “Picky Eaters” to Children With Feeding and Swallowing Disorders, Tips for Helping Kids Navigate Tricky Food Situations
Source: ASHA
Summer Mealtime Struggles: From “Picky Eaters” to Children With Feeding and Swallowing Disorders, Tips for Helping Kids Navigate Tricky Food Situations
Camps, Vacations, and Gatherings Can Bring Seasonal Feeding Stress
Summertime with a difficult eater brings food off the grill (char lines!), vacations with family and friends (with their unsolicited opinions and advice), and new mealtime environments such as day or sleepaway camp (with limited or unfamiliar food options). The potential for child and parent/caregiver anxiety around meals is high, but there are ways to help limit seasonal feeding stress—and even thrive.
“Picky Eater” or Disorder?
There are many reasons why a child may have difficulty eating. For some, it’s a phase—a part of natural development where they are asserting independence (typically, during the toddler years). For others, it may be due to sensory sensitivities (e.g., to certain textures or smells), developmental disorders, or feeding and swallowing disorders. Although it’s easy to feel frustrated, situations like this are often things that a child can’t control. Keeping that perspective—and sharing it with family and friends—can help.
So how can a parent or caregiver tell the difference between a child who’s simply picky versus one who has a feeding, swallowing, or other disorder? Signs to look for include coughing or gagging during meals; pocketing food (holding it in their mouth); eating only foods with certain textures (e.g., soft or crunchy foods); having trouble chewing; having a gurgly, hoarse, or breathy voice during or after eating; and not gaining weight or growing.
Regardless of whether a child is exhibiting these signs, parents and caregivers should trust their instincts and seek an evaluation with a speech-language pathologist specializing in feeding and swallowing if they have concerns. For children from birth to 3 years, parents/caregivers can connect with their local early intervention program to request a free evaluation. Generally, children ages 3–5 can be evaluated through the local school system—as can school-aged children. Families can also find help from private speech-language pathologists. A searchable database of these professionals can be found at www.asha.org/profind.. Your child’s doctor should also be able to provide recommendations for local professionals.
Why is Summer So Challenging?
Summer interrupts a child’s familiar routines. A day at home or at camp may look completely different than their day at school. They may even be going to different camps each week—with significant variability in the way meals are handled or foods are offered. There also may be more non-routine events such as parties or cookouts, which can create feeding stress when children are faced with new foods and new faces in an unfamiliar environment. Sources of difficulty for a child might include these scenarios:
New foods/requirements. A camp may provide set options for meals, offering limited choices. Even if a parent/caregiver can pack a lunch, a camp may have specific parameters around what may be provided (e.g., no food that needs to be heated, no nut-based foods). Unfamiliar foods may also be served when visiting family members and friends or when traveling.
Changes in mealtime schedules/procedures. A child may be eating earlier or later in the day at camp than they are accustomed to. They may be eating outside—or they may have less time to eat.
Changes in services. Some children might see a speech-language pathologist or other professional at school for help with their feeding and swallowing—or have other services during the school year that aren’t available over the summer.
Tips for Handling Picky Eating
Below are some do’s and don’ts that can help families:
DO: Serve a variety of foods. It takes multiple exposures to a new food (up to 10 or 15 times!) before a child may decide if they like it. Do this again and again, although it’s easy to get discouraged after a child rejects something three or more times. Summer offers a variety of fruits and veggies in season. Let kids choose what they eat. Even accepting something on their plate or on the table is progress for many. Should your family be food insecure and you are unable to feed your family in a healthy and balanced way, be sure to reach out to resources like Feeding America, https://www.feedingamerica.org/find-your-local-foodbank, for help.
DO: Get them involved in food preparation. Summer may allow more time make meals together. This is a great opportunity to take your time, explore new possibilities, and allow them to develop cooking skills. Involving your child in food preparation exposes them to new textures and smells and may make unfamiliar foods less overwhelming. They may even want to taste new foods as they cook with you!
DO: Make meals fun. Mealtime is about connection and family time—and nourishing children in more ways than just what they eat. Try to resist allowing your child’s picky eating to hijack every meal. Try a picnic, dinner at the pool, or themed meals. Look through cookbooks or children’s magazines such as Highlights for fun meal ideas. Children learn through play—making food fun and exciting may encourage them to try something new.
DO: Build on what they already like to eat. If they eat chicken nuggets, try a chicken patty. Or a homemade chicken nugget. Or a fish stick. Or chicken parmesan. Continue to take foods one step further.
DO: Prepare a child for summer changes. Talk about the food that will be served at camp or grandma’s house—or the fact that you may not know everything that will be provided. Get as much information in advance about what will be available and what their options will be.
DO: Set expectations for others. Tell grandparents, aunts and uncles, and other family members ahead of time how you handle your child’s eating. Let them know they shouldn’t feel offended or concerned—and that you appreciate their respect for your choices.
DON’T engage in a power struggle. The more people push a picky eater, the more likely the child is to dig in and resist trying anything new. Bribing, badgering, and shaming aren’t effective and are usually counterproductive. They also can create longer-term unhealthy food habits and behaviors.
DON’T make your child’s eating the focus of mealtime. Avoid the urge to make your child’s food intake the center of the conversation. By doing so, you may be inadvertently making them feel bad about something they can’t control. It also makes the meal less enjoyable for everyone. Encourage your child to listen to their body and learn about their hunger and fullness cues—this can foster healthy eating habits and a long-term positive relationship with food.
DON’T feel guilty about your child’s eating habits. Family members and friends will have opinions about how they would change what you’re doing and how meals were handled when they were a child. Even the most adventurous eater can have a picky child! Many people have children who are on opposite ends of the spectrum when it comes to their eating.
DON’T hesitate to make contingency plans. Although children should be given a chance to eat what is provided to them—and, in some cases, there will be positive peer pressure that spurs them to try new foods—it’s okay to provide them with familiar foods in an environment that can be overwhelming, like a loud barbecue or a day at the beach.
What If My Child Has a Feeding and Swallowing Disorder?
Below are some ways to help your child have a successful summer:
Talk to camp staff about ways to make meals and snacks at camp successful and safe. A child with a feeding or swallowing disorder may require special food preparation such as thickened liquids or specific food textures. Discuss your child’s medical needs with camp staff ahead of time and provide them with detailed instructions for food and liquid preparation.
Involve your child’s medical team members, including your pediatrician and speech-language pathologist, to help the transition to camp go smoothly. They may be able to provide ideas and strategies, which are specific to your child’s needs, to make your child’s time at camp successful.
Embrace all that the season has to bring. New activities, like camp or a barbecue at a new neighbor’s house, can feel scary and overwhelming when you are worried about your child’s medical needs. Having a strong support system—including your child’s physicians, speech-language pathologist, family members, and friends—can help you and your child overcome fear and stress, and can also help everyone get out there and enjoy some sunshine!
Stefanie LaManna, MS, CCC-SLP, CNT, is Associate Director, Health Care Services in Speech-Language Pathology for the American Speech-Language-Hearing Association (ASHA) and a NICU feeding specialist.
Source: ASHA