My Baby Won’t Eat! Tips from a Pediatric Speech-Language Pathologist

Baby with a spoon of food near its mouth.

My Baby Won’t Eat!

“She just pushes the food away and shakes her head ‘no’.” “He won’t take anything but his bottle!” “She gags every time I try to give her something with texture…”
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Sound familiar? These days it seems as though everyone knows a child that can be described as a “selective eater”. Frustrated parents report food refusal, crying and gagging especially when attempting to transition from bottles and purees to table food. In extreme situations vomiting and poor weight gain may be present. When an underlying medical condition has been thoroughly ruled out, family and caregivers are mystified as to why an otherwise healthy child is having issues with eating. The good news is that most toddlers eventually accept a broader repertoire of tastes and textures. For those that continue to create havoc at mealtimes, here are some tried and true strategies that can help parents create a more positive feeding experience.

1. Increase acceptance of textures and tastes.

Selective eaters often flatly reject textured foods. The chunks in mixed, Stage III purees can cause gagging or refusal. Babies having difficulty transitioning from puree to thicker, coarser textures are often distressed when their food is not of homogeneous consistency. Parents can facilitate a careful transition to textures by thickening a favorite puree with crumbled Ritz crackers or rolled Rice Krispies. The amount of cracker or cereal should be advanced gradually depending on the child’s tolerance. Over the course of several feedings, many children will accept their favorite puree in a thick mashed potato consistency. At this point, other foods of similar texture can be presented.

Use of a food processor when preparing table foods is an excellent option. Most foods can be pureed and then bulked up to an accepted texture using crackers or cereal. Coarse ground and chopped consistencies are generally introduced around the time your baby turns two, but readiness for these foods is highly individual.

2. Change taste or texture- NOT BOTH!

In the early stages of transitional feeding, take the cue from the child. If he/she will only accept purees, introduce new purees with a different taste but the same texture/consistency. When increasing demands of texture, use an already accepted taste and modify it. Texture/consistency then becomes the only modification made to a familiar puree.

3. Take the fight out of feeding.

Many children who refuse to eat want to be in control. Providing the child with more opportunities to self-feed can be effective in changing mealtime dynamics. One way to do this is to increase the child’s exposure to nutritious but easily managed “finger foods”. For example, yams and potatoes can be boiled until soft, then skinned and cubed. Dipping pieces into catsup or even a readily recognized puree can be a fun activity for your toddler that may eventually lead to acceptance. A spoon coated in puree will give your picky eater an opportunity to try to self-feed, while you, the parent, use another spoon to supplement these attempts. If the child is not ready for picking up cubed or otherwise prepared foods, or has difficulty bringing a utensil to his or her mouth, use other surfaces such as the back of their hand or a plastic toy covered with puree for independent feeding.

4. Modify existing mealtime routines.

Young children do best when their environment is predictable and structured. Feeding schedules are important but should be periodically evaluated for necessary changes. Often a morning bottle or mid-morning juice box can have an adverse effect on afternoon intake.

Involving the older toddler in food preparation can be an effective strategy in eliminating distrust of new tastes and mixed textures. For example, many children this age can watch as ingredients are placed in the food processor and perhaps participate by pushing buttons. This involvement encourages interaction with the food before it is presented for eating, and hopefully helps to dispel some of the anxiety surrounding acceptance of a new taste.

5. Desperate times call for desperate measures.

In situations when increased intake is critical and aversive feeding behaviors persist, an Elmo DVD can be a powerful tool! While the thought of putting a toddler in front of a television during mealtimes makes most parents squirm, if used properly this practice can serve as a compelling distraction. Oftentimes gagging and food refusal can be temporarily avoided if the child is distracted by a favorite DVD or television program.

6. Don’t obsess over it.

While easier said than done, an anxious parent can only make the situation worse. Accept that progress toward your child’s feeding goals will be slow and at times, frustrating. Realistic expectations should be based on individual developmental capabilities- don’t expend too much effort comparing your child’s eating to those of their peers. Otherwise, try to create a positive mealtime experience emphasizing family interactions and the enjoyment that comes with just being together!

Denise Mantione, M.S. CCC-SLP is a Speech-Language Pathologist in the Monroe County Early Intervention Program. Early Intervention Services are provided at no charge to families and do not require a referral. For more information: 585-753-KIDS.

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This post originally appeared on our September/October 2011 Magazine