Food Chaining: Feeding Therapy for Picky or Problem Eaters

Emma’s Story

Picture this scenario: Emma, who just celebrated her first birthday last month, is vehemently refusing to eat any pureed vegetables. She cries and moves her head to the side in defiance even when her mother playfully hovers the spoonful of puree in the air and makes noises to simulate an approaching train.

Moreover, she even has an obvious gag response if the mushy potato and squash mixture merely touches her lips. The ironic thing is that when Emma’s mother introduced the mixture last month, Emma was responsive and ate a few bites. All of a sudden, she was developing a very picky eating habit and Emma’s mother was beginning to worry about how this could affect Emma’s growth and nutrition.

What would you think is the best route for Emma’s mother to take? Some parents argue that picky eating is a slight problem – a short phase that can be bothersome but is not serious enough to cause the parent to become worrisome. However, since food is a vital part of life, more cautious parents worry that their child who is a picky eater could be malnourished and grow at a slower rate than normal, or easily develop an eating disorder later on in life.

Common Causes of Picking Eating and Feeding issues in Infants

According to an article, “Feeding Disorders in Infants and Children”, published in the scientific journal Pediatric Clinics of North America, between 25 to 35 percent of children in the United States have feeding disorders, and up to 40 to 70 percent of children with chronic medical problems have problems related to feeding and nutrition.

The truth of the matter is that the deficiency in certain nutrients and vitamins as a result of prolonged picky eating can cause malnutrition, oral aversion, congestion, erratic sleeping patterns, fluctuating weight, as well as a host of frequent and chronic illnesses.

Some children are simply picky eaters and refuse the smell, taste or texture of certain foods. In other cases, the problem may be more physiological, relating to a struggle in the process of chewing or swallowing. Finally, in some instances, the child may be revolting to a specific food type because of a genuine physical allergy that s/he cannot help.

In any of these cases, it would be most beneficial to consult with a feeding specialist who would be able to assess the situation, find the main issue causing the food aversion, and implement an individualized plan that can effectively deal with the aversion in a gradual way that puts the child’s health above all else.

Food Chaining: A Popular Treatment Method for Children

In the situation outlined above, Emma’s mother shouldn’t panic and start thinking of a way to reintroduce these purees haphazardly. Instead, she should immediately seek out the advice of a feeding specialist who is familiar with child-friendly methods of feeding therapy. One such method that has gained popularity in recent years is the process of food chaining, which incorporates a variety of techniques to make food more palatable for infants and young children. Since this method is built on the principle of making disliked foods not only acceptable but also enjoyable, it has a high rate of success in pediatric feeding therapy programs.

Most children who are problem eaters have a handful of preferred foods that s/he willingly eats. For a feeding therapist who has mastered the method of food chaining, the process of introducing disliked foods begins by first finding out key information about the types of foods that the child already enjoys to eat. Flavor mapping of those foods to better understand their tastes, textures, smells and colors can help the therapist find overlapping similarities between these foods’ characteristics. Then, the therapist is able to leverage his/her expertise in flavor mapping to identify new nutritious foods that have a similar flavor or texture as the ones that are currently accepted by the child, and introduce them gradually.

The important thing to know about food chaining is that it is a comprehensive and interdisciplinary treatment program. After the therapist analyzes current likes and dislikes of the child, and works to find foods that would likely be accepted, s/he then uses various age-appropriate, playful methods and functional tools to engage the child and introduce the new food in a non-challenging context. For example, if your child dislikes and refuses the taste of pureed mango, the therapist may choose to introduce a fruit similar in texture and with a milder taste like the papaya. The child may be encouraged to first touch the papaya, play with it, lick it, and smell it before being asked to place it in his mouth and swallow it.

Food chaining has been shown to reduce the risk of refusal to certain food groups because the foods introduced are essentially based on the child’s original preferences. Over time, even the original food choices may be slightly modified, by adding another flavor for example, in order to slowly diversify and work toward the ultimate goal of expanding the child’s accepted palate.

Chicago Speech Therapy – Experts in Food Chaining

If your child is beginning to show signs of picky eating that can be disruptive to his/her nutrition and normal growth, contact Chicago Speech Therapy to schedule a free, no-obligation initial consultation with one of our certified and licensed pediatric feeding therapists as soon as possible. We love helping children discover new healthy foods and are eager to work with any family who is excited to start a feeding program for their child.

Karen believes strongly in the importance of nutrition for a growing child, and has enough experience under her belt to implement a food chaining plan for your young one, regardless of how picky of an eater he or she is.

If you are concerned with your child’s speech or language development, please contact Chicago Speech Therapy by calling 312-399-0370 or by clicking on the “Contact Karen” button on the upper right section of this page.

Karen George is a Chicago speech-language pathologist. The practice she founded, Chicago Speech Therapy, LLC, provides in-home pediatric speech therapy in Chicago and surrounding suburbs. Karen and her team of Chicago speech therapists have a reputation for ultra-effective speech therapy and work with a variety of speech disorders. Karen is the author of several books such as A Parent’s Guide to Speech and Language Milestones, A Parent’s Guide to Articulation, A Parent’s Guide to Speech Delay, A Parent’s Guide to Stuttering Therapy, and A Parent’s Guide to Pediatric Feeding Therapy. She is often asked to speak and has addressed audiences at top Children’s Hospitals and Northwestern University. Karen is highly referred by many Chicago-area Pediatricians and elite schools.