Fun with food can improve nutrition

Jan 19, 2012
A boy plays with shaving cream.
Touch sensitivity often correlates with aversion to the textures of some foods. Eat and play sessions at the CPD include having fun with different textures.

Every parent has seen a child refuse healthy food.

But sometimes eating difficulties can lead to problems in development or disrupt a whole family—even for years. Nutrition problems can lead to dental problems, obesity, lack of energy and delayed development.

"It can have such drastic effects in life down the line,” said Ryan Winn, who leads the Let’s Eat and Play (LEAP Frogs) class at the Center for Persons with Disabilities. The class is offered to families at the CPD’s Up to 3 Program who want to address feeding problems in very young children.

Perhaps the problem starts early on, as a newborn struggles to eat. Maybe it becomes more apparent later, when parents realize that their family schedule revolves around the tiny spurts of eating that that their healthy-looking child does, all day long, to maintain a healthy weight.

Vicki Simonsmeier directs the Pediatric Feeding Clinic at Utah State University (the clinic is affiliated with the CPD). The clinic often serves children referred from hospitals, and she often sees the self-blame that the parents of reluctant eaters feel every day. Eating seems like a basic activity, so if a child isn’t doing it, it’s easy for parents to blame themselves.

As it turns out, feeding is more complicated than it seems. Coordination of thirty-one muscles is required for a young child to learn to swallow.  Sometimes a child is born with a physiological problem that complicates eating, or he may develop one. Perhaps feeding blocks an airway and interferes with an even higher priority action: breathing. Maybe sensory issues mean the child doesn’t like the feel of a nipple or foods with certain textures. Or it could be that the wrong formula is upsetting the child’s gastrointestinal tract.

“I’d rather have the parents come see me earlier,” Simonsmeier said. If a problem can be addressed before a child has accumulated too many bad eating experiences, its solution will come easier.

Winn agreed. Life is easier for a child who will eat a broader range of foods. Sometimes it’s hard for parents to know if the child is simply a picky eater or if there is indeed an underlying problem. Some children have such an adversity to different foods, they will gag if they touch or even smell them.

Whatever the problem is, if eating becomes an ongoing negative experience, it can lead to behaviors that may persist long after the physical problem is corrected. The CPD’s feeding-centered services are there to help children learn to like healthy foods. The feeding clinic works with children 0 to 12 years old, while LEAP Frogs targets children up to three. The approach in both programs is similar, Winn said.

Kristen Allsop brings her little boy to LEAP Frogs.  The experience has taught her something too—for example, to let her son play with a banana even if he doesn’t eat it. It was hard at first, but she understands that touching a food is one of the strategies that may someday lead to better eating. Touching leads to tasting … but it may take multiple tries.

The LEAP Frogs class uses a number of strategies to encourage good eating, starting with the timing of the class: right at lunchtime. Parents are told not to feed their children snacks before they come, and the children spend some time playing in the gym. This “gross motor-sensory” stimulation includes swinging, climbing and jumping, which helps decrease stress and calms and organizes the nervous system. If it makes the child hungry, that’s even better.

Next Winn has the child work on learning to tolerate touching certain textures with the hands and fingers. --"Most kids that come in here have touch sensitivity, which is highly correlated with oral and texture sensitivity," Winn said. The key is to have children experience things because they want to, because then they process the experience better. He encourages them to take an active role through play.

From working with hands, he then encourages the children to touch on their face, cheeks, nose and eventually toward the mouth. He hands the children what looks like a lollipop stick with a sponge on it. At first they use the stick to explore near the mouth; later they can dip it in something flavored, like fruit juice. The approach is play-centered. Winn doesn't want to turn the food experience into a fight.

A boy eats a tortilla

Finally they break out the real food: chips, vegetables, pasta, fruit. Winn encouraged experimentation, putting pasta on a chip, for example. One strategy is to pair something the child loves with something that may be more difficult, working to accept more textures and flavors.
In any one session, even the most reluctant eater can make progress, even if it’s just voluntarily touching a food he doesn’t like. The bigger challenge is to apply the progress in a home environment. Sometimes solutions seem to come easily, like when Winn suggested a parent cut a child’s milk consumption in half. Suddenly mealtimes went much better.

Other times, behavior is hard to change, not just for the child but for the family. For example, if family members have candy stashed in easy reach throughout the house, it will be difficult to direct the child to healthier things.

"Without the behavioral changes I can work on the sensory all day and never get very far," Winn said.

The rewards make the changes worth it, though. Better nutrition can mean better development, more energy, even better behavior.

The LEAP Frog classes have been good for Kristen Allsop’s son, she said, and he’s been good for the other class members because he sets an example for others, touching and tasting foods that they avoid. Her boy won’t touch a banana yet, but she’s learned his chances of eating it may grow if he will touch or kiss it.

“My hope is that when he’s five, he’ll eat it,” she said.

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