Fun with Food!

"Feeding Disorder Hell"

2011-11-22T12:41:00.000-08:00

http://lovingamiracle.blogspot.com/2011/11/feeding-disorder-hell-our-narrow-escape.html

What a wonderful post, written so open and honestly!

Food Play!

2011-10-28T04:10:00.000-07:00

Another Trader Joe's snack find--"Fruity Flakes". These are similar to "fruitaboo" roll ups in taste. Here is Adalyn eating "fruity flake leaves" off of our picture! To help your child become familiar with a new food---Play! Today he may feel o.k. with placing the leaves on the tree, tomorrow he may bring one up to his nose or mouth!

"Sensory Processing Issues Explained"

2011-10-27T10:48:00.000-07:00

Here is a wonderful article explaining the complexity of children with Sensory Processing Disorder.

http://www.childmind.org/en/posts/articles/2011-10-26-sensory-processing-issues-explained

"It's like a traffic jam in your head, with conflicting signals quickly coming from all directions, so that you don't know how to make sense of it all."

"What parents often notice first is odd behaviors and wild mood swings, strange at best, upsetting at worst. Often it's an outsized reaction to a change in environment—a radical, inexplicable shift in the child's behavior."

Feeding Issues in the Schools

2011-10-25T05:22:00.000-07:00

http://speech-language-pathology-audiology.advanceweb.com/Article/Feeding-Issues-in-the-Schools-2.aspx

Freeze Dried Mangoes

2011-10-06T06:59:00.000-07:00

One of my Trader Joe's finds. I love using freeze dried fruits in therapy to help teach lateral biting and munching. They are also great snacks for the child who prefers crunchy foods. These crumble into fine crumbs which is great for small tastes on fingers or Nuk brushes, teethers and toys! Keep in mind for babies and children who are learning about food and who are tube-fed!

Laying the Foundation--Part 2 of "Family Food Fights"

2011-07-28T14:44:00.000-07:00

Without a comprehensive feeding evaluation to further investigate feeding history, possible allergies and GI complications, respiratory health, sensory responses and oral motor feeding skills it is impossible to give an accurate opinion in regard to WHY meals are difficult and stressful for you, your family and your child. We must look at the whole child and his everyday feeding environment, current diet, meal schedules and many other factors before reaching a conclusion or starting point. It is best to first seek a feeding evaluation and go from there. In this post I want to give some general tips to help reduce mealtime stress and help lay the foundation for successful feeding.

What is your routine? Do you have regular meals and snacks scheduled for your child or is your child prone to graze throughout the day? Work toward 3 meals and 2 snacks spaced throughout the day, with the snacks being lower in fat and calories in order to allow for increased hunger at meal time. Some children with feeding tubes can only manage small amounts of food during a given time therefore working toward a consistent schedule can be difficult. It is not always easy to find that balance between gastrointestinal comfort and satiety. For example if your tube-fed child is retching or vomiting during tube feedings then it is not the best time to introduce tastes or new foods--negative associations are formed rather quickly. We find this to be true with the child who has suffered from reflux. Discomfort in general is a barrier to successful eating. To read more about mealtime routines click on Establishing Mealtime Routines.

Does your child insist on eating only a specific food, possibly from a specific restaurant or is he particular with brands, shapes, textures? Children with sensory based feeding complications have more difficulty with introducing change and variety, but as a parent of a 5 year old I know that 'food jags' are easily created and it takes a lot of effort to make that transition from McDonald's chicken nuggets to a healthier homemade version of a nugget. Children often have a fear of the unknown or a new food, known as "neophobia" and this can begin at age 2 and earlier! I suggest you read and share with others on the topics of food jags and sensory 'steps to eating' on page 4 of this issue of Journal of Pediatric Nutrition and Development and work toward expanding on those jags by reading Suggestions on Expanding Current Foods.

Remember in the post on Family Food Fights how our own stressors as parents can influence our childrens eating. Feeding struggles alone can be a big enough stressor, causing arguments and tension between spouses and family members. Add in work stress and responsibilities, parenting responsibilities, a long day, the 'witching' hour for those who have newborns (ME!) and exhaustion and you have quite the recipe for a disastrous mealtime experience. I remember how I felt at different times at different points in my life and on those days when I had the time to talk to my daughter about what we would be having for dinner in advance, had her pick out something from the store with me, go to the farmers market or participate in the meal preparation or ideas, set the table with her help, lit a candle and put on some music...we had a pleasant meal. EVEN with some new or different foods. Stress was low, expectations were set according to principles from Division of Responsibility paired with her comfort level with various sensory 'steps to eating'. Sometimes it is best just to let go of all control and see what happens. It is also good to plan for your child to choose the meal one night. Take the stress off of everyone. Allow for success all around. What are your Attitudes toward Mealtime? Review these Steps toward Succesful Eating and see what you can do now to make a change for the better.Getting on the same page with the rest of your family can be difficult but hopefully you can get there and be well on your way to a happy mealtime!

Family Food Fights

2011-07-27T14:29:00.001-07:00

...And I don't mean tossing meatballs at each other! Take a minute and try to honestly answer these questions:

*Is mealtime in your household stressful?
*Do you ever find yourself coaxing and bribing your child to just 'take one bite'?
*Did you take the time to prepare a meal for your family only to find your hopes of sitting down with smiling faces shattered by crying, refusal to eat and an overall unhappy experience?
*Do you find yourself having mixed emotions on where to draw the line with what goes on the plate, in the mouth or how much control you should have over your child's meal/intake?
*Does the frustration extend beyond your child? Are you and your spouse/significant other arguing over what the right or wrong approach is with your child?
*Does this tension cause dread and stress for the entire family?

If you answered No to these questions then congratulations, you have escaped an experience that many of us have not been able to avoid at one point or another! If you said "yes" to many of these questions then I promise you...you are not alone! Am I right? I think we all struggle with finding that middle ground with our responsibilities and expectations. Being on the same page with our spouse is a feat within itself. Being on the same page with extended family members and close friends is also a stressor for many. In fact I am sure many of you reading this have heard "He will eat when he is hungry", "Just tell them they can't have that cupcake if they don't try a green bean", or "Take them to time out" about as many times as you wish to hear. Everyone wants to label your child with behavioral problems or as having an issue that lies within the responsibility of the parent. But guess what? That just isn't the case, is it? I wish every one of my own family members could attend the conferences that I have attended, courses I completed in graduate school, read the books that I have read or seen firsthand what I have seen with working with many many families over the years. Those families wish the same for everyone they know.

What we want families and friends to know is something a little different than the disciplinary suggestions we have all been given. We want to turn the Family Food Fight into the Fight for our Family. Since attending courses and conferences and extensive reading is not an option for most then the least we can do for those who could benefit from a greater understanding of feeding development and making mealtimes less stressful is to let them know that you are seeking help and that you trust your resources and need others to trust this as well. If I were one to care little about what my family and close friends felt then I would not be writing an article entitled "Family Food Fights"...but I do, I like to be understood and more importantly I like to get the message to others so they can follow suit when given the opportunity. I have readers and families, including my household, in mind when I write this and I know many of you struggle with these very same issues.

The Facts. You may have read this on a gerber pamphlet or from your local pediatrician but it takes at least 10 exposures of a new food before acceptance of that food. Where do your expectations at mealtime lie? Do you put a new food on a plate and expect your child to take a bite because YOU love squash casserole and simply can't imagine that anyone on Earth would refuse a bite? Is your child thinking "You have GOT to be kidding me, that tablespoon of so called squash casserole looks like something my baby brother expelled an hour ago"...is it the sight of it, the smell of it, the texture? Know your child. Knowing your childs fears and aversions is very helpful in the eating process! If your child already knows that you Expect them to take a bite of that casserole no matter what then you may be setting yourself and your child up for disappointment. Children want to feel that they can accomplish something and they generally love the acknowledgement whether it be a smile of approval, verbal praise or some kind of reward they are working toward. I feel that knowing your child's level of anxiety can be very helpful toward building their food repertoire. You can of course push a little and change things up accordingly, but the point I am trying to make is that we sometimes have higher expectations for a child that may have heightened anxiety in those situations. We can't forget to praise the small steps and use our positive language to talk about the food and not ask impossible things of them. Today they may be o.k. with helping to put the squash in the food processor, but trying that little taste of the finished product may be months, or further, away. It does not mean that we should give up on the challenges, but learn to back away when needed and push when you see an opportunity. If you would like more information for yourself or for others please leave a comment or email me at kris.starnes@gmail.com as I have a few links that may be of interest to you or others.

Its OK to be different!

2011-07-08T09:08:00.000-07:00

Trying a new food or a 'tried and true' favorite with Chopsticks is fun!

The Bigger Picture: Changing your attitude toward mealtime

2011-04-28T12:00:00.000-07:00

I think the best practice for all of us, whether we have a child with food aversions or not, is to put ourselves in their little (or big) shoes. The Big Picture, always about the Big Picture. Our own anxieties and fears as parents feed directly into our children---how does this play out in a child with feeding complications? You want so badly for them to try a food, to eat a certain amount so they can reach a desired weight for their age, but sometimes ignore the fact that eating in itself is Not Enjoyable for them! Therefore the act of “trying a food” can be a really far-fetched idea in many instances. Not only that but it is often not one, but two or three people surrounding the dinner table coaxing the child to try the food and once again, our own anxieties set in and result in an overall stressful mealtime experience for everyone! There definitely needs to be a shift in the thinking here, and not only in the caregivers but also in many therapists treating children for feeding issues.

Here is a great example—a few years ago we had family in town to celebrate our daughter’s 3^rd birthday. We went to a great little seafood place and had some delicious food! My husband was really wishing for Adalyn to try the grilled shrimp but everything on her face said “No!”…thus the coaxing begins, “Just try it, you’ll love it” “Just one bite and then you can__(fill in blank here)” We all know this scenario, right? For a moment I found myself also wanting to appease him as well as the inlaws at the table; however, I knew I didn't expect her start stuffing shrimp into her mouth so I said “Hello? Do you not know anything about what I do for a LIVING, treating very selective eaters? Please don’t worry about her not trying the shrimp” I said we’d just do a seafood or shrimp night one night. Which is exactly what we did! I started talking about it the night before and mentioned it a few more times the next day, took Adalyn with me to the store and started calling out for “Popcorn Shriiiimp, where are you?” We even got some hush puppies since that is always a nice addition to any seafood! We came across some yummy looking breaded butterfly shrimp in the frozen food section and went that route instead of popcorn shrimp. I showed her the tails (on the picture on box) and asked if I could take them off for her, she thought that was the most generous act and thanked me in advance right there in the store “Oh, thank you mommy!”

That night we had a great meal of baked tilapia with butter, lemon, mint from the garden, lots of parmesan cheese, a few new shrimp and some hush puppies! She immediately asked for her ranch—her favorite choice for dipping, especially with new foods, but I asked her if she would try some mango preserves for a sweet dip for our shrimp. She tried it, seemed to enjoy it, but politely declined any additional dips! Only 3 or so bites of the shrimp, but you know what? That’s ok! What a different reaction than the night in the restaurant! She was not prepared for trying shrimp, she shuddered at the thought and there was not much that was too familiar about it to her.

We, as therapists, work with many children whose need for more careful observance of caloric intake are much more important. I am a big believer in finding calorie packed foods that can be added to current accepted foods, I learned this from the beginning of my career and it is a perfect way to continue to allow a child to choose what they will eat and how much they will eat…it just so happens that some of their choices have more calories in them! The outlook I have in many situations is the same, “This too shall pass”, or many small steps toward the bigger picture. And like I said, it’s all about the Bigger Picture.

** I love you dear husband, just using you as a wonderful example!

Fun with Food Facebook Page

2011-02-07T09:05:00.000-08:00

There is now an official facebook page for Pediatric Feeding Support. Just go to Fun with Food-Pediatric Feeding Support and click "like". Hope to see you there!

Breakthrough Moments

2010-12-06T09:03:00.000-08:00

We all love breakthrough moments whether it be in therapy or just in the experiences of life! Lets take the first acceptance of more than one bite of an apple for example. What was 'ok' about the apple or the experience this time around? First of all most of the children seen for feeding therapy do have some inefficient compensatory strategies that are used to manipulate foods and in many cases those patterns appear to develop secondary to abnormal sensory experiences.

Of course some children do have limitations due to issues surrounding strength, tone or range of motion but in this post I am specifically referring to the child who has learned to 'chew' with lips closed, rolling food across the mouth, tongue mashing, 'suckling' food as a result of a combination of factors...not just oral motor. I feel this is sometimes overlooked as a child is put into a category of "sensory" or "oral motor" or strictly "behavioral"....when in fact there is likely many factors contributing.

A child who refuses an apple chunk may readily accept a very thin slice of apple. When looking at strictly sensory you may think "Well, it is visually more appealing, he likes the flat shape" or something to that affect. When looking at strictly oral motor one may say "This is easier to handle from an oral motor standpoint as the flatter, thinner shape is easier to chew".....when applying both sensory and oral motor I can see that the following is also true "The appearance is not only appealing, thus decreasing his anxiety, but he also knows that he can bite AND consistently chew this food creating a more normalized sensory response" The thickness of chunks may be overwhelming from both oral motor and sensory viewpoints resulting in "This is too hard to chew, too yucky feeling in my mouth, too painful to swallow whole...i'll either spit it out or refuse it all together!"

Point being...explore all possibilities and different angles before landing on your own conclusion prematurely! Know your child, observe his whole being, his reactions to sensory stimuli, the types of foods accepted vs the types of foods avoided. This does not always result in a clear pattern and despite identifying your child's favorite spices, flavors, textures, shapes, environments, etc underlying conditions play a role as well. Inconsistent feeding behaviors varying from accepting wide ranges of food one day and next to nothing the next or on another day could indicate gastrointestinal discomfort. This brings me back to the importance of NEVER assuming a child's feeding complication is strictly sensory, behavioral or oral motor. Those who know me know that I am opposed to some of the intensive feeding programs that are out there or behavior approaches that reinforce having to swallow food that is spit out or waiting the entire hour for a 'breakthrough' in which the child is broken down to try a bite. This is not the kind of breakthrough moment I like to experience with my own child or with any child in treatment! I realize each child is different and there is probably a basis for choosing that type of treatment, I hope to encourage parents to have patience as their child learns to eat in a happy and healthy way!

A breakthrough moment for one child may simply be pretending with the food

For another, it is dipping a food into a new sauce!

I wanted to share a sweet story of a little boy and his own breakthrough moment! The fact that these 'new finds' were carried over from the hospital to his home is a very big deal for Jackson and his family, way to go Jackson! Click on Marbles from Heaven to hear about his success!

Adult Picky Eaters--Today Show Article

2010-12-02T04:58:00.001-08:00

http://today.msnbc.msn.com/id/40357712/ns/health-diet_and_nutrition/

Cheers to Firsts!

2010-07-08T15:43:00.000-07:00

Sweet baby girl Lexi trying corn on the cob for the first time!

Planting the Seed

2010-06-09T17:18:00.000-07:00

A LOT has gone on in the last several months, hence my very long delay in posting! My family and I have moved from Asheville to Mount Pleasant, SC near Charleston. It will take some time to adjust to our new surroundings and distance from friends and our Asheville nest. Before jumping right back into work I am hoping to volunteer some time and advice to families here in my new community as I am quickly realizing how many families experience feeding difficulties and how little help is readily available in a convenient location for those families.

I love to observe and people watch and through doing that I see that we are all so very much alike--we all want the best for our children and we all strive for a happy, functional life. I am thankful for the many experiences I have had with children and feeding complications over the last 8 years because those experiences have helped me so much with my own daughter! I do feel that we, as parents, put a lot of pressure on our children to follow through with all of our expectations. We can plan for the scheduled meals and snacks with plenty of opportunity for hunger to try new foods or eat what is 'on the menu' , but when it comes right down to it, we tend to forget all of the other factors. For instance--if you have been thinking of PF Changs hot and sour soup and honey chicken all day long and your husband brings home take out BBQ--doesn't it take you a while to adjust to the idea of bbq sauce over soy sauce? We only wish we were 3 years old so we could shout "But I don't Want BBQ for dinner!!!!!!" Or if the pollen has taken over your ability to breathe and sinus drainage takes all of the enjoyment out of any food that doesn't meet your specific requirements at that given moment. We don't always need or want to explain why we want a sleeve of saltines and a REAL coke versus pink lemonade and cottage cheese. We just know that the pink lemonade and cottage cheese would make us vomit and send us running. I am not saying that every situation is like that with your selective eater. What I am saying is that we need to constantly evaluate and learn from our own preferences.

There is a lot to be said about mental preparation and planting the seed. Lets say you want to cook pork chops one night. My daughter loves chicken but she has never had pork chops, so pork chops would be a similar meat in appearance, taste and texture and a good choice for a family meal. I would go ahead and tell her that we are having pork chops "the other white meat" for dinner one night this week. I remind her again that day and I choose some small jobs in the kitchen during dinner prep. If I just threw the pork chops on her plate for dinner she might not be as receptive to actually tasting the pork chops. Take a child with a history of feeding difficulty or selective eating and you can almost guarantee refusal of the pork chops being within sight or smell.

So I challenge you this week to approach new food and new ideas in a new way...and start by planting the seed today for what might happen tomorrow or the next day. Enjoy the journey!

Fun with Food!: Little Blessings

2010-05-16T16:09:00.000-07:00

Fun with Food!: Little Blessings

www.carolinapeds.com

Little Blessings

2010-05-08T11:17:00.000-07:00

Thank you for sending in these photos! I will love having these pictures to look back on and remember all of the fun (and challenging) times in therapy. So many of these pictures really capture their awesome little personalities--love it! I will add more as I get them. I have loved working with the team at Carolina Pediatric Therapy in Asheville--a special thanks to all of you and to the families for making my job so enjoyable!

Potato Mice

2010-05-02T12:18:00.000-07:00

Here is a fun recipe to try with your little one!

http://family.go.com/food/recipe-ak-796467-potato-mice-t/

Thanks Althea for sharing the Potato Mice recipe found on the Disney website. Her little one enjoyed feeding the mice some cheese and although he may not have been ready to chomp down on these cute little critters quite yet...he enjoyed helping his momma in the kitchen and that enjoyment plays a big role in his feeding development! Check out Althea and Ty's creation:

**Instead of using toothpicks to secure the nose, Althea reserved a little of the potato mixture to 'glue' the noses onto the mice.

Carolina

2010-04-27T15:04:00.001-07:00

I wanted to send out a special thanks to all of the families that I have worked with in Western North Carolina. I will miss you all so much and you have touched my life in a way I will never forget! I wish I could take you all with me to Charleston! I hope to post some pictures soon. Keep up with your hard work and remember to enjoy the special little moments every step of the way... even when you feel you are miles away. "Faith is taking the first step when you cannot see the entire staircase" --Anonymous fridge magnet :)

***Western NC--send me a favorite picture of your kiddo for me to post!

Eosiniphilic Esophagitis--CHOPS study of possible allergy gene identified

2010-03-11T04:56:00.000-08:00

Click on the link below to read the post from Food Allergy Assistant:

http://www.foodallergyassistant.com/2010/03/allergy-gene-identified.html

Steps to Successful Feeding

2010-02-10T15:23:00.000-08:00

Listed below are ways to create a positive feeding experience for your child, starting with early feeding experiences. It is important to realize that the caregiver and child both have different roles and responsibilities during meal time and showing respect for your child’s choices leads to trust and increased success.

Let your baby guide you during meals. Wait for cues that let you know he is ready for a spoonful and avoid force-feeding. If your child is refusing food, force feeding will only result in further refusal. There may be an underlying reason for the refusal and you should consult your feeding specialist for further evaluation.

Messy, messy, messy! Put the ‘clean freak’ side of you aside and allow your baby to make a mess. Exploring food textures is part of the feeding experience and you will be surprised at what your child will be willing to eat when he is allowed to have some independence!

Give choices and offer a favorite food in addition to new or undesired foods. Make realistic expectations. It may take several tries for your child to accept a new food. If he refuses the first presentation, continue to offer the food and incorporate it into several meals.

Pair a new food with an accepted food. For example, if your child loves to munch on club crackers, mash a new, soft fruit or vegetable on the cracker or dip in various purees or dips. Place it on the tray for independent feeding.

The parent’s role is to provide the choices for the meal and to decide when and where to eat. The child’s role is to decide what and how much to eat. If your child is taking an inadequate amount of food, provide plenty of encouragement but do not force. Seek professional help if your child continues to refuse foods.

Provide regularly scheduled meals and snacks and stick to your routine. Research has shown that children who ‘graze’ throughout the day with eating end up taking in 25% fewer calories.

Eat together as a family. Children learn from watching others and keeping a meal time structure at home is a vital part of the feeding process.

Schedule play dates for your children and create an opportunity for the children to watch each other eat.

Talk about food and interact with it in other ways than just eating. Feed the ducks at a local pond, plant a garden in the back yard, take a stroll down the produce aisle, and build food creations at home.

Remember to be patient with your child’s feeding. If you are stressed out, he will be stressed out. If his anxiety is up and that anxiety is created at each meal, then the stage is already set for unsuccessful feeding. Start now by creating positive associations and a laid back feeding environment.

Kristina M. Starnes, M.S. CCC-SLP

Speech-language pathologist specialzing in Pediatric Dysphagia

Q&A--What types of cups should I use with my child?

2010-01-27T19:37:00.000-08:00

Q: What type of cup or sippy cup should I be using with my 12 month old son?

Hi! I would first begin working with open cup and straw drinking. I use yogurt drinks, baby food puree mixed with formula, milk, or water and sometimes powder pudding mix for beginning cup drinking. Thickening slows the flow allowing some independence while learning as well as practice with lip closure. You can gradually thin the liquid as he becomes more efficient.

As far as sippy and transitional cups, I like this one without the valve, playtex tumbler....http://www.amazon.com/Playtex-Coolster-Tumbler-Sippy-Girls/dp/B0011E4HBM as it is similar to open cup and does not require as much suckling when valve is out. Also the toss and go cup he was using at school was fine too as well as straw cups...You should allow him opportunities for open cup drinking and sippy without valves. The suction required for sippy cups, especially with valves, often results in the same suckle pattern with manipulation of foods requiring a consecutive lateral munching pattern. I also like this one: http://citikids.com/ProductImages/24026.1.jpg I forgot about those! I need to get those for my daughter for school :) That was Munchkin brand and so is this one: http://usera.imagecave.com/loveski777/Munchkin%20Dora%20Big%20Kid%20Cup.jpg You can also take valves out of this one as well.

Pizza Chefs!

2010-01-19T15:13:00.000-08:00

Vanilla Pudding Cups with Pomegranates and Oranges from Green Lite Bites

2010-01-19T11:03:00.000-08:00

http://greenlitebites.com/2010/01/17/pudding-oranges-pomegranates/

Email Responses to Families--Establishing your Routine

2010-01-18T16:41:00.000-08:00

I have several 'long winded' email replies to some of the Asheville and Western NC families I work with and I thought it might be helpful to organize some of these responses into a more general response for anyone who is searching for some help. I have a list of great resources and blogs on this site and I encourage you to check them out. It has been really nice to find other therapists out there who share the same beliefs and I feel confident in their methods so please check out their posts, articles, books, etc for additional learning as well as some of my older posts. I will try to post a few email responses over the next few weeks. Here is the first (name changed):

"First of all I know dinner time can be anything but enjoyable at times. Not only for you guys who are faced with the challenge of having a very selective eater, for a lot of families in general. I suggest taking the time to fall into a more relaxed, somewhat predictable routine. This could be Sam watching a movie while the meal is being prepared. I would also start talking about what you are having for dinner at the start of the day “Its fish night Sam”-- talk about it again on the drive home from daycare. Stay positive!

Little jobs in the kitchen…can be as simple as Sam picking the plates or pushing some buttons on the microwave. Sprinkling some cheese on the quesadilla, shaking some salt or seasoning on one of the dishes. This will help him feel like a pretty big helper and hopefully be the start of a more relaxed mealtime for all of you. Over here we sometimes turn on the music at dinner or have a candle. The point being to create the routine so he knows what will happen next First this, then that, then time to eat….You want this to be as free of stress as possible and start turning the process into one you all look forward to. I know it feels like so much of a hassle at first but this will get easier. You will probably find your own routine and way to de-stress everyone. I do think it’s important for us as parents to keep the stress out of our lives so the kids don’t pick up on it. For some this may be a walk around the neighborhood (depending on how hungry everyone is and the amount of time you have), for others it may be sipping a glass of wine while preparing the meal or turning on some favorite music.

We talked about some ideas for these dinner time meals today. I’ll make a list of some ideas for you and you can go from there:

“Chicken Night” chicken tenders, sweet potato fries, green veggie (you can substitute different potatoes, fries, tator tots and different chicken for other nights)

“Quesadilla Night” keep it simple, cheese quesadilla. Make another with finely chopped meat or veggie. Refried beans for ‘dipping’ quesadilla or chips

“Breakfast for Dinner Night” Pancakes, bacon or ham—maybe crispier the better right now. Try the savory waffles from www.pickytots.blogspot.com. You can just use a Just Add Water pancake or waffle mix with some chopped or puree veggies and seasonings. Ketchup to dip …why not? J

“Fish night” --he has been eating Dr. Praegger’s ‘fishies’ You could try something in a breaded filet form or serve fish nuggets along with your veggie or other food.

These are foods that are somewhat familiar to him but ‘a little different’ so you may not see a lot of interest right off the bat but it is a good way to introduce food family style. Don’t put too much pressure on yourself for things to be perfect or for him to eat a certain amount. Shift your focus over to creating more of a positive experience for him. You are doing that with the routine, the conversation and meals that are not too far- fetched of a possibility for him. He will get there, it is going to take time but he is already doing some great things in a one on one situation…please please don’t get discouraged that he is not carrying those new foods over right away. Or that he won’t try things in restaurants or pot luck situations…one step at a time, this too shall pass! So start with one goal in mind….”Chicken night” I would show him the chicken before you put it in the oven, before that you can start talking about what you’re having for dinner, then have him pick out his plate and utensils…talk about how he can dip the potato pancakes or tator tots or sweet potato fries (whichever you are having) in ketchup. This helps plant the idea and image in his mind…making it more likely that he will want to try these things that you talked about. Don’t beat yourself up over the fact that he may refuse his food. Like anything else a new routine will take time. I would also give him a small portion of crunchy food to ‘wake up his mouth’ and possibly something to chew on during the meal. He did this over the last 2 sessions and I feel he responds well to that additional sensory feedback. You could even give him a few crunchies between some of his food. Have a great week!"

Here is a short video clip of my little helper in the kitchen. You can always see the satisfaction in her smile when we sit down to eat and I say "Guess who made this pasta? She pushed the buttons on the microwave and even stirred in the butter and cheese by herself!"

Happy New Year!

2010-01-02T15:32:00.000-08:00

I had to type out this lettuce wrap recipe before I forgot--its so very yummy! An evening of PF Changs will leave you longing for more so I bought the lettuce and some crunchy rice noodles for an added 'crunch' and figured I could come up with the sauce out of surprises in the fridge and pantry! I was especially happy that Adalyn wanted to make wraps with me and she enjoyed making 'baby wraps' and later came up with her own idea to add shredded cheese to a few. I definitely recommend having your child make the small baby wraps, even as small as the size of a quarter for starters! Just enough to crunch and you have to admit, small cutefood is sometimes more fun to eat-- especially when it is new!

What you need:

Iceberg lettuce leaves
1 tablespoon sweet chili sauce (or regular, but we had this on hand)
1 tablespoon soy sauce
1 tablespoon low fat Newman's Own Sesame Ginger dressing
4-5 chicken tenderloins
1/4 cup or less diced green onion

Cut chicken into small pieces, saute in olive oil in pan with the green onions
After chicken is cooked, mix in the sauce
Sprinkle sesame seeds on chicken
Scoop chicken onto lettuce leaf and wrap---make extra sauce for dipping if you please!

We really loved these!

***We made these again later in the week and added about 1/4 cup of grated carrots to the saute pan as they are a new food for Adalyn and they tasted great in this recipe!

Holiday Cheer!

2009-12-27T19:49:00.000-08:00

Adalyn and her Nana enjoying the cookie making process!

A Son's Message of Patience with Trying New Foods

2009-11-14T05:05:00.000-08:00

The following video is a message from a child with Autism. Take a few minutes to listen to his precious words and allow his honesty and message of patience to be a lesson to all of us! Thank you Jake--you are putting into words what many children cannot and I'm proud to feature you on my blog!

"Waffle Hash"

2009-11-13T06:14:00.000-08:00

I wasn't sure what to call this one. This is what I came up with when combining frozen hashbrowns, a few turkey sausage links, pancake mix, sharp cheddar cheese and some seasonings. In several of my other posts I have mentioned the fact that some children need and desire foods that offer more sensory feedback. These crunchy waffles have protein, starch, dairy and fat all in one nice little Crunch!

Since this was more of a Use Whatcha Have kind of recipe I will approximate the measurements to the best of my ability!

Grind sausage (or your preferred meat/protein) in Magic Bullet or processor
Approximately 1 cup pancake mix (I used the 'just add water' mix)
1 cup frozen hash browns, thawed
2 tbsp water
1/4 cup sharp cheddar cheese
dash of Lawry's seasoned salt

These were very good and crisp! We made Adalyn's into a waffle tower with a few dabs of yogurt butter and cheese.

Easy Dairy Free Pumpkin cupcakes

2009-11-13T06:03:00.000-08:00

Looking for a yummy dairy free dessert for the holidays? Some Duncan Hines brands are completely milk free--be sure to check labels! Another favorite is the spice cake mix. You can add some canned pumpkin to the mix for added nutrients and flavor, yum!

Don't ask me why this "Buttercream" frosting happens to be milk free but it is and its good! We also mixed the pumpkin and frosting together for a 'pumpkin mousse' topping for some of the cupcakes...or hey, just eat a little of it by itself! Some of the little ones who have not yet developed the ability to chew may love it!

Visual Learning!

2009-11-01T16:21:00.001-08:00

I am trying to capture realistic opportunities for the parents who cannot be a part of weekly feeding sessions to implement at home…both on video and in writing. I am hoping that others will find this beneficial as well. I am considering posting more video of some food prep with my daughter helping or just simple ‘how to’ videos of food that was targeted during a session. The video serves a dual purpose—watching the video with your child can plant the seed so to speak. He may feel a little more anxious when not knowing what to expect and often being in the same vicinity as the undesired food triggers anxiety. Video on the other hand is a safe way to explore what would otherwise induce anxiety. Watch a video, talk about it and give it a try! I also feel it is important to do what you can to mentally prepare your child for any new food or change. I talk more about this in an example given in the post entitled The Bigger Picture.

Back to the topic of video learning—I recommend that parents of these very selective little ones watch some of Roni’s videos with her son on her website GreenLiteBites. She has so many great video clips of how food exploration should be! I came across this particular post Crazy Fruit Day the other day and wrote to her immediately asking if she would mind if I linked this video to my site. New fruits, new experiences, no pressure---this is hard to teach! Positive outlooks are so contagious! So I encourage you to watch this video and first and foremost take note of the comfort level between both parent and child in relation to the food. With a child who has a hard time getting past even touching or smelling the food you take several steps back…maybe talk about the color and the shape and use your own judgement with setting your expectations beyond what you feel is his level of comfort. This will pay off in the long run! It can be easy to confuse “What you Know you need to target” and “How to target”…for example you may know that your child is having a very negative response to your requests to touch a food. This is because it is being asked of him and his anxiety is still pretty high. Incorporating these sensory steps is also a process as is eating. Instead of saying “Can you touch the food?” you could try asking your child to hand you pieces of food or help clean up as well as incorporate other nonfood sensory play: play dough, rice or bean box, shaving cream, textured balls and other toys, etc. There are many articles on these topics and websites dedicated to sensory integration that may be very helpful in your child’s acceptance of food and the many steps involved in eating.

Pediatric Basics--The Journal of Pediatric Nutrition and Development

2009-10-22T09:18:00.000-07:00

This is a wonderful resource for anyone, especially pediatricians who would like to learn more about pediatric dysphagia. I encourage you to read this as it includes a great summary of oral and sensory motor feeding development as well as a few one page articles related to Understanding Why children Won't Eat and How to Help, Treating and Preventing Food Jags and Putting Research Into Practice .

http://www.arslpedconsultant.com/documents/Relevant%20Reading/Ped%20Basics%20Feeding%20Gerber.pdf

Thank You

2009-10-21T21:02:00.000-07:00

I wanted to post a special thank you to Alisa Fleming of godairyfree.org who featured an article of mine entitled Food Allergies and Intolerances and their Impact on Feeding. Her post can be found at http://www.godairyfree.org/200909303749/News/Nutrition-Headlines/Food-Allergies-or-Intolerances-and-Their-Impact-on-Feeding.html

Alisa's website features many vegan, gluten free and casein free recipes that many of you may find helpful in your dietary challenges! Take a look at the Top Ten Cutest and Tastiest Dairy Free and Vegan Halloween Treats for 2009!

Favorite 'crunchies'

2009-10-20T12:46:00.000-07:00

These are a few favorite 'crunchy yet dissolvable' picks for working on lateral munching skills, transitioning to fruits and veggies (pairing the veggie crunchy foods with soft or pureed fruits or veggies of similar color) and 'waking up the mouth'. Very tasty too!

Little Chef of the Week!

2009-10-15T14:59:00.000-07:00

If you have a little girl then you are probably familiar with Pinkalicious, the tale of a little girl who can't stop eating pink cupcakes despite the warnings from her parents. This is one of my daughter's favorite books...that and of course Purpilicious!

Pictured below is sweet 4 year old Caroline from Arkansas making her very own Pinkalicious cupcakes! The results look...well, pinkalicious for lack of a yummier description! A special thanks to Caroline's mother who took these great pictures and shared them with me! If you have a picture you would like to share feel free to email it to me and I will be sure to post it!

Turkey Nuggets

2009-10-15T14:38:00.000-07:00

Simple and daughter approved!

1 package lean ground turkey (1-1.5 pounds I believe)
1/4 cup egg beaters or 1 egg
1/4 cup Sesame Ginger Dressing (use any type of vinaigrette or favorite dressing)
1/4 cup bread crumbs

Spray muffin tins with baking spray. I used a mini muffin tin and a regular tin, filled both up with none to spare! Pack each tin approximately 2/3 full. Bake at 350 degrees for 25-30 minutes.

Fun with food!

2009-09-29T13:41:00.000-07:00

These pictures say it all!
GROW a garden, EAT your garden, TEACH someone about your garden, ENJOY food, Be Princess Nugget if you wish! DISH OUT a bowl of chocolate pudding for your little one learning about food, DONT BE AFRAID to get messy! HAVE SOME FRIES in your hospital bed because you want something you know you like..salt! MAKE A BOWL out of your own avocado and dig in! POPSICLES in the yard with your friends! BE CONSISTENT with your meals and snacks and pick out a fun dinosaur placemat if you wish! GO AHEAD and buy that cotton candy at the fair..gotta love the experience!

Snippets of Success

2009-09-28T14:29:00.001-07:00

After attending an awesome Food Chaining workshop with presenters Cheri Fraker, Laura Walbert and Sibyl Cox I felt compelled to share some of my own home video clips of me working on some new foods with my daughter. I have said to my families many times that the kids I work with often surpass my own child in terms of food repertoire simply because I do not take the time to work one on one with some difficult 'new' foods! Aren't we parents all guilty of that? Despite what we know we sometimes like to take the easy way out. On a good week I love to have Adalyn help in the kitchen (especially where new foods are concerned) and we make an effort to sit down and eat as a family in the evenings to enjoy each other and our meal. In this video we are using an activity for positive reinforcement, but it is not an expectation for the food to have to be eaten--however the foods are a variation of something she already accepts so it is likely that she will want to try them. For example Adalyn loves pancakes and loves frozen blueberries but will typically refuse a blueberry pancake. In this video she chooses a blueberry pancake cut into a butterfly shape (cookie cutter) and is also given some other new food choices such as sweet potato fries, spinach artichoke nugget and veggie mac pasta with spaghetti sauce. My therapy tools are novel to her as they usually stay in my office or car, so that was a bonus in her willingness to try new foods.

Aside from my training and experience at Carolina Pediatric Dysphagia in Raleigh I came across a great resource, a gigantic book entitled Pre-Feeding skills. I was familiar with the book from my time at Arkansas Children's hospital as a graduate student, but I really grew to use this resource when I had 8 feeding patients per day in Raleigh, all with varying needs. The more I read and practiced this in daily therapies or evaluations, the more it just made sense to me and the easier it was for me to sort of 'weed out' other beliefs and practices from various feeding experts, but incorporate certain aspects of other therapies into my own. It was clear to me that the clinic in Raleigh practiced in this same way and we all learned from each other, sharing ideas and techniques. The authors Marsha Dunn Klein and Suzanne Evans Morris' outlook on feeding and the whole child approach is one that I have come to feel is necessary and have since felt about very passionately. As I am sure my Myer's Briggs "INFP" description (the idealist) would justify this calling! The truth is, folks, it is real and if I didn't feel it was right I would not be able to freely write without having 'writer's block'. I am sure there are many grammatical errors--please ignore!

When I worked in Raleigh I caught on to the fact that a child had less anxiety with foods that were similar in some ways to foods that they already accepted. I was also directing families to the article Expanding Children's Diets on a regular basis as I felt it was important for them to understand the need for a child to feel that comfort and safety with foods and approach their feeding concerns in a non threatening way. There is of course more to it than this and I strongly encourage anyone who has a child with feeding difficulties to seek out help from a speech-language pathologist and/or occupational therapist who has a similar philosophy as hopefully you will find on this site and others. So...Later I find out that these 'similar properties' are the same concepts in Food Chaining. I KNOW this because I attended a course over the weekend! So if you happen upon my site please check out their book and website at cheriandlaura.blogspot.com.

I hope you enjoy the video clips! Please don't wait for help if you find you really need it. Another point that was reiterated at the conference I attended...one that also stood out to me at a Kay Toomey conference and I feel has become part of my 'evaluation speech' and training for other feeding therapists for the last 5 years is "Only 3 percent of children with feeding difficulties are truly behavioral in nature. 3 percent" So find your support team, they are out there! Althoug I miss my time in a pediatric feeding clinic in Raleigh and am so grateful for my experience there, I now work with a fantastic team at Carolina Pediatric Therapy and we all turn to each other for consulting and help within the various disciplines!

Here we are collecting items for our 'lunchbox'--a cute game one of my therapy families found and laminated for us to use!

Taking turns!

Recipes

2009-09-18T08:39:00.000-07:00

Click on the pictures or the recipe name below for the recipes

Chic ken BOPPS

Seasoned Butterbean dip

Savory Veggie Waffles

Crunchy munchy peppers for dipping

Oven Baked Squash Fries

Crunchy vidalia onion dressing chicken

Samurai veggie meatballs

Veggie Surprise mashed potatoes

Reuben cups

Fun "sushi" rolls

Crunchy spinach cakes

Indian inspired Squash recipes

Turkey Nuggets

Waffle Hash

Easy Dairy Free cupcakes

Lettuce Wraps

Squish your Squash Indian style!

2009-09-18T06:47:00.001-07:00

As a first time gardener this year I grew an abundance of 'accidental' garden surprises...including pumpkins. Many many pumpkins! This first recipe was inspired by a friend of mine, Tina, who told me about the wonderful squash fritters she made for her family. Tina is one of my most creative friends and she and her husband are always coming up with the greatest ideas whether it be a recipe, party theme, creative art or halloween costumes for themselves and their children---as evidenced by last Halloween's costume, can you guess which soft drink she is representing?

I have adapted the recipe in order to make use of one of our pumpkins as well as satisfy my craving for curry that day. Tina says there are several squash fritter recipes online and you can change them up to fit any mood including Italian, Indian or Seafood. These fritters do resemble a crab cake so she and I were thinking of making a seafood feast one night during one of our get togethers--just substitute the other spices for some Old Bay for a seafood twist!

Indian inspired Spaghetti Squash and Pumpkin Fritters

½ small pumpkin (approximately ½ cup)

½ large spaghetti squash (approximately 1 cup)

Salt and pepper to taste

2 tbsp Indian seasoning (I had Kohinoor brand Sheek Kebab Special in the pantry)

¼ cup egg beaters or 1 egg

¼ cup whole wheat flour

Mix all ingredients together. Form into patties and roll in breadcrumbs. Pan fry in tbsp of olive oil, flip after approximately 3-4 minutes on each side. Serve warm and crispy!

Well I didn't stop 'squishing squash' there since I wanted to use the remaining half of the spaghetti squash. I plugged in the Magic Bullet and made a great curried squash bisque--without the use of any dairy. This was very simple and very tasty! Adalyn had a few spoonfuls but I actually had myself in mind for this recipe. I know one of my favorite little patients will like this one though!

Curried Spaghetti Squash Bisque

1 cup spaghetti squash

2 tbsp water (add more or less depending on desired consistency)

½-1 tsp yellow curry (depends on your taste!)

1/4 teaspoon coarse sea salt or kosher salt

Blend first 3 ingredients (I used magic bullet), add seasonings

Homemade Happy Meals

2009-09-09T12:46:00.000-07:00

Who doesn't love a happy meal every now and then? We thought it would be fun to create our own happy little box and fill it with some food samplings for a picnic! Our box--a cupcake box-- is very simple with some hearts and butterflies but you could go crazy with characters and personalize this in whichever way you please. In the next few weeks I will be personalizing a few boxes for feeding therapy patients and will include small portions of their new foods. Adalyn's box had a small dish of boca burger, blueberries, cheese and a fruitaboo. Happy Eating!

Breakthrough Moments

2009-09-08T15:10:00.001-07:00

Local Locomotion

2009-09-08T11:56:00.000-07:00

This week I wanted to spotlight a local bakery which provides an option of gluten free, dairy free and vegan goodies! So if you live in Asheville head on over to 225 Haywood Street where you will find Jodi Rhoden and her talented crew at Short Street Cakes ---not to mention a variety of yummy goodness.

When a child (or parent) has made the decision to eliminate dairy, gluten or eggs from their diet for their own elimination trial it is always a good idea to have some exciting and delicious alternatives on hand. Treat yourself to a dairy free cupcake for instance! Having a substitute treat makes the dairy free (or gluten free, egg free, etc) transition much easier. Bring on the Cake!

Photo credit: Becca Johnson, courtesy of My Life in Cake

***A message from Short Street Cakes: because we do bake with dairy and wheat on a daily basis, we are not a dedicated kitchen and cannot guarantee a 100% “sterile” gluten-free or vegan product.

New Foods in New Ways

2009-09-03T14:02:00.000-07:00

If you are asking yourself "Are those skewered green beans?!" the answer is Yes! They are. Sometimes it pays to be weird--or non-traditional I should say-- and when it comes to new food for your cautious child food kabobs can be a wonderful thing! Not only is the food presentation novel and fun, but eating food in this manner is also easier for a child who has a difficult time with food textures on hands. Sure you are working on goals to help your child tolerate food on hands, but for introducing very new foods just the simple novelty of the way in which a food is presented can help decrease anxieties.

Try this at home: Does your child have a favorite food? How about a certain food you are trying to introduce? Why not take those 2 foods and make a kabob? In this picture you can see the cheese, representing the favorite, and the blackberry, representing the new food. I'm going to pretend the child already eats something similar to a blackberry, maybe a blueberry or other berry, so it is not too scary for him when he sees it. The blackberry is placed in the middle so that after the favorite food is eaten off of the end, he somehow has to bypass the blackberry to get to the rest of the cheese! Maybe he'll eat it, but more than likely he will slide it off as quickly as possible :) How bad does he want the cheese? Bad enough to slide it through the blackberry juice? See where I am going with this? If he eats the cheese off of the skewer that is considered success because the blackberry is on the very same toothpick. If he slides it through the blackberry juice then eats the cheese that is HUGE. Remember the older post about seeing the Bigger Picture? Well this is a step toward getting there!

If you have a great food presentation idea I'd love to hear about it! As you may have noticed with your own child, many babies have aversions to utensils and shudder at the sight of a spoon. Try using graham cracker sticks or other foods as a 'spoon' to dip into other foods or dips. My daughter likes to use a little appetizer fork that we purchased at World Market. Its metal just like she sees mommy and daddy use all the time and it is her 'fancy' fork so that makes it extra special. The bamboo forks and toothpicks in my pictures are also from World Market. In the spirit of non-traditional food presentations and utensils I used the wine bottle cheese tray just for the pictures! My mother makes these in her kiln using recycled wine bottles and I wanted to show mine!

Crunchy spinach cakes

2009-08-31T15:29:00.000-07:00

These are so good! Another panko crusted oven creation that is fun for the whole family! I am bringing these to therapy sessions this week and so far they have been a success. I suggest serving them with a favorite dip--today the preferred dip was Catalina dressing. My daughter chose Ranch dressing (of course-- I would expect nothing less from her when a new food is concerned!)

Recipe:

1 package frozen chopped spinach, drained and water 'squeezed' out
1 egg
1/4 cup grated parmesan cheese
1/4 cup whole wheat flour
sea salt to taste
1/4 cup panko bread crumbs

Beat egg and mix parmesan cheese and flour into egg mixture, add spinach and form into small 1/2 dollar size patties
Roll each patty into panko crumbs, add salt
Bake at 375 degrees for 15 minutes on a foil lined sheet sprayed with olive oil or other baking spray. I flipped these halfway through to ensure a good crisp!

Makes approximately 20 half dollar size patties.

**** To make the egg free version of this recipe I used 2 tablespoons of vegan canola oil based mayonnaise in place of the egg

** Delicious change: Add approximately one large tablespoon of goat cheese to this recipe! I also substituted chopped kale for the spinach and it was delicious!

If you enjoyed this recipe, Try another crunchy green snack from Meghan Telpner: Crispy Crunchy Kale Chips

Panko Paradise

2009-08-31T15:20:00.001-07:00

If I knew how to insert audio clips and sunbeams I would try my best to recreate National Lampoon's Christmas vacation scene. You know the scene...Clark Griswold and family stumble upon "THE" perfect Christmas tree and the light beams are shining down in conjunction with a gigantic harmonic Ahhhhhhhhhhhhhhhhhhhhhhhhh!!!!!!

Well, this is how I feel about Panko bread crumbs and successful new food creations lately. I even decided to dedicate a spice jar JUST for Mr. Panko---welcome to the spice jar family!

"Sushi" rolls

2009-08-17T16:31:00.000-07:00

After meeting a friend for sushi today I got into one of my experimental phases...go figure! While the chicken was in the oven I glanced over and noticed the box of Fruitabu 'smooshed fruit' rolls in the pantry. There was an abundance of Apple at Amazing Savings in Asheville this week (maybe this is not a favored flavor!) and I thought...what a great 'roll' for faux kid-friendly sushi rolls!

I took some of my daughters favorites out of the fridge including deli ham, laughing cow light cheese wedge and some avocado slices. Placed a little of each in 3 separate 4-5 inch fruitaboo strips, which was equivalent to the length of one pre-packaged roll. Add some crushed cracker crumbs for Tempura and Whalla! A little shudder on the first bite but with a few changes (smaller rolls, less filling) this could be a Thumbs Up for the future! I used avocado for the 'wasabi' garnish and more ham for the 'ginger'.

Pudding and Prayers

2009-08-16T13:44:00.000-07:00

The sweet little "cover girl" on my blog is a patient whose mom has given me permission to post pictures. She is recovering from her 3rd open heart surgery in Boston and has experienced some complications including infection, elevated heart rate and fever spikes.

Please keep this little girl and her family in your thoughts and prayers so they can all find the strength to push through each day! Here she is re-discovering the joy of chocolate pudding :)

All Natural "Sprite"

2009-08-03T11:27:00.001-07:00

Since I have decided to "eat clean" (for the most part) I wanted to find a satisfying replacement for cola. I was also inspired to do this because my daughter recently discovered the joy of Sprite while traveling to the beach this weekend. Sprite and other carbonated beverages are a big staple in many diets of the kids seen for feeding therapy--they do give a great amount of sensory feedback and 'wake up' the mouth. Since many families are seeking a more natural alternative, however; I feel compelled to share any new discoveries that may be helpful!

Carbonated water, lime juice and a stevia packet is the concoction that I made for myself. I found some canned drinks, La Croix, which is made up of sparkling water and natural lime. There are no artificial flavors or sweetners nor are there any other sugars, 0 calories. I bought these because of the green shiny can! I thought my daughter would enjoy the fact that it looks like a cola. She did not like it plain but did take a few sips when mixed with juice and again when I added a slice of lime and the stevia. Lets face it it is not going to be the same as a yummy cold Sprite but it sure is close!

Introducing First Solid Foods

2009-07-21T16:37:00.000-07:00

A few friends have asked if I could post on the subject of introducing solids: How, When, What to Expect. I wanted to write out a few of my thoughts on the subject. If you are the parent of an infant you can start right away by giving your little one oral stimulation by means of gum massage, tongue strokes and stimulation that help build oral awareness. Give your baby firm kisses around the mouth and playful taps with your finger while singing familiar songs. Although your baby may not be ready for solids you are creating positive oral experiences by doing these simple motions.

Allow your baby to explore orally with different teethers, Nuk brushes and textures. I love the vibrating teethers that are available in stores such as Target, Wal-Mart, and Toys R Us. Check your local pharmacy for the hummingbird vibrating flosser--I have so many patients that love this quiet steady vibration that can be added to spoons, nuks or just held by hand. I use a product called Z-vibe with several kids in therapy but it is not always necessary to buy expensive products when there are others readily available and more affordable. These nuk brushes and teethers will come in handy when it is time to introduce your baby's first cereal!

The general consensus in the medical field is to introduce solid foods no earlier than 6 months of age. I won't go into much detail regarding that statement but would like to attach a portion of the July 2006 issue of The American College of Asthma, Allergy, & Immunology. This organization developed a consensus document for introducing solid foods into an infant's diet to avoid development of food allergies, and they published the new guidelines in the July 2006 issue of the Annals of Allergy, Asthma, & Immunology.

Specific recommendations are as follows:

During the first 6 months of life, exclusive breast-feeding is recommended, with exclusion of cow's milk formulas and any supplemental foods. Exclusive breast-feeding protects against the onset of allergic symptoms extending far beyond the period of breast-feeding.
Complementary feeding of supplemental foods can be introduced starting at the sixth month of life. Introducing supplemental foods during the first 4 months of life has been associated with a higher risk for allergic diseases up to the age of 10 years, which confirms current WHO recommendations.
Exposure avoidance is an effective means of preventing cow's milk allergy. By extrapolation, delayed exposure to solid foods should prove to be similarly useful in preventing food allergies.
In the developed world, the main foods posing an allergy risk are bovine milk, egg, peanut, tree nuts, fish, and seafood. If introduced early, other foods can become clinically significant allergens. Therefore, it seems reasonable that foods should be introduced individually and gradually.
Mixed foods containing a variety of food allergens should not be given unless tolerance to every ingredient has been determined.
For processed foods, such as beef and kiwifruit, that are less allergenic when cooked, it is preferred to serve these foods cooked and homogenized.

In addition to this information the consensus statement recommends that "pediatricians and allergists should cautiously individualize the introduction of solids into the infants' diet. For infants at high risk for allergy, the optimal age for the introduction of selected supplemental foods should be 6 months; 12 months for dairy products; 24 months for hen's egg, and at least 36 months for peanut, tree nuts, fish, and seafood."

You are now ready to introduce your baby to solid foods and you ask yourself "How exactly should I do this?" This is where the nuks and teethers will have come in handy! We often think we need to do everything "by the book" but when it comes to parents of children who have had a very difficult time with feeding, this is not always the case. Place a small amount of the cereal and milk mixture on your baby's favorite teether for self exploration. The idea is to keep things familiar to him and to avoid a lot of suprises. It can also be helpful to pre-blend dry cereal so it results in a smooth puree when the liquid is added. Offer tastes on your finger, nuk brush, teethers and even your child's own fingers. Gradual exposure to the food can be very helpful in the long run! Use these opportunities to focus on the experience and not the volume. As he becomes comfortable with the tastes he will be more receptive to larger quantities on the spoon.

While we're on the topic of spoon feeding I'd like to point out that there is actually a 'better' way to spoon feed than to simply put the food anywhere in the mouth and scrape it on the roof of the mouth. Most people spoon feed that way so that is why I am mentioning it! Wait until your baby opens his mouth then place the spoon directly on the tongue (anterior-middle part) with a small amount of pressure to help elicit a central groove (the groove in the tongue helps with organized collection of the food bolus) This technique may not sound all that important..."Hey, he's opening his mouth and swallowing, what more do I need?" .... but since I am keeping babies with inefficient oral motor patterns in mind I wanted to give that brief description of typical tongue patterns for feeding. Wait for your baby to bring his top lip down to meet the spoon and clear. Good luck on your journey!!!

**For additional reading on the importance of coordination and feeding as well as suggested feeding tools/ products check out this fantastic post by Cheri Fraker over at cheriandlaura.blogspot.com entitled "Treatment Summary for the First Year of Life"

Reuben Cups

2009-07-20T10:24:00.001-07:00

Ok, Now I know that there is nothing about a recipe involving sauerkraut that screams "Picky Tot Friendly" but I have a particular child in mind. He, like many others I have seen for therapy, is very receptive to foods with a tart taste, whether it be Italian dressing, vinegar based, garlic or lemon. I had seen a recipe in a South Beach cookbook for spinach cheese cups and I thought it would be fun to try with ham, sauerkraut, cheese and a small amount of shredded baby spinach. I made this for my own lunch and added a dab of dijon mustard to each cup. So yummy!

So many of the children I see like the taste of ham but they may be turned off with the contents in this recipe so you could try just melting cheese inside or puree the contents so the consistency is more uniform. I posted this for the adults as well, I think this would make a great appetizer for a party or a quick lunch or dinner at home!

1 serving = 6 slices in mini muffin pan

6 sices thin sliced honey ham (I used oscar meyer)
sauerkraut
1 string cheese (this is what I had on hand!)
dijon mustard
3-4 baby spinach leaves

Place 1 slice of ham in mini muffin tin, pinch sides to create a little bowl
Peel strips of cheese (or shredded cheese) and place a few in each 'ham bowl'
Chop (tear) spinach leaves into small pieces and place a pinch in each bowl on top of cheese
Place approximately 1 tsp of sauerkraut on top of mixture
Bake at 350 degrees for 10 minutes.

Add dijon mustard before eating! Here is the finished product:

The Bigger Picture—how Attitudes affect Mealtime experiences

2009-07-02T08:01:00.000-07:00

Here is a great example—last week we had family in town to celebrate our daughter’s 3^rd birthday. We went to a great little seafood place and had some delicious food! My husband was really wishing for Adalyn to try the grilled shrimp but everything on her face said “No!”…thus the coaxing begins, “Just try it, you’ll love it” “Just one bite and then you can__(fill in blank here)” We all know this scenario, right? I of course had to jump in and say “Hello? Do you not know anything about what I do for a LIVING, treating very selective eaters? Please don’t worry about her not trying the shrimp” ha! I said we’d just do a seafood or shrimp night one night. Which is exactly what we did! I started talking about it the night before and mentioned it a few more times the next day, took Adalyn with me to the store and started calling out for “Popcorn Shriiiimp, where are you?” We even got some hush puppies since that is always a nice addition to any seafood! We came across some yummy looking breaded butterfly shrimp in the frozen food section and went that route instead of popcorn shrimp. I showed her the tails (on the picture on box) and asked if I could take them off for her, she thought that was the most generous act and thanked me in advance right there in the store “Oh, thank you mommy!”

That night we had a great meal of baked tilapia with butter, lemon, mint from the garden and lots of parmesan cheese, a few new shrimp and some hush puppies! She immediately asked for her ranch—her favorite choice for dipping, especially with new foods, but I asked her if she would try some mango preserves for a sweet dip for our shrimp. She tried it, seemed to enjoy it, but politely declined any additional dips! Only 3 or so bites of the shrimp, but you know what? That’s ok! What a different reaction than the night in the restaurant! She was not prepared for trying shrimp, she shuddered at the thought and there was not much that was too familiar about it to her.

I do realize that different personality types make it easier or harder to come to grips with inconsistencies in life. Especially when dealing with the health and nutrition of our children. I am considered an “Idealist” (according to the Myers-Briggs personality test anyway), and I know my ability to really empathize with another person in combination with some other ‘weird’ qualities help me help others and I have a strange knack with the pickiest of picky eaters! It is a challenge but I do love it—at times I find it harder to relate these mealtime concepts and beliefs to the parents of these children, but I do believe a shift in attitudes toward mealtime is needed. This is why I am content with a "1 bite shrimp night" and the fact that she may have eaten a third of what she did the day before. With the children we, as therapists, work with however the details to caloric intake are much more important—I am a big believer in finding calorie packed foods that can be added to current accepted foods, I learned this from the beginning of my career and it is a perfect way to continue to allow a child to choose what they will eat and how much they will eat…it just so happens that some of their choices have more calories in them! The outlook I have in many situations is the same, “This too shall pass”, or many small steps toward the bigger picture. And like I said, it’s all about the Bigger Picture.

** I love you dear husband, just using you as a wonderful example!

Quick “Veggie Surprise” Mashed Potatoes

2009-06-18T16:38:00.000-07:00

What You'll Need:

½- ¾ cup sliced zucchini
1 cup cauliflower
1 cup potato flakes
Dash of sea salt and garlic salt
1 tablespoon light butter
¼ cup shredded sharp cheddar cheese

1. Steam the zucchini and cauliflower. (I used a microwave steamer bag)
2. In a separate bowl mix the potato flakes with ~ ¼ cup skim milk and ¼ cup water and add the butter and cheese, place in microwave for 3-4 minutes
3. Puree the steamed veggies (I am loving my Magic Bullet ...makes a super smooth mixture) and add to the potato mixture. Whalla! Yum yum. It’s always a good sign when the 3 year old asks for More! Matching taste and texture to the ‘preferred’ food (mashed potatoes) is the secret to success!

Meat and Veggies on a Stick please!

2009-06-08T15:09:00.001-07:00

Here is another milk and egg free recipe that is fairly simple and fun to eat! If not avoiding eggs you can replace the egg-free mayo with regular and the panko breadcrumbs with regular.

1/2 package frozen chopped spinach, cooked on stovetop or steamed then pureed
1/2 package lean ground turkey (approximately 3/4 pound)
1 tablespoon egg free mayo
1/3 cup whole wheat panko crumbs
sea salt, garlic powder and onion powder to taste

Preheat oven to 350 degrees. When mixed together, roll into balls and place on a greased cookie sheet ( I also used mini muffin pan) Bake for 30 minutes.

My daughter enjoyed eating these on a wooden skewer and dipping them into her favorite dipping sauce which was presented in a Smile across the plate. I would make one change and that would be to make Smaller meatballs because they were a little too big for that perfect bite-size! Hope you enjoy!
***Disclaimer: Be careful with pointy Skewers! I've already gotten 'scolded' by Nana who suggests "transferring them to a plate and eating with a fork"...haha!

Crunchy Vidalia onion dressing chicken

2009-05-07T15:01:00.001-07:00

This was just an idea I had for dinner and to share with some of the egg-free milk free families!

Meal for 2:

1 large chicken breast, cut in half length wise then into nuggets or strips (you could hammer flat if you like!)
spray with olive oil spray
Pour 1-2 tablespoons Ken's Light Vidalia Onion Dressing (this was surprisingly milk and egg free)
Roll in Panko bread crumbs that have been seasoned with creole season (other seasoning if you wish)

Bake at 350 degrees for 35 minutes and enjoy! I do not have a picture right now but if I ever make them again I will be sure to add it to this post!

Breakthrough moments

2009-05-06T15:56:00.001-07:00

Q&A

2009-04-28T11:19:00.000-07:00

The following questions and answers are adapted from my responses to some specific feeding questions from friends via email.

Q: My child loves bread and crackers but is refusing almost all fruits, veggies and most proteins. What can I do to help introduce healthier options into his diet?

A:

You may want to try baking pureed foods into his waffles or pancakes since this is already an accepted texture of his. While he is becoming comfortable with these other textures and tastes, etc That would be an excellent way to still give him nutrition in a way that is likely fun and yummy to him! Example...I make 'savory' waffles for Adalyn sometimes and give her ranch to dip them in. I just use a baby food processor or the regular one. You can use a blender if you don't have either. I use the steamer bags because they are quick and easy and you can steam broccoli, cauliflower, whatever!

I also recently tried a potato pancake mix and added chopped onion and some bacon crumbles as well as sea salt and some rosemary which was all very good! Of course I was fixing this for my family and would adapt this recipe depending on likes and dislikes. This morning I opted to make some pancakes instead of our usual quick routine of the frozen kind and I used the rest of our strawberries and a container of mixed fruit to toss in the food processer. You can always take an hour or so on a weekend to freeze the purees or make a bunch of pancakes or waffles and freeze them. These are options to help ease the transition back into these other foods he has dropped out of his diet. Deceptively Delicious, the cookbook, has great recipes and examples, a little more elaborate than the ones I’ve just made up, but they look good. I tend to find easier, simpler versions of something similar.

You mentioned that he likes all things with bread, breading or cracker consistency. You are basically just taking his fruits veggies that he is not eating on his own...and putting them into a way he may accept. I think it is important to always expose him to those foods regardless but since they are causing him anxiety, just go at his level...even if it is just sitting on the table while he is eating his other foods! Things will start to look up, I promise. I do feel your frustration as I've spent lots of time with parents who have often cried in the evaluation or therapy room---sometimes friends and even family do not understand how complicated or frustrating a meal can be until they have been in your shoes. Everyone has their "Well I just fix it and if he doesn't eat then I do this..." etc, and it is just NOT true for all children--if that were the case then you would have it all figured out by now!

**It is very important to rule out underlying conditions such as reflux, food allergy, other gastrointestinal complications as these are often present in children with feeding difficulties. If you have concerns about this please talk to your pediatrician about these issues and a referral for a feeding evaluation.

Q: We are noticing several signs of possible milk intolerance in our child. Since she is so limited in her diet already and eats so many foods containing dairy, what will we do to replace milk?

As far as trying a dairy elimination--its not too hard, it just sounds intimidating. You wouldn't believe the foods out there that are actually milk free and still very good (duncan hines cake mixes and most of their frostings, even the chocolate and buttercream) You just have to look at it as a trial process and take it one day at a time. I can help you with really good butter, milk and cheese alternatives. Cheese--you may want to just limit or leave out because the substitutes, in my opinion, do not taste as good as other milk alternatives; however, there is a pretty good, "meltable" casein-free rice cheese and that is the one that I would recommend. But Smart Balance, Earth Balance and Fleishman's light butters are milk free and are good...you can also cook with oils, etc.

Feeding is so involved and the environment plays a huge role as well. I have had kids come in for feeding therapy who would initially cry at the sight of the chair or the spoon...so we had to work on making that a positive place first and sometimes that meant using the high chair just for some play to create more positive associations. Sometimes a cd with calming or rhythmic music can be helpful as well as making things predictable . Small portions when introducing new foods is key in my opinion. Too much food on the plate or surrounding her can be overwhelming and she may refuse everything in that case. Since she loves crackers, dd some cracker crumbs on top of the foods with softer textures (use similar colors paired together if possible)--if she works hers hardest to pick off only the tiny crumbs, that OK because she is at least getting exposed to the 'new' food or texture. When I watched her eat I stuck a cheeto on top of a bean and she ate the cheeto with the 'bean juice' on it and then copied me dipping it into it. This is a step! So if she has a favorite crunchy food, like the cracker, you can keep some pieces plain and some with a bit of mashed food on it. Might sound strange but she will be in control of what she is eating and will surprise herself! I mentioned the Veggie stix in my email because they have green, orange and yellow mixed in and she may be more likely to try the green 'crunchy' food before a green vegetable but then you can pair the two green foods (squishy one and crunchy) or do crumbs...and gradually she becomes comfortable with that. This is not to have to rely on everything always being textured, but a way to help her lessen her anxiety with those foods that she is really objecting. Use those foods for the exposure and food play for now. This takes patience and that is ok--you want her to enjoy the feeding process, not just endure it!

**Again, consult your pediatrician if you have concerns of food allergy or intolerance as a nutritional consult may be recommended.

Oven Baked Squash "Fries"

2009-04-27T12:18:00.001-07:00

This recipe was inspired by a toddler's love of Tings--a dairy free puffed corn chip very similar to Cheetos. My daughter Loves them and many of the kids I work with love them too! If you have a 'picky' toddler or VERY selective eater, you may notice that he/she has a diet full of yellow foods, do I hear an Amen? Most crunchy snacks are yellowish as well as breading for lots of toddler accepted foods. I find that a lot of toddlers and older children love the feedback that these crunchier foods give them. Parents wonder why in the world their child will not eat wonderfully cheesy casseroles or vegetables with butter, etc but these textures and tastes may be "too much" for them to handle from a sensory standpoint. Meet your child where he is at by exposing him to these foods--but at no point should you ever force the issue. One thing I have my families I work with do is keep a list of "accepted foods"--I then help find a starting place to expand on those foods. Similar tastes, colors, shapes, textures and always a subtle change. I will list some examples below:

Accepted Food--Spiral noodles with melted butter
Food to Try--Spiral noodles with melted butter + seasoning such as salt or garlic powder/salt (depending on child's likes) or different shaped noodle with melted butter

Accepted Food--French fries
Foods to Try--potato smiles, tator tots

Accepted Food--silver dollar pancakes
Foods to Try--bread cut into small circles, potato smiles, circle sandwiches

Accepted Food--beef hot dog
Foods to Try--turkey dog, pork hot dog, ham (Some kids may only accept the hot dogs when cut into circles, so you would want to present the turkey dog in circle shapes as well when first introducing)

The goal is to expand on each accepted food, no matter how small the change because you are aiming for a goal your child can actually REACH. It feels good to accomplish a goal and your child needs to feel that he can do this. I realize that this is a Very different approach than some feeding clinics across the country but I think there is a lot to be said about the feeding process and actually enjoying it!

I was recently told about a book called Food Chaining in which this like-minded approach to increasing your child's food repertoire is discussed in a 6 step program. I have not even read the book and am already recommending to people based on what I have read on their blog. I also highly recommend reading Expanding Children's Diets by Suzanne Evans Morris. I'm pretty sure all of us would get along really well if we ever met in person!

Getting back to "Squash Fries"-- As you can see from previous posts I enjoy creating and pairing foods together and presenting them in a way that feels 'safe' for children. I've recently become a fan of Panko bread crumbs as they produce a nice Crunch to foods and they are also appropriate for milk and egg free diets. These came out delicious with a nice and crunchy coating!

Recipe for 1-2 servings of Squash Fries
1 yellow squash, cut lengthwise and into fries (cut about 1/4 inch thickness)
1 bag of "tings" (or favorite crunchy chip)
2-3 tbsp Panko breading
olive oil spray
sea salt

Place Tings in food processor or blender, blend into fine crumbs
Mix with Panko
Coat pan and squash with oil spray and sprinkle coating all over and roll to fully coat
Bake at 375 for 25 minutes....enjoy!

Almond Milk

2009-04-27T11:10:00.000-07:00

I just read a great post by Roni of GreenLiteBites and wanted to share her recipe for almond milk, which includes some great pictures. I have not tried this yet but I do encounter many kids with soy and milk allergies as you can see from my other posts and links!

http://greenlitebites.com/2009/04/27/homemade-almond-milk-take-1/

Food Allergies and/or Intolerances and their impact on Feeding

2009-04-25T19:57:00.000-07:00

Common referalls: child not progressing to age appropriate textures and would rather graze throughout the day than sit for meals. Often have high intake of dairy, such as yogurt, pudding milk, goldfish crackers. IgE allergy testing reveals no allergies, however there may be a strong indication of food intolerance as congestion is increased when these foods are eaten, darker areas or lines (Denni morgan lines) appear below the eyes, Constipation that has to be stimulated by thermometer or Miralax or other treatment.. or Diarrhea that has been persistent. May have diaper rash and eczema or just one red cheek or ear that seems 'flushed' and is hot to the touch, not to mention recurrent ear infections. Does anyone have this experience and if so do you mind sharing?

This is a scenario that has repeated time and time again over the past 7 years in my work and more likely than not the above mentioned symptoms subside, or at least lessen with a milk elimination trial of 2-4 weeks. You would not expect to see any sudden changes in the eating, other than a possiblity of the Willingness to try foods that would have otherwise been put on the back burner. We all know how huge that is though! I hope to post a letter I am writing to area physicians on this particular topic of food allergy and its impact on feeding development, specifically the sensory component of feeding--at a later time.

If a child were to have a food intolerance that in turn leads to silent, non regurgitant reflux, it may not be too much of an issue in some children, but in others it seems that the sensory aversions are heightened and sensory feeding information is processed in a very different way. That statement is based on numerous cases over the years in which a child with reflux and/or food intolerance had accompanying sensory aversions, hugely impacting mealtime and feeding development. Those toddlers in particular do not have a normalized response to various sensory stimuli. This could be observed in a child who does not tolerate walking barefoot on grass or sand, does not enjoy the feel of playing in rice or bean boxes, tags on the back of shirt, and who may experience gagging on all food textures with the exception of smooth foods or very crunchy, etc. Those are just a few examples. Imagine how it feels for a child to be uncomfortable with certain textures and input on hands and feet, the thought of exploring such textures in their mouth is less than appealing to them.

I mention this topic so families can be aware of these 'red flags' which may indicate a food sensitivity to milk. A child who has congestion, history of ear infections, history of diaper rashes often needing anti-fungal cream (Indicating presence of yeast)...these are all indicators of a possible food intolerance or allergy that often go overlooked as some symptoms are not typical of a classic IgE mediated response. Symptoms may not appear immediately after the food consumption and the only indication may be the history of ear infections or the thought that your child "always has a cold". Immediate reactions are often taken more seriously than these delayed reactions, as there could be anaphylactic reactions leading to life threatening circumstances.

From the feeding standpoint I feel it is very important to rule out the presence of these food intolerances. A child's battle with food, his finicky eating, his anxiety increasing at the very thought of being in front of a food he is expected to eat, despite a known underlying diagnosis such as sensory processing dysfunction or Autism, Asperger's, developmental delay, etc and despite an immediate allergic reaction---All may be related to a food offender. Treatment is available, but I encourage you to do you research before randomly choosing a feeding therapist or a program. Some intensive feeding programs take a very different approach than mine or other therapy clinics.

We must look at the big picture, the whole child and all factors involved, not just medications to help with the possible reflux, the eczema, the constipation, etc. Although these may be warranted in time, I feel it is important to really look into these food intolerance possibilities as well. We have many success stories, or should I say these families I have worked with have many success stories and wish they would have looked into the possibilites of food allergies sooner than later. I suggest taking a detailed food journal for 3 days and be sure to list any and all changes in any physical changes (bowel, appearance of eyes, rash, etc) behavior, sleep patterns, eating (new foods tried?) and anything else worth noting.

It is a little overwhelming how often I and other therapists working with feeding have seen this connection to delayed food allergy/intolerance and the sensory component. Perhaps the elimination of the food reduces or eliminates silent reflux that had been occuring unknowingly. Symptoms of Reflux can be found in this article Gastroesophageal reflux and Childhood Feeding Disorders and http://reflux.org/. We know that with sensory integration therapy, as the child progresses with various sensory goals, there is often an increase in eating. I strongly encourage looking at all modalities and to not rule out possibilities of underlying GI discomfort such as food intolerance as a strong culprit to the feeding aversions. When I had morning sickness with my daughter I did Not want to smell coffee (which i loved before) I could not pick up my dog's waste from the yard (intense smell made me gag). I compare those changes in sensory experiences to the changes these kids must be feeling! They know what feels best to them and they know what sets them off. There is help for these children and so many ways to build on their current accepted foods. I just wanted to take this long post and highlight the need for a wholistic treatment approach for these kids. Do you have a child craving their milk or pediasure in addition to the little voice inside of your head saying "Something he is eating is making him sick or making him have a very difficult time in a lot of areas" At least worth looking into! Email me for further information re: Milk Allergies and Elimination trials.

Suggested Reading:

http://www.nutramed.com/children/kidsmilk.htm
http://www.askdrsears.com/html/4 /t041800.asp
http://www.nutramed.com/Foodallergy/fachildren.htm

Whole Foods "Make it Natural" cupcakes

2009-04-22T13:52:00.000-07:00

Have a child with multiple food allergies and looking for a treat? Just follow this link!
http://blog.wholefoodsmarket.com/2009/04/make-it-natural-cupcakes-for-special-diets/

Fun with Food!: Laughter is the best Medicine!

2009-04-07T12:55:00.000-07:00

Fun with Food!: Laughter is the best Medicine!
Where Laughter Lives

Laughter is the best Medicine!

2009-04-07T08:36:00.000-07:00

I recently found out about a free online magazine called Serious Life Magazine. The magazine is owned and published by a family who have seven kids, three adopted and one who has Leukemia (www.riggsfamilyblog.com). The magazine gives away a lot of ads to charities and ministries. They feature inspiring stories and include "life" topics involving family, adoption, personal finance, spiritual life, and humor.

The creators of this magazine have a family blog, today's post is part of "Laughter Lives! Tuesday" on the Riggs Family Blog. Check our their blog to read everyone else's "Laughter Lives!" posts.

In honor of "Laughter Lives!" and keeping in line with the content of my blog, I wanted to share a video of my own 2 1/2 year old daughter helping in the kitchen. Her vocabulary is changing daily, last week she was all about being "fantastic" and in this video she is commenting on the sauce which she finds "Awfully good!"

Some of my other favorite "Adalyn" moments and words:

Scene--Adalyn on the potty with my mother in law standing by
Grammy: "Hurry up, try to go potty"
Grammy: "Are you done yet?"
Adalyn: "Just be patient, Grammy"

Having to start over dinner prayers because Adalyn "forgot to pray for her biscuit" or other food items

Telling me she can do something herself because she is "superman"

Oh, and one more blast from the past:

Problem Eaters...A parent's struggle

2009-03-21T16:47:00.001-07:00

In an attempt to bring some real life stories to this blog I wanted to share a few blog posts from both the mother and father of child who have had an ongoing mealtime struggle with their son. This family's story is so very similar to many children I have seen before who do not fit the mold of "They will eat when they are hungry"...would rather go without eating than try something in different packaging or something unfamiliar to them. I feel it is important to hear these families, put yourself in the shoes of this child, and meet them where they are....forcing, bribing, threats simply do not work! Please take some time to read the following posts! http://marblesfromheaven.blogspot.com/2009/03/not-just-picky.html and http://johnmarblecrna.com/2008/08/08/my-boys/

Thank you Marble family for sharing your story and showing others that they are not alone. I pray that you find the right treatment program for your son and continue in your efforts!

Positive Peer Pressure!

2009-03-18T13:25:00.001-07:00

The circumstances do not always allow for your picky or 'problem eater' child to be in a lunch or snack setting where they can observe and interact with children around their own age; however, if you can arrange for this set up it is ideal! Children have a way with each other, even if it is just by being themselves and being silly with their food or talking about their likes/dislikes, examining the food properties, etc. I wanted to share a great site with many links to a son helping his mother in the kitchen. One reason I so love these natural and realistic video posts is because here are Real Life examples of how you can be a role model for your child! Here is a link to Roni's GreenLiteBites in which she and her son are making a healthier version of a chicken nugget. I encourage you to watch some of these videos with your child! I'd consider this a baby step toward having your own child become more comfortable with meal time experiences...food preparation, smelling and touching are all steps toward the bigger picture, which is Eating!

If you are reading this post and thinking "my child would never do this" or "he would never eat this"...remember that you can adapt most anything and create your own recipes! Pairing favorite foods with something like chicken is a great idea as mentioned in a previous post re: coating chicken in a favorite chip or crunchy coating. The exposure of being around or in the kitchen while you are cooking is very therapeutic for a child who has many food aversions. I encourage you to pay attention to his/her cues and if you think he is getting overwhelmed or overstimulated, simply take a step or two back and try again later!

Muffin Tin Mondays

2009-03-15T11:49:00.001-07:00

I have been meaning to link to this post and just kept forgetting! So here it is--Muffin Tin Mondays from Sycamore Stirrings. What a wonderful idea! I have adapted this idea in therapies and used mini muffin tins (the kind from my old Easy Bake Oven days) and kept tiny portions, limited to one or two and dips in every other space. If you have a link to other 'muffin tin' pictures or would like to share on this site, please feel free!

Sycamore Stirrings has a flicker group in which you can share your ideas and images: http://www.flickr.com/groups/muffintinmeals

Heightened anxiety and Sensory based feeding aversions

2009-03-14T09:51:00.000-07:00

Many of the children I see for feeding therapy have increased anxiety surrounding new foods and many will "shut down" so to speak at the very sight or mention of a new or undesired food. When working with families I ask them to list their child's favorite foods and then I examine the various properties and help plan which foods to introduce based on the similarities. Pairing desired foods with new or undesired foods has been helpful with many children...you do not want to be 'sneaky', but rather discuss the similarities and provide opportunities for exposure and for your child to build trust and familiarity with the new foods.

It is not uncommon to see a child with a limited diet Love foods that are crunchy, sweet, salty, even spicy. What is the common factor in those type of foods? They all have an increased sensory value and give more feedback! A child who loves barbeque chips for example, may love the idea of having chicken tenderloins coated and baked in her favorite bbq chips. This is a way you can expand on a food. Children who prefer these types of foods often Overstuff foods, usually the foods that are a little softer. Here is a great article by Suzanne Evans Morris regarding overstuffing: Mouth Stuffing.

Yesterday I discovered a great blog written by the co-authors of Food Chaining. I did not realize that the treatment approach I use with many children is similar to the concepts and plan in Food Chaining. Please check out the site, it is a great resource and lists many others! I plan to order the book and incorporate some of the examples in my own therapies! I spoke with a very sweet, very concerned mother of a 5 year old son who has a diet limited to 4-5 'staple' foods. Her story is like many others--she knows her sons anxiety and panic surrounding new foods is not typical of other children his age but she is having trouble seeking treatment. A speech-language pathologist or occupational therapist specializing in pediatric feeding disorders is sometimes difficult to come by but we are out there! I hope to continue adding to this site and eventually have a list of treatment centers and speech and occupational therapists working in the field of pediatric dysphagia; so if you happen to be reading this and are a professional in the field or have a recommendation for other families, please leave a comment below! Most Children's hospitals have a feeding/swallowing program and will offer outpatient treatment. You can also check with any company that offers speech or occupational therapist and ask if there is a therapist/therapists who works in the area of feeding.

Below is an example of introducing a new food, discussing its properties, presenting it in a new form (puree for dipping) and pairing it with a like colored desired foods.

Savory Veggie Waffles

2009-03-02T13:40:00.000-08:00

Here we go again with the broccoli! We had so much fun making these and loved the added crisp when made in the waffle iron! A great twist on this recipe is using potato pancake mix, adding some cheese, onion and rosemary, mmm!

Recipe:
Steam 1/4-1/2 cup broccoli (I use steamer bags)
Place in food processor along with seasonings of your choice (I used parmesan cheese, 1/2 american cheese slice and garlic salt)
Add to waffle mix according to box directions (I have Fiber 1 and Quaker Oatmeal pancake mix)
As an egg replacer I use ground flaxseed and very hot water.
To replace one egg:
1 tablespoon ground flaxseeds
3 tablespoons water (or other liquid)

Once again, my daughter enjoys dipping these into light ranch dressing! (It's a southern thing I think!)