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Twin Cities Mom Collective

How To Help Your Child With Feeding Difficulties

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Most parents have experienced feeding problems with their children before. Research shows that 25% of all children have feeding problems and 80% of children with developmental disabilities have feeding disorders.

First, it is necessary to have a medical evaluation to determine whether there is a medical reason for their feeding problems. Your child’s feeding difficulties might be due to medical problems, acid reflux, allergies, or constipation/diarrhea. If a medical professional determines there are no known causes, then it is possible that your child’s feeding problems may have been learned or acquired and can be improved through behavioral interventions.

If your child does not respond to some of the interventions described in this information, it may be beneficial to seek out help from a feeding specialist or feeding team. More specifically, if your child’s feeding problems are causing a delay in development or their diet is severely deficient in caloric intake/nutritional content, seek medical assistance immediately. Another sign of the need for specialized services would be if your child frequently coughs while eating, engages in choking or gagging behaviors on a regular basis with foods/drinks, or your child has oral motor delays.

Some children that may benefit from the following behavioral interventions are picky eaters, children with food selectivity, children with difficulty processing different textured foods, children with autism, and children with anxiety surrounding food.

It is important to determine the reason why your child has food selectivity or engages in difficult behaviors at mealtime. There are three different functions that could be present during food refusal, temper tantrums at mealtimes, or gaging/vomiting when presented with non- preferred foods. One reason they may engage in these behaviors may be to gain attention from their caregiver. This could be happening with tantrums, food refusals, or even gaging/vomiting. Maybe your child likes the attention they receive when they need “help” eating their food.

Another function of their behavior could be to gain access to other preferred items. Maybe your child doesn’t prefer eating vegetables, but only wants macaroni and cheese. If the child knows that they will eventually get the preferred food item, then they may continue to engage in problem behaviors until they get their preferred food. The final reason they might be engaging in behavior problems surrounding feeding could be that they are trying to escape or avoid an unpleasant situation or non-preferred food item. It is important to know which reason your child might be engaging in behavioral problems at mealtime to best determine which intervention to begin.

Set the Stage for Successful Eating

Make sure all meals are happening at a table, with your child in an appropriate chair. Do not allow distractions at dinner such as watching TV or playing on an iPad. Create a predictable mealtime schedule so that meals are more consistent and less anxiety producing. Present your child with less food on their plate so it is not as overwhelming. Decrease the number of times they can eat outside of mealtime. Evaluate the number of beverages they drink besides water (especially milk or juice as it may be filling).

One thing to remember with all of these interventions and foods is that a child needs to try something 10-15 times before they like it. The repeated presentation of new foods is good for any child or feeding problem. Constantly model what foods you want your child to eat so they see repeated exposure to the food item. Additionally, children respond well to peer models. Have one of their good friends or someone they look up to help model eating the new food.

Reoffer Non-Preferred Foods

If you suspect that your child is engaging in difficult behaviors during meal times to either gain access to preferred food items or to escape non-preferred food items, then this intervention may be helpful for your child. If your child refuses to eat non-preferred food items, you should continue to present the food in front of your child, not allowing them to escape from the non-preferred food. For example, if your child vomits on the food being presented, you can give them a new plate with the same food to try again. If your child runs away from the table, physically bring them back to the table.

If your child refuses to eat, do not give them a new food item. Instead, let your child know that when they are hungry for a snack later, you will present the same food again. This will help your child understand that their behaviors will not get them their preferred food item or allow them to escape from non-preferred food items.

Successive Approximation

This strategy is great to use with children who have extreme protests to non-preferred food near them or on their plate.  You want to meet the child at the level they are at and slowly make the task more difficult for them. Start at the level they are most comfortable with the food and move to the next step when they appear comfortable with the previous step.

Create lots of opportunities for exposure to each step so that they become more comfortable quickly. Here is a list of possible steps- remember to start them on the level they are at:

  • Allow the food on the table without protest
  • Child allows the food on their plate
  • Child touches the food with a finger
  • Child picks up the food and touches it to their lips (Kiss)
  • Child touches the food to their tongue (Lick)
  • Child takes a bite of the food (start with crumb sized bite and then move slowly to larger bites)

More steps can be added if the child is becoming stuck on a particular step. Maybe you can add touching to teeth, making bite marks, or taking a bite and spitting it back out after. Some children progress through the steps very quickly for new foods, while other children need daily practice for weeks to get through the steps. When picking the new foods to add, offer foods that the rest of the family consumes on a regular basis. Consider the foods that the child currently eats and find foods that are similar in taste or texture.

Positive Reinforcement

Do you offer anything rewarding for your child after they try a bite of a new food? One way to provide reinforcement is to give your child a bite of their preferred food item as a reward for taking a bite or engaging with non-preferred food items. If using this method, only allow your child to have the preferred food when taking bites of new foods during mealtime. At times, reinforcement is the only way to motivate some children to eat different foods. Sometimes your child may not be motivated by food. Instead, find something that does motivate them!

If your child is not motivated by any food, then use a toy or game to help motivate your child to eat. For each bite, they get to play with a special toy for 3 minutes. Could you have your child take a bite of food and then you read a page from their favorite book?

If you don’t want the re-enforcer to disrupt your mealtime, have your child earn stickers or tokens during mealtime that can be exchanged for iPad time after dinner. For many children, the decrease in the feeling of hunger or the taste of the food is not rewarding enough for your child to eat; therefore, we supplement with some external motivation that can be faded over time.

Whatever re-enforcer you choose, use it only for mealtimes so that it maintains its effectiveness. The use of sticker charts or tokens can be successful for children age four and older. Additionally, it is important to remember that you want the reward to be greater than the demand. Start out with small goals so that they can be successful. Start out with a small goal, such as one bite gives them 15 minutes of iPad time. Then when they are successful, you can switch to 15 minutes of iPad time for 2-3 bites. Slowly increase the demand. When starting with a new food again, you will need to decrease the demand before slowly increasing it again.

Your challenge this week is to determine the function of your child’s behavior and try one of these interventions to change your child’s feeding behaviors!


Dr. Jenna Edlund, LP is a licensed child psychologist working at Clinical and Developmental Services in Waconia, MN.  Dr. Edlund has gained experience working with a wide variety of ages in both home, school, and office settings.  She has extensive training in behavior analysis and cognitive behavioral therapy.  Dr. Edlund also has experience providing parent trainings and teacher in-services on a variety of issues that occur during the early childhood years.  Dr. Edlund specializes in a type of therapy called Parent Child Interaction Therapy that gives parents the tools to shape problems behaviors and strong self-esteem in children ages 2-7.  Additionally, Dr. Edlund is a psychologist that consults in the classrooms at Lake Area Discovery Center.  Through her consultation, Dr. Edlund provides parent trainings, staff in-services, and individual modeling for teachers on behavioral strategies in the classroom.  Dr. Edlund received her Bachelor’s Degree in Psychology and Spanish from the College of Saint Benedict.  She received her Master’s Degree in Clinical Psychology from Minnesota State University, Mankato.  Dr. Edlund completed her Doctorate in School Psychology from the University of Utah.

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