Food Wars: Eating from an OT Perspective

Eating can be hard for a child. The moment a child begins to establish what they want (and don’t want) to eat, they attempt to express themselves in a multitude of ways that aren’t always straightforward. 

Out of nowhere, they start to refuse what is on their plate for what could be an assortment of reasons. For some, they may only want the same foods with minimal taste (fries and chicken nuggets sound familiar?) or they’ll frequently seek out candy. Sometimes they may become messy eaters with food all over their face or constantly overstuffing their mouths with food. 

From an OT perspective, there can be a few reasons for food aversion. 

Taste and Smell

Closely tied to each other, taste and smell react to chemicals in the environment and on the tongue. Taste buds can only detect four different flavors (sour, bitter, salty, and sweet), while the other “flavors” experienced when eating come from smell. There is another type of nerve that also reacts to the environment called the common chemical sense, located in the membranes around the eyes. It is responsible for the other sensations that don’t fall into smell or taste, like when you feel the heat of eating a hot pepper or the sting of biting into a lemon slice. 

Because of these senses, a child develops a memory with each food experience. This explains why we dislike certain foods and why we get excited for others. If a child has a bad experience associated with a certain food due to taste, or a pungent odor, or texture, or a scolding for not finishing their food, they get triggered and will refuse to eat.

Different kinds of “picky” eating

Aside from the food itself, here could be a few other reasons for “picky eating”:

  1. Oversensitivity to smell and taste 
    They may not want to engage in food with a strong smell or taste as it may overwhelm their system. It’s like being presented with stinky cheese or durian fruit for the first time.
  2. Under-sensitivity to smell and taste
    If they are under-responsive to tastes or smells, this could be a sign that your child has an under-responsive gustatory system, meaning that they need more sensory input to in order for taste to register. They may enjoy eating intense flavors like a lemon slice or drinking pickle juice.
  3. Tactile defensiveness
    Your child might not like the feeling of certain substances and textures on their hands or in their mouth. If this is the case, your child may look at what’s on their plate, determine it’s a “threat” by looking at it, and then refuse it just by appearance alone. This can happen even if they have enjoyed various food items in different forms. Your kid could enjoy a scrambled egg, but not a fried egg with a runny yolk, for example. This can also apply to aversions in food temperature and food consistency. (I didn’t like raspberries growing up because they had hairs.)
  4. Picky eating can be a learned behavior
    If your child has a sibling who doesn’t like mushrooms and sees that they don’t eat it, they will assume that mushrooms are undesirable and therefore not eat it. 
  5. Under-responsive touch, poor oral motor skills, or poor hand-eye coordination
    These look like food overstuffing, food all over the plate/placemat, or messy face and hands. Your kid may have a tough time eating certain foods in a neat and timely manner, resulting in bad experiences eating out at a restaurant or embarrassment eating in front of others. 

Other reasons include:

  • Food fatigue. We all can get sick of the foods we love if we have it all the time.
  • Food neophobia, where a child does not want to try new foods. This could be due to exhaustion from taking in new information or tolerating sensory experiences throughout the day that unfamiliar foods are just too much for them to handle.
  • Your child may be eating snacks throughout the day and therefore may not be hungry when it’s time to eat a meal.
  • Younger children under the age of 2 might not have enough teeth yet to chew certain foods, or certain preparations of foods. 

The truth is that, second to potty training, this is a battle that parents can’t honestly win. This is an area where a child truly has meaningful control, even if it’s at the detriment to their own healthy eating habits and nutrition.

In addition to treating kids with food sensory issues, my husband and I have definitely put in the hours fighting the dreaded food fight with our toddler. It was definitely confusing at first, but after some experimenting, we found some shortcuts to preventing the food battle.    

What can we do?

Allow your child to be part of the cooking. The more they understand food and how it is cooked or seasoned, the more they are willing to eat it. Let them go shopping with you or prep a meal with you. Find healthy substitutions for ingredients that you child doesn’t prefer. For example, if they don’t want asparagus, switch it to green beans. If they want carrots but not the way you are preparing them, make the exception within reason. 

Education is key. If they are old enough, educate them about nutrition and what their body needs to achieve a balanced diet. Understanding why you insist they eat certain foods (like vegetables) may help their willingness to compromise. Introduce the food pyramid, and have them choose which fruits, vegetables, and grains they’ll have for the day. 

If your child is a grazer, adjust the types of snacks they are consuming so they can be healthy (real fruits over fruit snacks). That way, if they do not eat a lot during meal time, you won’t be battling them to obtain nutrition. Alternatively, you can portion control the snacks they consume, or set up a reasonable meal/snack schedule. 

If your child overstuffs their mouth, provide food items that can help work the muscles in their tongue and jaw, as well as deliver sensory awareness (see Treat Yourself). You can also portion control how much food is on their plate, or suggest that they finish what’s in their mouth before having a sip of milk or water.

Here are some other non-OT suggestions for better eating habits:

  1. Introduce new food, a tablespoon at a time, early in the day when they aren’t tired. 
  2. Offer new foods without pressure. No pleading or scolding if you can help it. Remember, we don’t want to create bad memories associated with new food.
  3. Be a positive role model. If you like the food and show that it’s yummy, the least likely they will be to reject it. We all know that kids like to eat more from your plate than they do their own.
  4. Avoid making only your child’s favorites.
  5. Keep trying, even if they stop liking a food item or don’t want to try it. Prepared it in a different way, or wait a couple weeks before introducing it again. 
  6. Select food that is similar to one of the foods that your child already eats. If they like spaghetti, change the pasta shape. If they like crackers, change the flavor.
  7. Have your child engage with the food. That may be moving it around the plate with a fork or picking it up with their hands. 
  8. Provide a dipping condiment. It may be weird that your kid likes putting ketchup on everything, but they eat it and they have fun while doing it. BBQ Sauce, Mayochup, Ranch, etc. can all be used to help your kid ease into foods they might not try otherwise.
  9. If food/nutrition habits continue to be an issue, consult with your pediatrician. 

For younger children, eating is about discovery. The more you open them up to different tastes and flavors, the more they will be curious and excited about eating. Don’t get me wrong, this definitely takes time. So, bring your patience and we hope these tips will give you a good battle plan.


Sources:
Solutions for Toddler Feeding Problems“, Elizabeth M. Ward, MS, RD. WebMD, 2015.
Mauro, T. (2006). The Everything Parent’s Guide to Sensory Integration Disorder. Avon, MA: Adams Media.
Delaney, T. (2008). The Sensory Processing Disorder Answer Book: Practical Answers to the Top 250 Questions Parents Ask. Naperville, IL: Sourcebooks, Inc. 

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