written by Kathy Daniels-Balzano, speech therapist/feeding therapist at Foundation for Blind Children
It always amazes me how involved oral eating is. It requires so many precise motor movements, strength, pressure changes and timing in order to successfully consume one bite. If you are successful with physically being able to consume food, there are other, much more intense levels of complexity that include our sensory and psychological systems. The process of eating food involves so much more than simple nutritional intake. It incorporates all of our senses: taste, smell, touch (texture), sound (crunching) and visual.
There is an intense psychological component associated with food. We need to know that it’s safe, that we can trust it. Rarely do you see feeding concerns associated with only one component. When we have children and adults with oral feeding concerns, it almost always consists of a combination of each of the three areas. Allow me to share a story.
I recently started eating a raw food green smoothie program where you place a wide variety of fruits and vegetables into a blender and blend it. It can turn out smooth, chunky, liquid and creamy or any other combination. The first time I made this creation, I knowingly added foods that I liked and enjoyed. I had complete control over what I was going to eat. However, when it came time to consume this nutritious wonder, I was looking at having to drink a thick green concoction. I need to reiterate, I liked all of the foods that I put into it. While looking at this thick green drink I began to realize there was no way I was going to put that in my mouth. There was nothing familiar about it and I did not trust it to meet all of my senses in a pleasurable way. As a therapist I require a three bite rule. You have to be presented with a particular food for three bites in order to truly determine if this is a physiological rejection or a true sensory-motor inability. I found myself in the situation where I had to employ the three bite rule on myself. I had to force myself to try it and to move forward with this. I was pleasantly surprised and I continue to enjoy my green drink regularly.
Think about the foods in your life that you will not eat for whatever reason. Picture yourself in a situation where you must take a few bites, most typically associated with being polite and not disappointing your host. Even as adults it’s difficult and most definitely a mind over matter situation. When we have children with sensory-motor concerns, psychological distrust, lack of experience or any number of combinations of blocks that interfere with what they can and will eat, it becomes a most difficult situation for both the child and the parents or caretakers involved. We all want to provide our children with the best, most nutritious foods we can obtain. However, sometimes what they eat and the variety of what they eat is limited. Our job is to help by continuing to introduce opportunity and variety, and at the same time also maintain and reinforce a trust for eating.
It goes without saying that this is a difficult dance. We all have to experience new things and create a level of trust with our experiences. As parents we can’t blame ourselves for not being successful with our child’s eating. The best we can do is create a loving, caring, trusting environment that allows for opportunities and failures. We meet the child at his or her level and expand from there. Because feeding involves all of the senses, motoric success and psychological openness, force feeding will not lead to success. It’s much bigger than just having a picky eater, so remember it’s a dance. Change the rhythm and the movements and hopefully you and your child can work together as loving, caring partners to establish a happy relationship with food.