My Child Can’t Eat-Meltdowns and Tantrums: Part 1

It is also important to know that picky eating is typical in young children. Take toddlers for example. They are all about testing limits and quite inconsistent in their behavior. For example, they might reject a food they liked previously and then eat it, when offered at a different time, quite happily. If you have a toddler who is doing this, know that this is quite normal behavior, and if you let the behavior slide for that particular food at that particular time you will avoid limit testing, power struggles and control issues that are common during this stage of development.

Problem feeders or extreme picky eaters are those who are severely limited in the foods eaten. Often the child self-selects to one or two foods only, and will only drink milk. I have observed some children self-select to only eating a certain color of food within a select few options. You might observe gagging, choking, meltdowns, and other unhappy behaviors when a food outside the child’s repertoire of food is offered. At well child visits, the topic of conversation is always about your child not eating.

Problem feeders often have significant medical issues and/or developmental delays either clearly diagnosed at birth or yet-to-be diagnosed. Any one of these issues can compound the challenges revolving around consuming food and drink successfully.

If you have, or suspect you have a problem feeder, please get professional help as soon as possible. There are many caring people who are specifically trained in this area.

This blog is not a substitute for professional help.

For more significant or severe eating disorders, there are teams of feeding specialists housed in hospitals across the United States that evaluate: postural concerns, sensory integration issues, motor challenges, behavioral components with ability to learn, nutritional factors and medical history.

I will be writing a series of blogs addressing those who have more “sensory” based feeding/eating challenges. Often, children who have the following diagnoses will also have sensory based feeding challenges. These diagnoses may include the following:

• Autism
• Asperger’s
• PDDNOS (Pervasive Developmental Disorder Not Otherwise Specified)
• ADD (Attention Deficit Disorder)
• ADHD (Attention Deficit Hyperactivity Disorder)
• Extreme Prematurity
• Children who have had extended stays in the hospital from birth due to medical conditions
• Developmental Delays
• Some genetic conditions

In addition to the main diagnosis or diagnose(s) your child may obtain, a host of other disorders might be awarded to your child, including: sensory processing disorder (SPD), obsessive-compulsive disorder (OCD), oppositional defiant disorder (ODD).

Be aware, your child does NOT have to have any of the above diagnoses to have sensory based eating challenges. Commonalities within the above diagnoses as relates to eating/drinking are:

• Food refusal
• Behavioral meltdowns
• Disliking food textures and unable to tolerate the sensation of food in their mouth
• Brushing teeth is a nightmare for the caregiver and going to the dentist is a major struggle
• Some children refuse to swallow their food
• Gagging, coughing, choking and at times vomiting at the sight, sound, smell of food or the sound of the microwave
• Selecting down to eating only a few foods, usually refined carbohydrates and highly processed foods
• Only eating certain colors of food
• Only eating certain textures of food (smooth, crunchy, etc.)
• Having meltdowns if foods touch on the plate
• Inability to use utensils when they developmentally should
• Only drinking one beverage from only one cup, sippie cup, etc.
• They are the children who do not want to get their hands dirty or do not want to touch many things because it feels unpleasant and will rush to wash or wipe their hands making it difficult to finish what they are trying to do
• Messy art classes are awful for them
• Dislikes certain clothing, shoes, hats, mittens and complain about the tags, the fastening, the type of fabric, the style, etc.
• Dislikes hair combed, washed, or cut
• Some toddlers refuse to be held or touched
• They might cry out in pain if the wind touches their skin or grass gets on their feet

The above are a few symptoms of a larger challenge, and “picky eating” is a consequence of an overall global picture of what is known in occupational therapy language as tactile defensiveness. Often, working to correct this issue can have a positive impact on eating.

If you are concerned, and you identify with a lot of these symptoms, please look for some professional help. You will be looking for an occupational therapist trained in sensory, oral motor and feeding issues and if you seek out a speech-language pathologist, please make sure they are trained in oral-motor and feeding.

I encourage you to refer back to my series called “My Child is a Picky Eater” for some general tips that you can use even in these extreme situations.

Useful Websites

• I also really like Angie Voss, OTR’s website. She has great explanations on sensory issues and some fantastic inexpensive PDF downloads.
• I also like the Sensory Processing Disorder (SPD) website, it has some good information on it as well.

My next blog will discuss ways you can increase your awareness in what motivates your child from a behavioral/sensory perspective.

Please contact me if I can help you any further.

Rosemary Slade, PLLC, OTR, NC is a practicing occupational therapist and mineral-nutritional balancing practitioner. She can be reached on this website. This article is not in any manner, shape or form intended to be considered or construed as medical advice or providing a medical diagnosis. This article is for entertainment purposes only. Please see your medical doctor for medical diagnoses.