Types of food
For some reason there seems to be a tendency toward salty foods for some reflux kids. Salty foods also have the added bonus of making them thirstier for liquids (preferably with some calories in them). This could be because of an electrolyte imbalance because of a loss of bile, but for some reason, some of the following salty foods seem to work when others don’t:
– french fries (ie those string-style, finely cut, very crispy chips)
– hot chips
Other tips from parents about types of food include:
– mix everything with pureed pear
– mix veggies with sweet potato
– won’t eat puree from a spoon? Offer it from a food pouch (the commercial bought ones).
But take care with texture. Sometimes smooth purees are okay, but adding texture may mean refusal eg adding meats and broccoli to a puree because the change in texture may suddenly mean refusal.
Food temperature
Try food at a different temperature. Often veggies that we would think should be nice and warm are better taken if they are room temperature or even cold. Even frozen foods can be a success especially if they’re teething. But if you think of your throat and oesophagus being regularly burnt, frozen foods can often be quite soothing. Even try things like bread rolls and cold purees.
Fortifying food that they will take
If calorie intake is an issue, consider fortifying foods that they will take (be careful not to overdo it – you don’t want to lose foods from an already limited range).
– if your child is on dairy and drinking cow’s milk, you can boost it by adding full cream milk powder to the milk & / or cream.
– consider adding Nuttelex, olive oil or any other kind of innocuous cooking oil or spread to foods
– if your child will dip and tolerate mixed textures, sauces are your friend… tomato, mayonnaise etc.
– Milk / formula concentration – if you’ve got access to a paediatric dietician, they can help you with increasing concentration of the formula safely – to increase calorie intake if you need to. You need to be careful with constipation though.
Odd places
Try feeding them:
– in the bath
– in front of the television
– in front of youtube
– in the shopping trolley while doing the groceries
– in the car
– some kids we know will only eat when watching a certain 2 minute clip of their favourite show on a loop. Whatever works!
Less odd places:
If one thing’s not working, try something else:
– booster chair at “the big table”
– high chair
– little table and chairs
– Bumbo with tray
– or just freelancing. You know, eat while traversing the furniture around other people who may or may not be eating.
Independence
As soon as it’s possible, let them try rusks and finger foods that won’t be a choking hazard. Kids who have feeding aversion experience loss of control over their feeding very early and have often (necessarily) been almost force fed. Allow the child to feed themselves when possible, even if messy, as it can really help.
Family & routine
Kids love being with their “peeps” and will often eat more when they are surrounded by family or friends and sitting at the table (even if with significant help – booster chairs, someone’s lap… whatever). The distraction and example will be the best motivator. Lack of fuss is the key. Even if it doesn’t work for eating, sometimes establishing a routine around food can be helpful in the long run. It’s the old-fashioned, forerunner to the play picnic.
Time of day
Try to pick a time for feeding that is likely to be before they are too tired and ratty behaviour sets in.
Equipment
Take this with a grain of salt – what works for one, doesn’t necessarily work for another and if you’re dealing with a child with food refusal, it’s likely you have a drawer full of every anti-colic sippy cup and teat on the market. That said…
– the Pigeon MagMag spout cup with the slit in a cross pattern at the end of it was recommended by a speech pathologist who can’t account for why it’s her most successful sippy cup. When they tip it up they don’t get a shocking gob-full, but when they bite on it (as they so often do) they get a bit of reward for effort and then they’ll seem to suck a bit. Don’t expect miracles though.
Mess is best
Traditionally its called baby led weaning. In line with some of the above tips, many people advocate for and there are many tips and ideas around about foods to prepare for baby led weaning. Remembering that each child is different, many respond well when left to feed themselves. In slow order, giving time to explore things, consider tipping purees, rice, spaghetti bolognaise, soft cooked veggies, chopped fruit and other foods straight on to the tray of the high chair. It is very messy, but much less stress. You would be amazed at what a young baby can manage with only one or two teeth (but please supervise carefully).
For further information on help with feeding see these presentations from our 2013 conference:
- Nutritional management and meal time management and oromotor skills of children with GORD – Nicole Dennis, Dietician and Sandra McMahon, Speech therapist – introductory clip. Buy full presentation here.
- How Sensory Processing Affects Meal-Time Management – Vivienne Williams, Occupational Therapist – introductory clip. Buy full presentation here.
- Tube feeding in infants with GORD – Looi Ee, Paediatric Gastroenterologist – introductory clip. Buy full presentation here.