Although my little boy loved to put things into his mouth, he refused to eat food. Every toy, every piece of dirt, and every hair he picked up went straight into his mouth. But if I placed any type of food in front of him, he would look me in the eyes and throw it on the floor.
He didn’t finger it, play with it, or even look at it. He just picked it up and dropped it on the floor. I would watch other babies happily making a mess, playing with their food, and eating it. They would be gobbling down different textures easily and I would wonder to myself, how did their parents get them to do that?
My little guy simply had no desire to eat. Since it hurt him to eat because of his reflux, he learned to hate food and everything associated with it, especially his high chair. As soon as we lifted him up to put him in the high chair, he would stiffen his body and scream until he choked. By the time we were able to get him into a sitting position, fasten his belt, and slide the tray into place, he was screaming and crying so much that he couldn’t even see the food that we were trying to offer him.
But he needed to eat. He wasn’t growing or gaining weight fast enough. He needed more calories and more nutrition. However, every time we tried to feed him he lost more calories than he took in. If I put even a tiny dot of pureed food into his mouth, he would immediately vomit.
After several months of attempting to feed him, we figured out that he wouldn’t throw up a teeny tiny bite of food if he was distracted. If he was busy playing with a new toy, we could slip a small spoon of pureed food into his mouth and he would absentmindedly swallow it. But if he realized that we were feeding him, he would immediately gag and spit it up.
Because he desperately needed all of the calories he could get, and because we would do anything to get him to eat, we developed an odd routine. As Little Bear played on the kitchen floor, we would follow him around with a plate of food and slowly sneak tiny spoonfuls into his mouth while he was distracted. Our method was unconventional, but it worked. He was finally eating.
Luckily, our pediatric gastroenterologist was very perceptive. She knew exactly what was going on and she explained that the pureed food felt like reflux to him and it triggered the vomiting reflex. She also knew that our family needed some extra help, so she referred us to a pediatric occupational therapist who specialized in feeding difficulties.
Here is the link to the slideshow that was presented to us at the very first meeting.
Here are some of the highlights from what we learned and what worked for us:
We learned that eating is the hardest thing that we do since it involves every body system, all of the major organs, and even the mind and the emotions. The simple skill of eating includes many large and small muscles including tongue, lips, and cheeks. It also takes a lot of coordination and fine motor skills to eat. We realized that it will take some time for him to learn all of these new skills.
We learned that our Little Bear needed to be in a high chair. Because he had to use all of his muscles and focus on his coordination, he required the support and stability that a high chair provided. “That sounds good,” I said, “But how do I get him to eat in his high chair when he won’t stop screaming?”
“Eventually he has to stop screaming to take a breath,” she said, “When he takes a breath, praise his good behavior and say, ‘Good job sitting in your chair!’ You need to put on your poker face because the look on your face reinforces what he is doing.”
We learned to ignore a lot of negative behavior. “Even when he throws up, just keep calm and tell him, “You must feel better.” He will gag and throw up. The only way to get over gagging is to gag a lot.”
We also learned to praise positive behaviour. We applauded everything: trying new foods, holding the spoon, sitting in the chair, putting the spoon to his mouth, and even just trying:“Good job trying to eat!”
We also learned that toys and TV were not appropriate distractions during mealtime, since when he is focused on his toys, he is not engaged in the eating process. To keep him involved, we gave him kitchen and food-related things to play with while he ate such as measuring spoons, a whole pineapple, pieces of squash, plastic utensils, and various containers.
We learned to always eat with him since he learns from watching.
We learned to provide easy foods to grasp and chew like pieces of watermelon, avocado, canned fruit, banana, ripe pear, and mango pieces. Since too many choices can be confusing, we also learned to keep menus simple and portions small.
We learned the importance of a routine and how it is necessary to stick with a schedule even if he does not eat. Instead of constantly trying to feed our little guy, we learned to let him go a couple of hours without eating so that he would feel hungry and be motivated to try some food. We also learned to limit mealtime to about twenty minutes.
Out of everything that we learned, we realized that the most important thing is to keep trying. There will be good days and bad days, good weeks and bad weeks. We will go three steps forward, then two steps backward.
Although I was slightly skeptical about the occupational therapy, it turned out to be one of the best resources for our family. After several months of patience and persistence and applying everything that we learned, our little one is now eating a wide variety of textures and colours. He loves food and everything associated with it, including grocery shopping, working in the kitchen, baking, washing dishes, and wiping the table. Most importantly, he loves to try new foods, new flavours, and new textures. His experimenting doesn’t always go well, and he doesn’t always like the new foods. But it is so rewarding to watch him keep on trying.