Do you wonder why your child is so selective in her eating?
While there is never a simple answer to this question, we know that feeding problems typically arise from a whole bouquet of reasons. These reasons include, among others, sensory challenges, oral motor delays, anxiety levels, the history of a food trauma, incorrect feeding strategies, genetic predisposition and a whole host of organic issues that can make eating very difficult.
Today I would like to talk to you about oral motor delays including chewing problems. Chewing problems can be a hidden root of feeding difficulties in children. As kids grow and develop, they go through a set of milestones to learn to manipulate different textures in their mouth. Occasionally, they may get a couple of steps behind kids of their age.
What I learned from my professional practice, is that chewing problems are easily missed by parents, especially if the child has only a mild delay. At the same time, the impact on mealtimes can be enormous, from taking very long time to eat to rejecting a whole set of challenging textures.
So I decided to catch up with Simone Emery, a nutritionist from Australia with two children of her own. She has been working in a team care clinic for extreme fussy eaters for over 3 years and has accumulated tons of experience, including in treating children with chewing difficulties.
I love Simone’s work because she uses a personable, non-judgemental and holistic approach to helping with the root causes of picky eating. She teams fun recipe ideas with tasty morsels of feeding tips at her site playwithfood.com.au. Simone is also part of Your Feeding Team, a very exciting project that is coming your way in a very short time!
Feeding Bytes: At what age are chewing problems likely to start affecting a child’s eating?
Simone: Depending on the root cause of the chewing issue, they impact a variety of foods from a range of ages.
Feeding Bytes: What are the signs that a child may need more help with chewing?
Simone: If a child has immature chewing skills they will often struggle with mixed texture foods (like casseroles and chunky soups).
They may stick to a beige diet as these foods present less oral motor workloads. The beige diet is also more consistent in its sensory properties and needs less work from that point of view.
A child may also pocket food in their cheeks and leave it to rest there for a while.
The child may also nibble foods and have the pieces float around their mouth.
They may not lick-clean their lips.
Or they could overstuff their mouth. Noting that overstuffing is part of normal development of skills but it is expected to not be prolonged.
Other indicators of chewing concerns include using the roof of the mouth to manipulate foods, struggling to transition to different textures of foods, struggling to use an open mouth cup to drink from and constantly prolonged holding the food at the mouth with fingers instead of biting off pieces.
Feeding Bytes: Why is it so hard to identify chewing problems?

Simone: One of the main reasons is that children with chewing concerns may have a limited diet and only eat easy to chew foods. Hence, we get less opportunity to notice the issues. Parents can focus on the foods consumed rather than the functional goals that some foods can help children with.

For example being able to bite into a dissolvable food on the molars is an important oral motor development step, yet, dissolvable foods are often seen as “unhealthy”. I am not saying to ONLY serve children Cheetos and meringue, but just to remember that this functional aspect of these sorts of food also has some merit.

We can’t expect children to go from an apple puree to curried chickpeas on rice without learning how to bite into foods whilst still using their mouths to contain the liquid component too.

Chewing often flies under the radar as a problem due to the environmental factors of the meal too. Perhaps children eat with a screen on, are spoon fed for a longer period of time or don’t eat with a parent sitting and modeling chewing regularly.
Feeding Bytes: Why do some children have trouble developing their chewing skills?
Simone: There are medical reasons for immature chew skills including a history of pain, reflux, tongue tie, pallet/mouth formation, and hospitalizations. There is also lost opportunity for development if children have been fussy about the foods they will eat. Some children need more practice than others too.
One possible hidden reason your child has trouble eating - Feeding Bytes
Feeding Bytes: What are the first steps parents need to take if they suspect that their child is falling behind in respect to chewing?
Simone:
Talk to a feeding health professional about your concerns. Getting individualized assistance is always so important.
At home, sit with your child for a few meals with different foods and textures and gently observe the way they manipulate foods, chew and swallow them. If you want to write your own notes that can be helpful if done privately away from the child. Make the observations as pressure-free as possible.
Once you have some clarity about what your child is doing, try some playful exercises in front of a mirror with them away from mealtimes to see what else they can do.
Talk to a feeding health professional about your concerns. Getting individualized assistance is always so important.
Feeding Bytes: How can parents support their child at home?

Simone: I have a few videos and playful exercises that parents can do with their kids. There are 8 videos of approximately 2 minutes each in “Let’s Chew” – an online class for parents. The accompanying handbook helps parents get some deeper understanding of what sorts of chewing concerns children can have, how they manifest and what easy things they can do at home to help.

A set of chewing exercises for children with chewing problems

Disclaimer: I have seen first hand the positive effect Simone’s resources have on many cases of feeding problems. I am now a proud affiliate of her online resource for parents – Let’s Chew. If you decide to purchase the product, I will earn a small fee, to help with the running costs of this website, so I can keep supporting you every day.  It does not affect the price of the product.

Disclaimer: The course is not a replacement for individualized therapy plans. It is a tool to equip parents with knowledge and some first steps towards helping their child in the home environment.

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