How do you know if you need feeding therapy?

malcivar

DS2 will be 2 yrs old next week and we have an unsettling problem.  He still eats baby food.  

He flat out refuses and will throw up if you try to give him table food - except in the following cases:  bread, cookies, waffles, french fries, tater tots, goldfish, cereal (Honey Nut Cheerios), graham crackers, saltines, regular butter crackers and chips.  Granted some of these aren't ideal choices, nor does he get them in large amounts but we keep trying to see what he'll reject and what he won't.  

I did get him to eat 5 blueberries on Saturday but Sunday he refused them again but did eat 3 raisins.  

He'll only eat jarred baby food for everything else.  If I try to give him a piece of banana, nope - maybe some cooked carrots - nope, elbow pasta - nope, mashed potatoes (thinking it was a consistency thing), nope, rice - no.  And forget about any kind of meat.  

Oh wait he'll eat PB&J.

He has his 2 year appt next week and I'm wondering what exactly feeding therapy entails and is it something that maybe we need or is this just typical pickyness?  We never had issues with Christopher, other than he won't eat anything that's not room temperature but he has a pretty good variety of food he'll eat.

Thanks  

MirandaHobbes

I've never dealt with this so have no idea, but I find it intriguing because baby food tastes so horrible! Does he know that it is coming from a baby food jar? Can you puree something and put it in a baby food jar and make him think it is baby food (just to start the proces and then increase consistency)?

ShieldMaiden

My DD is receiving feeding therapy for similar issues. She eats mostly beige, crunchy food, and lots of milk, and will throw up if presented with certain foods. She also ate baby food for a longer time than is typical. Our SLP/feeding therapist thinks her issues are mostly sensory in nature given that she doesn't have issues with chewing and swallowing, and that she will occasionally eat other textures.

Her therapy is focused on desensitizing her to non-preferred foods through play with those foods. We've painted with all sorts of items (mustard on bread, whipped cream on strawberries, pureed fruit on cake), and worked toward touching those foods, then tasting. Her SLP has also brought Jello with toys embedded, tries to get her to stir and scoop, etc. We also use rubber Nuk brushes to help stimulate her mouth during these exercises. The SLP tried a Z-Vibe, but DD didn't care for it.

For us, progress has been incredibly slow because she is so reactive/resistant. We even tried cutting back on the amount of milk she's allowed, but she is one of those kids that will starve rather than eat things she doesn't like. She didn't make up for the decrease in milk by eating other foods, and as a result, we think she was constantly hungry, and her therapy sessions began to suffer. She also lost some weight, so after a month we had to increase the milk again.

malcivar

ShieldMaiden, I think we have very similar children!  He's very similar to how you're describing your daughter.  I'll bring it up when I bring him in for his checkup next week to see if we can't get the ball rolling for feeding therapy.

The other thing is that because we've had so many issues, we just realized the other day, that we haven't actually tried to get him to start eating w/ utensils by himself.  He can pick up his sandwich and feed himself finger foods but nothing with a spoon or fork.  Time to start that!

greyt00

I would be concerned as well.  My son is a lot like that, except with less variety.  He ate baby food well into his second year.  Nearly every jarred meat/veggie baby food contains carrots as a main ingredient and my son literally turned slightly orange.  He stopped eating jarred baby food and went to pouches.  Little by little he got pickier about which pouches.  He often dropped a food when he got sick (cold, stomach virus, etc.) and then never got back on it.  We've been stuck on Happy Baby mango pouch for a long time.  They did the unthinkable and changed their packaging.  NOOOOOOO!  He wouldn't eat the new one.  We bought out supply of the old one in every store nearby.  Fortunately he had just started feeding therapy in his ABA center and their first task was to get him on the new pouch. Mission accomplished.  Phew.  Now they are working on real food, but it will take years.  Until we get sufficient parent training, we are not doing anything with food at home.  Our first training is tomorrow.

He gets OT as well and she is working on sensory stuff but not really with food.  I like the treatment ShieldMaiden is describing, but our OT is just dealing with touching non foodstuff and working on his play skills.  My son really likes carbs, too, but he will only eat (usually) French toast sticks, and sometimes club crackers, chex, graham crackers, cheerios, and Nilla Wafers.  He mastered Ritz crackers and cheddar cheese slices at ABA, but we've not yet offered it at home.  We will after the training.  He has not yet mastered green bean or mango (the other first foods we picked).  That's going to take longer.  We're about to start scrambled eggs and plain old bread.

The lack of nutritious food has affected his growth (height as well as weight) and we put him back on whole milk a few months after switching to 2% when he turned 2.  It's awful.  I mean I kept fearing he'd need a feeding tube and he doesn't (yet) so it's not that bad, but it still drives me completely insane.  We can't even put Duocal in his milk because he can taste the difference (it's supposedly tasteless).

I have no idea what to do anymore so I'm letting the experts do their thing and teach us.  We both work and we have a younger child and it's just so much to deal with.  We are all convinced it's in his head.  My child will also prefer to go hungry so we are very dependent upon milk for calories and protein.  Which he will only drink out of a particular cup.  Which is something we can't mess with until he's getting more calories and protein from somewhere else.  Such a mess.  When I hear people say their kids eat a lot and will eat almost anything I seriously want to hurt them!  ;-)

mightmom13

DD would only eat out of the food pouches at this age; only certain flavors and certain brands. She was a vomit-er too on solids but it would mainly happen in the crib so not sure if it was related to what or how she ate. She was also in the "white eater club" for a long while. I believe with in home food therapy we started to graduate to bananas, Cheerios, chicken (notice all still white), apples, no milk though or almond mild and stopped with the rice cereal even when added flavor. She graduated from feeding therapy right before dysphaghia diagnosis and is now starting to trend to packets again (I got the apple sauce for on the go) and spitting out other food without swallowing.

I just found out about a feeding therapy clinic semi-locally from another ASD mom. Oh, and we still are not using utensils consistently. 

macchiatto

I would be concerned as well.

When my son was finally evaluated by EI at 2y9m, he was able to get feeding therapy for relatively minor issues. He ate a somewhat varied diet but he:
* was still drooling and seemed unaware of it

* would overpack and choke on his food

* generally seemed to have some oral motor and sensory issues and anxiety related to food/eating

* would develop a full-blown panic if there was a speck of something on something else (even a dot of tomato sauce on his napkin or something) 

* had really high anxiety about trying anything new and having certain textures in his mouth

When the SLP evaluated him, she said we could basically go either way with feeding therapy for him or not, but asked if I thought it would be helpful. I said yes, and it was, very. He had 6 months of feeding therapy and we worked on "waking up" his mouth, the sensory issues and anxiety, the overpacking/choking, awareness of and reducing the drooling, etc. Lots of food chaining helped too. It also helped the NT twin who was just a typically picky toddler, since the therapy was in our home during lunch.  

lemen99

I would be concerned.  Both of my kids were in feeding therapy - my oldest (on the spectrum) was it in for a while.  My youngest puked on any texture (as you describe) and the OT said he had silent reflux, 2 weeks on prilosec, he was fine.  My oldest also had reflux but was on meds, but being a preemie, had sensory/texture issues & oral motor coordination issues & oral aversion.  Therapy was amazing and both of my kids are fantastic eaters now.