Wondering whether feeding therapy for picky eating works? Read about our experience with feeding therapy for our toddler's picky eating, and tips for how to make the most of every session with your therapist!
This blog is about our toddler son who's had eating issues his whole life and is a picky eater. As soon as we realized that he is pickier than typical babies, I started doing lots of research about how we can get him some help (and get some help for us as parents, because mealtimes were so stressful for us).
I was surprised and relieved to find out about feeding therapy! It was such as relief to find out we were not the only ones going through this, and that we would be able to get professional help for our son.
I wanted to write about our experience with feeding therapy for our toddler and how it helped him. Hopefully this post is helpful to other parents who are considering feeding therapy for their picky eater child.
What is feeding therapy?
The purpose of feeding therapy is to help babies and toddlers learn to eat, or learn to eat better. It can be used to help babies learn to chew and swallow properly, decrease tantrums during mealtimes, and increase acceptance of new foods. It can be both a physical and psychological therapy, depending on the child's needs. (Source: 1,2)
Feeding therapy for toddlers is typically done by an occupational therapist (OT) who specializes in speech or oral motor function. Some OTs specialize specifically in feeding therapy, some are more general speech pathologists. The reason speech therapists often offer feeding therapy services is because speech and feeding both require similar oral motor skills.
Feeding therapy is typically recommended for babies and toddlers who have some kind of diagnosis, such as sensory processing disorder, autism, or other disorders. But food therapy can be an option healthy babies and toddlers who are having difficulty chewing or drinking, and can be a good option for picky eaters to improve their relationship with food and get them eating a wider variety of food.
This article focuses on feeding therapy for picky eaters, and I am simply sharing our experience, not providing professional advice.
Does my toddler need feeding therapy?
Obviously, I am not qualified to answer this question for you. Your pediatrician or an OT should determine if your child needs feeding therapy. Depending on how hands-on your pediatrician is, they might be more or less inclined to recommend seeing a therapist. One of my son's pediatrician has been practicing for 32+ years and has seen it all. He waved his hand dismissively when I mentioned feeding therapy. Another pediatrician recommended it because she was super concerned for our son's weight (read about our son's struggle with weight gain).
Every OT we spoke to highly recommended it, even before evaluating my son in person. This is not only because it would make them $$$, but also because every toddler can probably benefit from working one on one with an OT in some way or another. They are experts in this, they know how they can help, so obviously they recommend it.
My recommendation as a mom of a picky eater is: if you're worried about your child's picky eating, if you believe they are pickier than others, if your baby or toddler gags or vomits a lot while eating, if they refuse to touch some foods, if they are not trying new foods, if they are having tantrums while eating, if they refuse to get into the high chair, if they don't like playing with sticky slimy textures, if they freak out at the sight of new foods, if they are underweight, or if the thought of having to feed your toddler is seriously stressing you out, then it is worth looking into feeding therapy.
I started looking for food therapy when I started having panic attacks thinking about my son's delayed weight gain, his limited food options, his constant gagging and vomiting while eating, and him not getting enough nutrition from his diet.
Trying to feed our son was a constant source of stress, and I knew we needed help.
Online picky eating class
An online course is a great option if you are not able to put your kid into in-person therapy right away.
We live on a small island where there was no occupational therapist for the longest time, so I turned to the internet. I found this Mealtime Works Picky Eating Class from Alisha at YourKidsTable and signed up for it IMMEDIATELY. It is a very detailed course created by an occupational therapist and mom of 3 kids, and it consists of several modules with lots of how-to videos and worksheets.
It teaches you a good foundation about picky eating and teaches you how to approach your mealtime environment at home, how to introduce new foods to your kid, how to add more variety to their diet, and lots of things you can do outside of mealtimes to improve your child's relationship with food and make them more open to trying new foods.
Honestly, it was mind blowing to learn how wrong we've been about our approach to my son's eating. Even though we honestly tried our best for many months, we just had no idea what we were doing. It wasn't our fault, no one ever taught us any of this and all our friends and family offered the most unhelpful advice (no matter what good intentions they had).
Considering that the course is less than the cost of ONE in-person feeding therapy session, it was a no-brainer.
It felt so empowering having a step by step plan for dealing with any problem we might encounter with my son's eating.
I would recommend the class even if you do plan on getting therapy in person. The course seems pricey, but it is cheaper than a session with most therapists, and it will give you the foundation of how to speak your therapist's language so you can get the most out of in-person therapy sessions.
We were able to save lots of time (aka money) with an in-person therapist because we already knew how to approach picky eating, how to offer my son food, how to deal with his sensory issues, and we knew what to expect from feeding therapy overall.
The course also gives you access to a private support group where you can ask questions specific to your child and their issue of the week (because we all know it's something new every week!) and get answers from Alisha herself within 24 hours. I was in there every day asking questions.
We've been following the techniques we learned in the class for almost a year now, and we're seeing huge progress. We went from literally eating only 5 cheerios a day and throwing up in the middle of meals, to regularly eating pasta, rice, chicken nuggets, deli meat, and lots of fresh fruit. We still have work to do, but this is amazing progress! My son is gaining weight and looking forward to meals. And most importantly, we know the strategies we need to keep expanding my son's food variety.
We don't feel so helpless anymore. Mealtimes are no longer a reason for stress in our house. We actually have a good time as a family when we sit my son down in his high chair.
If you're interested the course, you can get more information here:
- Mealtime Works
- If you're curious about Mealtime Works but don't want to commit yet, Alisha also has a free online Picky Eating Workshop that takes you through the basics of 3 strategies to try to turn picky eating around.
In Person Feeding Therapy with an OT
A few months after we completed the above course, an occupational therapist was finally available on the island where we live. We hesitated for a while whether our son still needed therapy since we've seen such huge progress from the course and knew pretty much everything we needed to keep doing to help our son on our own. But we decided to go for it. I figured, if we don't take this chance and my son's eating gets worse again, we will regret it forever.
I am really glad we signed up for feeding therapy.
Cost of Feeding Therapy
The cost of feeding therapy was of course the biggest concern. Our therapist charged $300 for the initial evaluation and then $150 per 1-hour session. This is actually on the lower end of the spectrum in terms of price. Luckily, after lots of phone calls to insurance and referral letters from a pediatrician, we were able to get our insurance to cover a total of 20 feeding therapy sessions. Our doctor had to write a specific diagnosis code in my son's file in order to get coverage because just "eating issues and underweight" was not enough for insurance to cover the cost of the sessions.
If you live in a place where you have the option of early intervention, look into how that all works with you insurance. But either way, your therapist should understand that it is a very expensive service. They should work with you to make a plan that makes sense based on your budget, the amount of therapy that your insurance covers, your child's needs, and how long of a therapy session your child can handle in one day.
Our insurance covered 20 sessions no matter how long each session was, so we decided to do 1-hour sessions every two weeks to maximize the benefit. This worked out great for my son who doesn't get stressed from being around a stranger, but the longer sessions might not work for every child. If our insurance only covered a total dollar amount instead of the number of sessions, we would have made the sessions shorter and more frequent. Work with your OT to figure out the best plan for your child.
Luckily, an online course such as Mealtime Works is an affordable option to supplement the expensive therapy sessions, and can really help you learn how to approach mealtimes with your kids, how to introduce new foods to them, and expand the variety of foods they eat.
Feeding therapy goals
When we first met with our therapist, I was able to summarize my son's eating issues very succinctly thanks to the Mealtime Works class we took. The OT evaluated our son while he was eating lunch in daycare and confirmed that his issues came mostly from sensory and textural issues. His motor oral skills were mostly fine, though he was an extremely slow chewer. I felt frustrated at first, because I knew all of this. Did we really just pay a huge copay to learn what we already knew?? But I gave it a chance.
Our therapist had us write down the foods that my son eats (read about it in my Picky Eater Foods Worksheet post) and set a goal for my son:
After 4 months of therapy, my son will eat a carb, a meat, and a veggie at most meals.
Again, this felt frustrating. All that time and money, and he will eat just ONE veggie?? But we decided to go for it, because we were afraid it would be too late if we didn't get our son the help he needs now.
Pediatric Feeding Therapy Techniques
Our therapist was very transparent about what she did at every session and what feeding therapy techniques she used. She did ask us to leave most times so she could work with our son one on one. This was a good approach because our son is definitely on his best behavior if we are not there to act out to. He actually listens and does as he's told instead of skipping around like a baby goat like he does when mom and dad are around.
Since we went for the 1-hour sessions, each session started with a sensory exercise. They would finger paint, use sticky glue, play with sand and dirt, play with jell0, and make simple crafts that required touching different textures such as cotton balls, grass, and sand.
(By the way, check out 52 Weeks of Sensory - it's a year's worth of sensory activities I put together with a focus on picky eaters!)
The therapist always says "if it feels good in his hands, it will feel good in his mouth." We learned the importance of sensory play from Mealtime Works, but our son refused to participate in most sticky and wet sensory activities at home with us, so we were glad he was able to do do this with the therapist. It felt frustrating to have to pay someone so our son can finger paint, but that's what we had to do.
After that, the therapist would clean my son's hands and start the feeding session. She would always ask us to bring a "preferred" food (pasta and deli meat for us), a non-preferred food (we were working on vegetables and breads, so it was usually steamed carrots that were pan-fried in salted butter to make them yummy, and soft hamburger buns), and 2 preferred snacks of different textures (cheerios and jello for us). By the way, I have a recipe of homemade jello with fresh fruit on this blog if you want to make your own to avoid artificial colors and flavors.
The OT would take turns feeding my son his favorite and his non-favorite foods. Sometimes she would feed him. Sometimes she would lay it all out and have him pick what he wants, but the rule was he couldn't have the same thing twice in a row. I don't know HOW she explained the rule to a two year old! But he totally listened to her.
She also sometimes sang and made silly sounds and cheered my son on really loudly and enthusiastically when he tried new foods. It made my son giggle and it worked.
After just a few sessions, he started eating bread when it was "hidden" on a fork with pasta, or when it had a slice of deli turkey on it. He also started eating carrots with pasta. A few weeks after, he was taking bites of the bread on its own, and a few bites of carrot on its own. Here is a video of my son eating a carrot on his own in therapy:
AMAZING! I cried tears of joy when I saw it!
But what's even MORE AMAZING is that our son suddenly became more open to trying new foods at home. He was willing to touch slimy foods, such as oily salmon. He started eating pizza. He ate saucy pasta. He tried most vegetables we offered. He still spit most of the vegetables out, but even trying a vegetable is progress when it comes to picky eater toddlers.
So we were able to meet and exceed our feeding therapy goals. My son now regularly eats pasta, rice, tortillas and sandwiches with soft buns, cucumber, corn, cherry tomatoes, and sometimes carrots at home. He also eats chicken breast, pork (pulled pork and pork chops), and LOVES salmon. This is a huge step from chicken nuggets just a few months ago, and ONLY thin sliced deli turkey just a few months before that.
Benefits of Feeding Therapy
So yea, I am super excited that we did this and totally see the benefits of food therapy for picky eaters. We've seen such huge progress. Of course, in-person therapy is fantastic if you have access to a therapist and can afford it. But even if you don't, you can implement lots of the same feeding therapy strategies at home.
In fact, our therapist recommends we continue to use the same techniques at home. Luckily, she didn't have to spend time teaching us because we were already educated thanks to the Mealtime Works class we took. But if we didn't know all this already, we would have learned it all from her. So make sure you find a therapist who you enjoy working with, enjoy learning from, and who is willing to share her knowledge with you.
It's a long journey. Sometimes it's a one step forward, two steps back situation. But feeding therapy is definitely beneficial for picky eaters and has played a huge part in our approach to mealtimes at home.
Feeding therapy at home
You can absolutely do a lot at home and save a ton of money on in-person therapy. But please follow a professional's advice or use what you learn from Mealtime Works instead of just relying on what you read on this blog. 🙂
The main problem with trying to implement all food therapy techniques at home is that kids are often not on their best behavior with mom and dad, especially if we are trying to get them to do something challenging. As I mentioned above, my son is much more willing to try finger painting, or to follow the rules of the eating game with our therapist than at home.
But it doesn't hurt to keep trying. You can also try to get other family members involved. Perhaps it's more fun to finger paint with grandma or an older sibling or cousin. Or maybe other moms would be interested in a playdate where kids get messy and play with slime or jello. Get creative! Find new ways to introduce these techniques in a low-key no-pressure way. Basically, trick your kids into doing them. 🙂
Sensory Play as Part of Feeding Therapy
As I mentioned above, our feeding therapist started every therapy session with a sensory activity. This made me realize how important it was to keep doing sensory stuff at home. It can be SO HARD to remember to incorporate sensory activities into our daily lives, but I decided to make a commitment to my son and do sensory play with him at least once a week for a year.
So what do you think? Was this helpful? Have you tried feeding therapy for your child or are you just starting to look into it?
If you are considering feeding therapy for your toddler but have any mom-to-mom questions you want to ask, I would be glad to help answer any feeding therapy questions that you wouldn't want to ask a professional. Just leave a comment here, or send me a private message on Instagram or Facebook.
Helpful resources for picky eating:
- The 7 Rules of Picky Eating - these 7 easy rules will help shift your mindset and help your child through their eating journey.
- 3 Easy Sensory Tricks that Help my Son Eat - we've been using these with my son for over a year and they work, almost every time!
- How the Nuk Brush Helped Stop Gagging and Throwing Up During Mealtimes
- The Picky Eater Food Worksheet - this is a super helpful tool that helps me realize that my son eats "more than just 5 foods" and helps me plan his meals
- How to Get a Toddler to Gain Weight
And if you think this would be helpful to other parents, please share it on Facebook and save it on Pinterest for later!