TODDLER DISLIKES TEXTURED FOODS

My toddler of 2 years doesn’t like textured foods like oats, mealie meal and red meat. He tends to vomit when he swallows. What should I do? How can I help him?

Having a child who is a fussy eater can be very frustrating. Aside from making mealtimes difficult, it is also a nutritional concern. But before understanding how to help your child, it is important to have a general understanding of food aversions, or dislikes.

Food aversions are complex in nature, with a variety of causes, but are generally due to sensory problems or oral motor issues. Eating is an experience rich in sensory inputs obtained through smell, visual appearance, taste, temperature and texture. We have five basic senses: vision, hearing, smell, taste and touch. Three additional senses can be added as proprioception (awareness of body movements), interoception (understanding what is going on inside your body) and vestibular (sense of balance). These form part of sensory perception and help one make sense of the world and experiences. Often when a child presents with a food aversion, additional sensitivities may be seen in these areas. Therefore, children with sensory aversions may demonstrate other sensitivity issues, such as avoidance of certain textures or even be sensitive to bright light or loud sounds. Additionally, sensory aversions can often be the aftermath of a traumatic or negative event involving certain foods.

On the other end, food aversions may be due to oral motor issues, such as weaker muscles or uncoordinated movements.

Children with oral motor issues may demonstrate reduced ability to chew food and move food around in their mouth and may also demonstrate speech difficulties.

It is advisable to seek professional guidance from professionals who specialise in working with children with food aversions. You can talk to your paediatrician if you are concerned about your child’s food aversions, as it may be partially related to other conditions and issues.

Additionally, a speech-language therapist can assist with oral-motor difficulties, while an occupational therapist may assist in sensoryrelated feeding aversions, and a dietitian will be able to assist in creating a comprehensive plan to ensure your child maintains adequate nutritional intake, while building the required feeding skills.

These professionals’ approaches and expertise differ, but they combine to improve the holistic view of feeding for ultimate intervention success.

Although it is difficult knowing what may cause your son’s food aversion without an indepth assessment and case history, there are some general guidelines you may want to give a go. Firstly, try using an electric toothbrush twice a day, and allow your child to take the toothbrush and brush his teeth. Secondly, cook together. Your child will be more relaxed and may be inclined to try food he helped cook.

Thirdly, adapt food to look and smell different. Add small amounts of textures he struggles with and mix it with more tolerable textures. Add more over an extended period of time until your son tolerates the given textures easily.

Fourthly, sit at a table with your son, and give a plate with one type of food that he eats, but isn’t necessarily fond of, then have various other food that he might not tolerate on your plate. Exaggerate how you are enjoying your food. Keep doing this until he takes something from your plate. Don’t make a big fuss, just comment on how you are enjoying your food. Lastly, take an ice tray, and place various textures (ones he loves, some he tolerates and others he doesn’t tolerate) in different containers of the ice tray. Use different colours and textures. Then go outside and paint using these soft textures. While the two of you are painting, smell and taste the various flavours.

All of these activities should be done in a playful way. Don’t force your child. Allow him to experience this at his own pace, and keep activities light and playful. Remember, each child is different, so you might want to consult a professional to obtain an individualised plan and advice.

As soon as you get used to what they like, your toddler surprises you and starts refusing foods she previously enjoyed. When your toddler sticks to only a few favourites and starts to reject most other foods, it can leave you exhausted and confused. But even though these fussy toddler eating patterns are a normal part of growing up, an understanding of why it happens helps you figure out how to deal with it.

Children have their own language through which they communicate with you heart to heart: their behaviour. It’s important to notice this language, so that you can lead your children to grow and solve problems. You should see your child’s behaviour in the context of your relationship, says Hettie Redelinghuys, an educational psychologist and mom of two based in Bloemfontein. If your little one for example fetches his pyjamas himself to prepare for bath after dinner, it’s positive (complementary) behaviour, as it shows he’s learnt there’s a routine in your home.

On the other hand, difficult (compensating) behaviour will show in spots in your relationship where your child through his behaviour tries to bring about a shift, so that your relationship can be more balanced.

Your child’s behaviour wants to tell a story or show you something, Hettie says. “It’s important for parents to ask: ‘What is my child’s behaviour trying to tell me about our relationship?’ And then ask, ‘What can I learn about my child from this behaviour?’ The aim of the behaviour is even more important if it is repeated or forms a pattern.”

If you interpret your child’s behaviour, remember the following, Hettie says:

• Behaviour communicates feelings. “What’s the first spontaneous feeling that makes an impression? Focus on this feeling that his behaviour communicates, not your own emotions.”

• Naughty behaviour usually points to a problem area in the child or parent that needs to be sorted.

• Naughty behaviour can indicate that it’s time to set new boundaries or take away existing ones. Unnecessary boundaries get in the way of communication.

Carin Bester, a clinical psychologist based in Stellenbosch, explains what children are actually telling us with their naughty behaviour – and how you can use this information.

Thube’s (4) parents are very angry. They told him to leave the shampoo next to the bath alone – but the next moment, he has gone and emptied the bottle of expensive shampoo into the bath! They don’t understand why Thube is so deliberately disobedient.

I’m discovering my environment, and everything that can open, shut or I can throw out fascinates me. Everything looks like a new opportunity for play. I can’t resist the temptation.

It’s important to keep children stimulated in an ageappropriate way at their different stages of development. It could be that Thube is a little bored and wants to discover interesting new things. Thube’s parents can create a space with things that he enjoys – for instance playing with water or clay, or getting dirty – where he can make a mess to his heart’s content and satisfy his curiosity. Thube’s parents should also focus on their son’s listening abilities by practising them.

They could say: “Thube, look at me while I’m speaking to you: don’t touch the shampoo, but we can play with your bath toys.” His parents must make sure he understands and follow up to make sure he listens.

If Nonki’s (2) friends, brothers or sisters make her cross or have a toy with which she wants to play, she hurts them. Her dad has repeatedly told her she’s not allowed to hit, bite or hurt, and punishes her when she does, but she keeps on doing it.

I’m just two years old, and my language abilities are not well developed, so I become frustrated quite quickly. I battle to say how I feel and what I want, and

I use biting, hitting and hurting as ways to convey my message.

At this age, it’s important to have clear rules and boundaries about hurting, like: “We don’t hurt others, Nonki!” Try and distract her before she gets into this behaviour, and encourage her to use her words to describe what she wants or how she feels. You can help describe how she feels: “I can see you’re upset because you can’t play with that. Let’s rather draw a bit.”

It’s important to help her understand that her behaviour hurts others. Parents can do this by focusing on the child who got hurt and giving them extra attention, and also asking Nonki to say she’s sorry.

Ravi (5) knows he’s not allowed to play rough games in the house because his parents are worried he’ll break something or hurt himself. But before long, he plays rough, and now he’s broken a precious heirloom.

I’m a little boy with lots of energy, and we usually play a little rough. I never plan to play rough; it only happens when I pretend I’m Superman. Then I forget I’m inside the house, and that I’m actually only allowed to play like this outside.

Ravi’s parents can help by focusing on the good behaviour, like when he’s playing calmly inside for a bit, and by constantly reminding him that rough play should be reserved for outside. Children of Ravi’s age need enough robust play every day, so that they can get rid of their excess energy. So it will help if Ravi’s parents could ensure that he plays with his friends outside for a couple of hours each day. Another plan is to enrol him for sports such as gymnastics, so that he can use his energy in a positive way.

Her parents don’t know how to handle it. Loveday (6) steals. It’s reached the point where they have to search her pockets after she’s been to a friend’s house for a playdate.

I steal because I’m battling psychologically with handling or processing something that’s going on in my life (like being bullied, struggling with homework, not getting enough love). By stealing, I’m trying to meet the psychological need that arises from what’s going on in my life right now.

Stealing is wrong, and children need to know and be taught this. So, it’s important that there are appropriate consequences. Loveday’s parents can for instance help her return things to their rightful owner and say sorry. If it becomes a pattern, a psychological evaluation is the best plan, so that potential underlying psychological issues can be treated. Serious psychological help is needed when Loveday’s not only stealing but also behaving antisocially in other ways: playing truant, vandalising, abusing animals, telling lies or committing arson.

The moment things don’t go Andile’s

(3) way, he says things like “I hate you!”, “You’re not my dad!” or “You’re awful!” to his parents. This hurts them.

The fact that I’m saying these things does not mean that I don’t love you. I don’t yet realise the emotional load these words carry.

I hear them from other people and use them when I’m hurt, angry or frustrated, because I’m still learning how to express my feelings. I can say anything to you because I know you’ll always still love me. It hurts when a child uses this kind of language with you, and it’s often difficult to process. It will help if Andile’s parents try and understand why he’s so upset, and put this into words, like: “Andile, we don’t say we hate someone, but I can see you’re very upset. Can you tell me what’s wrong?”

Susan (5) has the gift of transforming a room into absolute chaos within five minutes – but then she’s doesn’t want to tidy up afterwards. Her parents don’t know what to do, have reprimanded her time and again and even given her timeout, but without success. It’s a daily battle.

I’m not really good at picking up toys. It’s hard work for me. If I look at the untidy room, the chaos overwhelms me, even if I created it myself.

Susan needs to learn that there are rules and boundaries in the world.

Even if she complains when she has to tidy up, it is necessary for her to understand that it’s expected that she’ll tidy up. Her parents need to be very consistent with this: “Susan, you can’t go and play outside before your room is tidy.” Then she has to ensure that this happens. Children quickly feel overwhelmed with the size of a task. Susan’s parents can limit the chaos by rotating her toys, so that she plays with fewer at a time. She can also break the tidying up into smaller chunks: “Tidy the dolls first. Now pack away the blocks.” Susan’s parents can also get creative by for instance singing a special song while they help at first, or to make a game of it by racing against time.

A star chart for a room that’s tidy at the end of the day can help.

Always warn beforehand that tidyingup time is near: “Susan, I’m fetching juice now. We need to tidy first before you can have your juice.”