Having trouble getting your children to eat right?
Does your child attempt to subsist on Goldfish crackers and Cheerios?
Does your child express fear when offered a new food?
People like Cheri Fraker and Alicia Hart may be able to help.
Fraker, a therapist with the Center for Selective Eating and Pediatric Feeding Disorders at Koke Mill Medical Center in Springfield, and Hart, Family and Resource Coordinator at the Autism Program in Charleston, gave a presentation on picky eating recently at Helen Matthes Library in Effingham.
With the help of a PowerPoint presentation, Fraker gave the handful of parents in attendance some ideas on why their child might be a picky eater.
Fraker said picky eating manifests itself in a number of ways.
“They might not be getting enough liquid, or they may only be eating limited food groups,” she said.
“Other children have problems tolerating foods with multiple textures.”
Fraker said the vast majority of picky eaters have a medical condition that makes eating a variety of foods painful.
“Only 3 percent of our patients have behavioral feeding problems,” she said. “The rest are bio-behavioral.
“There’s something wrong with them like acid reflux or a swallowing issue.”
But Fraker said the prognosis is good, with the right kind of treatment. She is a member of an interdisciplinary team that treats more than 500 children per year, some from as far away at Italy and Turkey. Other team members include a pediatrician who specializes in gastrointestinal disorders, other specialist physicians, pediatric dietitian, various types of therapists and nurses, and psychology and social work professionals.
“It takes a team to treat a child,” Fraker said.
Fraker said feeding disorders begin in infancy. Some of the early-warning signs include the inability to swallow saliva, liquid spilling from mouth, the inability of the baby’s lips to seal around a nipple, and the inability of cheeks to help move food in mouth.
Fraker said there’s a number of products that can help babies successfully feed, including modified bottles, nipples and cups. She said using the right feeding products is important, as well as developing a feeding schedule
But she added that the vigilant parent can catch early-warning signs of a feeding disorder.
“Be aware of the signs of allergies and GI disorders and treat it appropriately,” she said.
Fraker said therapists use the Kedesky and Budd Scales of Selectivity to determine the scope of the program and develop an intervention plan. The scales measure degree that the child refuses food, the role of food texture in their selection process, the volume of their aversion, persistence to intervention, and the consequences of their problem.
Fraker also talked about the timetable for a child to develop its appetite.
The baby’s primary source of nutrition includes breast milk, formula and rice cereal in its first 12 months. From there, the child should be able to progress to what she calls “first table foods” such as graham crackers, vanilla wafers, toast, cheerios, pancakes or mashed table foods.
But that transition comes with a warning, Fraker said.
“Lumps or mixed textures are often most difficult for the sensitive child,” she said.
Fraker said one of the key early warning signs that a child may be a problem eater is gagging. Determining when the child gags is important, she said.
For example, does the child gag at the sight or smell of food, when it is touched, when it enters the mouth, during chewing, or during the swallow?
Fraker said gagging before eating typically denotes a sensory disorder, while gags during the swallow could indicate problems with the body’s swallowing mechanism, as well as sensory issues. Gagging during the swallow could also indicate esophaegal problems, such as inflammation to irritation.
Fraker said there are several steps to a successful treatment plan, including making nutrition top priority, treating any underlying problems, and building good feeding skills.
For more information, contact Fraker at 217-862-0403 or by e-mail at email@example.com.
Bill Grimes can be reached at 217-347-7151 ext. 132 or firstname.lastname@example.org.
Having trouble getting your children to eat right?
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