10 Tips for

Feeding
Difficulties
Shelby Montgomery
Indicators of Feeding Difficulties
● Limited range of textures
○ Reliant on “easy to eat” food: puree, dissolvables
● Limited range of foods
○ < 30 foods
● Prolonged meal times
○ > 30 minute meals, > 2 hours per day spent trying to feed child
● Problematic behaviors during meal times
● Family stress related to meal times
Tip 1: Food Chaining
Problem: my child only eats a select few foods

Solution: A food chain is a list of foods that have the same features such a flavor,
shape, and/or texture

1. Begin with your child’s favorite food

a. chicken nuggets with ketchup
2. Choose a variation of that food
a. different brand of nuggets with ketchup
3. Then, branch to a similar texture
a. grilled chicken with ketchup
4. Finally, switch to foods of different flavor or texture
a. grilled fish with ketchup
Tip 2: Concentration Change
Problem: my child will only drink water

Solution: present water and gradually change the consistency

● Water/juice: 100/0 → 90/10 → 80/20 → 70/30

○ Continue linearly until desired concentration is reached

*this could also be done the opposite way if the child only drinks juice or a select drink
Tip 3: Shared Control
Problem: I’m engaging in power struggles with my toddler during mealtime

Solution:

● Allow the child to self-feed as this gives the illusion of control

● Present your child with choices
○ “Do you want the green or blue plate?”
○ “Do you want mashed potatoes or peas first?”
Tip 4: Praise
Problem: my child exhibits unwanted behaviors during mealtime

Solution:

● Praise can be verbal (“great job sitting!”), physical (high five), or simply
your attention
● Focus on the positive, ignore the negative (i.e., tantrums)
● Praise must be specific and immediate
○ “Thank you for taking a bite!”
● Avoid general statements such as, “good job.”
Tip 5: Minimize Distractions
Problem: my child will find any excuse not to eat

Solution: Where do mealtimes happen? Is the TV on? Is the iPad near? Are
there toys within reach?

● Limit distractions so the focus remains on the given task: eating

Tip 6: Modeling
Problem: my child engages in unwanted behaviors to avoid eating

Solution: We all learn by watching! Eat with your child and provide an ideal
model for mealtime-- siblings can be models too!
Tip 7: Follow-Up
Problem: my child fatigues easily during mealtimes

Solution: follow foods that require chewing with “easy to eat” foods (puree,
dissolvables) to instill a natural “break”
Tip 8: Play!
Problem: my child is unsure of new foods of varying text

Solution:

● Encourage food play!

○ Talk about how it smells, tastes, and what it feels like
● This allows children to learn how to eat new foods and minimize their
potential anxiety about the unknown
Tip 9: End It
Problem: my child will sit at the table, refusing food, for hours, if I let
him/her

Solution: end mealtime after 30 minutes and consistently do so

● This allows the child to know there is an “end”

● Minimizes grazing and establishes that this is mealtime
● Avoid distracting or coaxing your child into eating
Tip 10
Give yourself credit!
Research suggests it takes 15 exposures to neutral foods to develop a preference
for that food. Remain persistent!

Creating mealtime structure and rules can be stressful and changes don’t happen
overnight. Sticking to these tips will help your child try new foods, avoid unwanted
behaviors, and ultimately make mealtimes more positive!
Resources
Guide to Feeding Your Toddler:
https://www.youtube.com/watch?v=rLrFKs9mBUU

Toddlers at the Table: Avoiding Power Struggles:

https://kidshealth.org/en/parents/toddler-meals.html

Tips for Picky Eaters: https://www.choosemyplate.gov/preschoolers-picky-eating

References
Barnhill, T., Tami, A., Schutte, C., Hewitson, L., & Olive, L. M. (2016). Targeted nutritional and behavioral feeding
intervention for a child with autism spectrum disorder. Case Reports in Psychiatry, 2016, 1-7.

Blissett, J., & Harris, G. (2002). A behavioral intervention in a child with feeding problems. The British Dietetic
Association, 22, 255-260.

Dodrill, P., & Marshall, J. (n.d.). Behavioral feeding interventions for children 1-6 years of age with persistent feeding
difficulties [PowerPoint slides].

Eicher, P. S., & Kerwin, M. E. (2004). Behavioral intervention and prevention of feeding difficulties in infants and
toddlers. Journal of Early and Intensive Behavior Intervention, 1 (4), 129-140.

Frey, L. (2017). Food chaining: a proven technique to double the number of foods your child eats. Retrieved from
https://inside.akronchildrens.org/2017/05/24/food-chaining-a-proven-technique-to-double-the-number-of-foods-
your-child-eats/

Weller, S. (2017). 7 tips to make mealtime less stressful. Retrieved from https://blog.cincinnatichildrens.org/healthy-
living/child-development-and-behavior/7-tips-to-make-mealtimes-less-stressful/