Food Aversions and the Gut/Brain Connection

GUT-BRAIN Connection-

Children who are picky eaters often have severe gut issues including poor absorption of nutrients.  This poor absorption and difficulties breaking down foods into essential nutrients can cause their guts stress.  When there is stress in the gut this often = cortisol and histamine to be released, blocking Serotonin, and other essential brain nutrients.

Psychologically, eating becomes a very stressful event for them...

Common problems seen when a child has gut digestion issues: limited number of foods, texture preferences and aversions, unusual mealtime habits (self stimulation, has to be in a certain container, has to be from a certain restaurant, rituals) and they become very CONTROLLING over the meal experience and foods going into their mouths. 

Children who have sensory issues or sensory defensiveness also can become very controlling at meal times, since their sensory systems are unpredictable and they feel like the world is chaotic...then they start to control the only thing they feel like they have the right to control- their mouths. 

How to help:

• Get them comfortable with the environment first. Sit at the kitchen/dining table and color, play, and have fun "non-eating" activities in that environment. Be relaxed, fun and engaging with all aspects to food.

• Make it a calming place to be- calming music or low noise level and fun seating options (move and sit seat wedges, vibration pad for lower back in chair, fidget toys that can be placed in the dishwasher and put on the plate).

• Gradual progression- your first goal is for them to sit for longer periods at the table, without food and gradually add in things such as utensils, plate, cup, and then last is food!

• Reward for food acceptance, sitting at the table, touching foods for fun, etc.  Use an immediate reward like a special game you play together after meals, fidget toy reward basket and/or stickers but do not reward with sweets please.

  Play time with foods is essential...they must, must, must get MESSY and have FUN with foods.  Use plastic dishwasher safe toys like dinosaurs and dogs that can "eat" the food at the table. 

• Let the child be in more control of the situation (help them learn to feed themselves and be in control)

Difference in a picky eater and a problem feeder:

Picky eater: decreased variety of foods or less than 30 foods. Foods lost due to burn out on same foods eaten daily, able to tolerate new foods on plate, touch, and taste. Picky eaters usually eat at least 1 food of each texture, and they will add new foods after 15-25 tries or seeing the food many times. Picky eaters are often controlling food intake due to psychological factors over physical issues. 

Problem eater: less than 20 foods eaten, foods not regained once burned out, falls apart when presented with new foods, refuses entire catagories of textures,and usually adds new foods in more than 25 tries.

Problem eaters are this way because of actual medical issues affecting their gut, oral muscles or physical pain associated with eating and need Feeding Therapy to help improve issues.

Physical: pain, discomfort, nausea, gut digestion issues, stool issues, allergies, sensitivities, intolerance to foods

Motor: delayed self feeding, over stuffing, choking, delayed chew, tongue, swallow coordination

Sensory: texture hypersensitivity, oral hypersensitivity, oral aversion, sensory processing problems, auditory (hurts to hear the crunching sounds, or the sounds in the meal room), mealtimes are too overwhelming due to smells and gagging issues. 

Behavioral: hyperactive, low frustration tolerance, highly distractable, need for routine, impaired social interactions. If they can't sit in a chair any other time, why would they sit there to eat for 15 minutes or longer?

Impaired social skills: eating meals is very social, they have to answer questions, look at others, and possibly touch one another.

Parenting factors:

• Negative reinforcement always backfires and causes the child to desire even more control, please use positive reinforcement only!

• Social modeling (parents must be sitting for the meal and making good food choices as well) and children need structured meals that are positive and fun. If you are not eating healthy, they will not eat healthy. 

• Do NOT allow  carb/gluten or dairy filling snacks or drinks in between meals. This will bloat up their bellies, and they will not feel like eating at mealtimes.   Offer fresh fruit and veggies for snacks, leaving them out on the kitchen table for no pressure grazing for snack time.

• Offer water to drink in between meals, no sugary drinks like juice or milk that will fill up their tummies.  Offer milk after they have eaten meals, not in place. 

• You must identify and find medical help to treat GI problems.  If the gut is under stress or does not have enough probiotics then they don't feel like eating new foods, they eat like they have a stomach flu all the time craving sugary and high carb snacks rather than healthy proteins, veggies and fruits. 

• Ask for a Feeding Evaluation with an SOS trained therapist to look at oral sensory, oral motor and swallowing skills and treat this area along with a great home plan.

• Ask for an OT evaluation to treat sensory issues that affect eating.

• Ask for Behavior Therapy to conduct a Behavioral Functional Assessment to see what behavioral factors may be affecting meal times.

General tx strategies: with any child these can be done!

1. Social modeling: the family eating together, not the child eating separately from the child. Have the family come for part of the meal, so there is an overlap of time together if SI issues.

2. Structure meal and snack times and have fun, use toys with foods, make it an engaging place to be, not a stressful place to be!

3. Manageable foods: look at the plate, don't put more than 3 foods at a time, 1 tblsp for each year of age and no more! They become visually overwhelmed if too much of a new food on the plate.

4. Positive reinforcement: don't say don't, say "do this, try this"

5. Use appropriate mealtime language:  don't beg them to take foods (they will take control and say "no") but talk about the fun colors, shapes, interesting textures and how yummy the foods are!

6. Help prevent "food jags": food jags are when a child eats the same foods over and over and then all of a sudden they stop eating that food and never go back to that food. It is suggested that from early on, do not give the same food too often, switch it up every other day, and change the foods shape, what is with it, etc.

29 Steps to eating a new food: introduce food in a playful way, away from meal time first...1 at a time with a safe food.

1. Tolerating the new food in their personal space is the first step: the food is in the room with them...the food is on the other side of the table...food is on plate next to them to play with...food is on their plate...then they start interacting and playing with the new food often with a toy.

2. Interacts with the new food: assists in preparation, uses utensils to stir or play with the food, and then uses utensils or containers to serve self the food!

3. Smells: gets mouth and face close enough to the new food to actually SMELL it!

4. Touches: plays with the new food using dishwasher safe toys, this means they want to interact with this new food!

5. Tastes: it is ok to have a spit bucket handy and let them know they can "try" a food. 

6. Eats and then swallows the new food! 

Remember, a child has to interact with a food about 20-30 times before they will eat it usually!  Have you had broccoli or spinach 20-30 times on the table to interact with? 

• When they aren't ready for the next step they use escape mechanisms such as tantrums, run away, scream, be goofy, make you laugh, get another toy...

• And parents and therapists need to remember that:  eating problems are not a sprint, they are a marathon, enjoy the successes along the way!

The SOS (Sequential Oral Sensory) Approach to Feeding notes:

Once the child can tolerate BEING at the table with a food (you have successfully played with a food and they can tolerate being near it) then do the following:

1. NEVER let the child see the package or container that the food came in, always put it in a ziploc bag, or clear container so they will start to see the food, not the fancy advertising.  This helps to avoid cases where the child is addicted to certain chicken nuggets from a certain place. 

2. Never force feed!!!!!!!!!!!   Eating should be fun and low stress, don't create negative feelings towards eating this is only counterproductive in the long run and causes them to stop eating new foods.

3. Always make it fun and non stressful to eat and make it the "joy of eating".

4. Provide a lot of deep pressure calming touch before the mealtime, using OT sensory diet activities like massage or therapeutic brushing.  Let them have a weighted lap pad, vibration neck massager and other sensory calming choices at mealtime. 

5. Use a white plate, and white napkin to present foods so the food colors "pop" and speak for themselves.

6. Let the child cover up the food with the napkin if they don't like it, but offer another way to interact with it through play rather than to push it away.

7.  Give the child a "SAFE FOOD" on their plate with a new food,  this is a food that they normally eat and enjoy such as chicken. Introduce a new food that is either the same color or the same texture to that child with the safe food, such as chicken with apple chips close to the same color, other examples: green beans and green snapeas (baked snapeas), or potatoe chips and the same color of dried fruit such as pineapple or banana, or green beans and peas, carrots and sweet potatoes

It can be the same color, shape, or texture as the "safe food". Keep talking about how the two foods are the same all through the session and mealtime. Even making PECS and do a matching game of those that are the same. The idea is the convey that the new food is also safe, because it is the same as the food they normally eat.

8.  Please do not let the child fill up on snacks, juices, milks, or other drinks and/or snacks in between meals. Make meal time a priority 3 times a day to sit and work on skills when possible. Sweets, drinking, and chewy foods fill the child up quickly, but make them hungry again without giving them the nutrition their brains and bodies need. Then they learn to snack, graze, and drink to get calories instead of eating well balanced meals.

9.  Get help...this is a huge psychological and physical issue and professional help is needed.  We are here to help, call and ask for a Feeding Therapy evaluation today! 931-372-2567 

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