What is typical feeding behavior?

A recent study revealed that almost half of parents describe their child as a “picky eater”.  Many parents and professionals struggle to identify if a child is a “picky eater”, or a “problem feeder” that requires intervention.  Dr. Kay A. Toomey, a pediatric psychologist and feeding specialist, has developed a list of specific observations to assist in differentiating commonplace feeding behaviors and feeding difficulties that require intervention.


Dr. Toomey has also outlined feeding “red flags”.  If a child presents with one of these, they should be seen by a feeding specialist.


If you have further concerns regarding you child’s feeding, do not hesitate to discuss it further with your pediatrician or contact me at 760-685-7694.

Kids in the Kitchen


Children learn about food qualities through their eyes, hands, nose and tongue. Interacting with food before the demand of eating promotes success.

Children develop their perceptions towards various foods differently than adults.  We perceive food with a cognitive lens, in which we recall past experiences, categorize foods and reason our way through choosing which foods we are going to eat.

Children perceive food with a sensory-motor lens, in which they decide which foods they are going to eat through there eyes, hands, nose, in addition to their tongue.  Many children are highly aware of changes in food’s shape, size, color, smell, temperature and texture.  In some cases, children will refuse foods that appear slightly different than their preferred choices.

There are many reasons why a child may have a limited food repertoire and prefer to eat the same few foods again and again.  All children benefit from interacting with food in more ways that just eating.

My suggestion: Invite your children into the kitchen.  Scoop, pour, shake, stir, open, close and mix.  As a bonus, you’ll be engaging in activities great for sequencing, imitation, attention, planning and fine motor development.  Most young children are thrilled at the chance to join their parents in the kitchen.  Also, it’s a better use of time than the parent occupying or distracting the child away from the kitchen so that the parent can hurry up and get the cooking done.

With son #1, before he could walk, every morning we would make smoothies and my coffee together.  I helped him scoop the protein powder, pour the milk and kefir, peel the banana and scoop the ice.  Next I helped him scoop the coffee grounds (“one, two, three”) and pour the water. Then we washed the dishes together, in which he played in the water with his hands while I loaded the dishwasher.  And yes it was always a mess.  And yes it took three times longer than if I just did it myself.  You need to rethink your kitchen time as more than just preparing food.  It’s a place to develop your child’s lifelong relationship with food.



For a little parenting humor, check this out this diagram from the “Honest Toddler”:

Breath Activities


My favorite go-to activity to help our little ones with regulation is Bubble Mountain. All you need is water, a straw, a container and a few pumps of dish washing soap.

I suggest placing the container on the floor and having children lie on their stomachs, resting on their elbow and forearms. This position stabilizes the upper trunk, which discourages upper trunk breathing. Movement in the belly is desired. Movement at the shoulder and collarbone is inefficient and fatiguing.

Just a few minutes of blowing can reset a child’s arousal state. Children of all ages love this activity.

Breath Activities

Breath Activities

Bubble Mountain

Bubble Mountain


Another great tool are soundless pipe whistles. Most whistles are loud, shrill and alerting. The soundless whistles are fun and calming.



Below is a fun Elmo video song called “Belly Breathe”.  Watch it with your little one and try modelling diaphragmatic (aka “belly breathing”) breathing next time your child has a high arousal state.


Starting Solids: Hard Munchables


Baby is improving his oral motor skills in preparation for eating.  His tongue reflexively moves towards the carrot during a munching chew pattern.

As babies transition from milk to solids, hard munchables are a great food to introduce around 8 months old, after purees and before crackers. Baby won’t actually swallow this beginner food, but will engage in oral motor play to prepare for chewing.

Hard munchables are firm foods, appropriately shaped into a stick form.  They are long enough so that baby can easily grasp the food and reach the back of the gums.  It’s important that the food be firm enough so that it won’t break, and thin enough so that it will fit between the gums.  Also, it is crucial that the food is at least 5 inches long and that baby is supervised, in order to prevent choking. My favorites are carrots, celery, jicama, fruit leather, bell pepper strips and bagel strips.  My sons always preferred their hard munchables cold from the refrigerator (probably felt good on their gums).

Placing objects in the mouth (in a safe manner of course) is a crucial preparatory activity for eating.  Hard munchables encourage the gag reflex (which is present at the front of the tongue in newborns) to move to the back of the tongue and throat.  They also inhibit tongue protrusion (movement pattern used for sucking at the nipple), promote tongue tracking (needed for managing solids) and support the emerging munching pattern.

Coordinating lip, tongue, jaw and throat muscles for eating is hard work for little ones.  Providing hard muchables while introducing solids will help give your baby a good start.


BrainBeat: an in-home program developed from the Interactive Metronome

The Interactive Metronome is a research-based tool that has been used by professionals during treatment to improve many skills including focus, sequencing, timing, and fluidity of movement.  I became a certified Interactive Metronome provider in 2008 and have successfully used this program with many children.


Brain Beat has been developed from the Interactive Metronome to improve access and affordability.  The child completes the program in their own home, on a personal computer, on their own time.  Also, Brain Beat is a dynamic game with levels and various themes, which helps keep kids motivated and engaged.

In order for rhythm based tools to be the most effective, the child should perform the activities with good form, use fluid movements and appropriate force.  Some children, who have difficulties with sensory processing, body awareness or coordination, may need assistance from a trained professional so that the activities are the “just-right challenge”.  I suggest consulting with a pediatric occupational therapist to determine which program is best for your child.



Occupational Therapists: What Do They Do?


The article by the child mild institute explains how pediatric occupational therapists play an important role in a child’s development when they are having difficulties in the following areas:

  • Attention, Arousal and Sensory Processing
  • Gross Motor Skills
  • Fine Motor Skills
  • Self-Help Skills, including feeding, dressing and toileting

Five Activities for Crossing the Midline (and why it’s important)


The post written by Devany LeDrew, a former kindergarten teacher, includes a few great activities for crossing the midline that include easy to follow pictures.  Pediatric occupational therapists often include some of these activities during their therapy sessions.

Engaging in activities that cross the midline can be beneficial during a homework break, in the morning before school or incorporated during playtime.

Addressing Feeding in Occupational Therapy

My two areas of specialty in occupational therapy are sensory-motor processing and feeding therapy.  Often the two areas are related.

I have been trained in the Beckman Oral Motor Protocol for assessing and treating oral motor skills, which are foundational for manipulation of food by the lips, tongue and jaw.

The approach that I have been trained in and use during feeding therapy is the SOS approach developed by Dr. Kay Toomey.


If you have concerns regarding your child’s feeding skills, do not hesitate to contact me.