The CHOC Children’s Multidisciplinary Feeding Program and Rehabilitation Team uses special guidelines for slowly introducing food concepts and eating to children who struggle with feeding disorders and delays while carefully balancing the child’s nutritional needs.
Food Introduction Process
The list below serves as a general guide for how children typically progress through the process of food introduction (or in some cases, reintroduction). Children begin on the step at which they are currently accepting food. This introduction to food is done in conjunction with other therapies that are individualized to the child’s specific problems with feeding and/or swallowing.
- Child tolerates food in the room, but away from them.
- Child tolerates food on the plate or on the highchair tray.
- Child touches or plays with food using a toy, utensil or napkin.
- Child touches food momentarily with one or two fingers.
- Child plays with food using their whole hand.
- Child allows food to touch their head, neck and ears.
- Child allows food near their nose and mouth to smell or blow on it.
- Child allows food to touch their chin, cheeks or nose.
- Child allows food to touch their lips so that they can “kiss” the food.
- Child licks food off their lips.
- Child touches food with their tongue in order to “lick” it.
- Child holds food in their mouth.
- Child takes small bites on food using front teeth called “rabbit bites.” This stage usually starts with light pressure and gradually gets stronger.
- Child moves food in their mouth and chews with larger movements using molars at the back of the mouth in what is called, “crocodile bites.” At this stage the child may spit out the food.
- The child bites, chews and swallows food.
This can be a long process and because every child is different, some patients may skip certain steps and some may stay on certain steps for a longer period of time than others. The important thing is to be patient and positive throughout the process. Every child deserves a lot of praise for even small steps forward.
It is understandable to be worried about just how much a child will actually eat while undergoing treatment. The child’s treatment team includes a dietitian, nurse practitioner and gastroenterologist who closely monitor the child’s progress and weight. Some children do lose weight while undergoing therapy but the team keeps a close eye on the child’s weight to ensure the weight loss does not become unsafe for the child. The team also ensures each child eats or drinks enough calories by making the most of the foods a child is willing to eat and adding nutritional supplements like juices, powders and/or higher calorie milk-based supplements to the patient’s meal as needed. These additions are made based on the child’s needs and willingness to accept the supplements.
The dietitian and therapists will work with caregivers to help them order the right foods for their child. Learn more about parent responsibilities.