When I evaluate a toddler that hasn’t made the transition to table food, one of the first questions I ask is “Did he mouth on toys/hands/lovies as an infant?” If the answer is yes, I always ask how much and how that child compared to other children in the home with regard to mouthing and early acceptance of oral play.
However, more often than you would think, I hear from parents that these children with extreme aversion to texture in their food did not mouth at all. They blithely say “We didn’t have to baby-proof!”, unaware that their well-behaved infant’s choice to leave that paperclip on the floor is at least part of why he hasn’t moved on from pureed foods.
I recently saw an older toddler who fit this description exactly—to the extreme. When observing her oral motor skills without food, there were no noticeable deficiencies. Lateral tongue movement was present, she could open and close her mouth in mock chewing, was able to blow a kiss, and kept her tongue in her mouth where it is supposed to be. No outward signs that this child had never had one bite of actual food. Not one bite swallowed. Theirs was a successful breast feeding dyad, but that was the only sustenance she got, and not from lack of trying on the parents’ part.
So why couldn’t this child learn to eat?
Interestingly, the family had many older siblings who had mouthed as infants, accepted spoon feedings of purees without incident, and had no trouble learning to eat the family foods. So it wasn’t what the parents had or hadn’t done, that was clear. Something was different about this child’s system.
Looking at this little one from a sensorimotor perspective and not just one of oral motor skills allows for a broader understanding of why she hadn’t made any strides toward eating. Babies learn about their environment through their mouth; they don’t have the dexterity to manipulate objects well with their hands and aren’t yet mobile, so their mouth is their “window to the world”, as Suzanne Evans Morris calls it. If a child is hypersensitive to touch in and around his mouth, his sensory system holds him back from exploring his environment in an effort to protect himself from discomfort.
Providing “mouth toys” is an important step for these children who never went through this stage. By teaching them to explore with their mouth, the sensory system can receive crucial information about size, shape, texture, pressure, and movement. This knowledge can then be generalized when the child is ready to progress to actual food with texture.
How do you start?
• Model how the child can put his hands in his mouth. It is his safest mouthing “toy”. If there are smooth foods he enjoys, show how he can lick them off his fingers.
• Provide smooth toys that promote sensory awareness, with possible vibration.
• Provide textured mouthing toys to promote sensory discrimination, or more specific knowledge about differences in texture and shape.
• Provide toys with contrasting textures and higher chewing durability as the child gets comfortable and acquires improved oral motor skills.
Tip: Offer but don’t push. Model chewing and mouthing on toys and tools while offering your child a turn. Leave the toys around the house for easy accessibility and to capitalize on that moment when your child gets interested—they may wait until you aren’t looking to start the exploration process!
Children don’t learn to chew on food. They learn to chew and also handle a massive amount of sensory input through early oral exploration, giving them the tools they need to move through the myriad of textures we find in food. Tools like the Chewy Tube, Ark’s Tri-Chew or Z-Grabber, or Chewelry can be used in many ways to promote that exploration and development of chewing skills.
With that in mind, we can help these wee ones with extreme picky eating by letting them go through the early stages of exploration that they missed in positive, supportive ways. It is through that integration of the sensory and motor systems that we find the path to eating foods with texture—or eating foods at all!