Tuesday, September 4, 2012

The Difference Between a Picky Eater and a Resistant Eater

As I mentioned before, we've been seeing a lot of feeding changes around here lately.  In fact, I feel like we have been seeing monumental changes over the past couple of weeks.  Logan has been eating like a champ.  In fact, I feel like he does nothing BUT eat these days.  What a change!!  Chloé's had a bit of an insatiable appetite for everything these days too.

Yesterday, while we were apple picking, Logan ate 4 apples.  

No, that is not a typo.  

He actually ate 4 apples!!!  Including the skin!  

This is the kid who wouldn't even consistently eat an apple a few weeks ago.  He has, on a few completely random occasions, eaten the odd apple - but he generally refuses them when offered one.  Time will only tell if apple picking was just special incentive to eat some this time...

that's right - two at a time!!!
He has also miraculously begun loving corn on the cob this week:

This is the child who, up until recently, ate a very limited selection of foods and refused to try anything new.  At all.  Well, unless it was a new kind of cracker.  Or cereal.  Or ice cream.  And he would throw such wicked fits if we didn't just give him his preferred foods (such as hot dogs and crackers). 

I'm sure that some of these changes are due to tips we have gleaned from our OT, and from the book Finicky Eaters: What to Do When Kids Won't Eat, which our OT recommended to us.  

But I have to admit that I also feel that his eating has changed drastically since we cut gluten and dairy from his diet.  My gut tells me that the elimination of these foods has also contributed to the recent massive changes in eating we have been seeing lately.  I'm suspecting that he is truly intolerant to something or other.  But we will only know for certain whether or not he has any food intolerances once we have reintroduced these foods, in a few more weeks.

These days, I feel like Logan is almost more of a typical picky 2 year old than a resistant eater.  He now tolerates most anything on his plate, even if he doesn't always touch or taste it.  He doesn't gag on food nearly as much as he used to and he hasn't vomited while eating at all lately (thank goodness!).  He is sometimes willing to try new foods on his own.  In fact, he has incorporated the word "try" into his vocabulary, which is huge.  He actually asks us to let him try things now!! (as if we wouldn't!).  We can also sometimes negotiate with him to get him to try a tiny, tiny bite of things he doesn't want to.  And he doesn't freak out when he doesn't get exactly what he wants on his plate the way he used to.  

Mealtimes, though still noisy and chaotic, are much less stressful than they used to be, as he will often sit and eat little bits here and there instead of running around in a screaming, tantruming mess. 

In a later post, I will share some of the tips we have learned that have helped improve his eating.  

But first of all, I wanted to explain the distinction between a picky eater and a resistant eater.  This information comes from the book Finicky Eaters.  

Picky eaters don't eat a huge variety of foods.  They don't like to try new foods.  They have favourite foods that they prefer eating and complain when this is not what is served.  It is quite typical of toddlers to be picky eaters.  And I'm sure that every one of you can think of an adult you know who you would consider to be a picky eater. 

Resistant eaters are further down the severity continuum than picky eaters.  They are picky eaters to the extreme.  We are now in the realm of dysfunction.  Ernsperger and Stegan-Hanson (2004) have stated that "resistant eaters typically have an extreme reaction when presented with new or novel foods that continues even as they grow older".

Picky eaters, in comparison, are less intense in their food choices and in their reactions to novel foods.

The characteristics of a resistant eater are as follows (child demonstrates one or more of the following):

1.  Limited food selection.  Total of 10-15 foods or less.
2.  Limited food groups.  Refuses one or more food groups.
3.  Anxiety and/or tantrums when presented with new foods.  Gag or become ill when presented with new foods.
4.  Experiencing food jags.  Require one of more foods be present at every meal prepared in the same manner. 
5.  Diagnosed with a developmental disorder, such as Autism, Asperger's Syndrome or Pervasive Developmental Disorder-Not Otherwise Specified.  May also have a diagnosis of mental retardation.

Before I read this book, I knew that Logan was a picky eater.  And though I found his eating patterns caused stress in our lives, I didn't necessarily understand that it was abnormal or problematic.  I mean, my gut told that me it was, but everyone kept telling me that toddlers are picky and that it's just normal.  So I was somewhat conflicted between what my gut was telling me and what I was hearing from everyone else.

When I read this book, there was no more denying the obvious.  Logan met all of the last 4 criteria (for number 5, I considered diagnosis with a sensory processing disorder to meet this criteria).  And in terms of the different food groups he ate - at the time I read the book, he would not consistently eat any fruit other than bananas, any vegetables or any meats.  So starches and dairy were really the only food groups he would accept to eat. 

I realized that I was dealing with a resistant eater.

Not much of a surprise.  Logan's been a bit of a resistant everything ;)

Plus, being a resistant eater is very common in children with sensory processing disorder.  Some have issues with the texture of food, some with the flavour (some kids don't like anything with flavour, others crave intense flavours).  And still other kids have issues with the temperature of food (disliking or craving things that are hot/cold).

I have had people frequently tell me that if we were just "tougher" with Logan... more strict and the like... that he would just eat more.

Thing is (and my gut already knew this), pushing a resistant eater to eat... it just won't work.  It'll only make things worse.  These well-meaning people have clearly never actually dealt with a resistant eater.  But in an upcoming post, I'll give you some tips that will actually help you to get them to eat a bit more.


Ashley said...

I really need to read that book!

Andrea said...

love the double fisting of the apples!

Zelda said...

I found your blog via Kitchn's 'kid food' discussion. Sorry to hear that you are experiencing food issues with your children. I have encountered my fair share of picky eaters, and I know how demoralising that can be, how tedious it is, at the end of a hard day, to chase around a small child in an attempt to get him to finish his food! What I found worked for us was, as soon as our kids were old enough (from about the age of 3), to have them eat the same foods at the table with us. The disadvantage is that they may have a later bedtime, and you have a little less child-free time in the evening, so this may not be for you. The advantages for me were not having to worry about cooking separate meals, and, importantly, for the kids to witness the rhythm of a 'normal' mealtime, in particular whenever there were friends or non-family members at the table. There is something about seeing other people enjoying and talking about the food, serving themselves seconds, moving on to dessert that seems to spur kids to do likewise. They learn that they are not always the centre of attention, that the meal will happen and people will enjoy the food and company whether they choose to join in the ritual or not. More often than not, they will be drawn to where the fun, conversation and enjoyment are happening. Mealtimes are about more than nutrition, likes and dislikes. They are opportunities to SOCIALISE our children, for them to feel that they can respectfully join in with adults. Good luck.

Food for Thought Linds said...

Hi Zelda,

Thanks for stopping by. You summed up perfectly the frustrations of having a child with feeding issues! Though things have gotten a lot better since I wrote that post.

I completely agree with your recommendation that the whole family eats the same meal. This was also mentioned at the conference I recently attended (as an SLP) to learn how to treat children with feeding disorders. They also mentioned that the child should never eat on his/her own, for the very reason you said - they can learn from the behaviours modeled around them.

I have to admit that, early on, I found it very challenging to serve the same foods to my kids. My husband and I love a wide variety of foods (as you can tell from all of the recipes on my blog!). I didn't want to have to be eating only pasta every night. S.O.S. Feeding recommends that the child always have at least one food that they eat well on their plate and that the rest can be new. I realize now that I could have just served some pasta (or other food they accepted at the time) alongside whatever we were having. This is what I eventually started doing, as their eating improved.

I am happy to report that tonight, for the first time ever, I served a meal that I would have served pre-kids (fish, rice and cauliflower) and the kids actually ate it!!! Or bits of it, but enough to get them full and keep them quiet!!

Zelda said...

Glad to hear about the progress! If it's any consolation to you, one of my kids refused to eat most green veg, 'round' food such as peas and pizza, and another hated 'long' vegetables. I'm pleased to say that we can laugh about this now, and they are the first to complain if there are no greens on the table! Your kids are still very young, and you'll have a few years of 'pickiness' ahead, but it sounds as if you're doing absolutely the right thing by cooking delicious meals, and including your children at the family table. Perseverance is key!

Food for Thought Linds said...

Thanks for the encouragement Zelda :)