Ep. 16: Strategies to Support Selective Eaters w/ Kimberly Hirte, SLP




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From food play to food chaining, there are many practical strategies in this episode, as explained by speech language pathologist Kimberly Hirte.

She is dedicated to helping what she calls “selective eaters” eat an increased quantity and variety of foods while fostering a fun and secure mealtime experience.


Vegetable cutters: https://amzn.to/2C3c2Wl

Adjustable Highchair (Tripp Trap): https://amzn.to/3gRl6wa

Straw trainer cup: https://amzn.to/2CkQaFZ

Divided suction plate: https://amzn.to/38KIcBS

More on the division of responsibility in feeding: https://www.ellynsatterinstitute.org/how-to-feed/the-division-of-responsibility-in-feeding/

Short and nubby baby spoons: https://amzn.to/32cL0Xl  

Episode Transcript

Kimberly Hirte  0:00  
"Your child should be more motivated to participate in the mealtime and have a better response to eating because they're gonna feel hungry."

Madeline Cheney  0:09  
Hey, you're listening to The Rare Life. I'm your host Madeline Cheney. I'm so excited to share with you a conversation with Kimball's feeding therapist, Kimberly Hirte. Feeding struggles in one way or another are actually super common. In this episode, Kimberly gives us some practical strategies that we can use to help them increase their variety and quantity at the table. Each of them are fun and creative. And so it's also there to help give a positive feeding experience which I really appreciate. In this episode, Kimberly shares when a child should be receiving feeding therapy so that may be of interest for those of you that are listening that are not seeing a feeding therapist, and may benefit from one. Depending on your experience in the feeding world, some of these may be review, and some of them may be brand new that you've never heard. There are several strategies that she shares. And so instead of being overwhelmed by the amount of ideas, I encourage all of us to pick one and work on it. And then once that comes naturally, to pick another and work on it, that's been a successful way that we've been able to go about feeding therapy with Kimball because it can be a very slow and frustrating process. For about nine months, we were receiving feeding therapy visits from an occupational therapist in early intervention. It was such a stressful topic for me, because at this point, Kimball was not eating anything, he wouldn't put anything in his mouth. He had extreme oral aversion. And it was so stressful that I failed to even put him in his highchair most days. I would feel really proud of myself if I put him in his high chair once a week. So finally, after months and months of just this really stressful thing that was we were seeing very, very little progress, his feeding therapist was like, Do you even want him to eat food? Because if you're okay with him just drinking milk the rest of his life, we're done here. Like you need to start doing the things I'm telling you to. And I was like Well, we're moving soon. And she was like, Ok, once you move in, and you get settled in, I encourage you to just go full force and really dig in and commit if this really is what you want for him. I was like, Okay! So we moved in, and we got all settled. And then we started bringing Kimball to our local hospital outpatient therapy. And we met Kimberly and because of that kind of pep talk from (or I guess that chastisement) from his previous being therapist, I was I was ready to go, I was ready to really make some progress in his feeding. And so Kimberly was so great. I immediately liked and trusted her, which is not a given. For me it takes me a little bit sometimes to warm up, but she is so great. And I hope that you will feel that too in this 30 minute episode that you're with her. She has her master's in speech language pathology and she specializes in pediatric feeding and swallowing disorders. She hails from Colorado and lives in Utah with her husband Kyle. She is a lover of backpacking and her chocolate lab. Let's jump into our conversation. 

Hi, Kimberly, thank you for joining me today.

Kimberly Hirte  3:37  
Hey, of course.

Madeline Cheney  3:39  
So I am really excited to talk about feeding and specifically for children that have a rougher time, to put it lightly, in the feeding sphere.  What would you say as kind of an intro for parents or educators that may be listening right now and also struggle with feeding with their child like I do with with my son.

Kimberly Hirte  4:08  
That's really common for families to have difficulties getting their child to eat, whether it's eating anything by mouth, eating an increased variety, even just participating in meal times, being interested in coming to the table, all of that is really common. I think it's more common than people realize. And there's a lot of really simple things and simple strategies that families can implement, to get started in the right direction with more positive meal times, which can really have a huge impact on like, your overall day and just the dynamics of your family.

Madeline Cheney  4:42  
Yeah, yeah. Because, you know, I think feeding is such I mean-- you have to eat so frequently, whether you're tube-fed or you know, eating at the table with the family. It's such a frequent thing that it really takes over your whole life. So if you're having positive experiences with eating with your child, then you're whole day is more positive. And when you hit those roadblocks and you're frustrated and they're frustrated, then you know, it can really affect your whole whole day and therefore your whole life, day to day.

Kimberly Hirte  5:11  
It's a very emotionally driven area to there's a lot of emotion around meal times and eating. And so it can cause a lot of stress and anxiety for families. And I see that every day.

Madeline Cheney  5:22  
Yeah, that totally makes sense. So let's dive right into it. I love that we're going to talk a lot about today, some practical strategies that families can implement. And I will add, if you're seeing a feeding therapist in one form or another for your child already, a lot of these might sound familiar or even just things you've heard principles that are maybe more well known. But this can be one more little like motivation to really try to implement some of these practical strategies. So what would you say for us, to families that are struggling with eating, what are some strategies we can implement?

Kimberly Hirte  6:05  
So the first thing that I always talk about with every family that comes in, the number one question I ask is, What is your schedule and your routine around feeding? I really like to know--I say, start to finish in a 24 hour time period. When is your child's being offered food? And what does it look like when they're being offered it? So I really like to get detailed information on: are you sitting down for meal times? Is the family sitting together? Is it stressful, are parents using positive words to describe meal times, we really kind of hone in on what that schedule looks like. And that's always the number one thing that I recommend families typically change. Most people come in with an atypical mealtime routine for their child. If feeding your child has been difficult, you tend to do whatever you can to get them to eat. Kids tend to eat more, if they're not in a stressful situation. So maybe while they're playing on the ground, they're snacking on graham crackers, or they have their goldfish in their little snack cup that they're walking around the house with. And parents are counting that as a win because they're eating, which is so true. And those are things to celebrate, but I always tell families, you're going to get more in the long run if you can have a structured schedule, the benefits to a structured schedule are going to be increased hunger drives. And so kids are going to have periods where they're eating and they're getting their stomachs full, and then periods where it's empty. So when it comes time to the next meal time, your child should be more motivated to participate in the meal time and have a better response to eating because they're gonna feel hungry.

Madeline Cheney  7:39  
Right. I remember that was one of the first things we talked about when we came in to you with Kimball and we we were able to finally--it's hard, especially when you want them to gain weight and you want them to eat. It's so hard to say no to them when they want food because you're like you just want them to eat. But when we actually started doing that (it took awhile), once we started finally implementing a schedule and saying no to him between meal times, we saw a huge increase in how much he was eating. And so that was really--I can get behind you on that one and say "it works"!

Kimberly Hirte  8:12  
Yes. It usually takes parents a couple sessions and just like you did, you came in and said We're closer, but we're not quite there. A lot of the times it takes a couple of sessions for people to really figure out because it's changing your whole routine and how your whole day works. And so and there's a couple of strategies that I tell people, you know, if they're like, Well, my child doesn't even want to come to the table. A couple of things that I encourage people to do is like a visual schedule. And so your child knows breakfast, snack, lunch, snack dinner, so you have a visual schedule that they can check off, they know what the expectation is. Also creating kind of a fun, positive routine around it; We always wash our hands. We listen to a song about participating in a mealtime, then we sit at the table. Timers can be really helpful there's lot of apps with visual timers, depending on the age of your child, you could set like a visual timer for five minutes, or maybe even two minutes if it's early in the process. And the child can count down to when they're allowed to get up and leave the table. But setting that expectation that every single meal time they're coming to the table, and they get to choose if they're going to eat or not, but they at least have to participate in that structured scheduling routine. 

Madeline Cheney  9:22  
Yeah, I really like that. 

Kimberly Hirte  9:24  
The other thing I encourage people to do is sit down and eat together as a family. Oftentimes, parents are stressed and they're dealing with a lot of different things. And you're juggling a lot of different aspects. But one of the best things you can do is sit down and participate in that mealtime with your child. If they're going to see you eating, they're going to be more likely to eat and you're going to default less to distraction. A lot of people will try to use like videos or things like that to keep their kids sitting and entertained. And as much as you can I encourage parents to be the entertainment, to sit down and talk and discuss the food and interact with the food together. Because it leads to more positive mealtime experience for you and for the child.

Madeline Cheney  10:08  
Yeah, and we've even had a couple of times where Kimball tried a few that I was--like, he tried soup. And we were so surprised. And that was because we were all sitting and eating soup. And we, we gave him a bite from our bowl. And he was so excited, and he wanted more and more. So I think that can also be a good opportunity to give them some of the foods you're eating and they might be more open to it.

Kimberly Hirte  10:30  
Totally. Yeah, I hear parents say all the time, They want what's on my plate, not what's on their plate.

Madeline Cheney  10:33  
Yeah, totally, totally,

Kimberly Hirte  10:36  
Just like you were saying with the soup and Kimball being excited to engage with a new food just because you guys are eating it, that's typically what I encourage families to do. You always want to make sure that you're offering at least one familiar food because your child's going to feel more safe at the table and at the meal time if there's something that they can safely participate in. And then I always encourage families to offer whatever they're eating, or at least one new food per meal time. Kids are going to be more likely to engage with it if it's a small portion. A lot of the times I see parents come in and they'll put a big scoop of something new on the child's plate. And immediately the child gets really nervous because what they see when they look at that plate is that large portion of the new foods. I always tell people to stick with them being really small, to a small piece, less than a tablespoon of something new. And then if the child's interested in it and accept bites of it, they can totally have more.

Madeline Cheney  11:32  
Yeah, totally. I've really seen that too.

Kimberly Hirte  11:36  
But we can't expect kids to eat new foods if they're never exposed to new foods. And so the safest, best way to expose them is just at a mealtime when you guys are all participating eating the same thing. That's a really safe exposure opportunity for your child. 

Madeline Cheney  11:51  
Yeah, totally. 

Kimberly Hirte  11:53  
Which kind of goes into the division of responsibility and feeding. Ellen Sattar is a dietician and she came up with this idea of the division of responsibility of eating, and it talks about how the parent is responsible for what they offer, when they offer it, and where they offer it, and the child is responsible, and in charge of if they're going to eat it, and how much they're going to eat. And when I can talk with parents about that division of responsibility and encourage people to stick with their area, we tend to see children do a lot more and be a lot more interested in eating and overall have a more positive mealtime experience. 

Madeline Cheney  12:32  
Yeah, I think it's it's easy to want to force them but there really isn't anything you can do to force them to eat. In fact, you know, it often backfires. When you get really like Eat it! Eat it! They're like Nope!

Kimberly Hirte  12:44  
Yep! Food is one of the number one things kids can control in their life. So much of their lives are outside of their control. And food is one thing that they can say no to, and they can be firm in that and there's nothing we can do about it. A lot of the time kids are exerting control with food. And since it is such an emotional area, parents get really upset about it too. So there's often a little power struggle there. And the kid almost always wins. And that's typically what I hear from parents who come in and are frustrated with a selective eater, and they can't get them to eat anything else, parents always tell me that dinner is ending in arguments and timeouts. And that's the number one thing I say to change. The child is in charge of what they eat, whether or not they eat it. And we don't want to provide a punishment for that, we really want to keep our language and the experience very positive.

Madeline Cheney  13:40  
Yeah, and I think that kind of goes back to to having a schedule eating time because that's such a natural consequence that happens. It's like Okay, but if you don't eat it, then we're done. And then once you get out of your highchair, we're not getting you back in which I sometimes when, you know, Kimball refuses food that we give him and then he's like, Oh, all done! And I know, I always know and I'm like, he did not eat enough and like, oh man, here we go because the next two hours until the next eating time is gonna be him crying for his high chair wanting to eat and it's hard not to give in. But I feel like that is a very, that's a natural consequence that can just happen instead of having to do you know, timeouts or getting really frustrated just to let that kind of be the teacher.

Kimberly Hirte  14:24  
Totally, totally. And when there isn't that back and forth argument a lot of the times it's not as big of a deal to kids, and they just go Oh, I guess this is my routine I get to eat when I'm offered and that's all I get. It stops being such a big deal, but it feels like a really big deal that first couple weeks.

Madeline Cheney  14:42  
Yeah, it gets a lot easier when it's part of your just your day to day life of like this is just what we do. It really takes a lot of the thought out of it and you can just stick to your habits that you've created. But that is a really hard--I remember you telling us that. Like it'll take a couple weeks before you see results. And so that was helpful to know, so we could stick to it and try to be consistent. And just kind of get through those weeks. And we still have battles now. But it's more of a like this is just how we do things and you don't have to think about it as much.

Kimberly Hirte  15:13  
Totally. There're a lot of positive, simple strategies that you incorporate into a mealtime to have your child be more interested in exploring new foods. I always encourage people to--I have a lot of parents come in and say, My kid wants to play with food, or they're more interested in playing with it than eating it. And I always say, That's awesome. Kids learn through play. Play is how they engage with their environment and how they learn new skills. And so I always encourage families to have fun and be playful with food. When something is new or scary, playing with it typically makes the child feel more safe. And so that's one of the first steps that you can do with new foods. If you're getting some push-back from your child or they're not interested in eating by mouth at all, food plays an awesome strategy to get them more engaged in interacting with food. You can take your grapes and pretend that it's a soccer ball and flick it between your fingers and score goals. You can make a car out of a carrot stick, there's so many different silly, random fun things you can do with your food that's going to take the pressure off of eating it and put more importance on just experiencing that food. The more times a child experiences a food, the more likely they're going to be to eat it.

Madeline Cheney  16:38  
Yeah, totally. We've seen that a lot, too, it's really helpful.

Kimberly Hirte  16:44  
Yeah, we call it The Steps to Eating before our child's going to chew and swallow food, they have to be able to be in the same room with that to look at it, to smell it, to touch it with a fork to touch it with their finger, to bring it anywhere near their face, put it inside their mouth. Some kids once it's inside, they want it right back out. There's lots of tiny, tiny, tiny little steps that you can take that's going to get you closer to chewing and swallowing foods. It's going to feel really positive and fun to your child.

Madeline Cheney  17:17  
Yeah, I think it's important to to recognize that-- because that might happen naturally. Maybe you play with food with your child without really knowing that it's like a strategy to help them eat. But I think it's important to to realize that it's a strategy and that's helping, because then you can be like, I did something today and we are a step closer, because I think a lot of times in our case, at least I think in a lot of people's feeding is such a slow process before they will accept a food and actually regularly eat it. And so I think, like the other day, I was feeling so discouraged about feeding and I was like Okay, I'm just gonna play with these little watermelon pieces that we gave him and he wasn't touching. He wasn't interested in it at all, so I dipped it in his yogurt, because he likes yogurt. And we used that as like a little dipping stick so he could eat it with the watermelon. And finally he was he was okay with doing that. And I was able to really recognize that that was a moment of success, even though I would have rather him eating the whole thing. I get impatient, like, just eat the watermelon. But I think it's nice to be like, I made progress today. And he made progress today. And we can be happy about that. And you know, really accept those as triumphs, because it's, it is often a long battle before they will--I shouldn't say "battle".

Kimberly Hirte  18:37  
It's an uphill climb for sure.

Madeline Cheney  18:39  
Yeah, yeah. So I think it's nice to be able to relish in those little triumphs.

Kimberly Hirte  18:45  
Yeah, I really try to encourage parents to shift their mindset with feeding. A lot of the times it is Well, my child didn't eat anything new. But then when I get down to Well, what were they exposed to? What were they interested in? Was there any timeouts followed mealtimes? And when parents start to say, Oh, no, that is getting better. I really like to help parents shift their mindset to really recognizing those small successes. Not as much focused on that end goal of just eating a new food.

Madeline Cheney  19:15  
Yeah, totally. 

Kimberly Hirte  19:18  
And kind of going along the same idea of play, a lot of kids really like novelty. And that's something we don't often think of as adults. Because when we eat dinner, we typically use the same plate, the same fork, we place foods the same way. And that's just our routine, we're creatures of habit. So we do the same thing pretty consistently. Toddlers love experiencing novelty with mealtimes. It's something different, it piques their attention, it gets them interested in whatever is happening. So using things like toothpicks, or taking the watermelon and using it like you said as a spoon or as a dipper-- That's a novelty strategy that's something new and different that sometimes gets kids excited. Cookie cutters or vegetable cutters--if a little kid is obsessed with cars, you could get a car cookie cutter and you could cut a peanut butter sandwich into the shape of the car. And that child's going to be more likely to interact with and be excited about that food if you're using a novelty strategy. Using different utensils, serving food on like a variety of plates or in muffin tins, really, it can be anything. You can walk around your kitchen and find something different. And your child will probably be excited and more interested in experiencing a food if it's presented in a different way.

Madeline Cheney  20:45  
Yeah, you know, as you're talking like, that is a takeaway I can take from this episode. I'm gonna try out to work on the novelty because I think it's just so easy just to be like, here's your plate. We're gonna do the exact same way every time. But I love that, that sounds so fun. And we can involve Wendy in figuring out what would be a fun way to present food. And I'm sure she would love that. So maybe, I don't know, I think maybe older siblings would be a good resource and that like thinking of creative ways to present food.

Kimberly Hirte  21:15  
Yeah. And they can be a really good model, you know, they can show how they're going to eat their soup out of a ladle instead of a regular spoon. And that's going to get the other child's probably more excited about it, too.

Madeline Cheney  21:26  
Yeah, I'm excited about that. I think you've told us this before. These are things I've heard before. But I'm like, that's one I'm excited to try out.

Kimberly Hirte  21:35  
Totally, and a lot of it is repetition, hearing the same thing consistently and choosing one strategy to work on at a time. A lot of the times, you're given a list of 5 or 10 different things to do, and that's just not achievable. But I encourage parents choose one strategy this week, focus on novelty, focus on toothpicks and different bowls. And then if you can focus just on that piece, and implement that strategy and get comfortable with that strategy, then you could add another one the week after.

Madeline Cheney  22:04  
Totally, because a lot of times, like if I feel like I have a ton of things I want to try and I'm excited about them, none of them have been because I'm like, so overwhelmed by them. So I really appreciate that tactic of just choosing one and then go for it and try to be really consistent. And then once you get that you can add other things and it's not as overwhelming because the other ones are habits.

Kimberly Hirte  22:24  
Yeah, exactly. Another strategy that I really like that you kind of mentioned with the yogurt-watermelon combination, we call it like food chaining, more like food stretching. So the idea behind that is you're going to take a food that your child really likes. For example, if it's chicken nuggets, you're gonna take chicken nuggets, and you're going to look at all of the different ways you can change or modify chicken nuggets. So for your child if they really liked the dinosaur chicken nuggets. If you purchase a regular round chicken nugget that is going to feel like an entire new food. That's as adults for like, it's the same thing, it's just a different shape. But to your child, that different shape means it's a whole new food. So that can be a really safe, comfortable way to make some small changes and get some increased variety. So you could do like round chicken nuggets, you could do a chick fil a chicken nugget, which is going to be a little bit of a different type of meat, a little bit of a different flavor. Chicken patties, like a chicken patty sandwich is going to be a lot bigger. So you can look at really small step instead of trying to do like a huge jump. And then you can add a lot of increased variety with those small steps.

Madeline Cheney  23:44  
Yeah, I really like that and that might feel safer for them. You know, just the smaller steps instead of like, and now here's pasta where it's so different.

Kimberly Hirte  23:54  
Totally. It feels safe and it feels a lot more positive. And then when they take a bite of something new and they realize that it's good and it's familiar, it's similar to what they like, they get excited that they got to be successful and try something new too.

Madeline Cheney  24:09  
Yeah, yeah, I really like that.

Kimberly Hirte  24:11  
Another way to get older siblings engaged--because I think that's a lot of family dynamics too, is how to have the whole family participating. One of my favorite strategies, depending on the child's age, is being like a food scientist or food explorer. And so what that does is it utilizes the five senses. And so you're going to take a food, whether it's a new food or familiar food, and you're going to talk about what it looks like, what it smells like, what it feels like, what it sounds like when someone eats it, or you crunch it with your fingers, and then what it tastes like. And I have a handout that I give families that lays this out in a table. And so then you can bring that paper to the table and it's something to talk about at dinner and it's a way to get engaged with a new food. You can do it a couple different ways. You could have everyone in the family choose a different sense that they describe and write down on the paper. One person can be in charge of talking about all of it for one food, and then you can rotate it to a different food. It's a really easy, safe way to get everyone involved in talking about food, and exposing in a really safe positive way.

Madeline Cheney  25:24  
Yeah, can we put a link to that in the show notes? Can we share that? 

Kimberly Hirte  25:28  
Totally, totally.

Madeline Cheney  25:29  
Awesome. So that will be in the show notes. So I feel like that also kind of goes along with food play when we were talking about food play, because it just helps them become more familiar with it. Like another way to play.

Kimberly Hirte  25:44  
Yeah, and it gives kids a language to use around food rather than just that's yucky, or that's yummy, which is what I hear a lot. And especially the kids a selective eater, majority of the things that we talk about is yuck, that's gross. I don't like that. Or parents say What do you think about food? It's almost always a negative word that they use to describe it. And so being a food scientist helps to give caregivers and the child different language to use to describe food. So if I have a child take a bite of something new, like if they went to take a bite of a strawberry instead of saying "yuck", I would say what does it feel like in your mouth? It feels wet. It feels slimy. It feels squishy. It's juicy. It's sweet. You would use different words to describe it as opposed to just yuck and yum.

Madeline Cheney  26:36  
Yeah, that totally makes sense. Because I think that probably even just goes into adulthood to have like your relationship with food and it's not so black and white like good and bad and yummy and yucky, where they have all these different nuanced flavors and different characteristics. That totally makes sense.

Kimberly Hirte  26:55  
And you can use it with young kids, I just encourage parents at the beginning to give them the language, they're not going to come up with those terms themselves. But if you model it for him consistently, they totally will.

Madeline Cheney  27:09  
Yeah, that's great. And what are some feeding tools that you typically recommend for families?

Kimberly Hirte  27:18  
Yeah, one of the most important things that I encourage families to look at is their seating at home and how the child is seated for mealtimes. We always encourage good posture and stability for more success with eating. If your body is sloppy, or you're leaned over to this side, you're going to be less engaged in what you're doing. And you're gonna have a lot harder time chewing and managing that food, especially if there's any sort of mobility difficulties, or delayed gross motor skills, fine motor skills, everything we can do to make sure that child is in a nice upright position is going to increase success at mealtime. So I typically tell people, make sure that the hips and the knees are at 90 degree angles and try and provide some sort of foot rest. Because if you think about you as an adult, if you were to sit on like a barstool or an elevated stool, we typically don't like our feet to hang, the first thing I'm doing is like trying to wrap my feet around the edge find something to rest my feet on. And in a lot of high chairs, kids are left with their feet dangling.

Madeline Cheney  28:24  
So interesting.

Kimberly Hirte  28:25  
Yeah, yeah, most people don't think about it. So you don't have that stability that resting your feet on something can give you which is going to increase your child's engagement at mealtimes. I've had parents say that just switching to a different chair made a huge difference in their attention and interest in participating at mealtime.

Madeline Cheney  28:44  
That's amazing. That's awesome.

Kimberly Hirte  28:47  
Yeah, and typically, you know--there're a lot of awesome fancy chairs out there, that if a family can swing it, it's worth it. Or you can find it on like Craigslist or use Facebook marketplaces. Like that a lot of people are selling their old highchairs. But you can also just look at what you have and create something from that. You can put a stool under your chair, you can add something to the legs of it, there's a lot you can do to modify what you currently have as well.

Madeline Cheney  29:14  
Yeah, I love that.

Kimberly Hirte  29:18  
Another one, I always encourage people to look at the utensils that they're offering, too, because sometimes we're offering forks or spoons that aren't necessarily developmentally appropriate, and it's gonna make it a lot harder for your child to be successful with feeding and self feeding. So looking for utensils that are going to be short and have a wider handle are going to make it a lot easier for your kid to hold on to it, maintain a grip and be able to successfully bring it to their mouth. There's a lot out there on Amazon or at Walmart, Target, your local grocery store. They all should have some sort of shorter handle, wider grip utensil that's going to make it a lot easier for your child to self feed.

Madeline Cheney  30:00  
Yeah, we noticed a huge increase in Kimball's self feeding when we switched. We had these like, long handled baby spoons, but we switched over to a short nubby handled spoon. And that made a huge difference even just that switch right there. So that was really exciting.

Kimberly Hirte  30:17  
Yeah, and with utensils comes messiness, and I always encourage families to let their child be messy. It is part of learning to eat, and that's part of learning how to manage a variety of food textures is to get messy, and it's something that parents just have to become comfortable with. Yeah, yep.

Madeline Cheney  30:39  
Yeah, yep. That's a hard one.

Kimberly Hirte  30:42  
It is hard. But it's important. With cups, the best thing that we recommend as speech therapists and feeding therapists is to look for like an open cup or a straw cup. Sippy cups are everywhere when you walk down baby supply aisles. Sippy cups are actually not typically supported by feeding therapists. They're not great for oral-motor development. And so the pattern that they facilitate is opposite of what we want to develop for chewing and mature oral motor skills. They also start to impact dentition. I kind of call them a glorified bottle, and we typically try to move away from that. The same thing is true with sippy cups. They're convenient, but they're not the best option. And nowadays, there's so many straw cups and straw water bottles that are no-spill. I really encourage families to look into straw options and start early with teaching your child how to drink from an open cup.

Madeline Cheney  31:47  
Yeah, and we really like that straw trainer. What is that even called? It's like the little honeybear?

Kimberly Hirte  31:52  
Oh yeah. Yep. I call it the honeybear straw trainer.

Madeline Cheney  31:56  
Okay, yeah, we really liked that because he would put his mouth on the straw and we'd kind of squeeze in and the water would go up. So he probably thought he was getting it out himself. But then sure enough, after a couple weeks of that he was able to just drink it without us helping him. And that was, that was awesome.

Kimberly Hirte  32:13  
Yeah, it's so great for teaching how to drink from a straw. And then once they've mastered that, I tell parents, they can move on to any straw cup, but a lot of kids really love their honey bear and they prefer just to keep their honey bear. It's lightweight, it's easy to move around, the straw is flexible. Yeah, the honey bear, I call it my miracle cup. I give it to almost every single family. And every kid is successful with it. 

Madeline Cheney  32:36  
That's awesome. Yeah, everyone always makes a comment like Is that a honey container? Because they think I'm so clever for having thought of that because they assume that I like cleaned out the honey container and then gave it to him and I'm like, No... we got it from our feeding therapist. But ya know.

Kimberly Hirte  32:50  
Yeah! There are so many different utensils and cups and all different kinds of things that a feeding therapist-- if you are struggling with figuring out a utensil that can work for your child or a cup that can work for your child, a feeding therapist has access to lots of different feeding tools that they can use to help support you in that process. Sometimes it's overwhelming to look on Amazon. If you just search cups or kids utensils, it's overwhelming to know what to choose. So looking to your feeding therapist for ideas can be helpful too.

Madeline Cheney  33:29  
And I like that you offered some guidelines where we can, you know, say okay, I want a short nubby handle and then sort through them that way or I want a straw not a sippy cup and kind of these guidelines to kind of use to be able to find tools that will be more of a successful experience for our child.

Kimberly Hirte  33:48  

Madeline Cheney  33:50  
So for people listening, that are not seeing a feeding therapist or any form of a feeding therapist and have a child who struggles with eating In one way or another, how would you recommend them going about knowing if their child needs to see a feeding therapist, and then what the first step would be to get into a feeding therapist?

Kimberly Hirte  34:16  
So typically, my rule of thumb with that is if mealtimes are stressful, and you're concerned about it, you could probably benefit from the support of a feeding therapist. We always talk about how we would rather see kids sooner rather than later and be able to help support families early in the process than when we're older and kind of deep into her behaviors and routines and patterns. So if you're feeling stressed and you feel like you need more ideas and support to get through some of these feeding difficulties, I encourage all families to go and seek out help from a feeding therapist. The best way to do that-- so there's two different disciplines that work on feeding therapy typically. It kind of depends on where you live, speech language pathologist, and occupational therapists, oftentimes both work with children with feeding challenges. So seeking out a speech language pathologist or an occupational therapist in your area can be a great starting point. You can typically do that through early intervention if the child's under three, through like a private therapy company, an outpatient clinic associated with a local hospital. Asking your pediatrician or anyone on your medical team how to get in touch with a feeding therapist is usually a good starting point.

Madeline Cheney  35:32  
Yeah, I really like that. And like, what's the worst that will happen? Maybe you'll go in, and maybe you'll work with them only for a few times. And maybe you'll be like, okay, we've made progress. We don't need to keep seeing each other. Like that's the worst case scenario. Best case scenario is you're like I'm so glad I came in here. And we will continue this for a long time and continue to make strides and help it help reduce the stress of eating time.

Kimberly Hirte  35:54  

Madeline Cheney  35:56  
I would love to kind of wrap up with a pep talk to parents who have children who are selective eaters. Because everyone who's in that situation knows it is a really challenging thing to be up against. So what what can you say to encourage us?

Kimberly Hirte  36:16  
The number one thing that I would say is be consistent, find small steps that you can take and be consistent in them. It's okay for progress to be slow. As therapists we talk all the time about how progress is slow, but as long as we're taking steps in the right direction, that's something to celebrate. So change your mindset. Focus on being consistent with small changes, and you're gonna see that progress.

Madeline Cheney  36:46  
I really like that. Well, thank you so much, Kimberly, for joining us today and for teaching us. You're awesome.

Kimberly Hirte  36:54  
Yes, it was my pleasure.

Madeline Cheney  36:58  
Links to a few feeding tools that we've really liked for Kimball that also fit Kimberly's criteria can be found in the show notes as well as the food scientist printout. You can like my Facebook page, The Rare Life Podcast to know about episodes as they are released. And I would like to give a big thank you to all that shared their takeaways from season one. Those have been so fun to read through. Next week's episode is season one finale, where I will read some of my favorite takeaways and respond. See you then!

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Ep. 119: Your Child’s Medical Team | How to Push Back, Ask Questions, and Build Your Dream Team w/ Dr. Kelly Fradin, MD https://d3ctxlq1ktw2nl.cloudfront.net/staging/2023-2-23/319744619-22050-1-1e2071eee4df4.m4a


Hex Code

68: Dipping My Toes into Educational Advocacy