Welcome to part 4 of my series on the Sensory Oral Sequential (SOS) Approach to Feeding. Today, we’ll cover a strategy that I implement when when working with picky eaters and problem feeders – preventing food jags.

Without warning, a picky eater or problem feeder may drop food that they were previously willing to eat. How frustrating! This may be the result of a food jag. A food jag is when a child will only eat the same food prepared the same way over and over again. The key issue with food jags is that they lead to boredom or burn out, which in turn results in the food being dropped from the list of foods that the child will eat.

We know that picky eaters and problem feeders typically have a limited list of what they will eat. If a food jag causes that list to grow smaller, parents often become increasingly concerned that they have little left to work with. This is why we need to prevent food jags.

How do we prevent food jags?

A strategy that I use with families to prevent food jags is called a preferred foods menu. The purpose of a preferred foods menu is to not repeat the same food item over a two day time period. There are two types of preferred foods menu that I use – (1) full preferred foods meal plan or (2) one preferred food at every meal and snack. Which menu I use is based on severity of the picky eating.

To get started, I begin by working with the parent to make a list of every food that the child will eat. We get very specific with this list. For example, if the child eats crackers, we will list every single type of cracker that the child will eat and we will treat every type of cracker as a completely separate food item. Once that list is created, I will separate the foods into three different categories – protein, starch, and fruit/vegetables.

Let’s look at an example of a full preferred foods meal plan with 3 meals and 2 snacks per day.

Here are the foods that the child will eat.

Goldfish. Peanut butter. Saltine crackers. Wheat crackers. Cheez-its. Cooked carrots. Baby carrots. Sliced apples. Cheddar cheese. Strawberry yogurt. Sliced turkey. Whole wheat breaded chicken nuggets. Dinosaur shaped chicken nuggets. Spaghetti noodles. Pears in fruit cup. Bananas. Peas. Tostitos. Wheat tortillas. Graham crackers. Strawberry pop tarts. Cherry pop tarts.

Here are the foods that the child will eat split into the categories of protein, starch, and fruit/vegetable.

There are a different number of foods in each category and that’s okay. Now, that I’ve got the foods separated into categories, I’ll start building the menu. My goal is to have a protein, a starch, and a fruit/vegetable at each meal and snack while making sure not to repeat the same food item over a two day period. If I’m not able to do that, I’ll notate that I’m missing a food category.

Day 1 and Day 2 are done but there are several spots where I’m missing a food category. To fill in these spots, I’ll add a food item that is similar to a food item that the child will eat or I’ll provide a food item prepared in a different way.

Example – the child likes cheddar cheese so on day 1 at snack #2, I’ll specify that cheese to be sliced cheddar cheese and make one of the missing proteins cheddar cheese cubes.

Another example – the child likes sliced turkey and there are several other versions of sliced meat so make one of the missing proteins sliced chicken.

Once I get the missing food items filled in for those 2 days, I can begin working on day 3.

Here’s the same menu as above but completed. (The items that were marked as missing before have been bolded and if I edited an item to be prepared differently, I italicized that item).

This menu can be intimidating and time consuming to create but if you’ve got a problem feeder it can help your child to not experience a food jag and drop a food while we work through things in feeding therapy.

The second type of menu, one preferred food at each meal and snack, is a little easier to create and is one that I commonly use with children who are picky eaters but are not problem feeders. The goal of this type of menu is to make sure that there is at least one food at every meal and snack that the child will eat. This food can be part of the meal that everyone else is getting or it can be in addition to the meal.

Let’s look at a meal plan for a family. The foods that the child likes will be from the same list that we used in the above example and they will be in bold type in the below menu.

In this menu, I took the foods that the child likes and made sure that there was at least one at every meal and snack. For the most part, there was one liked food at each meal and I didn’t have to add an extra item for the child. With dinner on day 1, I added cheez-its to ensure that there was something that the child would eat at that meal.

Picky eaters and problem feeders can be mind boggling, frustrating, and challenging. In addition to having the challenge of getting food into the child, we also have the challenge of good nutrition for the child. Having a trained pediatric feeding therapist who is a registered dietitian can help make sure that we are maximizing the child’s nutrition for what the child will eat.

Nutrition is a piece in all of this that I also look at when working with a child in feeding therapy. I examine the menu and the child’s food likes to see where there are nutritional deficiencies and how I can decrease those deficiencies. I look at what needs to be added and how it can best be added to the child’s intake…more on this to come in a future post!

As always, if you have any questions, please feel free to reach out.