The SOS Approach to Feeding – Food Jags

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.

picky eater

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.

Protein Starch Fruit/Vegetables
Peanut butter
Cheddar cheese
Strawberry yogurt
Sliced turkey
WW breaded chicken nuggets
Dinosaur shaped chicken nuggets
Goldfish
Saltine crackers
Wheat crackers
Cheez-its
Spaghetti noodles
Tostitos
Wheat tortillas
Graham Crackers
Strawberry pop tarts
Cherry poptarts
Cooked carrots
Baby carrots
Slice apples
Pears (fruit cup)
Bananas
Peas

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 Day 2 Day 3
Breakfast Peanut Butter
Wheat Crackers
Canned Pears
MISSING PROTEIN
Strawberry Pop Tart
Sliced Apples
Sliced Turkey
Snack Strawberry Yogurt
Graham Crackers
MISSING FRUIT/VEG
MISSING PROTEIN
Saltine Crackers
Banana
Lunch Sliced Turkey
Cherry Pop Tart
Peas
Chicken Nuggets (Dinosaur)
Cheez-its
MISSING FRUIT/VEG
Peanut Butter
Snack Cheddar Cheese
Wheat Tortilla
MISSING FRUIT/VEG
MISSING PROTEIN
Tostitos
Baby Carrots
Dinner Chicken Nuggets (WW)
Spaghetti Noodles
Cooked Carrots
MISSING PROTEIN
Goldfish
MISSING FRUIT/VEG

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).

Day 1 Day 2 Day 3
Breakfast Peanut Butter
Wheat Crackers
Pears (fruit cup)
Banana Yogurt
Strawberry Pop Tart
Sliced Apples
Sliced Turkey
Graham Crackers
Applesauce
Snack Strawberry Yogurt
Graham Crackers
Applesauce
Cheddar Cheese Cubes
Saltine Crackers
Whole Banana
Plain Yogurt
Wheat Crackers
Cooked Carrots
Lunch Sliced Turkey
Cherry Pop Tart
Peas
Chicken Nuggets (Dinosaur)
Cheez-its
Strawberries
Peanut Butter
Blueberry Pop Tart
Sliced Banana
Snack Sliced Cheddar Cheese
Wheat Tortilla
Sliced Banana
Sliced Chicken
Tostitos
Baby Carrots
Chicken Nuggets (WW)
Wheat Tortilla
Pears (fruit cup)
Dinner Chicken Nuggets (WW)
Spaghetti Noodles
Cooked Carrots
Diced Turkey
Goldfish
Peaches (fruit cup)
White Cheddar Cheese
Linguine Noodles
Peas

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.

Day 1 Day 2
Breakfast Oatmeal
Banana
Strawberry yogurt
Granola
Snack Goldfish
Sliced Apples
Pears (fruit cup)
Sliced bell pepper
Lunch Peanut Butter & Jelly Sandwich
Strawberries
Turkey (sliced) sandwich
Salad
Snack Baby carrots
Hummus
Graham Crackers
Applesauce
Dinner Lasagna
Roasted vegetables
Cheez-its
Tacos

  • Hard taco shells
  • Wheat tortillas
  • Ground turkey
  • Shredded cheddar cheese
  • Salsa
  • Shredded lettuce

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.


How do you know if your child is a picky eater or a problem feeder?

Welcome to part 2 of my series on the Sensory Oral Sequential (SOS) Approach to Feeding. In this post, we’re going to take a look at the differences between a picky eater and a problem feeder.

Part of being a toddler is going through a picky eating phase. This picky eating phase is part of typical child development and in most cases, it will end. However, there are times when it’s more than picky eating and you may have a child with feeding difficulties (i.e. a problem feeder).

An integral part of utilizing the SOS Approach to Feeding is understanding if the child is a picky eater or a problem feeder. The SOS approach can be utilized with both types of feeding issues, but how it is approached may be a bit different based on whether or not the child is a picky eater or a problem feeder.

The chart below describes some of the differences between a picky eater and a problem feeder.

If you have any questions or concerns about whether your child is a picky eater or a problem feeder, feel free to contact me. I’m happy to talk things through with you.

Picky Eater vs Problem Feeder


Reasons Your Little One Isn’t Eating

Feeding children, especially those toddlers, can be wildly frustrating. Their likes and dislikes can change quickly. They can reject an entire meal for what seems like no reason, making mom and dad feel helpless and scared. It may seem like your little one is refusing to eat in an effort to drive you crazy but that may not be the case. There are a number of reasons that a child may not eat and stubborn isn’t one of those reasons. Let’s take a look at a few.

baby s green and purple highchair

Too much pressure!

Do you feel pressure surrounding getting your child to eat? Is there pressure to get through meal time quickly so that the family can make it to an event? Are you anxious when your child doesn’t eat? If the answer to any of these questions is ‘yes’ then these feelings of anxiety may be behind why your child isn’t eating. Children are pretty intuitive little creatures and they pick up on environmental cues to help tell them what they should do. If your child feels your anxiety and pressure, it may manifest in the child as food refusal.

What can you do?

Try to relax. I know, easier said than done. Don’t hover. Don’t push your child to eat. Sit back and have conversations with others at the table. Eat your meal. Let your kiddo eat at his/her own pace and be in charge of what and how much to eat.

The kid just isn’t hungry.

Maybe, just maybe, your little one isn’t hungry. Children are intuitive eaters. A study conducted in 2002, found that children are able to recognize when their body needs calories and when their body does not need calories. This is dependent on the child not having any diagnoses that impact metabolism or nutrition. For example, if a child sit down to eat a snack and they need 300 calories but you only give them 250, the child is going to want 50 more calories. If you sit that same child down and give them 400 calories when they only need 300, the child will leave 100 calories on the plate. If you’re kid sits down and doesn’t eat, he or she may simply not be hungry at that moment and this is okay.

What can you do?

Don’t panic. Make sure that you provide eating opportunities on a regular schedule, and remember, it’s your job to provide the food and it’s your child’s job to decide how much to eat.

Large Portions.

Have you ever been out to eat and when your food comes out you think: “oh my, this is WAY too much.” This same overwhelming feeling at the sight of too much food can happen to children. When eating at, if portions are too big, your child might feel overwhelmed and shy away from that much food.

What can you do?

Decrease the portions that you’re serving and serve food in child sized dishes. If need be, provide additional, small second servings.

Too many snacks or too much milk/juice.

This can go hand-in-hand with the “not hungry” example above. If you don’t feel like your child is getting enough to eat, it’s natural to want to constantly offer snacks, milk or juice. This constant grazing can lead to always feeling full which in turn leads to low intake at meal times.

What can you do?

Provide meal and snack times on a schedule. Don’t provide constant opportunities to snack. Keep a meal time schedule that allows your child to build up an appetite. Keep a meal time schedule that allows you comfort in knowing that if you child doesn’t eat at one eating opportunity, there will be another.

Sensory or texture sensitivities.

Does your little one avoid foods based on their texture? No crunchy foods? No slimy foods? This can go the other way as well – does your child only eat food based on a certain characteristic such texture? Your child might be sensitive to certain textures and this can lead to not eating those textures.

What can you do?

Encourage your child to interact with those textures. This interaction can be as small as touching the food. It’s okay to smart that small and build up to tasting the food. It’s also perfectly okay to play with our food as part of the experience of getting used to a specific texture. Sensory issues are an area where you may need the help of a Feeding Therapist. There are several dietitians (like me!) who are Feeding Therapists. Many Occupational Therapists and Speech Language Pathologists also offer feeding therapy services. Be sure to reach out to a professional whom you trust if your at home strategies aren’t showing any progress.