Expert: Jene Aviram - 3/8/2010

Question
My 3 yr old son, who has been diagnosed with autism, will not eat any solid foods. He does eat "stage 2" baby food, 2 types only, and even that is becoming a rarity. Hes been seeing O.T. for a year but hasnt made any progress. Me and my wife have tried everything we can think of to get him to just try different foods. Im really getting concerned about his lack of nutrition.

Answer
Hi,

You are not alone.  There are so many parents out there who have gone through/or are going through the same as you.  I take it you've been doing this for a while and have probably done a lot of research.  I will share with you some tips that parents and professionals have used.  You might have heard of many but it's worth writing them.  It often just takes one food that a child is willing to eat which then spirals into a whole repertoire of new foods for a child.

Firstly, if you find that your OT is not making progress would it be possible to switch to a different OT?  Each person has different strategies and techniques and that can make a big difference.

While an OT is really good with desensitizing kids with different textures, nutritionists are very skilled at getting young toddlers to eat.  Have you seen a nutritionist?  Your child will certainly qualify for services.  

I must also ask if your child has seen a pediatric gastroenterologist?  It's always worth ruling out a medical issue - just in case.

You didn't shed light about what you feel the reason is that your son won't have any solids.  Is it texture?  Is it taste?  Is it a gag issue?  That does make a difference in knowing what to try.

What is your son drinking?  Is it milk?  Is it pediasure?  If it's pediasure will he have different flavors?  One thing I've seen be successful is making instant pudding in the same flavor as the child likes his pediasure.  For example, if your son drinks vanilla pediasure, then it's worth making vanilla instant pudding.  To start, make the pudding a lot more "liquid" than it's supposed to be.  And let him drink it with a thick straw before you move to a spoon.  If it's a success you can gradually increase the thickness and method of eating it.

Another thing I've seen work a lot is "dips."  Peanut butter is one.  Let your son dip his finger in the peanut butter.  Or does he still drink from a bottle or use a pacifier?  How about dipping the teet in a dip, either peanut butter, or pudding etc.  Then let him suck on it to warm him up to the idea of a new taste.  Remember that Rome wasn't built in a day. It takes eating a new food a number of times before we really grow to like the taste.  This will be very exaggerated in your son.

Does your son eat the fruit kind of baby food?  If so, there are all kinds of apple sauce in different flavors that he could try. This can be incorporated into other foods later or used as dips.

I know most nutritionists might not agree with this, but I met a mom once who was at the end of her wits.  She tried everything to get her son to eat solids.  Of course it was all the healthy stuff that was recommended.  But one day she gave her son a smart puff cheese curl to hold.  He started nibbling on it and threw it away.  But she kept up with it.  Within 2 weeks he was eating the whole cheese curl.  And he really liked them.  He began requesting them.  This really seemed to open the door for him and he slowly became open to trying more and more foods.  It took a few months but he added toast, plain butter cookies, cream cheese and quite a lot of other foods in his diet.  

Does your child like ice pops?  A lot of kids are willing to eat frozen things but not solids.  And I have seen all kinds of frozen items.  In fact, sometimes I'm amazed by what works.  One person said she made mashed potato with milk and froze it in pop sticks.  Her son gladly ate it.  Another person blended chicken stew and froze it into popsicles.  That really worked for her.  She was able to then give him the food blended but at room temperature.  And then in chunks.  With this strategy and with some patience she was able to start introducing a whole lot of new tastes.  This step made her son more ready for solid foods.

Autism can make things a little more difficult when it comes to motivation, but do you think your son will enjoy preparing foods?  For example, you can make faces out of bits of cheese and then eat it.  Or make custard together and then eat it.

I've seen a lot of people try and blend solid and smooth food together.  However, in my experience this is not always the best strategy.  For example, if a child likes yogurt, it's often recommended to try and add crackers or some other food into the yogurt.  However, if one is sensitive to textures, it's pretty common that they don't like to blend solid and liquids together.  In other words they might be happy to eat yogurt.  And they might be happy to eat crackers.  But they would never eat them together or even have them on the same plate.

I know you are concerned about the nutrients and because of that I'm pretty sure you have everything on track.  You have to check with your pediatrician on this.  As long as your child is growing consistently and your pediatrician is happy.  One pediatrician told me once that I'd be amazed just how little a kid has to have at 3 years old to keep nourished.  Is your pediatrician prescribing you a good multivitamin with fluoride?  This can come in liquid form so that you can add it to your son's drink or baby food.

Lastly, there are a lot of pretty good books and speakers on how to get your child to eat.  You might have already attended a bunch of them and read a whole library!  But if not, it's a great way to meet other parents who are going through the same thing.  And a wonderful meeting ground to hear from others about strategies that have worked for them.

I know you're going through a very worrying and trying time right now.  But you clearly are taking all the right steps for your child to include solids in his diet.  Don't give up.  It's often a maturity issue as well before a child is ready to make that jump.  I wish you great luck and success.

Jene Aviram
http://www.nlconcepts.com