Help! My Child Won't Self-Feed!May 21, 2020
Parents often ask me for advice about how to encourage their child to self-feed.
Common questions include:
• Should I force her to feed herself?
• Should I let him go hungry, so he starts self-feeding?
• Should I introduce utensils or let him use his hands?
• What if she doesn’t eat enough?
The answers are no, no, yes and worry-not.
Babies should be provided with opportunities to self-feed as early as possible. Babies and children that are allowed independence and control of their eating tend to be happier and more adventurous eaters. They are also better at regulating their hunger and satiety cues.
Self-feeding is a developmental process. It can start by simply allowing your baby to hold their own bottle or your breast. Some babies initiate this themselves; others need gentle encouragement. Children with developmental delays or a disability may need extra support to become involved in their feeding times. As soon as solid food is introduced, babies should be presented with foods on their tray to touch and explore with their hands. Whether you are introducing baby-led weaning or purées, it’s important to give your baby frequent opportunities to touch food and eventually bring it toward their mouth. This early food exploration allows your child to learn about food with all of their senses.
Self-Feeding: A Developmental Continuum:
Hands and toys to mouth
Reaching, patting, or holding bottle or breast
Touching and squishing purées on tray
Picking up pieces of food with palms then fingers
Holding and dipping foods and utensils
Bringing utensils to mouth
Scooping and poking food with utensils and bringing to mouth
Why isn’t my child self-feeding?
• Developmental Delay
• Sensory Processing Issues
• Parents don’t like mess
• History of slow growth: parents fear loss of control and their child will not eat enough
• Cultural differences
• Feeding aversion
How Can I Introduce Self-Feeding?
Self-feeding does not need to be an all-or-nothing approach. I believe in wee baby-steps for self-feeding. There is no need to push/force or make your child miss a meal while they are learning to self-feed. Here are some option for introducing self-feeding.
• Co-feeding: Child and parent participate in the feeding at the same time. Child feeds herself and parent feeds her at the same time.
• Child does a few bites at the beginning of the feeding when hungry and motivated to eat. Parent feeds the remainder of the meal.
• Child helps to self-feed every few bites (e.g., every 3rd bite or using turn taking).
• Parent works on self-feeding during just one meal per day when they don’t feel too rushed/stressed (e.g., dinner vs breakfast when trying to get out the door for school drop-off).
Babies (0-6 months):
The beginnings of self-feeding emerge when babies start to bring their hands and toys toward their mouth for sensory exploration. Mouthing is an important part of a baby’s feeding development.
Allow your child to control their intake from infancy. Follow your baby’s feeding cues and allow her to pull away from the breast/bottle when finished or in need of a break. Allow your child to come back toward the breast/bottle when she wants more. This is the start of self-feeding and self-regulation.
If you child is not reaching for the breast/bottle, gently bring her hands upward toward midline and rest or rhythmically tap them on your breast or the bottle. If your baby pulls away, that’s ok, maybe she’s not ready yet. You can hold your breast or the bottle and gently place your child’s hands on top of yours for skin-to-skin contact. This will encourage her to learn to bring her hands toward midline.
Adding a rubber grip or handles around the bottle and starting with a small-sized, lighter bottle can make holding easier for beginners with little hands.
Babies (6-12 months):
Always place food in front of your child on his feeding chair. If he is resistant to touch the food, gently support his arms from under the elbow and guide his hands toward the food. This also works very well for children with motor delays who have difficulty initiating reaching and grasping by themselves. They may benefit from some gentle encouragement and extra help to support their delays.
If your child is very resistant to touching her food, never force her, instead model touching yourself, or try counting 1-2-3 while tapping her hands in the food, then quickly wipe her hands to remove the food. When working with children with sensory differences, I often say “touch-touch-touch, wipe-wipe-wipe”, followed by praise and smiling. With repeated exposure, your child will become more comfortable with touching foods and leaving food residue on her hands.
Some children with sensory issues require a period of just looking at food and perhaps smelling it before they are ready for touch. The key with self-feeding (and all feeding) is not to push or force. If your child is not yet ready to touch foods, just start with looking and modelling the behaviour.
You can introduce a baby-sized spoon with a small, round, grippy handle or a pre-spoon like the NumNum GOOtensil. Try dipping and preloading the spoon and leaving it on the tray or handing it to your child vertically. Vertical presentation of the spoon sends a message that you are not trying to put the spoon in your child’s mouth, you are handing it to them. Often, I find kids will reach for the spoon and bring it toward their mouth.
If your child is resistant to holding a spoon, you can dip familiar teethers, toys, or mouth brushes (e.g., The Baby Banana Brush) in foods and let them bring the item to their own mouth.
Start with thicker or mashed foods that stick well to the utensil, so the food doesn’t slide off when your child tries to bring it toward their mouth.
Silicone Fresh-Food Feeders work well to encourage your child to hold and bring food toward his/her mouth. These feeders can help kids that are gagging or have difficulty with chewing and/or moving pieces of food around in their mouth.
Toddlers (12-24 months):
Offer both finger foods and utensils at feeding times. Both are equally valuable skills.
Try cutting foods into cubes, fun shapes, or long strips. Toddlers often respond to fun-food presentation. Foods that are cut into long sticks or fun shapes often work well for toddlers that are self-feeding.
Backward Chaining for Self-Feeding:
If your child is resistant to self-feeding, try backward chaining to teach the skill. This involves teaching the very last step first (putting spoon in their mouth) and gradually working toward the first step (scooping the food from their bowl).
• Hold the loaded spoon 1 inch in front of your child’s mouth. When they open their mouth to indicate “yes”, gently place their hand on-top or your hand and say “help” as you move the food into their mouth together. Give specific praise, “good helping” and smile.
• Once this step is well established, move your hand toward the end of the spoon, so the handle is accessible for your child. When they open to accept the spoon, gently place their hand on the handle and say “help” as you move the spoon into your child’s mouth together.
• If your child is successful with this, you can slowly start letting go of the spoon as your child grips the handle. Remember to keep the food about 1-2 inches from your child’s mouth. Give specific praise, “Good holding the spoon!”
• Over time, start moving the spoon lower, further away from your child’s mouth, and more toward the bowl. The distance between your child’s mouth and the spoon will gradually increase and your child will slowly start to learn to reach toward the spoon in the bowl.
• As a final step, you can scoop the food and leave the spoon in the bowl. Your child will learn to reach down and grab the loaded spoon and bring it toward his mouth. Lastly, you can use hand-under-hand assistance to scoop the food together. Give specific praise “Good scooping!”
In my experience, hand-under-hand (your hand under your child’s) is better tolerated than hand-over-hand (you hold your child’s hand), as I find many children with sensory processing issues are very resistant to having their hands touched. As an adult, I wouldn’t want anyone to grab my hands, as my hands are very much apart of my personal space. I always aim to treat kids the way I would like to be treated. Remember to guide versus push your child toward self-feeding.
Practice family meals and eat with your child. I invite you to read my blog about the benefits of family meals. You child will learn to self-feed by watching you. Seeing which foods you eat and how you feed yourself or use utensils is a wonderful learning opportunity.
Developmental Delay and Disabilities
Some children with developmental and motor delays require extra support and/or adaptive equipment to support their journey with self-feeding. Your child may benefit from support from a Speech-Language Pathologist (SLP) or Occupational Therapist (OT) to promote optimal seating and positioning and prescribe appropriate feeding equipment (e.g., tray, mat, utensils).
Your child may require extra help bringing his hands toward midline or initiating touching and exploring foods. Follow your child’s cues and view self-feeding as a developmental journey. Even if your child will not be able to achieve full independence with feeding, it’s always important to provide him with opportunities to explore and exercise control at mealtimes.
Mess is Best!
Learning to eat is an immersive experience. Babies and children learn about food through play and sensory exploration. This means that mess is part of the journey. Often parents tell me that they don’t like a mess at mealtimes, and they fear that they are teaching their child bad eating habits. I assure parents that messes are essential to learning to eat. When my kids were babies, I would strip them down to their diapers at mealtimes and let them engross themselves in their meal by touching, squishing, and smashing. As babies and toddlers, I allowed them to learn to eat, later, as they got older I moved some of the focus toward manners. My kids are teenagers now and I assure you that are no longer squishing, smashing, or throwing their foods during family meals. Please remember that every mess can be cleaned up and your child won’t always be a messy eater; however, it’s an essential stage in their feeding development.
It’s also normal for babies and toddlers to throw food and utensils on the floor. They are enjoying learning about cause and effect: watching the item fall, make a noise, and seeing the food splat on the floor. They also enjoy watching your response. Try not to be discouraged if you child is throwing food and utensils on the floor and consider this as a normal part of their feeding and cognitive development.
As a clinician it’s important to discuss with families whether self-feeding and utensil-use are important to them. Often our goals as clinicians may not be in-line with what is important to families. I always ask families what a typical family meal looks like and whether self-feeding and using utensils is one of their goals. I further discuss cultural considerations in my Family Meals Blog.
When a child has not been eating or growing well, self-feeding often becomes less of a priority for parents. They fear that letting their child self-feed will result in reduced food/caloric intake. Parents in this position are often measuring food and monitoring their child’s intake volume. Allowing their child to self-feed means that parents feel unsure if their child has had enough to eat. In this situation, I encourage parents to introduce self-feeding gradually. I counsel parents that letting their child move toward independence will eventually lead to better eating patterns. Co-feeding works very well in this situation, where the child is provided with opportunities to self-feed while their parent is feeding them at the same time (see options above). This allows the child to learn about self-feeding, while the parent feels more relaxed and comfortable that their child is getting enough calories to grow and thrive.
Slow and Steady
As with all feeding steps and stages, self-feeding should not be forced. It can be viewed as a developmental learning curve that starts early in infancy. Always follow your child’s lead. If she is not ready to self-feed yet, just provide opportunities, but don’t push. Evidence has repeatedly demonstrated that the more stressed kids feel at mealtimes, the less likely they are to eat. Keep mealtimes positive, model good eating behaviours during family meals, and follow your child’s lead; with time and practice he will learn to feed himself and become a happy, independent little eater.
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