Saturday, February 21, 2009

Stopping food pocketing

Wow! What an interesting week at work! I have to share....I have a little 2 year old who I have been working with on trying to decrease the amount of food that is being pocketed in the cheeks, in order for this child to be a safer, more efficient eater. I was so proud of "Client A" (we can't tell gender, names or specifics for HIPPA privacy policy reasons) who slowly but surely is starting to pocket food less. How do you stop pocketing? Well...we (mom & I) started with changing the mealtime set-up. Instead of watching "child A" eat, mom & I became active participants with "the child". You've heard the expression "Lead by example"...well...the same is true about feeding...children learn by watching your example...if they are fed in a high chair seperated from the family or at a different time they miss out on watching the "Leaders" (their mom & dad) eat. & I started talking about what was happening to the food in our mouths as we chewed up the food. For example...if we were eating a pretzel rod...we would talk about and show ( feeding therapy showing the chewed up food in your mouth is a necessity) we use our "Strong teeth" to "chew-chew-chew"...then we would talk about our tongue..."Uh-oh Mr. Pretzel is all smushed now..he needs some help getting off of my comes Mr.Tongue"...We would EXAGGERATE moving our tongue to the lateral incisors and while keeping our mouths WIDE OPEN (for better visual effect) ...we show how to move the chewed up bolus (a bolus is food that has been chewed and is ready for swallow) to the tip of the tongue...then we would say "bye-bye" (overly exaggerating this as well) and with our mouth open show how the bolus moves to the back of the tongue and then we swallow...after the swallow we opened our mouths wide and showed the empty oral cavity...tah-dah..

We did lots and lots of this "play" with our food...talking about how some food is crunchy and some food is goey and needs "Mr. Tongue" more to get it to go bye-bye..etc...etc...

So thats might be thinking...???

Well..not "Child A's" case we also had to work on increasing oral motor skills through strategically placing food, cutting food into specific shapes in order to elicit a specific oral motor movement, chosing food that has specific textures, etc...etc..but pretty much this little one took off with feeding when we broke food down to his level and had "fun" while we ate. We also taught what to do with the bolus if we were tired of eating...aka we showed how to spit food out of our mouths...Hey :) Thats a lot better than "child A" keeping in the mouth and choking on it later...or making us be the bad people by using our finger to scrap out the leftover bolus...Safety first, right...Safety and then we can think about "manners" later :)

Special note :
Children are like open books..and sometimes we forget they still need lots of pages to be filled with "how to......". Children need models, they need explanations, they need to "Feel experiences" to remember them...especially a 2 year old...God gave us several senses in order to take in our world and the amazing thing about children is that when you explain "how to..." in a way that uses each of those senses...the children REMEMBER and begin doing it! WOW!

Is "Child A" done with therapy...well not quite yet but the little one is getting there and since "child A" has great parents who are carrying over all these "fun mealtime" changes "Child A" is learning quickly. Soon...


  1. I have a 15 month old daughter who does this. Usually it's with meat and certain fruits. My son also did this at this age. I just wondered if there was more to it than they just don't know how to chew and swallow properly. In your experience, is there anything related to digestive problems that causes this? They both struggle with food I wondered if that had anything to do with it.

  2. Good question becky my son does this too and has food llergies.

  3. This post was a blessing to me. We have a 3 y.o. boy who was born at 25 weeks gestation. He had a Gtube inserted with a Nissen before he was adopted into our family. So with that combo, he has encountered feeding problems- the biggest one being pocketing. He spends about 6 hours in his high chair/ day, as a feeding can last 2 hours. Please contact me- we've been through feeding therapy without success.

  4. Hi there. There is a medical condition called Eosinophilic Esophagitis in which proteins in foods attack the body, causing esophageal inflammation, furrowing, narrowing and the presence of eosinophils--white blood cells that should not be in the esophagus.

    This condition can cause painful swallowing, the sensation of food being stuck, food refusal and food aversion. In cases of EoE, no amount of feeding therapy will help without medical intervention (e.g., medication, special allergen-free diet). I hope this helps someone.