We are making progress. We have narrowed down the reasons for TJ’s resistant eating as part anxiety and very possibly an impaired sense of smell.
Smell is very important in the function of taste. Jelly beans are a great way to better illustrate this. Pinch your nose closed and without looking at the colour, pop a jelly bean into your mouth. While you chew it, you’ll detect the texture (crunchy, sticky, gooey), the temperature, and the taste (sweet). Now, unplug your nose and continue chewing. This is when you’ll detect the flavour of the jelly bean (strawberry, watermelon, etc..).
Without the sense of smell, you can still detect the taste of sweet, salty, sour, but without retronasal air flow (from the back of the mouth up through the nose) the flavour will be missing. It is this retronasal air direction that is blocked during a cold, for example. TJ’s allergies, we suspect, impairs this direction of air flow. Meat without the flavour, to him, is much like chewing on an elastic band.
Anxiety feeds a large part of TJ’s food selectivity and unless we break the anxiety cycle, he will never have a comfortable relationship with food. I’m not certain that he remembers the episodes of choking, but the trauma of the event has certainly stayed with him. He ate something that caused him to stop breathing, obviously a frightening experience. The next time this item shows up on his plate, he thinks it could kill him, so he avoids this particular food. Soon, he avoids all unfamiliar food, secure in the belief that all unknown edibles are dangerous. Familiar foods that have changed flavour or texture are seen as strange and strange things are unfamiliar… and around and around we go.
I’ve known for years that when TJ is willing to try something new, the time is golden for reclaiming lost ground, but there’s a catch. As soon as he meets something with an unpalatable taste or an unfamiliar texture, this rare window of opportunity seals shut and we have no other choice but to wait, often several months, for it to open again. When this happens, TJ will start to reject foods off his safe list. At the moment, this rare window of food exploration is open and I’ll do anything to keep it that way.
While our pediatrician steers us toward (tick tock) now a five month wait for a specialist to rule out the unlikely diagnosis of autism, I focus on learning more about anxiety and how to deal with our specific brand of it. More than transforming him into an adventurous foodie, I would like TJ to feel comfortable enough with his food choices so that the inevitable future ridicule about his picky eating doesn’t continue to feed his food anxiety. Accomplishing this means knowing how to feed the child and not the monster that dictates the menu.
The following are excepts from an Anxiety UK online pamphlet that discusses common childhood anxieties:
- Anxiety has been found to be one of the most common causes of distress in children and young people. As many as one in five primary school children suffer from a low sense of well being.
- Anxiety can affect us all in very different ways. Experiences of anxiety can vary greatly from person to person and no two people have precisely the same experience.
- Not all anxious children and young people will display classic characteristics (pale, clammy, crying, shaking, feeling ill). Some hide their anxiety for fear of someone finding out that they are anxious, with others showing no signs of anxiousness at all containing their feelings of anxiety inside.
- Anxiety is not only common, but also extremely debilitating. The impact an anxiety problem impacts the whole family’s life.
The ‘fear of the fear’ often makes people feel worse as they are literally on edge waiting for bad feelings to happen; they stop doing things that link with the negative (bad) feelings or thoughts. This is called avoidance. The more that someone avoids the thing that links with feeling bad, the more they think of it as being dangerous.
The fear of new foods
Some children, mainly boys, can only eat a very narrow range of foods, and show extreme anxiety if they are expected to try new foods. The foods that they usually are able to eat are usually beige, dry carbohydrates, such as biscuits, crisps, cereals or bread; dairy products such as milk or yogurt; and chocolate. This diet does not seem to be harmful to the child, who will grow normally if they are allowed to eat from their acceptable range of foods.
The fear of trying new foods stems from a normal development stage that occurs at around the age of two years (the neophobic stage). At this age children narrow down the range of foods accepted and commonly refuse foods that don’t look the same as foods that they have learned to like. Most children grow out of this stage, and are able to try and accept new foods into their diet. Some children do not move on from this stage; whatever the parents try to do. The reluctance to try new foods becomes a fear, and all new foods trigger a disgust response in the child. If the child is forced to eat foods that they cannot accept then they will often vomit, or show a gag (disgust) response. Certain food textures, such as lumpy or slimy food, can be more disgusting than others.
How to cope with food related anxiety
- Never insist that your child eats food that they do not like.
- Make sure that your child gets the calories that they need from the foods that they do like; whatever those foods might be.
- Get your child used to being around the food that they fear, just getting used to the smell and being able to touch ‘disgust foods’ is a start.
- If you are trying to get your child to taste new foods, don’t do this at mealtimes. Do it at a time when other people aren’t watching and your child is less likely to be anxious.
- Start with very small amounts of food; just a taste will do. A food needs to be tasted quite a few times before it is accepted.
- Make sure that your child’s school is aware of the problem. Your child may need to take ‘unhealthy’ foods in their lunch box, or be able to eat at break time. Get a letter from a health professional to support this if need be.
We have made progress. In the past year, TJ has transformed from a child who was terrified to sit at the table to one who will openly ask for something else to eat. I have abandoned my hobby as a short order cook and found ways to let the family explore different dishes and still accommodate TJ’s food selectivity. We have found strategies that keep that elusive window of food exploration open for longer periods of time. Most importantly, we’ve learned that eating “normally” is not a standard that should be imposed upon TJ, instead, we encourage him to eat in a way that feels normal to him.
Fighting anxiety a long journey that we take in very deliberate and small steps, one positive experience with food at a time.
Sources: Anxiety UK