Question
I have a four‑year‑old who will only eat pureed foods. There are no medical issues or oral issues. He refuses to allow anything with texture to touch his mouth. Ideas?
Answer
I would probably use the technique of texture fading. For example, if you have a bowl of stage two bananas and you want to get him to eat a regular banana by itself, you may have to go as small as taking one tiny piece of a banana and mixing that into 4-ounces of banana puree and have him eat it. When that's tolerable, then use two pieces, and then three pieces. It may need to be that scientific to get him to progress with the texture. It can take a really long time and needs to be methodically charted to know what level you are at with which food - how many bites you are putting in, the size of the pieces, etc. It has to be very structured for the family. I have had good success with that, but you have to take it slowly.
Jennifer Dahms is a pediatric speech-language pathologist in Boise, Idaho. She received her bachelor's and master's degrees from the University of Wisconsin - Milwaukee. She has worked in pediatric outpatient clinics and Birth-to-Three programs in both Wisconsin and Idaho and currently has her own private practice, Valley Pediatric Feeding, LLC.
