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Local author, therapist helps children overcome eating fears little by little

Local author, therapist helps children overcome eating fears little by little

When Marsha Dunn Klein meets a family needing mealtime help, she often starts with a story that’s a bit unappetizing.

Klein was visiting Mexico, the story goes, and her gracious hostess prepared her a surprise: crispy, garlicky grasshoppers. Klein, who had never eaten insects before and wasn’t sure she wanted to, quickly figured out a way to make it work.

The grasshoppers were served with small tortillas and guacamole so Klein, for her first taste, loaded up the tortilla with lots of spread and very few insect parts.

She got it down.

On the next tortilla, she added a little more grasshopper and a little less guacamole so that, by the last one, she was ready to chew and swallow a small mound of fried bugs.

Klein explains to parents that this same approach can work for a child: go slowly, try just a little at a time, mask it with something you like.

And if it’s hard to understand what’s so scary for your child about a seemingly normal food?

“Pretend it’s a grasshopper.”

Baby steps

Brady Ziemba turns 10 today, but his life experiences have given him insights far beyond those years.

Brady, for reasons that are difficult to figure out, is only eating a few foods right now: certain fruits, saltines, smoothies.

He’s working to change that.

In fact, he’s so invested in helping himself and others that he’s started making videos about the best ways to go about trying new foods.

When Brady was younger, his mother, Lauri Ziemba, tried just about everything to help him before turning to a local organization Klein founded called Mealtime Connections, which she started with several other occupational therapists about 12 years ago.

(Klein also started a nonprofit here in 2010 called Nourish, which provides support to parents and financial assistance for therapy and evaluations as well as help getting specialized equipment not covered by insurance).

In the last few years, Brady has taken what Klein refers to as “tiptoe, tiny little steps.”

The progress has given the family hope.

Ziemba was so taken with Klein’s approach and intuition about children that she encouraged her to write her most recent book, “Anxious Eaters, Anxious Mealtimes.” The self-published book, available on Amazon, is full of stories and tips so parents realize they are not alone in experiencing these challenges and, moreover, that there are sensitive, child-empowering ways to help.

The years spent trying to reach an anxious eater can leave parents exhausted, Ziemba said. There are days when dealing with it seem impossible, she said, and sometimes parents just don’t have the mental or emotional energy to go through one more challenging mealtime.

Ziemba’s son was about 2 and starting solid foods when the challenges started. Before that, she says, he’d been eating all different kinds of mushy baby foods.

“There was definitely a switch and then he didn’t want anything,” she said.

For some kids, she said, giving them the power to choose what they are going to eat takes the upset out of it but for her son, it was more visceral. Strong food smells bothered him greatly, and the consistency of other foods made them impossible to swallow. Even water can make him gag.

For a while, Goldfish crackers were a big hit. And he’s usually OK with smoothies, she says.

The hardest part is seeing that he wants things to change and longs to eat what others enjoy.

Once Klein started working with Brady a couple of years ago, things started to slowly improve and the anxiety began to recede a bit.

“He wants to do what she asks of him, but she always tells him, ‘I don’t want you to do this for me. I want you to do it because you want to do it and you’re OK with it,’” Ziemba said of her son and Klein.

“It’s hard, but it feels more manageable now. It’s just feeling validated that this is a real thing and your kid is not trying to drive you crazy.’ ”

Brady asked his mom to relay his take on it, too: “Just help your kids and don’t worry so much. Tell them it’s OK.”

The ‘Get Permission’ approach

The reasons a child will only eat certain foods might be because of a physical challenge, or a sensory or emotional one. Genetics might also come into play since eating problems often run in families.

Klein says it’s hard to say how many kids have these challenges because there have been so many different ways they’ve been labeled over the years. An online search shows multiple categories including picky eating, extreme picking eating, fussy, food neophobia, problem eaters and, most recently, ARFID, which stands for Avoidant/Restrictive Food Intake Disorder.

Many young children go through periods of selective eating or pickiness related to their developmental stage, but this is far more long-standing than that.

The fear of eating may be direct, meaning the child feels nauseous or experiences abdominal pain when eating, or indirect and including overwhelming worries about gagging, vomiting, choking or having an allergic reaction to the food.

Figuring out the reasons is always part of what Klein’s approach and, while her findings might change her approach a bit, the bottom line is always this: nothing happens without the child’s permission.

“The child tells us,” she said. “They say, ‘That’s working for me, or it’s not.’”

With her years of experience, she has settled on this as an absolute. Children should be invited to try new things but it should never be forced. Instead, parents need to get permission and not do things that increase a child’s worry about food.

“The stress is compounded when whatever it is that’s holding them back is met with parental disapproval,” she said. “Mealtime is about community and family and socializing.”

She also emphasizes avoiding any sort of labels.

“My approach is that I want you to enjoy this process,” she said. “I want you to love food. I want you to want to eat.”

A little bit of extra help

The oldest of Stephanie and Josh Hartung’s four children, a daughter who is 8, has been seeing Klein for just a little while now and there’s already been progress.

For one thing, they are now letting their children select what they want to eat from a variety of things on the table rather than serving them a plate.

They are also committed to Klein’s emphasis on making mealtime a peaceful time of sharing and love.

Their daughter, like so many other children with eating challenges, likes only certain brand-name foods and insists on certain shapes and colors.

Stephanie Hartung now thinks of the help her daughter is getting as being no different than getting speech therapy.

“Some just learn to speak, but others need a little bit of extra help,” she said. Eating, she said, is no different.

The couple, concerned about her food intake, used to sneak in foods masked by other foods, but they have stopped doing that after Klein explained that being forthright will help their daughter trust them.

“It’s a slow progression but she’s more willing now, little by little,” Stephanie Hartung said. They are encouraging her to do a “finger try,” which means touching a new food and then just smelling it or rubbing it on the lips.

They also encourage their daughter to pair something she loves with something new, like a little bit of a new vegetable between two Ritz crackers.

“It was frustrating to me that my kids wouldn’t eat but now I understand there’s an underlying element,” Stephanie Hartung said.

Klein tells the parents to have “rehearsals” before trying new food, and to make it playful.

Let them smell the food, kiss it, put it in their mouths with the option of spitting it out, she said.

“This makes the kids feel celebrated,” she said, “instead of feeling like they are disappointing their parents.”

Contact reporter Patty Machelor at pmachelor@tucson.com or 806-7754. On Twitter: @pattymachstar


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