Key Strategies for Picky Eaters: Will They Grow Out of It?

Episode Transcript

Dr. Nicole Beurkens: 

Hi everyone, welcome to the show, I am Dr. Nicole, and on today’s episode, we’re talking about a topic that many of you deal with every day: Picky eating challenges with your kids. It’s one of the topics that all of you as listeners repeatedly asked for more information about, so this is going to be great. Almost all kids go through developmental phases where they might be pickier with their eating at one time or another. But what happens if this seems to become more of a chronic issue than just a phase? And how do we know if a child will grow out of it or not? What can we be doing to make eating easier and less stressful for our kids and for us? To help us sort through these important questions, I’ve invited feeding specialist Melanie Potock on the show today, let me tell you a bit about her. 

She is a speech-language pathologist and an international speaker on the topic of feeding babies, toddlers, and school age kids. She is the co-author of the award-winning Raising a Healthy Happy Eater: A Stage-by-Stage Guide to Setting Your Child on the Path to Adventurous Eating. Great title! The tips in her parent and child cookbook, titled: Adventures in Veggieland: Help Your Kids Learn to Love Vegetables with 100 Easy Activities and Recipes, and based on the latest research and Melanie’s 20 years of success as a pediatric feeding therapist. Her children’s book: You Are Not An Otter, takes preschoolers on a food adventure exploring all the ways that various animals eat. Her advice has been shared on many television stations and in print media, including The New York Times, Wall Street Journal, Parents Magazine, on and on! Melanie, welcome to the show, so great to have you here!

Melanie Potock:

It’s wonderful to be here and get to talk about my favorite thing, kids and food and family. 

Dr. Nicole Beurkens: 

Yes! And actually, I came across your work on Instagram with all of the amazing things that you cover there, and I was like “I have to have her on the show” because you get, really, what parents and kids are dealing with, and give such practical strategies that people can use, and it is, it’s rooted in child development, it’s rooted in the research. I’ve been so looking forward to this conversation. Let’s start out around this idea of kids and sort of developmental phases and eating, because I’ve raised four kids, my kids are teenagers and young adults now, but I remember with my kids when they were little, went through various phases with things. Do you feel like all kids go through natural phases of more hesitancy with their eating, more pickiness? What do you think happens there? 

Melanie Potock: 

I think most kids do, not all. Sometimes you get those kids who are just the most adventurous eater from day 1. That was my very first child before I ever became a speech pathologist, before I ever got interested in this realm of pediatric feeding disorders, picky eating, etc. I got the most adventurous eater, and I have to tell you: I just thought to myself, “I am so good at this!” And then I got my second child, and she was my very picky eater. And I’m parenting the two of them the same exact way, it’s the same foods showing up on the plate, and that’s when I started to get interested in why do some kids develop more of a hesitancy than others? And why is it that since we know most kids will go through a natural phase of picky eating around those toddler years, why do some kids not really grow out of it?

Dr. Nicole Beurkens: 

I’m so glad you brought your personal experience into that because I’ve had so many of those experiences as a parent, myself where you’re like “I’ve got this! I know what I’m doing!” And then you have the next one come along who shows you that absolutely, you do not know anything that you thought you did. I have found that children, both in my own home and professionally at the clinic, have a way of keeping me incredibly humble day after day after day, right? 

Melanie Potock: 

Absolutely. And no two kids are the same. That’s what I’m most stressing to parents is: Listen, if I could just give you a recipe on how to solve this, then I’d just put myself out of a job for one thing, but B, it just doesn’t work that way. Every child’s different, every family is different, and we’ve got to figure out a plan that will work for you in your situation and have the quickest success possible without having to put this incredible 24/7 effort into it, that’s just not realistic. 

Dr. Nicole Beurkens: 

Yeah, and I think so many families’ mealtimes, snacks, the whole issue around eating can become such a 24/7 stressor, right? I mean it’s one of those things when I talk with families, I’m like yeah, there are very few things that we have to deal with every few hours repeatedly, day in and day out, and when you have a child where there are stressors and issues around eating, it can really become a stressful thing, not just for the kids but for parents, for the other kids, the whole family. 

Melanie Potock: 

Absolutely, absolutely my point and I know that the most common feedback I get when a family is first coming to consult with me is they dread mealtimes. They dread trying to get this kiddo to eat something reasonable in terms of nutritional balance, etc. What sort of scene are we going to have today at the dinner table? And why don’t I just let them eat in front of the Tv because then I don’t have to deal with this and they’ll at least eat something? And I get it. It is incredibly stressful. 

Dr. Nicole Beurkens: 

And I love what you said even with your own experience, with your kids about two kids, both being raised in the same way, by the same person, being fed the same foods, and what makes those differences? And I think that that’s really relieving for a lot of our parents listening, because we tend to put a lot of blame on ourselves, like “What am I doing wrong here?” and it’s like look! There can just be kids where there are differences for them in how we need to address this. And while yes, there are many things that we can change on our end to help with that, blaming ourselves and saying, “Oh, I did this…” That’s not a helpful way to approach it.

Melanie Potock: 

No. Exactly. And when parents ask me, “I never thought I would have a kid who is so picky!” Or “I never thought I would have a baby who couldn’t eat, who is at risk for having tube feedings and is drastically losing weight. Don’t all kids just kind of learn to eat?” And the truth is no. Learning to eat or feeding is developmental. And Dr. Nicole, I have to say, I think I say this in every single interview and to the day I die, I’m going to keep saying it. Feeding is developmental. It’s just like learning to crawl, walk, run. It’s not something that kids figure out on their own, 100% of the time. Some kids pick up walking really quickly and others need a little boost along with a little physical therapy, and they still go off to college and live an amazing life. Every kid is different. But what happens is, depending on how our kids respond to food opportunities, it changes the way we respond in turn. And so these are amazing parents, these are wonderful parents. They are doing a lot of really good things. But where my work and your work comes in is to help them tweak those parenting principles a little bit to suit this particular child’s sensory system, his response to food and his own anxiety and hesitancy about trying something new.

Dr. Nicole Beurkens: 

I actually love that you’re using that word “Hesitancy/Hesitant eating”. I think that’s really just a lovely way to think about this. It gets to a more supportive aspect there, instead of saying, “Oh, such a picky eater/refuses to eat” this idea of it’s sort anxiety-driven, this hesitancy eating and just to me, when you say that, it just feels like a more understanding, empathic, sort of joining forces approach to “Let’s help you feel more confident and less hesitant.” I really like the language around that. 

Melanie Potock:

Well, thank you! One of the first things we work on is not using the term “Picky eater” in the house, granted it’s on my website. I use that term because that’s the number one term people search for for help, so it has to be on my website for SEO purposes. But the first thing we do is we ban it in the house. We’re not going to use that word anymore, everybody is a learning eater, everybody is a food explorer. Everybody is somebody who is learning about food in different capacities. Just because we’re not eating it yet doesn’t mean we aren’t interested and we don’t want to boost along and support that interest. 

Dr. Nicole Beurkens:

I think that’s so important because the overt and covert messaging that we send to kids around whether it’s feeding or any other aspect of their behavior or development, it’s so powerful and so I think that that’s really an important foundational piece.

Melanie Potock: 

To help them think differently about themselves. 

Dr. Nicole Beurkens: 

That’s right, and to see that this doesn’t define me. This is where I’m at right now, but I can continue to grow and explore and get better with this, as opposed to sometimes those kinds of labels, whether it’s “picky eater” or “your behavior problem” or whatever labels we put on kids that they begin to define themselves by that and to see that that’s just who I am.

Melanie Potock:

Kids will always live up to the labels that we assign to them.

Dr. Nicole Beurkens: 

Yeah. I think that’s so true. So let’s get into this idea of feeding is developmental, we’ve got these phases that kids go through, especially as you said the toddler years, let’s talk a bit about how parents can kind of decipher whether a shift in eating behaviors or more hesitancy around eating is part of their natural developmental phase or if there are really some red flags that are happening that they need to be looking at?

Melanie Potock: 

Sure. One of the reasons why I wrote Raising a Healthy, Happy Eater, and I wrote that with pediatrician Dr. Nimali Fernando, her patients called her Dr. Yum and she’s all about helping kids learn to love a variety of foods. We wrote this book together because we wanted parents to really understand that whether we’re talking about those first bites of solid foods at 6 months or into school-age and high school years that learning to eat a variety of foods is actually based on a child’s cognitive ability, his gross motor skills, his fine motor skills. It’s developmental, and then it’s influenced by parents and caregivers, obviously, teachers, etc. So when do these kids really start to look more hesitant? Most often, we see that at around 18 months to about age 3. Some of the literature shows a little bit older than that, but in general, that’s where I encounter it and where I found it in other pieces of research. It’s simply because growth slows down at that time. These babies are growing! From that moment they’re born. They’re just growing at such a rapid rate, and they’re eating because of it. Some babies will have some difficulties, and that’s kind of another topic for another time, but when we think about true picky eating, most parents report to me that the kids seem pretty picky in those toddler years. 

And then how do you help them grow out of it? Well, just by lots of positive exposures and experiences around food. But what are the red flags? The number one red flag that this is an issue that we need to address is any sort of discomfort. That’s it in a nutshell, discomfort. Whether it’s discomfort in that the child seems to cough a lot or gag a lot, not just a little bit occasionally, or has temper tantrums if they get new foods on their plate, or they just have big, huge emotions around wanting to be more rigid around food. But also discomfort when it comes to the family. Mealtimes are hard. Mealtimes are stressful. So that’s always my red flag: What sort of discomfort are you concerned about and how can we figure out how to help you?

Dr. Nicole Beurkens: 

I think that idea of whether there is truly chronic discomfort there, that’s a great way of thinking about it. And it could be discomfort on a number of levels, as you said, it could be physical discomfort with eating, it could be emotional, but looking for where it goes beyond what we would expect to see in kids. In my experience, both as a parent and working with young children, kids who maybe are in a phase developmentally of being more hesitant, they’ll still tolerate exposure to things. They may not be adventurous in wanting to put it in their mouth, they may pick at it, they may back away from it, fuss a little bit, but they’re not having clear discomfort, as you said, around it. They’re not having major fears around it, they’re not throwing huge tantrums, you can have different foods around and they’ll tolerate that it’s there, so that’s been my experience and I think that discomfort, when is it getting to the point where, wow, this is really happening for them all the time around food?

Melanie Potock:

Sure. Exactly. And that’s how they know that those kids won’t grow out of it too. It isn’t that typical, “Yeah, you can put it on my plate but I’m not going to bite off it today.” That’s fine. Nobody has to eat anything on their plate. But if the response is so out of proportion where they are just having a big meltdown or the parent hasn’t served anything new to the child because they’re scared of the meltdown: That is a big red flag, and those kids will not grow out of this. I just want to interject for one second. To also stress to everyone listening that there are a lot of reasons why kids develop pediatric feeding disorders or extreme pickiness. It can be medical, it can be sensory-based, it can be anxiety-based. It can be just due to one episode of choking. There are a lot of medical things that kids grow out of like gastroesophageal reflux disease, with a little bit of medication support, etc. But if they learned early on that eating hurts, they don’t grow out of that picky eating without some support around them. So those learned behaviors that occur, they happen because something went array in terms of body and brain functioning or medical reasons, etc.

I will often have kids come to me who are 5, 6, 7 years old who “never grew out of it”, but then when I take a thorough history, I can almost pinpoint what started this. 

Dr. Nicole Beurkens:

I think that’s a great point, that sometimes it is a clear thing that started it, but then it perpetuates, it continues because of the emotions and the relationships and the patterns around eating. Yeah, for sure. And I think this is a good time to mention too just the connection between these types of feeding challenges or more hesitant eating with neurodevelopmental issues with other things. The research is clear that kids on the autism spectrum, for example, or with, as you mentioned, sensory processing disorders, some of these kinds of neurodevelopmental issues do seem to have more of a tendency to get into these patterns and not grow out of them. That’s my reading of the research and my experience. Is that the same for you? 

Melanie Potock:

Absolutely. For sure. Not all kids with autism have difficulties with food, but yeah, a high percentage of them do. Not all kids with sensory-processing difficulties have autism, but I never met a child with autism that didn’t have sensory-processing difficulties. We also want to look at the whole child and of course, no matter what, the parents are the ones who can really, really help these kids get back on the path to adventurous eating with the right guidance. 

Dr. Nicole Beurkens:

Yeah, absolutely. And I think the big thing being that the sooner you get some guidance for it, the better for your own stress levels around it. I just have a lot of empathy for parents who come into the clinic with kids at 10 or even older, who have been struggling for so many years with this. So I think my message to parents is: If you seem some of these red flags or just if it’s feeling like there’s discomfort there, you’re feeling a lot of discomfort on your own end around feeding one or more of your kids, it doesn’t hurt to seek out some consultation or some advisement around that earlier. Best case scenario, a professional is going to tell you “Keep doing these things and it looks like it’s going to be okay.” But I think so many people wait unnecessarily, and then it just builds and can create such distress for everybody.

Melanie Potock:

And they wait because they hear those common phrases, “Oh, all kids are picky/My own ate like that too, he’s a big football player now.” They get that feedback from friends and family because they’re trying to reassure them that it’s going to be okay. But actually, what I prefer the feedback to be is, “Hey, if you’re worried about it, talk to your pediatrician. Ask for at least a one-time consultation with a pediatric feeding specialist”. And that’s typically an SLP or an OT, sometimes an RD, sometimes someone like yourself, Dr. Nicole. It kind of depends on what the root of the issue may be, and the pediatrician will ask the right questions. By the way, if any of your followers are wondering, “How do I even talk to my pediatrician about this? We have 10 minutes.” You just go quick to get in and out of there. And I have a whole playlist on how to talk to your pediatrician about your concerns, on my YouTube channel. 

Dr. Nicole Beurkens:

Fantastic, and you’ve got so many resources and we’re going to make sure by the end of our conversation everybody knows where to find that. We were talking about these toddlers, these developmental phases, younger kids, let’s touch on older kids, so our kids who now are 5 and up getting into school age, by the time kids get to that point, walk us through what more extreme or chronic picky eating looks like in those kids by that age.

Melanie Potock:

Those are the kids — I actually had two calls his morning about those kids. Those are the kids who are eating the same foods for breakfast, lunch and dinner. Or they’re eating a handful of foods, and I mean — Gosh, not that I want to give you a specific number, but it’s sure, maybe they eat some fruit, but they never touch vegetables and they only eat one brand of chicken nuggets and they only eat cereal if it’s a particular brand, and no milk and it has to be in a certain bowl. Those are just some of the overreaching word there? They’re rigid. They’re really rigid about their food, about the way it’s presented, they don’t want new things on their plate, they eat the same thing all the time. They also don’t have a lot of joy around food. Sure they might come home from school starving and chow down on the exact same fish crackers that they always do, but let’s face it: If we all ate the same foods everyday, it isn’t a joyful experience. It’s kind of like “I’m hungry, I’m going to eat this and I’m going to move on.” So they don’t look forward to meal times, and everything is a big deal to them when it comes to food, and it requires a lot of control. A lot of control. 

Those kids, sometimes, will end up with the diagnosis of avoidant/restrictive food intake disorder from the DSM-5 or ARFID, we call it. And although we do have a new diagnostic code coming down the pipe for this here, we won’t see that till fall. And I imagine that ARFID will still be in the DSM-5, if I suspect correctly. Without going through all the criteria, just in brief, what you’re watching for is: Has the child had a significant weight loss or failure to achieve a certain weight gain? For example, I am working with a child right now who is an identical twin, and although he has been following his own curve, his brother is so much taller and so much bulkier. Something is different there, right? it doesn’t really matter in that case who is following his own growth curve, because identical twins should be pretty similar. So we know something’s up. Also, perhaps they might have a significant nutritional deficiency. Again, they only need to have one of these criteria. The third out of the four criteria would be a dependence on some other type of enteral feeding. It doesn’t have to be a tube feeding. It could be drinking a high protein smoothie twice a day in order to grow and thrive, they’re dependent on that. 

But the one that is near and dear to my heart, honestly, and why I love these kids so much and why I so much want to help them is there’s a marked interference in psychosocial functioning. And what that means is they decide they don’t want to go on the school field trip and it’s because they’re worried there isn’t something to eat there. They never want to go to summer camp because they can’t eat anything there. They don’t want to go to the summer party because what if they get pizza but it’s not the pizza they eat, which is the one brand with no sauce and no cheese. That’s called pizza crust, you know? But they don’t necessarily want their friends to know that, or if they do, it really interferes with those peer relationships. So to me, that’s one of the most important ones. And I never met a child with the signs of ARFID where they didn’t have some sort of psychosocial impact, or the family did. They don’t go to restaurants because he won’t eat there, so we haven’t been to a restaurant in a year, you know?

Dr. Nicole Beurkens:

That’s so important because really, at least in our culture, food and relationships are so interconnected. Food is a big part of what we do together, how we relate to one another from babies all the way up through older adults. And so when kids are struggling with this, it really does have an impact on their relationships, on their activities, and I think that has been the thing that I’ve noticed in my practice over time, often it finally clicks for a parent to go, “You know? I sort of lost track of how much we were doing to manage this until my kid got to the age where suddenly I realized he or she isn’t doing things that they should be doing or want to be doing because of this food avoidance issue.” And then it clicks like, oh, this is actually something that we really need to look at. 

Melanie Potock:

Yeah. And “We’re not doing things as a family because of this food issue. And my other kids aren’t able to do things because their brother can’t do that. So we’re just not going to go to that event.” And realize how it changes the entire family dynamic. It’s not the child’s fault, it’s not anybody’s fault, but it is something that we can change for sure, if we follow a step-by-step process, we can get back to that real joy of food that you described. 

Dr. Nicole Beurkens:

So let’s start talking about that, you know? What are some of the keys? In your experience, what are some of the things that you feel are important principles or strategies for parents and professionals to have in mind about how we can help these kids, where it’s not a developmental phase, it’s something that is creating difficulty in them in their life? What do we do to help them?

Melanie Potock:

Well, with the help of a professional to guide you — that’s extremely important, the way I always think about it, especially when it comes to kids with ARFID and these extreme picky eating habits is that one of the things they’re trying to do is they’re trying to avoid the feeling more than the food. So when they get around new foods, their anxiety goes up. It’s very uncomfortable, it’s a very uncomfortable sensation, and just like you and I, we avoid things that give us that kind of scary internal “I don’t like this kind of feeling”. So the issue is it’s the feeling they’re trying to avoid. And then they start to assign it to the food. So my job is to build skill and ability, to help the child get to a point where they can learn to tolerate new foods on their plate, or they can learn to cook in the kitchen with their family, where they can learn to at least go to the restaurant, even if they don’t order anything. 

So we’re starting with just some baby steps, because these kids avoid a lot of those things as a way to avoid that feeling. So part of that is also learning to be okay with that feeling, kind of sitting in the nervousness and being okay. It’s like learning any new skill. I certainly was nervous when I tried to learn to ski, right? If you kind of sit in it and you figure it out, then you do it. What kinds of things can the parents do though to help kids with just some of that foundational skill is they can definitely bring the kids into the kitchen. And if the kids have a big emotional response to something that seems — if the response seems out of proportion, in other words, just coming into the kitchen creates a big response, try your best as a parent not to respond in turn to that. Instead, rather than reassuring the child and trying to really pull them into the kitchen, instead, handing them a spoon and saying, “You want to stir? Or do you want to chop? I’ve got this knife or I’ve got this knife, which one do you want to do?” Sort of approaching it like “Hey, we’re doing this and I’m right here to support you. Which one would you rather do?” So helping parents take that attitude of “You want tea or you want coffee?” And approaching it in that sort of nonchalant attitude, that is so helpful for these kids that we don’t buy into their emotional response, but we also have to build skill and ability or we’d just be mean to make the kids do it, and that’s where a professional can really, really help.

Dr. Nicole Beurkens:

I think that there are a few things there that are so key. The first is that you’re not starting with anything that involves the child having to actually eat something they’re not comfortable with, and I think that’s so critical, because so often, when parents or family members or even well-meaning professionals try to work on this, it’s like well, “You have picky eating, you’re not eating these, we need to get you to eat more things!” And what you’re saying and what the research shows is that it’s actually starting at the level of “You need to put this in your mouth and chew it and swallow it” oftentimes only serves to perpetuate the anxiety and the dysfunctional eating patterns and we don’t mean to do that, but we actually can make it worse, or at the very least not make it any better. And you’re saying we’ve got to back up and start with just building this trust tolerance, building more comfort around food before we even get to the part about “Hey, we’re going to work on eating this.” 

Melanie Potock:

And how do you do that? So I, years ago, tried to compartmentalize that. And I decided to call it The Three E’s: Expose, Explore, Expand. And it’s something I talk a lot about in my cookbook, which is Adventures In Veggieland. And although that’s a book about learning to love vegetables, you can apply the principles to any food, and it’s the same principles I use in all my work. So first we start with exposure, and exposure can be simply going to the grocery store together or buying the beets and washing them and getting all that rough dirt that comes on beets off and learning how to peel them. Exploration is very, very closely related to that, in that it’s about chopping up the beets, it’s about learning how to cut off the top and grow some more in some dirt. Like, can you actually grow another beet out of the green tops? Maybe! Let’s give it a try. Those sorts of things. So science and food activities are a big part of what we do. And then we explain from there and we start with really simple recipes, very basic foods that we learn to lick and bite and hold in our mouth, and then eventually chew. We might even chew and spit it out on a plate. So you’re exactly right: Parents come to us naturally wanting us “To get their kid to eat more” but that’s a little bit like throwing somebody into the deep end and they’ve never learned to swim. They’re just not ready, we’ve got to get their toe in the water first. 

Dr. Nicole Beurkens:

I don’t know if you had seen this in your practice, but what I have noticed is that children who have been through what I would call more behavioral types of feeding programs where it’s sort of like forced compliance around eating, “You will put this in your mouth, you will chew it and swallow it, and then you get a prize”, or whatever, those kids may temporarily expand the number of things they’re eating, but they never truly become comfortable around food, and eating becomes a pretty high-anxiety, stressful, unnatural experience for them, ongoing. And I think it’s important to distinguish between that kind of approach that may get you what feels like some short-term benefit with more of what you’re talking about, which is actually slowing down in order to speed up over time. 

Melanie Potock:

One of the things I teach in my courses too, is that it’s very easy for us to decide if a certain approach is good or bad. But the reality is — and this is true I think for any professional in terms of the work that we do with children. The reality is that many of us use a blend of approaches and then we customize it for that family. So sometimes, parents will call me and say “Are you going to take more of a sensory approach?” What they think of “playing in food” or you can take more of a behavioral approach, because I actually have an extensive background in ABA. Well, the truth is I don’t know, because I need to figure out what’s going to work best for your child, but 99.9% of the time, I am going to do a blend of both.
So we have to be careful that we don’t look at two extremes because the truth is most treatment is a blend of everything in between. It’s tricky and it just brings home the point that when you are talking to someone as a parent, who is there to help your child to ask them what therapy will look like, what it will feel like for my family, how often I will need to do this, what happens if he doesn’t eat? Then what do you do? What happens if he won’t touch the food, what happens if he does? Get a clear picture of what you’re getting yourself into so that this ends up being successful and you’re making sure it’s really a good fit for your family.

Dr. Nicole Beurkens:

Yeah, I think that’s so important whether we’re talking about feeding therapy or anything: The fit with who your kid is and who you are as a parent and knowing what even is workable or not workable for you. Because as parents, we are playing the primary role, even when a therapist is involved, we’re the ones implementing it day in and day out, every meal, every snack. And so making sure that it’s an approach that you feel supported with as well. 

Melanie Potock:

Absolutely. 

Dr. Nicole Beurkens:

I wanted to go back to — you said that exploration phase, and you gave a couple of examples and it made me think about how that can look different for younger kids versus even high schoolers, because we’ve had much older kids and even young adults in our clinic who have come in for a workaround this, and it’s that same idea of exploring, but it can look different with a 5-year-old, as compared to a teen. Can you give some examples of how that can be approached, because I think a lot of parents here are like, “Oh my teenager or my 10-year-old or whatever isn’t going to want to play with food.” Well there are all different ways to kind of go about that exploration, right? 

Melanie Potock:

Oh yeah, that’s a great question! In my caseload is anywhere from 6 months where they start solids, all the way up to — I have a few adults that I help too, but they’re mostly kids, but all the way up to high school. And gosh, the way it looks different is that with the younger kids, I often will use fun board games or Connect 4, or I love old school games because a lot of kids have never seen them, but you know, I’ve got them still in my closet!

Dr. Nicole Beurkens:

We call that retro now!

Melanie Potock:

So retro! And with the older kids, I often will incorporate more things like sports or sometimes we’ll do some YouTube activities, something that’s a little bit more in their vein. But the similarity is when we’re working together, we try our best to keep it fun, but we also recognize sometimes this is going to be hard, and sometimes there might be — your eyes might well up with tears because it’s a little scary, you know? But I’m here to support you, and I’m never ever going to ask you to do anything you’re not capable of, ever. I promise. That’s my one promise to every single kid I work with.

So my job is to build that skill and ability. So that’s where they look very similar. Where they look different is that I might be in the backyard shooting hoops with the 17-year-old and we’re taking a lick of beets and shooting a hoop every time, trying to tie some fun into this food practice. Or he and I might be going to the website for the fancy restaurants that he’s praying he gets to take this girl to prom, but he only eats chicken nuggets. So how can he take her to prom if he can’t take her to the fancy restaurant? So he and I are going to that website, pulling off the menu and saying, “What’s the one thing you think you can order? Let’s figure out how to learn to eat that. We’ve got two months.” And we are coming up with a game plan. And older kids love that. You’ve got to find their motivation. And dating is a big motivation for teenagers!

Dr. Nicole Beurkens:

And just so important to tap into what is important around this for them! I think even for elementary-age kids, how are they able to tune into how this is impacting them and what they want to be able to do, because a lot of time we just assume that oh, they don’t care, they want it to be this way — they don’t care if they eat the same thing. My experience, even with kids with more significant levels of impairment, they don’t want it to be this way. They want to have a wider range, they want to be able to eat and do the things the other kids are doing. They don’t see how they can get there, but they want that. So I think we make some assumptions sometimes about “Oh they don’t care, they just want to have it this way.” In my experience, that’s not true. 

Melanie Potock:

And that’s my experience too. I think it appears that way to the families, because the kids truly don’t believe that they can get better or they’ve had precious therapists and it didn’t work, so they see themselves as the failure, when really, they just didn’t have the right therapy or the right fit for them and their family. I always say that being an extreme picky eater is like desperately wanting to get in the swimming pool but avoiding the swimming pool at all costs. Does that make sense? You’re standing there on the edge of the pool and you really want to get in but you’re just shaking and you’re nervous and you’re backing up every step, and after a while, you don’t even go near the swimming pool, though you really wanted to. 

Dr. Nicole Beurkens:

Yeah. I think that’s a really helpful way of visualizing that, and it really speaks to why there are so many different components that play into this. It’s the strategies of helping kids with the process of eating, that developmental step-by-step piece, especially if there are some oral motor kinds of issues or other things getting in the way, there’s the skill of that, and then there’s also the emotions of it. There are the relational pieces between parents and kids, there are a lot of dynamics, and it really does take a skilled therapist, someone who really does this work and understands the multiple layers of it. It’s never just about the food. 

Melanie Potock:

It’s never about the food, unless there is a motor component, as you said. But even then, when you have had bad experiences with food in your mouth because you can’t control it from a motor aspect, you don’t want to try that food again. 

Dr. Nicole Beurkens:

Yeah, it feels scary. And I think that fear piece, and as you talked about so well, that need to support kids in having a higher distress tolerance, just like we do in so many other areas, right? Food is no different. Things can feel unsettling, things can bring up lots of big uncomfortable emotions. And how do we manage that? How do we soothe ourselves as parents? How do we help kids in those moments to be able to, as you said, sit with that and know that they can be okay? It’s so important. 

Melanie Potock:

Yeah, how to parent bravely, right? 

Dr. Nicole Beurkens:

Absolutely. Yes. I love that, how to parent bravely, even when we’re not feeling brave inside, how do we do it anyway, right? 

Melanie Potock:

Yeah. You’ve got to put on your best Academy Award performance sometimes, you know? It’s so true. 

Dr. Nicole Beurkens:

You’ve got so many wonderful resources. I’ve been to your website, your social media, you’ve got lots of great things available. I want to make sure that parents know where they can find you online, where the best places are to go to get more information about your work and about the books and programs and things that you have available? 

Melanie Potock:

Well, thanks! It’s a little bit tricky, but actually not so tricky, in that there are two ways to find my website: The first one is mymunchbug.com, and that came about 20 years ago, because I always called the kids I treated at the hospital my little munch bugs. But from there, it morphed into melaniepotock.com, they’re both the same website. So just google Melanie Potock, it will pop right up. Then that’s where you’ll find all of my video courses, all of my masterclasses, also my books and my blog and lots of free information, as well as one particular page that’s nothing but free downloads for parents to help them on this journey. 

Dr. Nicole Beurkens:

Yeah, you’ve got such an array of resources. I really want to encourage those of you listening to go and check those out, things for different circumstances too, and I think that’s where regardless of where you are in your parenting journey, or the specific challenges or the age of your child, you’ve got a wide array of things there. Everything from — some of the stuff that you post on social media, and I highly encourage everybody to follow Melanie on Instagram in particular, it’s where I’ve seen a lot of great content. Everything from parents with toddlers and preschoolers around how to pick the best kinds of cups to support drinking and oral motor and all of that, all the way up to things that you’re talking about with older kids and exposure, just a wide variety of things. So I really think for all of you listening, wherever you are in your journey with your particular child, there’s just great resources available there. 

Melanie Potock:

Oh, thanks so much! I’m glad you’re trying to get helpful. I loved your Instagram too, and this has been so fun to do this together!

Dr. Nicole Beurkens:

Yes! I’m so glad we had the opportunity to do this. Thank you for taking the time to share all these really valuable insights with our families. AS I said, this is a topic that is requested over and over again, and so I’m really glad to have introduced you to my community and to have been able to spend time with you today, thank you!

Melanie Potock:

Thank you.

Dr. Nicole Beurkens:

And thanks to all of you, as always, for being here and listening, we will catch you back here next week for our next episode of The Better Behavior Show.