Created by Samantha Levy, Ph.D.

Eating Strategies for disordered eating from abdominal issues:

If there are specific foods that the kid definitely has sensitivity or allergy to, then remove from the diet.  But otherwise, be careful not to eliminate too many foods at once. I like to tell the dietitians that if they are going to remove a food, they need to replace it with an alternative.

Strategies:

Frequent very small meals, such as a few bites every hour.

Liquids: Some people do better with liquid first thing in the morning, such as cold Boost (best tasting supplement) with a straw.  That can stimulate the digestive system and make eating easier later.

Don’t go too long without eating-acid builds up and makes the stomach feel uncomfortable-Put something to eat by the child’s bedside, like a banana or protein bar—so she can eat it first thing upon waking.

Experiment with thickness of liquids.  Some people tolerate thin liquids better, such as Vitamin Water and Boost/Ensure.  Others prefer thick liquids, such as thick smoothies or acai bowls.  You can then slowly titrate up or down in thickness to get used to variety.

Find the food that is most tolerated and then add in foods that are similar at first.  Example, if only can eat ice cream because it is smooth, add in yogurt, pudding, blended soups, smoothies. Then start to expand to things with some texture, such as cottage cheese and soups with some pieces in it, etc.

For nausea, the thought of swallowing is difficult. Try eating foods that do not have to be swallowed because they disintegrate in the mouth. Just focus on chewing and not swallowing, and eventually it just trickles down.  Foods that work well for this are things that melt/crumble, such as Bamba (Israeli Peanut puff), Hippeas (high protein chick pea based puff), graham crackers, scones, cheerios, Rice Krispies.

Sometimes just licking foods helps, such as licking peanut butter or guacamole from a spoon, so no chewing is required.  That can feel less like you are actually eating something.

Eat ANYTHING that sounds good, as long as you aren’t allergic to it or definitely have more pain every time you eat that food compared with other foods.

Do not worry about what time you are eating.  If you are hungry, eat! Take advantage of those hunger cues. Eat when you can!

Do relaxation/meditation/guided imagery before, after (or both) eating, depending on which works better to be able to eat and keep it down.  This may be breathing exercises, guided imagery app, imagining eating and feeling good afterwards.

Eat things high in healthy fats and calories, such as Hippeas, peanut/almond butter, avocado, cheese (if dairy is tolerated).

Ask your doctor about an appetite stimulant and anxiety medications.

Behavioral plan with earning rewards for trying new foods (if limited repertoire is the problem) or eating a certain amount (if volume is the problem).

If there are no hunger cues, just create set times (routine) that meals and snacks are eaten.