I recently wrote about a woman whose 1-year-old daughter fusses if she is given anything other than puffs, Cheerios and other crunchy snacks to eat. I gave her a 5-point plan for correcting this problem from a behavioral perspective.  But what if your child has a puffs or Cheerios fixation because she has a problem chewing or swallowing?

The mechanics of eating are actually fairly complicated and there are lots of things that can go wrong.  If you have a child who prefers one kind of texture over another, seems to have trouble chewing foods, or in any other way indicates that there may be a problem and you should have an evaluation done.

But where should you go?  According to Kay Toomey, PhD, pediatric feeding specialist and creator of the SOS Approach to Feeding program, as much as our children’s doctors want to help, many physicians are not specifically trained to identify the many oral-motor, sensory, postural stability and/or developmental problems which can interfere with a child eating well.

If you are worried that your child may have a physical or developmental problem, start by talking to your child’s doctor to rule out any larger medical issues that might be causing your child’s feeding problems.  Then, see a feeding specialist for a consultation.

Either ask your pediatrician for a referral to a feeding specialist or find one near you by searching online.  The American Speech-Language-Hearing Association (ASHA) has information about feeding and swallowing disorders (known as dysphagia) and listings of therapists by city/state.

In some states you might need to contact an occupational therapist instead of a speech pathologist.  A good place to start getting information is the American Occupational Therapy Association (AOTA), although it doesn’t look like they have an online search function.

If it turns out your child has a physical problem eating, therapy will sort it out.  And if you get an evaluation and it turns out your child handles the mechanics of eating just fine, then you can return to behavioral techniques.  Either way, you’ll have a lot more information to address the problem.

Good luck and let me know how it goes.