Picky eaters get help in Burnsville

Zachary Bachmeier, 6, of Lakeville, tries banana peppers with encouragement from occupational therapist Jackie Steffenhagen. (Photo by John Gessner)

Problem on the rise, therapist says

Zachary Bachmeier’s parents encourage him to eat with “Jackie bites”  — the kind he learned from Jackie Steffenhagen, an occupational therapist with Fairview Pediatric Rehabilitation in Burnsville.

Zachary, 6, has been at nutritional risk for most of his life. He’s a “picky eater” whose parents, Derek and Kim Bachmeier, of Lakeville, have consulted with nutritionists and other professionals about his feeding problems.

“He had his favorite foods, the baby foods, up until last year, 5 years old,” Derek said. “We put butter in the baby foods, just to add calories.”

Zachary also depended on a high-calorie drink called PediaSure for sustenance, his father said.

“Now, with Jackie, he’s become a better eater,” said Derek, who brought Zachary to Fairview Pediatric Rehab’s feeding program about a year ago. “He eats most of his calories from foods — not a wide variety, but more than a year ago.”

Feeding problems in children are on the rise, Steffenhagen said. About a third of the children served by the Fairview Pedatric Rehabilitation location in Burnsville location have them, she said.

“It is becoming more prevalent, and there really isn’t any explanation from what I know and what we’re finding,” Steffenhagen said. “There’s some of it linked to kids with autism. I don’t think we know what is causing it, but there’s been a significant increase in, I’d say, the last three or four years.”

Dr. Kay Toomey, a pediatric psychologist and national expert on child eating problems, draws a distinction between “picky eaters” and the more seriously affected “problem feeders” who usually have fewer than 20 foods in their diets.

Zachary is up to maybe 15 or 20 foods, Steffenhagen said.

“We’re definitely getting there,” she said. “We started at that more serious point.”

Zachary, who has a twin brother, Blake, weighed 1 pound when he was born prematurely at 31 weeks. He attends kindergarten classes at Highland Elementary in Apple Valley, where he also has an individualized education program.

“The eating problems have always been there,” his father said.

Children with feeding problems tend to have special needs, though the problem isn’t limited to them, Steffenhagen said.

“A lot of kids come in with limited diets of under five foods,” said Steffenhagen, who coached Zachary to sample banana peppers and oatmeal during a recent afternoon appointment. “That’s their whole repertoire. They will avoid foods, whether it’s due to anxiety or due to the visual presentation of the food.”

For some children the problem is sensory — they won’t touch foods that are sticky or messy or otherwise objectionable, Steffenhagen said. Some simply lack the “oral motor musculature” to property chew some foods, she said.

“We do have a lot of children that are followed by dieticians as well and are sent to us because of poor weight gain or other issues,” Steffenhagen said.

Therapies include a 32-step program developed by Toomey. It starts with tolerating being in the same room with an objectionable food and progresses to touching, licking, spitting out and ultimately eating the food, Steffenhagen said.

“Progress can be very difficult,” and success can take four to six months or longer, depending on underlying diagnoses in a child and follow-through at home, she said.

Zachary has come a long way since his baby-food days.

“It’s gone from that to hot dogs,” his father said. “And he’s been eating spaghetti the last couple of nights.”