What is the first thing that comes to mind when you hear “picky eater”? Refusal to eat certain foods? A behavioral issue? While picky eating can be due to behaviors, this is not what this post will be diving into - it’s the other potential causes for picky eating that I find in my practice are often undiscovered. This post series is an overview of 3 of the most frequent reasons that I find in my practice for kiddos consuming a limited variety of foods.

In this 3 part series, we will dive into how “picky eating” can actually be related to tongue ties, muscle weakness, and sensory issues. Today’s post will focus on tongue ties’ relationship to the appearance of “picky eating”.

Tongue tie – no, this is not just a saying.  It is a medical condition. If you are unfamiliar with what a tongue tie is, you are not alone. Please scroll down to my post entitled “What is a Tongue Tie?” to learn more. (Also, many people have a misconception of exactly what is involved in a tongue tie so this may be something to check out even if you are somewhat familiar with tongue ties.)

To understand how tongue ties can lead to “picky eating,” first, we need to think about the role of our tongue in eating…. it’s an important one. The tongue is what controls the food in our mouth. It directs the food to our teeth to be able to break down the food to a size that is safe to swallow. Then the tongue collects the food together and moves in such a way to initiate a swallow. In correctly initiating the swallow with its movement, the tongue then causes the 25 muscle pairs involved in the swallow to do their jobs to make the swallow safe and effective. (All the food going down together and not choking, etc.) Wow, I bet you never considered how important your tongue is to eating and swallowing!

The problem comes when the tongue does not have the ability to move in the ways that are needed in order to do its jobs in the eating and swallowing process. When a tongue is not able to move to direct the food onto the surface of the molars, children must attempt to chew with their front teeth as they are putting the food in their mouth, and then attempt to keep the food near the front of the mouth where they have more control of the food. The problem in this scenario is that our front teeth are not nearly as effective at breaking down food as our molars. Alternatively, I have also seen kids place food directly on their molars when taking a “bite”. While they may be able to initially break down the food more effectively, this is short-lived because as the food breaks apart, pieces fall off the biting surface of the tooth, and the tongue is not able to do its job to push the food back to where it should be. This results in food of a variety of sizes rather than the uniformly chewed food that we are meant to swallow. And it creates more of a challenge to safely swallow.  Even more importantly, it creates a choking risk if the pieces are too big.

After experiencing difficulty swallowing, children will often avoid foods that caused this uncomfortable and/or scary episode. They may avoid foods that require thorough chewing such as meats, raw veggies, apples, etc. Think about when you have swallowed a piece of food that was too big. Would you keep doing that? Or even worse, what if the food particles were far too big to swallow and you started to choke, would you want to have this experience again? As these experiences occur, children may weed out those food options that are more of a challenge to chew, focusing more on foods that require minimal or no chewing or are more easily broken down with saliva. For example, applesauce, eggs, crackers that break down with saliva, macaroni and cheese, etc.

Come back next week to learn about how muscle weakness can lead to limited food choices!