Food Chaining- From Picky to Successful Eater

toddler girl eating vegetables

Guest Blogger: Heather Reymunde Wittmer, MS RDN LDN

Food Chaining can help parents broaden the variety of their child’s limited diet from the comfort of their own home. 

PIcky eating can leave parents feeling helpless, worried, stressed, and exhausted. Over time this can lead to feelings of desperation and allowing kids to eat the same few foods repeatedly. And so begins the cycle of picky eating. Picky eating can be a result of poor mealtime habits or behaviors, but sometimes it can have other causes. Picky eating can also be a result of texture or other sensory aversions. In all of these cases, food chaining may help.

What is food chaining?         

Food chaining is a child-friendly feeding technique used to increase the variety of foods your child will consume.  It is based on the principle that a child will eat what they like (1).  As a result, this process is especially helpful and effective when working with children who have sensory or texture aversions or extreme picky eating.  Food chaining can help a child transition from an accepted food to a new food through a series of new food introductions with similar sensory qualities such as texture, taste, temperature, smell. The goal of food chaining is to ultimately expand the intake of the child, widening the range of foods they eat from the comfort of your home. 

The practice of food chaining has been around for over 20 years. however, it has little published research and appears to have recently gained momentum in practice.  A small study published in 2006 assessed the efficacy of food chaining in treating children with severe selective eating. The study found that all the participants were able to increase the number of accepted foods over a 3 month period using food chaining.  The median number of accepted foods at the beginning of the study was 5 (with a range of  1–10) and at the end of 3 months, the median number of new/target foods was  20.5  (with a range of 8 –129).  To find a full copy of the study check out the link below. (2)

Chaining baby carrots, to carrot sticks, to sliced orange or red bell pepper, then bell pepper rings to cooked bell pepper ring with egg.
Chaining baby carrots to bell peppers

Who is involved?

Parents play a key role when it comes to food chaining but before beginning, parents should seek guidance and advice from their pediatrician or family doctor. The next step will be to schedule an appointment with a Pediatric Registered Dietitian Nutritionist (RDN) to help assess current nutritional status, growth, intake, and nutrient needs. A dietitian will help the family and the patient set attainable goals and will guide the family in the food chaining process. Other practitioners that may be involved throughout the process are Speech-Language Pathologists (SLP) to assess chewing/swallowing issues and Occupational therapists (OT) to assess feeding skills. 

When/Where:

Unlike some traditional feeding therapies such as outpatient weekly feeding therapy or an inpatient program where your child would be admitted to a feeding therapy facility to work with trained therapists and other healthcare professionals,  food chaining can be done from your own home with you (the parent) as the facilitator.  By food chaining at home along with the feeding care team you have chosen, you can have professional guidance and support from health care practitioners while helping your child learn to eat a variety of foods in a familiar environment with friendly faces your child knows and loves. 

How does it work? 

Each food chaining program is completely individualized based on the current intake of your child. The process starts off with a food that is currently accepted by your child. Then new foods with similar characteristics are slowly introduced until the target food is accepted. Some children may only require 4 steps/links in their chain while others may require 5-6. Before getting started, there are steps that should be taken. First, you will need to determine your child’s preferences. Then select target foods that you will be chaining to, and lastly, choose foods that you can link to the chosen new food. 

  • Steps:
  • 1: Make a list of all of the foods your child currently accepts, previously accepted, and always reject
  • 2: Assess the textures, colors, flavors, smells, and temperatures of the currently accepted foods. 
  • 3: Group foods together by their similarities. At this step, you will observe your child’s preferences and have a good idea of the best starting places for your child. For example, my child likes foods that are crunchy and salty. 
  • 4: Slowly add foods with similar characteristics until each new food is accepted
  • 5: Continue through your food chain until you reach your target food
chicken nuggets to fish sticks to breaded fish filet to lightly coated fish fillet to baked fish
Chaining chicken nuggets to baked or grilled fish

Example: Chicken Nuggets to Baked Fish

  1. BRAND Chicken Nuggets
  2. CUT BRAND Chicken nuggets
  3. NEW BRAND chicken nugget
  4. Chicken Finger
  5. Chicken breast with panko
  6. Baked chicken breast
  7. Baked Fish! 

OR 

  1. BRAND Chicken Nuggets
  2. NEW BRAND chicken nugget
  3. Fish stick
  4. Fish fillet with breading
  5. Baked Fish! 

A few extra tips: 

As your child begins to accept new foods regularly, novel foods (foods that are completely new to a child) can begin to be added without linking or food chaining. In addition, a food chaining rating scale is also a helpful tool to assess how each item has been received.  Do not be afraid to try masking flavors with dips and sauces at first and slowly reducing those as acceptability has increased.  

To find out if food chaining is right for your family visit your pediatrician or talk to your pediatric dietitian and check out other food chaining resources from Seeds and Sprouts Nutrition for Kids. 

References/Tools:  

  1. Food Chaining, The Proven 6-Step Plan to stop picky eating, sove feeding problems and expand your child’s diet. Cheri Fraker CCC-SLP, CLC, Mark Fishbein, MS, Sibyl Cox, RD, LD, CLC, and Laura Walkber, CCC-SLP, CLC.
  2. Food Chaining: A Systematic Approach for the Treatment of Children With Feeding Aversion

https://www.researchgate.net/publication/7222254_Food_Chaining_A_Systematic_Approach_for_the_Treatment_of_Children_With_Feeding_Aversion

Helpful links: 

http://pediatricfeedingnews.com/wp-content/uploads/2014/01/newsletter-Julyl05.pdf

For more help with picky eating:

Get your Free Picky Eating Tips Guide from Seeds and Sprouts Nutrition for Kids

Check out other Resources and Amber’s Favorite Amazon Finds for all your child feeding needs!

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