A: I can understand how frustrating this must be! It may help you to know that other moms have successfully dealt with this problem, since a small percentage of children tend to “pouch” food in their cheeks. Why some children do this isn’t entirely clear; there can be a variety of contributing factors. Sometimes it’s simply a phase that children go through, but in some cases a swallowing disorder is to blame. If your daughter doesn’t hold food in her cheeks when she eats her meals and snacks with your nanny, it’s likely that she’s capable of chewing and swallowing properly. If she does display this type of behavior when she eats with the nanny, it would be wise to have her evaluated for a swallowing disorder. If your daughter is found to have a swallowing disorder, her doctor can refer her to a speech and language therapist, and this professional can work with her to help her learn to chew and swallow properly.
Since your daughter seems to eat well for your nanny, it might be helpful to watch and see what your nanny is doing differently at meals and snacks. It could be that the nanny offers different food choices, or that she prepares the food a little differently. For instance, the nanny might be warming your daughter’s food to a different temperature, cutting the food into smaller bites or mashing it to a different consistency. Toddlers are very sensitive to size, texture, and temperature of their food, and these factors all play a role in their eating behaviors. It could be something as unexpected as the fact that your nanny allows your daughter to eat with her hands or with a grownup spoon instead of a toddler spoon.
It might also be helpful the kind of attitude that your nanny displays during mealtimes. Is she very attentive to your daughter while she eats? Or does she take a more nonchalant, hands-off kind of approach? Since toddlers are working hard to establish independence, her behavior could be a result of her feeling the need to establish control over her food intake. It’s natural for parents to feel stressed when their children don’t seem to be eating properly. Your nanny might not feel—or exhibit—the same degree of stress about your daughter’s food intake, and as a result, mealtimes might be more relaxed. If your daughter has noticed that you become overly attentive, concerned, or upset at mealtime, this could be influencing her behavior.
While you’re working on improving your daughter’s eating habits, it’s important to make sure that she’s not running around with food pouched in her mouth. You’re probably already asking her to open her mouth when she’s finished eating to make sure she’s not hoarding any food in her cheeks. Food left there can pose a choking hazard, and it can also contribute to tooth decay. If you haven’t taken her to a dentist yet, now’s a good time. You’ll want to make sure that she doesn’t have any problems with her teeth that might be contributing to the problem, and to make sure that she doesn’t have any damage to her teeth or gums as a result of pouching her food.
Your daughter’s pediatrician can help determine if your daughter is getting the nutrients she needs to grow and develop properly. If she’s growing and gaining weight at an appropriate rate, you can take comfort in knowing that she’s getting enough to eat. Toddlers can be rather erratic eaters, and your daughter’s reluctance to eat well at lunch and dinner might just be “normal” toddler behavior.