Q&A: 4-year-old holding food in mouth

Ali writes:

"Our 4 year old DD has thrown a new and less than delightful issue our way – she’s started holding her food in her cheeks. It’s not an issue of liking the food – she does it with everything, including her favorites. She’ll chew it up, and then forgo that final swallowing step. Eventually we end up telling her she has to swallow or spit; mealtimes have become really unpleasant, and I’m starting to dread giving her any food at all. I tried ignoring it, and she kept some masticated waffle in their for over thirty minutes before nearly choking when she coughed with a mouthful.

Most of the stuff I’ve come across on the web seems to be either an issue of the child not liking their food, or a muscular issue. That isn’t the case here. DD is a very independent minded child, and loves nothing more than a power struggle, so I’m leaning towards a control thing – but in the meantime, what on earth do we do?!?"

Eew.

My almost-2-year-old does this (and it drives me nuts), but I haven't heard of a 4-year-old doing it before. I think you've hit it directly on the head when you say it's a control issue.

It seems like you have a few choices:

1. Ignore it some more. See what happens if you just steadfastly ignore it for 3 days in a row. It's going to kill you, but she'll figure out how not to choke, and she may well completely lose interest in this idiotic food-storing scheme.

2. Find some pictures on the internet of what will happen to her teeth if she continues to hold food in her cheeks. Don't click here if you're squeamish. Show her this pictures, and tell her it's her choice, but holding food in her mouth could result in teeth like that. If you're lucky, it'll scare her straight.

3. Ask her to help you come up with a way to get her to stop holding the food in her mouth. Kids that age can be surprisingly rational about this stuff, and she just tell you exactly why she's doing it, and how to get her to stop. Either that or she'll be so surprised that you asked her to help you come up with a plan that she'll just swallow without realizing she's started swallowing again.

Those are the three things I've come up with that aren't going to to get you into a fruitless power struggle. Does anyone else have any ideas to stop the hoarding that don't involve any showdowns?

Comments

[smashedpea]

For us, ignoring these sorts of behaviours usually does the trick. Our daughter is younger (20 months) and has never tried this thing with her food, but we've had other issues.... We can reason with her and try to explain it until we're blue in the face, read books about it, whatever, but it often doesn't accomplish anything.

She's incredibly stubborn, so nothing is ever easy and it's often about control. We found that if the usual methods (talking to her, etc.) don't do anything, but instead lead to an increase in whatever it is she's doing, ignoring it for a few days straight makes her get over it really fast.

I also have a friend with a kid who always tucked his last bite into his cheeks, too, and there was nothing they could think off to get him to move past that (he was around 3 at the time). In the end, they let him fall asleep with the food in his cheeks and then pulled it out. He eventually stopped doing it on his own, but it went on for quite some time.

Good luck!

[Shandra]

Just out of my backside (and having recently started to re-read Playful Parenting), what if you started playing a chipmunk game with her to see how long she can keep it in there or stuffed your cheek full for a while, showing her the digusting mess with great glee from time to time?

I realize that seems counterproductive but it might diffuse the power struggle.

[Katherine]

Does she start doing this with the first bite of food at a meal? If so, you might calmly tell her she can't have another bite until she shows you she has swallowed the first. Be very casual and unconcerned about it, avoiding the power struggle. If she'd rather not swallow yet, that's fine. Eventually hunger should override the desire to be a chipmunk.

[Dani]

My daughter started doing this last month. She just turned three. At first I ignored it, but then when she would keep putting more food in her mouth until she would cough, gag, and make a mess, I started telling her calmly that she could only have one bite at a time. Maybe not the best way to handle it, but ignoring wasn't working out. The problem resolved itself last week when she got some kind of nasty virus and pretty much stopped eating. She's starting to improve now, and I really hope by the time her appetite is back to speed she'll have forgotten the whole no-swallowing debacle.

[kirsten]

When I was 4, I choked on a bite of food. Afterwards I became afraid to swallow for over a month. My mother had to be very patient and walk me through the chew chew swallow routine for a while until I lost my fear. Maybe something similar made her want to stop swallowing? Just an idea.

[jessica]

Whatever you do, don't get her a pet hamster.

[Charisse]

Is she too old to make it a reward thing? Like maybe keeping a jar of nickels or beads on the table and if she shows you an empty mouth when you ask she gets a nickel? (Or a quarter, or whatever denomination works for 4-year-olds.) Or maybe jellybeans which would go into a dessert bowl if you're not stressed about sugar?

I too have a younger kid, but when my very headstrong almost-3 decided she was darn well going to wear panties but was never going to voluntarily poop again (with delightful consequences), we solved it with a bowl of little wrapped trinkets in the bathroom. We had to be totally nonchalant about it, though--wait for her to ask about the bowl, provide minimal information "oh, those are your poopoo presents" and move on...wait for her to ask what a poopoo present is...explain and move on...wait for her to decide she wants one. Etc. You can translate it to the dinner table:

"what is that jar?"
"hmm? oh--jellybeans. So, partner, how was work today?"
"mommy mommy can I have a jellybean?"
"hmm? oh well, sure--if you show me your empty mouth after you swallow I'll put one in this dish for dessert. Your boss did what, honey? What a jerk! Are you going to go over her head?"
"mommy I swallowed, my mouth is empty!"
"oh, nice! that's so polite and healthy! I'm putting this red jellybean in your dessert bowl. What were you saying, dear?"

[amy]

No advice (my own 4.5 DD often refuses to eat, but she never hordes food in her cheeks). But I have a friend whose 4 yr old does this (and has for some time). With him it's clearly a control issue. They handle it by demanding he swallow. Forcefully demanding. And hence, in an effort to assert his own control over his body... the behavior persists. So... (wait, I do have advice!)... *insisting* she swallow might backfire in the long run.

(I should add that the reason my friend demands he swallow is that he's underweight and has eating issues in general, so allowing him not to eat or swallow what he does put in his mouth is not an option... though I think that goes back to control as well... sorry, I'm getting totally off topic here.)

[Jennifer]

Ditto what Kirsten said above. When I was about 5 I saw someone choke and I became terrified of swallowing food. It took my parents weeks to figure out what was going on. The only thing I wanted to eat was soup. It took quiet a few additional weeks of talking it through to get the issue resolved.

Hope it's not this!

Good luck!

[chimera]

There are some great comments and ideas about the control issue. I work with kids and behavior disorders and so many times what we might think of as "clinical" behavior is control and really, how much can a four year old control? However, just because I know that if I type it I will be wrong there is a very small possibility that there is a disorder of early childhood going on, specifically ruminating disorder that might be worth talking to your pediatrician about. This would be especially applicable if she is actually swallowing and then regurgitating the food to hold in her mouth. She seems a little old, the usual period for this is 3-12 months, but there are some weird things that can go one in early childhood around eating. Here's hoping she's just being a bit of a silly girl!

[joline]

I can remember doing this as a kid. I dont remember it being about control. I just remember that I loved food, and Iknew that after I finished and was full I wouldnt be eating any more. SO instead of chewing and swallowing my last bite when I was getting full. I held it in my mouth and basically saved it for later. Kind of like gum. I especially thought apples worked really well for this and did it longer with them than anything else. I dont remember what age I was when I did this, nor what age when I stopped. So I wonder perhaps, that while this COULD be a control issue certainly, it also could just be a new experience she is tryign on for size. It could be self limiting and go away on its own once she is done with the little experiment.
Just a thought.

[amy]

My first reaction is in line with the above comment. Her behavior struck me as a clever way to extend the enjoyment of food. I overeat; I tend to scarf down ALL of a particular food I am enjoying and then am left unsatisfied once there is no more available. I imagined the holding of food in the cheek as a creative solution, a way to stop after having eaten a reasonable amount of the food and then spend time savoring the taste, rather than engaging in continual eating of the entire inventory only to be left with nothing. I am somehow not able to focus and savor taste and really enjoy what I am eating with each bite all along as I eat; perhaps she is having trouble doing this as well, but has found a way to at least savor after she has eaten an appropriate amount instead of continually needing additional food to fill this need. If this might be the case, perhaps she can be encouraged to do what I cannot, to really taste and enjoy each bite.
How does she respond when asked about the reasons for this behavior?

[TheLuckyGal]

Every obnoxious behaviour my daughter displayed from the day she turned four to the day she turned 4.5 was power-struggle based. (These last coupld months of 4-and-a-half have been a dream!) I would diffuse the struggle through whatever means possible. Serve soup! Invite friends over and feed all the kids together so she can eat with peers and not you. Ignore it. If it were my kid and I made her swallow, she would dig in her heels.

[Kayla'sMommy]

I've always had some type of feeding problem with my daughter since she was about 6 months (She is now 23 months). It started when she was about 6 months, she began to vomit after each feeding and sometimes even several times a days for weeks!! Our pediatrician suggested cutting back on dairy but it didn't help much..I wasn't overfeeding her at all either. The problem got a little bit better but it has been an ongoing problem to this day. It will get better for a week here and there and come back off and on.

Then once we started her on solids, however, we noticed that she will gag constantly throughout each feeding and most of the times she will eventually vomit from the gagging. We kept her on Stage 2 because she could not handle the Stage 3 and the very second she felt a piece of carrot in the back of her throat she would gag and even choke at times! After talking to our pediatrician he believed she had a sensitive gagging reflex and suggested that we keep her on Stage 2 and to continue to offer her more textured foods off and on. He said she will take it once she was ready and not to push too hard. He said most children have problems with Stage 3 and that our daughter will eventually outgrow this.

It is still somewhat of an issue now, maybe worse now because although she doesn't gag with textured foods, she holds food in her cheeks from the very first bite and we cannot get her to swallow it!! We constantly remind her to chew and swallow but she won't swallow the food. Eventually she either takes the food out of her mouth herself or we end up taking it our because it's been sitting there for over an hour. So needless to say I have to go back and give her the baby food because she hardly takes a bite of the regular food. The interesting thing is that she can eat finger foods, cookies and crackers without a problem but not the texture foods where she needs to chewing and swallowing are involved. Our mealtimes have become extremely stressful and although our pediatrician still doesn't believe there is a health problem associated with this new feeding problem, he feels is more of a 'control' issue. I'm growing very concerned because the only types of food that she gets her nutrition from is the baby food (stage 2)!! To increase her daily caloric intake I add a tablespoon of olive oil to her meals (2-3 tablespoons of olive oil a day). I checked with our pediatrician and he doesn't seem concerned that she is still being fed with baby food. He also says that adding the olive oil to her diet won't affect her health in a negative way. We are really considering taking her to a Gastroentorologist for a second opinion. However, she is in the 90th percentile in weight and 95th in height, so I'm not sure if a Gastroentorologis would even see her since she appears very healthy. If anyone is having a similar problem, I would love to chat and any suggestions are very welcomed!

SORRY FOR THE VERY LONG POST!!

[vicki s]

in response to lisa and daughter eating just baby food. I child mind and have a colleague who has a child with the same situation and the same age. She is addressing it by giving textured foods in small amounts then once she has eaten it she can have her jar food or yoghurt. She has been told what is expected pre-meal and is left to get on with her meal without nagging. No time limits for eating. This appears to be successful as recently she ate pasta bake, grapes and cheese roll. Also sandwiches.

[vicki s]

sorry! last comment was in response to kaylas mom!

[michelle aleo]

my 2 yr old nephew is not eating. He hold his food in his mouth. he has even started holding his saliva in his mouth. Like he refuses to swallow. I follow him around telling him to spit. We tried different foods, I let him choose. This goes on with snacks, fruit, every meal. I am at my wits end and his mom says it means he ready to begin potty training. Any advise. Michelle

[Granny2]

I have grandaughter who will eat junk food and other things... dinner time she hoards the food in the side of mouth and won't swallow.. This leads to crying, pouting.. She is taken away from table,set in the bedroom and she may or may not swallow the food.. Lately its been in the room and she refuses to swallow, so dad spanks her and into bed for the nite.. Is there anything that will help on this.. It seems to be power struggle.. Wits end on this perlex problem.. I don't believe the spanking will help, but he seems to think she isn't going to win.. Who would be right in this..?

[Jen]

My 7 year old is holding food in his mouth and refusing to swallow. He doesn't do it all the time, but when he does, it's a fight for 30 minutes or more before I finally give up and let him spit it out. He says he is afraid he is going to choke. He has never choked in the past to my knowledege and most people on this board are talking about way younger children. I just don't know what to do. I guess I will take him to the doctor. The thing is he stopped doing this for a whole week and then started up again. HELP!!

[Natasha Nickell]

My son is 20months and holds saliva, food, and juice in his mouth for hours until he cant hold it anymore then spits it out and starts over he wont drink smile eat nothing just holds it until his cheeks are so full it looks painful and he is very adamant about not letting it out until hes ready! I'm just so glad to read that it is not just my son. I was very concerned but now feel more at ease with this weird phase of his.

[reychel]

i have a 5 yr old son who has been refusing to swallow his food.Its only been for the last 2 days but he's not eaten a thing. He is drinking fine. He seems scared to swallow, do you think the longer we leave it, the worse it will be in his head and the bigger he'll build it up as a problem. Or do you think that if we're patient and dont force him, he'll eat when he's hungry? Last thing I want is to do the wrong thing and have him end up with a deep rooted eating disorder. Any suggestions??

[candi]

I have a four year old and she holds her food in her cheek. A typical meal for her is four hours long. A 4 piece nugget happy meal from mcdonalds lasts 3 hours. She has done this for the last two years. I don't know what to do. I have tried to not pay any attention to it and when that did not work i tried forcing her to swallow. When that did not work i tried different foods and rewards and so far none of it has worked she will be five soon and weighs 31 lbs. She will eat junk food fine but cries when it is time to eat dinner or any other main meal. Can anyone help us?

[Amy]

My daughter (4) has held food in her mouth ever since she was 8 months old. I was getting infuriated, especially lately, with her advanced age. She is very, very smart and independent and I pretty much thought it was either biological or a control issue. After reading something that said - ask her help to you come up with a way to get her to swallow- I asked her to devise a plan and she took a dried starfish we have on a shelf and said that holding it to her belly would help her swallow. And she has been swallowing just fine when she "uses" the starfish to help her. That worked with grapes, we'll see about chicken.

[diana]

I think there is something very wrong here and so do all of you i for the first time have experienced in my grandchild

[Kirsty Kelly]

My 6 yr old has been doing this all week holding chewed solid food in his cheeks and swallowing the juices in tiny bits then spitting out the solid left overs, he's drinking fine and eating soft wet options no problem. We are really worried about him he has bee sick for some time and we've had lots of tests, he's had whooping cough 18 months ago, Glandular fever, and now we are treating for giardia. last week he got hives and this week has been this swallowing issue, we've asked him why he won't swallow and he shrugs, says I'm scared or just says I hate it he also said his throat is too little and sore, can't work it out we can't trust what he says either because he hates school and for the last two terms has begun the morning with I'm really really sick ( usually Tummy pains) He also has dyspraxia and this has been linked with swallowing coordination difficulties ( but why would it only show up now?). We don't think he's had a choking scare and are beginning to clutch at straws for a reason he is soooo skinny and we can't afford for him to lose any more weight.
Any Ideas

[Concerned Sister]

Hello all! I have a very similar concern- actually identical to some of the comments I've seen. My almost-3-yr-old brother, Cameron, holds EVERYTHING in his mouth. At mealtimes he seems to eat until he's full, and then eat more to store in his cheeks. When he isnt eating/snacking, he holds the last of his liquids in there too (water, juice, ect.). But the most concerning for me is saliva; when he isnt chewing on snacks/meals or drinking anything, he stores saliva in his cheeks! My step-dad has gotten to a forceful solution since it bugs him so much: He holds a towel underneath Cameron's chin and plugs up his nose. He's forced to either swallow or spit out the food in order to breathe. It isnt fixing the problem, it's just temporarily getting the food out.

Any suggestions/advice?

*Notes: Cameron also has a delay in talking. He's only just starting to say a few words, but he's SO socially capable. He loves being held and talked to, and he stares at books/toys for hours, inspecting them and playing with them. He just cant say sentences yet. He babbles a lot, and has a terrible temper when he does get mad. He thrashes about and knocks toys around/throws things. He is an identical twin and his brother is far more ahead. (Johnathan, his twin, has even started to take interest in potty training. he says full phrases and while he might be a tad delayed for his age he is far better than Cameron with verbal communication) Johnathan does not have any pressing food-holding problems. Both babies were premature by 3 months and had to be kept in the NICU for a while. I dont know if any of that info helps, but, there you go!

[sarah]

Kirsty, it sounds like Cameron could have something more significant going on than just a problem with eating. To be 3 with such limited speech is a red flag. Playing with and "staring" at toys for hours at a time is also concerning. Has he been evaluated for any developmental disorders?

To everyone else commenting here, it is certainly somewhat comforting to hear of other people's struggles with their kids and eating. My two sons are both extremely sensitive to different textures. My 6 yr old still eats Gerber Oatmeal for breakfast every day. He gags and vomits if there is a speck of anything unexpected in his food. It is frustrating because he also seems to have an easier time with snacks like crackers and cookies, although he inpects everything closely and will shy away from an unfamiliar cracker or cookie. Neither of my kids will eat any candy except plain chocolate and only after thorough inspection to make sure there isn't anything "hidden" inside. They really seem to have an issue with chewing any "real" food, and much prefer soft foods like yogurt. I am reading and responding here because my 2 1/2 yr old recently started holding food in his mouth, sometimes for 30 minutes or more. He does this with previously accepted foods, so I'm not sure what the issue is. It is very frustrating. I wish I had something more positive to say. I had my older son evaluated by our children's hospital "feeding team", and he spent several months meeting with an occupational therapist to try to help with his eating struggles. It didn't really help, and the therapist and I actually agreed to give up because it just wasn't working at all. I had suspected it might be more of a psychological thing, and maybe it is, but my younger son has the same issues. My husband is extrememly picky with food (he strains Ragu plain sauce to remove any "pieces") so I think it is a genetic thing that has just gotten completely out of control with my kids. Good natured folks think this is a parenting issue but it really isn't. I tried "just give him what you're eating...he'll eat when he's hungry" numerous times. My kids have little interest in food of any kind. My older son went a week without dinner when I tried this method. I'm not sure what the problem is, but it doesn't seem to be behavioral. I don't think he can help his extreme reactions to new foods. Anyway, I am rambling on and not providing any help. I guess I just want other moms to know that they are not crazy, they are not poor parents and there are other people (I think more than we know) who struggle with these issues every day. On the bright side, my 13 yr old step-daughter recently started trying new foods. She was just as "picky" and sensitive to food as my sons. I am hoping my boys get there sooner, but at least there is some hope. : )