Home Speech-Language Pathology The Great Pouch Debate: Pros, Cons and Compromising

The Great Pouch Debate: Pros, Cons and Compromising

by Melanie Potock MA
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pureed food

pureed food

Brace yourself. We are about to talk about pouches. You know, those little packets of convenience, filled with all sorts of fruits and vegetables, sometimes with a little chia or quinoa mixed in. Parents love them, kids push up the puree and suck it right down in a flash, and speech-language pathologists get all in a fluster about them.

Let’s chat about the pros, the cons and a few compromises in the great pouch debate among parents and those of us who treat clients with feeding challenges. The benefits seem obvious to parents, but as a pediatric feeding specialist, I’m not a big fan of those plastic bags of puree. Why? It’s just too much of a good thing. Let’s examine the pros and cons of feeding kids via pouches on a daily basis.

Pro: “No prep required!”

Con: All kids, including those with feeding challenges, benefit from being exposed to a variety of foods via food prep in the kitchen Peeling carrots, snapping green beans and using kid-safe knives for cutting up an apple teaches kids about whole foods—what they feel like, what they smell like and what they look like—which leads to kids venturing to taste them.

The compromise: Encourage parents to keep kids involved in food prep, helping with mealtimes, shopping, gardening and visiting farmer’s markets. Don’t let convenience stop food exploration.

Pro: “Kids consume fruits and vegetables!”

Con: Purees offer a safe start to eating solid foods, but ultimately, we want to practice chewing and swallowing foods in whole form. Research shows babies who linger on purees are at risk for developing a feeding disorder.

The compromise: Recommend parents or caregivers use them occasionally. I suggest a few times a week at most—unless a child has special needs that require daily purees—ideally fed from a spoon. Dispensing baby spoons that connect to pouches are available on Amazon. Just be sure to choose a flat one to allow the baby’s lips to close on the spoon as he learns to effectively clean the spoon with both lips and propel the puree to be swallowed. Silicone straw tips attached to the hard spout—for kids 9 months and up—also help, as they require true sucking to activate facial muscles, rather than squeezing the puree into the mouth.

Pro: “Less mess!”

Con: Less mess means less interaction with the sensory system. Pouches inhibit interaction with most of the sensory properties of food. Kids need to get messy to become adventurous eaters. They are programmed to explore with all of their senses, and I’d rather they didn’t rely on sucking food from a pouch until they grow up to be an astronaut.

The compromise: Show families how to embrace the mess when they can, and occasionally give a pouch when you can’t.

Pro: “They are quick!”

Con: Pouches seem to be the next best thing to a drive-thru kids’ meal and it’s easy to get hooked. I want kids to learn to sit at table and eat mindfully, whether it’s to practice oral skills in feeding treatment or just be with their family around the table, building language and social skills. Feeding children is based on caregiver and child relationship, not on how quickly we can consume the food.

The compromise: I encourage my clients’ families to eat together at the family table—with no screens and no pouches—as often as possible. Tell caregivers to reserve pouches for rare times when they must eat on the go.

Note: For kids who require tube feedings, pouches may offer parents a convenient, quick solution for mini-meals between other tube feedings. If a pouch is a necessity, focus on being together while using the pouch to feed a child. Fed is best, and sometimes parents only have one option. It’s always a family meal when there is eye-to-eye contact, smiles and conversation.

Pro: “Perfect in the car!”

Con: Eating in the car seems to be a way of life nowadays. But eating in the car daily equates to not eating around the family table. Research from Columbia University says kids who eat family dinner three times a week make better life decisions and are more connected with their parents.

The compromise: Encourage parents to schedule family meals and make them a priority. Then they can offer pouches or other healthy alternatives on the other days.

Pro: “Great for toddlers!”

Con: I wish I had a dollar for every time I’ve seen a toddler running about the playground with a pouch hanging from his front teeth. I could give the money to each parent to help pay for the upcoming emergency room visit. The American Academy of Pediatrics reported that common injuries treated in the ER involved bottles, pacifiers and sippy cups lacerating the child’s face during a fall, from holding these items in their mouths. The study was conducted prior to the surge in pouches, but common sense lets us apply the information to a pouch’s wide plastic spout between a kid’s teeth.

The compromise: I strongly advise parents to offer their children pouches only when sitting down.

Pro: “He ate 4 ounces!”

Con: When some kids on my caseload eat 4 ounces, the parents and I are hysterical with joy. For some clients, it’s a volume milestone. Once we move past that stage, however, measuring food isn’t always helpful and doesn’t necessarily equate to good nutrition. Parents who get caught up in exactly how much their kids eat are driven by fear and that’s not healthy for anyone.

The compromise: Collaborate with a registered dietitian. Four ounces is a volume, not a nutritional requirement like calories or vitamins and minerals. Watch this video from ABC News on the nutrition labels on some pouches.

The takeaway? Parents love pouches. Many SLPs prefer parents limit pouch use and focus on the feeding relationship and building oral skills for all types of whole foods. Aim to provide variety beyond purees—unless swallowing safety is a concern.

Share your professional pros and cons in the comments below!

 

Melanie Potock, MA, CCC-SLP, treats children birth to teens who experience difficulty eating. She wrote the upcoming book, “Adventures in Veggieland: Help Your Kids Learn to Love Vegetables with 101 Easy Activities and Recipes.” Potock also co-authored “Raising a Healthy Happy Eater: A Stage-by-Stage Guide to Setting Your Child on the Path to Adventurous Eating (2015), “Baby Self-Feeding: Solid Food Solutions to Create Lifelong Healthy Eating Habits” and “Happy Mealtimes with Happy Kids, and produced the kids’ CD “Dancing in the Kitchen: Songs that Celebrate the Joy of Food!” Potock’s two-day course on pediatric feeding is offered for ASHA CEUs. She is an affiliate of ASHA Special Interest Group 13, Swallowing and Swallowing Disorders (Dysphagia). mymunchbug.com/contact-us/

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7 comments

Dana Lepien March 30, 2017 - 12:53 pm

Thank you Melanie! I talk to parents about this all the time! Now, how about your thoughts on 360 cups! 🙂

Melanie Potock, MA, CCC-SLP March 31, 2017 - 3:31 pm

Hi Dana! It’s a question I get often and we dove into it the last blog post titled https://blog.asha.org/2017/02/28/sippy-cups-3-reasons-to-skip-them-and-what-to-offer-instead/ – see the comments section. Always appreciate all that you do, thank you!

pamslp March 30, 2017 - 11:53 pm

Need to convince parents to stop buying these things? How about mold? I would never give my child or grandchild food that I can’t see and that’s exactly what these pouches are about.
http://www.goodhousekeeping.com/food-recipes/news/a43449/mold-motts-applesauce-pouch/

Loretta Reust March 31, 2017 - 4:17 pm

Great article. I would also add as a “con” that it is better to get the food out of the package and into a bowl. Some kids with sensory issues become attached to a particular brand or shape or package. Then they will only eat applesauce if they suck it out of the package, and they refuse it served from a bowl or spoon. The same kids might only eat chicken nuggets from McD’s, but not if you cut the pieces in half, and not if you serve a different brand or shape.

Melanie Potock, MA, CCC-SLP April 6, 2017 - 5:09 pm

Good point Loretta!

Susan Harper April 1, 2017 - 11:07 am

As a foster parent who works with medically challenged and developmentally challenged children around feeding therapy, I look at this as one more tool I can use to get a child to suck and make that lip closure, similar to using a straw. All are steps on the continuum. The goal is weight gain and nutrition. Any oral nutritional intake trumps tube feeding any day. Yes they are convenient and provide an alternative tool for when we need them. Nutritional intake is key to all other growth and development!

Melanie Potock, MA, CCC-SLP April 6, 2017 - 5:09 pm

Great insight, thank you Susan!

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