Question & Answer - Feeding, Eating, & Drinking
What cultural differences should we consider when working with Latino children in feeding therapy to ensure better follow-through in home programs?
ANSWER FROM: Maria Yakos, MHS, CCC-SLP from Diamond, Illinois
As speech-language pathologists, we consider cultural and linguistic differences in our decisions for treatment. As feeding therapists, it is necessary to consider available utensils and foods in a child’s natural environment when working with families from Latino cultures.
The Latin kitchen provides unique and wonderful food and meal preparation opportunities for feeding therapy. Utensils, fruits, vegetables, and grains found in Hispanic homes provide many healthy flavors, textures, and techniques that can be added to a feeding therapist’s repertoire of options for treatment.
Using available utensils and foods in feeding therapy automatically allows the family to become involved in treatment. Involving the family in the decision processes for therapy helps ensure follow-through and provides the family with education about how to use foods and utensils found in their own pantry in the home feeding program.
Ask families what utensils are available in their kitchens. Latin kitchens often have a food mill or molcajete (mortar and pestle). A stainless steel food mill can be used to puree and mill a variety of fruits, vegetables, and bean soups when a child requires pureed food for feeding treatment. The molcajete (mortar and pestle) is also useful for crushing items to a fine paste or powder. This can aid in processing spices used in cooking and to eliminate pieces (such as whole cumin or other spices common in Latin dishes) that may be difficult for a child to handle. Additionally, running onion, garlic, and peppers (common in sofrito, a tomato-based sauce) through a blender before sautéing in oil will not affect flavor but will alter the consistency by eliminating pieces that may cause swallowing or sensory difficulties.
Vegetable and Grain Options
Many of the vegetables and grains found in a typical Latin diet are healthy choices for feeding therapy. For example, a visit to a Latin grocery store demonstrates the wide variety of root vegetables used in Latin cooking (e.g., malanga, yucca or cassava, boniato, a variety of sweet potatoes with different textures and colors, etc.). These can be boiled, fried, or baked and served with sauces or butter. In feeding therapy, sauces can help a child form manageable food boluses as the sauces mix with solid food. Butter can add needed calories. When using root vegetables, it is important not to discard all of the water after cooking. The water contains vital nutrients, and some root vegetables like malanga can become very hard leftovers if not refrigerated in the cooking liquid.
Latin recipes also include a variety of nutritious squash and pumpkin dishes. Butternut, chayote, and zucchini squash are excellent in a chicken broth-based soup. Plantains are another nutritious food frequently served in a pureed form. This is a food choice the entire family can enjoy. Depending on ripeness, plantains can have very different tastes or textures. This must be taken into consideration when preparing plantains for feeding therapy.
Tamales are made from corn, and their preparation varies from one region to the next. Some regions have tamales made with fresh corn and a fine cornmeal resulting in a very creamy consistency. Goya manufactures a finely ground cornmeal that makes a creamier version than the more coarsely ground cornmeal used in polenta dishes. Therefore, Latino families have many healthy vegetable and grain options that can be prepared in a variety of ways for feeding therapy.
Since many Latin-American countries enjoy warm climates, tropical fruits are a part of basic meals. Nectar thick juices found on the shelves of Latin grocery stores or bodegas provide ready-made options for feeding therapists who are not familiar with some of the fruits in a family’s diet. Fruits (not in season) are often canned or jellied and also can be found in bodegas or larger grocery stores. For example, guava may be canned whole or sliced in syrup, pureed with a light syrup (mermelada de guayaba), or made into a paste. Often these sweeter processed fruits are served with cream cheese which can add both nutrition and needed calories to a child’s diet. These fruits, found in a variety of forms, are perfect for providing different food textures during treatment.
Additionally, mangoes, papaya, pineapple, coconut, mamey, guanabana, and guava are some nutritious options that may be used to make smoothies. These fruits can be frozen and then blended with milk to make a delicious sweet-tasting drink which can help with caloric supplementation. However, please work with your dietician on this process.
It is also common to see fresh fruit popsicle venders in Latino neighborhoods. Real fruit is blended and frozen to create a popsicle or “duro frio.” These popsicles provide “cold” to wake up the mouth, as well as, exposure to a variety of tastes. Many children with feeding disorders like cold foods. Additionally, when considering fruit options, avocados are a healthy, fatty, creamy food that can be used as a thickener in a smoothie or drink, as well as a nutritional enhancer.
Variety is the Spice of Life
Children living in Hispanic homes are exposed to textures and smells of a wide variety of foods typical to their region. Recipes can be found online or by asking the family. Since each country has its own flavor and terminology, including the family in feeding treatment allows the therapist to obtain information about family food preferences. In addition, it helps the family partner with the therapist in treatment to assure follow-through.
Keep in mind that depending on the family’s original country or region, food terms may vary and dialectical differences may result in culinary communication break downs. For instance, in the Dominican Republic a banana is called a guineo. Using descriptive terms or pictures will help avoid confusion when discussing options.
So, now you have many ideas about how to implement feeding treatment in Latino homes. I think you will agree that the options are great and varied. If you have further questions, please feel free to contact me at firstname.lastname@example.org. I wish you well in your work.