Recently, a mom asked about the way her child stored food in his mouth. The stuffed cheeks reminded us of a chipmunk. And honestly, it sounded kind of cute. Until, we discussed the issue with one of our experts.

Alaina Everitt, a licensed psychologist at Cook Children’s, has seen this issue throughout her career. It’s a symptom of a feeding disorder she describes as “pocketing.”

Everitt said the issue of pocketing usually begins when children are young. The children may experience something painful, such as reflux or a sore in their mouth, and they find it difficult to eat.

The children then may begin a process of holding, spitting out or refusing food altogether.

Children who pocket food should be checked out by an occupational and speech therapist, even if they have had no other type of therapies or been diagnosed with any medical conditions, according to Everitt. She said those specialists can make sure there are no other problems, such as difficulty moving food around in their mouth with their tongue or if the tongue is weak. These children can usually be cured with basic therapy exercises to overcome these obstacles.

If it’s a sensory issue, more extensive therapy may be needed. Children with sensory difficulties, autistic children for instance, may need a lot of food for them to even feel it in their mouth.

“These kids will over stuff and pile food in their mouth and get the ‘chipmunk cheeks,’” Everitt said. “These children tend to like crunchy or spicy foods because they may have trouble tasting or feeling other foods because of sensory issues.”

Lots of toddlers will hold their food and that tends to be developmentally appropriate. If a child gets closer to age 5 then parents may have cause for concern.

As children get older, they become more skilled at pocketing food. The kids may keep their food in their cheeks until they discard it or the parents can’t get their children to swallow.

“It becomes a meal-time battle,” Everitt said.

Cook Children’s helps parents with a team approach to treating children with a feeding disorder. A pediatrician would help guide the child’s care. A dietitian may help the child find foods they can swallow. The physical and occupational therapists lead the actual therapy portion to teach swallowing and resolve sensory issues. Everitt comes in to help with any emotional or behavioral issues, such as anxiety or parent-child power struggles.

“Therapists have little tricks they teach parents; how to do the right type of massage or how to get in their child’s mouth with a vibrating tool as it helps them from a sensory perspective,” Everitt said. “These things can help children swallow easier. You also have to make sure they don’t have a swallowing problem at this phase and the speech therapist will help with that. If the kid has choked before or has trouble swallowing, why would they try to swallow? Even when that issue gets treated the kids are still scared and that’s when they come to me.”