Facilitating (Not Forcing) Your Child’s Eating (Extreme Picky Eating Edition)

“I’m not forcing, I’m just aggressively facilitating…” I was watching a show on Netflix* when I caught this line, “I’m not forcing, I’m just aggressively facilitating.” My ears perked at the words facilitation and force, and of course made me think of children with extreme picky eating, of feeding, and the “aggressive facilitation” that can sometimes happen, even in feeding therapies. There is much research that suggests that when children are pressured or coerced to eat, overall intake, and intake of fruits and veggies decreases.  Here are a few examples… “…approximately half of all mothers and a greater proportion of fathers… ignore the child’s hunger signals and may use force, punishment, or inappropriate rewards to coerce the child to eat. These practices initially appear effective, but become counterproductive, resulting in poor adjustment of energy intake, consumption of fewer fruits and vegetables, and a greater risk of under- or overweight.” (Kerzner 2015) “…stringent parental controls can… limit children’s acceptance of a variety of foods and disrupt children’s regulation of energy intake by altering children’s responsiveness to internal cues of hunger and satiety.” (Brown & Ogden, 2004) Pressure to eat likely disrupts child’s ability to respond to internal cues of hunger and satiety (Carper et al., 2000) Pressure to eat … “exacerbate feeding problems and make mealtimes more negative for both parent and child.” (Harris 1992; Skuse 1993) Pressuring strategies could be implicated in the development and persistence of these problems (Farrow & Blissett, 2008) Pressure to eat predicted food avoidance behaviors: slow eating, emotional undereating, satiety responsiveness (Powell 2011) Parent prompts assoc w/ food avoidant behaviors, correcting for child emotionality and maternal...

Navigating Relational Feeding in a Medically-Minded World: When Calories Aren’t the Whole Picture

For many families, weekly (sometimes daily) doctor and therapy appointments are the norm rather than the exception. They strive to make everything fit into the schedule, because doing so keeps their child “well”- or at least not sick- and hopefully making medical or developmental gains due to professional, sometimes intensive intervention.  This may be a temporary scenario, or not. For parents of chronically ill or medically fragile children, every day begins with a status check: Is he running a fever? Is she going to hold down her feeds today? Did I give her all of her meds on time? Why is he doing X? Then on to the scheduling and phone calls- to the doctor’s office to sign a request for records to be sent to the out-of-state specialist, to the insurance company to fight yet another battle about payment for the child’s numerous procedures and office visits. For the parents who live this reality, it can be mind-numbing and terrifying all at once. Having a child who is well is the exception rather than the rule. Being truly well, however, is not the same as not being sick. For many kids, they have never been truly “healthy”, as the WHO states: “Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” What about these situations in otherwise “healthy” children? the baby who screams every time she sees a bottle, but takes a small amount when it is forced into her mouth the toddler who throws up at least once a day after being fed the preschooler who exists on Pediasure because he doesn’t...

Ask, “What’s Important Now” (WIN) to Help Your Child with Extreme Picky Eating

I was at a conference recently speaking about ARFID (avoidant restrictive food intake disorder) with folks who treat eating disorders and some who provide early feeding support in the community. When I can, I reserve a chunk of time for discussion and Q and A– for selfish reasons, partly.  I almost always come away with some new tip, story, or information that has tremendously shaped my work over the years. I had mentioned research that dads tend to pressure children more with eating, and boys tend to be more pressured. (Our theory is that if boys fall on the smaller side of the growth curve, the tendency is to try to get them to eat more to be ‘big and strong.’ Boys also make up a higher percentage of children with extreme picky eating.) Anecdotally, Jenny and I find that more fathers than mothers tend to struggle with letting go of rules and pressure; one area in particular is manners. One attendee talked about her rural area where there are a lot of fathers who are in the military, and that she observes that these dads seem more insistent on rules, order, and compliance with manners. For one family struggling with extreme picky eating, there are many mealtime battles around trying to get the kids to eat with elbows off the table, knives and forks held a certain way, not too loud, all asking to be excused only after everyone has finished… The fighting about manners adds to the tension and conflict over who is eating what and how much. The first STEP when we work with parents (and in our book)...

Picky Eating Progress Reports: Spirited 3 1/2 year-old

Sharing one mom’s early successes (and tips) with her son with extreme picky eating. My 3.5 year old and I needed some help. I read your book, Helping Your Child with Extreme Picky Eating and started the process this past Friday. While reading the book I realized how emotional I have been about our struggle with food. My husband was on board when I told him about it. My family said they’d be respectful and help. My son’s daycare already operates just as your book describes. While I teared up several times while reading the book, as it so closely related to my sense of failure, it gave me hope to try something new. He is developmentally fine, but is spirited and strong willed. The struggles seemed to be escalating and I was ready for help. Since starting last Friday (one week of trying) things have already gotten so much better!!! I started our dinners new with all glass serving dishes so he can see the food. Changed the placemats and put flowers on the table so I felt like it was a fresh start. Since starting STEPs+ he helped make blueberry pancakes (winced when the blueberries came out, but I wanted them so I stayed the course) and then at the table he put one on his plate!!!! He has watched me eat cherries (many times) acting as if he’s not watching. Today he asked if I eat the stem. When the dessert is on the table he eats a bit of it, but goes to his safe foods and eats them instead. His asking for crackers has almost...

Food Allergies and the “Spotlight of Difference”: Guest Post

Children may face eating challenges for various reasons. Children with extreme picky eating tend to experience higher levels of anxiety, around food and in general. Perhaps the most anxiety-provoking feeding challenge that parents face is life-threatening food allergies. Some children with extreme picky eating also struggle with food allergies, which can complicate the picture even further. Kristin Beltaos has made it her mission to help parents and children not just be safer and healthier, but thrive. We were intrigued and impressed with Kristin Beltaos’ work with parents, children, and schools (A Gift of Miles). She has graciously agreed to share some wisdom in our first guest blog post.   1. We are intrigued by your “Spotlight of Difference” TM. Can you tell us more? First off Katja and Jenny, thank you for the opportunity to communicate with you and your followers. Usually when you think of placing a spotlight on a child you think of something positive, i.e., accomplishing an awesome grade, playing a great sport game, writing a wonderful paper or doing well in a recital. These are all great ways to shine a positive spotlight on a child. It’s fascinating how when we are confronted with a challenging situation, such as creating a safe environment for a food allergic child, our initial instinct is to determine how a child will adapt to our environment, rather than how the situation can be modified so that it’s safe for everyone. When we only address the individual child it will almost always create a Spotlight of Difference TM. In our efforts to create safe environments for children with food allergies, parents and schools alike...

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