Weaning off Distractions with Extreme Picky Eating

We recently got a question from a psychologist working with a family. (Details changed.) “I’m working with parents of a seven year old boy with sensory challenges and extreme picky eating. He brings several stuffed animals to the table and insists on feeding them bites before he will eat anything. He seems reluctant to give them up. In the past the family has done sensory based therapies where the child was to touch and lick certain foods which seemed to make his anxiety worse. Dad is reluctant to take the stuffed animals away as for now it does seem to help him come to the table and get a few bites in. They are very new to the STEPs approach and wonder if they can let him have his stuffed animal friends for now. They worry if they take those away, he won’t eat. Thoughts?” Quick answer is “Yes he can keep his stuffed animals for now, and…”These parents are asking a great question that shows that they are tuned in to their son’s anxiety and are looking for ways to keep anxiety at bay as much as possible. REDUCING ANXIETY for the child and parent is the first STEP in our responsive process.This family is very early in making the transition to a responsive feeding approach. There are many things they are likely working on and they don’t have to do it all at once! Honor the parent’s instinct to work on other things first. They might work on having more regular meal and snack times, (STEP two is routine) and avoiding any pressure, both more “negative” (multiple prompts to...

“What do I say when…” Extreme Picky Eating Edition

A big challenge that trips parents up daily is, as one mom put it, “Knowing what to say in the moment.” Sitting across from a child,  parents often feel pulled into those familiar, but counterproductive patterns: the negotiating, bribing, nutrition lectures, sticker charts, or threats around video game time. When the old patterns haven’t worked, but parents aren’t quite sure what to say, we offer some suggestions that: reduce conflict, build relationships, support appetite (anxiety and conflict can kill appetite and curiosity) and make mealtimes more enjoyable for everyone. These “scripts” can be used flexibly and adapted for different situations. We even recommend parents practice some of the phrases. Here are a few that we include in the book with the reasoning behind them. For more thorough discussion of how to transition to responsive feeding and more script examples, check out Helping Your Child with Extreme Picky Eating. One caveat: If you say something like, “We won’t make you try foods anymore,” be sure you are ready to mean it. This is tricky stuff. Learn as much as you can before you jump in, learn about common obstacles and ideas on how to approach them, know what to expect, consider online support (we love the private Mealtime Hostage group) or get help from a responsive feeding professional. These are just suggestions; adapt and find the words that work for you and your child (be responsive). Acknowledge your child’s feelings. Anxiety often plays a big part in extreme picky eating. If it helps your child, begin by slowing down and acknowledging his feelings. “I’m sorry you’re upset about X.” “I...

Find Your Fit: Your Family’s Feeding Therapy Partner

We recently wrote about how different the feeding therapy experience can be and how confusing it is for parents who may be simply handed a referral. One mom who described the eight months her son was in a behavioral feeding therapy program as “traumatic for us both,” was furious to learn that she had options. Her son thrived after a tongue-tie release procedure and responsive therapies that worked on healing his reluctance (worsened by coercive feeding and therapy), supporting appetite and decreasing anxiety. Most of our clients have “failed” months or years of various feeding therapies. Jenny was the 6th feeding therapist for a 3 year old client she worked with recently who made more progress in six weeks than he had in the three previous years. When you don’t know much about a program, and the website uses language that is confusing, or you don’t get a clear idea of what kinds of therapies they offer, you may need to dig further to find out if a therapist or program is a good fit for your family. Here are some questions you can ask and discussion points (link here: Finding Your Feeding Therapy Partner PDF) Of note, these are complex issues, and we go into this in depth in chapter eight in our book, Helping Your Child with Extreme Picky Eating. Sometimes, even if you are contemplating formal therapies, you can make progress at home. We practice Responsive Feeding and Therapies  with our STEPs+ approach (including links if you’d like to learn more). If this is what you are looking for, here are some suggested questions to see if a potential therapist...

My Child Choked and Won’t Eat! Help!

We recently got a question from a mother whose daughter had a choking episode and is refusing to eat. “Our six year old had a choking episode two weeks ago, but the food popped out pretty quickly. She is now only drinking Pediasure. Our pediatrician is not concerned since she is drinking Pediasure (“Total nutrition” he said!), but our daughter is panicked about choking again and seems to be getting worse. We called the local eating disorder treatment center, and they can see her- in three months! We don’t know what to do!” (Assuming her weight is stable or minimal decline, and that her development and eating were typical before the aversive event, and assuming the pediatrician has ruled out any reason behind the choking event…) A few general thoughts for this mom and others with the same concern: You are right not to wait three months! Most children in this situation don’t need inpatient or intensive Eating Disorder treatment, but things can get worse quickly. This is not an uncommon event, but scary all around. EARLY support leads to best the outcome. Your doctor isn’t too worried, but you are seeing a dramatic difference and your gut says you need help. The phobia can become more entrenched the longer it goes on. (See case study below we wrote for doctors on Medscape for more. Part of why we are sharing this is for parents to have it to show to the child’s doctor if they need help finding resources, or having concerns taken seriously.) This is a traumatic event, and can take time to heal, but you should see steady progress with support. Find a therapist...

Picky Eating Doesn’t Have to Be Lonely

Picky Eating and Social Isolation One of the main reasons parents and teens seek out help for persistent or “extreme” picky eating has less to do with what they are or aren’t putting in their mouths, and more to do with the very human drive for social connection; the child who misses out on parties or sleepovers because he is anxious he won’t find anything to eat, the tween who skips the block party because of comments from neighbors, the teen who won’t eat in front of others and dreads dating. Selective teens and adults tend to have more anxiety around eating with others, and social anxiety in general. It makes sense; most of our social gatherings and celebrations revolve around food and meals, and people seem to love to talk about what others are or aren’t eating. The following are some tips on helping children and teens who are selective eaters avoid isolation and stay connected. Stay connected... it's what's important now. CHILDRENStaying connected to parents: It’s not worth damaging your relationship with your child for short term goals. Meals ending in tears, mealtime “hostage negotiations” and conflict over getting your child to eat will likely make her eating worse, and can push a wedge between you and your child. Focus on pleasant mealtimes and routine meals and snacks. Our book Helping Your Child with Extreme Picky Eating tells you how, step by step.Protecting your child from outside pressure: Comments, teasing, shaming from family, friends and teachers can make your child self-conscious about eating with others. You may have to talk for your young child to fend off pressure....

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