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*The information on this blog and website is for informational purposes only. It is not meant to replace careful evaluation and treatment. If you have concerns about your or your  child’s eating, nutrition or growth, consult a doctor.

Keeping Your Kids Hydrated in the Heat

Keeping Your Kids Hydrated in the Heat

It’s summertime and as the weather heats up, staying hydrated is even more important, especially for our little ones! Dehydration can lead to loss of energy, lethargy, irritability, headaches, difficulty sleeping, constipation, fainting and if severe, can lead to more dire consequences*. Sometimes that cranky toddler is really a thirsty toddler, but with regular opportunities to drink and take in food with high water content, almost all children do just fine. (Use common sense around activity on hot days and sun exposure. Some kids are more sensitive than others, so watch your child and maybe skip that all-day soccer tournament when the temperature is in the 90’s!) Here are some tips to keep your children well hydrated and happy during the summer months. Pushing children to do anything around eating and drinking can backfire, so avoid pressuring them to drink more. Instead, try these ideas:   For the child who enjoys strong or interesting flavors, consider offering tart juices like cranberry or pomegranate, or add lime or lemon juice to water. If they seem to enjoy the carbonation of soda, offer flavored seltzer water or mix sparkling water with juice. Turning up their nose at plain water? Consider adding water flavoring like Mio, Hansen’s Natural Fruit Stix, or watered-down juice or Gatorade. Get shaped ice cube trays and make ice from juice or water for a fun addition to water. Let them pick out a special new cup that they can drink from at home and on the go. Keep an insulated cup in the car during days spent driving around in the heat. Show your child how to use the... read more
Five ways facilitation can turn into pressure with extreme picky eating

Five ways facilitation can turn into pressure with extreme picky eating

1. Offer opportunities to sample new foods in a low-pressure environment such as Costco, Trader-Joes or other stores with samples. facilitation: “I’m glad you liked it, I’ll pick some up next time I’m at Kroger (Walmart, etc.). Can you help me find oranges?” pressure: “Okay, but there are 64 of them and you promise you’ll eat them all if I buy them?” (“I will!” he insists, but you still have 62 of them a year later…) 2. Your child eats some gnocchi with pesto off your plate at a restaurant. facilitation: Offer to put a few on his plate (if you are comfortable with it he may continue to eat them from your plate for now if he doesn’t want them on his plate). Maybe pick up some gnocchi later in the week or offer pesto with pasta as an option the next time you serve spaghetti. (You could try to ask what he likes about the dish, the pesto or the gnocchi, but keep it casual and change the topic. Consider not drawing attention to it if your child is super sensitive to any interest/focus on his eating…) pressure: On the way home you go to a store and buy two packages of gnocchi and three jars of pesto, telling your son, “We’ll have it again tomorrow since you liked it so much! We’re so proud of you that you added a new food!” 3. Offer a paper napkin with meals so your child can spit food out (get food out of their mouth without gagging or vomiting). facilitation: Place the napkin next to each setting, or have a child... read more
One Page Essentials Handout for Extreme Picky Eating

One Page Essentials Handout for Extreme Picky Eating

Parents often ask us for concise information for family and friends: perhaps a grandparent will have your child who struggles with eating for the weekend or you want to share your philosophy with a nanny or childcare provider. Here is a one page handout (click here for free, printable PDF Extreme Picky Eating Essentials) perfect to stick to the fridge or the inside of a kitchen cabinet! Share the blog to preserve links with more information. Let’s face it, your parents probably won’t read a book, but they might read a one page handout and a few links!                                                     Essentials of Helping a Child with Extreme Picky Eating There are many reasons why a child might not eat enough quantity or variety to support healthy emotional, physical, or social development. These are complex issues, not the result of a child just being naughty. Help a child with extreme picky eating by reducing anxiety and supporting appetite with routine and pleasant meals. Progress may take longer than you’d like, but pressure, bribes, rewards, threats, and even praise can slow the process. Here are some ways to help children learn to enjoy new foods, and eat the right amount for healthy growth. (For more, read Helping Your Child with Extreme Picky Eating.) Rotate a variety of foods at meals and snacks, including foods the family enjoys. Use this food preferences list to help with ideas of what to serve. Offer foods many ways, many times. Consider blueberries: rotate... read more
When You Worry That it Won’t Work: Lessons from Responsive Tube Weaning (Guest Post 2)

When You Worry That it Won’t Work: Lessons from Responsive Tube Weaning (Guest Post 2)

This is the second part of our series around using Responsive Feeding Therapy when the stakes are the highest.  Our first guest post from Heidi Moreland from Thrive by Spectrum Pediatrics can be found here. When You Worry That It Won’t Work Elisabeth Kraus, MiT; Becky Keifer, MA-SLP, CCC; Lisa Grentz, RD Growing Independent Eaters I’ll never forget that phone call.   I was speaking with a mom who had spent the last years trying to be everything, and everyONE, that her little girl needed. A dietitian herself, she wept as she told me that she never imagined that her child would struggle to eat – struggle badly enough to require tube feeding in order to grow, in order to stay alive. And here they were, years into their journey, her daughter eating and drinking nothing by mouth, all while she tried to function as dietitian, nurse, doctor, feeding therapist, house cleaner, chauffeur, cook, and everything else that you can possibly imagine. Nothing, she told me, was helping her daughter learn how to eat, and she was exhausted – tired from the years of trying to do it all.  “I just want the chance to be a mom,” she said. “I’m don’t think I can keep doing it all.” I’m not sure if she knew, but I sat on the other end of that phone call, crying myself as I recognized so deeply the pain she felt. She wanted her baby to be okay. She just wanted her baby to eat, not just because she had to, but because she experienced the wonder of family mealtimes and the food... read more
Responsive Feeding Therapy with Severe Feeding Challenges: Lessons from Responsive Tube Weaning (Guest Post 1)

Responsive Feeding Therapy with Severe Feeding Challenges: Lessons from Responsive Tube Weaning (Guest Post 1)

From parents and even professionals at workshops, we are often asked, “Well, Responsive Feeding Therapy sounds good, but does it work for children with severe challenges, or who ‘can’t’ feel hunger due to medical issues or feeding tubes?”  In this first guest post of two, we explore responsive therapies where relationship, autonomy and trust are guiding principals. The lessons learned from these challenging cases can apply to every family struggling with a child who is an anxious or reluctant eater.                             Heidi Moreland graciously shares some of her thoughts around tube weaning. Heidi Liefer Moreland, MS, CCC-SLP, BCS-S, CLCKids who are on feeding tubes have often missed the early period of learning to eat. For some of them, the medical difficulties that led to the placement of the feeding tube may continue to impact their development.  On top of that, the feeding tube itself will impact hunger, making learning to eat seem like unnecessary work. Children who are fearful, who learn more slowly, or have more difficulty with physical coordination are at even greater risk of getting “stuck” in a pattern of fear, feeding refusal and family frustration.Unfortunately, that often leads to the belief that they can’t or won’t learn to eat in the way that other children do. Parents and other professionals feel that if they want to help children become oral eaters they have no alternative to direct instruction, bribing, or forceful feeding tactics.  The problem is that we know those strategies are harmful to a healthy relationship with food and result in the most fragile eaters... read more
Weaning off Distractions with Extreme Picky Eating

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... read more
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