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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.

The Trauma Trap: Impact on Families and Feeding

The Trauma Trap: Impact on Families and Feeding

Trauma: • an injury (such as a wound) to living tissue caused by an extrinsic agent • a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury • an emotional upset   We don’t usually use the word trauma when discussing feeding disorders, but we should.   Children who have experienced significant emotional stress during feeding because of GI discomfort, poor oral control, cardio-respiratory issues, or forced feeding are at risk for disordered behavioral responses around feeding for many months (or years) to come. Infants born prematurely exhibit feeding problems due to neurological and respiratory immaturity and the myriad of issues that can arise while in the NICU. These challenges follow them out of the NICU and into the home, and while being able to go home is a milestone in and of itself, there are many more milestones to overcome when it comes to feeding. “During development, the cognitive, motor, emotional and ‘state’-regulating areas of the brain organize in response to experiences. And in each of the diverse brain systems which mediate specific functions, some element of previous experience is stored.” (Perry, 1999) The infant’s early experiences (good or bad) and their responses during feeding down the road are inevitably linked. Take Nash*, an 18 month old (corrected age) who struggles to get through a meal without gagging and vomiting. Born at 30 weeks gestation, he relied on a naso-gastric (NG) tube for nutrition for 6 months, which involved the trauma of reinsertion when the tube had to be changed as well as the chronic discomfort inherent in the placement of a... read more
My Child Choked and Won’t Eat! Help!

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... read more

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.... read more

conquer picky eating for teens and adults, what “conquer” means to you

When we were mulling over the title of our book for teens and adults, we hit on the word  “conquer.” Conquer Picky Eating for Teens and AdultsConquer is a bold word, and one that we invite you to define in a way that works for you.  conquer: to overcome, get the better of, control, master, get a grip on, deal with, cope with, surmount, rise above, get over; quell, quash, beat, triumph over As we write in the book: “Success” with eating looks different for different people. Some of you may turn into “foodies” down the road, and others will learn to enjoy enough foods to eat out comfortably, or you might add a handful of foods to round out basic nutritional needs. Why not reach for the stars? You might not have to settle for slogging through meals, or having to chase every bite with a slurp of soda or a piece of candy as you may have been told. For some, taking eating from a negative experience to at least neutral (or not unpleasant) may be enough.” What does “conquer” mean to you? What do you hope to rise above, triumph over, or deal with in terms of your relationship with food?    order now Share this... read more
Giving Your Teen a Self-help Book About Picky/Selective Eating

Giving Your Teen a Self-help Book About Picky/Selective Eating

Maybe you’ve given up hope. Maybe you decided fighting over every bite wasn’t worth it so your teen fixes a bowl of cereal or you pick up a plain burger and fries on the way home from work most nights. Maybe you are still trying the bribes, rewards, nagging, punishment tactics you’ve been doing for years.Maybe you eat dinner alone and your teen eats and texts in their room.Now there’s a new book, Conquer Picky Eating for Teens and Adults. We want your teen to have this book, that’s why we wrote it after all. We’ve heard from parents who are planning to buy this book for their teen. We’re glad… but we advise caution. For those of you who have read our first book (Helping Your Child with Extreme Picky Eating,  geared towards parents of younger children) you’ll know we review that for most selective eaters, pressure to eat, even rewards and praise, doesn’t work.So, how can you approach this topic of picky eating without your teen feeling it as pressure?  “It is normal for teens to seek independence from parents and this may include rejecting parental suggestions.”Erin VandenLangenberg PhD Ideally, we want teens to come to this work with their own motivations, to feel ready to take control of the process; to explore their past around eating, why they might have had picky eating that persisted beyond what is common for half of their peers. Turns out, temperament can play a big part. We’ve worked with countless families who shared how wonderfully independent and strong-willed their children could be (okay, they didn’t always say “wonderfully”) but you get the... read more
A Journey to Healing and Growth: One Mother’s Telling

A Journey to Healing and Growth: One Mother’s Telling

Bethany’s Journal: Amari’s Journey of Healing   Amari, age two, was adopted at age 14 months from Ethiopia and initially had some hoarding behaviors. After being home for about a year, her eating changed dramatically, with no identifiable cause. While underlying medical causes were being evaluated, Bethany needed help. The following are excerpts from Bethany’s notes and emails on the first few months during the transition from an anxious/pressured feeding relationship to one focused on routine, avoiding pressure, and healing anxiety. This post is largely excerpted from Katja’s first book Love Me, Feed Me,  focused on adoptive and fostering families. Bethany used responsive, trust-based philosophies expanded upon in the STEPS+ approach in our book, Helping Your Child with Extreme Picky Eating. This post is for informational purposes, and not meant to replace care of the individual child.   February 10, day one: A few months ago, she started to get pickier and ate less and less, eventually eating about five bites at each meal and down to two cups of milk a day and gaining nothing. She would pocket and take an hour to finish those bites. In one year home, she grew four inches and gained only nine ounces . . . We saw a nutritionist who told us how to sneak calories into her food. We saw a speech pathologist who determined that the issue was “psych” and barely glanced at her. In the last week, Amari has gotten SO much worse. She hardly drinks 1 and a half cups of milk/day, drinks nothing else, and takes about three bites at meals. I can force feed her more, but she gags constantly and... read more
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