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...

Trust Your Turtle: Patience with Picky Eating Progress

Here’s a story I read recently and shared with a client when she asked, “How can I get my daughter to accept new foods on her plate once she’s feeling good about her safe foods? Can’t I just put them on her plate?”   A woman was with her college geology class on a field trip by a river. She noticed a turtle up the river bank near a road and worried that the turtle would get hit by a car. So, she carried the turtle back down the hill and put it in the water. Afterwards, the professor came to her and said, “That turtle has probably spent weeks crawling up the hill to lay her eggs in the muddy slope and now she will have to start all over again.” The moral was, “Ask the turtle first.” (Gloria Steinem from her book, My Life on the Road) (See below our clarification of “ask”. Most children won’t want to be verbally queried along the way. Our moral is to be responsive to your turtle.)    What does this have to do with feeding? Well, many children with extreme picky eating have anxiety around foods, and often have struggled for years. As parents, and even professionals, we hope for and want improvements NOW, or in say,  six weeks. But progress is generally slow, slow, slow, and it might not look like what we think of as “progress” (eating new foods). Sometimes when we miss early signs of progress (less anxiety, eating more safe foods, curious about foods but not yet tasting or eating them...) it is easy to want to rush the process, to pick up our little turtles and carry...

Confessions of a Mommy Feeding Therapist

Working with families who struggle to feed their children on a daily basis, I often hear, “Your kids must be great eaters!” or “I bet you don’t have any trouble at the table with your kids!”.  Well, let me tell you, it isn’t quite that simple. As a feeding therapist, I am confident that what I am suggesting to parents will at least help, and not hinder, their child’s progress with eating. When I am working with someone else’s child, I can see their issues objectively. That makes it fairly easy to navigate next steps and to tease apart what may be going wrong. I have done loads of research and reading on the topic, wrote a book, and provide therapy for children from newborns to teenagers. I do trainings for other therapists, physicians, and students. So you would think I would have all the answers with my own three kids, right? Not so much. At home, things are a little more complicated. Do my kids sit at the table and eat at most meals? Yes. Are mealtimes a beautifully harmonious experience where all three of my children eat complicated dishes with a smile on their face? Hasn’t happened yet- I am still waiting. So what does a feeding therapist’s family mealtime actually look like?  Here is a window into my world: Setting:  We eat at our kitchen table for all meals, using family-style serving. I do a lot of “pile-on” and deconstructed meals and we don’t pre-plate the kids’ food. I work full-time and the kids have lots of activities, so our meals are fairly simple, and I get take-out about once a week....

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...

Childhood Fears: Food or Fluffy, the Fear is Real

When M was little she had a dog phobia. I’m talking screaming, climbing on me, uncontrollable fear of even a toy poodle.  I can’t count how many people tried to talk her out of her fear, usually with a dog thrust into her personal space, and often against my explicit requests for them to stop. Take the German shepherd owner whose dog was off-leash, jumping on me while M clawed at my hair shrieking, and the owner kept smiling, “Oh, she won’t hurt you! She’s very gentle.” Well-intentioned dog owners (including friends and family) would bring dogs closer, insisting the dog wasn’t scary and everyone loved the dog, and, “Stop being so silly!” (super helpful)  or, “Look, Timmy is younger than you, and he’s petting the doggie!” (Throw some shame in while you’re at it! Works every time!)  I wish we could have had a sign at those times that said, “Seriously afraid of dogs. Back off. It’s not your job to get my kid over her fears…” It is this sticker that I saw on my walk home that led to this post. If I was behind a car on a hill and it started rolling, I might get mad or honk. But with this sign (Kid Driver   Manual), I know it’s a young person who is learning and I’ll be more patient. This sign reminds us to cut this kid driver some slack; have a little patience and understanding (something I struggle with behind the wheel sometimes). Of course it made me think of kids learning to eat. Imagine the child with extreme picky eating who only takes crackers at...

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)...

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