Brody’s Journey: One family’s path to tube-weaning and eating by mouth

By: Ashlei Fisher Brody William Fisher was born on July 5, 2015 weighing in at 7 pounds 8 ounces and measuring 20 ½ inches long. He was perfect in every way and still is. He nursed well and took pumped breast milk from a bottle with no problems. He loved baby food when he was 6 months old and ate every drop of yummy fruits & veggies. Around 2 ½ months old, I noticed a dip in Brody’s chest wall as I was about to bathe him one evening. I immediately showed my husband and called the pediatrician the next morning. She had us get x-rays taken and quickly referred us to an orthopedic surgeon. He sent us to get an MRI when Brody was 3 months old. He was diagnosed with scoliosis and needed to be monitored. The curves continued to progress in that time, so the orthopedic surgeon applied a Mehta cast when he was 7 months old. The first cast went well, however his second cast application was extremely tight. Frightening vomiting started and then he quickly stopped eating, drinking, peeing, and pooping. I had never seen vomit like what I was seeing come out of my baby boy. I would give him 1 oz. of milk and he would projectile vomit it all over me and the floor. I rushed him to the emergency room, where they removed the cast. After that, he wasn’t keeping anything down and started to drastically lose weight. We were referred to a GI specialist who did numerous tests and told me Brody had a sliding hiatal hernia, which means...

“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...

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....

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)...

The Manners Monster: 5 Tips for Taming the Beast at the Table

Do you ever find yourself wanting to pull out your hair at mealtimes because your children’s manners are atrocious? I do. From my almost-tween putting his feet on other people’s chairs and sitting sideways while he eats, to my second son burping loudly and using his hands to eat, to my preschooler throwing her food at her brothers (among other things). Sigh. It is a daily occurrence, and it requires even the most Zen of parents to dig deep for that calm place. I find myself asking my husband, “Are we raising a brood of Neanderthals?” But, we aren’t (even though I could swear it at times!). We are raising children, and they are not little adults. They don’t have the social awareness to know that their behavior isn’t appropriate, and it is up to us to gently guide them so they won’t end up being shunned from social gatherings. However, even though we know what the end goal is, there are considerations when we are talking about the acquisition of manners. Much of what seems like bad manners may actually be typical development, or may help children with sensory issues learn about their food. Using hands instead of utensils is normal as little ones explore the physical properties of their food and gain skills with utensils. They may switch back and forth for a while, depending on what type of food it is, how hungry they are, and what their experience and comfort is with that particular food. There is also the possibility that your child actually can’t help it. Consider the elementary-aged child who was constantly told to chew with her mouth closed; she finally was able to...

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...

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