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...

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...

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....

When “It’s Not Working”: 10 Opportunities to Support Children with Extreme Picky Eating

Helping your child with picky eating, extreme or not, is a marathon, not a sprint… When we work with clients, or hear from parents at workshops or parents who’ve read our book, the STEPS “click” right away for some: their children are less anxious, enjoying meals, and tuning in to appetite and curiosity about new foods. But occasionally we hear, “It’s not working!” Sound familiar? Then this post is for you. Much of the time when families struggle or see no progress, they are still working on getting some (or all) of the steps in place. Perhaps there is unaddressed fear and worry, or families are afraid to go “all in.” We’ve compiled a list of the ten most common opportunities that we see. But first, a reminder in broad terms of the STEPS+ we outline in our book (with chapter numbers for reference) Step 1: Decrease stress, anxiety (yours and your child’s), and power struggles (chapter 4) Step 2: Establish a routine (chapter 5) Step 3: Enjoy pleasant family meals (chapter 6) Step 4: Build skills in “what” and “how” to feed (chapter 7) Step 5: Strengthen and support oral motor and sensory skills (chapter 8) Top Ten Opportunities to Get in STEP and Help Your Picky Eater 1: You and your partner aren’t on the same page. Let’s say Dad makes Timmy earn dessert by eating a bite of veggie, or requires milk with meals, while Mom is trying not to pressure. (A 2014 study found that dads tend to pressure more than moms.) Result: There is no consistent approach, which is confusing for Timmy, and this increases his anxiety! (STEP...

Medscape’s ‘War and Peace at the Dinner Table’: Is MAKING Kids Eat the “Only Way”, and Other Points to Ponder

This clip won the America’s Funniest Home Video $10,000 prize. Is it helping her learn to like green beans?   As clinicians, parents, and experts in childhood feeding struggles, we are concerned about the one-sided nature of the online article and video War and Peace at the Dinner Table: Advising Parents of Picky Eaters, presenting advice to physicians on how to help children with extreme picky eating. Below, we present a discussion and resources for parents and professionals who might like to learn more. First off, we agree with the following points in the article: clinicians should take a parent’s concerns about picky eating seriously (Kerzner), and that ARFID (avoidant restrictive food intake disorder) or extreme picky eating (EPE) impacts family life and the social and emotional development of the child. We also agree that without support, a significant proportion of children will not outgrow their eating struggles and that mealtime “hygiene”, like avoiding grazing, supports appetite and curiosity around new foods. However, we feel that several statements are not supported by the evidence, and in the absence of a widely accepted ‘best’ practice, must be examined. 1) This sweeping generalization: These children don’t have sensory sensitivities. Many children who suffer from ARFID or EPE had medical or underlying conditions and challenges, including sensory issues, that contribute to the establishment of a feeding disorder (Arts-Rodas, Chatoor). The DSM-V ARFID diagnostic criteria recognize three subtypes of the disorder sensory (emphasis ours), associated with an aversive experience, or associated with low appetite. Sensory challenges are at least a contributing factor for many children with EPE, particularly for those on the autism...

“Help! My Child Isn’t Eating at School!” 8 Fuel-at-School Tips for Picky Eaters

School has started for some of us, and will start for the rest of the country soon! A big worry for parents of picky eaters, especially those with more extreme picky eating and anxiety, is what happens at school around food. We get emails with a variation on this theme all the time: “My son is six, we’ve struggled to get him to eat enough his whole life. It’s all worse at school where he is already anxious. He has twenty minutes, and lunch staff try to make him eat which makes him upset. They threaten to take away recess time. He comes home with his lunch untouched most days and is understandably crabby when I pick him up.” Government programs address child hunger, often through schools: from breakfast in the classroom to free and reduced lunches, millions of children are getting fuel for their day. But what about the “hidden hungry”? The kids these programs can’t help? There are hundreds of thousands of kids heading to school every day from homes with enough food and resources. But they are too distracted, anxious or scared to eat.     Helping Your Child with Fuel at School Gather information How much time does your child have to eat? Can he open containers on his own? Is temperature an issue? Does he prefer foods hot, warm or very cold? Is lunch right before recess, so he’s eager to get outside to maximize playtime? Is he eating in his snowsuit or carrying gloves, or has a hat that gets in his way? Are adults or other children pressuring him to eat? Ask him...

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