by Katja | Jan 3, 2019 | extreme picky eating, Uncategorized
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...
by Jennifer | Jul 22, 2018 | anxiety, extreme picky eating, parent experience, research, Responsive 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...
