Laying the Foundation--Part 2 of "Family Food Fights"

Without a comprehensive feeding evaluation to further investigate feeding history, possible allergies and GI complications, respiratory health, sensory responses and oral motor feeding skills it is impossible to give an accurate opinion in regard to WHY meals are difficult and stressful for you, your family and your child. We must look at the whole child and his everyday feeding environment, current diet, meal schedules and many other factors before reaching a conclusion or starting point. It is best to first seek a feeding evaluation and go from there. In this post I want to give some general tips to help reduce mealtime stress and help lay the foundation for successful feeding.

What is your routine? Do you have regular meals and snacks scheduled for your child or is your child prone to graze throughout the day? Work toward 3 meals and 2 snacks spaced throughout the day, with the snacks being lower in fat and calories in order to allow for increased hunger at meal time.  Some children with feeding tubes can only manage small amounts of food during a given time therefore working toward a consistent schedule can be difficult. It is not always easy to find that balance between gastrointestinal comfort and satiety. For example if your tube-fed child is retching or vomiting during tube feedings then it is not the best time to introduce tastes or new foods--negative associations are formed rather quickly. We find this to be true with the child who has suffered from reflux. Discomfort in general is a barrier to successful eating. To read more about mealtime routines click on Establishing Mealtime Routines.

Does your child insist on eating only a specific food, possibly from a specific restaurant or is he particular with brands, shapes, textures?  Children with sensory based feeding complications have more difficulty with introducing change and variety,  but as a parent of a 5 year old I know that 'food jags' are easily created and it takes a lot of effort to make that transition from McDonald's chicken nuggets to a healthier homemade version of a nugget. Children often have a fear of the unknown or a new food, known as "neophobia" and this can begin at age 2 and earlier!  I suggest you read and share with others on the topics of food jags and sensory 'steps to eating' on page 4 of this issue of Journal of Pediatric Nutrition and Development and work toward expanding on those jags by reading Suggestions on Expanding Current Foods. 

Remember in the post on Family Food Fights  how our own stressors as parents can influence our childrens eating.  Feeding struggles alone can be a big enough stressor, causing arguments and tension between spouses and family members.  Add in work stress and responsibilities, parenting responsibilities, a long day, the 'witching' hour for those who have newborns (ME!) and exhaustion and you have quite the recipe for a disastrous mealtime experience.  I remember how I felt at different times at different points in my life and on those days when I had the time to talk to my daughter about what we would be having for dinner in advance, had her pick out something from the store with me, go to the farmers market or participate in the meal preparation or ideas, set the table with her help, lit a candle and put on some music...we had a pleasant meal.  EVEN with some new or different foods.  Stress was low, expectations were set according to principles from Division of Responsibility paired with her comfort level with various sensory 'steps to eating'.  Sometimes it is best just to let go of all control and see what happens.  It is also good to plan for your child to choose the meal one night.  Take the stress off of everyone.  Allow for success all around.  What are your Attitudes toward Mealtime?   Review these Steps toward Succesful Eating and see what you can do now to make a change for the better.Getting on the same page with the rest of your family can be difficult but hopefully you can get there and be well on your way to a happy mealtime!