Tag: feeding difficulties

The Best Ways Any Caregiver Can Support a Picky Eater

Mom is stressed, Dad’s frustrated, Grandma is worried… and a few more recognize that this little one should be eating more or have a wider variety in his diet. So, what can the village who loves this child do to help?

Every child is different and when I treat children with feeding difficulties, each child’s treatment plan looks different also. But, there are a few things that can be put in place with anyone, in any home and for almost every child that can support more individualized strategies used later.

I hear concerns about children with limited diets from parents, but also grandparents, aunts, uncles, daycare providers… The strategies recommended here are simple enough they can be implemented by anyone feeding the child. If all caregivers are working together to support the child, the positive outcomes will be seen quicker and with better staying power!

Make mealtimes enjoyable, fun and stress-free!

This point is absolutely the number one strategy! No other strategies will be effective without a pleasant mealtime environment and trusting relationships established between the child and her caregivers.  

Each one of us creates strong emotional memories when we eat. Think of your favorite foods and what that reminds you of… My husband absolutely loves sugared cereal… Froot Loops, Lucky Charms, Apple Jacks… Growing up, his dad had a long commute to work, so left early in the morning and came home late at night. As a boy, my husband wanted to see his dad during the day, so he would set his alarm early in the dark morning hours and eat breakfast (sugared cereal) with his dad before he left for his long drive. He’d then go back to bed to sleep a bit longer. My husband has fond memories of those early morning talks with his dad and has associated the food that he was eating with that fondness.

Now think of foods you can’t stand to eat or won’t even touch… My husband hates bananas and doesn’t even like them on the counter in our house. When he was young, he had a babysitter who was determined that he would finish all the food on his plate. He has memories of being force-fed bananas, with it squishing between his teeth as he was fighting it. He’s a grown man and still has definite strong aversions to even the thought of touching bananas.

So what emotions are swirling around your food being served at your house with your children? What’s the stress level with the adults and children? Children pick up on our adult stress level so quickly and profoundly, so it’s important that caregivers come to the table able to enjoy the meal also.

Eat together and enjoy social interactions around nourishing foods. Have fun! Create a mealtime environment that makes your child smile and feel at ease as you’re eating together. This means you may have to relax traditional table etiquette and that’s perfectly fine. Because in the long-term, we would rather have our child be able to independently eat a healthy, balanced, nourishing diet. Table etiquette rules can be implemented more fully at a slower pace after they’ve learned to acquire a taste for a well-balanced diet.

Creating a pleasant environment also means you are avoiding power struggles and stressful pressure on the child during the meal. Absolutely never, ever force feed a child! Don’t make them sit pouting at the table alone until they eat every last bite of food. Don’t require they stop eating a favorite food served with dinner because you feel they have already had too much. Part of enjoying a meal means the child feels a sense of control over their body, hunger cues and what enters their mouth. (If you’d like to learn more about this philosophy of feeding children, called The Division of Responsibility, The Ellyn Satter Institute is a great resource.)

Remember that the swirling smells and tastes of food and emotions at the table will mix together to form strong emotional memories during mealtimes. Caregivers have control over the mixture that will create a lifetime of emotional memories and food preferences.

Offer both preferred and non-preferred foods at meals and snacks. 

First off, I want to emphasize the word offer. The definition of offer is to present or proffer (something) for (someone) to accept or reject as so desired. Yes, in offering food you are presenting it to your child with the option to either accept or reject. That’s ok.

Tell your child that placing the food on the table or on their plate is not a requirement for them to eat it. In fact, don’t even ask your child to eat it, just tell them that this is what you’ve prepared and are offering them for their meal. If asking or requiring them to eat it creates too much stress, we’ve destroyed step number one of creating an enjoyable environment necessary for any other strategies to work.

A caregiver’s responsibility is to choose what foods to buy, prepare and present to nourish your child. Your child’s responsibility is to decide what and how much of that food to eat.

Make a list of safe foods your child will almost always eat. When planning your meals and snacks, be sure that at least one of those foods is always served with the family meal (not separate from the family meal). So, your family meal on the table may include goldfish crackers with spaghetti and salad for dinner or chicken nuggets with scrambled eggs, toast and orange juice for breakfast.

Now, make a list of foods your child won’t eat consistently, but you’d like them to incorporate into their diets. Be sure to include at least one of these foods at meals and snacks. I recommend offering foods everyone else is eating at the meal or snack. It’s convenient to offer a small spoonful and if it’s not eaten, it’s a such small amount that it’s not a worry when it’s thrown away.

Remember that caregivers decide what is offered, not the child. The child give some input, but the caregiver has the responsibility to make the ultimate decision. Caregivers will want to choose foods for a balanced meal with starches, proteins, fruits and vegetables. Include at least one food the child feels safe with and will almost always eat. Also include a non-preferred food that you’d like them to eat, even if you’re sure it will be rejected.

Yes, food may go in the garbage because we will allow the child to eat the food or not. That’s ok. Because food has been thrown away is NOT a reason to be a short order cook or hurry and make a second meal. The important recipe here is exposing the food to the child in an enjoyable mealtime environment. Caregivers and children will have another chance in a few hours to perform their jobs again at the next meal or snack and again after that… You can always load up on safe foods and only include one non-preferred food if the child didn’t eat much at the last meal.

Encourage interaction (not necessarily eating) with non-preferred foods. 

So far, we’ve created a pleasant mealtime environment without stress and have offered and introduced non-preferred foods into that safe environment.

For some children, just presenting a non-preferred food at mealtime, such as setting it on the table or serving it on their plate may be where you start with this step. They may not tolerate more than this. If that’s the case, don’t push any farther until they are comfortable with this minimal interaction of seeing it close by. Realize with the food even this close, they will be seeing what it looks like and smelling it, and really are interacting with some of the food’s sensory properties

From this point, you can slowly start to encourage and challenge the child to interact with the sensory properties of the food, while maintaining a safe and enjoyable environment. Look, smell, touch, listen to and finally taste the food. Ideally, interaction with the food should gradually get a little closer to the face and mouth until it is finally eaten.

Remember again that this step is where the child’s responsibility comes in to decide what and how much food they will eat. Every caregiver should absolutely respect the decision of the child. You can continue to encourage while maintaining a trusting relationship.

Support other caregivers without judgemental attitudes, especially the primary caregiver (usually Mom).

Feeding a child with feeding concerns is SOOOOO stressful! It’s hard to hide a caregiver’s stress from the child during mealtimes.

In my feeding therapy and my own mama experience, moms especially seem to carry a heavier load of guilt and worry if their child isn’t eating how they feel like they should. They also seem to hear and receive feedback and opinions from others sensitively, especially when they are already stressed.

Be supportive of the child and all caregivers. Share small successes. “She really liked helping me pass out carrots to the other children.” Or, “He seemed to enjoy making a smiley face out of his apple slices and even tasted it to his lips!”

Avoid pointing blame towards other caregivers. “If you were more strict, he’d eat more.” Or, “Well, he eats that at my house.”

Don’t sabotage mealtimes with treats, like unexpectedly showing up with a box full of donuts to eat just before dinner is being served. Ask the caregiver preparing the meal when an appropriate time would be to give treats and present it towards the end of the meal.

One caregiver can destroy a safe mealtime environment in every setting by force feeding. Never, ever force feed a child!

Seek out professional support sooner than later if these suggestions don’t help. 

Talk with your pediatrician or seek out an experienced pediatric occupational or speech therapist who specializes in feeding therapy. They can help screen for and identify underlying conditions or delays that may be hindering progress with your child’s eating and give more individualized treatment ideas. Don’t wait to seek out more support. Children who receive treatment earlier have better outcomes and often times need less professional support because they’ve avoided further complications. If you’re trying to decide if your child needs more help, this earlier post I’ve written, “When Does Picky Eating Become a Problem?”, may be helpful.

I’d love to be able to help in your northern Utah home with any feeding concerns. Happy eating!

6 Dos & Don’ts After Recognizing Your Child is Struggling & Receives a Special Needs Diagnosis

Your child’s been struggling and you’ve seen the signs, hoping that maybe your fears are wrong. You’re doing everything you can to help him and searching out resources. Maybe you are just recognizing the concerning signs or maybe you have just received an official diagnosis or maybe you’re in the middle of a long search, trying to find answers about why your child is struggling. Your emotions are intense and raw and tears are always close to the surface. The reality of your demands in caring for your child and the emotions that come along with that are overwhelming. Where do you start?

After over 15 years of working with children and adults with a wide variety of disabilities as an occupational therapist and with input from some wise and amazing parents of children with different special needs, I’d like to share 6 dos and don’ts to keep in mind while on your journey of parenting a child with special needs. The child you love is counting on you. You can do this!

1. Do educate yourself from reliable sources.
    Don’t believe that anyone has a crystal ball to predict what your child will do or become.

“Education [has] led to less frustration for me. I learned my daughter was having a hard time, not giving me a hard time. Talking to other parents helped me feel less alone and that I wasn’t crazy,” said one mother of a daughter with Sensory Processing Disorder. She also recommends finding support groups in physical locations or online. 

Another mom of a son with Autism says, “Understanding why [he] has certain difficult behaviors has made all the difference in the world as I try to cope with them. [He] does a kabillion things that drive me BONKERS…, but when I started learning about the reasons why [he] might be acting in these ways and the science behind it, suddenly it was more fascinating to me than it was annoying.”

Education helps you understand how to help and support and accommodate for your child. You will learn what can be expected and what can’t in different areas. You learn how to interact, how to create the best environments, what services, therapies, treatments, products and equipment may help. Parents who are always seeking out education will find the newest research and innovations on their child’s condition.

Seek out reliable sources and recognize not all resources are trustworthy. Ask doctors, therapists, teachers, and other special needs parents who are familiar with your child’s concerns about good resources. Internet searches will help you find many, but be ready to sift through them to find good and dependable sources and be emotionally prepared to deal with the worst-case scenarios you will find. One mom was given a diagnosis while her micropremie baby (born weighing less than 1 pound, 12 ounces or before 26 weeks gestation) was in the NICU (neonatal intensive care unit). “The doctor had given me lots of information, which I only remembered part of what he was saying [because my] emotions started kicking in. So I googled it… BAD idea… which made my anxiety even worse. Google is great, but it’s always [the] worst-case scenarios.”

Parents always want to know what to expect in the future. Doctors, professionals, experts and other resources want to give realistic expectations. But, no one has a crystal ball for what to expect for your child. Use your child’s prognosis as a guide, not a determination of a final outcome. Sometimes a child has better outcomes than expected and sometimes there are more complications than expected. Take it day by day and do your best with what you’ve learned.

2. Do create, maintain, strengthen and use your support system of family and friends.
    Don’t feel guilty for taking time to care for yourself and other members of your family.

A mother, whose child has received multiple diagnoses over several years, has had to repeatedly rely on her personal support system. After his most recent Autism diagnosis, she said, “I had every emotion you could think [of]. That’s when I really had to rely on family and of course, [my partner] the most! Having that support so you’re not in it alone makes a world of difference!!!”

Parents of children with special needs must learn to accept and ask for help from family and friends. Keep your personal relationships strong. Take care of yourself. Take care of your families. Remember that a loving and healthy home, family and caregivers are most important for your child. Never feel guilty for prioritizing that over offering every opportunity, service or experience available for your child with special needs. Find the right balance for your family.

“I can’t try every new therapy and every new medication I read about. I can’t be twenty-two places at the same time. I can’t neglect myself and those I love to care for my son. [He] is not the only member of this family, and I have to remind myself often that we cannot let everything revolve around him all the time,” says the mom of a child with Autism.

3. Do find and create a team of professionals, specialists and experts in the area of your child’s concern.
    Don’t exclude yourself from the team of experts.

Search out a team that you feel comfortable with and will listen to you. It’s OK to find a different doctor, therapist, school, etc. that you feel works well with you and your child. But remember, perfection is very hard to find, so settle for a good fit. You most likely will need professionals in the medical community, at school, and in the community. Advocate for your child by making allies, not enemies. Find ways to work together with your team, not fighting against them.

Write down your questions and concerns. Bring them to appointments and meetings. Ask questions and seek out information and resources from your team. Write down notes or ask for handouts and copies because you’ll need to remember and refer to that information again. Follow through on important recommendations from your team.

Remember that YOU are THE expert on your child. Don’t forget the importance of your input! No one knows your child like you do. During her first meeting with her son’s school, one mom realized, “Maybe I did know a thing or two that these experts didn’t. After all, they didn’t know that [he] needs help blocking out environmental stimulation before he can focus on a task, or that he will never, ever respond to a loud voice. They didn’t know that music is always the best way to calm him or that he will move heaven and earth for Nacho Cheese Doritos.”

Realize that you will be unofficially appointed as team manager and communications specialist between all team members. Take this job seriously. Learn to gather, organize and share important information from the doctors, to the therapists, to your child’s teachers and anyone else.

4. Do create a realistic perspective of your child’s abilities.
    Don’t let your child’s struggles or diagnosis become their identity.

Children with special needs will be different from their peers. After educating yourself and consulting with your team of experts, begin to create realistic expectations for your child. Her condition may always create significant differences from others for the rest of her life. An insightful mother realized that she needed to be mindful of the way she talked to her daughter about her struggles. “I knew that how I framed [her difficulties] would be how she would frame it. She wasn’t bad or broken, her brain just had a different operating system, like computers. How I spoke to her about it would become her inner voice.”

Your child’s condition or diagnosis will absolutely define who they become, but don’t let that be the only defining aspect of their identity. I’ve met nonverbal children who are wheelchair-bound that can brighten the entire mood in a roomful of people with one smile. I’ve met children who haven’t learned to make friends with their classmates, but can explain in detail about differences in a large range of dinosaur species. A little friend in my neighborhood struggles to sit still and listen to teachers, but she has no reservations in calling any person her friend and holding their hand as they walk together.

One mom tells, “[My daughter] still occasionally says, ‘I hate all my issues!’ but I often remind her that although she has a few struggles, she’s so much more than that. She’ll eventually learn coping skills to deal with her [condition], but she’s already mastered things that are really important in life like kindness, hard work, enthusiasm for learning, and compassion.”

5. Do expect your child to achieve.
    Don’t forget to celebrate even the smallest of achievements!

“Learning does not come as easily for [my son], and my tendency is to swoop in and make things easier for him, but the only way [he] is ever going to master a skill is if I don’t keep doing it for him. I firmly believe that EVERY child is capable of learning and growth, but we’ve got to stop making excuses for them. Have realistic expectations, but make sure you have expectations,” says one mom. Yes! Progress is possible with hard work. Give your child the opportunity to work hard with the right expectations and support. Your team can help you and your child prioritize and set realistic goals to strive for.

Celebrate even the smallest of achievements! “We celebrate taking one tiny bite of meat or the fact that he’ll not lose his mind over something on his hands… We celebrate all the small things that are an everyday normal to some.” Involve those who know your child well in those celebrations. Not everyone will recognize what big achievements these small steps really are, so share them with your support systems and your child’s team.

6. Do live in the moment.
    Don’t forget to laugh!

A wise mother of a daughter with Cerebral Palsy says, “Live in the moment—good or bad—and [don’t] let the future dominate your thoughts. Obviously, make necessary plans, etc., but don’t let worry about future hurdles or joy about imagined future success take up much of your time. It has taken me several years, but I have learned that by living in each moment of each day, I can enjoy the surprising pleasures of this crazy adventure without borrowing trouble from my future self.”

Another mom who often shares funny stories of her son with Autism says, “Humor has saved my life. Laughter changes everything when you find yourself in a high-stress environment, and it has been my saving grace. Cultivate the ability to find humor in the unexpected, and your life will be so much easier!” (I’ve shared many thoughts from this mom, who recently wrote a similar article about receiving her son’s diagnosis of Autism on my blog here.)

Yes, this journey of parenting a special needs child will be exhausting, overwhelming and full of sadness and tears. But, make plenty of room for joy and laughter and fulfillment with your child! Again, I remind you… The child you love is counting on you! You can do this!

How a Simple Teal Pumpkin on Your Porch Can Make a Difference for a Child on Halloween

Halloween celebrations always include dressing up in a costume and candy! I have so many little friends who excitedly anticipate Halloween night and trick-or-treating, including my little friends who have severe food allergies, are on special diets for medical reasons or are unable to eat food by mouth and are supported by tube feedings. The parents of these children work tirelessly to provide and support typical childhood experiences as much as possible. As children get older, they learn about childhood cultural traditions that siblings, cousins and friends do and they want to join in the excitement also.

A fun-filled Halloween night of trick-or-treating can turn into pure disappointment when candy buckets are dumped and sorted upon returning home… Only to realize that from the large loot gathered, you can only safely eat or keep a few of the treats or none at all! Everything else must be thrown away or worse, given to your siblings to eat!

You can help with some very simple things to make some of these children have an enjoyable Halloween and minimize the disappointment. Join the Teal Pumpkin Project!

Set a teal pumpkin on your porch! A teal pumpkin is a sign to families of children with food allergies and feeding difficulties that your house will be handing out non-food treats… stickers, pencils, small toys, glow sticks, temporary tattoos, etc. Many of you are already doing this, but let those families know with your teal pumpkin so they can add another house to their route of safe houses they plan to visit with their children.

My friend, Ryder, loves to dress up in theme with his parents every Halloween. Last year, he dressed up as Toothless from How to Train Your Dragon. His mom and dad dressed up as Vikings. He loves walking the neighborhood and joining in the Halloween fun. Ryder has an extensive list of food allergies and sensitivities that prohibit him from eating all but a very short list of foods. So, it comes to the point that he cannot safely eat ANY Halloween candy. How a Simple Teal Pumpkin on Your Porch Can Make a Difference for a Child on Halloween

His mom, Kim, loves the Teal Pumpkin Project and puts a teal pumpkin on their porch every year. She makes sure she has non-food treats to hand out to trick-or-treaters. When they went trick-or-treating last year in Morgan, Utah, they didn’t see any teal pumpkins in the neighborhoods they were in. Kim wishes more people handed out non-food treats. Ryder loves stickers, little toys and bubbles. Fortunately, Ryder has a sweet grandma that prepares a special non-food treat package for him every Halloween.

Confession: Several years ago I decided to plan ahead for Halloween and buy bulk bags of candy (mostly chocolate since that’s my favorite), but I ate almost all of the candy before Halloween came! Now I buy my non-food treats early and and candy last-minute to avoid my chocolate addictive behaviors! Win-win for any candy addicts like me!

My daughter loves painting a teal pumpkin and insists on adding her own artistic flair. She is excited to paint another this year to set out on the porch to signal anyone who prefers non-food treats. My sons make sure we still hand out candy for anyone else (or eat it themselves before any trick-or-treaters arrive). How a Simple Teal Pumpkin on Your Porch Can Make a Difference for a Child on Halloween

A few tips to keep in mind:

  • Set your teal pumpkin out before Halloween night so families can plan to make it to your house.
  • Keep food and non-food items in separate containers to avoid allergens touching the non-food items.
  • Avoid non-food items with latex or wheat. Some clays contain wheat.
  • If you don’t have time to paint a teal pumpkin, click on this link to download and print out a free sign at food allergy.org. Or if you’re interested in making a donation to the Teal Pumpkin Project, FARE (Food Allergy Research & Education) will send you a Teal Pumpkin Project window cling.
  • You can also add your house address to the Crowd Sourced Fever Map on food allergy.org to let others in your area know you will be participating in the Teal Pumpkin Project.

For more information on the Teal Pumpkin Project, visit foodallergy.org.

Teal and orange compliment each other well, so use both colors for front-porch pumpkin decorating! You can make such a difference for a child who struggles with feeding difficulties with this simple change in your Halloween decorations and treats handed out on Halloween night!