Love me, feed me: part two

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Author: 
Katja Rowell, MD
Source: 
Focus on Adoption magazine

Most folks who work with kids and food begin with a question: “What to feed?”

There are countless articles and books about how to disguise veggies or sneak in more protein. But without steps one and two in place (the “how” of feeding, or the “feeding relationship”–see “Love Me, Feed Me” part one), step three is even more of a struggle. The key to improving what kids eat boils down to how they are being fed. Let the child count on enjoyable, no-pressure, family meals that include a variety of tasty foods.

Parents have heard about the USDA Food Pyramid for years, and MyPlate more recently [Ed. Note: these are American government-published nutrition guides similar to Canada’s Food Guide], but trying to follow too many prescriptive rules brings pressure into the feeding relationship. Young children tend to eat erratically, consuming a lot at lunch and almost nothing at snacktime, or vice versa, and most often picking one or two foods from what is available. Kids who are offered a variety of foods without pressure tend to consume a balanced diet over several
days.

At meals, try to offer:

  • One or two grains, one being bread or cultural equivalent (carbohydrate)
  • Two fruits/veggies (carbohydrate and fiber)
  • One dairy or dairy substitute (protein, fat, and carbohydrate)
  • One meat or bean or nut (protein and fat)

Offering fat, protein, and carbohydrates, at meals and snacks, is essential for stable blood sugar levels and  energy. I see too many parents offer their child a snack of Goldfish crackers and juice, or peeled apple slices and juice. Such snacks are generally followed, 30 to 60 minutes later, with a meltdown or whining for more food.  Carbohydrates offer quick energy and are certainly necessary and favoured (particularly by small, growing  children), but protein and fat (and fiber) are also needed to help the child feel full and to give him the extended  energy to make it to the next meal or snack.

Notice that I did not say, “Get the child to eat fat, protein, and carbohydrates.” I say, “Offer them.”

While it’s work to put all these options on the table, it can save time and aggravation. A parent’s food prep job is done when the food is on the table. There should be no separate meals for kids and no need to argue or negotiate over food.

Addressing food insecurity

When children are not fed reliably, do not get enough food, or have to compete for enough, they develop food  anxiety. If a child hasn’t been able to count on being fed, he will have trouble trusting or understanding that it is coming again.

“Marcus liked to hold and play with teething biscuits. He would chew on one a little, then lose interest, but keep it clutched in his hands for hours. If we tried to take it from him, he became very angry,” said Sue, soon after adopting her 18-month-old son.

Many resources on adoption and hoarding advise allowing the child to have snacks in his backpack or carry food  in a pocket, or even to keep Tupperware containers of food in his bedroom at night. Consider Marcus, who did  not want to let go of his biscuit. He might be allowed to hang on to it for a while, and maybe even to keep one in a baggie in his pocket. Follow his lead. If he throws a tantrum about having his biscuit taken away, allow him to  carry it. But the parent must also be absolutely reliable about regularly providing food. You may need to offer  food frequently during the initial post-adoption period, perhaps every hour or so.

My main concern with the general recommendation of allowing kids with a history of food insecurity to have their own food stash is that it may make parents less concerned with providing regular meals and snacks. Also, the  child allowed to get food whenever he wants may still feel responsible for feeding himself. It is a missed  opportunity to deepen the attachment with your child. Feeding your child directly shows her that you will take care of her. It builds trust. Completing the cycle of need and having her need met, over and over again, is the  basis for attachment.

One foster mom had a little boy she couldn’t keep out of the fridge. On occasion, he would eat to the point of  making himself sick. The mom didn’t want to lock the fridge, feeling that restricting his food access was the wrong strategy. Instead, she assigned one of the refrigerator drawers to him. She stocked it with food that he  liked, and told him that the drawer would always be full. While he could not take food at random, this drawer was his. He checked the drawer often, with Mom’s reassurance that this was his food, and he could choose from it for meals and snack times. She stuck to a consistent schedule of meals and snacks, and made certain that the drawer was never empty. Gradually, he forgot about the drawer.

Another boy, adopted as a preschooler, loved cereal. He would frantically gobble as much as he could, and cry if he was limited. His parents realized that, when he saw an empty cereal box, he thought there would be no more cereal, ever. Overstocking the pantry with his favorite cereals reassured him. At breakfast, he was allowed to eat  as much as he wanted. During the day, frequent trips to the pantry with a parent assured him that he would get  enough. Pretty soon, he was eating about the same amount as his brother and was no longer anxious at meals.

While you can allow access to food, or let your child clutch a biscuit for hours, don’t use constant access to food  as an “easy out” from the task of reliable feeding. The way to lessen hoarding behaviors is to lessen anxiety about food. The best way to lessen anxiety about food is to be reliable about feeding, and not to limit what your child eats. Your child may need reassurances, such as “There will always be enough food.” Show him the well-stocked pantry and say, “See, there is always enough food here.”

Your first meals together

You may have months to prepare for the arrival of your child, or, in the case of foster care, hours. If you are able to find out what foods your child is used to eating, having these on hand may help with the transition. However, you may not know your child’s history with food. Assume that it has been less than ideal, and be absolutely  reliable about providing food. Your child won’t know she can trust you yet, so showing her, with feeding and  everything else, will help her feel safe and begin the process of attachment.

You may want to offer a meal or snack every few hours during the transition period, even for an older child. For a younger child, offer food in different forms, especially if you don’t know her skills with eating. Have a bottle with a few nipple options, a sippy and a straw cup, some soft foods, and some finger-food options. Your child will let you know what she is ready for and what she likes to eat. Sit with your child and reassure her she can eat as much, or as little, as she wants.

When eight-month-old Adina was adopted from Ethiopia, her weight-for-length was close to the 80th percentile. Her mother, Rebecca, was told that her daughter had been “overfed” in the orphanage and was advised to limit formula. Even though Adina screamed after every feeding and clearly seemed interested in eating more, her  mother thought she should stick to the limits her pediatrician had advised. Adina’s trust in her new mother was undermined from the start.

Adina is now two years old, and the family is changing to the Trust Model. Rebecca says, “I did what the doctor told us to do. Now I wonder: If I had given her a few ounces more here and there, and let her decide when she was done, maybe she wouldn’t have developed such a serious food obsession.”

You may have heard the phrase “food is love,” but when you think about it, feeding is love. Food is sustenance, feeding is nurturing. A scrambled egg on a plate is delicious and fulfills nutritional needs. But scrambled eggs shared over a smile and a chat about weekend plans brings you together. Food is food and feeding is love. Add a pinch or a generous handful of love to every meal.

Don't forget to read "Love me, feed me: part one".

Katja Rowell, M.D., specializes in helping families with feeding and weight worries. This piece was adapted from Love Me, Feed Me: The Adoptive Parent’s Guide to Ending the Worry About Weight, Picky Eating, Power Struggles, and More. Check out Dr. Rowell's YouTube channel, The Feeding Doctor, for brief videos on various topics, from snacks done right to  feeding well when eating out.

Reprinted with permission from Adoptive Families magazine. For more articles like this one, to subscribe, or to sign up for the AF newsletter, visit Adoptive Families online. www.AdoptiveFamilies.com.

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