Feeding Consultation

This morning I spent two hours on the phone with specialists at the Fraser Center.  By far the most important part of the morning was when I spoke to someone regarding feeding and mealtime.

Amelia is a picky eater.  I've heard people tell me, "if she's hungry, she'll eat" more than once.  It always upsets me because I (and Jason) know her better than anyone and I realized early on that that wasn't necessarily true with her.  In fact, it was one of the first things that I brought up this morning and I shared that I didn't feel that it was the case with her.  The therapist I was speaking with couldn't have agreed more - some kids will not eat, even if they are hungry.  

Children that have a sensory issue often will not eat if they are "hung up" on something.  Amelia is a very visual child - especially when it comes to eating.  Example?  If you give her a piece of cheese and it is not whole, she will not eat it because it is "broken."  If something is visually off to her, she will not eat.  Even if she is hungry.  You cannot make her eat it.  

With all that being said, here are some things that we will be working on with her:

• Offering smaller portions.  Children with sensory problems, especially visual ones, can often feel overwhelmed at the sight of too much food - even if it is a familiar and accepted food.   
• Offer our meal in small portions alongside her chosen meal.  If we are having tacos and she would like Macaroni and Cheese, we will make her the macaroni and offer her some taco fixins' on the side.  I imagine her divided plate will be very useful in doing this!  
• When offering new foods, do so with zero expectation.  By not putting pressure on her to eat the foreign foods the idea is that she will get used to seeing certain things on her plate and one day she will probably just try it on her own.  *All we can do is try with this one.  It is clear that the pressuring her to eat new things does not work!  In fact, all it accomplishes is her leaving the table upset and not eating a thing.
• Setting the table.  We plan to teach her to set the table for everyone who is eating.  Why?  To put a stop to this:

November 2011

One of Jason's biggest issues with mealtime is the fact that she brings every piece of her flatware to the table.  (I've sort of let it go at this point.)  We've tried hiding some of it but she knows it is gone.  We've tried giving her just one fork and one spoon but she needs it all.  We are going to teach her that each plate gets one fork and one spoon and then we are done.  They think she needs it all there because to her the drawer being empty signifies "done."  We need to teach her a new "done."  

• Bridging.  In order to get her used to new flavors we will blend it with things she likes.  One suggestion today was marinara sauce.  She will sometimes eat it but often won't.  It was suggested that we blend it with ricotta cheese to turn it more pink.  We know she loves cheese so having the cheesy flavor will likely make her enjoy the "pink" sauce.  Over time we would reduce how much ricotta was mixed in until she was just eating straight marinara.  Another example of bridging would be in changing one element of an accepted food.  An example would be pasta.  We know she loves pasta so try different colored pasta.  I have actually done this.  I got her orange  farfalle vegetable pasta (tomatoes and carrots) because I wanted to get some more nutrients into her.  She refused it because it was orange.  Once she had an interest in butterflies we revisited this pasta and now she loves to eat "orange butterflies" for dinner.  In this example I changed the color of the pasta but I also related it to an interest of hers which I was told to continue doing whenever possible!
• Small utensils for small tastes.  Offer her teeny, tiny tastes of new foods on toothpicks.  If she tries it, great!  We're opening the door to trying new things - even if it is just a microscopic taste.  The important thing is that she let her guard down and tried it.  That's what we want.
• Juice.  I was informed that juice can sometimes trigger hunger in people.  She compared it to soda drinkers tending to snack more often - the sugar makes them hungry.  By offering a small amount of juice thirty minutes before mealtime we may be able to remind her body that she is hungry.
• Limiting milk intake.  This is something that we have been doing for quite some time now.  Amelia loves, loves, loves her milk.  She would drink it all day, sun up to sun down, if we let her.  Now we give her some at each mealtime whether she eats or not.  She also gets a cup between meals as well as one at bedtime.  She was filling up on so much milk that she was not hungry at all - ever.  Her speech therapist actually was the one that suggested we do this and it has worked great!  Plus, her overnights don't leak nearly as often anymore ;)
• Food groups.  It was suggested that we try to get her to eat her way through the food groups weekly vs. daily.  At this point she is nowhere near getting a meat, dairy, vegetable, fruit and grain each meal or even each day.  The weekly goal seems much more attainable to me and as we work on building her menu this will come more easily - I hope.

As you can see, we have a lot to work on!