The Blame Game
Is it my fault? Did I cause my child's poor eating? Was it something I did?
This week alone I have been asked all of these questions. One dad said, "I feel like a failure." This from a dad who dedicates hours every day to help his little boy be the best he can be - he supports him in learning to communicate, eat different foods, dress himself and in countless other ways. It brought tears to my eyes. He is a champion dad - not a failure.
I would be hard pressed to think of a parent that I have seen who has not tried every tip, trick and recommendation they have been given to improve their child's eating. They have served new foods hundreds of times, not just twenty as the paediatrician advised. They have baked, steamed and fried and have spent hours trying to perfect the homemade chicken nugget. Recipe after recipe has been tried and meal after meal has ended in tears and in the bin.
Out of complete desperation, they have tried bribing, begging, crying or shouting! Not because they think it will work but because they feel guilty that their child is not eating the "right" foods or is eating the same foods every single day - they are exhausted and they are ready to give up. And who do they blame? Themselves!
So did these parents who tried everything, cause the poor eating? Is it their fault?
The children I see tend to fall into one of three main groups when it comes to the underlying cause of their poor eating.
- Physical causes
A number of physical causes can impact a child's eating. Allergies, intolerances, reflux, low iron and constipation to name a few.
I would like to spend a little bit of time talking about poo. Did you know that a child can open their bowels every day and still be severely constipated? And that children with very loose stools can be constipated too?
Stools can build up in the body and the longer they remain, the harder they get as the body draws the moisture from them. Constipation can cause feelings of bloating and fullness and can wreak havoc on reflux, eating, sleeping and behaviour.
What appears to be diarrhoea, can in fact be overflow where liquid passes around the hard stools.
If your child has very hard or very loose stools, I would highly recommend speaking to your doctor. If your child’s eating, sleeping, behaviour or reflux has deteriorated I would always consider whether they could be constipated.
- Sensory causes
This group often has no known physical issues but in their history they have had difficulty starting solids or difficulty moving onto lumpy textured or finger foods from puree. As toddlers and older children they often prefer one texture of food such as dry and crunchy.
Many of these children are sensitive to other things in their world, not just food. They might be sensitive to noises, crowds, getting their hands dirty or tags in their clothes. The list can go on and on.
These are children that are often very set in what foods they do and don’t eat, what the foods have to look like and how they are presented. They are frequently very sensitive to small changes in the shape, texture or temperature of their foods and will refuse to eat a food if it is not just the way they like it.
Anxiety around mealtimes is almost always present.
Sensory based feeding difficulties can be difficult to understand and family members will often describe the parents as being “too soft” on the child or the child as being “naughty” or “stubborn”.
Children with sensitive sensory systems are already overwhelmed daily by all the sensory information around them. Eating requires every sensory system in the body to function at the same time, making eating a challenging and stressful experience.
One of the ways that these children help to maintain a feeling of control is by being rigid in the food choices they make. The small range of foods they eat, make them feel calm and safe and that the world is ok.
- BOTH physical and sensory causes
My biggest group by far. Almost all of the children that I see who have had early physical issues that impact their feeding have some level of sensory sensitivity.
The combination of both physical and sensory issues can, of course, have a significant impact on eating and on mealtime behaviours.
Refusing to eat at the table, needing the television on to eat, eating a different meal to the rest of the family, becoming upset if a new food is placed on their plate, refusing to even touch new foods, asking for food and then refusing to eat and becoming anxious at mealtimes are all common behaviours seen in children with physical, sensory or a combination of causes.
Are there things that parents can do to change their child’s eating? Absolutely! For most of the children I see, the recommendation of “just keep offering the food you want them to eat” does not work and the steps towards eating new foods need to be made smaller so as to not overwhelm them.
Is there light at the end of the tunnel? Definitely, even if the tunnel is quite a long one.
What caused the child’s poor eating?
Poor feeding is usually caused by some underlying physical or sensory issues or by a combination of both.
In my opinion, parents do not cause poor feeding. Parent behaviours are driven by their desire to feed their child, by their child’s repeated refusal to try new foods and by a sense of desperation.
As parents we put so much pressure on ourselves and are often overwhelmed by parent guilt.
Parents need love, support and a non-judgemental attitude when it comes to their child’s eating - not blame.
If you know anyone who is struggling with their child’s eating, I urge you to please:
- Listen to their concerns with an open mind.
- Avoid judgemental comments such as “you should be firmer with him”.
- Try not to give advice. Most of the time parents don’t want to hear tips about what has worked for your children. If you have tried it, they have most likely tried it too.
- Be supportive. Offer to have “safe foods” that their child eats in your home and don’t encourage their child to try new foods. This only causes stress for both the child and the parent.
- Avoid talking about the child’s eating when the child is present. Any conversations should take place away from the child as these just increase the child’s awareness of how much of an issue their eating is.
To all my families - You are doing an amazing job! You are headed in the right direction and that is our goal. To everyone who knows a family dealing with feeding difficulties - listen, support and love.