We’re eagerly awaiting the start of our SOS workshop, the feeding disorder program we’re starting at the end of this month. We’re taking a parent workshop provided to us by Thames Valley Children’s Centre. The SOS feeding approach is intended to help families of problem feeders (SOS has a really quick and easy to understand explanation of the difference between picky eaters and problem feeders). Maddy is a problem feeder, and this is why we’ve been referred to the SOS workshop (if you’re wondering if your child is a problem feeder, take a quick look at the SOS list of red flags).
There are many reasons a child may become a problem feeder. Some of these include sensory issues, pain associated with eating (food intolerances, reflux), and problems with coordinating the muscles needed to eat. The SOS program has a really interesting (and quick) read on the top ten myths of mealtime that I highly recommend to anyone who is interested in this topic. This list can help bring an understanding to some of the misunderstandings that surround problem feeding.
We are really excited to start this program, because despite the good intentions of the various professionals that have tried to help us with Maddy’s feeding issues, very few of them have truly got it. So many of the recommendations given to us were about withholding preferred food (crackers) and limiting Maddy’s intake of fluids. What I hope you have come to understand through reading my blog (and the additional SOS information provided in this post), is that although these suggestions may work for picky eaters, they do not work for problem feeders.
Maddy does not refuse to eat because of behaviour, she behaves poorly during feeding because there is a root issue that prevents her from enjoying eating. We have worked a lot with our occupational therapists on the sensory side of Maddy’s feeding, and we have honestly seen tremendous improvement. When Maddy was 9 months old she couldn’t tolerate a spoon in her mouth without gagging, and she had a food repertoire of three items, only one of which she would eat consistently when it was presented to her. Today she will consistently eat two to three food items when they are presented to her (gluten-free crackers, pasta, and usually waffles), but she will occasionally eat up to 25 food items. Despite this improvement, mealtime is still very frustrating in our home.
Mealtime in our home still means that most of the time Maddy will not eat more than a bite or two. It often ends with Maddy in tears. Many days Maddy asks for food repeatedly, but screams “NO” as soon as she sees what we’re offering her. She’s hungry, but for whatever reason, the feeling of hunger does not overcome whatever is preventing her from eating.
These feeding issues permeate our lives, because it is often the case that Maddy refuses breakfast and lunch, and then wants a meal while we’re out running errands mid-afternoon and don’t have a meal (or enough snacks on hand to keep her in non-meltdown mode). Some of you might be thinking that Maddy will eventually learn to eat when food is present to avoid being hungry (and this is the message that many professionals have sent us) – I hope what more of you are beginning to understand is that problem feeders will not learn this lesson the same way picky (or non-picky) eaters will learn it.
Conveniently, late in 2012 my sister, Lindsay, attended an SOS conference for clinicians (she’s a speech-language pathologist). She has been sharing a lot of information with us about what she learned and we’ve slowly been making some changes in our house. We’ve successfully implemented our first strategy: a change in Maddy’s high chair.
We originally had a very typical high chair:
We absolutely loved this chair – particularly for its ability to fold compactly (it was very easy to bring this chair with us when we had meals outside of our home). However, Lindsay learned during her SOS conference that the first change that should be made is to a new chair that allows the child to sit at the table with the family. There are a handful of reasons why (and I’m probably missing some of them):
- Sitting together at the table with the family allows mealtime to become a positive experience, and parents can model eating skills in front of their child(ren).
- Chairs with adjustable foot rests and seats allow for an ergonomic sitting position (body, hips, legs should all be at 90 degrees) and provide increased comfort to the child while reducing as much external sensory input as possible.
- When a chair can pull up to a table, it means food does not have to be placed directly in front of the child on a high chair tray. There are 32 steps to eating for problem feeders, with the lowest on the hierarchy described as “tolerates being in the same room as the food item.” There are three steps between this first step and the fifth, “looking at the food when directly in the child’s space” (say on their high chair tray). Yes, folks, some kids (like Maddy) actually find it too distressing to have some food items in their space. Just as an fyi, there are actually 21 steps before a child will touch a food item to their mouth, and 26 steps before a child will bite a food item.
We opted to buy a Leander, certainly not the cheapest of chairs, but Maddy already loves it, and we have high hopes for it. We decided on this chair over the Tripp Trapp after some amazing customer service at Springy’s in Hamilton. The chair is built really well, will grow with Maddy, and Springy’s recommended we keep it as a desk chair once it is no longer needed at our table.
Maddy absolutely loves her new chair (she was begging to get in it as Eric was putting it together). Introducing the Leander, accompanied by a varied set of facial expressions Maddy has started making in the last four weeks (hoorah!):
While at Springy’s, we also sprung for a few new goodies to assist with mealtime: a dry erase place mat that Maddy can colour on, and some new divided plates (helps to visually organize the food, as well as separate different textures). You’ll notice in the photo below we have separated corn pasta with sauce from corn pasta with olive oil and garlic – this is because Maddy is really a no-sauce kind of girl. By presenting them separately, we know Maddy has food that she can eat to get full, and hope that with light encouragement she will progress along the eating hierarchy with the pasta with sauce (touch it, kiss it, etc.).
The SOS program is another step in our feeding journey with Maddy. I’ll share little tidbits about what is working for Maddy so that hopefully some of you who also have problem feeders can learn how to support your child as they learn how to eat. We’re so thankful that SOS is rescuing our family from mealtime battles.