Where to turn for a child’s picky eating or feeding issue

When the average person gets hungry, they eat. Sometimes, they even think about a delicious food, their mouth starts to water, they get excited about obtaining said food, and they look forward to their snack or meal. This is why it is SO difficult for the ‘average person’ to understand feeding issues. Sure, all kids are picky eaters … to an extent, and for a period of time, usually. But people, even educated, medical professionals on occasion, can’t seem to wrap their heads around ‘feeding issues’ that go beyond the ‘typical’ childhood phenomenon of complaining at dinnertime. Even when parents themselves have a child with feeding issues, it is still a mystery. Even though they are living it day to day, it is still hard to comprehend. I like to break it down like this: If your child is having a hard time with food, think about all of the steps that are involved in eating. Really, try it. You’ve probably never given a second thought to the numerous steps involved in consuming food. Here is just a list off the top of my head. I am sure that my speech therapist, occupational therapist, GI doc, and dietician friends can come up with a bunch more! Child becomes aware that mealtime is approaching. They start to think about whatever it is that makes eating difficult for them (smell, texture, hunger, sitting still, using a utensil, chewing, swallowing – or lack of hunger, etc.) They may start talking about not wanting to come to the table, or start crying, or acting out. Child is asked to come to the table, closer to the ‘eating experience’. They don’t want to. They may not want to sit in the chair, they may not want to see the food or smell it. They might physically resist coming to the table. Child sees the food on the table, or worse, on their plate in front of them. They have to accept the food visually. They have to SEE that food that is so difficult for them to manage (for whatever reason). Child is presented with the food in front of them, or prepped on a utensil for them to pick up or allow into their mouth. Child smells the food. So now, they are seated, which may be an issue for them, they are looking at the food, they are smelling the food … all before it is even in their mouth!! Child has to PICK UP THE UTENSIL or the food itself and PUT IT IN THEIR MOUTH. Imagine how much that takes out of them when they DON’T want to eat what is in front of them. They have to either put it in themselves, or allow it to be put in. This is where a lot of behaviors come out …pushing, throwing the food, crying, gagging, coughing (even at just the sight or smell). Once the food gets in, if it gets in … they have to manage the food. Maybe they don’t have the skills to chew and swallow properly, or maybe they are sensitive to different textures. Here is where we often see an increase in gagging and coughing. Sometimes the gags and coughs are a result of all of this time to think about how difficult eating is going to be in conjunction with actually having the food in their mouth. Then, once the kiddo has managed the food in their oral cavity, they have to SWALLOW it. Again, often gagging and coughing are at play, and sometimes vomit. But why? What is the issue …are they not managing the food effectively? Are they worked up with anxiety? Are there other, yet to be determined issues? Once it is swallowed, there is a whole new set of ‘steps’. How is their GI tract going to handle the food? Are there allergies? Diagnosed? Undiagnosed? Are they going to vomit some more? Are they going to be constipated? Are they going to have a reflux episode? When you start to think of all the steps involved in eating, it is a wonder it comes so easily to the rest of us. When trying to support a child with feeding issues, or a friend, or yourself, consider all that is truly involved in eating. What would you add to the list? __________________________________________ Kristin Quinn is an experienced feeding specialist. Trained at one of the nation’s top Children’s Hospitals, Kristin is well versed in the complexities of feeding, and the impact feeding difficulties can have on an entire family. Kristin is passionate about helping parents find a plan that will work for them. Contact her today for more information! toddlersandtomatoes@gmail.com The Toddler and Tomatoes website is not a substitute for medical advice. All information is intended for your general information only. Information presented on this site and through our services should not be considered a substitute for medical consult or treatment for specific medical conditions. Information obtained by using our services is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatment. You should never disregard medical advice or delay in seeking it because of something you have read on our site. If you think you have a medical emergency, call your doctor or 911 immediately. Thanks!

Most days, there is something I am feeling guilty about. Guilty that I’m sending my almost 5 year old to preschool when I am not going to a 9-5 job – even though I think that she thrives in the structured and fun preschool environment, adjusting much better to school and the outside world than I ever did. Guilty that the laundry has been sitting – clean but unfolded in the laundry basket for three days. Guilty that I haven’t seen my grandparents, haven’t brought in a paycheck, haven’t cooked a real meal, haven’t called my dad, haven’t reached out to this person or that. Haven’t written an overdue thank you card, or called my non-mom girlfriends. Guilty that I don’t have a perfectly landscaped yard or an immaculate (or even remotely put together) home. There is always something to feel guilty about, if you think about it. But today, I felt content. Except for this post …at the very end of the day, I didn’t do any ‘work’. I didn’t try to network or engage via social media. I didn’t think about my bigger picture plans, or what I’ll do to be a ‘useful member of society – or the household’ once both kids are in school full time. I simply lived the day I was in, and it felt good. I dropped my daughter off at school (on the later side of the ten minute window, unlike me, but because I hit snooze … and braided my daughter’s hair, and let my little guy sleep in til the last minute, and snuggled them both as I was putting them in the car … and then we stopped to admire the fresh coat of paint on the outside of the house, and the new flowers …) After drop off, my little guy and I went to the local spot, and I had a coffee, and I let him get a sugary icing coated cookie. We sat outside in the beautiful weather. We chatted about Iron Man, and the other little guys we know, and where daddy was and where big sister was, and what we were going to do for the rest of the day. Then we met for a playdate at the park. We were the only ones there, and it was great! We came home, we had lunch, and we played outside. Then, we picked up my daughter. I let them watch TV, and I cooked a real life, honest to goodness, home cooked meal. (I didn’t expect them too, but they both ate it!) I didn’t feel (too) guilty about the TV, or focusing on making dinner (a totally worthwhile endeavor). I felt content. I felt good. My goal is to have more days like this, appreciating where I am now, not where I want to ultimately be. Planning and wishing and thinking are great and have a purpose, but shouldn’t take away from where you are now, what you have now, what you mean to those little people who think you are the bee’s knees. __________________________________________ Kristin Quinn is an experienced feeding specialist. Trained at one of the nation’s top Children’s Hospitals, Kristin is well versed in the complexities of feeding, and the impact feeding difficulties can have on an entire family. Kristin is passionate about helping parents find a plan that will work for them. Contact her today for more information! toddlersandtomatoes@gmail.com The Toddler and Tomatoes website is not a substitute for medical advice. All information is intended for your general information only. Information presented on this site and through our services should not be considered a substitute for medical consult or treatment for specific medical conditions. Information obtained by using our services is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatment. You should never disregard medical advice or delay in seeking it because of something you have read on our site. If you think you have a medical emergency, call your doctor or 911 immediately. Thanks!

Feeding is complex. People take it for granted, and also have a lack of appreciation for the stress that comes with a child who isn’t thriving due to feeding difficulties. Even if a child ‘meets the numbers’ of weight gain, caloric intake, or whatever else is quantifying their health, mealtime struggles are just that – struggles. Whether or not a bystander, medical professional, family member, or friend *thinks* it’s a problem, only the family who is managing tricky mealtimes day in and day out can truly appreciate the all-encompassing stress of challenges with eating.

The days are long, but the years are short. I don’t know who said it, but it is something you hear often as a parent of young children. Hang in there. Cherish this time. Time flies, they’ll be out of the house before you know it. I know it. I believe it. I try to remember it. But, man, are those days long sometimes. I’ve been a working mom. I’ve been a stay at home mom. I’ve been (am) a mom trying to get a business off the ground, keep the house in a state just above complete chaos, and keep the kids alive. No matter how you cut it, the days ARE long. Here is how I feel like my day should have gone when I was a working mom: spend 8 intense hours totally focused on the tasks at hand. Engage meaningfully with my co-workers. Make a difference in the lives of children who were not my own. Leave work re-energized, secure in the knowledge that I helped people, was a stellar employee, and the best co-worker a colleague could ask for. Travel to pick up my daughter, with no trace of road rage, enjoying my music and the sunshine. Pick-up said daughter, spend an hour playing with her with my attention completely on her, and when my husband came home, hand off the baton so that he could give our little girl undivided attention while I prepared a completely nutritious and delicious meal for us all to enjoy. After dinner, a leisurely bath time, story time, snuggle. All of this, in this dream, would be complete by 7pm, at the latest, and my hubby and I would enjoy several hours of adult conversation, perhaps a television show, and map out our future, filled with many dream vacations and quality family experiences. As a stay at home/work at home … the ‘perfect’ day looks similar, again in this dream world. Except instead of co-workers, my mom friends would find me engaging and interesting, and Pinterest-worthy. They would envy my creatively planned daily itinerary, my blossoming business, and when I picked up my daughter from school, I’d have a Martha Stewart-esque snack planned, a playdate lined up, and still have time to make that nutritionally sound dinner. I know people who have this reality. But it isn’t me. My days as a working mom, went more like this: Get up at a god awful hour, half the time pregnant, nursing, or bleary eyed from an all-nighter (not the fun kind). Lament over the unfairness of not only getting myself up and out, but also waking up my baby to ship her off somewhere. Go to work. Flip flop between being focused at work or focused on other, more important things, like my daughter and family. Race home, or try to, in gridlock traffic, pick up my daughter, rush home to start dinner, ignore my daughter. Hubby comes home, plays with her a bit, eat dinner. Bed time … but bed time was, and is, our sticking point. It. Takes. Hours. And part of the reason I haven’t instituted some sort of behavior protocol to shorten bedtime goes back to that whole long days short years thing. It won’t be like this for long … might as well enjoy it while our kids still want us to snuggle at night. Anyway .. the day ended then and ends now with me and my hubby, exhausted from the day, vegged out, not talking to each other, not doing anything that needs to be done … and this doesn’t even happen until 10:00 at night sometimes! My days as a stay at home mom trying to build a business are not much different. I still get up with an alarm. I’m still at the beck and call of other people (children, clients, professionals I connect with, etc.). I like to think, and I guess I used to think when I was a working mom, that stay at home moms can make their own schedules. They don’t have to answer to anyone. They can watch a movie in the middle of the day. Right. No, wrong. I’m not complaining … But I just want to know, am I the only one who sometimes would prefer to zone out in front of the television instead of engage in another round of hot potato, a round of hot potato that is conducted in such a way that you have no clue what is happening … the brainchild of your four year old… perhaps a combination of the hot potato game you played as a child, an adaptation of it your daughter learned in school, with a few four year old revisions thrown in, just for good measure? I’m tired at the end of the day. I know my husband is tired at the end of the day. And we adore our children, and want to play with them, and know that the ‘days are long, but the years are short’… but really, is that what you want to hear when your eyes are glazed over and you are just. Trying. To. Get. To. Bed. Or, at least the couch? How are you at appreciating the loooooooong days with your kiddos? How to you manage your time? Have you figured out the perfect way to balance all of life’s demands? Please, share!! __________________________________________ Kristin Quinn is an experienced feeding specialist. Trained at one of the nation’s top Children’s Hospitals, Kristin is well versed in the complexities of feeding, and the impact feeding difficulties can have on an entire family. Kristin is passionate about helping parents find a plan that will work for them. Contact her today for more information! toddlersandtomatoes@gmail.com The Toddler and Tomatoes website is not a substitute for medical advice. All information is intended for your general information only. Information presented on this site and through our services should not be considered a substitute for medical consult or treatment for specific medical conditions. Information obtained by using our services is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatment. You should never disregard medical advice or delay in seeking it because of something you have read on our site. If you think you have a medical emergency, call your doctor or 911 immediately. Thanks!

Yes, my kids are picky eaters. Your kids must be great eaters. I thought you were an expert in feeding kids, how come your child is acting like this? It doesn’t look like you know how to manage mealtimes very effectively, your child has been complaining and not eating this whole time. It never ceases to amaze me when people assume that my children must be great eaters. I make a point to always remind my clients and followers that children are children. They do and say what they want. They have preferences, just like adults. They have mood swings. They get sick and grumpy and full. They have medical issues, developmental issues, or sometimes, just don’t feel like being cooperative. Feeding issues or not, kids are kids. You may look at my kids and think, sheesh … she doesn’t have a clue how to help families who have difficult eaters! But, in my humble opinion, you’d be wrong. People seek out help with mealtimes when the stress of meals, and worry over growth and nutrition become too much. I help families manage that stress, take it all in stride, make a plan, and alter the ADULT’s perception of what is happening. Kids are going to do what they are going to do, no matter what you know. But, you can control your experience of the situation with a little education and support. My kids act like any other kids. I just experience it in a way that some families do not. I know what kind of day my kids are having, or what they ate prior to the current meal, or I’ve anticipated their reaction, or decided my game plan. It may look like my kids are bad eaters, and I know nothing about mealtimes – but, rest assured, they are just kids, and I am ‘managing’ the meal without them (or the person watching) even realizing it! No matter how much I know about managing mealtimes, my kids didn’t sign up for that. They never said “I will be perfectly cooperative, and always receptive to new foods, and any demand you may place on me, ever. I will enjoy all of your lovingly prepared meals, without ever batting an eyelash, and try anything you put in front of me.” Nope. That never happened. I think one of the most frustrating things about children with feeding issues, for parents, is the inability to control their response to food. Accepting that you cannot control your child’s reaction to food and mealtimes is one of the hardest and most important things when working toward less stressful meals. You have to identify what you are in control of, and embrace it. I can help. Contact me today at t oddlersandtomatoes@gmail.com __________________________________________ Kristin Quinn is an experienced feeding specialist. Trained at one of the nation’s top Children’s Hospitals, Kristin is well versed in the complexities of feeding, and the impact feeding difficulties can have on an entire family. Kristin is passionate about helping parents find a plan that will work for them. Contact her today for more information! toddlersandtomatoes@gmail.com The Toddler and Tomatoes website is not a substitute for medical advice. All information is intended for your general information only. Information presented on this site and through our services should not be considered a substitute for medical consult or treatment for specific medical conditions. Information obtained by using our services is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatment. You should never disregard medical advice or delay in seeking it because of something you have read on our site. If you think you have a medical emergency, call your doctor or 911 immediately. Thanks!

If you’ve been paying attention to my posts and blogs, you know that I like to take a reasonable, middle of the road approach to most everything in life. I don’t like to get worked up about stuff, and I don’t like when other people take a stance, dig their feet in, and won’t budge – feeding related topic, or otherwise. It’s so disheartening to read blogs, from professionals (with titles nonetheless), demeaning and dismissing approaches to mealtimes that are different from what they preach. Not only is this … sort of unprofessional and obnoxious, but it also places another burden on top of already stressed out parents. “If you don’t approach feeding THIS PARTICULAR way, you are causing yourself and your child undue stress and probably traumatizing them for life.” Instead, the message should be, “Here is an option. Read about it, try it out, and see if it works for you. Here is why I think it works, and here is how I apply it to kids with different personalities, different temperaments, and parents with varying levels of tolerance for sticking to a plan.” A particular topic in the feeding world that seems to evoke strong opinions is the ‘no thank you bite’. The no thank you bite basically means a child must take one bite of each food, and can then say ‘no thank you, I don’t want anymore.’ This isn’t all that different than ‘last bite’, which is what I often recommend. I like the ‘last bite’ rule, because it only requires one single bite of one food at the end of the meal. The no thank you bite requires several bites, and could lead to long, drawn out battles of will. The no thank you bite and last bite require that a child follow through with a demand given by a parent. Assuming a parent is being completely reasonable (very small bites of food which can be easily managed by the child), it is absolutely the privilege (and job) of a parent to set and follow through with expectations for their children, at the table and elsewhere. Now, if you want your kiddo to eat a stack of pancakes… you might be asking too much …

Small Steps to Slim by Ashvini Mashru, MA, RD, LDN is not a book I would normally be drawn too. I am already slim, slim to the point of people often wondering (sometimes out loud), if I have some sort of eating disorder. Mull that over for a minute. An eating disorder, which google defines as – “any of a range of psychological disorders characterized by abnormal or disturbed eating habits (such as anorexia nervosa).” Probably the opposite experience of someone telling you your child with a true feeding issue is ‘just a picky eater’. People can be jerks. Said ‘people’ have actually asked me if, due solely to my thinness, I have an eating disorder. This made me hesitant to acknowledge that I read a book about becoming slim. What were people going to think now??? I did read it, and I loved it. It is not a diet book, or particularly about becoming slim, although that is the pretense – it’s a wonderful guidebook toward reaching your goals . Its principles are applicable to many life situations. Perhaps I should use it as a way to develop a plan for managing rude people. But, I digress. Ashvini’s website explains that she “… is an award winning Registered Dietitian and a professional Health and Wellness Coach who has over 12 years of experience in helping individuals achieve healthy lifestyles.” I’m happy to call Ashvini a friend and fellow business owner. She has been a pleasure to know and work with, and I am thrilled to incorporate the lessons of her book into this blog post and my work with clients. You’ll have to read the book for a full explanation of these steps in regards to lifestyle management for weight loss, but here are some basic examples of how I would apply Ashvini’s lessons to managing a child’s feeding issues, and making any goal attainable. Step 1 Commit to the Journey A goal is nothing without commitment to seeing it through. If you desperately want eating to be different for your child, commit yourself to finding the medical, behavioral, and developmental answers and mealtime management techniques needed to make that happen. Step 2 Pinpoint a Final Destination Think about what makes mealtimes challenging for your child RIGHT NOW. Then, consider what you want mealtimes look like with/for your child when you’ve achieved your goal. Commit that goal to memory, and commit yourself to getting there. Step 3 Choose one Small Navigational Change What’s that they say about Rome not being conquered in a day? Long standing feeding issues will not improve or change overnight. Before reaching that ideal experience of eating, many smaller goals must be identified and achieved. For example – if your child will not sit at the table for mealtimes, getting them to eat will be a challenge. If your end goal is to have your child eating a few new foods, your first goal might be getting them to come cooperatively to the table. Step 4 Break up the Driving Break up each goal into smaller goals. For instance, if your first goal is to get your child to stay at the table during mealtimes, consider using a seatbelt or scarf to remind them to stay in their seat, or for an older child, consider an incentive chart for sitting at the table x number of times during a week. Step 5 Plan your Route Take the time to think about your plan of attack. You could try a bunch of different tactics to see what works and you might have to, but it is helpful to have an idea of what you are going to do and how you are going to do it. Step 6 Expect Bumps Your child is not on board for your plan. Just know it, accept it, and plan for it! Neither is grandma, the waiter at the restaurant, or the lunch lady at school. You will encounter obstacles while attempting to achieve your goals for your child’s eating behavior. Anticipate them, plan for them, and be ready to meet them head on. Step 7 Recruit a Pit Crew Feeding challenges are stressful, anxiety producing, and hard for ‘outsiders’ to understand. However, you need support to be successful when attempting to change how your child experiences mealtimes. Identify people in your network – family, friends, medical professionals – who will support you in your goals for your child, listen to you, and help you stay motivated. Step 8 Stay on Course Don’t get discouraged by setbacks, keep your eye on the prize, and weigh the cost/benefits of what you are doing. Remember, your ultimate goal is to get to happier and more satisfying mealtimes for your child and you – that’s worth the hard work! Step 9 Refuel Take a step back and look at how far you’ve come. Identify actions that are helping you to achieve your goals, and things that may not be working. Adjust your behavior as necessary, and re-evaluate your end goal. Step 10 Focus on How Far You’ve Gone Give yourself, and your supporters, and most importantly, your child a pat on the back for doing such hard work! For another great perspective on goal attainment, head on over to my fellow bizzy mama Karen Cooley ‘s photography page, and check out what she has to say! For help creating your own action plan for managing mealtimes with a child who has feeding issues, contact me today at t oddlersandtomatoes@gmail.com

Our daughter has always been a …challenge, shall we say, at bed time. From infancy, she’s needed help falling and staying asleep. She is four, and still sometimes wakes up in the middle of the night. It can be quite exhausting for those of us who actually appreciate some shut eye.

"What will you do with all of your time?” A common question when one finds out that a mother will be sending one (or more!) of her children off to school.