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The Basic Steps to Feeding Infants & Toddlers

February 4, 2016 by Karen Leave a Comment

There are things that I know due to my training I take for granted. Things lead me to have in-depth discussions with my boy’s pediatrician. There is a reason why the kids of my Physical Therapist friend can ride their bikes without training wheels at 3 years old (not my kids) and a reason why my own kids of a Speech/Feeding Therapist are perfect speakers and wonderfully adventurous eaters. Therapists who specialize in pediatrics have a leg up when it comes to parenting in terms of their specialization. In our case it is knowing the Basic Steps to Feeding Infants & Toddlers.

Without my training, feeding my babies would have felt like being in left field.

This realization happens through mere observations of parents who are struggling when it comes to basics such as introducing solids, child nutrition, developmental food play (DFP), developmental oral motor skills, and the relationship with food.

If you are struggling with feeding your baby, you are not alone and may find yourselves doing the following:

  1. Feeling you’re not getting enough nutrition into your new feeder so you may be over spoon feeding your baby a puree or soft mechanical food you feel is nutritional for your child.
  2. Keeping the highchair, child and tray clean (usually by spoon feeding and wiping) before they are finished.
  3. Giving your baby something different from what you’re eating and at different times.
  4. Mistaking Developmental Food Play (DFP) as negative behaviors and complaining when they throw food on the floor and/or make a mess.
  5. Introducing solids too late 12-15 months.

The FIRST misconception

twins eating orangesI would like to provide some resources on both nutrition and PORTION size individualized for each little one. Parents simply need to constantly remind themselves that little ones have little bellies and the rule of thumb for portion size is the size of their teeny tiny fists. Take a good look because that is literally 1 chicken nugget for some two-year-olds. I know my boys could eat more at that age especially during a growth spurt but during the times that they only ate their expected portion size, I knew not to worry.  I’ve included a link to Dr.Berry Brazelton on the subject of examining our expectations and dealing with our anxieties when it comes to feeding our babies. 

The other resource falls into the public announcement category. The Basics of Nutrition and anyone who is thinking of buying baby food would greatly benefit from the following course available for FREE online: Introduction to Food and Health via Stanford University. You can access this course as well as Child Nutrition and Cooking via coursera.com I highly recommend these courses presented by Maya Adams M.D., check out her talk as a quick introduction. She has invaluable insight and knowledge on nutrition and cooking for your family. She also enlightens us with how simple it is.

The SECOND that leads to the THIRD misconception

The second and third traps parents may fall into is led by the high chair. High chairs can be a great thing for getting really messy and positioning, depending on the chair and how it is used. If you’re not letting your baby get messy in a high chair then you’re missing the perks of having a high chair.  Check out this article regarding messiness and avenues to learning.  In addition to learning, developmental food play skills are critical in learning how to eat, such as crawling is to walking and talking. In other words if you’re going to invest in a high chair, use it for all the opportunities that come tagging along with allowing your child to get messy. Proper positioning can be achieved by boosters or hook-on seats once the baby can sit upright independently. This enables the baby to be directly at the table, getting all the sensory information from the food they need to advance to eating it. The BIGGEST road block posed by the high chair is it separates the baby from the table where everyone is eating, creating a psychological dichotomy of feeding and halting their budding, impressionable relationship with food. In a high chair, the baby learns they are not an equal when it comes to eating with their parents. This often leads to eating different foods and at different times. Easy for a brief moment of time and detrimental as they quickly advance in other areas BUT feeding.

The FOURTH misconception

Developmental Food Play (DFP) is a series of feeding, fine motor, and self-help milestones that every baby exhibits. Here is a quick reference for the stages and why they are important.

Stage 1 (6-18 months) Smooshing, smearing, spitting and wearing. Babies are exhibiting these developmental food play skills to learn and accept new textures first with their hands and bodies, and then in their mouths. See how that works! Spitting is learning how to manipulate and manage the foods safely in their mouths, it’s a defense mechanism and you want to see it. Oral manipulation and management of food takes both time and practice and is not easily achieved without being messy.

Stage 2 (12-20 months) Throwing, crumbling, tearing, wearing. Babies are learning and achieving fine motor skills such as pincer grasp, pointing, holding, removing and bringing hands to midline(middle of the body). Does any of this sound neat and tidy?

Stage 3 (2-3 years) Pouring. A simple activity but a multitude of mad developmental skills. Here is why. Children are doing more than making a mess in the moment: they are forever changing their attentional biases and learning new concepts associated with language and learning.

Stage 4 (3-4 years) Cutting and manipulating. At this point your “baby” needs to do more than just eat in order to be an active participant in feeding themselves. This is where parents need to keep up with maintaining their child’s relationship with food. Allowing your child to cut (supervised) and manipulate via recipes and experiments gives them the confidence and skills to eat a variety of foods.

The FIFTH misconception

Most parents are shaking in their boots when you tell them to introduce solids at 8 months. Even as a well-trained oral motor expert, I found this book to be very helpful and reassuring, Baby Led Weaning by Gill Rapley. My boys were introduced to solids once they were sitting upright independently at around 7 months. They were still nursed regularly and the introduction to solids was closely monitored with big pieces of whatever they were showing interest in. I knew that babies do not develop the ability to transfer food back for a swallow until around 8 months, so basically, everything was pushed straight out of their mouth by their tongue. Plus, they were still suckling everything. I was surprised when one of my boys actually decided to take a bite out of a piece of naan pita bread one day. No teeth, just gums and they worked. Thankfully, he eventually pushed it forward but he definitely learned some new oral motor patterns from the piece he bit off and the crumbs he had achieved to keep in his mouth.

If you’re still unsure about introducing solids at this age them you can give them a chewy tube that will strengthen their jaw, desensitize their gag reflex and coordinate their tongue muscles (all things a big raw carrot can do) but if you want/need nonfood or want something in addition; you can find them through this link, Ark’s baby grabber.

Introducing solids at an early age is just for exploration and fun. Babies get to advance their oral motor development and adapt to new textures at the same time without the expectation to eat it. Even with my expertise, I still watched them like a hawk just waiting for them to choke. I kept reminding myself that coughing and gagging are defense mechanisms and not choking. It was not often that they coughed or gagged but the one time my one boy did start coughing on something, I panicked and was going in for the finger swipe. Lucky for me and especially for him I was not quick enough and he was able to work it out for himself, avoiding a negative feeding experience and gaining more confidence in his skills. PHEW!

Unfortunately, most parents don’t introduce solids until it’s far too late and the expectation for them to eat is looming.  The problem is the babies are not developing the oral motor patterns to confidently handle solids and/or varied textures. Add the expectation to eat it, rather than have fun and explore and learn than you’re going to run into some resistance. Sitting in a high chair away from the table where the good stuff is and what else can you expect a 12-15-month-old to do but throw it on the floor. Frustrating for the parents and the new feeder.  Follow the advice and resources shared and you can avoid the frustrations, endure the messiness and you will reap the rewards of seeing your child enjoy and accept a variety of healthy, nutritional food for a lifetime.

 

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Address the Social and Emotional Impact of Food for you and your Kids

January 22, 2016 by Karen 2 Comments

What is Food’s Social and Emotional Impact?

Therapists assess a child and family in feeding therapy and address their fundamental needs. The first few weeks of therapy focus on educating the family and collaboratively agreeing on a plan that will lead to success and eventually discharge from services.

Basic SOS (Sequential Oral Sensory developed by Dr. Kay Toomey) feeding protocol is a 12-week program. Most kiddos fly right through not always needing the full 12 weeks. Then there are what I call my curve ball kids. The kids who are not necessary text book cases and end up teaching me just as much as I have taught them. I love these kids, they are so brave.

There are many more components to feeding than just oral motor and sensory. That brings me to the basic things that I was taught as a student. When looking at feeding you look at 3 things.
1. Functional (are they physically able to do it?)
2. Sensory (what aversions are they responding to or avoiding?)
3. Behavioral ( what are the behaviors associated?)
I’d like to add a 4th aspect of feeding to review

Social and Emotional Relationship with food

This 4th aspect of feeding impacts all of us, beginning to form as young as 6 months of age. This is the age when feeding becomes a LEARNED BEHAVIOR.  I capped and bolded for all you parents who are picky eaters yourselves; for all the parents who like things neat and tidy and wipe their babies hands and mouths as soon as they get messy. Also, for all the parents who overreact (guilty of this myself) to protective mechanisms such as, gagging and coughing that happens (and you want it to in order to know these protective mechanisms are present and functioning ) when babies are learning to eat solid foods and different textures and consistencies. It is a deeply rooted thing that includes healthy eating, emotional eating, binge eating, poor self-images, traditions, cultural and economical differences.

Our relationship with food is contingent on the first 3 factors listed (functional, sensory, behavior) but it is also highly influenced by our families, peers, culture, and environment. The language surrounding food is critical for both vocabulary and developing perspectives on variable food items. I remember improvising the language with one of the twins favorite picture books by Sandra Boyton. The original image was of a Hippo saying, “Ew, broccoli stew”……in my version the hippo said, “Mmmm, broccoli stew!!”
Social Emotional Impact of Food      My boys actually had tantrums when the other drank the “broccoli juice” from the bottom of the broccoli bowl at dinner.  They read my version of that book since they were 6 months old. They are listening and learning very early on and developing their relationship with food in many different mediums of learning. They include language (both written and verbal), observation (watching family & peers), environmental (opportunities for mass exposure to a variety of foods) and most importantly, experience (being active participants in selection, manipulation/play and tasting); notice I did not mention eating. Eating is at the very top of all the layers of foundation a child has to experience before getting to the last step of eating.

Developing a positive relationship with food means acknowledging all the factors detailed above. We addressed the language piece, be hyper-aware of what you are saying and what others are saying about food in the presence of your children. Observation includes your child watching you willingly trying new foods. Buck up ma and pa, take a bite and keep a smile on your face, it’s called good parenting.

Environment is your pantry, your refrigerator, and your local eateries. Try to provide fresh and healthy choices and keep the snacks you don’t want them to have out of the house. They’ll get ample opportunity to snack when they’re out and about. Home is the place where they are developing their palate the majority of the time. When they are surrounded by fresh and healthy food, their palate develops a preference for those bountiful flavors. Synthetic carbohydrates become blah or overly sweet to their palate. It’s like tasting the notably marked difference between Aunt Jemima pancake syrup and fresh tapped Vermont Maple Syrup.

Experience is everything in terms of forming relationships, keep them positive. Acknowledge Developmental Food Play Skills, they’re messy and an integral piece to forming a positive relationship with food. Include your kid’s input, thoughts, and ideas regarding what everyone should eat as a family. When kids are included in the planning aspect for meals, it provides them with the control they need to feel safe with new foods. Kids love to be in “control”, allowing them to assume the control role in the initial stages prevents them from asserting their control at the final stage (eating) by saying, “no, I don’t like that“.

A good place to start is examining your own relationship with food. It’s a dynamic process, examine the layers and identify the components you feel need attention to develop a positive relationship with food. It’s good for your body, brain, and soul!
GO STRONG!
 
 
 
 
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About Us

All our Boys

Karen Rodgers is a mother of twin boys, wife, and speech language pathologist for the Champlain Valley School District in Vermont and New England Speech & Feeding. She knows her way around a weight room and here on the GoodFitFam blog Karen and her husband Chris will share their wisdom, experience and contagious passion for kids, fun and fitness.

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