Podcast

 

When parents have a picky eater on their hands it’s easy for them to unwittingly enter into a dance with their child that can lead to them becoming more and more resistant to foods as parents grow more and more frustrated during mealtimes. If you’ve been stuck in this dynamic with your own child, don’t worry, there is a way out of this vicious cycle.

In this episode, I’m joined by Rebecca Taskin, a trained feeding therapist and licensed speech and language pathologist. We’ll discuss techniques you can use to start gently stretching your child out of their food comfort zone and mindset shifts for you to make that will allow you to remove some of that pressure during mealtimes. We’ll also talk about the signs to look out for if you think your child might have a more serious feeding issue and when to seek clinical help if you’re worried their food struggles may be more than picky eating and could be a feeding disorder.

Rebecca  (00:00):

Somewhere between 25% and 33% ish of children have some sort of feeding challenge at home. The parents don’t even feel like they could take their child to a restaurant to sit down and eat, this feeding disorder is that challenging to the family. 

Dr. Sarah (00:23):

When you hear the phrase picky eating do you immediately have a visceral reaction? Maybe you’re a parent who has to keep the plate perfectly flat, knowing that your toddler will refuse to eat any food that has slid around and touched another item. Or perhaps you haven’t quite hit that toddler stage and you simply recall a time from your own childhood where your diet consisted solely of mac and cheese, grilled cheese and pizza. For me, I go right to a memory from last week when my almost four year old son declared he’s not eating anything that is green – ever again! Today I’m joined by Rebecca Taskin, a trained feeding therapist and licensed speech and language pathologist. Rebecca is the founder of Speech In The City, and also currently works part time at a school for children with profound disabilities. Her specialty in pediatric feeding disorders and feeding dysfunction makes her incredibly knowledgeable on this topic.

Dr. Sarah (01:16):

And I’m so excited for you to hear our conversation about understanding and supporting a child’s relationship with food. In this episode, we’re going to talk about some techniques you can use to start gently stretching your child out of their food comfort zone. Things like getting them into the kitchen with you, making mealtime more fun and playful, adhering to predictable rhythms and taking the pressure off of your kids during mealtimes. For most children, picky eating eventually goes away as they grow, but for about 30% of children, this issue goes a bit deeper and is classified as a feeding disorder. If your child’s food restrictions are significantly interfering with your day to day life, they may fit into this category. We’re going to go over some signs to look out for that could alert you to the fact that you may need to seek professional help and the steps to take. But we’re also going to talk about how to manage child’s relationships to food that aren’t pathological, or that aren’t a sign of anything deeper, but still are frustrating and challenging for families. So here we go.

Dr. Sarah (02:26):

As parents, we are always telling our children to do something – share your toys with your sister, don’t throw food on the floor, markers stay on the paper. It can really feel never-ending and it’s exhausting for them and for us. Little kids hear so many corrections throughout their day. Sometimes they start to tune us out and we often feel like we’re stuck on a never ending loop, trying to always correct their behavior. So that’s why I decided to flip the script in my next guide. And instead of giving you behavior modifications to try to get your child to do, I’m giving you swaps to make to your own behaviors as the parent. In my new free guide, Fostering Resilience From Birth, I help you understand the building blocks of resilience with actual phrases that you can swap out of your own language with your children to help your child tolerate distress, to develop a growth mindset, to increase self-esteem and to be more resilient. So you can stop feeling stuck in those moments when your child is struggling and really needs you the most. And you can start feeling really confident in your ability to support them in whatever challenge arises to download this guide, go to my website, drsarahbren.com that’s drsarahbren.com and click on the resources tab. Or if you’re listening to this podcast on your phone, as you browse through Instagram (I totally see you) just head over to my profile and click the link in the bio to get access to this free guide.

Dr. Sarah (03:48):

Hi, I’m Dr. Sarah Bren a clinical psychologist and mom of two. I’ve built a career dedicated to helping families find deep connections, build healthy relationships, repair attachment wounds, and raise kids who are healthy, secure, resilient, and kind. In this podcast I’ve taken all of my clinical experience, current research on brain science and child psychology and the insights I’ve gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights to help you understand the building blocks of children’s social, emotional, and cognitive development. So you can tune out the noise and tune into your own authentic parenting, voice confidence, and calm. This is Securely Attached.

Dr. Sarah (04:52):

Hi, I’m so excited to introduce you to my guest on today’s episode, her name is Rebecca Taskin. She is a speech and language pathologist. She’s a specialist in pediatric feeding disorders and feeding dysfunction. She has a private practice in Manhattan called Speech In The City, and she also works part time at a school for children with complex feeding disorders. So I’m so happy Rebecca, that you are here. Welcome. Can you tell us a little bit how you got into this line of work and how you kind of ended up doing this, this work that you’re doing?

Rebecca  (05:25):

This is definitely the most gratifying, satisfying job I’ve ever had. I’m super grateful to be in this line of work. Currently I work with children zero to 21 and it’s been such a journey to get here. I actually was a med student dropout turned speech pathologist. So the background of my thoughts is always medically based. And I actually started working at a school for kids with traumatic brain injury and working more on the technology to assist them and communication. And what I realized was actually I was more interested in helping them with their feeding rehabilitation. And so that kind of sparked my interest in feeding and complex feeding cases. And from then on I’ve really just immersed myself in figuring out ways to help children with various types of feeding disorders from picky eating, to preferred eating, to kids who are coming off of feeding tubes. It’s a very wide range that I work with now, and I’m super fortunate to have the challenge and be a part of the family life of so many families around Manhattan and, thanks to COVID, actually around the world. So it’s been really great to get here.

Dr. Sarah (06:45):

That’s amazing. I mean, that is such important work that you’re doing. It’s gotta be so exhausting, but also amazing,

Rebecca  (06:55):

You know, it’s, I see the struggles. I mean, if your child is not sleeping and your child’s not eating–two of the basic human necessities–parents are really struggling. If one of those two things are not working as expected. So to see and be a part of the family dynamic and routines has really helped shaped me in my practice. And it’s, I’m really grateful to be a part of so many families lives. So yeah.

Dr. Sarah (07:25):

I mean, that’s an interesting point that you bring up this idea that like when kids aren’t eating or sleeping or whatever it is that’s not working, it’s not happening in a silo. It’s not like, oh, this child’s just not eating. It affects the whole family because the family system, especially when kids are really young, it’s so interconnected. So if you have one child who is having trouble eating, the whole family can become, you know, profoundly affected by this. And that can be a strength for helping a child get better, but it can also become something that becomes a bit of a self fulfilling prophecy, right? Or if parents are very anxious about a child not eating the child starts to feel that pressure and then they dig in more. So it really does sound like it’s something that the whole family has to understand and you work together to improve.

Rebecca  (08:15):

Definitely. And thinking about that, in United States, we have somewhere between 25% and 33% of children who have some sort of feeding challenge at home and of that percentile in various reported studies, about 90% of those kids, the parents don’t even feel like they could take their child to a restaurant to sit down and eat because this feeding disorder is that challenging to the family. So it’s very real. And I think sometimes parents can feel isolated that they’re doing something wrong or it’s their fault, or they’re the only one that’s through this. But the reason why I work so hard and so much is because it is so high of a number, 25 to 33%. They don’t have it nailed down exactly, but it’s a pretty high number for children having feeding issues.

Dr. Sarah (09:11):

Yeah. Is it like a spectrum where you have sort of picky eating on one end and like completely profound disorders on the other or are these separate constructs? What are we dealing with here? What’s the difference between feeding issues, picky eating–these names are thrown out about, about kind of arbitrary.

Rebecca  (09:30):

It’s less of a spectrum, I would say. And more of a staircase in the sense that you can have a child who’s at the 1% weight who is just not a picky eater, but just doesn’t want to eat. And you could also have a child who’s at the highest percentile who will only eat chicken nuggets and is a very picky eater. Let’s just say of a certain brand of a certain temperature or whatever with like X brand of ketchup. So they kind of intertwine. So I don’t know that it’s linear in a way, but there are things with feeding disorders that overlap. So to answer your question more directly, different researchers have different perspectives on the different terminology, but as a 2021, it’s kind of all lumped together as a pediatric feeding disorder, if your child meets certain criteria based on a scale that was developed by Feeding Matters, which is a nonprofit that helps families who have children with feeding disorders. So it’s trying to alleviate some of the terminology and kind of helps classify feeding disorders as either yes or no. Okay.

Dr. Sarah (10:57):

And what are some things parents need to know? You know, when they’re like, I have a lot of parents who are listening to this, I can imagine who are like “My kid’s a picky eater. Do they have a feeding disorder?” Like what’s the threshold?

Rebecca  (11:10):

Yeah. So that’s a really good question. There’s a great checklist that parents can go and take and it’s free. It’s on feeding matters. Basically, if you feel like there’s a part of mealtime, that is a struggle for you in the sense that your child’s eating is interfering with their development and the eating of the family. That’s a big indication that they might need some support and there could be a feeding disorder present. So there’s a screening tool. And it, you know, addresses things like does your child let you know when they’re hungry? Does food cause some kids to not be able to self-regulate. Does your child, do you think your child eats enough? How long does it take for your child to eat? Does your child tell you when they’re full? Or they have to do anything special to help your child eat. So if that’s like modifying foods specifically for your child, things like that.

Dr. Sarah (12:11):

Whether or not your child meets a certain diagnostic clinical threshold for feeding disorder versus, you know, kind of run of the mill, I have a picky eater. What is something that, that you feel like parents would benefit from kind of just

Rebecca  (12:27):

Overall.

Dr. Sarah (12:28):

Knowing what’s their role? What’s their child’s role?

Rebecca  (12:32):

Basically, if you’re, if you think, okay, my child just  refuses to eat like a few foods, maybe like 30 or something, maybe they used to eat it, but now they’re not eating anymore. I would say the first thing in terms of your role is to get your child back in the kitchen with you. I think it’s important that the child understands where food is coming from and it’s not just put in front of them. So whether that is like making a smoothie together, which is one of my favorite things to do with kids, because then you could throw so much in there. Or it’s like making something, you know, when I was little, we used to have those celery logs with the peanut butter, you know, and the raisins, like the ant things and why I remember those is because that was fun eating.

Rebecca  (13:16):

So, you know, sometimes it’s getting a little bit crafty with your kids who may have some picky eating challenges to figure out ways to like make food a little bit more fun with them. You know, we all have the thought of like the dad or the mom flying the spoon with the airplane and making all the noises and try to distract the child to get them food in their body. But sometimes we have to help them understand that like, food is fun. Food is good for them. We want you to love food. We don’t want food to be a challenge. You know, for you and your life.

Dr. Sarah (13:50):

That’s an interesting point too, because I’ve always, I mean, I’ve, I’m guilty of the airplane for sure. But I also, from a psychological perspective and an understanding, developing a child’s relationship with eating, having that be a mindful process, a connected process, distracting them and playing sort of games like that. Does it help or does it hinder a child’s relationship to eating?

Rebecca  (14:16):

Oh man, it’s a touchy subject slash hard for me to answer because I don’t want to lead anyone down the wrong rabbit hole with this. But I think there needs to be a combination of heavily on the sensory aspect of allowing your child to kind of regulate and figure out when they’re full. And if we always, you know, kind of tell them, okay, you know, you have to eat this amount of food, otherwise you can’t get off the table. They may not figure that out themselves, but some children may need that. So it’s, it’s, it’s, it’s hard to answer it concretely know, I know everyone’s like, why don’t you just give me an answer, like, is this right or wrong? But it really just depends really, honestly, what is best for your kids? The best example I can think of right now is when you have a child who won’t brush their teeth and you say to them, “Child, brush your teeth,” and the child says, “no” what do you do?

Rebecca  (15:11):

You just say, okay, you know, it’s good for you to brush your teeth. You know, they don’t get it. So you have to like kind of parent them a little bit like you know, get them to brush their teeth. So sometimes with children, it’s a little bit of that, a little bit of pushing but never to the point of where it causes anxiety. And I think that that’s like the tipping point between a feeding issue and not a feeding issue is like when you start to feel that anxiety built up in the child, what do you think from more of like a psychological perspective? I guess?

Dr. Sarah (15:47):

Well, it’s interesting because the two, as soon as you said, toothbrushing, I’m like another massive power struggle with kids. And I think my, the first two words that came into my mind was power struggle. I’m like, how do we not make something a power struggle? Well, one of the ways we don’t make it a power struggle is to not give it a tremendous amount of intense attention. And cause our children feel our anxiety and that makes them anxious. And when they’re anxious, they get dysregulated and they do things like shut down or throw the food on the floor or just kind of get into a place where they can’t comfortably and in a relaxed way, enjoy a meal. And so I think a lot of times I find that kids do best when we’re all eating together and nobody’s really watching them eat that attempt, that intense attention can be really anxiety provoking in a child. And you brought up a really interesting point about, you know, before, when you were talking about a child learning to know when they’re full or hungry and that, that requires a level of regulation. Can you talk a little bit about that and how like, you know, yes, we want to eat because we need to feed our bodies, but also feed eating is not really just about food. It’s about relationships and it’s about a regulated nervous system. So like how do we, how does regulation play into eating?

Rebecca  (17:23):

Okay. So a lot of nutritionists have done a lot of research in this area because it’s, it’s about understanding your body’s rhythm, right? And understanding Ellen Slater, you know, we both love who is the pioneer. I feel a lot of this. And she talks about that, which is that if your child doesn’t understand what it feels like to feel full, then they’re not gonna know that mealtime has a finite end to it. Let me give you more of an example. If you say, Hey, here’s your meal child and the child says no, and then you just keep constantly replacing that meal so that, you know, because you are having anxiety that they’re not eating it, they’re going to never eat that initial thing that they rejected. And because they’re never going to have the opportunity to sit there and like feel some sort of hunger around that item.

Rebecca  (18:19):

So, you know, there, there is that to consider too. I mean, obviously we don’t want a child to like start losing weight. So it’s a fine balance, but a child does need to learn how to self sooth in terms of eating and figuring out when they are full and when it’s time to eat. The gauss model is a model for children who have severe feeding issues. And one of the requirements that they believe that the child needs to feel hungry to understand what hunger is, children who have some medical past for example, some children who are premature may not have, who are born premature, may not have a fully developed system where they feel those satiated feelings. So of course there’s the medical history to think about too. But for the site, let’s say more mainstream population, it’s just understanding that the child needs to have the feeling of what it means to be hungry. And then what it means to feel full.

Dr. Sarah (19:20):

That’s really interesting because that makes me think too about like, okay, rhythms having mealtimes be this sort of predictable and consistent rhythm so that a child’s body can get used to when I’m, when I’m fed the time in which I’m not fed. And hunger builds the time in between those periods where I’m fed again and I can eat until I’m done. And if that’s pretty consistent throughout a child’s day to day life, their body’s going to start to get pretty used to what hungry feels like and what full feels like. Now this requires that parents aren’t a constantly feeding their children because they’re feeling anxious. Like if I’m always offering my child food, because my child didn’t eat, what I think was enough at the last meal. And so I’m like, they’ve gotta be still hungry. I have to keep giving them options and more options and more options versus sort of allowing the child a little bit of space to, to, to say no at mealtimes.

Dr. Sarah (20:29):

And you mentioned Ellen Slater. And I feel like I should just give everyone just a quick one-on-one on her. She is, she wrote a book, an amazing book called Child Of Mine: Feeding With Love And Good Sense. And it’s kind of, if I’m correct me if I’m wrong, Rebecca, but it’s like one of the gold standards for understanding the parent child relationship, as it pertains to food in early life for a kid. And one of the things that she kind of articulates in this book that I found to be just amazingly helpful for me as a parent and just in general, is that there’s the parent’s job and the child’s job when it comes to eating and that the parent’s job is that they decide what goes on the plate. And when that food is served, it’s the child’s job to decide what they eat, how much they eat and when they’re finished.

Dr. Sarah (21:26):

And if we can own that, our job is the former and our child’s job is the ladder. It kind of can really let go. We can really let go of our anxiety about controlling something. We don’t have control over. And it gives our child an opportunity to learn how to direct what goes in their mouth and when they’re done eating so that they can articulate I’m done. And we respect that. And eventually they’ll learn if that was an accurate I’m done because they really were full. Or if it was an inaccurate I’m done and oops, I’m still hungry and I don’t have food anymore. Cause I, you know, I showed my mom, I was done either because I put my plate away or because I threw it on the floor and that’s usually in my house at sign that, oh, if you’re throwing food on the floor, that’s showing me you’re done. I’m going to put your food away. It’ll be time to eat again later.

Rebecca  (22:18):

Yeah. I mean, you bring up a good point with that too. I mean, she, she has that model and it’s kind of hard for some of us to take it in, but it really helps create that division of what she calls the division of responsibility for eating, where it alleviates some anxiety around meal time. So what ends up happening is this cycle where the child doesn’t eat enough at meal time, then they’re offered snacks. And then when we turn this child into what we call a grazer, like they’re just kind of eating sporadically throughout the day. They’re never really feeling full, but this is a lot really driven by the need and not like for our child to get enough calories. And so then it becomes, you know, all about the calories and the numbers. And, and then that’s where I see a lot of the picky eating breakdown starting around about two years old where the tantrums are starting and the power struggle is starting.

Rebecca  (23:15):

And the child’s really picking up their parents’ emotions and understanding how them not eating or eating or throwing food on the floor or throwing utensils on the floor is affecting that relationship. And what you talk about, which sticks with me a lot is that’s where that trust is, you know, and that that child is looking for the parents who regulate them at that point. And I really think that when you said that you a few, few months ago, it really has, it’s been sticking with me about the child kind of testing their parents in those moments of time. So yeah.

Dr. Sarah (23:59):

Well I think cause you’re referring to a conversation that we had on, on Clubhouse actually, which was an amazing conversation, too bad. We didn’t record it because it would have been a great podcast episode, but, but we talked a lot about this idea of like, okay, when we trust our kids to show us when they’re done eating, our kids can sort of own that responsibility and they can relax and we can relax. And even, I think it takes a lot of kind of, I mean, I think parents get a little hung up on like each meal being enough versus thinking about maybe the food intake over the course of an entire day or maybe over the course of a week. Because you said something really pointed to me once, which was your kid is not going to starve. Can you talk a little bit about why that’s a helpful thing to like sort of a helpful mantra for parents.

Rebecca  (24:52):

Yeah, most kids will not starve, most? We do have kids who are at the one percentile and I do work with a lot of kids who are the one percentile who are not actually eating enough food, but I don’t, your kid will eventually, if food is provided and you’re setting up a structure and it’s in this healthy environment and we have kind of ruled out all the medical underlying conditions and there is no known diagnosis, your kid will re we hope with everything put in place, your kid will regulate themselves and come up with some sort of regulation system that works for them to help them feel hungry, help them feel full. But yes, it would be very hard for your child to starve. And I think parents having a fear around that is very high and very, not as normal. Okay. It’s normal.

Rebecca  (25:46):

It’s very normal that you would think that. So just knowing that there is support out there, there is people out there, our parents are going through the same thing as you and there is, you know, hopefully that’s why you’re listening to this podcast, but we are here for you and we’re here to support you and kind of figure out what the underlying conditions are and looking at the whole child, because these are not just what we see as manifestations of other things with feeding. It’s not, it’s not just my kid doesn’t want to eat food. Right?

Dr. Sarah (26:15):

Yeah. We talked about the iceberg, right? How like, okay, well I talked about the iceberg a lot in relationship to behavior and how like you see a behavior, but really that’s the tip of the iceberg. And underneath the waterline is all of these emotional buildup triggers, things that are adding pressure on their nervous system that eventually erupts in a behavior. I think that this plays out with food too, right? We see, I don’t want to eat this food. That’s the tip of the iceberg. But I think underneath the waterline is a lot of emotional stuff around us child feeling their parents’ attention and anxiety around the food, which can make them feel anxious, which can, and then there’s also sensory stuff. There’s a lot of, we talk a little bit about, about the sensory piece to this.

Rebecca  (27:08):

Just to give you some, throw out some numbers out there about 60% of kids who have a feeding disorder, have a medical diagnosis, underlying medical diagnosis, while whether it’s discovered or not discovered, I would say of the kids, I see nine out of 10 of them. I’m figuring out what the medical diagnosis is to refer out, to get the actual diagnosis from the doctor, whether that be reflux or some sort of tethered oral tissue in their mouth, where they have tongue tie and lip tie, or they’re not able to use their tongue or lips or they have a tone issue whether it’s an adenoid tonsil issue things like that now in terms of the sensory feeding challenges. So that falls definitely into the occupational therapy world who are also great, who can be great specialists in feeding too. So feeding therapy kind of falls into either speech pathology or occupational therapy.

Rebecca  (27:59):

There are some nutritionists who also provide feeding therapy as well, but the occupational therapists really look at the sensory components of feeding. So is it looking more at the textures and the feelings around food? Obviously these are things I’m treating as well, but it’s just important to think about, you know, when I, I spoke to three parents today to do a feeding intake is actually, and some of the questions I go through, are are there texture issues that your child struggles with? Will they only eat certain textures. Will they avoid certain temperatures of food? You know, is there colors of food? Most of the kids I work with who have feeding challenges, one of those three things you’ll see a disordered in, in that they might only eat brown round foods, foods that are crunchy foods that are room temperature things like that. And so that’s a whole sensory component to feeding which is something that is involved in taking approach into feeding therapy, whether that be exposure to like breaking out of that temperature, changing the texture or figuring out, you know, a color system. So things like that are strongly considered and looked at during initial like feeding intake for sensory feeding.

Dr. Sarah (29:13):

What would be some, a reason a parent would want to reach out to you? What does feeding therapy look like and who needs it?

Rebecca  (29:21):

So if there, if you have intuition that there’s something wrong through a child’s feeding, for sure reach out because consultations or phone calls are free. And so we don’t like the wait and see approach. That approach usually ends up in becoming a more picky eater. I’ve seen this over and over and over where we get a child who went to their pediatrician appointment at two and it’s all, they’ll probably grow out of it. And then they don’t and things are getting worse. So these children are children who are now being very selective with their eating meaning eating is becoming a power struggle for parents. Parents feel they have to prepare separate meals for the child. The child is not eating certain textures and potentially there’s other things going on where they’re drooling a lot during an after meal time, just like out. So there’s a lot of different indications that a child might have a feeding disorder. But I always tell parents, your intuition will definitely help guide you there. Plus, as I mentioned before, there’s a free screening tool on feedingmatters.org, which you could take. It’s six questions. If you answer two or more of those questions as a yes. Then it’s, it would make sense to reach out to a feeding specialist.

Dr. Sarah (30:48):

And what are you going to do with the family? Like what can someone expect if they’re going to be reaching out to a feeding specialist and may, may actually their child may need some, some therapy?

Rebecca  (30:58):

So my , how I approach feeding therapy is very child centered and child led. So I like to get kids messy and dirty with food. So whether that be kind of exposure to new foods through play or providing them opportunities to eat meals and different foods outside of a traditional meal time. So a lot of the kids I work with have anxiety around eating. So it’s kind of creating a more fun, neutral environment for them to eat. I actually don’t do any feeding therapy in my office. It’s all done in the home because I feel it’s easier for the child to handle. And over time we develop a relationship and it’s through food and it’s also through play where I’m the trusted adult and I help provide the food for them. And eventually this is carried over, hopefully after that session with the parents, ideally I have parents there all the time, but I do have children who get a little anxious when the parents are around. So we have to kind of work the child and the parent in a more neutral environment outside of mealtime, maybe through games and things like that, you know, and do a lot of social stories, explaining to the child about mealtime, the importance for our body. It all depends on the age of the child, really.

Dr. Sarah (32:18):

That’s interesting. I think it’s interesting too, this idea, it makes sense to me that a child, that for some kids having the parent there is, is helpful. But I think for some when, when you started to get into a dance with your child around mealtime and all of a sudden, not really all of a sudden, it probably happens slowly and gradually over time, but you find yourself and your child kind of always getting into the same patterned, you know, dynamic where you’re getting more and more frustrated and they are getting more and more resistant. And so when you see families that have kind of dug into this ditch a little bit with food and eating and the power struggles, how do you help parents move out of, out of that dynamic?

Rebecca  (33:06):

Well, I think the easiest solution in my mind is to introduce a neutral person. So a lot of times, either a grandparent, a nanny, an aunt you know, some support system, that’s an adult, not a child. I’m not talking about like the sister or the brother. Some adult caretaker I think is a good first step to helping with our relationship. I’ve seen that work out very well for families. I also think it’s providing consistent, clear feedback to the child. So if I had I’ll give you an example of like kids that I work with. I had a child that only eat French fries in January. When I started working with him. Now he eats now it’s six months later and he eats a variety of food, but I would leave his session after he would try, like, let’s say five new fruits and his mom would prepare them for him for dinner.

Rebecca  (34:00):

And he would say, no, I don’t want to eat them. I’m not eating that. And she said, and she, and at that point, that’s where I have parents push a little bit, because at that point it’s a struggle. You know, it’s not just a sensory feeding issue. It’s that, they’re just, there’s a deaf parent. I don’t know what the right terminology is for it, but there’s a parent child breakdown where that, at that point, that the parent has to kind of step in more as in a parent role and say, you know, you did this with Rebecca, you were brave. I haven’t, Rebecca showed me and I send videos and parents videos and pictures to the parents. So we kind of like use those as a model for the child. So we’ll show them like, look, you just ate honeydew, you know, and didn’t, you were brave. And we try to like boost them up a little bit so that they’re in that power struggle with the parents is a lot less and more alleviated because I feel like sometimes it’s not about the food, it’s about the relationship with the parent, you know?

Dr. Sarah (35:02):

Yeah. And what about, I’m thinking, you know, we’re talking about some kids who have relatively serious feeding issues or pretty extreme pickiness, but what about the kids that don’t have, you know, they don’t meet that clinical threshold for serious feeding issues, but they’re just, you know, they’re just refusing certain foods. Like I, you know, my son is going through a phase right now. He doesn’t want anything green on his plate.

Dr. Sarah (35:28):

You know, what can we, as parents do to help kind of expand their confidence?

Rebecca  (35:34):

So from about two to six years old children, a lot of children will develop neophobia around food. It’s like, it’s a normal, it’s a thing. So it’s not uncommon. I think continual exposure of that food during mealtime is important eating as a family where everyone else is eating that food and a low pressure mind where the child doesn’t feel that they need to eat. It is also important. But typically we see these kids kind of come back to the food over time you know, these very mild picky, like I won’t eat broccoli or this or that. And some kids just may not like the flavor of broccoli, like, you know, like, or whatever it is. And that’s okay. It’s not gonna make or break their diet. It’s just more, what you want them to eat is that one food, they don’t want to eat for eight. So it’s a balance there. Yeah.

Dr. Sarah (36:31):

I mean, I think I, so it’s funny, ’cause like my approach, I have two things that I often say to my kids when I put something on their plate and they don’t want it. And my son will say, I don’t like that. And one thing I usually say is, that’s fine. You don’t have to eat it, but I don’t take it off the plate. Like I want it to sit on that plate. I want him to see it. I want him to smell it. I want him to accidentally lick it. You know, I want, I just want it to be there, like an exposure kind of, but with like no pressure. Right. I never tell him he has to eat it. I just, but I always serve it. And the other thing that I do is when he says I don’t like something like he’s like, I don’t like things as like a blanket statement I’ll often say, Hmm, you’re not in the mood for that right now. Like I just offer a replacement statement that kind of is a little bit grayer instead of so all or nothing, black and white, I don’t like this food as like a permanent way of being versus I’m not in the mood for something right now, which he’s been pretty open to kind of accepting that offering of a phrase. Just like, yeah, no, I’m, I’m not in the mood for that right now.

Rebecca  (37:38):

Yeah. I kind of do this. I, first of all, I do the exact same things. The only reason kids usually say I don’t like it or I like is because we frame their minds. That that’s what you’re supposed to say. So I said to the child, do you like broccoli? I’m framing their mind that you could like or dislike this, right. No matter how it’s served, no matter what toppings are on it, you are framing their mind as, from, you know, so better to approach the situation. As you know, when they say I don’t like it is what you’re doing is providing them more gray area and never really for kids that are picky eaters, I never ever have the parents use that phrase. Do you like it or not? Because what I’d rather say is, do you think it’s salty, do you think it’s sweet? Like describe like the sensory components of the food you know, in a, in a more gray environment because we kind of will pigeonhole them into that. And then our response to that will usually set off their dysregulation because we regulate our kids’ emotions, right?

Dr. Sarah (38:41):

That’s really interesting that whole focus on the process of eating rather than the product, like, is this good or bad, but what does it feel like in your mouth? What is it, you know, what are some of the qualities of this food? It’s interesting. Cause I talk about that a lot when I’m talking about helping kids build resilience and a sense of intrinsic motivation outside of eating, just in general, like when a kid shows you their drawing and we say, that’s so beautiful or I love that versus wow, you chose so many different colors. How did you, how did you come up with this picture? What did you, what were you thinking when you drew it or asking them questions about the process of creating it and how that orients them inward to their experience while they created that versus outward towards my approval or my praise and what you’re describing with food is very similar to this idea of like, if we can orient children inward, what does it feel like to eat this food?

Dr. Sarah (39:40):

What does it sound like in my ears as I crunched this carrot? Or what does it taste like? Is it salty? Is it sweet? Is it sour or whatever? That takes them out of this dynamic, right? So if we’re talking about kids who have power struggles with their parents around eating, that takes them away from what his mom and dad think about this food, what do they think about if I’m doing a good job eating or you know, it’s, it brings them back inward, which is where we really want them to be when they’re eating. We want them to be connected to their self and their body and their hunger fullness cues, and the sensations of eating. Because I think that that helps them develop their own relationship with food.

Rebecca  (40:26):

Yeah. I mean, what you’re saying is so spot on and we, you know, in terms of like your child, who’s not eating green foods right now, it may help you alleviate some of your anxiety about why or what is going on with them internally. If, you know, you discover that, oh, maybe my son doesn’t really like sour, salty foods, like pickles or something like that, you know, and, or other, I can’t think of anything sour and salty, but you get my point, vinegar, for example. So perhaps like us describing it and then them having the internal dialogue and external dialogue to express what’s going on with them internally made help. And honestly, it’s been helping for differential diagnosis to figure out a lot of the kids who have like reflux, like leftover from childhood, from like infancy, you know, understanding like, oh, I don’t like eating pizza. And like, mom’s like, how could you not eat like eating pizza? And the child’s like, because it makes my belly feel weird, you know, instead of, I just don’t like it. And how much more insight that give you into the what’s going on to the child internally versus I just don’t like it.

Dr. Sarah (41:40):

Yeah. And so I think we kind of feed them that phrase. Do you like it, “ooo, this is yummy, you’re going to like it,” versus “hmm, what’s it like to eat that?” “What does it taste like?” Or “what does it sound like in your mouth” or, you know, cause you can kind of hear the crunches and the chewing, like, you know, helping them, giving them language for the experience of eating rather than kind of something being good or bad or I like, or don’t like that’s an interesting, I like that approach too, even from the beginning, like when you’re introducing solids to a six month old for the first time, you know, what are some strategies that parents can kind of use in these very early stages of introducing food to a child that might set them up for a more healthy relationship with food or a more intuitive relationship with eating.

Rebecca  (42:35):

The more children I see, the more I learn and the, you know, it’s, you can take a million classes in the world, but really what you see in terms of child development. It’s not just about the food. It’s about the child. It’s about experiences with the children, everything going on in their world. So like, as I said in the beginning, my job is amazing cause I’m in the homes of people all day long and I think that’s important and understanding the whole family development and what’s important to the family and the priorities of the family around mealtime, around playtime, around socialization and how that all is intertwining with feeding too. So,

Dr. Sarah (43:10):

Yeah, cause I think, you know, if you have a baby who’s never eaten food before and we’re making that feeding about the relationship about eye contact, slowing down, smiling with them, enjoying that process, what does that taste asking them instead of saying, “mmm, that’s so yummy” versus what is, “what does that taste like? Do you taste that sweetness?” Do you taste that, you know, that’s a little bit, you know, crunchier, I mean a six month olds I’m getting crunchy foods, but I’m, can’t think of the adjectives right now, but you know, like giving them words to describe that experience from the beginning. And also I am a big fan, especially when kids are very little and we’re just introducing food undivided attention and having it be something that’s really about this is about connection and not really just about getting a task finished.

Rebecca  (44:15):

Yeah. And that’s what it is. It’s about loving food. It’s not about arduous eating, right? And also it’s important to not have an infinite amount of time at the table so that you do have a limited time it’s recommended children really should only be about 30 minutes at the table, longer than that, it becomes, you know, there could be some struggles, so we really try to limit their time. So it’s not just an endless time to eat and hang around and not eat I should say.

Dr. Sarah (44:50):

Yeah. Which goes back to managing our own anxiety about like, okay, you know what? I’m giving my I’m going to give ourselves 20 to 30 minutes of mealtime. And if my child doesn’t eat everything, I think they’re supposed to eat in that time. Then I’m going to accept that and allow the meal to be done. And that’s hard. It’s hard if you feel anxious about your child getting enough food. But I think you can always remember that, like there will be another meal time and it’s okay for them to get hungry in between meal times because that actually does give their body time to develop those cues of hunger so that they might be a little more adventurous or a little more curious about trying something at the next meal.

Rebecca  (45:29):

Yes. These are really good points and you have such good experience from a perspective of a psychologist and someone who works in the homes of so many different families. So it’s really nice to collaborate with you to help, you know, bring a better understanding of pediatric feeding disorders to families.

Dr. Sarah (45:48):

I know this is so fun. We should do more episodes on this because I feel like we could really talk for a long time about this, but so, okay. So how can people connect with you if, if they want more information, if they fear their child might, might have you know, an eating or a feeding disorder and they want some support, what can people do?

Rebecca  (46:12):

Please always email me. I will email you back and we can always set up a call and it’s, you know, hello@speechinthecity.com. I also just wanted to re-state that the website is discussed before feedingmatters.org was started by a parent who had a child with a feeding disorder, couldn’t really find the help or understanding of what to do next. So she created a directory of feeding therapists all over the world that you can search for and find someone in your area. So I would definitely check that out too.

Dr. Sarah (46:43):

Great resource. I’ll put also, I’ll put your email and the feeding matters website in the show notes. So anybody can go and reference that if they need this information. And I hope to see you back on this podcast again soon, because this has been just so helpful. Like as a parent, it’s nice to hear these things and it’s reassuring to hear these things. Then even if our kids are having even really challenging issues around feeding that are disrupting the family and you know, that there’s help that, that this is something that people can get better.

Rebecca  (47:18):

Yeah. I that’s, what’s so great about it. It’s seeing like the whole family recover almost when a child has a feeding disorder and they go through at therapy. It’s not just about the child or recovering or, you know, getting support. So

Dr. Sarah (47:35):

Yeah, I mean, I Feel the same way when I’m doing therapy with kids and with families, it’s like I’m treating the whole family always because you can’t, you know, I always say a family is like a spider web. If you pull one thread, the whole thing moves you. Can’t isolate family members when kids are little, they’re just, they’re all so interconnected. So clearly that plays out in your work. It plays out in mine. There’s something to that I think. Well, thank you so much for, for joining us and we’ll talk to you soon.

Rebecca  (48:07):

Thanks. Bye everybody.

Dr. Sarah (48:17):

Letting children learn to register their body’s own natural cues for when they’re hungry and when they’re full is an important experience. And we want them to be able to internalize this skill, knowing that it’s okay necessary even for your child to feel hunger can be a really profound shift in the way you approach feeding your child. And that shift can help you take some of the pressure off of yourself, which then translates to you naturally removing some of that pressure off your child too. And it’s in this calm, relaxed, and low pressure environment that kids will often begin to explore new foods and try new things. I’m really curious to hear what your experience has been with picky eating. Are you the parent whose kid like devour sushi or are you more in the chicken nuggets and plain pasta for every meal world right now, head over to @securelyattachedpodcast on Instagram and comment on the episode post to let me know how you’re navigating this within your own family. And if you have any specific questions, you’d like me to try to address in a future episode. So thanks for listening. And while you’re here, go ahead and leave a rating or review. It helps me reach more people and hopefully help more families. And while you’re there subscribe or follow the podcast. So you never miss an episode. Hope to see you back here next Tuesday until then don’t be a stranger.


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