"Eat it, no don't you dare eat it!" Confusion and pressure undermine eating skills and trust.

I was recently at a children's museum in another state. We were enjoying lunch, and I smiled and waved at a gorgeous preschooler at the table next to us. The mom and dad were attentive, loving, affectionate, and working really hard to get the two kids to eat (well, the mom was anyway). I have special experience and interest in helping adoptive and fostering parents, and the family was transracial, with white parents and black children.  The adoption is relevant in terms of attachment and trust issues, which I will explain later, but the scenario is one I have observed in all kinds of families:Here's the scene: Mom counted and reported every bite to Dad, in front of the children. Mom repeatedly put the pizza into the children's mouths, or up to their mouths, encouraging them to eat more, one more bite, "It's the cheese, that's the best part!" The children mostly refused, turning their heads, keeping their mouths shut, or pushing the pizza away. Rarely, the littler one would comply and try to nibble off a bite.Then Mom changed tactics, trying reverse psychology, "Oh, no! Don't you dare take a bite of my sandwich, no eating MY sandwich!" Which didn't work either...I observed that the younger boy appeared to have trouble chewing, I'm not a speech pathologist, but have some familiarity with the issues.  I saw what looked like an oral-motor delay, where he seemed to have trouble biting, and manipulating the food in his mouth. He chewed mostly with his front teeth, and used his cheeks a lot to move food around. He seemed to have the skills more in line with a young toddler. I wondered if the chewy crust and pizza that he had to bite and tear off was too hard for him to manage? It seemed so. The older boy, who was about five, seemed a little confused by it all, in particular after he was told to eat more, but then not to? (See worry cycle part I on feeding challenges, and why adopted and foster children are more likely to experience feeding challenges.)These parents were probably worried about intake. They may have been told that their children needed to gain weight, and to try whatever they had to to get them to eat. I talked with one foster mother who was parenting a little girl who had been taken away from her biological mother largely due to neglect and "failure to thrive" (low weight and disinterest in eating essentially). The pressure this foster mom experienced to get her child to gain weight was unimaginable...Back to our family at the museum. The parents were trying so hard, loving so hard, but falling into common feeding traps. I desperately wanted to reach into my bag and put my card on their table, but I didn't...My general thoughts, but particularly for parents and children working on trust and attachment, or if your child is anxious around food:

• The harder you work to get food into a child, the more likely he is to eat less and grow less well. (See the Worry Cycle series  and responsive feeding literature.)
• Try to avoid talking about how much of what children eat at mealtimes, or reporting to other adults. This can feel like pressure. Either children don't want to disappoint you and they feel badly, or they won't want to comply. Either way, pressure to eat can turn kids off the food, or teach them to overeat over time.
• Send the message that they can be trusted with their eating! You can do this by putting the foods out there, and then being good company and letting them do their jobs with eating (how much).
• Avoid trying to trick or use reverse psychology to get your child to eat. It is simply too confusing, and undermines trust.
• Be sure that foods are offered in ways that the child can handle in terms of oral motor skills. Consider an evaluation with an experienced speech pathologist to help you know how to support eating. (See my PDF on questions to ask your feeding therapist.) The younger boy in question may or may not need any outside help. If he can manage foods, and is gaining weight and progressing, support in the home may be all he needs. An eval from an experienced ST who knows about attachment, and will help you support your child may also be appropriate (I go into this in detail in chapter 3 and 4 of Love Me, Feed Me.) Remember, bad therapy is worse than no therapy, so trust your instincts if what you are asked to do in therapy is increasing power struggles. (This mom may have been able to pull small pieces of cheese off the pizza, or cut up the crust already softened with sauce for example.)

Meals are such a wonderful opportunity to connect with your children. Above all, it made me sad to watch these parents work so hard, missing out on the nurturing and bonding meals provide, and alas, probably making things worse in terms of intake and growth... Thoughts?