Changing Colors: The Blog of Spectrum Pediatrics

April 21, 2017

Mealtime Stress: When Professional Opinions are Conflicting

By: Heidi Moreland, MS, CCC-SLP, BRS-S, CLC

What happens if the medical team disagrees with you or with each other. This can sometimes feel like families are being bullied into believing one person or another, or into doubting their own beliefs and knowledge about their child. Many people report that dealing with conflicting medical opinions add a considerable amount of stress. We know that stress can derail mealtime progress considerably, so it isn’t surprising to find that any doubts and pressures from the medical team can show up and take a seat at the table, resulting in even greater stress.

Here are a few things to consider:

  • Have they considered the facts? Many people, even professionals, have an emotional response to novel approaches then look for the facts to back them up. Feeding has an additional layer of emotion that makes it difficult to separate feelings from facts. However, once them emotion is addressed, it is almost always helpful to address medical professionals factually, rather than emotionally.
  • * Do they need a paradigm shift? This can be true in many areas, but there is a particular need for a change in perspective regarding feeding tubes. Many medical providers view them as a positive factor, or at the worst a “neutral” factor in child development. However, that is far from the truth. It is true that they can start as a positive, but they can often become a negative.
  • Is this their area of expertise? The gastroenterologist specializes in the GI system, but isn’t really trained in feeding development, swallowing, or how to progress in feeding therapy. Pediatricians likely get a two hour lecture during their training about nutrition, and even less about feeding therapy.
  • Do they feel that they have failed?: Professionals are also people. When patients seek other input, it can feel like they have failed, making it difficult to separate emotion from facts.
  • Do they offer this service? Everyone has a lens through which they view information. Many big hospitals believe that their programs and personnel are the best. If they offer this service themselves, asking for them to refer out is actually a conflict of interest, or at least a conflict of philosophy.

Once you realize the direction of their hesitation, it may help you to prepare for the most positive interaction. Here are a few more general tips:

  • Remember that most medical providers want to help. Come to them and state clearly that pressure from any direction will have a negative impact on eating. Ask for their support in decreasing pressure around food and in strengths-based care. See our previous post on how to build a medical team!
  • Bring your own team to the appointment – If you are fearful that you will be entering into a confrontation with a medical bully, it is almost always helpful to bring someone with you. Both parents making a united front can help the conversation stay on task and become less emotional
  • Send advance information: Find out the best way to get your question or findings to the provider in advance of the appointment.
  • Try to remain positive and factual, and tell them specifically what you would like their input to be. For example, “Because we have made no progress with traditional treatment, we have decided to that we are pursuing this for our child and would like some parameters to ensure that we are being safe” Or you could try saying something like, “We have been successful with our treatment so far, but would like some help with monitoring future progress. We hope that together we can minimize the stress about weight, which will allow him to develop and grow on his own.”

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