Changing Colors: The Blog of Spectrum Pediatrics

Posts Tagged ‘spectrum’

February 12, 2018

Happy Mealtimes and Healthy Eaters: Four Things Every Parent Should Know

By: Jamie Hinchey, MS, CCC-SLP and Heidi Moreland, MS, CCC-SLP, BCS-S, CLC

“Isn’t my job to make them eat healthy?”: It is often forgotten that children and parents both have their own roles to play during mealtimes. Ellyn Satter describes the Division of Responsibility (sDOR), which breaks down the different roles between parents and their child.

  • Parents control the what, when, and where of feeding
  • Children determine the whether to eat and how much.
  • Providing limits while being supportive with food can be a difficult balance for families, but it is a worthwhile goal
  • Children should be allowed to explore food, but also able comfortable with saying “no”.
  • It is okay for caregivers to say “no” to certain behaviors and request and set certain boundaries during mealtimes, especially as your child matures.
  • Be intentional about allowing them to develop independence with self-regulation.
  • It may be helpful to focus on something else during the mealtime instead of paying too much attention to your child’s eating. This could be a great time to talk about your day, focus on building communication opportunities, or using the mealtime as a social gathering for the family.

Restricting “Bad” Foods + Pressure To Eat “Good”: “Does it add up to healthy eating?”: As a parent, you want your child to grow and develop. Part of this is can be accomplished by eating healthy and nutritional foods. Although you may want to push the “healthy” foods on your child during mealtimes, this pressure to eat certain foods can cause a decrease in interest. In fact,

  • Take a second look at labels: Look past advertisements such as “low sugar”, “fat free”, and “low carb”. You may be surprised at which foods might be labeled “bad”, but are full of nutritional value.
  • Model healthy eating: Children learn the most about food through the direct experience of observing others eating while eating (Savage, Fisher, & Birch, 2007). That means it is more meaningful to model a healthy diet for your child rather than it is to restrict “bad” foods.
  • Avoid the reverse effect: Research has found that when parents restricted certain foods, the children’s intake of those foods actually increased and put them at risk for excessive weight gain (Birch, 2014).
  • Trust your child to eat the right amount – they know better than you do: Katja Rowell shares in her book, Love me Feed Me, that when children are allowed to eat to “treat” foods such as high sugar foods, they are able to respond to body cues that regulate when their body needs to eat and when they are full. However, when adults interfere by restricting that type of food, it inhibits their ability to learn and respond to cues about how much their body needs.

The Hidden Danger of “Is This On My Diet?”: In today’s society, it is difficult to watch television, read a magazine, or go to the grocery store without hearing about a new diet or a “health fad”. This makes it almost impossible for anyone to feel good about food they are buying or eating.

This may feel like a healthy change, but can it actually be causing more harm. Surprisingly, emotions around food can have a number of negative consequences.

  • The way you think and feel about food impacts not only your enjoyment of food, but also your absorption of nutrients (Crum, 2014.)
  • Your feelings about foods impact family discussions about food. Many parents find that negative or conflicting emotions about food can make it difficult for them to talk about food in positive ways in front of their children (Lytle et.al. 1997).
  • Even at a young age, children are able to pick up on the discussion around food. Although they may not understand complex nutrition talk, they are aware of the focus on “unhealthy” vs. “healthy” foods and conflicting emotions around foods. As they process those emotions through their own lens, this may result in conflicting emotions around food and their bodies. For example, when the focus is “healthy” or “unhealthy” food, children may feel pressure to eat a certain food or feel ashamed for wanting to eat a “treat”.
  • Instead of focusing on discussing or dissecting food in front of your child, take that focus into meal planning and serve a variety of healthy foods that you enjoy.
  • Use mealtimes to have conversations with your child. You can talk about foods you enjoy. If it is interesting, you may also want to talk about how to cook the food, where the food came from, or different types of food that are similar.

Eating Together/Social: “It’s Time for Dinner”: Children develop early patterns around mealtimes through social interactions surrounding feeding (Savage, Fisher, & Birch, 2007). The Family Dinner Project, a nonprofit organization operating from the offices at Project Zero at Harvard University, lists many benefits to having a family mealtime. What they found is that even if it isn’t always possible, it is important to try to make time within your weekly routine to share a mealtime with your child.

  • Children who are part of regular family mealtimes have lower rates of substance abuse, higher self-esteem, and lower rates of obesity and eating disorders.
  • Family mealtimes provide an opportunity for kids to watch their parents and siblings eat, which can provide a foundation for more adventurous eating later
  • A study by Brown & Ogden (2004) found that family modeling has a more lasting influence than control at meals.
  • Family mealtimes allow children to be a part of a routine, see food as an enjoyable, social opportunity, and build exposure to a variety of foods, even if they don’t eat them the first time they are served.
  • Mealtimes aren’t just about nutrients begin consumed. They can also be about caring for others through preparing food, participating in social interactions through staying at the table and being part of conversation, and contributing to the family by completing mealtime chores.

Sources:

Brown, R. and Ogden, J. Children’s eating attitudes and behaviour: a study of the modelling and control theories of parental influence. Health Educ. Res. (2004) 19 (3):261-271. doi: 10.1093/her/cyg040

Crum, Alia and Corbin, William. ” Mind over Milkshakes: Mindset, Not Just Nutritents, Determine Ghrelin Response” Health Psychology (2011): 424-429

Rollins, Brandi Y., Loken, Eric, and Leann L. Birch. ” Effects of restriction on children’s intake differ by child temperament, food reinforcement, and parent’s chronic use of restriction” Appetite ( 2014): 31-39.

Rowell, Katja, MD and Jenny McGlothlin (2015). Extreme Picky Eating.

Rowell, Katja, MD (2012). Love Me, Feed Me. A Parent’s Guide to Ending the Worry about Weight, Picky Eating, Power Struggles and More. Family Feeding Dynamics LLC. St. Paul, MN.

Savage, Jennifer S., Jennifer Orlet Fisher, and Leann L. Birch. “Parental influence on eating behavior: conception to adolescence.” The Journal of Law, Medicine & Ethics 35.1 (2007): 22-34.

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January 31, 2018

Family Mealtime Coaching: What is it and how can it help?

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

We all want our kids to be the best that they can be.  In fact, many families hire coaches to pump up their kids’ soccer game, to improve their free throw shot, or to work on their ballet positions.  But a baby?  An eating coach?  That seems like the ultimate in helicopter parenting.  In reality though, working with a coach on your child’s mealtime abilities can be exactly the opposite of being a controlling parent.

One of the foundational aspects of eating is the development of self-regulation.   By definition, that means that the baby or child is learning to be in charge of themselves and their eating.  The job of a parent is to provide the necessary, developmentally appropriate support to help their child be successful to the best of their ability.  It sounds simple, but the mealtime relationship can be complicated by developmental difficulties, medical problems, culture, differing family expectations, and the child’s own temperament.  Often a feeding therapist is recommended to work on the child’s skills, but many times, skills are not actually the problem, or only part of the problem.  Parents need help with defining their own role and responsibilities within that relationship.  The job of a mealtime coach is to teach parents to be aware of their own impact on the mealtime relationship, as well as to read their child’s cues so they can determine when to step in, and when to allow their child to work through a problem with less support.  This balance is what will allow the child to advance their self-regulation skills without allowing them to try things that are unsafe, or inappropriate.

There is good evidence that shows many benefits to the development of self-regulation.  The benefits go beyond healthy relationships with food and weight.  Self-regulation was defined by Shonkoff & Phillips as “gaining control of body functions, dealing with strong emotions, and maintaining focus and attention.” That mean that self-regulation skills can also impact the ability to form and maintain relationships, pay attention in school, control anger and anxiety, and adapt well to new situations.  By working with parents on healthy boundaries and support during mealtimes, a mealtime coach can provide parents with the tools to read their child’s cues and support their self-regulation in all areas of life.

There are a number of reasons why coaching is a better model than therapy or teaching.   A coach may be a therapist or a counselor, or another parent, but the coaching model describes how the professional, parent and child interact in the mealtime setting.

  • The job of a coach is to listen first, to make sure they understand the whole problem.
  • A coach is focused on helping families identify some of the root causes of the difficulties
  • A coach will encourage families to come up with solutions that will work in their own home or circumstances
  • A coach will focus on the family and child interaction and relationship, rather than providing a strategy or intervention and expecting the family to imitate the therapy relationship

If you’re interested in learning more about how a mealtime coach could help your family, we would love to hear from you. Spectrum Pediatrics currently has therapists in Virginia, Tennessee, and New York. We are also able to coach remotely from a different state. Contact us here!

January 29, 2018

Feeding Tube to Family Table: How does that work?

Did you ever wonder why feeding therapy doesn’t look anything like the meals you hope to have?  We did too!  At Spectrum Pediatrics, we believe that tube-fed kids need to learn to eat in the same safe way that other kids learn to eat, utilizing the same principles of healthy eating that are good for everyone.

Meet Jennifer Berry and Heidi Liefer Moreland, as they introduce the philosophy behind the Spectrum Pediatrics Tube Weaning Program.  Watch as they explain how a healthy relationship with food that is shared by the whole family leads to freedom from tube-feeding, enjoyment at mealtimes, and lifelong healthy eating habits.


 

Want to learn more about the people who work with the children in the tube weaning program? Click here to meet Jennifer, the owner of Spectrum Pediatrics, and here to meet Heidi, the clinical coordinator of the tube weaning program. See our Tube Weaning Program featured in the New York Times here.

 

October 20, 2017

Spectrum at NPC-QIC: Lessons from a Tube-Weaning Program

Our wonderful feeding therapist and clinical coordinator of our Tube Weaning Program, Heidi Moreland, is presenting at the National Pediatric Cardiology Quality Improvement Collaboration conference in Chicago this weekend. Throughout this presentation, Heidi discusses the philosophy behind Spectrum Pediatrics tube-weaning program and provides a glimpse into what the program looks like for children and their families!

Check out Heidi’s presentation here along with helpful resources for the tube-weaning program:

References for Spectrum Pediatrics Treatment Program

Spectrum at NPC QIC Presentation

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