Elisabeth Kraus, MA
There are a lot of techniques that parents, therapists, family members and caregivers employ when trying to get a child to eat. Unfortunately, as well-intentioned as those methods may be, they are, at best, unsuccessful, and at worst, counterproductive, resulting in even more adamant refusals or more exacerbated meltdowns than we saw at the beginning.
Still, most of these tactics are hard to abandon because of the pressure that we feel: all good and loving parents know that so much of our job centers on providing sustenance for our kids, both physically and emotionally. When one of those things just isn’t working, we can feel a deep sense of shame and failure, resulting in overcompensating efforts to just get something into that mouth! The solution to all of this is two-sided: on the one hand, parents deserve the time, support and space to find healthy ways to process through and cope with their anxiety. On the other, it can be helpful to identify the practical tactics we resort to, to understand why they are not working, and to try different approaches instead.
We call these the “Three P’s of Pressured Eating,” and they are great illustrations of the reality that “trying to get your child to eat more results in them eating less…. Trying to get them to eat certain foods, results in them avoiding it altogether.”*
Prompting:
Prompting looks like encouraging your child to try the food that you’ve offered, asking them to take “just one more bite” when they’ve said they’re all done, requiring a “thank-you bite” before refusing a food, or bringing a loaded utensil right to the mouth and keeping it there, regardless of the child’s cues. Prompting creates a sense of pressure for kids because it overrules the cues their bodies are sending and asks them to oblige your request instead.
Still, it’s really hard not to prompt your child to at least try what you offered – or to take just one more bite! Especially when the amount they’ve eaten looks like so much less than they need. When you feel this anxiety rise, focus on the long-term goal of tube weaning: that your child can listen and respond to their appetite cues, joyfully, all on their own, of their own free will. And remember that every time you respect their choice to eat, to not eat, or to eat less than you want, you are making the space for them to hear those cues – and you are showing that you trust them to learn how to respond.
Parodies:
A parody is an imitation of something that is overly-exaggerated, often in a rather funny-looking way! When it comes to eating, a “pressured parody” can look like over-exaggerated chomping, or can sound like long “yummmm!” sounds that accompany the spoon coming to mouth or the “num-num-num” sounds we make to try and get our child to buy-in to how yummy food can be!
When you find yourself tempted to overly-imitate eating, remember that inclusivity will go further than imitation ever could! All you have to do is sit down to eat with your child. Children learn so much from watching their grown-ups participate in everyday life, and when you include them in family meals, you are telling your child that they are a valuable member of the family, whether they eat or not! This takes the pressure off, and allows them to learn what eating looks and feels like by watching their big people do it naturally.
Praise:
Praise looks like clapping, cheering, or offering incentives to children when they take bites/sips. It can sound like saying, “good girl!” after each bite or “good job!” when a child takes a drink. And praise can feel like a really natural response to a child who does something new or remarkable! And for a tube-fed child, eating feels like a remarkable event (and it is!).
However, for many kids, praise can feel just like pressure because it shows the child that everyone is, quite literally, watching every bite they take. And that is an unnerving experience! Praise also treats “eating” as something extraordinary, when in reality, the goal of weaning is to transition into a typically-eating life.
So, the next time you’re tempted to applaud when your child tries a new food (or any food, for that matter), switch to narration instead: rather than praising the choice to eat, describe the food you’re enjoying instead! “That mango is cold and squishy!” or “Those noodles have yummy cheese on them!” This way, you participate in eating with your child, and focus your attention on the joy of that relationship (before going for a secret dance party in the kitchen!).
All in all, we recognize that parents use the 3 P’s because they love their little ones, and want them to enjoy the process of eating! All 3 P’s come from the right place! But if parents can do the hard work to refocus on new, more productive approaches, they may find that the pressure begins to lessen – both on them and on their child. And less pressure almost always leads to more eating!
*The Ellyn Satter Institute. (2019). Retrieved May 25, 2019 at https://www.ellynsatterinstitute.org./positive-or-negative-it’s-still-pressure/