While some parents might approach parenting with the motto “Speak softly, and carry a big stick” (Roosevelt), others look at their dilemmas as a problem to solve with either a carrot (reward) or stick (punishment/discipline). We offer stickers and M&Ms until our toddlers make their way through potty training. We offer allowances as payment for the completion of chores. And while none of those approaches are inherently bad, the mindset behind them might need some evaluating before we apply it to the process of teaching our children how to eat.
You see, unlike peeing in the toilet or unloading the dishwasher, eating isn’t a behavior that should be extrinsically motivated. Children are not “good” for eating, and “naughty” for not – and this is especially true for those who have been tube fed for all or most of their lives. For this population, “not eating” is a strangely appropriate response to being tube fed. Their caloric and nutritional needs are met. Their bellies are full. And not eating is, weirdly, the response we want to see when those boxes are checked: not eating on top of full tube feeds means that your child is listening to the “full” cues that his body is sending, and is responding appropriately by not eating more.
For parents who are desperate to get rid of the tube, that can be a frustrating reality. But within it is actually something very hopeful: if your child can hear and respond to “full” cues, it’s likely that he can respond to “hunger” ones as well when the time for weaning comes.
But when we forget how appropriate food refusal is at this stage, it can be tempting to introduce extrinsic motivators in order to “get” our children to eat. Sometimes, we can be tempted to resort to sticker charts or added screen time in an attempt to provide the motivation to eat. This is something that I want to caution against, because when we, in essence, bribe our kids to “take one more bite” or to “just try it because you’ll like it,” we can convey the notion that it’s okay to ignore the cues that their bodies are sending – and that kind of thing can hinder our long-term goals in weaning from the tube.
In the long-term, I want my child to listen to her body. When she’s hungry, I want her to reach for foods that provide the vitamins and calories that she needs to thrive! When she’s full, I want her to put the cookie down, satisfied with the foods she ate and happy to move on to the next part of her day. Unlike the completion of chores or the use of the toilet, I want her relationship with food to be intrinsically motivated – cultivated by the foods that bring her nourishment and joy, fueled by a healthy appetite.
So, if you’re in that place of desperation where you’re tempted to get onto Pinterest and create the most elaborate sticker chart you can find? My advice is to walk away from the computer, and instead listen to the voice inside that is reminding you that your child is safe, thriving, and healthy. That the tube is a good friend, but not necessarily a forever friend. The time for weaning will come, and until then, offer opportunities to engage with safe eating experiences that are joy-filled and pressure-free. Because when you allow your kiddo to honor the “full” cues that his body is sending, you create the safety and respect he needs for the introduction of the “hungry” ones too!
Elisabeth Kraus, MiT, Parent and Family Coordinator