What can you do while you’re getting ready to wean? This week’s episode focuses on what you can do to help your child become a happy and healthy eater while they are still tube-dependent. This includes building in rest, play, and taking a step back from anything that could be harming your child’s initiation and interest in food.
First, Do No Harm:
When your child is tube dependent, it is still very important to implement strategies and therapies that will help build their positive relationship with food. We often ask parents to stop and think to consider if what they are doing is hurting or harming the way their child relates to eating by mouth. If the answer is that it is building their relationship and interaction with food, then continue. If the answer is that it is causing your child to have a negative interaction, it may be time to take a step back.
Parents and caregivers, as well as therapists, can sometimes put on a show without even realizing it. We like to think of these as different mealtime personalities that take over during meals. Children are very tuned into their parents, even young children, and if you are “working” on food a lot, your child recognizes those expectations at mealtimes. This can make mealtimes confusing and send the wrong message to your child.
Time to Play:
While building a foundation, you want to give your child the opportunity to explore and feel comfortable around food. What better way than play?
Play is NOT the only answer. In an attempt to rebound from traditional feeding therapy and move towards more responsive therapy, play became very important. If you have been using play with your child and have not seen progress, that is okay! Play by itself is not enough, it is only a small piece of the larger puzzle. Play is play if it is comfortable, and if it is not, it is time to take a rest!
Time to Rest:
When children have a feeding tube and are not learning to eat, there are often so many changes happening in their environment around the tube feed themselves (timing, schedule, what is going in) that rest is also just as important as play. Typical family mealtimes are restful, social, and should not be a panel of people who are focusing on “getting” your little one to eat. We want your tube-fed children to feel comfortable around food, come to the table, and be an active participant. It is also important to have well-defined limits, roles, and boundaries at mealtimes.
The tube matters:
When children have an extensive medical history, they can get stuck in the predetermined, non-child focus of the feeding tube that helped to save that child’s life and keep them alive while in the scary medical phase. When they are out of that phase, this medical model is often kept the same. Children are always growing and it is important to keep in mind that your child will become an eater one day. Talk to your medical team about when they feel like your child is in a safe place, and ask them “What is this going to look like when the tube isn’t needed any longer?” Here are couple strategies to help you in the meantime:
What is your child saying?
It is normal for your tube-fed child to not show hunger cues. They are getting their nutritional needs met by the feeding tube and do not have as many chances to show hunger. Sometimes, if they are hungry, food still has a negative association and hunger may not be enough. IF your child is not showing hunger cues, that is okay. That does NOT mean they will not wean successfully.
Thank you so much for listening to Episode 2 of Tube To Table! Stay tuned for upcoming episodes where we will talk more about hunger, where our program started, and talk to families who have successfully moved from feeding tube to family table!