In this week’s episode, your hosts Jennifer and Heidi, will discuss the difference between when children find comfort in eating vs. eating for compliance. It can be very difficult for families to identify if the success they are seeing is due to compliance. They break down the evidence behind the reasons why children eat and what strategies help build long-term success. Many families share that it can be easy to fall into compliance “mode” while feeding their child and the focus can easily be on “getting” them to eat rather than giving them space. In past episodes, we have talked about responsive feeding and what that looks like, but we rarely discuss what the other side looks like.

How do you know if a child is eating for compliance? What cues should you look for? Your hosts will break down the different cues you may see, and some strategies to try instead to help your child build comfort around food. This episode will also cover what progress looks like, how to reframe the word progress for families, and how to transition from a compliant environment to a comfortable environment. 

You can download this episode from Itunes, Stitcher, Spotify, Google Play, or listen to it below: 

As therapists, when we look at progress, we don’t focus on “getting” children to eat and how many bites, we focus on giving them space to let them learn how to eat in a comfortable and trusting environment. If a child is passively being compliant and accepting or tolerating the mealtime, that is not the same as building a positive relationship with food and overcoming feeding challenges in the long term.  

There are a few common things that we see when families first come to us and are wondering if they are falling into “compliant land”. So what are a few things we notice? 

• Environment: The environment is often loving as parents are trying desperately to try to “get” their child to eat, but there are subtle cues that their child is showing them that may not be as obvious to pick up. 

• Physical signs of compliance: Fisted hands in little ones, leaning back against their chair, starting to yawn or look sleepy, opening mouth WHEN something comes at them vs. Opening their mouth to SIGNAL they want to eat 
• Initiation: This is KEY! What does initiation look like? 
  • For an infant or a child with severe motor impairments, this may be as simple as eye contact.
  • It may not initially be reaching for food, but pay attention to the eye contact. We typically see that parents do not pause to allow the initiation to happen. By giving your child that space for initiation, you are giving them the chance to show you clear initiation 
  • Practice giving that pause to see what your child is doing throughout that pause. If there is no initiation (in the slightest form), then that may be a sign your child is eating because they are being compliant.  

Another common misconception is that a child “needs” the motor practice therefore they HAVE to eat. There is no clear evidence that suggests that this is true. There is evidence that suggests that purposeful, self-directed, and meaningful mealtimes can help build skills long-term. Eating for any other reason has less impact on their overall ability to gain and maintain a skill consistently.  

In today’s society and culture, it can be very confusing for families since there is compliance built into so much of what’s wrong with the way we feed ourselves and our kids. There are many behaviors that we know can have a negative long-term impact on children in the general population, therefore we do want to use those compliance driven activities on our most fragile eaters.  

It’s important to note that it is not your fault! It is extremely hard for parents and therapists to move away from compliance and see the real reason why your child is eating. We often recommend watching a video of a mealtime to see yourself feeding your child and think about what that might look like. Often, in the moment, it is hard to see these behaviors and identify how your child is responding. At Thrive, we spend so much time with families in intensive or in follow-up through in person or video observations and the reason is because it is important for other people to observe how these behaviors are coming across. Being able to identify expressions and faces, as well as possible tension, is important in turning mealtimes into a comfortable environment.  

This is not always something that is a “quick fix”. It is important to take your time and take baby steps when working to change your behavior at mealtimes or helping your child transition from eating for compliance vs. eating for comfort. A great place to start is to look at our Thrive Treatment Progression Pyramid to get back to the basics. We previously did an episode on the different steps of the pyramid and why it is so important to start with the foundation.

Resources: 

Ellis, J. M., Galloway, A. T., Webb, R. M., Martz, D. M., & Farrow, C. V. (2016). Recollections of pressure to eat during childhood, but not picky eating, predict young adult eating behavior. Appetite, 97, 58-63.  

http://www.sciencedirect.com/science/article/pii/S0195666315300970

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.  

http://onlinelibrary.wiley.com/doi/10.1111/j.1748-720X.2007.00111.x/abstract