Eating Concerns

Evidence
 
https://naspghan.org/files/documents/pdfs/cme/jpgn/jpgn%20cme%202019/March%202019%

20Article%20B.pdf 

Jinhee Park, Suzanne M. Thoyre, Britt F. Pados, and Matt Gregas. 

Compared to children born full term, preterm born children demonstrated greater symptoms of feeding problems regardless of their current age, suggesting children born preterm may require more careful monitoring of feeding throughout childhood. 

Education 

There are several reasons that feeding problems can occur.  Preterm babies often have difficulties feeding while in the NICU/SCN. Babies born before 37 weeks are not meant to be feeding yet and coordinating sucking, swallowing, and breathing can be challenging.   In addition to this, physical problems could exist and some just don’t have the energy to feed on a consistent basis.  Early feeding difficulty can lead into childhood, presenting as delayed eating skill development, food refusal and difficulty transitioning to textured foods (lumpy food aversion, aversions to strong smells and appearance of food).  

The skill of eating is not always straight forward with our premature or sick born children, and this can cause a great deal of stress for families because it’s a life sustaining skill.  Feeding problems in early childhood may impact a child’s growth and development and eating is a very social activity and this would make some children feel different and worry about what their peers think, as well as their family’s well-being especially at mealtimes. 

Another thing to consider is teeth sensitivity and dental issues. Babies born premature are also prone to teeth issues, some having problems with enamel making their teeth more sensitive to the temperature of their food.  This is important to understand if there are physical problems related to the eating issues at hand. 

More understanding is needed about feeding issues experienced by children who are born premature. If this topic is more well-known it will lead families to early intervention. At the ages of 6 – 12 years old there is normally no more developmental reviews for their child, and this would have families at a loss of why this is still a problem and what health care provider will help the most. More research is needed to help with the recovery from prematurity.  

One helpful tool that is available and helps to diagnosis these problems is, ‘The Paediatric Eating Assessment Tool (Pedi EAT).’ This Tool is a parent-report assessment of symptoms of problem feeding in children ages between 6 months and 7 years. This tool is used in assessments and for research studies, it helps to identify the symptoms of feeding problems in children born very preterm. 

Empowerment

Firstly, if you feel that your child’s problem with eating is causing your child and yourself worry and anxiety it might be time to have this addressed by the healthcare professionals. Sometimes this will take more than one type of healthcare provider and there are a few things that you can do at home that are helpful until you have the support you need. 

Create Small Short-Term Goals 

You may be worried and pressured to fix this situation and when helping your child you may run the risk of pushing too hard or too fast. So small achievable goals are needed. If we set expectations too high, it can ultimately make everyone involved think that treatment is failing when it actually isn’t. Change can take time, small changes in behaviour over a period of time can help keep the child and yourself motivated. 

Stay Focused as This Will Take Time 

Slowly Exposing your child to new foods is not easy. It can cause some strong reactions to your child and yourself. It could be 15 exposures before your child even try’s a new food. Repeating this process will help to increase the familiarity and show your child that you believe in their ability to try this new food. 

Take the Pressure Off 

It is extremely important not to pressure your child to eat. This can cause anxiety around mealtimes and family stress and then may have the opposite effect of your child not wanting to eat. Try to follow the Elyn Satter Division of Responsibility at all mealtimes, where it is the parent’s job to decide the what, where and when of eating and the child’s job to decide how much they would like to eat and if they would like to eat. Aim to make mealtimes fun so that your child wants to come to the dinner table. 
CLICK HERE to read article. 

Expose your Child to a Variety of Foods, Even if they Refuse it 

Make sure your child always sees and is offered a variety of foods.  Repeated exposure to a variety of foods is an important step to accepting new foods.  Once a new food becomes accepted, it is important to keep that food in the in the mix of mealtime choices. 

Involve Your Child in Food Preparation 

Did you know there are 32 steps to eating and only one of them is actually putting it in your mouth and eating!  One of the major steps to eating is interacting with food. Involve your child in growing food, preparing food, cooking food and playing with food. These are all positive steps towards the process of eating new foods. 

Take Care of Yourself 

It’s important to take the time to care for yourself making sure you are eating balanced diet, getting enough rest, and having your own support, when you are taking care of yourself some of the challenges will be easier to handle. 

If you need further support for mealtime at school during the primary school years, seek advice from an Accredited Practising Dietitian or an Occupational Therapist that works in the feeding space.  You can also ensure that our child has an individualised education program (IEP) for treatment for feeding and swallowing disorders in the school environment. Treatment addresses the impact on educational performance and supports the student’s ability to eat safely. 

 
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