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Restistant Eaters in Childcare Rss

Hi Ladies,

I haven't been on for ages, hope all is well.

I have a question out there for Mums with restistant eaters. My DD1 has recently been diagnosed as a restistant eater, we believe her issues are a combination of sensory processing disorder and low muscle tone. We have started seeing both an OT and a speechie, but are in the very early stages. We have been given some great strategies for home, and while she isn't magically eating anything new, at least dinner time is a lot less stressful and we are working towards something positive.

Anyway, I don't have a follow up appointment (by phone), for another few weeks and I need to have a chat to her child care centre director before then.

Currently, if she doesn't eat the lunch she is given she has to go and sit on 'the thinking chair' while the rest of the group eat theirs. I have been told by the professionals that punishment is the worst kind of therapy, so when I mentioned this to the Room Leader she seemed surprised and asked us what she would like us to do. Obviously a lot of the strategies that we have been given at home aren't workable in the child care environment. Any tips for what I should say to the Director next time? I really don't know as this is all a bit new to me and we are having to radically change our own thinking as well.

Thanks.




I've actually just had an appointment with an OT about my son's eating as he has limited foods he eats and minimal amounts of those will be eaten at a meal. Like you, we're having a major re-shuffle of dinner times etc but it's a major change to my headspace about dinner. While he doesn't go to daycare atm, he is starting school next year so I'm having to work out strategies for meal times with him at school that I can suggest/mention to his teacher when we meet them next term.

Things that I'm hoping to take from our 'home plan' and adapt to the 'school plan' are things like:
* leave him to eat as much/as little as he wants, don't pressure him to eat everything - I will be providing him with options so that he can choose what he eats and in which order, I don't mind if not everything is eaten or he only eats a little bit of multiple things I've provided (... well, I do mind because I HATE wasting food but I'm trying to let go of that and focus on getting him to eat things, increasing the amount he eats can come later).
* I will always provide something he likes to eat, if he's eaten some of that I'm happy, anything extra is a bonus. (If your child care provides the food could you either bring in something that she does eat each day for her or give them a list of things that she eats so that they can include just one item from the list in the food offered to the kids???)
* Focus on positives with eating, not the negatives - if he chews something and spits it out that may actually be a big step for him because he's trying something new. I understand that you don't want to encourage the kids to chew and then spit out their food but please don't pull him up on it because this is a stage/strategy we're using to get him more familiar with foods he doesn't currently eat (drives me absolutely batty but last night he actually put something in his mouth he's never put in there before, then promptly spat it out, so it's a step forward I guess).

Something else to consider, depending on the daycare's policies, is getting her involved with the food preparation/set out. If you provide her food than get her to help pack it ready to go. If the center provides it, is there some way she can help with setting the table or something related to food times?

You could also ask the center to give her a 5 min warning before meal times and to introduce some sort of 'change over activity' so that she has time to get into the right head space for meal times (one of the strategies we've been suggested to use at home).

The OT I spoke with also suggested that eating times at school may help with his eating because they're a social environment where he sees other children who don't have eating issues eat. They will provide him with the opportunity to learn more about the social side of eating so I'd say removing her is probably one of the worst things they can do because not only is it a punishment but it's also taking her out of that socialisation/normalisation opportunities. Even if the center just encourage her to sit and experience the food (touching it/smelling it/looking at it) and bringing in other senses that aren't taste while the rest of her room is eating is a step towards encouraging her with her eating. If they can also focus on praising the other kids in her room about things they're doing at meal time it works as a teaching experience for her without the focus being on her and her eating so the pressure is off her.

I'm VERY early on in this process, since I only saw the OT for the first time last week, so I don't know how realistic these suggestions are or how effective they'll be but they're the sorts of things I'm thinking of atm for my son.

Leisa.

My DS2 developed a feeding disorder as a toddler. He's much better now that he was, but still not great sad

I suggest you look up some resources:
www.speechlanguagefeeding.com/picky-eaters-will... is a good one.
Google the SOS approach to feeding

Isolating your daughter at mealtimes is not helpful. There is a massive difference between a picky eater and a problem eater. Your daughters mealtime behaviour is not a choice that she is making, therefore it is not appropriate to punish it. This, to me, is the most important point that your DD's daycare needs to understand.

Leisa's advice is very sound. You need to allow your DD to eat foods that she will eat. A problem eater WILL starve rather than eat non-preferred food. People who have no experience of paediatric feeding disorders will commonly tell you that no child will starve themselves. That is simply not true sad
Thanks Guys,
At home we currently use a lot of your strategies. We wash our hands before dinner as a trigger for dinner time, and we always eat family style now so everybody dishes up their own meals. We always have at least one 'safe' food of DD1's on the table. We also have a bowl that eveybody puts their left overs in at the end of the meal, so we all have a clean plate to finish. This helps her undertand that she can select a food and look/touch etc, but can discard it at the end of a meal if she isn't happy to eat it just yet. Is she eating more with this strategy? Probably not, but she isn't eating any less, and meals times are a lot less stressful and DD2 has stopped modelling her behaviour.

The day care centre is so frustrating, they tell me they put her in time out because she is setting a bad example to the other children for not eating, and they can't let her go unpunished but scold other children. I'm at a loss as to what to say to them. They have halal kids, and a vegetarian, and it OK for them to have different eating arrangements, but not her. Asking her to eat food that she hasn't seen prepared, is touching other food, and contains 'unsafe' food to her is like asking her to swallow poison. They wouldn't punish a Austic kid for being displaying autistic behaviour, so why they can't see she has a genuine issue and is beyond me.




Clax wrote:
The day care centre is so frustrating, they tell me they put her in time out because she is setting a bad example to the other children for not eating, and they can't let her go unpunished but scold other children.


Maybe they should try to avoid scolding any child around food time. That way they're not 'letting' her get away with things that other's can't. If they limit the focus on negatives and instead concentrate on the positive behaviours it's going to encourage all of the children that are slower eaters/pickier eaters not just your daughter while still taking the pressure off your daughter. I know that there are some things that have to be dealt with and simply aren't acceptable behaviours but I'm learning that, for my son, it's a case of picking my battles and maybe they need to do the same.

Something 'longer term' I know but it might also be worth asking the director to consider doing some professional development/training with the staff in relation to children with eating issues and maybe seeing if the OT you're working with can run it or can recommend someone to run it with them. From what the OT I'm seeing has said, the strategies she recommends (and sound pretty similar to what your OT has recommended for you) are designed for children with eating/feeding issues but benefit all children who are exposed to them so it's not going to 'hurt' any of the kids at the center if they use the strategies for everyone.

Leisa.
I also have no real advice for you but just wanted to convey my sympathy as I kind of understand what you're going through.
My DS has a metabolic disorder which means he HAS to eat regularly otherwise he gets low blood sugar and can end up in hospital, and being a typical toddler will hardly eat anything at times. I took him out of day care as I saw the food they served there looked most unappetising and they didn't seem to care whether the kids ate or not and I had no way of knowing if he had eaten enough for the day.
I placed him in family day care which means I provide his lunch and therefore I can give him the food that he generally likes to eat. When he comes home I can see any leftovers in his lunchbox and know how much he has eaten that day.
Do you have the option of changing her day care arrangements? I'm horrified that her day care would choose to discipline a child because of their refusal to eat or their eating habits. This is the sort of thing that can trigger life long problems with food association.
I do hope things work out for your DD1 soon, sounds like you have made a good start by going to the OT.
I have no real advice for you except to say, if care is totally necessary I'd probably be looking for another centre, perhaps a family dc where there are smaller numbers and might be able to be more accommodating to your dds needs. Its worrying that they ever thought it was acceptable to punish her (or any other child) for what they will or won't eat and how they eat it. I'd be furious!
I have her in family day care one day a week, I pack her lunch there and I generally pack a wide selection of food and her educator allows her to choose, encouraging her to start healthily and work her way down. But my lovely educator can't accommodate both my children in Monday's so I put her in a centre thinking it might broaden horizons. Places anywhere are hard to come by and I was hoping to stick it out until she starts school next year. But now I don't know what to do ????




Sounds like you're doing everything right but the centre is doing everything wrong! sad

I agree with Leisa and Ruby. I'd be concerned at any scolding occurring around mealtimes.

Has your DD been diagnosed with a feeding disorder? Can you tell the Room Leader that she has a genuine medical/psychological issue for which you are currently seeking therapy? I haven't had my kids in care, but I would think that there would have to be allowances made for children with additional needs.

Can you provide her with her own food at the centre, as you do at the family childcare? That way she has safe food so the staff are not driven to reprimand her as an example for the other children. I can understand that they can't allow her to be involved in the preparation due to OHS concerns, but if her lunch comes from home then she believes it to be safe. And it is the behaviour you will need to instil in her for school next year - to select her food from her lunch box.

If the centre can accommodate children with halal and vegetarian dietary requirements, surely they can accommodate a child who provides her own food, as long as you adhere to the standard nut-free fare.
She has been diagnosed as having a resistant eating disorder and SPD by an OT and a speech therapist. Unfortunately the centre is very strict on bringing in food as there is a child with a life threatening allergy. Even birthday cakes are banned and you need to pay them to bake one in the centres kitchen.

I spoke to the director of the centre this afternoon and I am still frustrated. I spoke to her about not wishing DD1 to be punished for refusing food, and not her to come home starving as she has been. She said she was hearing a lot of negative language and what I don't want and not what I want to happen. Geez i don't know! I'm not an early childhood specialist, I don't know what is workable within the environment etc, I would have thought that the centre would have some kind of process in place. While eating disorders in kids are rare, they aren't unheard of and affect 4-6% of the population. I felt like saying - you tell me what you are going to do! I have given you our action plan for home, you do one for the centre.

Ho hum




Wow, that sounds patronising! Of course she's hearing a lot of negative language - you are not happy with the way your DD is being treated and she is not assisting you to resolve the situation!

What does your DD eat? Is there any way the centre can provide at least one safe food each day? Unfortunately it sounds as though this may not be resolved to your satisfaction sad If the centre manager isn't willing to assist you, it will be very difficult to achieve a successful resolution sad
I worked in childcare for 8 years. I would go in and tell them that under no circumstances is your DD to be punished for not eating.
Give them a list of foods she will eat, ask them to offer the same as the others first then a safe food. If you can also supply them with a copy of her diagnosis.

If they want to argue mention the Disability Standards. These apply in you situation, they are required to make an adjustment for her.

Trust me it's not hard.

Don't take no for an answer, you pay them enough and she deserves better. I
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