Not a Phase

DR TESSA TAYLOR, founder of Paediatric Feeding International, provides some clinically-backed rebuffs for unhelpful comments and advice.

“Let’s not ‘wait and see‘. Instead, let’s cut the distance between empirically supported treatment and practice.”

So says Dr Tessa Taylor, a clinical psychologist and behaviour analyst who has spent decades helping families navigate paediatric feeding disorders. In that time, she's heard every unfounded theory and brush-off.

“People may mean well and feel like they are providing comfort or relief to people with feeding concerns, however, families tell us it does the opposite,” says Tessa.

“They are so glad to finally be heard rather than dismissed and to learn about real help. Access to life-changing treatment backed by research, not generic advice, is what actually reduces caregiver stress and guilt, as well as a child's anxiety.”

Here, Tessa shares her responses to some of the wayward words heard by parents and caregivers of kids who need nutritional support.

“They’ll eat when they’re hungry”

If only it were that simple. Feeding tubes and supplements exist for a reason. Contrary to common advice, some children will ‘starve themselves’.

Those unfamiliar with feeding disorders might find it unfathomable that a child won't eat. But whenever I'm out and about watching kids spear a cherry tomato with a fork, drinking from a cup, or biting into a sandwich by themselves and chewing it like it's nothing, I'm in awe.

Many children with feeding issues don't know how to do these things because they didn't get to practice at the right time, so they need lots of support to learn these complicated skills.

Other children may have these skills but, when faced with seemingly trivial differences in meals - like a different colour wrapper or food shape - completely shut down or struggle with meltdowns.

Simply taking away these children's lifelines - like feeding tubes - without alternatives does not teach them how to eat or drink.

“It's the child’s choice, don’t pressure them”

Parents may hear that children have an intrinsic motivation to eat. That you just need to minimise distractions and not give praise or rewards.

However, for many kids with feeding issues, eating and drinking has been paired with discomfort rather than pleasure. Learning these new skills can be hard and some kids require a lot of support before they get to the point of experiencing the joy of food.

Children need their parents to make critical life choices around sustenance. We don’t let kids decide on the medical consequences of feeding issues, like needing a feeding tube, or taking a suppository for constipation, or taking medication.

This might avoid tantrums at the dinner table, but it can also decrease eating and can be harmful. Guidance needs to be tailored to each child and family, not based on a blanket philosophy.

“It’s just a feature of their diagnosis”

It’s not okay to generalise and leave feeding problems untreated, regardless of a child's diagnosis.

A few years ago, a seven-year-old boy in the UK collapsed and died after a cardiac arrest. His mother said she had “spent years going crazy” seeking help for his feeding challenges, but was told they were just part of his autism. Only after this boy’s death was it discovered that his bones were deteriorating due to avoidant/restrictive food intake disorder (ARFID).

This is an extreme and harrowing example of how a lack of effective support can be life-threatening.

“They’ll grow out of it”

Often, feeding challenges are not ‘just a phase’. And even if they are, it’s not okay to go through critical developmental years without nutrition and hydration, or learning the many mealtime skills we need to be independent and participate socially. You can’t get those early developmental and brain years back and feeding problems, along with their impact, often become worse over time and with age.

Eating and drinking are intertwined with other aspects of development like toileting, sleep, communication and learning. Imagine trying to do toilet training when a child won't drink, or has pain from straining and constipation? And it's hard to have a sleep routine with irregular energy levels or getting up for bottles in the night.

If feeding challenges aren't present from birth, they typically start just after a year old and that's when families should get effective support.

A child should only be deemed ‘not ready’ or ‘not able’ to eat orally if there's an actual risk to safety - aspiration, for example. We can't assume a child can’t learn skills when they haven't been given the chance, with proper support.

Generally speaking, professionals who don’t specialise in feeding aren’t seeing the long-term and everyday impact of misinformation delaying vital, effective treatment.

I encourage parents or caregivers who are feeling unheard to seek out experts using well-established, empirically-supported treatments for paediatric feeding disorders.

You know your child best. Go with your gut and get the help your family needs.

This story was made in partnership with Paediatric Feeding International. Connect with Dr Tessa Taylor and her team at paediatricfeedingintl.com