The Worry Cycle of Feeding: Part I for Adoption Month

worry cycle with cr

In honor of Adoption Month (November) I will run four weekly posts on feeding issues related to adoption and fostering.  If you have biological children, children who came to you by birth and adoption, or no children at all, I hope you'll read the series. I'll introduce the "Worry Cycle" of Feeding, which is applicable to all families struggling with feeding and weight worries...Part 1  starts with the entry point to what I have called the "Worry Cycle" of Feeding (worry about feeding, weight etc. fuels the cycle). It's a visual representation of what I have seen with almost all of my clients to some degree or another, and jives with the research and training I've had around feeding difficulties. Let me give you a brief tour. Most children who are having trouble with feeding were more challenging to feed for any number of reasons. This feeding challenge is met by an often bewildered, overwhelmed, under-supported and scared parent who may even hear poor advice. This leads to the next phase— unsupportive or counterproductive feeding practices. Most of those practices are defined by an agenda or goal to get a child to eat more, less, or different kinds of foods, which is most often met by resistance or push-back from the child. Then the parent tries harder, or different tactics to control eating and weight, which is in turn met by more and more dramatic resistance. Alas, most of the clients I work with are deep in the center of the spiral and have been for months to years. Described by parents as the "black hole," or "bottom of the pit," it is a difficult place to come back from. Difficult, but not impossible. My main goal with this blog, the book, and my workshops is to help families from the start: to anticipate challenges, inform, empower and support parents with best feeding practices that fit their families, so they do not find themselves stuck or circling that black hole.

Let's back up and start with the initial feeding challenge. From Chapter 3 of Love Me, Feed Me:

Where Can Oral-Motor and Sensory Challenges Start?

It might help to think about this complex question this way: oral-motor and developmental/sensory concerns can have a “primary” origin, meaning the child presents with a challenge so that, even in the best environment, feeding may be more difficult. This could include a child born with:

• A chromosomal abnormality or genetic syndrome

• A neuromuscular condition

• Drug or alcohol exposures

• An anatomic abnormality such as cleft palate, airway or swallowing tube malformations

• Heart defects, lung problems, or other major medical conditions that increase calorie needs

• Severe reflux, constipation, or other gastrointestinal (GI) issues

Or the problem may emerge because of environmental factors, meaning how the child was cared for, including unsupportive or understimulating caretakers, environment, or feeding.

Within adoption and foster care, many children who struggle with feeding have a combination of primary and environmental factors. A child may have been born prematurely or is weak due to low birth weight, poor prenatal growth, heart or lung defect, or in-utero exposures. But what happens after birth also affects feeding and can lead to or worsen sensory and oral-motor issues. Lack of nutrition and poor quality of food can also affect feeding and development if there are deficits of critical nutrients during certain developmental windows...

FYI: The World Health Organization says this about the role of feeding: “Inappropriate feeding practices are often a greater determinant of inadequate intakes than the availability of foods in the households.” I was pleased to see that early feeding is getting more attention and needs to be part of the picture when evaluating feeding difficulties, particularly with adopted and foster children.

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If you've experienced feeding difficulties, can you identify what may have been the entry point, or the reason/s why your child was more challenging to feed? Was there a medical condition, malnutrition, trauma, temperament? Worries about size? Did you think some environmental, or early feeding experiences were part of the problem? What are your initial thoughts about the "Worry Cycle?" Are there other factors you would add? Next week we will examine parental worry, poor support, poor advice and move into counterproductive feeding practices...