Food Issues

I think I should call this post food issues, part 1. Seriously, food issues and foster care could be its own, very, long book.

We know that food issues are always listed on RAD symptom lists. What makes it particularly difficult is just how many ways one can have issues with food. Hence, the need for a whole book. Every, single, one of our placements have had issues with food (except the 2 infants). This includes Shirley (who came to us at 18mos) and all of the children we have ever done respite for.

So, it's a big issue. One worth talking about. It's also one of those issues that is present all the time. We eat everyday. We eat several times a day. So, this issue is constantly being dealt with. As is the case with so many attachment related issues, it is less about the intensity of the behavior and more about the frequency and duration of them that makes it so much to deal with.

It's not like all families haven't dealt with picky eaters

or rude table manners

It's important to remember (especially if you are a friend or family member of a foster or adoptive family) that almost all RAD behaviors when looked at in isolation, can seem like totally normal kid stuff. This kind of thinking is what leads people to begin to think maybe the parents have unreasonable expectations or somehow don't understand that this is pretty typical kid behavior. The reality is, all kids show some of these behaviors, some of the time. If you are parenting a child that displays many of these behaviors, most of the time, it's a different ball game.


So, what kind of food issues do we see?

1. refusal to eat
2. gorging with food
3. asking for food constantly
4. sneaking food
5. eating in a panicked or rushed state
6. picking at food, inspecting it, playing with it
7. eating strange food
8. bad table manners (intended to disgust those around them)
9. hiding or hoarding food

When we had our first placement of teen brothers, I wanted to be sensitive to their preferences. I asked lots of questions about what they like, what they don't like, what they were used to eating before. I took input on the meal planning and wanted them to feel like they had some say over what they ate. I also wanted them to feel like our family was able to make changes or incorporate some of what they wanted rather than having them have to do all of the adjusting to a new home.

This was a terrible idea!

Now, in theory, it is not a terrible idea. The boys were older and presumably could participate in these things. It's true that kids coming into your home have to do all of the adjusting and that seems sad and unfair. However, we aren't having our niece and nephew over for the summer, it isn't our friends sleep over where we ask the guest what they want to eat. We are taking care of traumatized children.

These children have unhealthy relationships and that includes unhealthy relationships with food.

Food is such a part of our early experiences with our primary caregivers. Infants are held and fed and rocked and comforted and soothed all while being nourished. Our brains are still developing and we associate food and nourishment with so much sensory input, with warmth, love and comfort. They become totally intermingled.

When there are disruptions to that normal development (cries of hunger are ignored, babies bottles are propped and left alone to eat, cries of hunger are met with an angry, abusive reaction), it has a profound impact on the child's ability to relate to other humans. It is an essential part of human existence to be in relationship with others. When that is disrupted, that is the first order of business for healing.

Repairing those broken connections should be of the utmost importance. When a child comes into your home, they need to know you are the one that meets their needs. And one of the most basic of those, is food.

So, what do we do?

1. specific meal and snack times (no asking for food between those times)
2. eat what is offered, or do not eat, makes no difference to me. My dog would love to have your dinner, if you don't. You can try again at the next meal.
3. eat appropriate amounts of food (can have more if still hungry, but I decide when you have had enough)
4. eat with appropriate utensils in an appropriate way
5. chew with mouth closed
6. say "thank you" when served
7. ask for more saying "please" and using complete sentences (if they have those verbal skills)
8. no negative comments about the food ("I don't like peas", smells weird, looks funny, is good, but would be better with ___)
9. no picking at food

When you start to do one of these behaviors, you are telling me that you are not hungry anymore and mealtime is over for you. In the beginning, you may be ending mealtime a lot. But they eventually get it. It's important to offer consistent mealtimes and snacks, so they have opportunity to try again a couple hours later.

You'll be able to tell when they are really hungry and when they aren't because when they really want to eat, they will use their fork or spoon like you never knew they could, they'll chew with their mouths closed and wipe their faces with a napkin. It's pretty amazing to me how nicely they can eat in one setting (our house) and how much they become like animals when eating in another setting (on visits with bio parents).

I have literally hundreds of food stories to share, so stay tuned for part 2!