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Tube to Table Podcast: Episode 16: Nibbles and Bits

October 23, 2019

Posted in: Early Intervention, Feeding, Feeding Tube Weaning, Tube To Table Podcast

Picture this: You’re starting a tube wean and you’re at the grocery store…what do you buy? On this week’s episode of the Tube to Table Podcast, Heidi and Jennifer are discussing a topic that is on every parent’s mind when starting to wean their child from the feeding tube. Making food choices while weaning can be very overwhelming for families. Parents are always asking for that “magic food” and although we wish we had that, it doesn’t exist. There is no one food that will help your child eat, but there are factors to consider when choosing certain foods. Helping parents with food choices during a wean can help eliminate some of the focus on the volume of food. It can feel complicated feeding a child who eats very little or who has never eaten before. We’re here to help! There are a few important factors to consider when shopping for food choices. These include ability for independence, consistency with food, texture/taste, and familiarity within the family. Heidi and Jennifer will also talk through some factors that should NOT be considered. You’ll hear a few of their favorite tips and tricks when they are helping families choose foods during a wean. 

You can download this episode from ItunesStitcher, Spotify, Google Play, or listen to it below: (LINK PLAYERS and EMBED PODCAST) 

“I want to do it myself!” 

One of the first recommendations we give to parents is to start with foods that allow children to have the maximum autonomy. When a child is in a new or scary environment, if they have something they can feel in control of, it typically allows them to be more successful. When starting with autonomy in mind, start with finger foods or foods that children can hold independently. This doesn’t necessarily need to be a food that they can successfully chew, but a food that they can feel successful with picking it up. Independence can also build with the utensils or tools the child is using. This can mean working with your therapist on finding the fork, spoon, or “dipper” that allows your child to be independent. This can also be while grabbing for food and learning to read your child’s cues which help with autonomy. Large pieces are easy to pick up, little pieces can be tough! Big foods are easier to find in their mouth and gives the child space to spit it out, or gnaw on it while they gain comfort. This could be: big slices of pears, apples, etc. At this point when focusing on independence, it is more important than the “intake”. This may mean big pieces of meat or big pieces of a bagel, that may be tough to bite off, but at least it is something they can put in, take out, while still feeling safe.  

What is BLW? 

Baby Led Weaning is a common approach that helps with independence. At Thrive, we typically make this decision and recommendation based on the child and what is most appropriate. When a child demonstrates the need for independence, we typically lean more to the baby led weaning approach because this allows for full autonomy.

“What do I make for dinner?” 

This is a question our therapists get during every wean. We encourage parents to think about food in a different way. Try and ask yourself what do YOU want for dinner? There is a market for “kids foods” now, but it is also very helpful to encourage your child to have what you are having! If you’re having pasta for dinner, there are ways to shape those foods to help your child. For pasta, that might be a larger piece of pizza or a large breadstick if you are eating a small piece.  Although your child may not be able to yet eat that food, they are enjoying an experience with you and able to engage during a mealtime. 

  • In terms of choosing foods, one of our most common recommendations is to eat what you eat and have your child sit in an area where they are able to reach or initiate interest in that food. In the beginning, your child doesn’t know why they are choosing certain foods, which can make it difficult to choose!  
  • Familiarity is a large reason why a child may show interest in a certain food, if they have seen you eat foods a lot.  
  • Eating at the mealtime in a stress-free environment, encourages your child to feel safe and learn that food is more about the social experience and positive engagement rather than their intake. 
  • It can be SO overwhelming to try and find “kid” foods. This can be very stressful for a child who is struggling to eat. Use these mealtimes to look at your child for inspiration. See what they are interested in for novelty, familiarity, or just because! 

“Food is food is food is food” 

At Thrive, we don’t believe in labeling food and there is research to support what we know about the impact of labeling foods as “clean”, “dirty”, “bad”, or “good”. When a child is confronted with all of these labels and given food in only ONE category, it can shut off or hinder their ability to self-regulate.  During a tube wean, we are working to help a child learn to self-regulate intake, so it is important to remember that this is not the time to focus too much on the labeling of the food. This means, if your child chooses a funfetti cupcake to start eating with, that is OKAY! This does not mean they are only eating that for the rest of their life, but for now, it helps them understand their body’s needs and build that positive association with eating.  

  • There is an appropriate time to focus on the body and growth, but that is AFTER the child has mastered eating and built a positive, comfortable association. 
  • Consistency can help with food choices. Many children go towards processed foods because they are consistent. Every cheeto tastes the same, or every cracker will always have the same crunch. For other foods, it can be inconsistent, which can be scary for kids.  
  • As children become more comfortable and relaxed, they can step out of their need for just certain foods and slowly build their variety.  

“Is it warm enough?” 

Many children are sensitive to experiences from the past (formulas or purees were warm, heated up, or too cold) and this could cause your child to demonstrate more temperature or texture preferences to things that are safe. Many times, children surprise us and love seasoned foods! This could be spicy, a little pepper, or a small amount of seasoning. It is important to pay attention to the texture and temperature to start identifying patterns your child may be showing. Spitting foods out is NORMAL whena  child is learning to chew and swallow. This doesn’t necessarily mean that texture doesn’t “work”, but it may need they need more time and exposure to build that comfort. It is very empowering for a child to be able to spit food out, and they are more likely to put it in, knowing they can take it out. It is a safety mechanism and developmentally appropriate for all children. This phase may last a little longer for a child who is weaning from their feeding tube.  

One last, but certainly not least, tip from the Thrive Tube Weaning Team is to always follow your child’s lead!