The Cart Before The Horse: Why do you feel stuck?

September 2, 2020

Posted in: Early Intervention, Feeding, Feeding Tube Weaning

A common mistake made by well-meaning therapists and parents is trying to work on oral motor skill development before they work on a child’s trust and understanding of food. These programs start therapy with a focus on the “how” to eat rather than a focus on the “why”. We know that we can’t expect the skill to progress if your little one is not able to build comfort and trust at the mealtime. If we focus on building the skills immediately, we are sending the message that food is “work” and if it is difficult, children often lose trust. Think about learning a new skill without any motivation to do so. It would be really tough!  

If we first start with building a relationship around food and helping them learn to trust the mealtime environment, we can then allow for skill development. Without trust and understanding, working on feeding skills is futile and often detrimental long-term. 

So why do you feel “stuck”? 

  • Families often share that they can’t move forward in therapy because their child’s oral motor skills have stalled. 
  • Therapy is likely focusing too much on skill development and too little on comfort, togetherness, curiosity, and hunger to help build a foundation for a positive relationship with food. When the focus is on oral motor skills, without building this first, it is so difficult for the skills to carry over to the mealtime environment. 
  • Therapy NEEDS to focus on decreasing any negative activities around food, building trust, creating responsive mealtimes, and introducing hunger. AFTER this has been established, then therapy can work on supporting skill development. 

We often hear, “They’re not ready for weaning because they don’t have the oral motor skills” – This should not be a factor when determining a child’s readiness for weaning or feeding therapy. What should be the focus? 

  • Keep in mind other important foundations. Children must establish a sense of trust around mealtimes and food. This can be done by allowing more play, exploration, and modeling during mealtimes.  
  • Take a step back and look at your family mealtimes: Are they fostering comfort around food? Are they providing a social opportunity for your little one? This should be a time for learning, modeling, and being together as a family. 
  • Allow your child to refuse and help to rebuild their trust around food. Take this time to decrease any expectation for volume or quantity and focus on the QUALITY of your mealtime and food interactions.