World War Food: An Update

+++++++++

It’s been a year since I shared an update on Operation Picky-Eatin’ Toddlers. Last January, Peanut had her first visit to the “Doctor Restaurant“, and a few months later, Squeak had his visit, too. Peanut’s was brutal, and Squeak’s was tough too (but nowhere near the epic battle of his sister’s). We had a plan and we were doing well early on, giving Peanut a nightly challenge food that she touched to her lips three times before she could have her dinner.

The plan went well for a few weeks, until the wheels fell off. She went from being cooperative to a total Toddler Arsehole. But we held our ground: no dinner until you do your food touches.

She called our bluff. Some nights she’d hold out for hours. Once, after two and a half hours at the dinner table, I sent her to bed without a scrap of dinner. I felt like a horrible mom. (Looking back, I ask myself, why did I feel so bad? My mother did the same thing, many times, and she seems to operate guilt-free… damn this age of parenting! All the friggin’ guilt is ridiculous.)

Nathan and I soon grew exhausted with the routine and—I’ll admit it—we gradually fell off the wagon.

We blamed our failure on a late winter and spring that knocked us all on our asses. Squeak was hospitalized for four days with a scary respiratory virus. Peanut got sick and battled a nonexistent appetite for weeks. Then I came down with influenza and spent a month trying to feel normal again (that influenza is no joke, people—get your damn flu shot!). We were spent, physically and emotionally. One more battle, especially the huge ones that dinnertime had become, was just too much.

By late spring, we had completely abandoned food touches. We fooled ourselves into thinking Peanut had made progress, because she’d added a couple of new foods to her roster… but she dropped a couple of foods at the same time, so it was fake progress. We were no better off, and Peanut was picky as ever.

Getting back on the wagon

The denial lasted a long time—until September. I don’t remember what caused me to snap, but I remember a particularly difficult dinner. I was fed up (sorry, bad pun). Crying. Frustrated. And hating myself for having lost my temper and yelled at my kid, again.

Help arrived in the form of a friend who was also seeing the feeding specialist for her picky eater. Lindsay was instead making appointments with Dr. C’s colleague, Dr. Bill. He was playful and connected really well with her daughter, she explained. She had seen Dr. C once too, but felt that Dr. Bill was a better fit.

My friend’s endorsement meant a lot, so I made Peanut an appointment with Dr. Bill. This time, my husband came along.

Meeting Dr. Bill

Just like our first visit, I was asked to bring a lunchbox of food: four items were “preferred” foods, and the other four should be “non-preferred”, or as Peanut called them, OH MY GOD IT’S POISON. 😉

I packed banana, cottage cheese, quesadilla, oranges, and peas (the icky foods) and a muffin, Cinnamon Life, pineapple, and string cheese (stuff she’d eat). I took a half-day off from work and wore grubby clothes. I remembered how disheveled I was after the last visit; this time, I was prepared.

Dr. Bill was an absolute delight. He sat on the floor with Peanut and played Barbies like a pro, marching their stick legs around the Barbie Dreamhouse, making up high-pitched voices for them, putting them in goofy scenarios (“Look, this one can’t find her shoe! Where could it be?!”).

He kept up his games with her while simultaneously asking us questions, and instructed us to set out four small bites on the plate we’d set up: two preferred, two non-preferred.

After some more Barbies, he set a timer. He announced to Peanut that when the timer went off, it would be time to eat. She nodded in agreement.

I looked at Nathan, one eyebrow arched. Just you wait, Dr. Bill, I thought.

When the beeper sounded, he jumped up excitedly and led Peanut to the table. She happily tagged along, and he explained that she could take a bite of anything on the plate. She chose a muffin first, then cereal. When the preferred foods were gone, he prodded her to choose another bite.

I cringed, waiting for the shitstorm.

To our utter amazement, Peanut thought very hard for a moment, then picked up the pea and placed it uncertainly in her mouth.

I looked at Nathan. His eyes were wide. What the hell just happened?!

Dr. Bill smiled at us but never broke character. “Great job, Peanut! Chew up that little bite and here’s another bite of muffin for you!” he cheered.

A moment later, her face fell. She stuck out her tongue and let the pea roll onto the floor. She climbed down from her seat and walked over to me, chin tucked to her chest, whimpering.

“Mommy I don’t like that, it taste yucky,” she said quietly.

Dr. Bill didn’t miss a beat. “Peanut, just one more bite here and we can play with Barbies again.”

We steered her back to her seat, where she opted for the quesadilla, chewing it slowly, and ultimately swallowing. She darted out of her chair and back to the Barbies.

Dr. Bill is the Wizard of Oz, I’m pretty certain

The surprising cooperation continued for our entire 2.5-hour visit. Dr. Bill convinced her to eat foods—without complaint—that she’d never eaten for us, like banana and cottage cheese. Not just touching them to her lips, but chewing and swallowing.

After Barbies lost their luster, Dr. Bill pulled out a Mickey Mouse Club video. He used the remote to pause the movie, prodding her to take a bite before he would push PLAY.

“Peanut, what do you think happens next? I want to find out! Go ahead and take your bite and I’ll start it up when you’re done,” he explained. The guy had an endless reserve of enthusiasm. After Mickey got old, they started racing up and down the hallway as a reward for taking bites. It was a sight.

Then Dr. Bill let us try our hand at coaching her through the bites. Nathan and I bickered a little about how to do it exactly right—I thought he was bargaining and rewarding bad behavior, and he thought I was being a pushy you-know-what. But we got through it.

Dr. Bill gave us some pointers and sent us on our way:

1. Four bites before dinner: two preferred, two non-preferred.
2. Ignore all negative behavior (whining, crying). Just keep repeating, “It’s time for a bite.”
3. No bargaining! The bites are the bites, and we won’t cut them in half or change them after they’re offered.
4. Use distraction, like the Mickey Mouse Club video. Pause until she takes a bite as a motivator.
5. Stay positive and keep your cool.

We left the clinic feeling hopeful and more than a little shocked. We couldn’t believe she’d been so good, and thought for sure she’d turn back into a mealtime terror that very night.

Giving it a go on our own

To our surprise, Peanut was a gem, doing bites like a champ, even at home. We stuck to the program and it worked, except for one thing: we couldn’t use the distraction video.

It was Squeak’s fault. He looooooves TV, and while he was overjoyed to see a movie come on, he’d lose his shit when we paused it. He wouldn’t calm down, even when we restarted the movie. It made dinnertime horrible, so we abandoned that strategy quickly.

Dr. Bill, to his credit, was amazing with follow-up. He checked with me on a weekly basis to see how we were doing. I’d let him know what Peanut was doing to avoid bites, and he’d give strategies we could try. Knowing he cared was a big deal, and helped me not feel quite so alone in our battle.

Within a few weeks though, the plan started to fall apart. Peanut was stalling like crazy. Her dinner would be cold, the rest of the family done eating and long gone from the table, and she’d still be dreaming up a million reasons to avoid her bites.

When she finally did eat her bites, she’d swallow them like pills with a mouthful of water, without chewing or tasting them. When I found myself bargaining and begging again, we went back for another visit to Dr. Bill.

The Wizard works his magic, again

This visit, Dr. Bill specifically wanted to address three problem behaviors: leaving the table over and over, taking hours to finish her bites, and swallowing the bites without chewing.

Magically, all it took was for him to say, “No, Peanut, we can’t leave the table while we’re doing our bites! It’s a rule!” She nodded and kept her booty in her seat. (At home, all we had to do was repeat that same line, and she’d stay in her chair 90% of the time. See? Magic.)

When it came to chewing, he told her, “Peanut, you’re four years old, right? Okay, so you have to chew each bite four times.”

Once again, she nodded in agreement and proceeded to chew each bite four times, as if it never occurred to her to defy Dr. Bill.

Finally, he set an egg timer (“You’re four, so we’re going to have four minutes to take your bites of food, and if you do, we’ll race down the hallway again!”) and used that to keep her on schedule.

Maybe because he was super good at playing Barbies and My Little Pony. Perhaps it was the hallway races, or his hide-n-seek skillz. Whatever the reason, Peanut took all of Dr. Bill’s suggestions and ran with them.

Over the course of the visit, she ate corn, cottage cheese, and mac-n-cheese, and only gagged a little bit on the macaroni noodles—which was major progress. Good girl.

Back home and on our own

We took Dr. Bill’s instructions and headed home to put it into action:

1. During snack, require Peanut to sit in her seat at the table
2. Place 2 bites of nonpreferred food on a plate (corn, cottage cheese) and 2 preferred foods and tell her to take a bite. Once she takes a bite, continue to encourage her to keep eating until all 4 bites have been consumed.
3. Remind her to chew each bite at least 4x
4. Once she has finished all 4 bites, have her finish her typical meal.
5. BE SURE to interact with her, keep her engaged, and provide positive attention for appropriate behaviors (e.g., taking bites of food and sips of milk) throughout the meal.
6. DO NOT provide attention for problem behavior (e.g., whining, crying). Ignore (i.e., no eye contact, no physical touch, and no talking to her) all negative behaviors and gagging.

We’ve been rocking this plan for two months now, and I’m happy to share that Peanut is doing GREAT. She now gets excited when corn is one of her bites (“Mommy, I like corn now!”) and cottage cheese is a breeze (she also claims to love cottage cheese, though she’s probably years away from actually consuming it by choice).

A few times a week, we introduce a brand-new bite, like sweet potato or black bean. New foods cause her to throw a bit of a fit, but I do my best to console her. She responds well to stories about my own childhood, and having to try foods I didn’t know. Just knowing that Mommy has been there, and that Mommy cried a little too, somehow makes all the difference.

Eventually, she takes her bites and almost always reacts by saying, “Mommy, that didn’t taste like nuffing at all!” If she takes too long, we get out the iPad and she starts the four-minute timer. The iPad is great because it uses a circle that gradually fills up with red to show how close she is to the end. That visual display is great, since the numbers don’t mean anything thing to her.

Mommy does not like all the foods

One night while Nathan was out of town for work, I presented Peanut with a new bite, and she said the saddest thing to me. She was sitting in her chair at the dining table, crying about the strange new food, tears streaked down her blotchy face, all the fight drained out of her.

“Mommy?” she asked softly. “Do you like all the foods?”

I wasn’t sure I understood the question. “What do you mean? Are you asking if I like all the foods in the whole world?”

She nodded tearfully.  My heart broke.

“Oh, no, sweetie. I definitely don’t like all the foods.” I tried to think of a way to explain it to her.

I placed my hands about a foot apart, palms inward. “Let’s say there are this many foods in the world.”

I moved my hands closer together, leaving about 4 inches between them. “Mommy likes this many of the foods.”

Then I placed my palms a half-inch apart. “But you, Peanut, you only like this many. See? It’s hardly any foods. All I want, sweetheart, is to get you to about—” (I moved my hands 2 inches apart) “—this many. Just enough so we can go places, like restaurants, and you’ll be able to eat what they have, and we won’t have to bring food with us. That’s all I want, sweetheart.”

She wiped her tears and took her bites that night without any more fight. She got it (or at least I think she did).

Peanut adds a food

Best of all, since we last saw Dr. Bill, Peanut has added a new food to her list: PIZZA.

I can’t tell you how happy this makes us, because it’s a staple on restaurant kids’ menus. Her favorite is Costco pizza from their cafè, but she’ll eat frozen pizza at home, too. We’re pretty psyched; a new main dish hasn’t been added in AGES for Peanut.

Looking back over the past year

We’re a year into Operation Picky-Eatin’ Toddlers. Though I couldn’t even picture it in the early days, we’ve reached the point where my kid is actually eating foods she dislikes. Chewing them up and swallowing. Wow. Who’da thunk it a year ago? Definitely not me.

We’re not quite ready to hang a giant MISSION ACCOMPLISHED banner yet, but we’ve made huge strides. I’m proud of my little girl. She’s worked hard. So have I, and so has my husband (who’s significantly more on board with this than he was early last year).

It feels good to know we’re all in this together, plus our healthcare provider. It can get better, but not without some hard work on everyone’s part.

+++++++++

If you’re struggling with super picky eating like what I’ve described, don’t suffer alone. Find a feeding specialist in your area. Dr. Bill and Dr. C both practice at the University of Iowa Hospitals and Clinics; she’s a pediatric psychologist, he’s an occupational therapist. Ask your pediatrician for a referral to a doctor in your area (if you’re not in Iowa). They can help you get some support, and a year from now, hopefully your situation will be bigly improved. <3