Posted by Cris on | June 22, 2011 | 1 Comment
We were very pleased to have Clinical Psychologist Shona Lowes join our monthly playgroup today to give a talk on how to handle fussy eating and food-related anxieties that often arise with children with food allergies.
Shona works jointly with Karen Wright, lead Dietician from the Food Clinic, to help children who are picky eaters. Together, they’ve dealt with numerous cases, from toddlers to teens. Shona’s own son has a peanut allergy, so she also understands the additional stress and anxiety a food allergy can have on both children and parents.
Shona is from the UK and has been living and working in Singapore for the past four years. She works with children and families presenting with a range of different problems and challenges, carrying out assessment and therapy/interventions with children and adults on an individual basis. She also supervises other Clinical psychologists in different settings in Singapore – NUH, private practice, MCYS, NUS and James Cook University.
Sneezywheezy.com conducted a Q&A with Shona in conjunction with today’s talk.
SW: Why – and how – does having food allergies give rise to picky or fussy eating?
Shona: There are several reasons why children might become fussy eaters:
All children go through a stage between one and two years where they begin to assert their independence and control and may refuse foods that they have previously eaten.
At the weaning stage some children have difficulties moving on to lumpy foods finding new textures difficult to accept.
Children also normally go through a phase of wanting familiarity and feeling anxious when they are faced with new things in their life including new foods (tastes, textures, smells).
Children may have experienced an illness, which becomes associated with a particular food or foods and they are reminded of the feelings whenever they are faced with that food. For children with allergies this may be having had a bad reaction to a food they are allergic to and the association may then generalize to other similar foods.
Many children who are picky eaters have a real fear and anxiety associated with particular foods or particular types of foods (related to texture, smell, taste and colour/appearance)
Parents of children who have allergies are naturally anxious at times when their child is eating new foods or eating in an unfamiliar place and the child, who may not really know what the anxiety is about, picks this up and so generalizes to wider range of foods or places.
SW: Do kids with food allergies often develop anxieties related to food? How do they show these anxieties?
Shona: I think because of the nature of some allergy reactions that it is common for children to develop anxiety related to certain foods. Anxiety in young children is often manifested behaviorally – they are not able to specifically identify what is making them feel uncomfortable but they do experience a real anxiety reaction. A child may refuse to eat, have a tantrum, gag or vomit. Older children will state that they don’t want to eat something or that they don’t like it and will refuse to even try, again they may not be able to specifically recognize that they feel anxious.
Helping children to manage their physical feelings of anxiety using relaxation techniques can help and approaching food in a non-pressurized way. Helping children to clearly understand their own allergy and the foods that they must avoid because of the allergy whilst reassuring them that other foods are good for them.
SW: What are some of the incorrect strategies parents use to try to correct picky eating?
Shona: The best approach comes from understanding the problem from the child’s point of view; if the child is feeling a real anxiety about food then any amount of consequence approach to management is not likely to work. Also it is important for children to be aware that they are actually eating and to begin to learn to enjoy food by experiencing it – therefore it doesn’t help to feed them while they are distracted by something else eg: TV or to try to ‘sneak’ a spoonful of food in while they are playing.
It is always understandable why parents are using these approaches because when faced with a child who won’t eat and our own anxiety about our child not getting the right kind of food or enough food, we will try a range of different strategies; some of them do seem to work in the short term but don’t usually work to solve the eating difficulties.
SW: What are some of the long-term implications of picky eating, if parents don’t deal with eat?
Shona: Some children do grow through a picky eating phase but for many it can persist and often parent’s think the child will grow out of it eventually, however when the anxieties become well established there is a need for a planned step by step approach to help the child overcome the difficulties. We often see children who are 9 or 10 or older who haven’t grown out of it.
SW: What are the strategies you advise parents use to help correct the problem?
Shona: The first step is usually to reduce both parent and child anxiety around eating and mealtimes. We do a full assessment by a dietician of the food that the child is currently eating so that the correct supplements can be given if needed and identification of the food groups that we need to work on gradually with the child. With this at least the parent knows that the child is getting the correct balance of nutrients and that there is a clear plan for introducing new foods and so feels less anxious about their child’s wellbeing.
Parents may also be anxious about the amount of food their child is eating – anxiety does sometimes affect our perceptions. A mealtime observation can help us to understand what is happening for the child in relation to food and mealtimes and sometimes it can help parent’s to see that their child is eating more than they thought at each meal.
The next step is to look at ways to make food and mealtimes more enjoyable and to increase the child’s general interest in food. We often work towards familiarizing children with different foods in situations where there is no expectation to eat the food – through play and exploration of food, letting the child be involved in food preparation and food shopping.
When the child begins to feel more comfortable we would then introduce small amounts of individual foods repeatedly at mealtimes until the child is able to eat the food then move on to another food.
SW: Thanks, Shona, for this very helpful information!
Sneezywheezy.com will run a second installment from Shona, on developing positive eating behaviour in babies and toddlers. So watch this space!
For more information or to make an appointment with Shona Lowes, you can reach her at:
Tel: 9750 2706