BECOMING A MEALTIME PARTNER
Children share many aspects of their meals with another person. Infants and younger children are totally dependent upon an adult partner who selects the food, the time and place of the meal. They rely upon an adult or older child to prepare the food and physically bring it into the mouth. Without this assistance they would not survive.
Adults provide a model at the meal that serves as a mirror through which children measure their worth and develop perceptions of their inner abilities. When adults act with respect and trust, their children feel capable and move through difficult challenges with greater ease. When adults control children and respond only to their perceptions of the child’s inabilities or misbehavior, children perceive themselves as inadequate. They frequently respond with fear and often challenge the adults to prove to themselves that they are capable.
Mealtime is at the core of the parent-child relationship. It is the vehicle through which nourishment is provided for both the child and adult. Nourishment is at the heart of the mealtime partnership. The essence of mealtime has little to do with the way in which a child eats or the type or amount of food eaten. Taking in physical nourishment orally is but one part of the picture. Nourishment includes the intake of physical nutrients to support the optimum growth and healing of the body. Nourishment is also required at the psychological and spiritual levels. The nourishment of the mind and spirit is more essential than that of the body. Children who are fed appropriate diets in a stressful and unloving interpersonal environment fail to benefit from the physical nutrients. They do not grow appropriately, loose weight and often die before the essential nourishment of bonding and love is provided. Infants whose bodies and brains have been severely malnourished for years have blossomed cognitively in an environment of non-judgment and unconditional love. Although our understanding of the relationship between severe malnutrition and brain development would predict long-term brain damage and retardation, this has not been the case. Adults feel nourished when they are able to provide what their child needs and when the child eats well and happily. Their relaxed interaction with the child becomes an aspect of nourishment for the child. The child and parent co-create a cycle of nourishment that affects both individuals.
When the child is uncomfortable or does not feel safe or competent at the meal, the parent may respond with anxiety or stress. The child senses the parent’s distress and responds with greater discomfort and resistance to eating. Parents often become frantic and temporarily loose their ability to find present solutions for their child because they are lost in their regrets of the past and their fear of the future. Each step creates a reverberating circuit of stress and distress for both the child and adult. The potential partnership is lost and mealtimes deteriorate into an unsatisfying and unfulfilling ordeal. Neither the child nor adult feels nourished when there is stress and distress.
The Essence of Partnership
All parents and professionals can develop or redevelop mealtime partnership skills with the infants and children in their lives. Becoming a more skilled Mealtime Partner involves conceptualizing the challenges of feeding and nourishing children in a different way.
Most adults are taught that they must get their children to eat specific amounts and types of food. If children do not eat or eat poorly, it becomes the adult’s responsibility to exercise the child’s muscles and modify the child’s behaviors so that eating skills will improve. In trying to follow this type of approach most adults do not incorporate the inner knowledge that the child has of his own comfort level, interests, preferred learning style and readiness for the challenge that has been presented.
Children can help guide their own program when adults listen and respond in an interactive manner. The resulting interaction honors the input of both the child and the adult. From this is created a partnership that supports the child’s ability to learn the specific components that support eating skillfully and nutritionally. One of the most important components involves implementing a division of responsibility at mealtimes in which children and adults assume different roles. Adults choose the specific food, location and time of the meal. Children choose what and how much they will eat. The adult role assumes a deep understanding of the child’s physical, sensory, oral-motor and gastrointestinal needs in providing the components of a meal that facilitate success for the child. The child’s role is built on trust and inner guidance of the eating process. It grows with the mealtime partnership as specific skills are developed and mastered.
The challenge to parents and professionals of children with feeding difficulties is to provide a loving and nourishing environment in which change can evolve. Change is always possible and always present. Readiness for a specific change depends on the individual child. Some children may be ready to make the transition from tube feeding to oral feeding. Others may be on the threshold of discovering an enjoyment of a wider variety of foods. Still others may be ready to move from an earlier pattern of feeding coordination such as sucking to a more mature pattern such as chewing. These changes will emerge for many children through their partnership with loving and knowledgeable parents and professionals who blend their understanding of the human body with the human spirit.
When therapists build their programs around the mealtime partnership, they engage both the child and parent as active participants in the process of change. They acknowledge that mealtimes involve a great deal more than taking in a specific number of calories or eating specific foods. Mealtimes include life skills as diverse as communication, socialization, sharing family values and culture, celebration and sensory exploration, Specific therapeutic work to increase gastrointestinal and sensory comfort, to provide a stronger foundation of postural control, and to improve oral sensorimotor skills is a vital part of the process. However, when it takes place within a mealtime context it assumes a value to the child that stimulates an inner desire to learn and master new skills and become part of the larger mealtime community.
About the Author
Suzanne Evans Morris is a speech-language pathologist who specializes in the development of feeding programs for infants and young children. Suzanne maintains a professional practice that includes direct clinical work, continuing education workshops, development of clinical materials and clinical research. She is the director of New Visions, which sponsors innovative workshops for the teaching of feeding-related skills, and provides family-oriented clinical services. She is the coauthor of Pre-Feeding Skills: A Comprehensive Resource for Mealtime Development ,2nd edition, and the Mealtime Participation Guide.
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