This is what’s rooting around in the back of my mind right now… which is more important – table manners or encouraging oral eating?
For some people, both goals may be fine… but for us, they are currently mutually exclusive. You see, Henry eats barely anything by mouth. On a good day, he may take a couple of sips of water and place some puree or other food up to his lips to “taste” it. Virtually nothing actually goes into his mouth, and if it does he drools it out immediately. Drooling is an automatic reflex for him now – it ensures no food actually stays in his mouth, thereby protecting himself from choking. And when needed, he produces a massive amount of saliva – food doesn’t stand a chance!
He has no psychological need to eat by mouth. For as long as he remembers, he has eaten through his tube – that’s how it’s done. He copies Shawn & I and pretend eats, but thinks it’s a game, not for any substantial bodily need. Working with Amina, our Occupational Therapist, we encourage Henry to explore foods with his hands, body, mouth, spoons, forks, cups, straws, toys… anything he might feel comfortable with. For us, food is for touching, rubbing on toys, “smooshing”, blowing bubbles in, tasting, licking… anything that keeps the experience positive.
His latest fun thing is helping Shawn and I eat. When he’s done sitting in his chair, he sits on our lap and helps us eat by placing the food from our plates onto our fork. This is one step up from his other favourite mealtime activity of placing food directly into our mouths with his hands.
All of this is in effort to encourage a positive experience with food. We’ve had our share of ups and downs with this. When we first introduced baby cereals when he was about 5 months old, he loved it! Gobbled it up, if you can believe it. We couldn’t have been happier. After 5 months of unsuccessful breast, bottle and cup feeding, it seemed like we finally had a plausible alternative. Unfortunately we didn’t know enough about what Henry could and couldn’t do… and after about 1 week he flatly refused all food.
Game Over… period.
We now know that the quiet coughing we heard was actually him continually choking on the food, unable to swallow strongly enough to get it down, and then breathing in the fluid that was left in his throat. No wonder he stopped eating. We’ve been on an eating roller coaster ever since… sometimes he will drink, sometimes he won’t. Sometimes he’ll eat purees, sometimes he won’t.
At times he has refused all foods – for up to several weeks at a time. Usually this is precipitated by his choking on something, but others times we don’t know of a definite cause. I tend to go a little looney at these times… but it’s happened often enough now that I know he’ll eventually try foods again. At times he will refuse to even sit in his chair – for a kid with low muscles tone he can sure arch his back in defiance! These times he’ll join us at the table by sitting on our lap or standing beside our chair.
Family meal time is VERY important to us, so we eat together any way we can… even if that means we all have a picnic on the grass, or sit on the floor in the living room. It doesn’t matter how we eat… as long as we’re together.
But this brings me back to my current dilemma… table manners vs. encouraging oral eating?
There are some things in life that I used to take for granted…
- no throwing food on the floor (once old enough to know better)
- no eating foods off other people’s plate
- other than the “at home 5 second rule”, no eating food off the floor
- toys are for playing, food is for eating
In the past 18 months, we’ve not only broken every rule… but often encouraged it!
So… here’s my rhetorical questions…
When Henry throws things on the floor – how do we respond? We don’t want him to throw his foods, spoons, etc on the floor. We tell him not to. Once he’s done in his chair we ask him to pick them up and give them to us. But… do we do more?
- When my nephew (now 3 1/2 years old) threw things on the floor, his parents would make him get out of his high chair and pick them up. Then, since he was out of his chair, mealtime was over (much to his displeasure). But my nephew is and always has been a great eater. He wants in his chair; he wants to eat… so having mealtime end early was enough of a consequence to eventually break the throwing habit.
- But Henry doesn’t want to eat. He sees no need. So taking him out of his chair early has no negative consequences. We continue his “tube” meals even when he’s out of his chair… right now weight gain is more important.
- We tried “time outs” when he threw – but he quickly formed a negative association with eating and started refusing to sit in his chair. So time outs promptly ended, at least in this context.
- He is slowly starting to throw less. Or we’re better ant noticing the signs and encouraging his to “pass it to mama” instead. Either way… it’s improving :).
What about “helping” us eat off our plates, by placing foods either on our forks or in our mouths?
- At home I don’t mind, so far. It gets Henry involved at mealtime and touching the food. He will sometimes lick his fingers afterwards, which means he getting some flavours. Plus, he’s learning all the different foods – what the smell, feel and look like. All important things for us.
- But I have to admit, we were out for dinner the other night at Whitespot. We were outside on the balcony and there was only one other couple there, who were both happy smiling and waving to Henry. They even suggested closing the patio door, so he could crawl around while we ate – very nice people. But part way through the meal, Henry sat on Shawn’s lap and wanted to put food on his fork. I felt uncomfortable. Suddenly what I thought I was ok with… I wasn’t anymore. There were different rules when out, and this was one of those times. So Henry went back to crawling around and didn’t help Shawn eat. Part of me is ok with this… but part of me wishes I’d been fine with letting him “help” Shawn eat, so that he could have experienced to restaurant meal too.
We were at a 1st birthday party for a friend of ours son a few weeks ago. There were about 8 kids there of various ages, mostly cousins of the birthday boy. One of the activities was cupcake decorating (great fun – wonderful idea for parties!) which Shawn & Henry did together. Needless to say, right from the start they were both covered in icing… we thought it was great! And Henry even started putting his fingers in his mouth and tasting the icing – we were thrilled! He kept smearing it around on top of the cupcake and then licking his fingers. Some parents might caution their child to not eat too much, but we were the opposite – go for it :).
- A background… the other kids were the cleanest,quietest, calmest kids I have ever seen at a party. No yelling, no grabbing dessert toppings… they didn’t even eat the cupcakes when they were finished decorating! As a result, Henry stood out immediately. And so did we for encouraging the mess. Other parents kept offering us paper towel and water to clean up with. We politely declined 🙂
- We’re ok with getting completely covered with food. I have to keep reminding myself, its not “dirty” it’s food. Food isn’t dirty – it might be messy, but not dirty.
At this same party, I was watching the mom feed her 1-year-old little boy. I have admit… I’m a bit of a voyeur. Not in a lewd, peeping tom kind of way… more in a “curious, I missed out on it” way. When ever I see kids eating – whether it be breast, bottle, cup or finger feeding, I find myself drawn in and watching. I don’t mean to be rude – but I never got those experiences with Henry and I think this makes me curious. Anyways, Mom was feeding her little one and he kept trying to touch her with the spoon. It was all very cute, except mom’s reaction (to me anyways). She kept saying, “Ew…yucky… don’t touch me with that…”. And she meant it… she didn’t want his food anywhere on her. I was horrified! We would never say food is yucky. And yet, for her… and he “good eater” son, this was normal. I recall my sister-in-law did that for a time too. I never thought anything of it, until now. When you have a child who eats well, it probably doesn’t cross your mind.
Anyways, all this rambling somehow leads back to my initial dilemma… which is more important – table manners or encouraging oral eating. I mentioned this to Shawn a few nights ago, and so far we both agree that we’re ok with the mess, the “help” and the occasional throwing. We would much rather have an ill-mannered child who eats by mouth, than a perfectly mannered prince who is scared of food.
Cheers, Shelley
Henry's Homemade Formula 