Feeding Relationships New Mexico WIC Program in collaboration with New Mexico State University and Ellyn Satter Associates Esther Devall Shirley Jaquez Lisa Shields
Dec 16, 2015
Feeding Relationships
New Mexico WIC Programin collaboration with New Mexico State University and Ellyn Satter Associates Esther Devall Shirley Jaquez Lisa Shields
Primary Intervention
Teach positive feeding.
Detect risk. Provide anticipatory guidance. Support parents.
Further Interventions
Secondary - WIC nutritionists with additional training.
Tertiary - referral to therapists in community.
The Issue in Feeding Children is Trust
Children are internally regulated.
Require trust to regulate. Ignoring their needs interferes with internal regulation. Ignoring their needs undermines their
self- esteem.
Children Are Erratic With Eating
Food acceptance varies.Accept/reject food
unpredictably.The amount they eat
varies.They don’t eat a square
meal.They eat what tastes good.
Equation for a Good Diet
Well Balanced Meals & Snacks + Positive Eating Environment __________________________ = Well Nourished Child
Division of Responsibility
Parent: What Infant: How Much and
Whether
Parent: What, When, and Where
Toddler: How Much and Whether
Parent’s Tasks
Choose and prepare food.
Have regular meals and snacks.
Make eating time pleasant.
Provide mastery expectations.
Children’s Eating Capabilities
Children will eat when hungry.
They know how much to eat. They will eat a variety of
foods. They will grow
predictably. They will mature with
eating.
Developmental Stages
Homeostasis – Birth to 3 months. Attachment - 3 to 6 months. Separation-Individuation - 6 months to 3 years. Initiative - 3 to 5 years.
Parent’s Tasks in Separation-Individuation
Provide opportunities to explore.
Support autonomy. Provide structure. Set limits.
Parent’s Tasks in Initiative
Make maturity demands.
Have realistic expectations.
Remain present and available.
Support without intruding.
Feeding Periods
Early Infancy - Nipple feeding.Late Infancy - Transition to solids.Toddler - Modified adult foods.
Eating Skills in Middle Infancy
Begins sitting.Follows food with eyes.Lips close over spoon.Moves semi-solids to back of tongue.Swallows semi-solids.
Eating Skills in Late Infancy
Tongue moves food to side of mouth.
Positions food In mouth.Delays swallow.Munches.Palms food.Scrapes food into mouth.
Eating Skills in Toddler & Preschool Years
Chews.Moves food around in
mouth.No pause in side-to-side
transfer.Begins to use utensils.
Child Characteristics That Risk Feeding
Difficult temperament.“At risk” or very small.Eats very large or very small
amounts.Illness.Prematurely born.Physical or cognitive limitations.Requires a modified diet.
Parent Characteristics That Risk Feeding
Over-active, too stimulating.Under-active, not engaging.Chaotic or disorganized.Rigid or over-controlling.Over-concerned about child’s food
selection or weight.Under-concerned about child’s food
selection or weight.Has a particular agenda for growth.
Growth Patterns
Normative
ConsistentSmoothGradual changes
Divergent
UnpredictableUnevenDramatic changes
Feeding Relationships in WIC Clinics
Certification Risk factor.Nutrition goal.One-on-One counseling.
Nutrition EducationFacilitated discussions.
Additional CounselingPrimary or secondary intervention.