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“Help! My preschooler is obsessed with food!” Food Preoccupation in Pediatric Feeding

“Help! My preschooler is obsessed with food!” Food Preoccupation in Pediatric Feeding

by Katja Rowell, MD | Food Preoccupation

Food preoccupation is one of the most common challenges I’ve seen over the years (in addition to avoidant eating). How do I define food preoccupation? Food preoccupation is when a child’s interest in (or seeking of) food gets in the way of the work of childhood...

Recent Posts

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  • Juice Isn’t “Bad” and May Be Good For Children With Feeding Challenges
  • Amy and the Magic Carpet: Assumptions in Pediatric Feeding Mean Missed Opportunities

Categories

  • Answering Your Questions
  • Avoidant Eating
  • Discussion point
  • Food Preoccupation
  • Lived Experience
  • Nutrition Notes
  • Nutrition Worry
  • Resources for parents
  • Responsive Feeding Therapy
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responsivefeedingpro

The parents and kids you work with may come to you The parents and kids you work with may come to you with the idea that being a supertaster is “to blame” for their avoidant/selective, or anxious eating - there certainly are many online articles that make that claim! ⁣
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Supertasting may play a role in avoidant eating, but it’s nuanced.⁣
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And we know Melanie Loomer PhD isn’t pushing kids to try food, but just like kids may have been told told they “can’t” sense hunger due to sensory and interoceptive differences or challenges, kids and parents may get the idea that they “can’t” try new foods, or won’t like them due to “supertasting.” ⁣
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This belief can be a barrier to curiosity and can increase anxiety and make kids feel LESS capable. (Note, this could be a good belief to explore using the Hot Cross Bun counseling tool Jo will share in a webinar on March 28th.)⁣
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Melanie offered some thoughts on how to frame it if it comes up. How do you talk about supertasting?⁣
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It may be an idea we would hesitate to introduce, as it can be misunderstood, but is a common topic that comes up. Hope this helps!⁣
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#responsivefeedingtherapy #feedingtherapy #pediatricfeedingdisorder #ARFID #pediatricOT #pediatricST #pediatricdietitian⁣
In just under two weeks, join Jo Cormack PhD (feed In just under two weeks, join Jo Cormack PhD (feeding specialist and researcher) for a discussion and examples on how to use the Hot Cross Bun tool to understand your clients, and WITH clients to support a responsive approach.⁣
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This is a practical session where you will learn how to work with parental beliefs in your practice, in a way that is non-judgmental and non-confrontational. ⁣
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Clinicians are often really good at identifying misperceived beliefs, and recognizing how these may influence feeding practices. However, supporting parents to adopt a responsive mindset can be difficult - especially where anxiety is high. ⁣
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And education alone is not enough. ⁣
‘Hot Cross Bun’ is a simple and powerful tool (from the world of cognitive behavioral therapy) that will help parents untangle what they are feeling, what they are thinking, and how they interact with their children around food.⁣
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*Note this tool is to be used with parents.⁣
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DURATION: 1 hour (w/15 minutes Q and A)⁣
DATE: March 28th⁣
TIME: Noon ET, 17:00 UK time⁣
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link in bio⁣
#responsivefeedingtherapy #responsivefeeding #pediatricfeedingdisorder #feedingtherapy #pediatricot #pediatricslp #pediatricfeedingtherapy #pediatricdietitian
Save the date and register for an hour with Erika Save the date and register for an hour with Erika Shira LMHC-MT-BC. 15 minutes Q and A. April 18th.
Erika is a licensed mental health counselor, certified early intervention specialist, and board-certified music therapist, in addition to foster and adoptive parent. Roles over the decades have included foster care caseworker, early intervention clinician, arts instructor in emotional/behavioral special education, various community mental health supervisor and director rules, individual and family clinician in a private acute mental health setting, state-contracted parent and child evaluator, as well as a member of various advisory boards to organizations focused on trauma-informed care, social justice, cultural competence, and neurodiversity. 
Learn more about Erika and what you’ll take away from this discussion at responsivefeedingpro.com #linkinbio
#responsivefeedingtherapy #responsivefeeding #fostercare #responsivefeedingpro #pediatricfeedingtherapy #pediatricot #pediatricslp #pediatricdietitian
Love this example of a deconstructed meal. This wa Love this example of a deconstructed meal. This way eaters with different preferences, skills, and sensory needs can find something they can eat. It supports autonomy and the child’s sense of capability. 
One child may only eat a plain crêpe, another child may eat a pile of cheese, and one blueberry. 
🧡 offering a variety of choices
🧡 allowing children to self serve
🧡 offering different condiments
🧡 NOT commenting on what the child is or is not eating
🧡 focusing on the child’s felt safety and  connection
…can help to children to feel comfortable and more easily access curiosity and appetite at eating times. 
#responsivefeedingtherapy #responsivefeeding #pediatricot #pediatricslp #pediatricfeedingdisorders #pediatricfeedingtherapy #pediatricdietitian #pickyeating
Link in bio to blog with handout. #responsivefee Link in bio to blog with handout. 
#responsivefeedingtherapy #responsivefeeding #pediatricfeedingdisorders #pediatricfeedingtherapy #feedingtherapy #pediatricslp #pediatricot #pediatricdietitian
Maybe you’re an SLP, OT or RD and you’ve been Maybe you’re an SLP, OT or RD and you’ve been doing feeding work for a while, or you’re new to the field and…⁣
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✅ sensory play or desensitization – or simply letting the child decide what to eat - doesn’t feel like enough.⁣
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✅ perhaps you want to build on your core skill-set and deepen your practice.⁣
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✅ maybe you sense that for a significant group of children, what you’re doing isn’t getting at the whole picture.⁣
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🧡 The RFPro team have all been there. Early in our careers, we knew we were missing opportunities to help children heal their relationships with food and to empower parents to support the process.⁣
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Connecting with colleagues, developing and working in the RFT framework was what we were missing.⁣
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In this series of six webinars you will explore how the RFT values of autonomy, relatedness, competence, intrinsic motivation, and whole child care:⁣
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🧡 empower parents to support healing for children who seem to progress in therapy but stay stuck at home.⁣
🧡 offer new opportunities for assessment and treatment.⁣
🧡 increase your comfort and confidence working with children and parents.⁣
🧡 provide a cohesive framework for your work with children and families.⁣
🧡 help you discover and address obstacles to progress that your families may face.⁣
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“The foundational webinar series has added so much depth to the way I work. The values are just so helpful for guiding families towards change and for not losing sight of the bigger picture.”�⁣
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Simone Mossop, Paediatric Clinical Nurse Specialist, Early Intervention Feeding Practitioner⁣
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“It [RFT] really spoke to me as a new clinician who wasn’t feeling great about the practices I was seeing.”⁣
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Daphnée SLP, Canada⁣
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“I cannot speak highly enough of this approach.”⁣
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Thalia Prum RD⁣
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#Responsivefeedingtherapy #RFT #feedingtherapy #pediatricfeedingdisorder #pediatricSLP #pediatricST #pediatricOT #pediatricdietitian⁣
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#Repost @katjarowellmd with @use.repost ・・・ #Repost @katjarowellmd with @use.repost
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This video is cute, but to me it’s a cautionary tale...⁣
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Children don’t need to be burdened with nutrition “lessons” that aren’t developmentally appropriate. A lot of nutrition education aimed at young kids in particular, doesn’t help. It can confuse them (note all the question marks and the different answers) and it can scare them (“salt will make my heart explode?!), which doesn’t help them feel good about food and eating. ⁣
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School nutrition lessons have been documented to contribute to (and in many cases kick off) eating disorders. Young children aren’t ready for nutrition messages and it is more likely to interfere with a good relationship with food than to help.⁣
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@dietitians4teachers is doing great work in this area if you want more resources.⁣
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Counter these kinds of messages. ⁣
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🧡”We eat all kinds of wonderful foods. We are lucky to enjoy cake and oranges and spaghetti and Doritos and Grampas cookies and apples...” or “All kinds of foods are healthy, and for lots of different reasons. Cake gives us energy, it tastes delicious and we get to share it at celebrations. That’s healthy!” “Red peppers are delicious and crunchy and we love them in stir fry.” ⁣
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🧡 Help your child skip lessons such as having kids sort foods into “healthy” or “unhealthy” categories. (A quick note on the top of the sheet to excuse a child from a lesson and a cell phone number the teacher can call with questions may take care of it.)⁣
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🧡 Speak about all foods in neutral terms (sweet, crunchy, store-bought, quick...).⁣
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🧡 Serve foods with the same emotional energy, whether it’s donuts or stir fry.⁣
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🧡 Serve and enjoy a variety of foods.⁣
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#lovemefeedme #responsivefeeding #responsivefeedingtherapy #intuitiveeating #pickyeating #adoption #fostercare #fosterparents #fosterparent⁣
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New webinar alert!⁣ ⁣ Hot Cross Bun: A Practic New webinar alert!⁣
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Hot Cross Bun: A Practical Psychology Tool for Working with Parent Anxiety⁣
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Date: March 28th ⁣
Time:  9-10 am Pacific time ⁣
12 Eastern time ⁣
5 pm UK time⁣
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‘Hot Cross Bun’ is a simple but powerful tool (from the world of cognitive behavioral therapy*) that helps parents untangle what they are feeling, what they are thinking, and how they interact with their kids around food.⁣
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*Note this tool is to be used with parents. It is not ABA or CBT-AR aimed at children.⁣
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Clinicians are often really good at identifying misperceived beliefs, and recognizing how these may influence feeding practices. Despite this - supporting parents to adopt a responsive mindset can be really difficult, especially where anxiety is high. Education alone is not enough.⁣
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For feeding and nutrition professionals with some knowledge of the RFT approach. (Intermediate level.)⁣
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Register now #linkinbio⁣
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And...⁣
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Thanks for your patience as we moved our content to a new platform. We hope this will make for a better experience. On-demand webinars are again available (with equity, student, and group discounts) and sign up for our newsletter for tips, research info, discount codes and more.⁣
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#responsivefeedingtherapy #responsivefeeding #pediatricOT #pediatricSLP #pediatricdietitian #feedingtherapy #feedingtherapist⁣
Yes, sensory and interoceptive differences and cha Yes, sensory and interoceptive differences and challenges impact eating; some children have a more difficult time tuning in to cues of hunger and fullness; some children self-regulate or self-soothe with oral input and/or food.⁣
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AND, if you are seeing kids or kids are referred to you for:⁣
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“overeating”⁣
“weight management”⁣
“oral fixation or seeking”⁣
“food preoccupation”⁣
“food seeking”⁣
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...then you need to know:⁣
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⚠️ Restriction, or trying to get kids to eat less, can backfire.⁣
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✅ How to assess for restriction and the anxiety that fuels it (usually around weight). ⁣
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Restriction looks like portion control, preplating portions, adults reminding kids to “check in with their tummies” with the goal of getting the child to stop, trying to get kids to drink water or eat veggies first, making kids wait 20 minutes for seconds etc. ⁣
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*Anything parents do or say to get kids to eat less can backfire.*⁣
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🧡 And how to support responsive feeding.⁣
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In this case, 2 years of therapy happened without exploring HOW the child was fed. ⁣
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From the parent’s email:⁣
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“I have been able to get through the majority of your book (Love Me, Feed Me second edition) and just have to tell you the adjustments we have made have changed our life... I know I have been triggered, and anxious about the amount of food and frequency she was seeking food. We were feeling like this was only related to her tendency for oral seeking, and interoceptive awareness. I suppose these do play a factor; however what I see is that our efforts to control has been the biggest factor in making this an issue. 😢 ⁣
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We have switched to serving family style again, offering a lot of variety, focusing on connected conversation at meal times, not commenting at all on portion size/what was eaten/not eaten. This has made ALL the difference for her and us.”⁣
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Check out related webinars on food preoccupation, Diet Culture, and Growth. Sign up for our newsletter for a bundle sale offer coming next week. Links in bio.⁣
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#responsivefeeding #responsivefeedingtherapy #weightneutral #haes #antidiet #pediatricOT #pediatricslp #pediatricdietitian #feedingtherapy #feedingtherapist⁣
#Repost @extremepickyeatinghelp with @use.repost
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So often, parents and therapists feel pressure to make change happen for a child. Doctors may be pushing  for weight gain (or loss), family members may judge how the child eats or how a parent feeds them, and all too often, social media tells us that if we only DO SOMETHING, we can “get” a child to eat more or differently. 
Just cut their veggies in cute shapes! Just put their lunch in a bento box! Just don’t feed them “junk”! Just serve healthy foods! Just just just….
It can all feel overwhelming! But we know from the research that INTRINSIC motivation is what children must have in order to change. They have to be curious, interested, and in a place of felt safety in order to move out of their comfort zone. And interference from us can derail that process—
And change takes TIME! 
So what do we DO? LESS! 
🙊We need to TALK less. 
✋We need to TOUCH less. 
🗣️We need to PRESSURE less. 
If we see ourselves as agents of opportunity rather than agents of change, it shifts our focus to providing a calm, safe environment that allows for many opportunities to see others eating, to learn about foods from afar, to engage with foods in ways that feel good, and to discover that intrinsic motivation that is so crucial to discovery of what THEY enjoy. 
#agentsofopportunity #extremepickyeating #responsivefeeding #responsivefeedingtherapy
Sometimes a focus on the sensory properties of foo Sometimes a focus on the sensory properties of food, “desensitization,” or food “exposures” increases anxiety. (Increased anxiety can dampen appetite, increase sensory sensitivity, and decrease internal motivation around eating.)
I’ve seen situations where this kind of anticipatory anxiety signals that a child is feeling pressured at eating times. 
🧡 Removing the sensory focus and applying the principles of responsive feeding therapy - with a focus on felt safety and connection - can open the door to healing.
#responsivefeeding#responsivefeedingtherapy #arfid #pediatricfeedingdisorder #feedingdisorder #pediatricslp #pediatricdietitian #pediatricot
Do you talk about sneaking food with the parents y Do you talk about sneaking food with the parents you work with? Do you explore the underlying nutrition worry? This is where a thorough assessment and food intake can be really helpful. Parents need to have their worries taken seriously. Really listening and evaluating is the first step. 
A thorough intake can also help you target supplements if they are needed. A registered dietitian is important if there are documented deficits. But often where parents are sneaking, the children are in fact, already meeting their nutritional needs.
Reassure where you can. Help support them through their anxiety. Point out early progress to support a responsive approach. 
#responsivefeeding#responsivefeedingtherapy #arfid #pediatricfeedingdisorder #feedingdisorder #pediatricslp #pediatricdietitian #pediatricot
Today’s snack shows how it feels when the focus Today’s snack shows how it feels when the focus is on felt safety and CONNECTION. If you haven’t seen it yet, check out yesterday’s reel where the focus was on WHAT and HOW MUCH the child ate. Can you watch the two back-to-back and compare? 
Does this snack support the child’s autonomy? Does it allow the child to feel comfort, and more able to tune in to “I do it” drives around food? (hunger, curiosity, comfort, pleasure, modeling...)
It may feel like “bad” parenting for your clients (or you!) not to work hard to get their child to eat the blueberries, but research tells us that pressuring kids to eat (even gentle pressure) can backfire. 
Think about the long-term goal of raising a child who can do their best with eating. Sure, we can often GET kids to eat a bite or two here and there (sometimes at the price of meltdowns or tears), but is that sustainable? Does that support the child in their growing capabilities and comfort around eating?
🧡 And more importantly, what does the child in front of you tell you? How are they reacting? What do you observe?
#responsivefeedingtherapy #responsivefeeding #feedingdisorders #feedingdisorder #feedingtherapy #feedingtherapist #pediatricslp #pediatricot #pediatricdietitian
Helping parents be attuned and empathize with thei Helping parents be attuned and empathize with their kids can open opportunities to healing.
Asking what parents have tried to get their kids to eat more or different foods, observing a snack… is likely to uncover many of these tactics. 
We know pressure backfires. But some of these common and more gentle tactics can fly under the radar. It’s “good” to eat the rainbow or eat growing food first… isn’t it? 
❓ How did you feel if you were able to imagine being the child in this scenario? 
When you consider the values of responsive feeding therapy, how does autonomy, competence, intrinsic motivation and relationship come into this scenario?
🧡 Is the child’s autonomy supported?
🧡 Does this bring parent and child closer, or create conflict?
🧡 What happens to internal drives like curiosity? 
🧡 Does a child feel capable with this much prompting?
#responsivefeedingtherapy #responsivefeeding #pediatricfeedingdisorder #arfid #feedingtherapy
Pressure can come in unexpected places. 🧡 Off Pressure can come in unexpected places. 
🧡 Offering anticipatory guidance, going beyond the “tip” or strategy around offering variety can make a big difference. 
#feedingdisorsder #arfid #feedingtherapy #responsivefeedingtherapy
#responsivefeeding #extremepickyeating #pediatricslp #pediatricot #pediatricdietitian
Do you use this question (or a version of it) in y Do you use this question (or a version of it) in your assessment? Have the answers surprised you? 
Often it has little to do with food prep, playful utensils, or sensory adjustments and more to do with felt safety. 
From the original caption: 
Staying with this example of low appetite and children who “can’t” sense hunger, here are just a few examples I’ve heard of a child eating happily and beyond a few nibbles:
🧡 At a park after swim practice
🧡 At a special buffet restaurant
🧡 From a particular take-out place (this family served foods from the takeout container and it seemed to signal something positive for the child who enjoyed meals more that way)
🧡 A foster child who hardly ate until food was given to them in a paper bag from a coffee shop
🧡 At a friend’s house trying a new candy that was out after Halloween
🧡 At the buffet after a religious service
Often it comes down to felt safety. And that is signaled in different ways to different children. The paper bag was familiar, the child at the park was enjoying the novelty of a new place, or their body was relaxed after swimming, the child at the fund raiser was with friends and maybe the skewers were easier for him to manage...
And sometimes the answer is as much in what WASN’T happening as what was. 
❗️Realizing that the last time children did well with eating is almost never at the table with conflict and tears over a bite of non-preferred food or after kissing a food… that’s critical information towards a healing food environment.
#responsivefeedingtherapy #responsivefeeding #feedingdisorder #feedingtherapy #pediatricslp #pediatricdietitian #pediatricot #arfid
As I try to figure out how to work smarter and not As I try to figure out how to work smarter and not harder, I’m considering sharing reels that I (@katjarowellmd) make for parents here and adapting for the feeding and nutrition professional audience. 
How do you assess parent worry? How do you help reassure parents where you can? Where are you experiencing the most resistance? 
#responsivefeeding#responsivefeedingtherapy #arfid #pediatricfeedingdisorder #feedingdisorder #pediatricslp #pediatricdietitian #pediatricot
Hope this is a helpful resource. Reviews from firs Hope this is a helpful resource. Reviews from first edition available under the first edition. Rollout to some countries on Amazon takes time. This can also be requested at public libraries. 
#lovemefeedme #feedingtherapy #responsivefeeding #responsivefeedingtherepy #feedingtherapist #foodpreoccupation #intuitiveeating #nondiet #haes
How have you been able to flexibly meet the needs How have you been able to flexibly meet the needs of the parents and families you work with? Or wish you could!? 
#responsivefeedingtherapy #feedingtherapy #feedingtherapist #pediatricfeedingdisorder #arfid #pediatricspeechtherapy #pediatricot #pediatricdietitian
#Repost @laurathomasnutrition with @use.repost Mu #Repost @laurathomasnutrition with @use.repost
Must read for feeding and nutrition pros working with kids… my commentary on mast slide. 
・・・
My latest piece for my newsletter - Can I Have Another Snack? - is a trip down memory lane to *peak* clean eating, and although we don’t use the language of ‘clean eating’ any more, all the hallmarks are still there. And the influencers who popularised the concept? 
Well, they’re parents now. And they’re presenting a super distorted picture of what good nutrition looks like for kids and families, and making other parents feel anxious and guilty in the process.
In this piece I’m looking at the dark side of what happens when clean eating comes for kids, and how we get from fairy innocuous to really extreme in just a few clicks. And, well, it’s really fucking terrifying. 
Click the link in my bio to read the article - or go to laurathomas.substack.com 
#feedingtherapy #responsivefeedingtherapy #antidiet #feedingtherapist #pediatricslp #pediatricdietitian
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