Meal time. Just the mention of those two little words is enough to make the pulse quicken and anxiety levels rise.
And that’s just me.
Feeding has been a huge issue in our house since day one. Literally. While I was still in the hospital recovering from an emergency c-section, my son was being seen several times a day by lactation consultants who were trying to help him learn how to latch on and nurse correctly. That never happened, so eventually we switched to bottle-feeding. Bottle-feeding was a challenge, too. It would take Jack over an hour to drink an 8-ounce bottle of formula, and he would then projectile vomit the entire contents of at least one bottle a day. At the time, we considered ourselves lucky if it was only one bottle a day.
Everyone kept assuring me that solid foods would be easier. It wasn’t. Jack did not want solids, and it was a struggle to get him to take them. When he would, he would gag and vomit, even on the smoothest stage one purees. I had these grand illusions of making my own baby food, but alas it wasn’t meant to be. I could never get the purees smooth enough for my baby.
By the time he was a year old, Jack was still eating only the smoothest stage one and two baby foods. Any chunky food would cause him to vomit. In vain, we tried food after food. As he approached 18 months old, Jack still could not feed himself. We spoke to his pediatrician, searching for a reason why feeding was so difficult for our boy, but we got no answers. We were told that we were coddling him, that he was just being picky, and that we needed to stop feeding him. After all, if he got hungry enough, he would eventually feed himself.
He never did.
After he was diagnosed with autism at 24 months, Jack entered feeding therapy. In reality, I suspect that Jack should have started feeding therapy during his first year of life, as he had both sensory and oral-motor issues that resulted in his feeding problems. The two stressful years of eating prior to that turning point resulted in a little boy who was terribly afraid of food, of eating, and it created an atmosphere of fear throughout our household at mealtimes.
Feeding therapy has helped my boy. It was a slow process, but we got Jack to the point where he could take preferred foods without fear. True, he has never really “enjoyed” eating as the rest of us do – we never see the expressions on his face that seem to say, “That’s good!” – but meals were no longer a battle. Jack was gradually able to take increased textures. He was eating a few new foods. Best of all, he was no longer vomiting daily as he once was. That, in and of itself, was a tremendous relief to this mama.
We entered a period of relative calm. Sure, Jack had only 5 foods, but he ate those foods well and without a battle. Approaching 3 years old, he was starting to take a more active role in meals by beginning to do some self-feeding. He still needed a lot of assistance, but we were seeing the first glimpses of self-initiative in our boy. However, Jack still had a long way to go, and recently it became time to change up things for our rigid-to-routine boy. We were to start offering Jack what we were eating for our meals and nothing else. He could make the choice to either eat what we ate or not eat at all.
You can surely guess what Jack chose. So many of our kids will starve themselves rather than take a non-preferred food. Jack’s therapists can get him to take non-preferred foods, and I’m not quite sure of their secret, because I watch feeding sessions occasionally and attempt to replicate it at home to the letter, but without their success. The result? A kid who has slowly shown signs of that same fear that we once experienced.
Here’s the thing – that was a very dark place for us. The anxiety was thick in our house in those first couple of years. Jack feared eating. He feared the food. We feared his meltdowns about eating. We feared the vomiting. We feared how he was slowly dropping in weight percentiles. We feared that if he started to meltdown, he would surely vomit. We actually kept a bucket by our dining room table – which was luckily located in a room with all hardwood flooring – just waiting for Jack to vomit. Meals were eaten on eggshells in our house, and everyone had to tread lightly for fear of upsetting Jack.
We didn’t want to revisit those times.
We have followed the therapists recommendations. We’ve had some limited successes – Jack will now eat jelly on his peanut butter sandwich! – and we’ve had some failures. We still have to force the first bite of food into his mouth to get him to even try it, which I absolutely hate and refuse to do (my husband doesn’t have the same qualms about that as I do). Meals still take upwards of an hour to finish. It is a tedious cycle of giving Jack a bite, encouraging him to chew, rubbing his cheek to stimulate him to chew, giving him liquids to try to get him to swallow, and repeating the entire cycle until the food is gone.
I think that another problem we have is that Jack doesn’t sense hunger. He never has acted hungry in his life. As a baby, he never once woke up to eat – we had to wake him – nor did he ever cry to be fed. In fact, he was eerily quiet as a baby. I often think that feeding would be so much easier if Jack just felt a bit hungry. Instead, we have to resort to continuing to feed him on a schedule, just to ensure that he gets the appropriate nutritional intake.
I think that the one thing I’ve learned about feeding therapy since we began it over 15 months ago is that it is a process – a long process. You take baby steps. You push boundaries. You take a few steps forward and then, when you hit a roadblock, you take a few steps back.
The good thing is that the fear seems to not be as severe with this feeding push, both for Jack and for us. It’s there, believe me, but not every meal results in a colossal meltdown. We also have more tools in our belt – like sensory activities prior to eating and oral stimulation techniques to help “wake” his mouth before meals. We’ve got a long way to go, but at least it seems like we will not revisit the dark days we once knew.