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Social and Behavioural Challenges During Mealtimes

Mealtimes for children and young people can often be a daunting and scary task, therefore, it is common for many families to face significant social and behavioural challenges throughout the day. Some obstacles families may face include difficulties engaging or communicating with each other during mealtimes, keeping mealtimes positive and stress-free, maintaining positive relationships and connections, as well as participating in mealtimes within the community (e.g. birthday parties).

Implementing a clear beginning, middle and end to mealtime can be a powerful tool in helping your child reduce food and mealtime-related anxiety and will therefore support their participation and engagement within mealtimes. This may look like helping to set the table/wash hands, sit at the table to eat and drink (if the child chooses to do so), and then assist with packing up/clearing plates of food scraps.

During your mealtime, it is important to try to remove the stress, focus and idea that ‘my child must eat their dinner’ away from the mealtime. Try to shift your focus away from focussing on eating, to using this time to connect with your child. This may look like talking about your day, what they want to do on the weekend, or if they have heard any funny jokes. By taking the focus away from the food, your child has the opportunity to explore their plate without the pressure or expectation that they must eat it. When this happens, a child will often feel more at ease, and willing to explore a food (e.g. look at, smell or touch) if they feel like no one is watching them.

With any new skill that children are learning, routine, structure and predictability are of the utmost importance. You may like to trial the use of a visual schedule or a timer, to further help your child understand the expectations and progression of the family meal (e.g. use the toilet, wash hands, sit at the table, eat and drink, pack away).

 

Completed by:
Lisa Kermond, Speech Pathologist
22/08/2024

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Oral Eating and Drinking Care Plans: Why, What and Where?

What is an Oral Eating and Drinking Care Plan (OEDCP)?
An OEDCP is a document which outlines the support needs for children with eating and drinking difficulties. It is completed and regularly reviewed by a speech pathologist in collaboration with parents and caregivers. An OEDCP may also be called a Mealtime Management Plan in some settings.

Why are OEDCPs important?
An OEDCP ensures clear, consistent care across multiple mealtime settings for children with eating and drinking difficulties. The overall goals of an OEDCP are to ensure safety during mealtimes, support adequate nourishment and hydration, and help maintain the child’s overall health and wellbeing.

What information is included in an OEDCP?
The OEDCP contains individualised information regarding a child’s eating and drinking support needs, including:

  • Level of supervision and assistance required for mealtimes.
  • Type of support needed, including equipment, positioning, mealtime processes.
  • Preparation and presentation of food and drink, including modifications to food texture or fluid thickness.
  • Strategies for supporting oral intake and minimising risk.
  • Communication strategies and needs.
  • Emergency response plan and emergency contacts.
  • Sometimes caregivers and staff may require additional training and information relevant to a child’s specific care needs. This can be provided by the speech pathologist completing the care plan either in-person or via telehealth.

Where is an OEDCP used?
An OEDCP is used in any setting where children participate in mealtimes with caregivers who are not their immediate family or guardians. This includes schools, childcare centres, day programs, camps and sporting programs, and in-home care provided by support workers.

Does my child need an OEDCP?
Your child may require an OEDCP if they meet one or more of the following:

  • Known risk of aspiration (food/ fluids entering the airway) or choking, with or without a underlying medical condition.
  • Tube fed, with oral intake of food and/or drink.
  • Modified food and/or fluid consistency.
  • Requires adult assistance for oral intake (e.g., spoon feeding).
  • Requires specific equipment, strategies or positioning in order to safely participate in a mealtime.

Generally, children who are picky eaters, have food aversions, or have an eating disorder do not require an OEDCP. Children who are fully tube-fed (with no oral intake) will usually have a health management plan or nurse care plan in place rather than an OEDCP.

How do I get an OEDCP for my child?
New or existing clients can contact Lively Eaters to make a booking for an OEDCP assessment with one of our speech pathologists. Developing the care plan will generally involve discussion and information gathering with parents/ guardians, an in-person mealtime assessment with your child, and collaboration with external providers (e.g., school staff) as needed.

Completed by:
Nicola Gregson, Speech Pathologist
29/05/2024

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Language at mealtimes

The language we use at mealtimes can have a significant impact on our children. Feeding is based on relationships and trust for both the parent and the child. If parents are feeling stressed and anxious about mealtimes, children will too. It’s important to keep mealtimes calm, happy, and as stress-free as possible. Focus on making mealtimes about spending quality time together, creating positive experiences and having fun with food. Some tips for language use at mealtimes include:

  • Avoid ‘Praise’ for eating: It is our natural instinct to praise a child when they’ve done something well. However, when it relates to food, praise reinforces that you are ‘trying to get them to eat’ and that you are ‘watching them’.
  • Remain nonchalant and avoid paying specific attention to your child’s eating behaviours. A child is more likely to have a go at something if a) no one is telling them to do it, b) they think no one is watching them and c) they get an intrinsic reward for the behaviour (i.e. not being hungry anymore).
  • Keep language neutral: Avoid giving your opinion on the food (“it’s so yummy! Try it!”) or asking children what they think of the food.

After all, we know that fussy eaters are often anxious eaters, so at mealtimes, have everyday conversations to help keep the pressure low and increase enjoyment!

Fun mealtime conversation topics:

  • Weekend activities
  • Hobbies
  • Telling jokes
  • Favourite animals
  • Books or movies

By Hannah Caon

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Back to School Lunch

Navigating the back-to-school hustle can be both thrilling and a tad overwhelming, especially when it comes to tackling the enigma that is the school lunch box. As parents gear up for another academic journey, a barrage of questions floods the mind – from the ever-elusive lunch box expectations to pondering over what their classmates are munching on.

Ever wondered about the unspoken lunch box norms? What do other parents pack, and how do you ensure your culinary creations align with the unwritten lunch etiquette? Let’s dive into some of the school lunch box mysteries.

Firstly, deciphering the lunch box expectations involves striking a balance between nutrition, kid-friendly delights and of course, what your child will actually eat. Opt for a variety that appeals to your child’s taste buds to give them the best opportunity of fueling their body to get them through the busy school day.

Bento boxes can help you to provide multiple options to make lunchtime an adventure. Concerned about foods turning into a soggy mess? Fear not – compartmentalising is the key. Keep crisp items separate from moisture-prone ones to maintain their crunch. We love https://www.nudierudielunchbox.com.au/collections/lunch-boxes

When contemplating the eternal night-before-or-morning dilemma, it boils down to personal preference. Some find solace in prepping lunches the night before, easing the morning rush, while others prefer the morning ritual as a fresh start.

Worried about food safety? Identify the items that need refrigeration and invest in insulated containers or ice packs to keep them fresh until lunchtime. It’s a game-changer!

In the realm of school lunches, embracing variety where possible (even if it’s a different brand of yoghurt or flavour of chips) and planning ahead can turn the lunch box ordeal into a triumph.

By Winter Marshall

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Tube Feeding

Tube feeding, also known as enteral feeding, is an alternative way of providing nutrition and fluid if a person is unable to eat or drink enough to play, learn, grow, or thrive. Tube feeding may be used in addition to any food/drink a person can eat or drink for themselves or it may replace it entirely. There are many reasons a person may have a feeding tube, not all of which are visible. There are a number of different types of feeding tubes and the type of tube a person has is decided by their medical team depending on their needs including the length of time they may need it.

Some babies and children need a feeding tube, some from birth, due to a range of medical complications. For these children, learning to eat and drink may be interrupted or halted entirely, and they often need assistance to learn about food, hunger or thirst, that mealtimes can be pleasurable and to develop safe swallowing skills. For a child to learn to eat and become a successful lifelong eater, they need to have a reason to want to eat (e.g. appetite) in addition to the emotional environment to allow them self-initiation, autonomy and control at mealtimes, along with safe chewing and swallowing skills.

At Lively Eaters, we understand that every child’s feeding and mealtime journey is unique and may be impacted by a range and combination of factors. Feeding disorders are complex and learning to eat is like any other developmental achievement – it doesn’t ‘just happen’ and every child needs a therapy program tailor-made to their, and their family’s, unique circumstances. Our therapists specialise in working out the many pieces to the puzzle that impact a child’s feeding and mealtimes. Dr Emily Lively (Director) has published articles in the area of tube feeding and her ongoing research focuses on the impact of the family on teaching tube fed children to eat and drink.

The Lively Eaters team provide support to the children who require tube feeding and their families, as we know one of the most powerful influences on children is their parents and family. We believe that positive outcomes develop from parents, therapists, and children working together to develop sustainable functional mealtime routines and behaviours to maintain long-term oral eating and drinking where possible.

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Fresh, Frozen or Tinned? A Dietitians guide to veggies.

Fresh, frozen or tinned veggies – is there a difference? The answer is… yes… and no.

Frozen and tinned vegetables often have a bad reputation for not being as nutritious as their ‘fresh’ counterparts. Frozen vegetables are often picked and frozen at their peak – so they are often at their best if you’re looking at the nutritional quality. Both tinned and frozen veg are cost effective and contribute to less food waste as they last longer. However, when comparing to fresh, they do have downfalls when it comes to texture.

 

The best option for you and your family will be what suits you budget, availability, skills and preference. Eating vegetables, whether they are fresh, frozen or tinned, is always better than going without.

By Dr Shabnam Kashef

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Language around food

Language can play an important role in your child’s relationship with food, and it’s often something we overlook as adults. When we label foods as “good” or “bad”, “healthy” or “unhealthy”, or simply “junk foods”, we inadvertently create a moral judgment around food choices. If a food is labelled as “bad” – does that make you a bad person for eating it? For children, this can be confusing. If you restrict or limit a food because it is “bad”, then you may be making the food more desirable and exciting – when it Is off limits.

Maintaining neutral language towards all foods is a great start, and it’s how we like to do things at Lively Eaters… but it’s often easier said than done (pun not intended!). Language around food is tricky to navigate and our team of therapists are here to help.

By Dr Shabnam Kashef

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Filling Snacks

Grazing on snacks or foods across the day lead to irregular eating patterns and make if difficult to regulate hunger and appetite cues for children (and adults!). To key to help kids feel full and satisfied between meals is offering filling snack options.

A good formula to keep in mind when thinking of filling snack option is to offer a meal that includes carbohydrates, proteins, fats and fibre. Some snack ideas could look like:

  • Cheese slices, biscuits and dried fruit.
  • Fruit, yoghurt with a handful or two of cereal.
  • Crackers and dip with carrot and cucumber sticks
  • Smoothie with banana, milk and peanut butter (and cocoa powder or Milo for added flavour!).
  • Cheese and vegemite on toast with apple slices.

If you’re reading this thinking ‘my child could never eat that’ – treat snack times as opportunities to expose your child to new foods. Pairing a safe of preferred food with a combination of carbohydrates, proteins, fats and fibre to provide the chance to learn about something new!

By Dr Shabnam Kashef

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Encouraging Kids to Try New Foods with Dips and Sauces

Introducing children to a diverse range of foods can be a challenging task. One delicious strategy to encourage your child to explore a new food is the use of dips and sauces. These not only enhance the taste of familiar foods but can act as a gateway to fostering a positive attitude towards trying new foods.

 

Children are more likely to embrace a new food when introduced alongside familiar elements. Dips and sauces can provide a bridge between the known and the unknown by offering a layer of familiarity. For example, offering a vegetable platter paired with peanut butter or tomato sauce for dipping can not only be a fun novelty for your child, but a familiar way to explore a new food.

 

Allowing children to dip, drizzle, and explore on their own fosters a sense of autonomy in their food choices. By giving them the power to decide how much or little sauce they want, parents can instil a positive association with mealtime, making it a fun and interactive experience. It can work both ways too, pairing a new dip with a safe food, such as chips or crackers, can be a gateway to exploring new textures and flavours. You may want to start with a small amount on your child’s plate to avoid overwhelm. And of course, eating with your child allows them to observe their parents dipping and exploring new foods, supporting their willingness to try new food.

 

Finally, dips and sauces can serve as flavourful tools to boost your child’s caloric intake at meals and snacks. If you need to increase your child’s calorie intake a nutrient-rich dip, such as hummus, avocado, or yoghurt-based varieties, offer nutritious opportunity for more calories at mealtimes.

 

In summary, incorporating dips and sauces at mealtimes can serve as catalysts to encourage exploration of new foods and textures for your child. If you’re stuck on ideas of what to include, here’s a list of enticing dips and spreads that can add a burst of flavour to your child’s palate:

Dairy: Cream cheese, cottage cheese, yoghurt, custard, tzatziki,

Dips: Hummus, avocado/guacamole, salsa, nacho cheese dip or any dip from the supermarket

Nut butters: Peanut butter (smooth or crunchy), any nut butter such as almond or cashew.

Sweet spreads: Chocolate spread, Nutella, melted chocolate, jams or marmalades.

Sauces: Tomato sauce, BBQ sauce, mustard, sweet chilli sauce or relish.

By Dr Shabnam Kashef

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Guide to Food Safety

Food safety tips – Taken from Food Safety Information Council https://www.foodsafety.asn.au/

Clean:

  • Remember the 20/20 rule: wash hands for 20 seconds with warm soapy water dry hands for 20 seconds before starting to cook repeat frequently especially after handling raw meats, or vegetables with visible soil.
  • Wash utensils and cutting boards with soap and warm water, and dry thoroughly, before handling different sorts of foods. This is particularly important when dealing with raw meats and vegetables.

 

Chill:

  • After purchase, all refrigerated meat, poultry, dairy foods, vegetables, salad ingredients should be refrigerated at or below 5ºC.
  • A fridge thermometer should be used to make sure the temperature is at or below 5ºC.
  • Refrigerate leftovers promptly.
  • Cooked food should be stored in covered containers and either put in the fridge to cool, or frozen immediately.
  • Frozen foods should be defrosted in the fridge NOT on the kitchen bench.
  • If in doubt, throw it out!

 

Cook:

  • Cook chicken, minced or boned meats, hamburger, stuffed meats and sausages right through until they reach 75°C using a meat thermometer.
  • Serve hot food steaming hot above 60ºC.
  • Defrost frozen poultry and rolled and stuffed meats thoroughly before cooking.
  • Always follow cooking instructions on packaged foods.

 

Separate:

  • To avoid cross contamination keep raw and cooked foods separate when storing and preparing.
  • Food should be stored in covered containers in the fridge and put raw meats and poultry in the bottom of the fridge so the juices don’t contaminate food on lower shelves.
  • Don’t put cooked meat back on the plate the raw meat was on.
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