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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Adding to my post above, for my medical kid, I'd do pretty much the same thing, except that I would have calculated what he needed to eat, and anything that didn't get eaten, I would have blended up and fed him through his feeding tube.

I say that, in part, because I get the fear that your kid won't eat enough and will be hungry.  Not, "it's time for dinner" hungry but malnourished.  I want to say that first of all, that's pretty rare.  If you aren't seeing signs of trouble, like failure to grow, then I would try really hard to let go of the idea that the kid being hungry is either a bad thing, or your problem to solve.  Your job is to provide healthy food within a structure, and their job is to problem solve their own hunger within that structure.  It's really OK for a kid to go a few hours without food because they are pushing against the structure.  Over time, the more consistent you are with the structure, the more they'll learn to anticipate their own hunger and eat accordingly, and the less often they'll be significantly hungry.  [/quote]

I am the PP and I just want to thank you for this and your last post -- really helpful. Admittedly we struggle with consistency at times especially on sort of the auxiliary issues of snacks and dessert (so much effort goes into being con

sistent and adopting the right attitude with regards to meals). But this is a good guide -- I really appreciate you taking the time to write it out.[/quote]

Thank you!  I'm really glad it was helpful.

I came back because after I wrote my posts I saw what someone else had posted about dessert and other kids, and I realized I hadn't addressed it.

I don't give or withhold food as a punishment or reward ever.  In my house, kids would get those cookies one of three ways.

One is that they would get one, or maybe two, as a dessert with a meal. We don't have dessert every meal, but we have it pretty often.   If that was what we were doing, then every member of the household would get offered one or two cookies, and it would have nothing to do with whether or not they ate anything at dinner.  Satter suggest simply putting the servings of dessert at their place at the beginning of the meal, for them to eat at any time during the meal.  Or I'd put one or two in their lunch box.

The second is that sometimes we have cookies for snack, usually with milk or something else, and in that case they can have as much as they like.  I don't usually do that for an evening/bedtime snack, more likely an afterschool snack or a mid afternoon snack on the weekend, but if the cookies arrived today and they seemed like they might go stale, then I might offer them in the evening, but usually our evening snacks when they were younger were bland easy things like a bowl of cereal with milk, or a banana and a glass of milk.  Again, it wouldn't be related to whether they had eaten dinner.  I think of balancing nutrition as something that happens over the course of a week, not a few hours.

The third would have been if the neighbor brought them over and we decided to try one then and there, maybe inviting the neighbor to sit with us.  Whatever we did, we'd all do it, unless it was some kind of cookie one of us didn't like.  [/quote]

PP again and this is again very helpful. Not least because I see a lot of recommendations to just eliminate dessert/treats from the household in order to address picky eating and I hate these recommendations because I have a very healthy and nutritious diet and also love a small treat after dinner or as an afternoon snack. Also our picky eater loooooves sweets and I hate the idea of essentially eliminating one of the few foods she eats with genuine pleasure. We also use baking with her as a way to share and talk about food in a fun, enjoyable way (since she won't eat most other foods we enjoy). We try to be balanced about it but you've given me some things to think about so I can deal with my own guilt/shame around my kid eating sweets when she hasn't eaten much else with nutritional value at a meal. Really helpful.

I know you recommended Satter before and we already use the Satter method but do you have any other resources you'd recommend. I also follow kidseatincolor and sometimes it's helpful but I feel like she's focused on the average kid with picky tendencies rather than extreme picky eating/ARFID (even though I'm pretty sure at least one of her kids is an extreme picky eater -- I think she tempers her advice to reach a broader audience and have found that the ideas that work for moderate/normal pickiness in kids are generally just not very useful for extreme pickiness). Any other recommendations for sever pickiness or ARFID?[/quote]

I think that letting go of the guilt/shame would be a good thing.  I think that restricting food isn't a good idea for all sorts of reason, and including sweets in a diet is important for all the reasons you mention.  Cooking with your kids can be a wonderful way to move them towards being more comfortable with food.

I'll also say that I don't think that the severely picky kid in my life has ARFID, although I've worked with kids with ARFID.  She eats enough variety, and enough calories that I don't think she'd qualify for that diagnosis, even though her diet is still quite limited and was even more limited a few years ago.  I'll also add that we have shared custody, so while we've seen improvement over the past few years, and I attribute it to the Satter method, the other household might attribute it differently.

I don't think you're doing Satter yet.  I think you've got some of the pieces in place, which is a great start, but I don't think that you are quite there.  At it's heart, a big piece of Satter is letting go of the responsibility for making sure that she eats enough calories, or gets protein, or has balance, or isn't hungry.  It's about a mind set where those things are her job, and you're confident that given structure she can problem solve to do her job.  If she's growing normally, even if what she eats doesn't look great through your eyes, then I would say you should have that confidence.  So, you decide what the foods offered are, and when and where she'll eat, and then you leave the questions of which foods, whether she eats at all, and how much she eats up to her.  Being calm, not showing anxiety, not pressuring her, and holding to the structure are key parts of "doing Satter".

As far as other resources, my picky eater is younger than my medically complex kid, and didn't come to me at birth, so I'd already done a whole bunch of Satter based work with a dietician before she came into my life, so I didn't go looking for resources specifically for her.  I have looked at Kids eat in color and I didn't love it.  From the Satter work, I am very aware of not pressuring kids to eat, and I kind of feel like the visual perfection that she crafts is pressure.  Maybe it's just me, but I feel like once you're cutting food into shapes, and arranging it just so, and obsessing over the colors, that's pressure, and I think kids with anxiety about food are really sensitive to that pressure.  I also think that Satter's approach of figuring out what your kid feels safe with, and starting there, doesn't really jibe with meal plans you can buy with lots of new recipes.  But I say all that as someone who hasn't spent much time on her site, and doesn't even have Instagram.

Finally, I will say that with both my picky kid and my medically fragile kid we probably spent the first six months, not working on expanding what they ate, but on being comfortable with having other choices on the table.  My picky kid would come to the table, and see that I was serving Brussel sprouts and spent the whole meal worried that we were going to have a fight about those sprouts.  Or worrying between meals that at the next meal or snack there would be nothing safe to eat.  It wasn't until she knew that she could really trust me to have enough safe food to fill her up, and no pressure to eat anything whatsoever, that she began to relax enough that we could begin to see progress in what she would eat, and even then that progress has been very slow. [b]I say this because I often read on here where people say they've done Satter for 2 months and it didn't work at all.  It's not a method that works unless you're willing to play the long game.  The very long game.[/b]

Can I ask how old your kid is?  And whether she's on track as far as growing and gaining weight?[/quote]

+100 the Satter DOR approach is not a trick or a quick fix to make your kid eat what you think they should eat. It is a complete change in your relationship with your child and attitudes about feeding. [b]It requires that you trust[/b] that (barring medical issues that require different treatment) when children are consistently provided with food in a structured environment, they will eat what they their bodies need and will become competent eaters as they grow. And it applies as much to the eager eater as the picky eater.

It was a hard mindset shift to make and the early years were hard but taking this approach made for much happier family life and kids who did eventually learn to eat better, and throughout that grew appropriately and are now young adults who eat almost everything and have a good relationship with food.[/quote]

I'm the PP you were replying to, and I think you said it better than I did.

Satter at its core is about two things.  One is trusting the kid, and the other is building a structure that supports the kid's problem solving and their ability to trust that they'll have safe food.  Trust is at the foundation of the model.   Which is why it's not something you can pick and choose from.  I will often see posts where people say that they did Satter, they just added something (a no thank you bite, the option of a peanut butter sandwich, no cookie if you didn't eat well at your meal, etc . . . ).  But those latter things convey lack of trust, and erode your child's trust in you.

To be clear, I'm not saying that trusting your kid is the only way.  But if you can't take that step, then it makes more sense to choose another methodology.

Here's the text of an article from the Ellyn Satter Institute that I think explains it better than I can:

[quote=Ellyn Satter Institute] 
[b]
Make an informed choice: sDOR or conventional treatment?[/b]

You may be offered conventional treatment for your child’s not-eating. A conventional therapist may tell you to follow the division of responsibility in feeding along with other methods listed below, but that means they don’t really understand sDOR: The advice is simply wrong. sDOR is based, absolutely, on respecting the child’s autonomy with eating. You can not both follow sDOR and try to get your child to eat certain amounts and/or types of food because that violates their autonomy. Trying to do both will hopelessly confuse you and your child. Beyond that, the choice is yours. To help you make your choice, understand what such treatment involves. Also observe your child when such methods are used to get them to eat. Are they relaxed and comfortable? Enjoying the process? Upset? How do you feel? Like your child is in good hands or like you want to rescue them?

[/quote]

You can read the whole article here:  https://www.ellynsatterinstitute.org/how-to-feed/intervening-with-pediatric-feeding-disorders/. It's the bottom one on the page.
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