eating difficulties in younger children - brighton
TRANSCRIPT
www.cwmt.org.uk
Eating difficulties in
younger children when to
worry, how to help
Dr Pooky Knightsmith
@PookyH
What?
Why?
How to help?
Aims
Healthy?Hungry? Happy?
When should you worry?
He would eat
chocolate,
biscuits and
crisps but
nothing else
Selective Eating
Fussy / Faddy
Can last months
Social issues
Otherwise fine
Things that help
Play it down
Never assume
GP / Dentist
Practical support for e.g. parties
He wouldn’t
eat or drink at school (unless
they offered
him Jaffa Cakes!)
Food Refusal
Places / people
Underlying worryControl /
communicate
Makes up elsewhere
Things that help
Support, not anger
WHAT is the message?
Draw and talk
Play therapy
She barely ate at all and was very slender - but
always seemed happy and full of energy
Restrictive Eating
Eats very little
Short and slim
May be familial
Otherwise fine
Normal range
Things that help
Don’t panic!
Bullying?
Self-esteem / body image
It was like she didn’t
care enough to eat. She
was so, so sad, you could see
just by looking at
her.
Food Avoidance Emotional Disorder
No fear of weight gain
General behaviour disturbance: • Sleep problems• Poor concentration• Tearfulness• Hopelessness
Associated with depression and anxiety
May isolate themselves / avoid school
Things that help
Trauma supportSupport for
depression / anxiety if needed
GP - supplements
Beware misdiagnosis
Why?
Coping Communication
Care
www.cwmt.org.uk
She didn’t have the words to
tell us how scared she
felt at school so she did it
by not eating there.
He equated food with care and love – so he tried
to soothe his pain
with food.
You inspire not by
what you say but
what you do
It made her so happy when we gave her food.
sweets and chocolates. It
was too much – she was
bingeing and ballooning but it
was a way to show we cared.
Every meal became a
battle ground. We just wanted
him to eat something.
Anything. There was shouting
and food throwing. It was awful.
What messages do we send?
I remember this teaching
assistant from infant school
who sat with me every day
through tears and tantrums. Quietly, calmly. It took a while but I started to trust her and
began to let her in.
He grabbed a bread roll and put it on his
tray like it was the most
normal thing ever. We
exchanged no words but the look we shared said so much.
We just quietly got on with the meal but inside I was partying!
What messages do we send?
Sustainable
Support
What response is wanted / expected?
Keep a Log
Help the child feel heard
Match the need…
Coping Communication
Care
We looked for
alternative ways for her to
cope and get that
feeling of control.
She just needed
someone to hear
her. She wasn’t so good with words but drawing worked
well.
We tried to find a hundred different ways to show we cared.
Post its was his
favourite!
Cope Communicate
Care
The most important slide
of all…Try to ensure
consistent care and support
Try to
Understand what the child is
trying to cope with or attempting
to communicat
e
Give the child the
time, space and means to be heard
ExploreListen Patient
She changed my life in five minutes by making me realise I
mattered to someone, no matter how broken I was. For five minutes I felt what it was
to be cared for.
It was a fresh start.
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