Involving Caregivers in Feeding Therapy

Feeding children is a dyad between the child and their caregiver who is responsible to buying, preparing, and presenting food. In all of my classes whether it be for professionals or graduate students, I talk about the importance and benefits of involving caregivers in your feeding therapy sessions. Many parents tell me that mealtime is the hardest time of the day or that they dread feeding their child. I believe it is part of our job as feeding therapists to help a parent feed their hard to feed child.

Parents need to know:

• The feeding issue is not their fault, they did not cause the feeding problem.
• They are not alone, many families are experiencing the same difficulty.
• Parent support is available- they can connect with another parent who has been through something similar through the Power of Two Parent Mentor program, through Feeding Matters; https://www.feedingmatters.org/resources-support/family-support/request-family-support/
• Children can improve their skills and it is a point effort between the medical and therapeutic team and the family!

By working closely with parents, we build their confidence and skill. We can also give perspective, that for many children having a pediatric feeding disorder is a long road and will take time for eating skills to improve. We can help caregivers work toward these skills while also finding ways to enjoy eating together as a family. 

Often in my sessions:

• Caregivers feed and I coach them, model strategies, and support the feeding process.
• I educate families on their child’s developmental skill level; this might include oral motor skill, appropriate food consistencies, positioning, balance of self feeding and need to be fed, strategies during feeding that will improve feeding skills. 
• I help with mealtime scheduling, figuring out when to practice strategies and when to not practice; enable a family meal without therapy so it can be more relaxing for caregivers and family time.
• We create goals together based on what is important to the caregivers. When caregivers are invested in the goals, they follow through with recommendations and home feeding plans.
• I encourage caregivers to videotape strategies as reminders for home and to track progress.
• Episodic care: we have started offering episodic care (8 week session blocks) with a planned break in between sessions for practice and time off. 

If a caregiver is not involved in feeding therapy, they may not understand why the therapist is using certain techniques. Sometimes, we meet parents in our feeding clinic and they tell me that they have no idea what is going on in therapy; “ I am not allowed back into the therapy room”. Children are eating multiple times per day in most cases (with the exception of some children on enteral feeding). We are missing opportunities for a lot of practice! Would the child eat better for me if I did all of the feeding? Perhaps, but what is most important is that they eat for their caregivers ensuring success at home. It is truly a team effort.