Good eating habits form the basis for lifelong health, and these habits begin in infancy.
Children who join their family through foster care or adoption may need time to learn new habits and routines around food in your home. Children who faced early adversity and trauma may have experienced food insecurity—which includes not getting enough to eat, having unpredictable mealtimes and having access to a limited selection of foods and textures.
You can help your child adjust by learning about your child’s former habits, experiences and preferred foods. The way your child was fed in the past will affect the child’s transition to a new diet.
We asked Adoption Medicine Physician Judith Eckerle, MD, director of the Adoption Medicine Clinic at University of Minnesota Masonic Children’s Hospital, for advice regarding mealtime support. Here are her tips.
By developing a comprehensive understanding of your child’s food preferences, potential allergies or intolerances and any other feeding problems, you can better provide appropriate mealtime support for that child. To become more informed about your child’s preferences, consider asking the following questions:
If you visit your child’s orphanage or foster home, you may want to consider watching how the home handles mealtimes and eating habits. You will see whether the children feed themselves, are fed by a caregiver or fed with a bottle propped up on a pillow. Note if mealtimes are quiet with little chance to talk, or if they are lively and social. Find an opportunity to ask your child’s caregivers about feeding issues, including the following questions:
Most children handle the change to a new diet fairly well, but it helps to serve familiar foods for your child during the first few days or weeks following adoption and integration into the home. After a few days, begin to serve new foods along with more familiar foods. Listen to and respect your child’s food preferences.
Some children may reject food no matter what options you offer or how loving and supportive you are. Food rejection may be due to the unfamiliar textures of food. Most institutional food is bland, liquid or pureed. If a child was not introduced slowly to solid foods, he or she may need to move slowly from purees to chunky and solid foods. Children may also reject food because of past traumatic feeding experiences. For example, in some orphanages children are fed quickly with a large spoon or are not given enough time to chew and swallow. Some may have been fed from bottles that had large nipple with big holes, which caused choking. Always remember that mealtime may not have been a good experience for your child in the past.
Some children have digestive problems caused by parasites or unaddressed medical conditions. This can cause diarrhea and cramping. Bacterial or parasitic infections can cause poor appetite due to chronic stomach pain and vomiting. If you child has had symptoms such as diarrhea, vomiting, constipation, bloating or abdominal pain, have your doctor examine your child. The symptoms may be due to infections, diseases, or severe malnutrition.
Have your child or children help prepare food, set the table and take part in mealtime planning, prep and cleanup as is age appropriate. Eat meals together as often as you can away from screens and other distractions. Talk about your day, share pleasant memories and discuss upcoming events.
It’s also important to model healthy mealtime behavior for your child or children. Modeling is another way to introduce new foods. When your child sees that you enjoy a certain food, he or she is more likely to try it. But be patient during this process. Even if a child rejects a food one week, they may eat it the next it is served. Encourage but do not pressure your child to eat their food. Feeding in a loving way nurtures your child and strengthens the bond between you. Your child will begin to look to you to meet his or her needs. You are fulfilling your child’s hunger for food as well as a need for security through a trusting, consistent relationship.
Often children who come from an orphanage or have been placed in foster care did not get enough to eat. They may be underweight or used to having little food. Some children may:
The child may have learned these behaviors as a means to survive. We usually see these behaviors decrease or disappear within 6-12 months of adoption, depending on the age of the child. Children will begin to adjust their food intake on their own and may self-regulate when they:
Your child’s appetite may vary greatly from day to day – a huge appetite one day and no interest the next day. You will want to make sure that your child knows there will always be enough food. It may be helpful to keep a snack on hand in case he or she wants more.
For children who eat ravenously, try serving smaller portions. Then, when the child asks for more, you can respond by giving more food and saying, “Of course you can have more food”. You are showing your love in a concrete way. Allowing them figure out when they are full will be important as they grow and become more independent.
Your child’s feeding behaviors might regress during this time. For example, younger children who are able to feed themselves may want you to feed them. During feeding, hold, talk to, smile at and make eye contact with your child. Don’t worry about “babying” your child. You are meeting their needs at his or her present level of emotional development. Once needs are met, your child will be able to move on to the next level.
Children who are malnourished may need extra iron and vitamins during their period of catch-up growth. This period can last up to six months after placement or adoption. Your child’s iron and vitamin D should be checked soon after placement or adoption, and again over the next six months. Supplements are the usual treatment for low iron. You can also offer foods rich in iron and fortified with vitamins and minerals.
The University of Minnesota Health Adoption Medicine Clinic works with families worldwide for pre-adoption consultations and referral reviews. We also see families from all over the world who travel to visit our clinic in person for Comprehensive Well-Being Assessments.