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Title: Feeding Problems “..our 12 month old daughter…is the happiest little baby we've ever met. ..However, she will hardly eat anything at all. The orphanage told us she was a picky eater, but boy is that an understatement. …We were expecting a child who wouldn't stop eating. Never dreamed we'd be in this situation!” I am always concerned, when I am hearing about a newly adopted child, who is a picky eater. Any child can have problems eating if he/she is exposed to new - Types of foods (meats, fresh vegetables, etc) - Textures (dry foods like cheerios or teething biscuits, or if foods are not pureed enough) - Smell ( kids are used to the smell of the orphanage food and would not tolerate new and unusual sensations) - Temperatures (children are usually not used to cold or very hot foods) - Feeding techniques (kids can be bottle-fed through a nipple with a huge hole, and unable to eat from a spoon) - Feeding position (frequently kids don’t see the person who is feeding them) - Feeding environment (café or buffet rather then familiar room with the small tables and familiar caregivers) Some of the other reasons for feeding difficulties can be - Oral aversions and other sensory deficits will have difficulties with accepting foods, chewing and swallowing. - Low muscle tone (generalized or of facial muscles only) will lead to early fatigue and poor feeding - Painful lesions in the mouth (past or present) - Abusive feeding techniques in the orphanage - Medical conditions like ear infections, gastro-intestinal problems, asthma, colds and so on - Behavioral and emotional problems
It is extremely important to - Anticipate this condition and to request orphanage to show you how exactly this particular child was fed in the orphanage and with what. - Be flexible with the feeding routines and techniques – feeding a bottle, spoon-feeding, giving local formulas, feeding with the baby’s face away from you and so on - Reduce over-stimulation as much as possible before and during feeding - Make sure that your child gets enough rest and sleep - Not to stare on your child, while he/she is eating - Offer your child warm formula/ milk / yogurt, sweetened enough for this child to take it willingly. You will be able to slowly reduce the sweetness later on. - Warm all foods, even milk. - Offer Russian-style foods, black bread and so on - Create as much routine as possible even while on the road – when the child is eating, with what, how, where and in what order - Not to be concern with the lack of food variety in your child’s diet in the first days and even weeks after adoption. Slowly introduce new foods/ textures/ temperatures if your child will tolerate them. - Not to give such child a sippy cup; use a bottle with the hole as large as your child needs, slowly decreasing the opening; straw cup or a regular cup can be used too - Spoon-feed your child if necessary, even with the fluids like milk and formula
When you will arrive home - Don’t expect for this particular child to get better on her own - Have the full medical evaluation, and - Evaluation by a specialized pediatric feeding team (usually present in speech departments of large hospitals) as soon as possible - Early intervention program evaluation has to be scheduled as soon as possible - Have formal occupational therapy evaluation - Don’t accept “all toddlers are picky eaters” and “You can not starve in a cornfield” as an answer
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