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Why You May See Increased Feeding Challenges During Times of Stress or Change

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Including the Covid-19 pandemic stay-at-home restrictions, vacations, new schools, a family move, or illness.

When children and their families are undergoing major changes in their lives, whether this is related to stress or a positive life event, any child’s eating or feeding can be easily disrupted.  This is even more true for children with feeding or eating challenges.  Interestingly, for some children and families, these life changes actually create opportunities for improvements in eating. For other children and families, a change is more likely to create a serious disruption in the child’s eating or feeding. So let’s take this issue apart and see if we can differentiate between families who do well and those who don’t during changing or stressful times.

Issue #1: Routine and/or Schedule Changes

Whether a family goes on vacation, changes schools, or moves to a new house (or goes on lockdown), the child’s routine and/or schedule has been changed. During times of change, unfortunately, some families will give up previously successful routines, and more often, the schedule goes out the window completely. So the #1 key in any of these situations is to KEEP as close to your child’s usual routine AND schedule that you can, EVEN when children are sick.

Issue #2: Child Expectations Change

Especially when children are sick, we as adults feel sorry for them and don’t expect them to do anything. The less you expect them to do and the more pampering you give them, the more difficult it will be for the child to get back into their usual routine and onto their typical schedule. This is a really fine balance. When our children are ill, they do need to be pampered and they will not be able to participate in meals at the same level. However, especially when we as the adults are stressed (e.g. on lockdown), we may feel even more sorry for our children and feel even more obligated to try and “make everything better” when an illness occurs. “Wow, our kids have already been getting a bad deal because of COVID-19 and now they are sick too! I really need to figure out how to make this better/special”. Do you see how this might lead to overcompensation on a Parent’s part? If you are letting them eat every meal/snack lying down in front of the TV or iPad, it is going to be really hard to come back to the table when they feel better.

Issue #3: The Reason Behind a Change Isn’t Communicated

If you are making changes to your routine, schedule, or expectations, regardless of whether it is a change due to location or illness, make it clear to your child that the family is doing something different because of X and that “we will go back to our usual way when X is over”. Many families do not make it clear to their children that the changes occurring are temporary and for a specific reason. Not doing this makes it harder for many children to transition back to the old way, especially if the new way is easier and more fun.

Issue #4: Stress Decreases Appetite

Any type of change, even a fun one, can introduce a component of stress for your child. The problem with stress (good or bad) is that it activates our Fight-Flight-Fright system and turns on Adrenaline. Adrenaline goes to the appetite center of the brain and tells the brain to turn off the appetite so that your body’s resources can be pushed to running away versus digestion. The more stressed a child is, the less appetite they will have. The lack of appetite can just make everything that much worse.


How long does being sick disrupt a child’s appetite?

Children who do not have active feeding problems usually get sick and recover within 2-5 days. They will often lose weight, especially if they are sick for a longer time and completely stop eating. However, when they feel better, these children will also typically come back to the table fairly easily because they are ravenous. They will eat “double time” and make up the lost weight from being ill AND gain the weight they should have if they had not gotten ill, within about a week’s time frame.

Children who are still struggling with feeding difficulties do not follow this typical pattern as well. They appear to take longer to recover from the illness and take longer to get to the point of feeling better than the other family members who got the same illness. They lose more weight and they do not come back to the table as easily because they do not appear to have the “ravenous” appetite kick back in. Very generally, it takes about 2 weeks for them to gain back the lost weight and potentially another 2 weeks to get back onto their growth curve. This is why it is very important to do the recommendations above to help a child with a feeding problem when they get sick.


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