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S.I.T.! Feeding Your Child Using Stability and Independence at the Table

(Guest Post by Melanie Potock)

Here on Science of Mom, we’ve been discussed starting solid foods over the last few posts. It’s a topic that I spent a lot of time researching for my book, and I ended up devoting two chapters to feeding solids. It’s also highly relevant to me right now, because 5-month-old BabyM is just starting to dabble in solid foods, and I want to be sure that we get off to a good start with his lifelong relationship with food. I was thrilled when Melanie Potock, a pediatric feeding therapist, joined the discussion about starting solids on my Facebook page. She helped me understand the importance of trunk stability for eating solid foods, and I asked her if she could write a guest post about the nuts and bolts of setting children up for comfortable and successful eating at the table. I’m so glad she agreed. After reading her post, you’ll understand why I’m working on improving our high chair with duct tape today!

Melanie also has a book coming out this fall: Raising a Healthy, Happy Eater: A Parent’s Handbook. She’s a wonderful resource, so please feel free to ask your questions in the comments.

S.I.T.! Feeding Your Child Using Stability and Independence at the Table

By Melanie Potock, MA, CCC-SLP

As a pediatric feeding therapist, I visit homes, daycares and preschools to help hesitant eaters become adventurous, healthy, happy eaters. The very first thing I assess is how the child is positioned in their feeding chair. As mentioned in Alice’s recent post on readiness for solid foods here on Science of Mom, babies must be able to sit upright before safely introducing solid foods. Why? Because fine motor development is always dependent on gross motor stability. But, did you know that toddlers and preschoolers also require optimal stability when learning to try new foods? Follow the S.I.T. Model to ensure that your child is seated comfortably and with appropriate support: S.I.T. stands for Stability & Independence at the Table.

S: Stability

Most feeding chairs are designed to hold up to 50 lbs. with the assumption that a small six-month-old or a heavier toddler would be able to sit in the exact same chair. Here’s the problem with that: There is a huge difference in the size of a six-month-old baby just starting to eat solid food and an eighteen-month-old toddler. Every child needs stability while seated as I noted in this article:

“Gross motor stability (in this case trunk stability) provides the support for fine motor skills. It’s very hard to learn to eat purees off a spoon or do any sort of self-feeding of soft solids if the trunk is not supported. Try it yourself by letting your trunk relax and fall into the back of your dining chair, slightly slumped. Now stay that way and try to bite, chew and swallow. Imagine if you were just learning to eat this way!”

To achieve stability in the trunk, begin by sitting your child upright in her chair. Be sure that the pelvis is tilted forward just slightly, as shown in this diagram.

www.MyMunchBug.com-1First, put a rolled-up kitchen towel behind the arch of her back to ensure that the hip angle tilts forward or is slightly less than ninety degrees. If baby appears to be swimming in the highchair, add another rolled-up towel or spongy shelf liner on either side of her hips, filling in the gaps between the hips and the sides of the chair. Next, assess the back of the chair: Does baby need to lean back slightly to rest and then do a little abdominal crunch every time she leans forward to eat from her tray or take a bite from the spoon? That’s exhausting! Fold a towel and place it behind her shoulders if the seat back won’t fully adjust to an upright position. To ensure that smaller kids don’t slip forward in their seats, you can do two things: 1) Place a piece of spongy shelf liner under your child’s bottom to make it stick and/or 2) Wrap a washcloth around the saddle horn (if your high chair has one) and duct tape it, creating a fat cone of fabric. This added padding will fill in the space between baby’s diaper and the saddle horn and prevent her hips from sliding forward.

Finally, make a mental note where all those rolled up towels were placed. Take off the high chair cover, duct tape all the towels to the plastic high chair beneath, and replace the cover. You now have a customized high chair for your child and can adjust or remove the towels as she grows.

No matter what size your child is, always visualize the diagram noting that stability begins at the hips with a slight anterior pelvic tilt. The trunk and shoulders align over the hips to provide stability for fine motor skills like eating, spooning purees and picking up finger foods. Chewing is also a fine motor activity, as is swallowing!

Ensure optimal stability from the hips down by providing every child a foot support. Why do you think your baby always hooks his big toe under the high chair tray? He can’t put his feet on the floor and he’s seeking out stability. Most high chairs have a footrest – but it’s impossible for smaller children to reach. Try raising it up by adding a saltine box (duct tape again) and add a sheet of shelf liner on the box for their little feet to get some added grip. For older children, please refer to this article on seating and picky eating in preschool settings.

I: Independence

In her post on readiness to eat solid foods, Alice noted:

“Trunk stability is also important because it allows you and your baby to be able to be face-to-face during feeding and for your baby to be an active participant in deciding whether, how much, and how fast to eat. You offer baby a bite, and he leans forward and opens his mouth if he’d like to accept, or he turns his head away to say no thanks. With good trunk stability, a baby can communicate his wants and needs to you, and you can be responsive to them. This way, feeding becomes a respectful and pleasant conversation between the two of you.”

Establishing sound seating is the bridge to independent eating. Once baby is sitting with confidence, he is more likely to stay at the table longer and participate in the family mealtime experience. This can also include finger foods from a very early age.

One of the best ways to begin to foster independent eating is to pull off the high chair tray and pull up to the family table.

T: Table

Depending on the height of the table and the height of the feeding chair, bring your baby to the table to eat as early as possible. The table should align with baby’s sternum or breastbone, so that when sitting upright she can rest her elbows comfortably on the table top for added stability. My favorite chair for this is the Fisher Price Space Saver. The seating is superior and requires fewer adjustments with towels as noted above and fits most kids quite comfortably. Be sure to add a towel behind their back, as it doesn’t adjust to a fully upright position. Another wonderful option for babies sitting up well on their own is the amazingly adjustable Keekaroo Height Right Chair, which grows with your child. In fact, it holds up to 250 lbs. and can one day be used as a desk chair or even a piano bench. I prefer that my clients do not feed their children in Bumbo seats, as they must be seated on the floor for safety and it puts the child’s pelvis into a posterior tilt, causing pressure on the stomach that can exacerbate reflux and spitting up at mealtimes. If you must use a booster seat, be sure that the child has adequate support as described above, including a footrest.

Table top feeding has many benefits, including:

  1. Children are less likely to throw food thanks to more surface area in front of them. One of my favorite tools for tabletop feeding is ezpzfun’s Happy Mat, which sticks firmly to the tabletop and has a partitioned plate built right into the mat. For the “little pitcher” in your house, it stops the tendency to toss bowls and plates too.
  2. Children are more engaged and included in family interactions at the table.
  3. Other family members are more likely to be eating with the child, rather than feeding the child – thus leading to more independence.
  4. Children see, smell, and sometimes taste the same foods that the rest of the family is eating. Science shows that early exposure to a variety of foods, especially when accompanied by modeling of enjoyable eating by other family members, helps kids to grow up to be healthy, happy eaters. (For discussion of some of this research, see here, here, and here.)

Stability & Independence at the Table: Just one of the ways to Raise a Healthy, Happy Eater. For more ideas, please visit www.MyMunchBug.com and sign up for my free newsletter at www.ParentingInTheKitchen.com.

Melanie headshot 2Melanie Potock, MA, CCC-SLP is pediatric speech language pathologist, an international speaker and a media consultant on the topic of hesitant, picky and selective eating. She is the co-author of the forthcoming Raising a Healthy, Happy Eater: A Parent’s Handbook and the author of Happy Mealtimes with Happy Kids: How to Teach Your Child about the Joy of Food! She is the executive producer of the award-winning children’s music CD titled Dancing in the Kitchen. Her advice has been shared on CBSPhilly, in print media including Parent’s Magazine and here, on Science of Mom!

(Product links are affiliate links to Amazon, and purchases through these links will give a small commission to support the Science of Mom blog. Products are independently recommended by the author, who has no financial relationship to these companies.)

How do you make sure your child is set up for success with feeding? Please share your comments and questions below.

 

20 Comments
  1. Could the Stokke Tripp Trapp high chair work as well? It looks very similar in design to the Keekaroo one. Thanks for a great post!

    Like

    June 4, 2015
    • HI Abby, yes for sure! Great option. I get both of those chairs on Craig’s List too because they are easy-clean and durable. Families tend to keep them a long time, so I search often to find and nab one!

      Like

      June 4, 2015
  2. Frith #

    How well does the HappyMat stick to the table, we have a great reclaimed wood table that has bumps and lumps in it and nothing seems to stick well and I am over the food and bowl being chucked on the floor. My son is 9 months old and is happily eating family meals cut up small if I feed him but if I put it in a bowl in front of him it just goes on the floor. Unfortunately my husband doesn’t get home from work till late so family meals aren’t happening, what can I do to help him become an independent eater?

    Like

    June 4, 2015
    • HI! Check with ezpzfun.com, the maker of the mat, but your table might be the culprit, as beautiful as it is! (-: For ideas on becoming a more independent eater, visit the My Munch Bug.com where I have over 50 different articles on the topic and sign up for our newsletter at Parenting In The Kitchen too – lots of tips coming your way! Meanwhile, my best tips to get started are: Keep him on a hunger schedule with no grazing between meals, so that when you sit down together he’s ready to eat. Eat with him, even just a bit, so that he sees that it’s a social family affair. If you also like to eat with your husband, this can be your snack and your child’s meal – but most importantly it’s together. Finally, keep portions small and underwhelming, so he has the chance to ask for more. Hope you find that helpful! Lots more in the links above!

      Like

      June 4, 2015
  3. Tom Adams #

    In her last “Science of Mom” blog (and in one earlier blog) Alice recommended a book on feeding by Ellyn Satter. I notice that you and Satter take opposite positions on some issues.

    Satter is completely against reinforcement. She says that “Praise, compliments, rewards, and other forms of outside reinforcement take away the child’s inborn desire to eat and pride in mastery”.

    Satter is also against withholding attention. She says “Negative parenting, such as warning, punishing, withholding attention, etc. all undermine children’s positive feelings and comfort with eating.”

    Satter says these approaches “destroy the utility of the division of responsibility”

    http://ellynsatterinstitute.org/htf/iwfr2.php

    I can see from your book that you take a different position on these matters. You view attention as form of reinforcement and say it’s counterproductive to give attention to failure to eat or picky eating. But, I think your position is that reinforcement of healthy eating can be a useful strategy.

    Please comment on this apparent “food fight” between Satter and you.

    Like

    June 5, 2015
    • Hello, thank you for this question. It’s something I often discuss with the parents of children in feeding therapy and in the courses that I teach. First, let me say that I am a huge fan of Ellyn Satter’s work and have all of her books, often sharing them with families. Her DOR model is something that is my ultimate goal for all of the children I work with – and feeding therapy addresses the underlying physiological, sensory, motor and consequent behavioral challenges that can stall the developmental process of feeding. Once we’ve managed those to the best of our ability and taken kids through the process of learning to love food again, we gradually shift to DOR. So, in essence, what I do by utilizing antecedent, behavior and consequence principles is just a bridge to getting to DOR. I cannot write in a “reply” all of the differences and nuances, but in short basic ABA truly is “Parenting in the Kitchen”. Satter and I both believe in keeping it fun and rewarding with attention – that’s just good parenting. But as a certified SLP and specialist in feeding, I may need to take additional steps to getting to DOR.

      Like

      June 5, 2015
  4. Reblogged this on aldogeng and commented:
    How to be a perfect mother?

    Like

    June 8, 2015
  5. Sarah Chisholm #

    Thanks for a really informative article. I have a hard time visualizing this with the bubble diagram shown above, any way to get some real pictures of what you’re describing?

    Like

    June 10, 2015
    • Hi Sarah – Melanie and I discussed this, and while she has lots of photos, they’re of clients so she can’t share them here. BabyM is almost ready to sit up like this, and when he is, I’ll take a photo, have Melanie take a look at his seating and posture, and post it here.

      Like

      June 11, 2015
  6. Katie #

    Hi, thanks so much for the informative article! I have a 7 month old who is currently being evaluated for feeding difficulties – he won’t accept solids at all, he actually vomits if he tastes any food. He also vomits intermittently at other times, to the point where he has not gained weight in three months. He has had an OT evaluation and is scheduled for a swallow study. He has some other chronic medical issues including low muscle tone. I understand that you can;t comment on my specific situation, but I wondered if you could recommend some books/blogs/other resources for parents dealing with actual feeding problems, and not just normal reluctant eaters? Thanks!

    Like

    June 12, 2015
  7. kaxtone #

    Reblogged this on KaXtone's Blog.

    Like

    June 20, 2015
  8. Kalindi #

    Did you ever get a picture of BabyM with proper posture? We’re starting to put our boy in his high chair this week and want to start off right.
    Thanks

    Like

    January 19, 2016
    • I tried, but I don’t know if I succeeded in getting a good photo of his posture in profile (and it’s hard to see in the chair). I pulled a few photos to send to Melanie and will post them here with her comments if she has a minute to reply. Thanks for the reminder!

      Like

      January 20, 2016
      • Hi again,

        Well, I sent Melanie this photo for her critique and have copied it below. I guess we didn’t succeed in getting perfect feeding posture with M, and I can totally see what she’s talking about. We did add towels under the padding as suggested in this post, but we should have done MORE!

        Cee feeding M

        Here’s what Melanie said:

        “So many things are lovely about this picture – eye to eye with his sister, well supported around his hips and trunk and table top (or tray) at the perfect height. I’d like to see him a tad more upright, just because as he starts to lean forward for the spoon, he has to do mini-situps over and over as each spoonful is presented and that’s tiring. Plus, a bit more upright lets him see the food on the tray.”

        “Forgot to mention that often the culprit is the adult chair – the seats on our dining chairs sometimes tilt back slightly, which contributes to the “tilt back” of the booster seat. Adding a soft towel under just the back of the booster seat and then, buckle tightly, evens out the angles a bit. But yes, that seat, as much as I like it, won’t sit a child upright unless we add towels, etc.

        Hope this helps! And thank you to Melanie for generously taking a look and providing feedback.

        Like

        January 21, 2016
        • Kalindi #

          Awesome! Thank you very much. We have the same booster seat so will add the towel underneath to help with the angle.

          Like

          January 21, 2016

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