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.
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.
First, 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.
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.
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:
- 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.
- Children are more engaged and included in family interactions at the table.
- Other family members are more likely to be eating with the child, rather than feeding the child – thus leading to more independence.
- 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 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!
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How do you make sure your child is set up for success with feeding? Please share your comments and questions below.