One of the biggest barriers I hear from care gives trying to weaning or even with their toddlers and older children is the chair. They say their "child doesn't mind eating but they have to eat walking around the house", or their baby "protests every time they are put in the highchair".
Often there is a number of factors at play which we'll discuss and we'll then look at some possible solutions.
Why is the chair important?
Positioning is a key component in the success of eating and drinking safely and effectively. One activity I always use when delivering eating and drinking training to care providers is to have a go eating something in a variety of different positions and see how easy it is - go grab an apple or a chewy sweet - whatever tickles your fancy or even that hot cup of coffee you've been desperate for since 5am (I see you at the back). Then try these:
Sit on the edge of your chair and have a sip or a bite
Sit on the edge of your chair then cross one leg over
Sit on the edge of your chair lean back and lift your feet off the ground
Put a few cushions under your bum until your feet can't touch the ground, sit back in the chair and then take a bite.
Walk around whilst eating or drinking
You may not have found these too tricky but you should have noticed a difference in how easy it is to chew when you aren't sitting in the best position.
Our babies and children are often not in the best position for eating and drinking. I know I know, "you try getting my tornado toddler to sit still" I hear you cry. I'm not saying it's easy but I am saying it's important to try.
The best position for a baby eating or drinking in a highchair when they first start weaning is something with a slightly semi-reclined position and full leg support so their feet are straight out in front of them and their body and head supported. When they can sit fully independently and can hold their head with ease, then they can sit in something that has them sitting up straight (but their legs still need supporting). As your baby's legs get longer they need to have their feet supported by a foot plate to replicate the next position I'm discussing below.
What about my toddler or child? - 90, 90, 90 is your aim. This means, every big joint - hip, knee and ankle - is at a 90 degree or right angle, with their bottom firmly planted in the back of the chair.
Both these positions give your child a really solid base of support. It allows their body to anchor them and in turn lets them concentrate on a fine motor skill. Switching one part of the big body off so the little body can function easily. If you don't anchor and switch off, the body is constantly working to find ways to do this, making it concentrate more on balancing than eating. Doing the above, allows the body to concentrate more on eating than balancing and therefore provides more chance at success.
90 degree angle sitting position, provides stability when eating and drinking, allowing your child to concentrate on their oral skills.
They might be sitting well now but how do we keep them at the table?
Many of the families and settings I work with say things like "they'll only eat if they're walking" or "they'll come to the table but they won't stay at the table" or "I have to follow them around with a spoon". It's one thing getting to the table, but staying at the table is a different kettle of fish.
Let's look at how we might build tolerance for the high chair or staying at the table:
The highchair:
One of the things we did was use a 'from birth' highchair. From about 3 months old, our baby sat with us at the table or in the kitchen. She loved it. We used a clip on activity frame and she chatted away to herself in the mirror. We used (and still use) the Maxi-Cosi Minla (self purchased); there are lots of other chairs that offer the same and we bought ours second hand. What this has done is help her get used to the chair, chuckle in the chair and feel safe in it. This meant that when we did introduce food she was already used to and happy being in her chair rather than it all happening at once.
If you haven't had that opportunity, please don't beat yourself up. This is rectifiable. Find some time in your day to play in the chair in short bursts. Keep the chair next to the table and sit together playing and interacting with your baby's favourite toy. Gradually, as your baby gets comfortable, introduce utensils to play with without food present. As soon as your baby becomes uncomfortable or upset, take them out of the chair and try again tomorrow.
For active toddlers, you can try working on table sitting skills with an appropriately sized table and chair. If their feet don't touch the ground place a stool or step under their feet until you have them in their 90*90*90 position. They might also benefit from a chair with armrest as a guide to keep them upright. Do some fun, attention grabbing activities in short bursts - this isn't a tablet, TV or phone - gradually building up to 5 minutes at a time.
Once your toddler is happy at the table again, start to introduce their favourite foods, presented in a way they can tolerate. Meal time needs to be fun and motivating (hopefully some of my other posts will address how to introduce variety later).
For toddlers and older children, visual cues can also be very useful. There is lots of research that shows how important visual cues are for children's understanding. Visual cues enhance understanding by providing a concrete piece of information that doesn't change. Visual cue side note: if you think about it, words disappear and they change, no matter how consistent we think we are being. We can say 'more' in so many different ways e.g. 'do you want more? please have one more bite' 'any more' and suddenly the message is saturated. Present it as a picture, symbol or sign and it stays the same every time, the child will start to trust and understand the message and be able to respond appropriately to it given some time.
So, use a timer or a picture to show your child what is happening. You could even use their bowl or plate (we call this an object of reference) to show it's time to eat.
I'd always suggest helping your child transition from one activity to another. Many children I've worked with have struggled to come to the table because there is no transition, they are busy playing and then told to come to the table. Give your child a 5 minute warning, even help them calmly pack away, then have them wash their hands and have them bring something to the table. This helps to trigger that all important 'anticipatory' stage and they will feel more ready to eat (link swallowing post).
Takeaways
Full postural support in a high chair until able to sit independently.
90*90*90 sitting position.
Make the chair and the table a fun place to be.
Use visual cues and prompts to help children come to the table.
If you feel I've missed something or you would like more specific advice for your child please get in touch.
Comments