Friday, February 15, 2013

Food Issues & Fostering

When I heard that today was National Pancake Day I laughed.  You see, our current foster placement, 2 year old Ty, has some food issues and pancakes (or "ba-bates" as he refers to them) are his favorite food obsession- so much so that he asks for them at least 17 times a day- even if it's been ten minutes since we've last eaten.  Basically, every day is National Pancake Day at our house.
Food issues in foster children (or anyone else for that matter) aren't just about food being a source of fuel- although children coming from an environment of neglect or abuse certainly are at a greater risk of suffering from malnourishment.  In cases where food is used (or abused) and eating or one's relationship with food is used for anything other than it's intended purpose, food becomes something much more than physical nourishment; it can be equated with a reward or punishment and it can represent LOVE, SECURITY, and CONTROL.  Is it any wonder then, that as foster parents it's not uncommon for us to see hoarding behaviors and overeating or undereating in the children in our care?
When I first went through the training to be a foster parent I heard about "hoarders"- that is, children who would sneak or steal food, even when they weren't necesarilly hungry, and even go so far as to hide it under their mattresses or in toilet tanks or anywhere else they could stash it away for safe-keeping.  The cause of this behavior was explained to us as a survival technique: these children may be coming from a place where they honestly didn't know where their next meal was coming from or perhaps they feared that they would never eat again and were thus simply acting out of self-preservation.  Sure, I've been guilty of using food as a diversion or of having an occasional secret stash of chocolate, but I've never been faced with a real fear of starvation, so although I tried to understand it, this kind of behavior seemed foreign and bizarre to me.  Now I just nod my head whenever I hear such accounts from caseworkers or other foster parents. 
I would estimate that roughly a third of our foster placements have had issues with food.  I remember my first encounter with this and how sad I was the day I caught Justin, just three years old and our first placement, scavenging through the garbage can for an almost empty can of yogurt.  The key word here is almost- there was still some yogurty residue left behind and he started using his fingers as a spoon.  I was shocked but tried to conceal my surprise so as not to shame him.    "You don't have to eat that."  I told him.  " I can get you a new one if you're still hungry."    I then tried to be reassuring and and told him that we would always have food in our house and that if he was still hungry he could always ask for more.
Our most difficult case with hoarding was a couple of years ago when 2 year old George was in our care.  The first night we brought him home he scarfed down more pieces of pizza than my husband.  The first couple of days I gave in to George's overeating because he was skin and bones and I thought "This kid is starving!"  But I had to limit his intake when he would eat so much that he would throw up afterwards.  He would immediately whine for "more" after meals even when I could tell that his small stomach couldn't possibly handle more.  It got to the point that we had to put a plastic doorknob lock on the pantry door which made me feel like a mean Food Nazi.  I have since learned from other seasoned foster parents that the best way to deal with hoarding is  NOT  to restrict food accessibility altogether, otherwise it will become a power struggle, but to reassure the child that there will always be food by having  healthy snacks available to them at all times- like in a basket or on a designated shelf. 
As for Ty, he didn't overeat the first week he was with us- quite the contrary- he would pick at his plate and we would have to practically beg him to get him to eat.  I wouldn't have worried about it so much if it weren't for the fact that, like George, Ty is skin and bones, measuring in at only the third precentile for weight at his last doctor's check-up.  We felt the need to fatten him up but to complicate matters he has some food allergies, including lactose intolerance, so letting him snack on cheese sticks or yogurt or even ice cream, (as we've done with other children in our care who needed the extra calories) was out of the question as it would just give him diahrhea and make him sick.  
Now, seven weeks after being in our care, I don't know if it's because he feels more comfortable with us (the honeymoon period is over) or if it's because he's going through a growth spurt or if  he's dealing with some emotional issues and feels the need to "fill up" the lack he feels in another aspect of his life, but Ty has made a 360 degree turn and seems to be hungry ALL THE TIME- even when he's just gorged himself.  And I'll be the first to admit that it can be really annoying when I've just fed him and five minutes later he asks, "Bek-bust?"(breakfast) or "Bunch?" (lunch) and I have to remind him that we just ate.  Equally annoying is when after a meal my daughter will have a couple of bites left on her plate and Ty will have allready cleaned his plate of seconds.  As soon as my daughter leaves the table (and in a few instances even before she's left the table) Ty will jump over to her spot or grab my daughter's plate and start scarfing it all down like a ravenous wolf. 
I've tried to "pace" Ty with his food at meals or snacktime so he feels fuller longer.  For example, cutting up his pancakes into tiny pieces and not putting the whole thing in front of him all at once- but reminding him to "slow down" and  that after he's done if he's still hungry then he can have a little bit more. 
Yes, it can be frustrating to parent someone else's child when you have to deal with the repercussions of neglect- including but certainly not limited to food issues.  But as with all caregiving you have to take a step back and remember, "This isn't about what's convenient for me- it's about meeting the needs of the child and making them feel safe, loved, and secure."   It's also good to try to see things from their perspective which is why I both benefitted from and felt saddened by reading the insights of a former foster child and his experiences with hoarding.  I had a similar reaction when I recently read this perceptive statement by an experienced foster mother: "Children should not have to vomit to make themselves heard."
If you'd like to be a more patient and loving foster parent or gain a better understanding of food issues (because despite it being National Pancake Day, if I hear a request for "ba-bakes" one more time today I just might pull out my hair!) there is  going to be an upcoming  Q & A Webinar sponsored by Adoptive Families Magazine on the topic of food issues by a "feeding expert" (I didn't even know there was such a thing!) which is appropriately titled "Love Me, Feed Me."  This couldn't have come at a better time for me.
Foster Parents or Current and Former Foster ChildrenWhat food issues have you encountered or struggled with and what is the best way to approach these difficulties?


Shine said...

Be sure to post the link to the feeding expert! I could sure use some knowledge with my son, even though he's not a foster child.

Mary said...

Click on "Q & A Webinar" in my post and the link should pull up!

The Queen Mama said...

Excellent post, Mary! It is amazing that we never even thought twice about eating food "normally", before we started fostering. We have experienced the constant eating with a few of our kids, but our most interesting case of a foster child with food issues was a little 2 year old girl who suffered from Munchausen by Proxy. We were told her mother didn't feed her well, leaving her very underweight. The problem was, from not eating much, she had not learned to eat properly. She choked and gagged on everything, even yogurt and pudding. When it looked like she was chewing and eating well, she was actually holding the food in her cheeks until they puffed out, then would try to swallow everything, resulting in choking. By CYS and physician orders, we had to write down everything she ate, how much, and how often, as they wanted her weight to increase. I was literally a nervous wreck every meal and snack time, afraid we would have to call the ambulance due to her choking. We made it through her placement, but not without a new understanding of the actual art of eating. Best of luck to you with Ty!

FootPrints said...

it crazy how your feelings about food are formed when you are a infant/toddler...we once had a 14 month old, who weight 14 pounds! so tiny like a new baby. stopped drinking formula at 6 months and was only given juice. his teeth were completely rotted. poor baby. no matter who he met he would immediately sign "more" he'd also keep food in his mouth for hours! it was awful!

Mary said...

14 months and 14 pounds? That is sad. Speaking of keeping food in their mouth (and not swallowing) when Rose was in our care the second time at just over a year old she would stuff her little cheeks and mouth like a chipmunk and I was so afraid she was going to choke! It took a week or two before she learned to slow down without getting upset about not having a mouthful of food.

Mary said...

Munchausen by Proxy- wow. Choking would definitely be scary to deal with!

Unknown said...

Wonderful post! We have had lots of food issues here..the hoarding, the eating-till-vomitting, the non-eating. Thanks for raising awareness!

Deidra said...

A women I met who adopted many children from international orphanages told me that she gave each child a backpack filled with healthy snacks and told them they could eat it whenever they needed to and she would refill it. They would keep the backpack with them or somewhere in reach. She claimed they never ate the food in the backpack and they didn't hoard, they just needed to know there was food available. Not sure if this would work but it's worth a try. Good luck. You are a great mom and foster mom!

Pink Panda said...

This is great to know as we will be certified to foster soon! Thanks so much!

Foster Care: What Have We Done?! said...

We have had 5 foster children (one at a time) ages newborn-18 months. They have all had issues with food. Our current foster so. Who is 18 months old panics at the sight of food. He cries, screams and throws himself down trying to get at it. Going to the grocery store with him is out of the question at the moment. My husband has to take him outside to play while I make dinner. And even as we're sitting at the dinner table eating, he is fussing because he wants our food as well. He used to vomit daily. We now put a small amount of food in his plate. When he has eaten that, we put more. He fusses, but it keeps him from vomiting. The odd thing is none of our foster children have come to us malnourished or under weight. One, quit the contrary. And our first was placed with us as a newborn so she always has healthy and adequate food. ???