New feeding plan

We had reached a fairly happy place with feeding Ian until a few months ago when Paul decided that Ian should be feeding himself by the time he turned four years old. At first I started alternating bites (I'd feed him a bite and then he'd feed himself a bite), and then Paul didn't want me to feed him any bites so the compromise then was that I'd get the food on the utensil, and Ian had to put in his mouth. Then Paul wanted him to also stab the food with his fork or scoop it with his spoon. Each time we took one of these steps, the time it took him to eat a meal greatly increased, and there also became more meals that Ian wouldn't eat anything, whereas if I fed him I could get him to eat almost anything. He did make some progress during this time, particularly with feeding himself yogurt at lunch and cereal at breakfast. He made the biggest progress with eating cereal in Maryland over Christmas. Dinner has been the main problem. It typically was taking 2-3 hours unless we had pancakes, pizza, or fish sticks. I was burned out from the constant reminders to take a bite and such. On January 8 I sent an email to Dr. Williams, the psychologist who is the head of the Hershey feeding team, and he wrote me back the next day.

I was thinking he might recommend using his "plate A, plate B" strategy that I saw him use with kids in the clinic who were able to eat but were very picky eaters. That method entails serving the child two plates of food at every meal. You put big bites of foods the child likes on the one plate and tiny (pea sized) bites of a food the child doesn't like on the other plate (he refers to these as novel foods). The kids have to alternate taking bites from each plate. That's not what he suggested. He said that if I am serving a "novel" food, that I can get the food on the utensil for Ian, but he needs to feed himself. Meal times may not exceed 45 minutes. The exception would be that if there is a food he has not taken any bites of yet, then he must have one tiny bite of it before he can get down. He said we are not to give ANY verbal reminders - just prepare the utensil, and if he takes a bite of a novel food, then we give him one incentive (ex. one M&M). The first night went great. We still gave verbal reminders, but with me stabbing the food onto the fork, he ate it within 45 minutes. Over the past several days dinner has gotten longer and longer again (90 minutes on Wednesday night for example).

Last night Paul and I decided to fully implement Dr. Williams' suggestions. This meant that yesterday he ate nothing for 45 minutes and then ate two bites (one of the casserole and one of vegetables) and then got down. I emailed him this morning to ask for clarification as to whether Ian was supposed to eat his dinner this morning or have cereal. In the past, we always made Nadia and Ian eat dinner at breakfast if they didn't eat it at dinner the night before. He said as long as he had the two bites, that was enough, and he could have cereal for breakfast. Shortening meal times will be easy for me to do. Giving him incentives is also not a problem, although Oliver also wants them. The hardest things for me to change are #1 not reminding him to take a bite (although I am very happy to stop doing this, it's quite a strong habit right now) and #2 not requiring him to eventually eat the food (aside from two tiny bites). I will say that tonight he came close to finishing in 45 minutes, and he actually burst into tears when I took away his food, which was a shock as it was the same food he didn't eat any of last night. He told me he wanted to finish. I reminded him that he had to finish in 45 minutes. He was crying because he really wanted a cookie for dessert, and I won't let him have dessert unless he finishes his food. Previously he wouldn't be allowed to watch tv, use the iPad, etc. unless he had eaten. In light of these new guidelines, those consequences are no longer going to be used. I am wondering how this is going to work in the long run, as Ian usually has no problems with skipping a meal. I can see him only eating dinner a couple of times a week, but this is what Dr. Williams does for a living, and what we were doing was not working. It's worth giving it a try. I imagine at some point he'll want Ian to get the food on the utensil himself, even with "novel" foods. Getting Ian to eat is generally the most stressful part of my week. I am hoping that this new strategy will make dinner time more enjoyable at our house. Even with a 103 degree fever today, Oliver is still our best eater. He loved the split pea and ham soup I made yesterday! I hope his fever goes away ASAP! The pediatrician's office said to bring him in Monday if his fever hasn't gone away by then.