Feeding issues with preschooler

[Busy ECE mommy]

I've got this daycare child, soon to be 3 years old. Came to me a year ago with no
ability to use utensils, and parents handed me pureed food for the first week. Yikes.I gave it to her for the first few days, as she couldn't swallow toddler sized bites of table food for me. I then just cut her pieces more infant-sized and she did better.
Of course there wasn't much mention of any feeding issues when I interviewed, only that the child sometimes takes longer to chew certain foods. So now that the 3 yr bday is approaching, I'm becoming very concerned. Child takes about 45 mins to chew and swallow a simple snack, and about 60-70mins to eat lunch. I have completely changed my schedule to accomodate child(can't go outside first as she takes too long to eat, so we do indoor stuff following snack in a.m.) Also becoming very disruptive to the start of nap time, as all are on beds 1/2 hr earlier because they have finished eating, and they won't settle, because she is still at table and takes her an additional 1/2 hr to settle once on the bed, so a full hour after the others first laid down, and none of them settle. Child pockets food in cheeks and will not swallow, and takes rediculously small bites(pin head-sized) to eat basic foods. Also has many sensory reactions to textures and gag reflex to many foods. Screaming/crying during mealtime is frequent, and lots of avoidance behaviour like stuffing food in clothing/nose/hiding in booster seat etc.
I have discussed this many times with parents, but it's the first child, so they have no point of comparison. I have suggested doctor's visit, but they see no need to see doctor until 5 yrs for the booster needle. Have also suggested dental visit to see if mouth structure/teeth may have issues. So they did the dentist but didn't bring up feeding issues. They are helicopter/over protective parents in many ways, but health issues/illnesses are repeatedly ignored or brushed off. It's frustrating. I know from my experience in a licensed centre that this child needs immediate consultation with a speech path to look at chewing/swallowing disorders and Occupational therapy for sensory/food aversion issues. I wonder if this child has oral apraxia? Parents aren't receptive to hearing it, and think this is all normal behaviour. I'm ready to term, as our whole day gets turned upside down from this child and this behaviour. When the child was away for a few days, everything ran smoothly, including meals and nap time. I have done a timer with her to allow 20 mins for snacks and 35 mins for lunch, and the result is about 2 bites consumed.
At a loss right now, but know she needs intervention. Any feedback on these issues or how to approach parents in denial would be appreciated. Thanks.

[Dreamalittledream]

Hello. First of all, I hope the parents are aware how blessed they are to have a child care provider that is doing so much to help their child (& them!). I too have a child that does this; but only if it's a food that he does not like. My response is to give him until all are finished eating and then I clear away all dishes. He then usually makes up for the minimal lunch with a hearty afternoon snack. My philosophy is that as long as I offer the food, make mealtimes healthy, varied and low-stress for them (& me!) & communicate with parents any irregularities; my job is complete. I cannot force them to eat. You have really tried your best. If it were me I would offer a very small portion, start her first to eat & clear her plate away as soon as everyone else is done. But, easy for me to say; I don't have the emotional investment with her or have to deal with it day-to-day as you do. I wish you much luck.

[mickyc]

agree with others. I start offering my infants bite sized pieces early on, encourage using a spoon or fork. I don't know how you aren't pulling out your hair already. I had a slow eater before, it drove me bonkers! I am glad she is gone, life is so much better now.

[MonkeyPrincess]

I've got this daycare child, soon to be 3 years old. Came to me a year ago with no
ability to use utensils, and parents handed me pureed food for the first week. Yikes.I gave it to her for the first few days, as she couldn't swallow toddler sized bites of table food for me. I then just cut her pieces more infant-sized and she did better.
Of course there wasn't much mention of any feeding issues when I interviewed, only that the child sometimes takes longer to chew certain foods. So now that the 3 yr bday is approaching, I'm becoming very concerned. Child takes about 45 mins to chew and swallow a simple snack, and about 60-70mins to eat lunch. I have completely changed my schedule to accomodate child(can't go outside first as she takes too long to eat, so we do indoor stuff following snack in a.m.) Also becoming very disruptive to the start of nap time, as all are on beds 1/2 hr earlier because they have finished eating, and they won't settle, because she is still at table and takes her an additional 1/2 hr to settle once on the bed, so a full hour after the others first laid down, and none of them settle. Child pockets food in cheeks and will not swallow, and takes rediculously small bites(pin head-sized) to eat basic foods. Also has many sensory reactions to textures and gag reflex to many foods. Screaming/crying during mealtime is frequent, and lots of avoidance behaviour like stuffing food in clothing/nose/hiding in booster seat etc.
I have discussed this many times with parents, but it's the first child, so they have no point of comparison. I have suggested doctor's visit, but they see no need to see doctor until 5 yrs for the booster needle. Have also suggested dental visit to see if mouth structure/teeth may have issues. So they did the dentist but didn't bring up feeding issues. They are helicopter/over protective parents in many ways, but health issues/illnesses are repeatedly ignored or brushed off. It's frustrating. I know from my experience in a licensed centre that this child needs immediate consultation with a speech path to look at chewing/swallowing disorders and Occupational therapy for sensory/food aversion issues. I wonder if this child has oral apraxia? Parents aren't receptive to hearing it, and think this is all normal behaviour. I'm ready to term, as our whole day gets turned upside down from this child and this behaviour. When the child was away for a few days, everything ran smoothly, including meals and nap time. I have done a timer with her to allow 20 mins for snacks and 35 mins for lunch, and the result is about 2 bites consumed.
At a loss right now, but know she needs intervention. Any feedback on these issues or how to approach parents in denial would be appreciated. Thanks.

All of the bolded things are concerning and the fact that you have concerns and the parents repeatedly dismiss you and their child's development and well being, would be reasons for me to terminate too. I am not a professional, but my gut would tell me something is up with the child. I

[kassiemom]

You are obviously doing everything you can and some parents just don't want to hear it. I would suggest to you a couple options
1. Terminate and hope that the child has better luck elsewhere
2. Keep her because you know she is better off with you than someone else! and maybe do what the PP said and offer the food then clear it when lunch is over (she won't starve herself)
3. You can try pulling all kinds of literature out for the parents and sit down with them for a meeting, be blunt and honest and explain to them your professional concerns, the risk is that they will pull her out but who knows they may actually absorb some of the info and if its brought up again by another carer in the future it may register that they need to do something .
Stay strong and i am sure it will all work out for the best. Just keep her on the same schedule as everyone else and continue to encourage her.

[AcornsFalling]

This sounds like a serious issue. I haven't had experience with anything like this but I wonder if it is worth contacting the ministry of children and families in your province. If this is a serious issue and the child's health is at stake, perhaps there is something that can be done through that route? The parents won't like it and would probably leave but perhaps it would be the reality check that they need to think about what they are doing?