20 Month Old Still On Purees & Barely Self Feeding Spoon

[nannywhack]

Hi everyone! I'm new to posting but have been referencing this forum for months and I always appreciate the advice and tips I find.

I'm fairly new to the daycare provider world and think I let this situation go on way too long already because of my lack of experience. I ask parents to provide lunch and I provide snacks. My snacks usually consist of a fruit/veggie and some sort of carbohydrate and protein (ex. veggies & dip with cheese & crackers, fruit yogurt with an arrowroot, fruit with bagel & cream cheese, etc).

I have a 20 month old dcb who is still on purees and can barely spoon feed himself. He also refuses to eat any fresh fruits and veggies at snack time no matter how I cut them. I've tried preparing them in from of him, taking a bite, touching it to his lips, but he will not eat any of it. He will not eat cheese or yogurt either (although mom says he eats yogurt at home, but it sounds like if he doesn't like the flavour, she'll try a different one until he'll eat it). At snack he will only eat the carb portion like crackers, muffins, banana bread, cheerios, toast, etc.

Just this week I (again) brought up the topic with mom telling her I'm researching and brainstorming ways to encourage dcb to eat h at sis fruits and veggies and try new things at snack time. She is very nice but is hard to read and doesn't say much when I bring up my concerns. I don't think it bothers her that he only eats carbs at snack time. Probably because she knows he gets his fruits and veggies at lunch. Which brings me to my next issue...

It's been a month and a half since I emailed mom about getting her support on spoon feeding. She didn't seem enthusiastic about taking this next step as she didn't even acknowledge this point in my email.

I have been working with dcb for quite a while teaching him to spoon feed himself. He can do it but he prefers that someone feed him. I don't blame him since he's still on pureed/strained fruits and veggies at lunch (as that is what mom provides) and they are like soup, so watered down, it's hard for him to keep any on the spoon. Dcb basically plays with his food until I feed him. If I don't feed him, he won't eat anything. Since he doesn't take in any fruits and veggies at snack I feel like I have to feed him to ensure he gets some nutrition, but it's a bad cycle and is not helping the situation. I have encouraged mom to pack finger foods for lunches thinking this might help encourage/advance dcb's eating habits but she has not done so yet.

I'm not sure if it's just a texture thing or a deeper sensory development issue. Dcb doesn't even eat stage 2 baby food. I've asked if his pediatrician has any concerns but apparently the food issues haven't been discussed with the doctor.

I am thinking about taking on a 12 month old in the summer so I need this 20 month old to be self feeding at lunch time before then. I've casually mentioned to mom that I may be taking on another young one so I'm concerned about dcb's reliance on being fed at lunchtime. I got no reaction/response and this was face to face. How can I approach this subject again? I want to set a goal for both of us to work on having dcb self feeding by x date. How much time is realistic? Is it awful to say, "I hope to have dcb self feeding by x date and I need your support on this at home. By x date, I will offer him whatever lunch you provide, but if he doesn't eat on his own, I will not feed it to him."

Any help and advice would be greatly appreciated!

[mimi]

Since Mom is not responding to your direct concerns about her childs lack of willingness to feed himself, I would just tell her that he needs to be self feeding and give her a time line you feel is appropriate. She is obviously not interested in taking the reigns so to speak and promoting self feeding techniques to her child so you will have to.
If this child refuses to eat at first because he is not being fed, so be it. I wouldn't even say too much except that the food is yummy and he can start eating like the rest of his friends. Just ensure he is well hydrated and when he realizes he is expected to fed himself because you won't he soon will. Be prepared for a few difficult days till he gives in and starts to feed himself.

[Lee-Bee]

I would have to agree with Mimi but would quite possibly go further and let them know that as of XX date you will no longer allow any purees at all. Only regular adult foods, they can be eaten with a spoon or fork (by the child) but nothing that is meant for a baby, as the child is no longer a baby and needs to be eating appropriately.

This child has unfortunately missed the point of moving past pureed foods easily...with the parents waiting so long to move on they have essentially made it a really hard task to do. This should have been done a year ago.

Be firm and direct with the parents and be firm and consistent with the child. The child will soon learn to self feed if you do not feed him. It's a sad reality for the child, but one his parents have chosen for him. I can assure you no daycare centre would be spoon feeding purees to a 20 month old. No home daycare should be either. Unless you receive written medical instructions that this is necessary for a medical condition it is of no benefit to the child to continue.

[babydom]

Was going to say what lee-bee said. No baby food allowed over 18mths. And don't feed him. No child will starve himself. Let him watch his friends and it may take a few days of sending the food back home but he'll eventually give in and eat like Mimi said. Good luck.

[kindertime]

Oh, wow. Beware! This situation is not going to improve with the dcm ignoring you like that. Nutrition is important, right, well, if she isn't listening to you on this issue, what's going to happen if dcb has other issues in the future. I would suggest going further than Lee-Bee said, give her till XX date and if things haven't improved, let them go.

[Suzie_Homemaker]

Lots of parent scared of new phases of development. Eating can be big challenge to some parent who are fearful of a child choking. They not think they are holding child back and creating future issues, they just think they are keeping child safer.

Must sit with parent and explain that progression to toddler finger foods very important at age appropriate stage. If they not address this issue, they risk their child having life long issue with food of certain textures or which feel different.

By holding back the child they actually creating more issues.

Must tell parent that they need to focus on getting their child eating foods they should have been doing a year ago .

[CrazyEight]

I have a child still on purees - except he turns THREE next month! It's ridiculous. He eats dry carbs, like cereal, toast, and crackers, applesauce, yogurt and baby food. That is literally it. His eating has not improved at ALL since he started with me at 10 months old. I've tried everything under the sun, to the point of only feeding him what everyone else was eating, nothing else, for a solid month. He did not once try to eat anything that month, unless part of the meal included one of the above list. He starved himself for a month, because he knew as soon as he went home, he'd get his infant cereal and pureed baby food for dinner, which they still feed him every night!!

Now, I don't have the spoon-feeding issue, he'll feed himself just fine, but I finally had to decide how upset I was going to get over the issue - was it worth terming over? At the end of the day, I decided to keep him, but I made it clear he wasn't getting any special treatment. So now he gets offered regular food, and if he doesn't eat it, which he won't, unless the snack/meal happens to include those few foods, he'll get topped up with an applesauce cup or a pouch of baby food, which I squirt into a bowl and hand it to him with a spoon. His parents provide all of this, every day.

Do I agree with it? Of course not. He's babied and coddled to an incredible degree, and also has pretty severe speech issues, which I think are tied into the eating issues. BUT he's not my kid, and the parents refuse to listen. So I can stew and stress over it, I can terminate him, or I can let it go, continue with my regular day and routine, and make the PARENTS do the "special" or "extra" by sending the food. I don't prepare special food, I don't feed it to him. It works for me. In my opinion, if the parents aren't receptive to your suggestions, then nothing is going to change, because if the kid is smart and stubborn, he'll simply wait until he gets home, knowing he'll get exactly what he wants. So it's up to you if you can find a way to make it work for YOU or if you terminate the family. I agree that spoon-feeding him is ridiculous, unnecessary, and, after your new little one starts, won't be possible. So that may be something to put your foot down with them on. If they can agree to work WITH you and get him feeding himself, maybe you can work something out with them sending purees. If not, maybe it's time to consider terming them.

[mickyc]

Omg!!!!! I cannot believe what you ladies are going through.

My child I had on purée doesn't seem so bad now! Lol. He started with me at 11 months. He refused stage 2 purée. We worked on it and eventually after what seemed like forever I got him over to stage 2 plus our foods. We had lots of struggles with this child but now at 2 years old he eats everything I give him. He will cry if I put something on his plate that is new but he knows he has to eat it, and does. He pretty much lives off peanut butter sandwiches at home.

Personally I would not accept this sort of bad habits. I would stress about it so they would have to find a new daycare because I know I couldn't keep feeding puree. I supply all meals and usually get parents to supply baby food but I even bought stage 2 baby food for this boy as mom was just sending puree. I also don't allow soothers at all and bottles must be gone by 15 months.

I know these kids are not ours but they spend the majority of their time with us. I feel it is up to us to enforce good habits even though it all gets thrown out the window when mom walks in the door. Kids learn quickly what rules are here and what rules are at home.

[bright sparks]

It's a tricky thing because there is a fine line as essentially yes, this is their child and they can do what they like. But my moral compass would not be responding well to being a sheep doing what the parents wanted me to do if it was in fact detrimental and neglectful to the child. There is more than one way of doing something and so there are different parenting styles. Those types of things don't necessarily cause harm to a child, but this actually could have pretty significant repercussions and I wouldn't want any part in it. I want to provide the best childcare possible to all children who come in my house. I could not be part of something like this which is clearly not healthy for the child. If it was a matter of working through this together, then that would be fine, but a parent who isn't willing to change her methods, regardless of her feelings, fear or parenting style, I would be giving notice. It's like talking to a brick wall all the while the one suffering is the child.

[Lee-Bee]

Baffling. It really is detrimental to the children in these cases. As much as it is there child to raise...they need to understand that other adults (even those they pay for childcare) do not have to do things the same way, especially when it is detrimental to the child.

I know a mom that was afraid to dress her own child because she thought she would hurt him in the process. At 6 months of age she had the father put the child in his swim suit in the morning before work so she wouldn't have to bend his arms to fit him in the shirt. Many days she left him unclothed (with diaper) until dad returned from work rather than change his clothes. Can you imagine having such fears while trying to raise a child? How does a child interpret such behavior? This mom was otherwise a perfectly normal, working lady. She just couldn't handle the responsibility of raising a child.

[bright sparks]

Baffling. It really is detrimental to the children in these cases. As much as it is there child to raise...they need to understand that other adults (even those they pay for childcare) do not have to do things the same way, especially when it is detrimental to the child.

I know a mom that was afraid to dress her own child because she thought she would hurt him in the process. At 6 months of age she had the father put the child in his swim suit in the morning before work so she wouldn't have to bend his arms to fit him in the shirt. Many days she left him unclothed (with diaper) until dad returned from work rather than change his clothes. Can you imagine having such fears while trying to raise a child? How does a child interpret such behavior? This mom was otherwise a perfectly normal, working lady. She just couldn't handle the responsibility of raising a child.

Poor woman!! Hopefully she got help. I'm sure this woman was in fact very far from a perfectly normal working lady. This is a significant problem likely not all she was dealing with. People have a way of putting on a front for the benefit of others while they are quietly suffering on the inside. This breaks my heart.

[Teagansmom]

How is the child's health otherwise? Meeting milestones, gaining weight etc?

[nannywhack]

Thanks for the input everyone!

I should mention that although mom sometimes doesn't seem to acknowledge the points I bring up and try to discuss, she does sometimes take into consideration what I'm saying. For example, I had mentioned on a few occasions cutting down/out bottles but didn't feel like she was on board (I was giving dcb 3 bottles a day at that point plus mom was feeding him 2 at home!!!). Then after trying to discuss it again at a Friday pick up, dcb and mom returned on Monday morning to tell me they successfully cut out two bottles. I was asked to continue giving 1 bottle a day. And yes, he still gets that bottle now! Dcb completely rejected the sippy after months of me trying. I have successfully taught him to drink from a big boy cup but he is still quite messy. I know I need to stop the bottle too and have been working on the transition with dcb without even discussing with mom.

Teagansmom, regarding development, dcb was born prematurely by about 2 months. His fine motor skills are quite good. We do a lot of fine motor practice and he is more advanced than my 18 month old. His overall developmental seems to be on par for his age.

I blame myself for letting it this get to this point. This was my first dck. I found it hard to be direct and firm in the beginning even though I didn't agree with a lot of requests. I've already reviewed my policies to ensure this doesn't happen again. There is definitely a learning curve when starting a home daycare!

[playfelt]

I would be setting a guideline of expectation that by 24 months child should have advanced to the level you would normally expect of an 18-20 month old which allows for his prematurity. That said it means no bottles at daycare and use of a sippy cup, feeding self finger foods and attempting to use a spoon or at least know what it is for even if they can't actually get food to the mouth etc. Sounds to me like mom got caught up in the prematurity and forgot the part about them catching up over time and that the goal was the same as for any child and to gradually push them to the next developmental level.

As to the puree that comes I use infant cereal to thicken it to a pudding consistency so easier for me to feed or child to feed themselves - ie neither one of us slops it everywhere. Also as of a certain date child should be eating the daycare menu so that you are no longer having to specially prepare his foods.

[Lee-Bee]

If he was around 2months preemie there is a good chance he had feeding issues in those early days and the mom definitely may still be fixated on that. Just happy he eats so not wanting to rock the boat by moving to the next step. Completely understandable...BUT she does need some help to move past that so the child can get caught up.

My daughter was 5weeks premature, luckily she had no feeding issues, from what I remember it is until about age 2 that they are referred to by their gestational age (if otherwise healthy). So, while some leeway can be given the child definitely should be further along or at least have home encouraging him to be further along than strained purees.

Maybe when approaching mom do it gently noting how far the boy has come from being X weeks early etc...so she can see you understand where they came from and she feels you are acknowledging that the child is "special" in that he started off at a different level than his peers. Perhaps this will help mom be a bit more open and accepting of your nudging them along!

[kindertime]

Teagansmom, regarding development, dcb was born prematurely by about 2 months. His fine motor skills are quite good. We do a lot of fine motor practice and he is more advanced than my 18 month old. His overall developmental seems to be on par for his age.



This information does change things a bit. If he was born 20 mths ago but was 2 months premature, then he is considered 18mths. That is untill his 2nd birthday, then they go by birthdate in terms of development.

Are there any resourses in your area for parents, children or caregivers? In Ottawa, I have worked with Andrew Fleck and the Children's Treatment Centre and in Quebec we have CLSCs and Pavillon du Parc. They all help with children with special needs and famillies that need support. I don't know, of course, because I have not seen this dcb, but it is possible that he has a slight delay that requires specialized interventions. Some occupational therapy, maybe.

It may just be a hurdle, he may get past it soon, who knows, but it might be worth looking into it. Do you think the mom would be open to this? If you found a resourse, would she call them? Would she give you permission (in writing) to call on her behalf? If it turned out that he could have an occupational therapist come to your house 3x/week at lunch time for 1/2 hour, would you be open to that?

Fine motor skills are different from chewing and swallowing. There can be serious issues with this and not in other areas of development.

I am just asking these questions, as things for you to contemplate. If you aren't aware of any resourses like the kind I've mentioned, I'm sure some of us could help with that.

[nannywhack]

Kindertime, looking into outside resources is a great option I hadn't thought of. It's hard to say if dcm would be on board with an occupational therapist coming to my home. Dcb does have follow ups with specialists aside from his pediatrician but I get minimal information regarding these visits.

I have had a pretty successful week with the spoon feeding and I know we're on the right track in that department. But the food issues in general still need to be addressed. I'll keep working at it and will hopefully get some outside help. Thanks for your advice!