GEAR UP Your Picky Eater: Consider Breath and Mealtime Stress
Check our the video companion for this blog post:
Quick Discussion on Breath and Mealtime Stress
Advanced Discussion - Breath and Mealtime Stress
Check out the FREE PDFs
I you are like me, some days I really do feel like I live to eat! When someone starts talking about my favorite food, my mouth starts watering and I begin to get a bit excited! My neurotransmitters begin releasing juicy appetite enhancing chemicals to my brain that ready my body for an enjoyable, comforting meal.
For many of the kiddos I meet, mealtimes don’t trigger that it is time to relax, it triggers the opposite of relax. Instead of the parasympathetic nervous system readying the body to rest and digest, the sympathetic nervous system takes over, heart rate and breathing rate increase, and our body prepares for fight or flight. Let’s face it, because of this; mealtimes often become stressful for everyone when feeding challenges arise. It is understandable how these feelings develop into huge concerns overtime. Food is often thought to be the primary resource we need for survival, but the truth is that the number one resource we need is breath! Considering the connection between breathing and mealtimes will empower you to make simple, meaningful changes when you need them most.
Consider Breathing and Functional Readiness:
Our ability to attain and maintain a level of arousal state appropriate for functional activities, such as eating, is referred to as readiness. Because our readiness state impacts our breathing patterns so considerably, it truly can be unsafe to ignore readiness before meals. Considering breathing prior to the onset of mealtime routines initiates foundational changes that ready the body for mealtime success.
When mealtime problems exist and it is caused by an inability to self-regulate arousal state, it is more common the person is “too high” rather than “too low”. If a person is described as “too high” (appear “on the go”, unable to focus, and sit still), then they struggle to attain the attention necessary for mealtime. When this happens, heart rate and breathing rate increases; breathing becomes arrhythmical and shallow. If a person is described as “too low” (lethargic/tired/sleepy, non-expressive, propping etc), then breath may be rhythmical, but slow and shallow with some intermittent deeper breaths.
The good news is there are many techniques we can use to do this once we assess the underlying cause of the difficulty attaining/maintaining a functional readiness state. When a person that is “too low” it is easier to determine the cause and thus can remedy it more easily. For example mealtime may be too late and the child is tired, consider earlier mealtimes. When a child is “too high”, simple changes such as: a heavy book or backpack, carpet to sit/ visual, or changes in speech and language can greatly impact functional readiness.
Consider the breath and sensory input:
Meals begin as soon as the food passes our lips, right? (Shaking head “No!”)
Parents KNOW this is not true; if mealtimes could just be this easy! Mealtimes begin with a thought, a routine, and an action. This sequence of events sets into play important foundations that ready our body for a successful meal. Mealtimes are announced in a variety of ways at various stages in life. Infants may perceive mealtimes beginning by their mother sitting down to nurse with a familiar pillow or they may see a bottle being prepared nearby. These routines are often initiated by smells and noises that fill the room. For those of us who do not struggle with eating, these preparation cues release signals to our body that it is a time to relax; appetite is enhanced at these times and breathing is steady, so that the body may ready itself for an enjoyable mealtime experience. Consider the variety of sensory input available at mealtimes such as appearance, smell, sound, touch, and taste, and how that impacts proprioception (how/where joints are moving in the body), vestibular (where your head and eyes are in space), and Interoception (what internal organs are doing: breathing, hunger, thirst, etc.).
To understand how this may feel, we have to think about our own experiences. Smell, images, and even sounds have the ability to trigger stress responses. Faster, shorter, shallower breathing patterns are usually accompanied by decreased appetitive and/ or upset stomach (GI issues). Personally, an emergency room or dentist waiting room can easily make me feel this way, but what if everyday food triggered a similar response?
When these cues trigger the opposite response (adrenal response) as mealtime routines begin, our body begins to adapt to protect itself from the perceived threat. As our body adjusts, breathing patterns often become shorter, quicker, shallower, and more irregular. The list of possible causes may be a combination of sensory deficits that contribute to mealtime aversion, but one of the first, observable responses to the noxious stimuli at mealtime is breathing patterns. Observations at the onset of mealtime routines can provide essential information about underlying causes. For example, If breathing changes are noted ‘as soon as the food hits the plate’, then it may be helpful to address visual sensory; if breathing changes are noted ‘at the first bite’, then it may be helpful to address textures or even auditory sensory tolerances.
Consider breathing and seating.
During mealtime, adults sit down to eat and automatically adjust to optimize breathing capacity. We understand how to prop our bodies, where we can put our feet, and how we can adjust as we experience fatigue. We understand how to adjust our weight as our stomachs fill up and push against our diaphragm. Children not only lack this same instinct, but they are also oftentimes at a disadvantage. Most chairs, high chairs, and tables simply are not designed to adjust with our ever growing child. Because of this, breathing rate can increase due to either the inherent challenge in the seating provided or decreased overall postural stability. It is also important to note that sitting posture impacts proprioceptive (how/where joints are moving in the body), vestibular (where your head and eyes are in space), and interoceptive (what internal organs are doing: breathing, hunger, thirst, etc.) systems that rely heavily on optimal functioning for healthy breathing patterns.
Consider seating and posture before beginning a meal; the goal is to sit at a 90 degree angle with feet on a flat surface, hips square on the seat, and sitting up right. Explore using a footstool/books/box under feet or consider using a Boppy, towels, or swimming inner tube around the waist/pelvic area. A grip mat may be helpful under the plate or on the seat to prevent sliding. Consider a seat with a back that is placed at an appropriate distance from the table. Lastly, consider if your child is left handed or right handed. Hand dominance impacts sitting posture and so placement at table can be significant.
Consider breath and oral motor:
As we observe newborns rooting and suckling during the first moments of life, it is easy to understand the assumption that we are born ready to eat. The assumption is often that eating is easy and instinctive and that it is not a skill that has to be taught or even learned. For many of the little ones that I meet, this couldn’t be farther from the truth. When oral motor is a concern, consider the magnitude of vulnerability when food or liquid is presented at such close proximity to one’s airway.
Fortunately, feeding is not our body’s number one priority and we can assume that our bodies will adjust to keep us safe. Exploring how our little one adjusts and compensates in these instances will allow us to make meaningful changes when we need them most. Simple changes in presentation can allow your little one to gain skill, without the need for unwanted compensation and mealtime stress. Be mindful of rate and positioning during bottle feeding by exploring a slower flow nipple or a side lying position to allow for unmanageable liquid to utilize gravity to pull unmanaged liquids out of the mouth. Observe your little one swallow and breathe during spoon feeding as they signal readiness for the next bite. Use stick shaped to allow for oral motor exploration and skill enhancement without the risk of airway penetration. Try a Nosey cup to decease flow rate by decreasing the angle needed for cup drinking. Lastly, teaching appropriate spitting early on can provide your little one with the confidence and freedom to embrace mealtime experiences!
