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Consult/FAQ

*Note: Katja Rowell is not taking new clients at this time.

Please check out Katja’s books and Mealtime Hostage facebook support group for resources for picky or selective eating concerns. Consider looking into coaching from Ellyn Satter Institute Clinical Faculty.

The feeding relationship is what happens between you and your child around food. For many parents, worry about nutrition and weight spoils feeding. Many parents rate their stress level around meals as “ten out of ten” when we begin our work together. One mom called dinner, “Forty-five minutes of hostage negotiating.”

It doesn’t have to be so hard!

The three concerns I most often address:

Picky eating, including sensory issues and children who have “failed” feeding therapies.

 

Weight acceleration, “overweight” or food preoccupation.

 

Children who may be “underweight,” or not gaining weight appropriately.

 

Do  you:

  • regularly cook special foods only for your child
  • worry about your child’s size
  • feel confused and anxious with feeding or meals
  • face unique challenges with adoption or fostering
  • worry about “passing on“ food or health issues

Does your child:

  • only eat a few foods
  • have a history of illness or prematurity
  • refuse to try new foods, fruits, veggies
  • have a diagnosis of “overweight” or “underweight”
  • have difficulty transitioning to solids or table foods
  • have a history of “failing” feeding therapies

Park Bugle 300dpi-1

photo courtesy of Lori Hamilton Park Bugle

See Frequently Asked Questions below for information about phone consult and support. Click the triangle at the top-right of each question for information.


We need help with our child. What does working with The Feeding Doctor (TFD) look like ?

Working with TFD is not a one-size fits all. We tailor our work together to fit your family’s needs.

  • I work in a “parent-centered” approach, meaning I work with parents to support a healthy feeding relationship.
  • We can do a detailed history of growth and feeding, review your concerns, review current feeding practices and strategies. An intake analysis from pediatric registered dietitian, Hydee Becker RD may be recommended.
  • I will review and recommend concrete steps to address the structure of meals and snacks, suggest approaches that work for selective eating and concerns with self-regulation (knowing how much to eat) that fit your family. You can bring peace back to the family dinner table. Each visit is followed up by an email summary reviewing the plan we came up with during the consult.
  • I also offer general informational chats if you just want to know about talking to your tween about food or body-image, for example.

I work by phone with clients across the country and internationally. Sometimes questions arise months after our last call. One mom that I helped with her older child around picky eating called months later to ask about weaning her youngest, for example.

Everything you tell me is confidential. If it is necessary or helpful for me to speak with someone else about your situation, I will do so only with your written permission.

My child is not adopted, would your book Love Me, Feed Me help my family?

Yes! The book is really a distillation of the support I give clients with a variety of issues. I wrote it particularly for adopting and fostering families because I heard adoptive parents saying that the Trust Model of feeding “wouldn’t work” for them. The vast majority of the book shares practical advice that has helped all kinds of families. I am currently co-authoring a second book on selective eating, but until then, I recommend it with confidence as a resource to all families. The main topic chapters cover selective eating, small size, sensory and special needs/feeding clinic explanations, and food preoccupation with or without weight gain. There is so much more. See the Love Me, Feed Me page for the table of contents.

My child has already been to a pediatric weight loss clinic. How is what you offer different?

You won’t get a diet from me. Clients I have worked with have already been given strict calorie counts or told to “get the junk out of the house.” Parents tell me what the research shows—it doesn’t work. If your child is sneaking food, hoarding, obsessed with food, and weight gain is still accelerating, it’s not that you aren’t trying hard enough, it’s because you are fighting physiology and psychology. You can raise a competent eater and guide your child grow up to have a healthy body— we can help.

My child is experiencing growth problems. What info will you need from the doctors?

If there are concerns over weight or growth, we will need to know that you have seen/are seeing a medical provider to address this concern. Growth charts from birth are helpful to review in the context of feeding. I can review these with you if needed. We can decide depending on the issue, if growth records will be helpful to address your worries and help you feed successfully.

My son has food allergies. I worry about his nutrition and it’s getting really stressful.

Food allergies make feeding harder. Not just choosing foods that are safe, but often allergies make the feeding relationship more challenging. We can work with our pediatric nutritionist to find foods that will help support nutrition, while supporting you with feeding skills and strategies to help raise a competent eater and decrease anxiety. I can also refer to resources and further support.

What ages do you work with?

I have worked with infants to adults. I am not a lactation consultant, but have worked with infants as young as four months. Most of my clients are toddlers through grade-school. (Bottle-fed babies and parents need support too.)

We did a food diary before. Why are you recommending I do this again?

Our intake analysis reveals far more than a standard food journal. We ask for more detail, including when and where are you offering foods. What are you offering, how is the interaction going? How does it feel? What is the context for the intake? So, in addition to Hydee’s complete micro and macro-nutrient analysis and letter, you get our input on the how of feeding. This is often a great starting point for our sessions and is often incredibly reassuring to parents worried about nutrition.

What about my son with autism? *0r* I suspect that sensory issues are playing a role. *or* We struggled with reflux and got off to a rocky start. His condition is better but he still seems to not like being fed…

I understand how medical conditions and medications may contribute to feeding difficulties, through pain, appetite and more. I do a brief screening for conditions which might warrant further evaluation. I do work with parents to support children on the spectrum and with sensory issues. The Trust Model of feeding I work with works well with children of all abilities. I am familiar with the S.O.S. approach to feeding (as well as food-chaining) if you have worked in that model in the past or are currently working with a feeding team. Some children do well with a therapeutic feeding team, for others it might not be the right approach. Some therapy also seems to do more harm than good, I can help explain options.

What does 'parent-centered' mean?

It means that I work  exclusively with parents. Especially with younger children, when parents change the feeding atmosphere, schedule and feeding relationship from their end, the children will most often follow with improvements.

We are about to adopt and don’t know his feeding history. How can we be prepared?

The feeding model I work in is supported by many adoption facilities/experts. A great time to meet would be before your child is with you to anticipate concerns and start feeding optimally from day one. Feeding is one of the most critical aspects of parenting and attachment. If you and your child are already experiencing problems that you think might be related to a rocky feeding history, an evaluation and support may be right for you. Also, my book, Love Me, Feed Me is for you! Read it before your child is with you if you can.

I don’t have an eating disorder, but I struggle with sweets too. How can I be an example for my child?

About half the moms I work with share a history of an eating disorder, or don’t feel they are competent with eating. I do not treat nor diagnose eating disorders.  A great resource is Secrets of Feeding a Healthy Family, by Ellyn Satter. Many parents are delighted to find that through feeding their children optimally, they are able to take a fresh look at their own eating. As parents watch the natural capabilities of children emerge, in terms of learning to like new foods and getting back in tune with eating the right amount for their bodies, parents often find motivation.

I’m an adult, and a picky eater. What can you do for me?

I do work with adult picky eaters on occasion. I tailor treatment to your concerns and goals. With focused eating exercises, I usually recommend at least 6-8 sessions depending on response etc. Plus, it’s really fun! There is a special joy working directly with the person making the food discoveries, rather than through the parents.

I’m on board, but my husband doesn’t get it. He wants to “fix” it. *or* My husband can’t get off work to attend our sessions, but my job is more flexible. Will this still work?

It is most helpful when both parents are on board. A parent or other significant adult who is actively working against the feeding recommendations is likely to seriously hamper progress. Ideally, both parents are present at least for the initial call. With that said, the reality is I often work with one parent, but families still find success if the parent not attending sessions is willing to follow the lead of the participating parent.

How many sessions will I need?

Depends on the issue and perhaps your own issues and feeding history. Some parents are able to make changes relatively easily, other struggle trusting the process. If things are going relatively well, but you have some questions about some selective eating , starting solids, or handling sweets, sometimes just one or two phone calls can help improve things dramatically. If the issue is more entrenched, meaning growth and nutrition is effected or there is a lot of conflict or the problem is more complex, more support may be what your family needs.

But, you’re a doctor, why are you doing this work?

I first came to this work when I realized I didn’t know how to feed my own daughter. I worried about weight and health and happiness, and I didn’t have the training or knowledge to do it right. (Most physicians have none to little training in childhood feeding despite it being one of the most common concerns parents have.) The standard approach wasn’t working. I happened to find Ellyn Satter’s book, Child of Mine. The research made sense, the clinical stories explained and mirrored patients, members of my own family even, and children I knew who were struggling. I read as much as I could, had a few calls with Ellyn, instituted the Trust Model in my home and watched how it transformed my daughter and our family. I was confident in how I was feeding, that I was doing what I could to instill in her a healthy attitude about food and her body. I started doing free early-childhood workshops and saw pervasive fear and worry and counterproductive feeding behaviors. I took further intensive feeding courses both for children and adults, and the more I learned the more I became convinced that eating competence is the key to preventive medicine, to health, happiness and wellness. Helping others succeed with eating and feeding is tremendously important and rewarding. I have read (and continue to read) related research and books, as well as obtained further training so I could be familiar with therapeutic feeding interventions (such as S.O.S method). I founded The Feeding Doctor in 2009 to pursue this work full-time, combining passion and purpose. I enjoy working directly with clients, and sharing this information through my blog and through workshops with parents and professionals.

How much does it cost, and does insurance cover it?

Initial visit by phone for 75 minutes is $200, which includes review of questionnaire and general review of optional three day journal (not nutrition analysis), phone call and summary email. Further calls are $150 per hour session with summary email.  Full optional seven-day intake analysis by pediatric registered dietitian Hydee Becker, reviewed during session, is $100 paid to Hydee directly.

No direct insurance payments accepted. Some clients are able to use health savings accounts.

What is your Cancellation policy?

If you must cancel or change an appointment, call or e-mail as soon as possible. For an appointment missed or canceled less than 24 hours in advance without good reason, there is a $25 charge. You must have a signed waiver before the consult.