Does this look like the chart of a child who is “failing to thrive?”
Worry, worry, worry! All good parents are doing it!
“She’ll need a feeding tube if you can’t get her to eat more.”
“She has pre-prediabetes…”
The parents I talk to, and emails I read are increasingly suffused with fear and anxiety. A very few cases are true emergencies, with children dropping weight or refusing anything by mouth, but many terrified and tearful parents are facing relatively minor feeding issues and some are even within the range of normal.
I don’t mean to belittle the fear. There should always be an investigation to see if the fear is warranted, but I hope to address with this post my belief that parents are being manipulated and bullied with fear tactics that are at times unwarranted and are almost always unhelpful.
Look at the growth chart above. This is from an infant who was misdiagnosed with “failure to thrive” and a “feeding disorder” and the parents were simply sent away with the vague threat of “Get her to eat more or she’ll need a feeding tube.” (The clinical snapshot? A child with a recent infection and antibiotics with decreased appetite and intake, a mom already anxious, now terrified that her daughter is in grave danger. The trigger was a misplotted weight measurement, but the seeds of fear had been planted and fertilized…)
With that threat of a feeding tube and no support, I’ve had parents admit to screaming at children to eat, force-feeding them while pinned to the floor, sobbing, begging, bribing, holding an infant’s head and forcing in the nipple… Before listening to parents with feeding problems for the last several years, I would have judged. Now I save my judgement for the system and the clinicians who so poorly serve parents and children.
I hear from parents of larger-than-average kids told their child has “pre-prediabetes” and told the child will die young if they don’t get them to lose weight. Many of these dire warnings are based on arbitrary BMI cutoffs alone with no clinical or historical risk factors, and “pre pre diabetes” is not a thing.
Scared parents without proper support and information can easily fall into counterproductive feeding practices and unwittingly make matters worse. Alas, I believe instilling fear is the intention, that somehow if parents are scared enough, they will magically get 100 more calories in a day or get the child to stop sneaking sweets at friends’ houses.
Trying to make a child eat more or less, overriding the cues of a screaming or anxious or withdrawing child feels awful and doesn’t help. Feeding from a place of confidence and feeling supported, even in the face of real challenges and uncertainties, gives parents and children the best hope.
Have experts tried to scare you? When were you scared but felt supported? If you feel like a doctor or nurse or feeding expert is using threats and fear-mongering to try to motivate you to achieve calorie or weight goals, is it working?
And PLEASE if there is ever a weight or height measurement that is concerning, insist on a recheck, and PLEASE plot it yourself. I cannot tell you how many growth charts I see with errors.