The perfect storm: adoption, malnutrition, obesity panic, and food "obsession"

I am heading to NYC this weekend to speak at the Child Welfare Symposium. It's been a busy several months, with finishing my manuscript, supporting adopting and fostering families with feeding challenges. (see below)I look forward to leading a workshop on the feeding relationship, and fostering and adopting. In particular I want to share the stories of the latest casualties I am seeing in our war on childhood obesity: these children who have experienced malnutrition and even starvation, only to come home with their families in the U.S, and be placed on calorie, or portion restriction, to avoid or "treat" childhood "obesity."I work with and hear from many families of adopted children, primarily right now from Ethiopia, and mostly girls between the ages of two and three. Most families have had their children with them for between 1 and 2 years, and are dealing with food obsession. These little survivors, who have already been through so much, are being harmed by our collective panic about obesity. The physicians and dietitians the families turn to for guidance and support, are encouraging distorted feeding practices that harm the feeding relationship, and bonding and attachment in general.Moms share..."We've been doing this for two years, and it's destroying our family.  All I do all day long is deny her food! How can she trust me?""We've spent thousands on attachment specialists, and this constant battle over food is ruining our relationship.""Everyone said, she'd get used to "normal" portions. Well, she hasn't.""She screamed after every bottle, but my doctor was very clear that I was to limit how many ounces and how often I could feed her."These children may gobble, eat quickly and very large amounts initially (survival behaviors and totally normal) and then, the child does catch-up growth, which can be impressive, at twenty times the normal rate.  As weight increases (and height) some may even pop into the "overweight" and "obese" range, the alarm bells are sounded, often by the child's doctor. As a physician myself, I think we must be very careful to remember, first do no harm...The child is then restricted, put on portion control, strict calorie limits, given specific ounces of formula and schedules. The youngest I have seen was an eight month-old adopted from Ethiopia, at a height and weight of 75th percentile, which the parent was told was "unhealthy."Once these children are not trusted, and are restricted, it seems to trigger a terrible anxiety, a perfect storm- an all-consuming worry about when and how much they might next eat, and wondering if their parents will provide for them and meet their most basic needs. These children are described as listless, clingy, not interested in toys, or play, ONLY interested in getting food. I cannot overestimate the misery this brings to these vulnerable children, and the parents who desperately love them and want to do the right thing. The bonding process is disrupted, with parents telling me of families destroyed by restricting the formerly-malnourished child. (In general, restriction is damaging to families and brings in conflict, but seems particularly so for these children who are working on trust, and  growing and eating.)The good news is, it doesn't have to be this way. I have shared my manuscript with a few families, and seen similar results as I have seen with the clients I work with. These children CAN be trusted. Parents need support and good feeding information from day one. Child of Mine, or Your Child's Weight, Helping Without Harming, both by Satter, are invaluable resources. And my hope is that my book, coming late summer/early fall, will help families avoid this problem, or climb out of the distorted feeding hole.Here are some quotes form parents who have read my manuscript and are seeing improvements with the transition."My husband and I longed for our son, and worked so hard to bring him home, and the last year has been miserable. Less than a week into this, it hardly seems possible, but he has rediscovered his happiness, and we are enjoying our family for the first time.""He has discovered spontaneous play and movement, he used to only cling to me, now, he plays with his brother...""She told me, 'I'm done mommy.' I haven't ever heard her say that. She has left food on her plate, and left the table happily for the first time ever.""He dumped out all the bottles of shampoo. I was so happy! He's two, and he had never had the energy for normal two year-old things. It's as if, free form the anxiety about food, he can now be a normal child."These children are worthy of our trust...Sign up for my newsletter for information on when Love Me Feed Me, The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles, and More... is coming out. The book also deals with special needs, oral-motor and sensory problems, low weight, picky eating and more. Get a free sneak peak, and info on specials and pre-orders...