What Is “Responsive Feeding”?
The US Academy of Nutrition defines Responsive Feeding as, “child feeding whereby the child’s hunger and satiety cues are recognized and responded to” and states that feeding practitioners, “develop and implement programs for educating parents and caregivers on how to foster healthful lifestyles in home, childcare, and school environments, based on positive feeding relationships, a responsive feeding approach, and regular family/family style mealtimes.”
So, what does this mean, exactly?
Basically, a Responsive Feeding approach puts less emphasis on the adult’s (caregivers, therapists, etc.) control over whether and how much a child eats, and more emphasis on the child’s independence while encouraging their internal desire to eat. The adult in the feeding relationship is responsible for determining what food is served, when it is served, and where meals take place (see Ellyn Satter’s Division of Responsibility in Feeding).
With Responsive Feeding, there is still a lot of emphasis on meal structure and allowing children to get hungry in between meals to stimulate appetite for new and non-preferred foods, but we avoid pressuring children to eat by saying things like, “Take another bite”, “You used to eat it!”, “(Food name) is healthy/not healthy”, and, “If you just try it, I know you’ll like it!”. We also avoid negative comments about weight and certain foods being “bad” or “good”. We give children opportunities to learn about and explore new foods through play, reading, grocery store trips, picnics, and other activities, without ever pressuring them to eat. We show them how to eat and we eat the foods we want them to try (when possible) in front of them so that they can see the foods are “safe”.
Other less responsive approaches to feeding therapy may focus on external control of a child’s eating, such as requiring a certain number of bites, smells, or licks to earn a reward. These approaches often have quick but short-lived success. Using a responsive feeding approach may feel, at first, that the quick success we were hoping for is not happening, but a Responsive Feeding approach is more likely to have a lifelong positive impact on how children and adults think about and eat food.
Exercise: Think about a food that you were forced to eat or maybe strongly encouraged to eat as a child. Do you like that food now? Many adults will report that they can’t tolerate or strongly dislike a food they were repeatedly encouraged to try as a child.
If your child has had feeding therapy in the past OR if you have been trying some of your own strategies at home with little long-term success, Responsive Feeding may look very different and require some changes in routine, habits, and perceptions. That is okay! You do not have to get everything perfect or completely change everything right off the bat! If you are feeling discouraged, please give yourself some grace.
One thing to be aware of is that a Responsive Feeding plan may look different for a child who is struggling significantly to maintain adequate growth or children with complex medical conditions. In any case, whether medically complex or not, it is always best to consult your feeding “team”, which should include your child’s pediatrician and could include a speech therapist, occupational therapist, dietician, gastroenterologist, and many other specialists.
If your child is struggling to eat and mealtimes have become stressful for your family, please consider asking your pediatrician for a referral to outpatient feeding therapy.
Gabrielle Denman, MS, CCC-SLP
Helpful Feeding Resources: