How to Make Food Less Stressful {EP 76}

Robyn: In case you haven't already heard about it, I want to take just a moment and tell you all about the amazing online community that's comprised of, y'all seriously, the most awesome parents on the planet. We call ourselves The Club. And by awesome parents, I definitely don't mean perfect parents. I mean, awesome, authentic, brave, willing to be real and honest and vulnerable parents. The Club is a space for parents to get that connection, the co-regulation and a little education, the connection, co-regulation, and the education that you need to keep making it through the overwhelming, exhausting, and those like no end in sight days of parenting a kid with big behaviors. This episode is airing on March 1, 2022. And today The Club is opening and inviting in new members into what we're calling our brand new Clubhouse. The Club hasn't brought new members in- gosh, it has been about five months. Which is the longest we've ever gone because my team and I have been working super hard on creating a new Clubhouse for all of our members. So we're finished with that we've brought our- our current Club members into our new Clubhouse. We've gotten all situated and all arranged and now we're ready to welcome you. One of the monthly features in The Club is a live masterclass where we go in depth into one specific topic. I occasionally bring in a guest speaker and in March, I'm bringing in today's podcast guest Dr. Katja Rowell. Whether you're in The Club or not, you get to meet Dr. Rowell today. Dr. Rowell has worked as a family physician in a wide variety of settings, urban and rural. And now she focuses her career on supporting families around food and feeding issues. So she's the author of three books, including Love Me, Feed Me, which is specifically written with the adoptive family and kids in mind. Dr. Rowell is also the co-founder of Responsive Feeding Pro. It's an online learning platform to make training accessible for health professionals in the responsive feeding model, which Dr. Rowell is going to talk about just a bit in today's episode. Dr. Rowell has so many amazing resources on her website, like I went over and I looked, I mean, it's too many to even just tell you about so just go to her website, and I'll put that link down in the show notes. As you're listening, definitely keep in mind that even though Dr. Rowell is a medical doctor, nothing in this episode is a substitute for actual medical advice. Dr. Rowell’s entire model is about attunement and felt safety. Which means taking the things that you learn and applying them in context with what you know about your child. You know your kid best for sure. Dr. Rowell is a really big advocate for taking, you know the quote unquote advice of a doctor and making it make sense in your family, not blindly following the advice of a medical professional. My conversation here today with Dr. Rowell is definitely just information for educational purposes, and should never replace the careful and attuned evaluation by your child's care and medical team. So y'all without any further ado, let's get into this fun conversation that I had with Dr. Rowell about how to make food and feeding less stressful in your home. Here we go. 

Robyn: Dr. Rowell, thank you so much for joining me here today on the podcast. And I'm also going to tell our listeners that there's going to be another opportunity to connect with you and a little bit more intimate way, coming up pretty soon as well. But thank you so much for you know, the work that you do and then the time that you've given today to connect with me and to all of my listeners. So welcome.

Dr. Katja Rowell: Thank you. It's my pleasure. 

Robyn: Yeah, I am really excited to chat with you about this topic. Because it's, as you know, comes up all the time. [laughter] Right? Like, I think food and lying tend to be the two topics. 

Dr. Rowell: Yeah.

Robyn: Yes. That I hear about the most often.

Dr. Rowell: Yeah, I've heard food and sleep. But so that's- yeah, yeah. It is definitely a top- top three with everyone. I've talked to parents, social workers, etc. It's big.

Robyn: For sure. I wonder something you know, as a mental health professional, I think sometimes parents aren't necessarily thinking about talking to me about sleep, although I- I asked them because I need them to talk to me about sleep because it's so relevant to everything else that's going on. But without question like the lying and the food related stressor has just hit parents so close to home. It feels like it just like lights all of our own stuff, kind of on fire. And then so often the kids of course that I work with, kids who’ve had a history of trauma have challenges with both with food related issues and with lying. So really excited to bring- we haven't talked about food and feeding on the podcast yet at all. So really excited to bring you to the audience. Tell everybody just in case you're not familiar with you just who you are, what you do, why are you here talking to us about food and feeding?

Dr. Rowell: Sure. So I am a family doctor by training and I fell into this work as a parent, I had a 9 pound 11 ounce baby and really did not know what to do in terms of how to feed her. I think that's one of the things I want to talk about is I'm not here to lecture about vegetables and nutrition. I think we all kind of know- you know what our kids ideally should be eating. 

Robyn: Yes.

Dr. Rowell: But and- but it's the how and- and I really struggled with the how. And this was- she's 16 now. This was at the time when the childhood- I don't like to use the word obesity. So I'm gonna use it now just to let you know I call it the O word because it's so stigmatizing. 

Robyn: Yeah, yeah.

Dr. Rowell: But yeah, so I had this really big baby at a time when this panic was ramping up and I was a family doctor raised in a fat phobic household with a lot of moralizing around food. You mentioned that it hits all of our buttons. So we have our own diet culture, our own body issues, we've got the culture at large around us. So I had a lot of anxiety and I was feeding her from a place of anxiety. And that was backfiring. And it was a nightmare. And so I actually then found my way to this work as a parent. And I found that Ellyn Satters, division of responsibility. And we instituted that. And within a couple of weeks, it was a huge transformation. And I was like, I gotta learn more about this. So I ended up training with Ellen and then becoming part of her clinical faculty. And then working a lot with- at the time in Minnesota, with international transcountry adoption, and- and they were like, This sounds great, but I can't make it work. Or, hey, my child was actually really malnourished and starving. And so this won't work for them. So really, a lot of- lot of these issues coming up. And then I've been working increasingly to support caregivers and parents of kids in the foster care system, and learning more about flexibility and brain based differences and trauma and sort of bringing that piece of it to this more responsive approach. And so that's why I'm here today to talk about these issues, and- and hopefully, to me, preventable suffering is just so not okay. And- and- and- and some things are going to just be hard, but the things that don't have to be hard, man, let's- let's dig into those opportunities to build connection, and trust, and help kids heal some of that- that relationship with food and their bodies.

Robyn: Oh, gosh, I'm such, like what you just said that part of like, some things are going to be hard no matter what. So there's things that we can look at and be like, you know, this- this piece here, it doesn't have to quite be as hard. If we kind of shift the way we're thinking about it or shift the way we're approaching it. Yes! Like I'm all about looking for those because our- families that we work with- we- you know, we both know, like, there's things that are hard about their lives that are just going to be hard. And so finding those places is like does this part have to be as hard as it is, with a little tweaking, I think can be so relieving. And also, I think it just helps our families feel so so seen, you know, they were able to see the little parts. Okay, so you use the language responsive feeding, tell us more? What you mean- what do you mean by that?

Dr. Rowell: So, responsive feeding is- I love this language, it's a- it's a feeding model that's been out there, you know, for showed up in the literature in 2011. And- and now is recommended by the Academy of Pediatrics and, and it- what we're trying to do is feed children in ways that they are able to, if they aren't already begin to tune back into internal cues of hunger and fullness. And also recognizing to me that there's the piece of food that is comfort, and that can be regulating and not denying that. And- and within that build, there is some structure that can help. So you know, it's a high nurture, lot of structure and routine goes in there. And- and the responsive piece to me is where the flexibility can come in where, you know, we'll talk about this, I'm sure later, but you know, yes, we have routine helps with anxiety, and particularly if there's been food insecurity. But it doesn't have to be rigid. And so we can build in that flexibility so that in the moment we're prioritizing felt safety. So one of the reasons why, you know, I've moved away from the, you know, Division of responsibility language is that many parents felt like it felt really rigid, like kitchens closed, you know, between meals, and, you know, you eat at snack time, and then there's nothing for two or three hours. But, you know, sometimes that cheese stick can help with, [laughter] you know, fend off a meltdown, or we need to build in flexibility. And so, to me, the responsive piece is- is about attunement, and I'm watching how my child is reacting to what's happening. And you know, how this teenager’s reacting to family meals or whatever it is. And then I'm adapting and I'm prioritizing felt safety. And so to me, that's responsive feeding. And I- I think that you know, there's a lot of research behind non responsive feeding, not being super helpful. Like the more we try to get kids to eat fruits and vegetables or try to get them to eat less or more, that can really backfire, and especially with these kids. So you know, we're getting more and more research around it. But yeah, that's in a nutshell, that's what it means to me. Also, we- there's several of us. The PhD researcher and psychologist, SLP, OT, dietitian, we wrote a white paper on it if you want to link to the values of it-

Robyn: Oh, yes!

Dr. Rowell: -really talks about sort of neurodiversity affirming care also, and- and size acceptance and you know, talking about food, you know, we're not healthy, quote, unquote, will be different for different families under different circumstances. So there's a lot of grace and flexibility in the values of responsive feeding and responsive feeding therapy.

Robyn: Yes, so many of the words you just use I know like so many of my listeners are breathing a huge sigh of relief right now. To hear, you know, people who you know, are- are committed listeners of this program are used to language like felt safety, and attunement, and flexibility. And so often, I think it is easy for those words to almost like disappear [laughter] when we start to think about food and feeding, right? Like all of our stuff gets hit. Not to mention, it's such an easy place for other parents to be judgmental. About right?

Dr. Rowell: And doctors. [overlapping conversation] 

Robyn: And yes, social workers, professionals, families are like- are going to in such a vulnerable state, right, like, please help me. And then- so many families I work with, it feels like there's this like wild little space, and it's food and feeding and nutrition, that's like sequestered away from language, like felt safety and attunement. And they're, like, I- and it's hard for me to make referrals, because just, it really is a struggle. So I just know, there's so many people that maybe press play, they didn't know who you were, like crossing their fingers that this would be like in line with what they were hoping to hear and are just having a huge sigh of relief that you're using this language. 

Dr. Rowell: I hope so! Yeah, well, and part of why I'm really happy to be here is because I know your listeners know all of this language. And so I don't have to go back and explain all of that. But, you know, and there's so much pressure, you mentioned nutrition, like with the internet, and with kids, maybe who are autistic or have an ADHD diagnosis. And there's so much out there about like, nutrition is the key and clean eating. And I see this across the board with all the families I work with, where I have, like, you know, responsive parenting or responsive positive parenting, and then like, the vegetables hit the serving dish, and suddenly all that goes out the window. And so parents who, two minutes earlier, we're like, you can choose, do you want to have the red plate or that- you know, and they're really sort of all day long? Rockin this like groove, and then suddenly they sit down to eat. And it's like, you have the two bites and the kids crying and the parent- and it's like, completely different parenting approach when food comes out. And I think that that's like our foodie, you know, this culture we're in right now with goop and everything's clean eating and, you know, food is medicine, quote, unquote. I don't- I don't believe that isn't sure I'm not saying nutrition isn't important. I think that's something I want to mention. Like I do think nutrition, and variety. But the ways that we've been told to get there generally make things worse. And so yeah, I just really feel for parents. So you know, one piece of advice is anyone who's saying clean eating or you can cure problems with nutrition or cutting out food groups as if that's not a major thing. I would unfollow those accounts. That's a huge red flag to me if you've got an account saying just cut out dairy, and just cut out, you know, soy, and wheat, and cut all these things out without a major discussion and lots of guardrails around that and reasoning why. I think those are really toxic places because it ups the anxiety, you know, it ups the anxiety. And when we feed from a place of anxiety, we're not we're not going to have good outcomes.

Robyn: Yes, I mean, I think that's so true about so many, like, quote unquote, parenting experts in general. That people get known with rigid ways of being. That's a really great way to become relatively quote unquote, popular like in the sort of media world. And it gets so confusing, and tends to evoke like this whole new layer of shame. And so I feel pretty good rule of thumb for me is if you're spending time on social media, and you're feeling worse- if the social media accounts you're following are making you feel like I'm really doing something really wrong. Then it might be time to just unfollow those accounts. I think kind of in general, because life is hard- life is hard enough without a stranger, evoking these rigid rules, a- kind of about anything. But then again, like this food and feeding, in addition to this very, you know, I think a lot, a lot of us could say we're connected in some ways to this very quote, unquote, health conscious way of moving- trying to be your move through the world. That, from a therapist perspective, that attachment part for me. That food and feeding and nurturing are, you- can't untangle those pieces. 

Dr. Rowell: Absolutely, yes.

Robyn: And we shouldn't try to.

Dr. Rowell: No.

Robyn: But if we're parenting a child who's already struggling with connection, with attachment, like there's challenges inside our parent child relationship with regards to these pieces that we have this idea should like, just be easy or come naturally to parenting. And so already, they're not coming naturally, or they're not feeling very easy. And then food, which for so many parents can just almost be like this linchpin of like, I can't even feed my child in a way that’s satisfying to my child and how that just seems to just cut right to our core,

Dr. Rowell: Yeah! Satisfying to the child or to the parent and caregiver. 

Robyn: Yeah, it's yes. 

Dr. Rowell: I mean, you know, I've had so many parents say like, dinner is 45 minutes of hostage negotiations, or I'd rather like, I'd rather poke my eyes with sticks than, like, sit down meal with my family. So- so yeah, I mean, I think that there are strategies that I'm you know, we'll dig into about, like, how can we build connection, decrease the power struggles, and here's the great part, felt- felt safety- prioritizing, felt safety, connection, and relationship is actually how we get to better nutrition and how we down the road, get to children learning to tune in. So that's what so- what I love about- about bringing this message is that it feels better. You know, you can connect over the food and then with time, you know, that- that goal of you know, helping them do their best with eating and with nutrition is- is- comes out of that connection.

Robyn: Well, let's go there. 

Dr. Rowell: [overlapping conversation] Yeah, let's do it.

Robyn: Yeah. So strategies, you know, prioritizing felt safety. What does that look like? Maybe let's start with like, what do you think that looks like in general? And then what does it look like when there is a really big problem? You know, what the parents are perceiving as a problem, like their child isn't eating anything but Doritos, and sprite. Which is actually not that much of an exaggeration, right? 

Dr. Rowell: Oh, for sure, for sure.

Robyn: Like, I know these- these families. So let's just start with maybe just in general, like when you were talking about attunement and felt safety with regards to feeding.

Dr. Rowell: So let's take a quote picky eater and maybe let's go with the most you know, I also have a book called Helping Your Child With Extreme Picky Eating, let's let's not do the extreme yet of the child who only eats Doritos and- although I think this works for them to or helps. So let's say we have a you know, a seven year old who doesn't like any vegetables. Eats a couple of fruits mostly eats variations of bread and cheese and crunchy, salty things. So a pretty typical, and I think what we've been socialized to do and what quote good parenting is, which is why everybody you know, preschool pickup is talking about their picky eaters, with the quote, good parenting option is not ideal for feeding for any kids. But so- so what we might do, what families are often doing is let's say they come off the- off the bus or you pick them up, and they're starving, but dinner's not for 45 minutes. And so you're trying to sort of hold them off, and maybe you let them have a couple of pretzels. And then dinner is there and there's a vegetable, you know, maybe a rotisserie chicken you picked up on the way home and some vegetable and a starch and they only want to eat the rice, whatever it is. And we're taught as good parents, quote, unquote, to say, well, you know, you need to take one- a little bit of everything on your plate, or maybe we're preparing for them so you're you know, you like the chicken drumsticks. So you have the chicken drumstick on your plate, there's two pieces of broccoli, that's all you have to eat. There's rice, and before the kids even sitting down, they're in meltdown mode. ‘You know I don't like that!’ Maybe they even throw the plate or you know, and so maybe you learn and so then you- you only put one piece of broccoli or you put it next to their plate. Well you don't have to eat it. You just have to lick it or you know, touch it with your fingers. So some of these, even what feeding therapists tell families to do can be too much. And so one of the most helpful things in this in all scenarios is is doing what's called family style serving. So the child gets to choose, we're supporting their autonomy, because if we- if we ask them to do something for some, you know, we- they might have that autonomy and demand sort of reaction, you're asking me to do something, I'm immediately gonna say no. And- or there's the broccoli, just seeing it on their plate, maybe they have some sensory issues, and it smells really strong to them. Now they've kicked- you've kicked them into, they've been kicked into dysregulation. So their fight or flight, they cannot tune in to hunger, appetite. They can't connect with you. They can't connect with their curiosity, which in almost all children, will be there eventually to try new foods. So what we would do in terms of prioritizing felt safety, we might have a discussion and say, ‘you know what, we're not going to ask you to lick the broccoli anymore, we're not going to make you eat anything you don't want to eat. Here's your plate, you know, you can take what you want to eat’, you might model how to self serve. And then you know, they might only the rice for a while or- but what we see is if they're in a place of felt safety, and now they can actually chat about their day. And then they watch you eat the broccoli, and now they might smell it. They might see it 15 times. And you might try different preparations and whatnot. But eventually, most of the kids and maybe broccoli is a tough one to start with, but will branch out. When they're in that place that felt safety, they can access that drive for novelty that most kids will have, even with challenges. So you know, self serve is a great way for a lot of kids, you've neutralized the battles, they come to the table, and so often families will email me after a couple of weeks and say, oh my gosh, once- once we stop making them take stuff on their plate, and once we neutralize that power struggle. Last night, they were talking, I was talking to the other sibling and they slid it- you know, baby carrot on their plate and you know, licked it. But that was more than they'd ever done willingly before. So that's just one example of how a common tactic of asking them to just have one bite or no thank you bite dysregulates kids, it pushes them into that resistance and fighting back and- and so if it's backfiring stop doing it. You know, just because your doctor says, do a no thank you bite or you read a book that French kids all take one bite of everything, and they eat better than Americans [laughter], you know? If it's not working for you. Stop and look. So that's another- this is the problem I get going. But that's another point is where you find conflict points, and where you're seeing dysregulation that's where you're like, Ooh, big red arrows. This is something where I have an opportunity to do things differently.

Robyn: Yes, so one thing that you just said that I really picked up on which again, it's like, even for me, it's so easy to almost sequester like food and feeding for like everything else we talk about. But I talk so much about curiosity, the drive for novelty, and the, you know, how important it is to help our kids develop the felt safety of noticing themselves. And, of course, like all those things are involved in food and feeding as well. So the moment we have stress involved in food and feeding- and I have an- I have an almost 16 year old who, this is not an exaggeration to say, has since he stopped eating baby food, which I wish I had not done baby food. I thought I was doing good by like making- doing like organic, homemade baby food-

Dr. Rowell: Right, not your fault!

Robyn: I know, I know. [overlapping conversation] But truly since he stopped eating, quote, unquote purees, which was obviously a long time ago, he's 16, he's never eaten a piece of fruit. Never. It's not an exaggeration to say. Never. It's like a non-issue. Like sometimes we forget that that's true about him. But I say that just to say like, you know, I am not immune.

Dr. Rowell: Oh, yeah, sure! Yeah, yeah, I mean, you know, and then I just think of my daughter's great uncle who never ate vegetables and he was eighty something when he passed away and he liked fruit better and never ate fish. And, you know, he was he-nowadays would be called a, you know, ARFID or a selective eater and we put you in therapy. And so some of this too is like, you don't you can be okay and not eat vegetables, and you can be okay and not eat fruit. I mean, most of the time kids will branch out and maybe for your son, it'll be when he's 18 or 22, or smoothies or whatever it is. But you know, that's the other piece of this too, I think is as a country like dieting is a $70 billion industry.

Robyn: Yes.

Dr. Rowell: And so most of the adults are- are struggling with dieting, and Weight Watchers tells us that if we don't have an app, or points or something external to tell us how to eat that we can't do it. And so, of course, it seems to make sense that we can't trust our kids to do it. That we have to teach them portion control, and we have to do something to get them to eat this stuff. And we've lost touch with what you said, which is that, yeah, you know, like you said, food- it's not different with food there, there is an internal curiosity, and you know, that all of that internal stuff, and- and autonomy, and food- eating is not a behavior. So one thing I want to mention is if your listeners are going for feeding therapy, I really do not believe that ABA or behavioral therapy is the right approach for foods. What you- what we put into our bodies, you know, this is also a consent issue. 

Robyn: Yes.

Dr. Rowell: And so to me, ABA rewards punishments, you know, this is actually was my introduction into feeding therapy way before I really knew what I do now, over a dozen years ago. And adoptive parents said, well, my feeding therapist is not to make eye contact, or give them any attention unless they're eating. But my attachment therapist says this is wrong. And I don't know. And of course, if you've got a traumatized child, and you're completely pretending like, you know, they’re see through unless they're eating, that's not how we help children learn, to grow up to be able to relate to the food in a healthy way. So I just wanted to throw out my- my little word of caution, if it doesn't feel right, if they're asking you to withdraw tension or do stuff that you wouldn't do in any other realm. You know, there are options.

Robyn: Yeah. Yeah. You mean, you're talking about so many important things, there's- way- more- more things and we could get to in this short time to the very beginning, you know, you talks about, like our fat phobic culture. And, you know, we could talk about that and how that's related. But I wonder if going maybe to the kind of the next challenge that I see with families will even give us an opportunity to talk about that language, because I'll bet a lot of my listeners haven't ever used- heard that word before. 

Dr. Rowell: Yeah.

Robyn: But on the opposite side of the picky eating coin is the hoarding or overeating. And my families who to feel like if they weren't-, I'm going to use the word micromanaging their child's food intake, all the time, their child would never stop eating. And then there's so many fears, it's like, well, and then what would happen? Right? And there's a lot of things that come after that question. And one of them is of course- of course about them being fat, being unhealthy. So let- can we talk about overeating and hoarding? 

Dr. Rowell: Absolutely, absolutely. Those- the two biggest issues that I see are really flip sides of the same coin. The one is, if I didn't make my child eat, they would never eat, and there's the anxiety, they're going to be too small. And so there's a lot of pressure to get them to eat which backfires. The flip side is food preoccupation, where if I didn't get them to stop, they would never stop.

Robyn: Yes. 

Dr. Rowell: They don't have a stopping place. My OT said, they can't tell when they're full, because he's autistic, and he has interoceptive difficulties. I hear that all the time. And I don't buy it. I know- that's- I know- that's- that's a tough one. So I see this all the time. It's a huge part of the Love Me, Feed Me book, because this is incredibly common with adoption and foster care. Because a lot of different reasons. There's often been food insecurity in their past, not being fed reliably, or enough, you know, neglect. And so food insecurity is deep, profound trauma and anxiety. And the good news is- is that you deal with it the same way. You know, that- that it seems like they can't be trusted, so we have to get them to eat less or cut off mealtimes or, actually, we will cut off mealtimes. We can talk about, that how to end meals. But you know, if we didn't stop them, they have no stopping place. And- and the families I've worked with, that's just not been true. And I- there are tons of family quotes in the book and really lots of detail on that. Because I don't see that really in any other places. There's a lot more resources for kids who don't eat enough quote unquote, or have extreme picky eating but not for the food preoccupation. So there is hope. And you know, The younger they are, the easier it tends to be. I mean, I've had- I'm actually just writing up a case study that I'm going to do for professionals on food preoccupation. You know, and we often will see signs of- of the anxiety decreasing within a couple of weeks. The sad thing is, is so often the advice parents get is like, well just let them carry around a baggie of you know, baby carrots or goldfish crackers. And that can be helpful, the stash can be helpful. But really, the main thing is we need to decrease the anxiety deeply and profoundly, they have to know they're going to get fed. And they're going to get enough, even if they're in bigger bodies, even if they're the O word on the growth chart. Right? So this means if a family- akiddo has been with you for two years, and you've been doing portion control, and the doctors are getting mad, because- they don't believe you, you know, that you're trying hard, or whatever it is. And I've had parents say, I'm doing this for two years, I'm the food cop. We can eat out at restaurants. If they see me eating, they will, you know, the kid will run into that- I mean, this story is, you know, you know,

Robyn: And then the doctors are mean to them! [overlapping conversation]

Dr. Rowell: Of course, they're fear mongering, they're gonna get diabetes and heart disease. And you know, what? Felt safety is heart healthy. 

Robyn: Yes!

Dr. Rowell: Felt safety is heart healthy. So let's set aside the weight worry for a second. Because I know this took me- that took me about two years of challenging and reading to my point where I'm now. So what- what can families do? First off, I would say, and I'm not here to plug my book but, don't just listen to one webinar, and then go, we're going to do this. And then because three days of saying, ‘well, I let her eat how much she wanted, and she ate more than my husband, and it scared me. So we had to go back to limiting’ because they're gonna seem to prove that they can't be trusted. So I would say, you know, if this is your issue, read Love Me, Feed Me or we can talk about it, you know, in our, I know the opportunity we'll talk about but. So one thing that I recommend, if a child is first coming to you, or if you're dealing with food, preoccupation, sit down, offer them food, like every hour. And so let's say someone's been with a family for you know, they're- been with you for three years, and you've been restricting for three years, they're not, quote, getting used to normal portions, or whatever. So you might say, you know what? Food has been really hard. And, you know, we're going to try to do things differently, we're going to figure this out. So- so every hour, hour and a half, you sit down together with food, and- and then you do that for three or four days, and you space it back out to the regular routine. So it's just like, super clear, we're going to feed you. And we're going to do it again soon, you know, in a couple hours, we're going to do it again.

Robyn: And to be clear, you're saying sit down together, like it's just gonna highlight that part, this relational piece, which, of course, I hope my listeners know, like, we're not forcing relationship. That's not relationship. But that when we can, you know, including a relational component in this is really important. 

Dr. Rowell: Yep, yep, yes. Absolutely. So you're sitting with your cup of tea, and maybe you're also joining them with the food, you're leaning back with your body language, you're faking, that you're not-, you know, as you talk about, get yourself grounded, take your breaths, try to be in your place. You know what I know, for some parents where this is too hard. If another- if a partner, another adult can take this on? That's fine. I've had- I've had mom- moms who've said, you know what, I've had an eating disorder. I can't watch this right now. I can't do it. But my partner can step in for these- for these next transitional weeks. So, and then at those eating times, they get to eat as much as they want. 

Robyn: Yeah. 

Dr. Rowell: And that's super scary. And they're going to quote over eat. But they need to do that, to know that they get to choose. And then they're also learning what that feels like. And when they're in felt safety, they can I kind of go, ‘Oh, my stomach hurts’. Or ‘my, that didn't feel good’. And then we don't jump in and say, ‘see, you ate too much. That's why your stomach hurts’. We just sort of let them feel that and experience it. Yeah, we, you know, we spread meals out then to the three to four hours. Flexible routine. And then we do limit the time at the table. So parents will say well, if I just let them eat as much as they wanted, they'd sit there for three hours and eat. Yeah, maybe for a while. So I generally say you can limit it to about 30 minutes. And again, this is all depending on the age of the child, you might say, oh, in about five minutes, we're going to insert favorite activity here. You know, so you're not saying oh my gosh, you ate so much, we got to- dinner's over. You know, it's you moving on to a positive thing. So it's because transitioning away from eating for these kids will trigger their anxiety. 

Robyn: Yes. 

Dr. Rowell: So let's play Legos together, whatever they like, let's go on the swing, maybe not after they've had their huge meal. [laughter] For a while, let's play with the dog, let's watch screen time, whatever it is. And you transition into a fun activity. So we do limit the time because that- that supports the routine, and the flexible schedule. And, you know, this is why I think having a resource, a book, and you know, knowing ‘okay, they're going to eat a lot for a while’, and then it gets- usually it gets better. And, you know, if but- if kids are 14, 15, and we're thinking, well, this is more like binge eating disorder, I may need them to have some help with this. But younger kids, this generally can go very well. And what we start to see signs of progress is slowing down with their rate of eating. So the child who was, you know, biting their fingers, because they were shoving it in so fast will start to slow down. They might even get more picky. So the child who ate everything in front of them suddenly now doesn't want to eat the, you know, lemon broccoli casserole. Then they- they start having preferences. So that's a good thing. They- they can talk and connect at the table, because they're not in- they're not frantically dysregulated with the scarcity mindset and just shoveling it in. They might play with their food. So they make jul- their toast into a fish shape and start playing with it. And they're available for connection. They're not just like a frenzied feeding. So- si yeah, so there is so much hope. And it's one of the things that I am super passionate about is this food preoccupation piece, and helping families with that. Because a lot- most of the time, we can really, really improve things. And- and then talking about the weight issue, when kids can heal that frantic feeling and start to tune in, that supports in terms of their weight regulation, that supports a healthier body. And it may be a bigger than average body, but it will be a healthier body, and in spirit and all of that good stuff.

Robyn: Yeah, there's so much research that's been out for a while now, right? That talks about how just chronic stress and the- how this is so harmful to our body, to our cardiovascular system, we see increasing all the things that you say we see increased of and being the O word like you said, is also really yeah, those are risk factors of chronic stress. Right? So I love reminding ourselves that. That if we are really truly worried about things like heart disease, and diabetes, and valid things to be concerned about a path towards healthier hearts, is increased felt safety, decrease chronic stress.

Dr. Rowell: 100% do- yeah, yep. And that. I mean, and that's a diagram that I've developed. And I show that now to my training with professionals and it's going to be in the second edition of the book is- is this is not neglectful to not fight with your kid over eating vegetables in the moment. If we can have them in that felt safety, you know, regulated zone, they have better digestion, better able to absorb nutrients, heart rate, the you know, the- the stress, the wear and tear on their bodies, the cortisol, you know, all of the, you know, all of that chronic stuff, in terms of what we associate with the O word in adulthood is actually more associated with, you know, dysregulation, and racism, and adverse childhood events, and trauma. And- and we can bring about a lot of healing with that focus on felt safety. And again, that's- that's the road with the long term goal to the improved nutrition and internally driven eating. 

Robyn: Yes. Oh, gosh, this has been so helpful. We've talked about picky eating. We've talked about food preoccupation, I like how you used that language. That was helpful, I'm gonna make sure- I'm gonna try to kind of switch some of my language over to for preoccupation. Yeah, I love so much this focus that you have about like as parents noticing ourselves and noticing like, what information are we taking in that isn't necessarily quote unquote, bad information, but is backfiring in a way- and some of the information is bad, don't get me wrong, but some of it is sure like it taken at face value. It's not quote unquote bad, but it's prompting these anxious- you know, ways of being in our own bodies. And if we can, you know, take a breath and pause. And remember that it's, you know, what we want more than anything is to remove stress, and dysregulation around food and feeding. 

Dr. Rowell: This is hard. This is so hard, you're gonna get comments and judgment from teachers, and your parents, and your neighbors, and other mommies. And, you know, so you know, that- that there's not much I can do about but I want to just have you feel seen that way that feeding in a responsive way where you might let them have sugar, you know, a sweet with the meal, you're not negotiating, or bribing, or making them earn dessert with vegetables, you might get some comments. And that's, that's just not easy.

Robyn: It's not easy. And I think for so many of the parents that are listening to this podcast, sort of has become just part of their parenting journey. People have opinions about their parenting, about their kids, about their kids’ behaviors, and finding ways to be okay with that, as we're continuing to just focus on our kids and their needs, and our- and our needs. Which is to be regulated. And having, you know, felt safe in our own bodies as well. So, gosh, thank you so much. I mean, I'm just so grateful for the work that you're doing. I'm always so grateful to connect the parents who are listening to my show to other professionals who care about them and love them in the ways that I do. And we- your book is definitely the kind of food and feeding books that I recommend. Love Me, Feed Me. I'll make sure I link to that. I actually I've never read your other book, remind me it was called the extreme picky eating book. 

Dr. Rowell: Yeah. Helping Your Child With Extreme Picky Eating. Yeah. And then I actually have one for teens. So and that's the Conquer Picky Eating Workbook for Teens and Adults.

Robyn: Awesome. And then you said, Love Me, Feed Me, you’re work- You're working on a second edition? 

Dr. Rowell: Yes, it's a little COVID delayed, I can't wait for that to come out. Because it really does have more of that responsive felt safety piece. So yeah.

Robyn: Awesome, awesome. Can't wait to see that. And then you have this amazing resource for professionals responsive feeding pros. Is that right? Did I get that right? Yeah. Talk a little bit more about that.

Dr. Rowell: Yep. Yep. Well, you know, there's a group of us who work in this way. And we just, I think one of the biggest tragedies to me is that the people your listeners go to for help. I know, I didn't, I never got trained in this stuff. The pediatricians, the family doctors, nurse practitioners, GI doctors, even some speech and occupational therapists who do feeding work. Are- they don't know. So they say, well, just you know, they won't starve themselves, or they'll get used to portions. They don't know the research around feeding dynamics, and restriction, and pressure. And so that's so not okay, that the first people families go to for help often don't know how to help them. They mean, well, but they just don't know. So we want to change that. So we're- we're just launching this growing library of resources for- for the professionals, social workers, etc. To try to grow this network that can do this responsive approach.

Robyn: Yeah, awesome. Well, everyone listening I will make sure all of that goes in the links in the show notes. There's always a very long summary of podcast episodes over on my website, so links will be there as well. Well, thank you again, so much for your time this afternoon. And I'm really looking forward to the fact that we're gonna get to connect again, really shortly and a just kind of smaller, more contained kind of intimate way in The Club when you're a guest speaker in The Club next March. So families will be able to talk with you and ask you questions, that's going to be really fun. So I'm looking forward to that as well. So thank you so much.

Dr. Rowell: You're welcome. I hope it helps someone.

Robyn: Oh my, y'all. How refreshing and almost miraculous, unfortunately, is it to hear words like felt safety and attunement from a medical doctor! One who understands food, and feeding, and the really significant challenges that come with parenting a kid who's experienced trauma. If you want to read a short summary of this episode, head to RobynGobbel.com/ResponsiveFeeding. 

Robyn: We are so excited over in The Club to have Dr. Rowell as our March guest for our masterclass teacher. This episode, this podcast episode you're listening to right now is airing on March 1st. And today, The Club is open for new members from now until March 7th 2022. We open periodically so if you're hearing this episode at some time in the future Just head to RobynGobbel.com/TheClub to get the details on when the club's opening next. Every month we have a masterclass, it's usually taught by me. But sometimes I bring in a guest. And then we have a separate live meeting where we take what we learned in the masterclass and quote unquote, put it into practice. Which means it's a meeting with lots of open discussion, problem solving, questions, and really getting into the practical application of the things that we're learning. Every month, we also always have at least one and sometimes two, kind of depending on our scheduling sessions that we call connect and co-regulate. So these are unstructured live meetings on Zoom, where we break into small groups and do exactly that. Connect and co-regulate, we offer and receive both connection and co-regulation with other struggling parents who just get it. Like without even saying a word. There's this felt sense of I'm understood, and seen, and known here. And that just in and of itself, is this wonderful little drop into the connect and co-regulate bucket. If you think this sounds amazing, head to RobynGobbel.com/TheClub between March 1 and March 7, where you can register and join right away. We are super excited to welcome you with open arms. 

Robyn: Alright, y'all, you know by now, I assume, that I just overflow with gratitude for every single one of you, who's listening. Thank you, thank you, thank you that you're here listening, that you're doing your part, whatever that looks like, and changing the world for our kids, their kids, and truly, everyone on the planet. I'll see you back here next week.