Feeding children in foster care can be a tricky endeavor. You and I take food for granted. It will be there when we wake up, when we are hungry for a mid-morning snack, and will have a table-full at dinner. We look at food as something to be enjoyed and shared around a table with loved ones. Some of us hyper-analyze what is in our food; is it vegan? is there fat? is it non-GMO? is it void of high fructose? organic?
Imagine for a second how you would feel about food if you did not have regular access to it? If you were limited to the three same food choices every day? What if you did not have electricity or the propane to cook? Would any of those above things even matter?
Have you ever visited a foreign country and while you are there the foreign food is new and exciting but then after a time you start wishing for food from home? I was an exchange student for a short period of time in the UK and after about three weeks with gravy on everything I started wishing for a big fat bacon-cheeseburger with a cold soda (their’s was always room temp). It’s not that I disliked their food, but it just wasn’t home. So it can be for a child newly placed into foster care.
Feeding a child in foster care can be exceptionally hard. A neglected child does not view food as joy, love, and family. They view it as a means to survival, energy to keep moving, or it may be a trigger for past trauma (were they abused with food– food withheld? food engorged?). I believe the best thing foster parents can do is try to view food from the kids’ eyes and keep that lens on while feeding them. Our first gut (pun intended!) instinct is to pack their bodies full of nutritious foods (that they need) but let me put my medical hat on for a moment: don’t do it. If the child is malnourished, and most likely they will be to a certain degree coming into foster care, then doing a 180° from their usual food intake can wreak havoc on their bodies.
What is Malnutrition? The best description I found is from here: “Malnutrition is a condition which occurs when there is a deficiency of certain vital nutrients in a person’s diet. The deficiency fails to meet the demands of the body leading to effects on the growth, physical health, mood, behaviour and other functions of the body. Malnutrition commonly affects children and the elderly.” There are varying levels of malnutrition. We most commonly think of the big-bellied, thin-extremity child in third world countries when we hear the word malnourished. However, we must shed this stereotype and remember the above definition. This is a deficiency of nutrients in a diet. An obese child can be just as malnourished as the catechetic child. When you have a child placed in your home do not judge their nutrition status on appearance. Gather as much information about the environment they were removed from as this will provided important clues. Take them to the doctor as soon as possible for a Well Child Check, look over their growth charts, ask about getting a Hemoglobin and Iron level checked. Hemoglobin is a normal screening done between 12-24 months old, but do not be afraid ask for it to be rechecked if necessary. A malnurished child will often have Iron Deficiency Anemia. Discuss with the medical provider what concerns you may have about their nutritional status and ask for a referral to a dietician if you think that would be helpful.
Five Ways to Introduce a New Diet to a Malnourished Child:
- Avoid engorgement. Offer smaller amounts of foods, not a feast. A sudden overload of food when the body is not used to it can cause damage at a cellular level in the body.
- Start with food that is high in nutrients first, and then slowly progress to more balanced meals. A PB&J will work: I love this adoption story behind the nut butter: Nuttzo!
- Calcium and Vitamin D. All vitamins and minerals are essential to health, but these two are especially important in growing children. Children with a regular consumption of these will grow at a healthier pace. Low intake can cause soft bones (rickets), low Vitamin D levels can cause depression, fatigue, body aches. I suggest starting with yogurt as it has higher protein, probiotics for gut health, and easier to digest. Depending on the child and their history, slowly introduce cow’s milk as their body may be intolerant to breaking down the lactose initially.
- Rehydrate. Malnourished children are often at some level of dehydration. Offer plenty of water. If they are used to drinking Hawaiian Punch all day, then offer a flavored water alternative.
- Limit options. Avoid an overwhelming smorgasboard of food which can cause stress and anxiety to a child who has only ever had a choice between Ramen or hotdogs. It’s normal to want to give them the moon, and you can, but just do it slowly over time.
Expect some upset tummys. It is normal for them to have diarrhea for the first few days as their guts get used to the new foods. Expect their poop to have a rainbow of colors. These are both reasons why going slow with food is important. The gut and cells are learning to digest and manage new vitamins and minerals they once lacked. The human body can do an amazing job at compensating when it has been subjected to a less than ideal health. The body is used to the compensated state, but this does not mean it is in a healthy state. Getting it back to a healthy state needs to take time to avoid overwhelming the body. For example, a person with chronically low levels of oxygen should not be given a blast of high-dose oxygen because the body cannot handle the sudden change and leads to acid-base imbalances resulting in respiratory distress and possibly death. The very thing the body needs can cause its death. This is why severely malnourished children are given special food in specific phases and not a Thanksgiving meal.
Leah’s Tips for Feeding Kiddos in Foster Care:
- Get off your high horse and let them eat a dang hotdog. If eating a hotdog, or Ramen, or Mac-n-cheese goes against every fiber of your being because you follow an organic, or vegan, or vegetarian diet: get over it (at least for the first few weeks). They are already giving up and getting used to so many new things that letting them have a familiar favorite food provides some semblance of “home.” You don’t have to throw all nutrition out the window, just encourage them to try the new foods but have one “comfort” food option along with the new.
- Give them open access to food. We have a snack drawer that is at the level of a child’s reach. There is fruit available on the counter. There is yogurt in the lower drawers of the refrigerator. This does not mean free reign but it allows for less anxieties. We teach them that there will always be food available but we would like them to ask first. When they ask, I try to avoid saying no, and instead give them two healthy options to choose from (if what they ask for is not something I’d like them to have at that time).
- Teach them to slow down. If you’ve been subjected to hunger most of your little life then your natural tendency will be to eat what is in front of you as fast as you can. Family meal time is often a foreign concept so be patient and flexible in your teaching. We frequently remind them that there is always more food and to slow down.
- Just roll with it. If they want parmesan cheese on their cucumbers–great! If they want to put yogurt on their crackers– oh well! If they dip everything in ketchup– buy a big bottle! (we’ve seen all of the above).
- Teach them about food. Read books about food, make a food list and go grocery shopping together, cook together, coach healthy versus poor choices. These are important life skills that most foster children are lacking.
What about that Picky Eater? Picky Eaters often act like you are hanging them upside down by their toenails at dinner time. The meal usually ends with a parent yelling, “You WILL swallow that food!” and the kid holding tuna fish casserole in their mouth until they turn 18. That is not a good tactic with foster kids. My #1 tip on how to feed picky kids from any background is this: Hidden Valley Ranch (no, this is not an ad). Go to your nearest discount bulk store (i.e. Sam’s Club or Cost-co) and buy your home at least 50 gallons of that white wonder. And then don’t hold back. Allow them to put it on whatever the heck they want, because then they will actually eat their food. One of our foster daughter’s favorites was on spaghetti. Yes, that’s right; spaghetti. She was a tiny thing but she could eat platefuls if it had Ranch on it. Other kids we’ve had love a mixture of Ranch and ketchup. This combination apparently goes well with tater tots, carrots, and apples. 🤢
–“People who love to eat are always the best people.” –Julia Child