Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Wednesday, July 4, 2012

Food Pouches, or, Bringing Up Mama


The topic of the week seems to be “food pouches”--  containers of pureed food that can be held and squeezed out by toddlers and even older children--  providing some nutritious food without any of the hassle of utensils, sitting at the table, being careful not to spill, etc., etc. They’re available at considerable cost, filled with elite foods like quinoa. A recent New York Times article discussed the use of these pouches by parents who are too busy to supervise their children’s meals and who want to make sure that foods their children eat are not just junk (also, presumably, who can afford the expense).

Food pouches would seem to be ideal for traveling families who can’t be sure of getting appropriate food for older babies and toddlers, or for situations where a sick or injured child has a poor appetite and may be intrigued by the container. But, for all the kids, a lot of the time? No, and for several reasons.

When babies don’t have any teeth--  or just the front ones—they obviously are not ready for corn on the cob or steak frites. But they do want to chomp on things (“how sharper than a child’s tooth”, as Pogo used to say), and they like to practice that chomping. Given a spoonful of applesauce, they slurp off the applesauce and then bite the spoon too. Bottlefed babies can be seen biting on to the bottle nipple and then yanking it out between their closed teeth.  

What’s the advantage? Part of it is that when teeth are being cut and gums are itchy, biting on things relieves some of the discomfort. But there’s more to it than that. When older babies negotiate lumpy foods, they develop skills in controlling how hard they bite and in using the tongue to chase lumps around the mouth. These skills help prevent choking and gagging, and toddlers who have not had this experience are all too prone to gag on any lumpy foods, like vegetable soup or rice pudding with raisins in it.

In addition, learning to control the tongue and biting pressure also contributes to well-articulated speech, because producing an exact speech sound involves using the positions of the jaw and the tongue to shape the sound-producing air stream coming up from the lungs. Many speech sounds, even though we hear them as the same sound throughout, actually involve exceedingly quick movements of tongue and jaws with changes right in the middle of the sound, so a nimble mouth is required in order to speak clearly. A diet stressing pureed foods after 8 or 9 months may not give the right kind of exercise.

Although the growth of the upper jaw is largely genetically determined, the growth of the lower jaw is guided by exercise and experience of pressure. This enables the growing child’s upper and lower teeth to fit together perfectly in spite of factors like preferring to sleep on one side, which may slightly change face shape. Without exercise and pressure, the lower jaw may not grow adequately, may have an unusual appearance, and may not provide for good speech articulation. (This is a problem for some individuals with cerebral palsy, whose difficulties in swallowing and tongue control have required a soft diet.)  One “evolutionary dentist” writing recently in the magazine Science, even suggested that foods like beef jerky might be important ways to get children enough jaw exercise in this time of soft processed foods. (Bubble gum, I wonder?)  Certainly pouches of puree are not going to do the job, not after the point when teeth are coming in quickly.

There’s more to this issue, too. Let’s think about parent-child communication (which is, by the way, a foundation of attachment as well as of language). Spoon-feeding is an excellent situation for practicing communication. Face-to-face, caregiver and child are ideally arranged for seeing each other’s facial expressions and gestures. They imitate each other--  can any adult offer a spoonful of food to a baby without opening his or her own mouth? For successful spoon-feeding, parents are forced to be sensitive and responsive to the baby’s cues. They can’t just keep shoving food in when the baby doesn’t want it, because baby will just spit it out, close the mouth and turn the head away. If the baby wants more, she will signal more and more clearly and loudly. When enough is enough, everybody slows down and sees that the meal is over. The spoon-feeding set-up is also ideal for practicing hand-to-mouth control. The hungry baby can pick up bits of finger food or hold an empty spoon in one hand and manage a full one with the other. (For some reason, both hands have to be occupied in this task.) As appetite is sated--   which the caregiver has to notice, thus practicing sensitivity and responsiveness-- the caregiver can offer more spoonsful  until no more is wanted.

What I’m saying here is that being spoon-fed, and eating lumpy or chewy foods, is beneficial for the baby’s development. But it’s also beneficial for the growth of the parent as a parent. Experience with babies teaches us to be parents, and the skills we learn at that time will benefit us right through their childhood and adolescent years--  not that we’ll still feed them, but we’ll be skilled in adapting to their changing needs.

[By the way--  wondering about the baby dumping food out of the spoon? Until he or she can rotate the hand on the wrist, it’s awfully hard for the baby to keep any runny food in the spoon. But something stickier will stay in even when the spoon is upside down. ]


2 comments:

  1. One trick for chewing/swallowing exercise for those who are a swallowing risk is to tie the gum in a piece of cheese cloth. The nurse/adult can keep the gum from being swallowed by holding onto the cloth.

    Thanks for all the info.

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  2. I must say this always makes me gag to think about it-- but when it's needed, food can be treated in this way for chewing exercise and development of oral food acceptance without risk of swallowing.

    But let's be careful that nobody decides to do this with typically-developing kids!

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