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Meal support

What is meal support?

Meal support means helping your child or young person emotionally during and around mealtimes. The specific aim of this support is to help your child or young person eat the food on their meal plan, whilst helping to redirect any thoughts or behaviours that might impact eating and recovery.

Our team provides meal support on an individual basis. We sometimes support your child your family within the home, or we can provide support if your child is in hospital.

We use mealtimes as a vehicle to support recovery work, such as exposure to foods that your child may find difficult to be around. We can help them unlearn eating disorder behaviours such as restriction, slow eating, deconstruction of food, or cutting food into tiny pieces.

During meals, distressing thoughts may enter your child mind. Meal support provides you and your family with a way to support and redirect some of these thoughts and feelings. By implementing the support and techniques, you can learn to stay calm in the face of anxiety and angry outbursts and guide your child through eating the foods they fear the most.

For child or young person who have returned or remained at school and need meal support, the team can liaise with an identified teacher or support staff who have been assigned to provide the meal support.

Before meal times

During parts of treatment, it might be necessary for you as the parent or carers, to shop and prepare the food, without the input of your child. This is to try to support your child with managing difficult and intrusive thoughts around food.

If your child tries to become too involved with preparing or cooking the meal, as a way to control what goes into the food, you could gently ask them to help with setting the table, or washing up.

The eating disorder may try to influence the size of the plate or cutlery that your child or young person uses, for example, a teaspoon or small plate. Make sure that appropriate plates and cutlery are used, dependent on the meal.

If your child is taking an active part in meal prepping and cooking, discourage weighing, measuring, calorie counting and label checking. Also discourage eating alone.

Discourage drinking large amounts of water or fizzy drinks either before the meal, or during the meal, as this can impact on the amount of food eaten.

Avoid low calorie options (of both food and drink).

Prompt your child to use the toilet before meals and snacks, so that this can be avoided after eating.

During the mealtime

Try to eat in a calm and relaxed environment. Encourage all family members to positively role model by eating regular, balanced meals.

Try not to focus on your child during mealtimes. Try to focus on enjoying your own meal and try to make conversation. Keep conversations light and positive and should be about subjects other than food.

It can be difficult for your child to speak about their feelings about food whilst they are eating. Try to distract your child with topics about everyday things, such as pets, TV programmes and so on. It might be that your child responds well to distraction techniques such as watching a favourite programme on a streaming site, or their favourite movie.

When a child is struggling to eat the meal, try to avoid persuasion and bargaining, in an attempt to encourage their food intake. Instead, try to use distraction techniques and positive language.

Throughout the meal, stay aware of your child playing with food, dropping or hiding of food, and cutting or tearing food into smaller pieces. These actions should be identified and discouraged. Also, discussions or negotiations around how much food will be eaten should be avoided.

Your child should be encouraged to eat their meal within around 30 minutes. This is to encourage a more normal eating pattern.

After the meal

We suggest engaging your child in an activity that is restful and relaxing for around 30 minutes after a meal or snack. This can include watching a TV programme together, drawing or colouring, or playing a game. This can help your child distract themselves from distressing anorexic thoughts and feelings of anxiety.

Snacks

Provide what is advised on the meal plan if your child does not have a choice in choosing their snack.

If your child has a choice in their snacks, only offer a choice of 2 snacks. More than this can become overwhelming and your child might not be able to make a decision. If your child does become overwhelmed, then give them a snack that your have chosen.

Your child should be encouraged to eat their snack within around 15 minutes. This is to encourage a more normal eating pattern.

Our team can provide support from our specialist dietitian, who can advise you about suitable snacks to offer.

Remember

It is normal for your child to experience distress and high levels of anxiety around mealtimes. Also, it is common for this distress and anxiety to temporarily increase as a result of re-feeding.

As a parent or carer, it is understandable that you want to minimise this distress and anxiety for your child. Many parents and carers back off when they notice this anxiety or distress that is caused by eating. However, standing firm against the eating disorder behaviours, whilst offering support and kindness is the key to reducing your child or young person’s anxiety and turning the situation around.

Further resources

Eva Musby has some accessible and supportive information for parents and carers around mealtimes. Watch the Meal support tips video and Helping your child eat with trust video.

Maudsley Parents is a volunteer organization founded in 2006 to offer hope and help to families confronting eating disorders.

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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: MH86

Resource Type: Article

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