1 00:00:00,080 --> 00:00:04,640 Sometimes when children suddenly stop eating something that they 2 00:00:05,440 --> 00:00:07,960 used to like, you want to pay attention. 3 00:00:07,960 --> 00:00:12,280 So if it lasts for a long time, kind of that's another clue for 4 00:00:12,280 --> 00:00:15,680 us to be curious and to look under the surface what what has 5 00:00:15,680 --> 00:00:18,120 happened maybe in those past couple weeks? 6 00:00:19,400 --> 00:00:23,640 Was there a stressful move? Transition, new school? 7 00:00:24,120 --> 00:00:25,840 All these things can really impact. 8 00:00:33,320 --> 00:00:35,800 This podcast shares personal stories and professional 9 00:00:35,800 --> 00:00:38,440 insights, but it's not a substitute for medical advice or 10 00:00:38,440 --> 00:00:40,760 therapy. If you're looking for support, 11 00:00:40,760 --> 00:00:43,640 do speak to someone qualified and trained in child development 12 00:00:43,640 --> 00:00:46,680 or special needs care. You'll find the full disclaimer 13 00:00:46,680 --> 00:00:48,200 on the screen and in the show note. 14 00:00:50,640 --> 00:00:53,840 Welcome to another episode of Adapting Together podcast. 15 00:00:53,840 --> 00:00:57,320 My name is Cindy and together with me today we have two 16 00:00:57,320 --> 00:00:59,960 amazing Co hosts, Kevin and Carmen. 17 00:00:59,960 --> 00:01:04,720 We are a podcast to empower, support and inspire parents and 18 00:01:04,720 --> 00:01:07,640 caregivers with neurodivergent children. 19 00:01:08,320 --> 00:01:13,040 Right, today we're going to talk about feeding and nutrition, 20 00:01:13,200 --> 00:01:16,800 which is a topic that many family finds it stressful. 21 00:01:17,400 --> 00:01:21,760 Parents might have children who refuses to eat, for example, 22 00:01:22,000 --> 00:01:24,680 only eat food of a certain certain. 23 00:01:24,840 --> 00:01:26,560 Time. Yeah, certain times. 24 00:01:27,640 --> 00:01:32,360 We need to breathe and eat every day and when our child don't 25 00:01:32,400 --> 00:01:37,400 eat, then to the parents, what am I going to do is like the end 26 00:01:37,400 --> 00:01:40,680 of the world kind of thing. And then we will try our best to 27 00:01:41,000 --> 00:01:44,520 either convince them to eat or try to make them want the food 28 00:01:44,520 --> 00:01:47,320 attractive enough for the food child to accept. 29 00:01:48,040 --> 00:01:51,080 But certain time for my own experience throughout the last 30 00:01:51,080 --> 00:01:54,920 three years, we have a lot of up and down when it comes to eating 31 00:01:55,400 --> 00:01:58,840 and it's not easy. Sometimes we stress the parents, 32 00:01:59,080 --> 00:02:03,480 left, right, centre. If you also felt like eating is 33 00:02:03,480 --> 00:02:06,440 a daily battle, I think this episode is really for you. 34 00:02:07,040 --> 00:02:11,240 We are very honored to have a registered dietitian and also 35 00:02:11,240 --> 00:02:14,000 the Co founder of Fat to Flourish with us today. 36 00:02:14,000 --> 00:02:19,040 Jenny, thank you for agreeing to do to be our guest today. 37 00:02:19,880 --> 00:02:24,520 Thank you so much for having me. Can you share with our audience 38 00:02:24,520 --> 00:02:26,720 a little bit of your professional background? 39 00:02:27,200 --> 00:02:29,640 Sure. Yeah, I worked as a registered 40 00:02:29,640 --> 00:02:32,640 dietitian. I'm actually from California, 41 00:02:32,760 --> 00:02:37,480 USA, so I worked there for about 10 years before I became a mom. 42 00:02:38,160 --> 00:02:42,080 And then a few years ago, we've been in Malaysia for like 4 43 00:02:42,080 --> 00:02:46,760 years now. And so during that season when I 44 00:02:46,880 --> 00:02:51,720 was parenting, I experienced a different side of feeding and 45 00:02:51,720 --> 00:02:54,560 nutrition compared to my professional side. 46 00:02:54,560 --> 00:02:58,840 And so that's really when I got into supporting families and 47 00:02:58,960 --> 00:03:00,800 that's what we're here to do today. 48 00:03:02,720 --> 00:03:04,640 Right. Can you share with our listeners 49 00:03:04,800 --> 00:03:07,200 what your role as a dietitian looks like? 50 00:03:07,840 --> 00:03:11,080 Yeah. So my role as a dietitian has 51 00:03:11,080 --> 00:03:14,200 really evolved over the years. And a lot of that is because 52 00:03:14,960 --> 00:03:18,160 recently, in the past decade or so, we've just had a lot more 53 00:03:18,160 --> 00:03:23,000 research done on pediatric feeding disorders, ARPIID, as 54 00:03:23,000 --> 00:03:27,760 well as neurodiversity and autism and trauma, and how all 55 00:03:27,760 --> 00:03:30,400 of these different things can impact eating. 56 00:03:30,720 --> 00:03:35,400 And so my role is to help kids and their families move toward 57 00:03:35,400 --> 00:03:40,720 that connected meal time, which means kids and their families 58 00:03:41,040 --> 00:03:46,800 can have calm, safe, enjoyable meal times, which can feel very 59 00:03:47,480 --> 00:03:50,760 far for kids and families with feeding challenges. 60 00:03:51,120 --> 00:03:55,680 And so we really have to take a more holistic perspective and 61 00:03:55,680 --> 00:03:58,200 approach to addressing these feeding challenges. 62 00:03:58,840 --> 00:04:02,480 We can't just focus on the food and the nutrition. 63 00:04:02,680 --> 00:04:05,800 We have to look at all the different factors that impact 64 00:04:05,840 --> 00:04:09,000 eating. And so I've been really blessed 65 00:04:09,080 --> 00:04:12,880 to work with some amazing speech therapists, both on our team as 66 00:04:12,880 --> 00:04:16,839 well as internationally who've been working with kids with 67 00:04:16,839 --> 00:04:21,040 feeding challenges for a while. And so getting that holistic, 68 00:04:21,040 --> 00:04:24,600 multidisciplinary approach to feeding is really helpful. 69 00:04:25,880 --> 00:04:28,520 Occupational therapists and clinical psychologists can 70 00:04:28,520 --> 00:04:32,640 really add a lot of input into these cases as well. 71 00:04:32,640 --> 00:04:36,280 Yeah. So very important thing. 72 00:04:36,280 --> 00:04:41,280 Music to my ears. Yeah. 73 00:04:42,240 --> 00:04:47,160 How I mean we, we may, we may have this perception that you as 74 00:04:47,160 --> 00:04:50,760 a Asian, we eat rice is our main staple food. 75 00:04:51,120 --> 00:04:55,520 So when my son stop taking rice to us, it's like something is 76 00:04:55,520 --> 00:04:58,400 not right and we have to immediately find a solution 77 00:04:58,400 --> 00:05:03,160 because he cannot not eat rice. I eat rice most of the, 78 00:05:03,560 --> 00:05:06,000 especially dinner. So when he don't take that, it 79 00:05:06,000 --> 00:05:09,960 becomes like, you know, the cause for panic and it stresses 80 00:05:10,080 --> 00:05:10,600 out. Yeah. 81 00:05:10,600 --> 00:05:13,240 Yeah. And I think I'm not the only 82 00:05:13,240 --> 00:05:14,800 parents who went through that. Yeah. 83 00:05:15,080 --> 00:05:16,920 Yeah. Yeah, definitely. 84 00:05:17,240 --> 00:05:21,400 So in what way does the food we feed our children or food affect 85 00:05:21,400 --> 00:05:26,920 them and their autism so. Yeah, food eating, you know, can 86 00:05:26,920 --> 00:05:30,840 definitely impact their mood, which impacts their behavior, 87 00:05:31,160 --> 00:05:32,800 and that can be really challenging. 88 00:05:33,080 --> 00:05:36,680 I think there's also a lot of, like, theories and opinions out 89 00:05:36,680 --> 00:05:39,880 there about how, you know, specific foods and specific 90 00:05:39,880 --> 00:05:44,600 nutrients can impact autism. And we have to really listen to 91 00:05:44,600 --> 00:05:49,600 that with kind of a, a critical eye, not taking everything we 92 00:05:49,600 --> 00:05:53,360 hear as facts and also stay open minded. 93 00:05:53,360 --> 00:05:58,000 So because research is always changing, recommendations are 94 00:05:58,000 --> 00:06:00,880 always changing. And so we kind of have to like 95 00:06:01,120 --> 00:06:04,640 be a little bit open minded and critical in what we listen to. 96 00:06:05,240 --> 00:06:07,960 But the things that we do know is that everyone needs to eat 97 00:06:08,400 --> 00:06:11,680 autistic or neurotypical, everyone needs that nutrition. 98 00:06:11,720 --> 00:06:15,320 We know that to be true. And we also know that kids with 99 00:06:15,360 --> 00:06:20,040 autism can be at a higher risk or tend to have more feeding 100 00:06:20,040 --> 00:06:22,240 challenges than a neurotypical child. 101 00:06:22,560 --> 00:06:25,760 So how do we take those two things and make them work 102 00:06:25,760 --> 00:06:28,080 together? And that's going to be a balance 103 00:06:28,080 --> 00:06:31,920 that we have to find that's going to be very unique to each 104 00:06:31,920 --> 00:06:36,960 family and each individual. So based on your experience 105 00:06:36,960 --> 00:06:40,560 working with parents all these years, what would be the common 106 00:06:40,560 --> 00:06:45,160 misconception that parents can learn about feeding and 107 00:06:45,480 --> 00:06:47,560 nutrition? Yeah. 108 00:06:47,960 --> 00:06:52,040 You know, parents, it's very easy for us to get stuck on 109 00:06:52,760 --> 00:06:59,160 eating rice. Yes, we see the behavior and if 110 00:06:59,320 --> 00:07:02,480 we're familiar with that iceberg analogy, we see the tip of the 111 00:07:02,480 --> 00:07:05,760 iceberg, the child's not eating and we need them to eat. 112 00:07:06,080 --> 00:07:10,480 But a lot of times parents aren't seeing all the things 113 00:07:10,480 --> 00:07:13,520 that are happening under the surface of, you know, under the 114 00:07:13,520 --> 00:07:16,800 surface of the water. So all the things that lead to 115 00:07:16,800 --> 00:07:19,520 these feeding challenges. It could be maybe they don't 116 00:07:19,520 --> 00:07:23,520 have those oral motor skills to chew the food, or it could be 117 00:07:23,520 --> 00:07:27,160 sensory issues that are making it hard for them to tolerate 118 00:07:27,200 --> 00:07:29,600 different textures, different smells. 119 00:07:30,440 --> 00:07:35,480 It could be even stress and anxiety that impact how they eat 120 00:07:35,480 --> 00:07:39,040 and you know if impact their appetite and their digestion. 121 00:07:39,040 --> 00:07:42,000 So we have to look at all the things that are happening 122 00:07:42,000 --> 00:07:44,760 underneath the surface and those behaviors. 123 00:07:45,160 --> 00:07:50,600 The picky eating that we focus on is a clue to help us pause 124 00:07:50,600 --> 00:07:52,680 and be curious about what's going on. 125 00:07:52,680 --> 00:07:56,840 If we just look at what's happening on the surface and we 126 00:07:56,840 --> 00:07:59,840 don't think about all the things, then we could end up 127 00:07:59,840 --> 00:08:03,680 with a bigger problem. It's it's will be every day will 128 00:08:03,680 --> 00:08:05,200 be a battle, right? Yeah. 129 00:08:05,440 --> 00:08:08,520 Because I think it's very important that yes, we see like 130 00:08:08,520 --> 00:08:11,040 you see, the iceberg is actually not eating, you know, and our 131 00:08:11,040 --> 00:08:14,400 target is making them to eat. But then what is the fundamental 132 00:08:14,400 --> 00:08:18,560 the core issue could be like you see sensory could be due to 133 00:08:19,120 --> 00:08:23,960 texture, could be due to just mood and all this thing, right. 134 00:08:23,960 --> 00:08:26,560 Yeah. So I think yeah, as a parents 135 00:08:26,560 --> 00:08:29,200 has to be like a detective, as I always tell parents, the 136 00:08:29,200 --> 00:08:33,679 detective to find out more is a core, core issue in order to 137 00:08:33,720 --> 00:08:36,720 achieve what we want them to achieve. 138 00:08:36,720 --> 00:08:39,039 Yeah, yeah, I. Mean if we just look at the 139 00:08:39,039 --> 00:08:43,159 surface, which is the behavior of not eating sometimes his 140 00:08:43,159 --> 00:08:47,000 parents also at risk of making conclusion that the child is not 141 00:08:47,000 --> 00:08:49,560 cooperating. Yeah, naughty. 142 00:08:49,560 --> 00:08:53,800 You don't listen to instruction and we miss out to really 143 00:08:53,800 --> 00:08:58,000 understand what's going on. So I guess what you said is we 144 00:08:58,000 --> 00:09:02,600 also need to be curious and seek first to understand what 145 00:09:02,600 --> 00:09:06,120 actually caused this behavior instead of trying to correct the 146 00:09:06,120 --> 00:09:10,200 behavior itself. Yeah, it's not easy and it takes 147 00:09:10,200 --> 00:09:11,920 time. Patients a lot. 148 00:09:12,360 --> 00:09:16,480 Of patients. What age should the parents 149 00:09:16,480 --> 00:09:20,640 start paying closer attention to feeding patterns? 150 00:09:21,320 --> 00:09:27,720 Yeah, I would say at birth, as early as possible when you start 151 00:09:27,720 --> 00:09:31,280 noticing something like that's a clue that something's not 152 00:09:31,560 --> 00:09:35,400 working as it should. Babies, even before they're 153 00:09:35,400 --> 00:09:38,480 born, are making those neural connections in their brain 154 00:09:39,240 --> 00:09:42,080 between the act of eating, so sucking and swallowing. 155 00:09:42,080 --> 00:09:44,480 Even before they're born, they're sucking their thumb in 156 00:09:44,480 --> 00:09:48,000 the mom's tummy, they're swallowing the amniotic fluid, 157 00:09:48,880 --> 00:09:50,880 and they're making that connection with the feeling of 158 00:09:50,880 --> 00:09:53,520 being safe and comforted in the mom's womb. 159 00:09:54,000 --> 00:09:57,720 When they're born, you put them to the breast, they're sucking, 160 00:09:57,720 --> 00:10:00,520 they're swallowing, they're learning to eat, and they're 161 00:10:00,520 --> 00:10:05,240 making that connection between the act of eating and being held 162 00:10:05,240 --> 00:10:09,440 and safe in mom's arms. But when there's like some 163 00:10:09,440 --> 00:10:12,520 medical conditions, maybe they're born early, they're 164 00:10:12,520 --> 00:10:16,320 staying in the NICU, they have tubes going down their throat or 165 00:10:16,600 --> 00:10:19,480 they're getting poked and pricked for tests. 166 00:10:19,760 --> 00:10:24,280 Mom's not always available, so they they might have those 167 00:10:24,280 --> 00:10:28,440 associations of being fed and maybe they're not even ready to 168 00:10:28,440 --> 00:10:30,440 be fed orally, so they're choking. 169 00:10:30,440 --> 00:10:33,200 So they're making those associations with the feeling of 170 00:10:33,200 --> 00:10:37,000 being uncomfortable, in pain. Yeah. 171 00:10:37,120 --> 00:10:41,280 So it might affect the later on we are trying to feed him. 172 00:10:41,360 --> 00:10:45,360 Yeah, yeah, it can. It can definitely lead to oral 173 00:10:45,360 --> 00:10:48,480 aversions. And so whenever you start 174 00:10:48,480 --> 00:10:52,960 noticing, that's the moment to start being curious and start 175 00:10:52,960 --> 00:10:57,600 trying to create more positive associations with eating. 176 00:10:58,480 --> 00:11:03,520 The good news is that at any age, your brain is neuroplastic. 177 00:11:03,720 --> 00:11:06,800 So you can at any age, whether they're toddlers or older kids, 178 00:11:06,800 --> 00:11:09,480 you can start making those positive associations. 179 00:11:10,000 --> 00:11:11,400 So that's the hopeful part of it. 180 00:11:13,120 --> 00:11:18,040 As young as they are just born as an infant, how do parents try 181 00:11:18,040 --> 00:11:22,080 to observe or notice that some signs attention. 182 00:11:22,240 --> 00:11:25,440 That's that's really important. You want to pay attention to 183 00:11:26,680 --> 00:11:29,920 their hunger and fullness cues. Sometimes parents get really 184 00:11:29,920 --> 00:11:33,520 stuck on, they have to finish this bottle, but the baby's like 185 00:11:33,520 --> 00:11:35,960 pushing it away. And so, you know that they don't 186 00:11:35,960 --> 00:11:39,000 want it. Maybe either they're full or 187 00:11:39,000 --> 00:11:41,520 maybe it's uncomfortable for them. 188 00:11:41,520 --> 00:11:44,960 Maybe the flow is too fast and they're getting too much so they 189 00:11:44,960 --> 00:11:47,200 can't breathe. So those are all signs that we 190 00:11:47,200 --> 00:11:50,800 have to pay attention to. And you know, sometimes parents 191 00:11:50,800 --> 00:11:53,280 will do everything to just get the milk into their mouth 192 00:11:53,280 --> 00:11:56,920 thinking. That it's the right thing to do. 193 00:11:56,960 --> 00:11:59,400 Of course, yes, because that's what they know, that's it's 194 00:11:59,400 --> 00:12:01,880 natural, like their job is to feed the baby. 195 00:12:02,080 --> 00:12:06,000 But when we miss all these clues, then that can lead to, 196 00:12:06,240 --> 00:12:10,280 you know, different problems. To say that for babies who are 197 00:12:10,280 --> 00:12:15,640 on breastfeeding is less chances of this kind of being made to 198 00:12:15,720 --> 00:12:18,960 finish the meal because we were taught that when the babies is 199 00:12:18,960 --> 00:12:21,840 full, they will just naturally detach or just push away. 200 00:12:21,840 --> 00:12:25,080 So we know that OK, it's finished already, full already. 201 00:12:26,000 --> 00:12:32,000 Yeah, breastfeeding is can be a lot easier to kind of tune into 202 00:12:32,000 --> 00:12:35,440 their cues because of the way our bodies created. 203 00:12:35,440 --> 00:12:38,440 Like it's that's not the natural way. 204 00:12:38,720 --> 00:12:43,680 Even the flow of the milk that comes out is tailored to, you 205 00:12:43,680 --> 00:12:46,240 know, what the baby needs. Even the content, the 206 00:12:46,240 --> 00:12:50,160 nutritional content of the milk is tailored to what the child 207 00:12:50,160 --> 00:12:53,080 needs. So it's really amazing, yeah. 208 00:12:53,360 --> 00:12:57,040 Thanks Jenny's for telling us so much more from born like the 209 00:12:57,080 --> 00:13:00,680 babies. I'm also curious about when when 210 00:13:00,680 --> 00:13:02,680 they started growing up like becoming a toddler. 211 00:13:02,680 --> 00:13:05,160 What are some of the signs that for toddler that you would 212 00:13:05,160 --> 00:13:10,760 suggest the parents to start seeing a dietitian or or to do a 213 00:13:10,760 --> 00:13:15,400 nutrition assessment when they have detected all this all this 214 00:13:15,400 --> 00:13:18,880 signs? I would say if they're eating 215 00:13:19,320 --> 00:13:23,320 less than 15 different foods, that's a sign that one size. 216 00:13:23,720 --> 00:13:27,120 Yeah, 1515 different types of foods. 217 00:13:27,120 --> 00:13:28,880 That's just kind of like a an idea and that. 218 00:13:29,040 --> 00:13:31,560 Idea. Yeah, yeah. 219 00:13:31,880 --> 00:13:35,480 Also, if they tend to avoid like, certain textures, they 220 00:13:35,520 --> 00:13:39,160 only eat blended food, that's also something to pay attention 221 00:13:39,160 --> 00:13:41,880 to. Or if they only eat, you know, 222 00:13:41,880 --> 00:13:46,520 certain, you know, avoid all meats, then those are things 223 00:13:46,520 --> 00:13:49,840 that can give us a clue. Also, you know, if they're not 224 00:13:49,840 --> 00:13:53,960 growing well, if they're not gaining weight over a period of 225 00:13:53,960 --> 00:13:59,000 time, that's also a flag that something might be. 226 00:13:59,400 --> 00:14:04,040 Yeah, yeah. So the number of food they take 227 00:14:04,160 --> 00:14:07,640 and their growth path, anything else? 228 00:14:08,520 --> 00:14:12,560 The types of foods that they're eating, you can kind of look at 229 00:14:12,560 --> 00:14:15,480 their physical like are they very lethargic? 230 00:14:15,480 --> 00:14:18,200 Do they have any enough energy for the day? 231 00:14:19,960 --> 00:14:23,640 Sometimes they're physical features like hair, nails, skin 232 00:14:23,960 --> 00:14:28,280 can be yeah yeah of nutritional deficiencies. 233 00:14:28,760 --> 00:14:31,640 Yeah. When you say 15 types of foods, 234 00:14:31,640 --> 00:14:35,000 right, that's the kind of like a junk food kind of bee snacks. 235 00:14:35,080 --> 00:14:36,720 All counts. I would. 236 00:14:36,880 --> 00:14:43,360 I would count that I would. Count that. 237 00:14:46,440 --> 00:14:49,720 I mean, like, you think of potatoes, you have French fries, 238 00:14:49,720 --> 00:14:51,720 potato chips and mashed potatoes. 239 00:14:55,880 --> 00:15:00,920 Yeah, they're very different. I see. 240 00:15:01,080 --> 00:15:03,880 So for parents who meet you for the first time, what could you, 241 00:15:04,040 --> 00:15:08,200 what could they expect like in the initial initial session? 242 00:15:08,240 --> 00:15:11,160 Yeah, so I first start with an intake. 243 00:15:12,000 --> 00:15:15,360 Would want them to fill out a form if they can and then when 244 00:15:15,360 --> 00:15:17,240 they come in then I talk with them. 245 00:15:17,320 --> 00:15:19,600 We have an interview. I really want to get to know 246 00:15:20,240 --> 00:15:24,200 what are their concerns? What is the child struggling 247 00:15:24,200 --> 00:15:27,640 with and also what does their day look like? 248 00:15:27,640 --> 00:15:30,600 What does the child's day look like from the morning to night 249 00:15:30,600 --> 00:15:34,200 time when they go to sleep? What are they eating and how are 250 00:15:34,200 --> 00:15:36,440 they eating it? Do they eat with the helper by 251 00:15:36,440 --> 00:15:38,520 themselves? Are they eating with the family? 252 00:15:38,840 --> 00:15:41,800 Are they eating in school? So I want to know all these 253 00:15:41,800 --> 00:15:43,720 different things, how are they sleeping? 254 00:15:43,720 --> 00:15:47,040 Are they toileting normally? All these different things that 255 00:15:47,040 --> 00:15:49,840 can impact how they eat. So I want to get a pretty good 256 00:15:49,840 --> 00:15:53,200 idea of that. So that that's the big part of 257 00:15:53,200 --> 00:15:55,640 it. Also getting to know the child. 258 00:15:55,640 --> 00:15:58,560 So building that trust with the child is really important, 259 00:15:59,160 --> 00:16:02,800 especially on the first visit. I want them to know that this 260 00:16:02,800 --> 00:16:06,760 place is safe and comfortable so that they're not dysregulated 261 00:16:06,760 --> 00:16:09,840 when they come, so that they're not scared when they're coming. 262 00:16:10,080 --> 00:16:13,960 And that will really impact therapy, ongoing therapy, 263 00:16:14,640 --> 00:16:18,480 because when they're comfortable and regulated, that's when they 264 00:16:18,480 --> 00:16:23,600 can learn and grow. And then also I want to observe. 265 00:16:23,600 --> 00:16:27,000 So I want, I asked parents to bring some foods that the child 266 00:16:27,000 --> 00:16:29,440 likes to eat so that I can see them eating. 267 00:16:30,120 --> 00:16:32,920 I watch how they're chewing the food, how they're swallowing. 268 00:16:32,920 --> 00:16:35,120 Is it, you know, spilling out of their mouth? 269 00:16:35,120 --> 00:16:39,240 Or does a child have a really hard time with anything touching 270 00:16:39,240 --> 00:16:44,480 their face or So those are some clues that help me figure out. 271 00:16:44,480 --> 00:16:49,280 Like what is the thing under the surface that is causing it to be 272 00:16:49,280 --> 00:16:52,840 hard for the child to eat? Very interesting. 273 00:16:54,360 --> 00:16:58,360 I'm trying to process like quite a lot of things that you need to 274 00:17:00,200 --> 00:17:04,280 during that period of time. And and we know that that if a 275 00:17:04,920 --> 00:17:08,640 child on the spectrum first time coming, definitely that's quite 276 00:17:08,640 --> 00:17:11,359 challenging. Sometimes they'll be not they 277 00:17:11,359 --> 00:17:14,040 don't have a raffle with you and yet you have to do quite a 278 00:17:14,040 --> 00:17:16,800 number of things. Yeah, and sometimes it doesn't 279 00:17:16,880 --> 00:17:19,440 always happen on the 1st. Visit it has to. 280 00:17:19,920 --> 00:17:24,160 Yeah, sometimes it takes time to discover just. 281 00:17:24,440 --> 00:17:25,720 It depends on. Yeah. 282 00:17:25,880 --> 00:17:28,600 OK. I was thinking what say just 283 00:17:28,600 --> 00:17:33,280 now, it's really very holistic because you try to really not 284 00:17:33,280 --> 00:17:36,640 just looking at what they eat now, but you also want to 285 00:17:36,640 --> 00:17:39,480 understand the day-to-day activities, what they do. 286 00:17:39,840 --> 00:17:43,240 So there's a lot of things that, you know, really very holistic, 287 00:17:43,320 --> 00:17:46,760 understanding the whole family, their lifestyle and whatnot, 288 00:17:47,040 --> 00:17:50,880 which I suppose can gives you a lot of insights and cue about 289 00:17:51,120 --> 00:17:54,800 why certain thing happens, which really go underneath the iceberg 290 00:17:55,040 --> 00:17:56,840 to check all the possible causes. 291 00:17:56,840 --> 00:17:59,040 Yeah. Sometimes parents just want the 292 00:17:59,040 --> 00:18:02,840 child to eat, but we have to understand that there's so much 293 00:18:02,840 --> 00:18:05,800 more that goes into it at. Least I was also wondering for 294 00:18:06,040 --> 00:18:09,680 the all the things you do during the first intake sessions, 295 00:18:10,040 --> 00:18:13,040 usually how long the sessions will be, 19 minutes or 16 296 00:18:13,080 --> 00:18:15,120 minutes? Oh, our first intake session 297 00:18:15,120 --> 00:18:21,440 will be 60 minutes, Yeah. Right, Janice, for new parents 298 00:18:21,440 --> 00:18:25,640 who just received a diagnosis, what are the first nutrition a 299 00:18:25,640 --> 00:18:29,400 priorities that that they should focus on? 300 00:18:30,040 --> 00:18:34,440 Yeah, so it really depends, because not all kids with autism 301 00:18:34,440 --> 00:18:38,160 have feeding challenges. So we really want to look at 302 00:18:38,840 --> 00:18:43,080 does this kid have a child? Does this child have a risk for 303 00:18:43,080 --> 00:18:46,840 nutritional deficiency? And so if they do, if they do 304 00:18:46,840 --> 00:18:50,120 have feeding challenges, then we want to identify what are the 305 00:18:50,120 --> 00:18:52,920 nutritional deficiencies that they might be at risk for and 306 00:18:52,920 --> 00:18:57,560 how can we address that? And so that looks different for 307 00:18:57,560 --> 00:18:59,600 every child. We want to be able to address it 308 00:18:59,600 --> 00:19:03,680 in a way that feels comfortable and safe and tolerable for the 309 00:19:03,680 --> 00:19:06,080 child. So if they're not eating meat, 310 00:19:06,560 --> 00:19:09,600 how can we make sure that they're getting the protein that 311 00:19:09,600 --> 00:19:12,440 they need? Are there other things that they 312 00:19:12,680 --> 00:19:15,720 are able to tolerate that they're willing to take that can 313 00:19:15,720 --> 00:19:20,280 provide that protein? So addressing those nutritional 314 00:19:20,280 --> 00:19:24,840 deficiencies in in a way that feels comfortable, in a way that 315 00:19:24,840 --> 00:19:30,200 can let meal time still be positive, not stressful. 316 00:19:30,400 --> 00:19:33,960 That's really important. Eating is such a social thing, 317 00:19:33,960 --> 00:19:36,800 especially in Malaysian culture, right? 318 00:19:38,200 --> 00:19:42,840 And so we want for our kids with autism, you know, that can look 319 00:19:42,840 --> 00:19:46,240 different, that social aspect can look different when it comes 320 00:19:46,240 --> 00:19:48,920 to eating as well. But how can they feel 321 00:19:48,920 --> 00:19:53,160 comfortable? How can eating be enjoyable for 322 00:19:53,160 --> 00:19:56,400 them? And for some kids, they may have 323 00:19:56,400 --> 00:20:00,120 that sensitivity to sound. They may not be able to tolerate 324 00:20:00,440 --> 00:20:02,800 the sound of someone else eating next to them. 325 00:20:02,800 --> 00:20:06,960 So maybe for them you can have them eat with you, but you're 326 00:20:06,960 --> 00:20:09,800 not really. Eating with them. 327 00:20:10,080 --> 00:20:13,480 And so that's one way to kind of adapt and adjust for their 328 00:20:13,480 --> 00:20:17,520 individual needs. I believe a lot of our listener 329 00:20:17,520 --> 00:20:22,080 would like to know like whether they chop their children really 330 00:20:22,080 --> 00:20:25,480 need to eat veggie or fruits because this is something that I 331 00:20:25,480 --> 00:20:29,360 always encounter when parents always come and tell us, come 332 00:20:29,560 --> 00:20:32,920 on, you know, my child is not eating veggie, is not eating 333 00:20:32,920 --> 00:20:34,160 fruits. But in my mind is that there's 334 00:20:34,160 --> 00:20:38,480 so many people that's not eating so and fruits and yet they are 335 00:20:38,480 --> 00:20:40,480 growing. Well, just would like to hear 336 00:20:40,480 --> 00:20:43,680 from you, you know, So what is your comment? 337 00:20:43,680 --> 00:20:46,840 And yes, yes. You know, veggies and fruits are 338 00:20:46,840 --> 00:20:53,720 great, yes, but I think if a child cannot tolerate that, 339 00:20:54,160 --> 00:20:57,800 they're not eating that, how can we find other things that a 340 00:20:57,800 --> 00:21:01,360 replacement, Yes, that can provide those vitamins, the 341 00:21:01,360 --> 00:21:04,520 thyroid, yeah, well, they take a smoothie. 342 00:21:04,520 --> 00:21:08,720 So how can we kind of think outside of the box and not focus 343 00:21:08,720 --> 00:21:11,600 so much on they have to eat these things? 344 00:21:13,400 --> 00:21:15,640 Yes. What are some most common 345 00:21:15,640 --> 00:21:19,920 nutrition or feeding challenges you see among children with 346 00:21:20,440 --> 00:21:24,680 autism? Yeah, so kids with autism, I 347 00:21:24,680 --> 00:21:29,160 would say a lot of the sensory needs would be a real challenge. 348 00:21:29,160 --> 00:21:32,160 So it's not just the food. It's not just the texture of the 349 00:21:32,160 --> 00:21:35,800 food or the smell of the food, but it could be the lights in 350 00:21:35,800 --> 00:21:38,520 the room that they're eating. It could be the sounds that 351 00:21:38,520 --> 00:21:41,440 they're hearing that are causing them to feel really just 352 00:21:41,440 --> 00:21:43,720 regulated and their body is stressed. 353 00:21:43,720 --> 00:21:47,120 And when their body is stressed, you know, you don't feel hungry, 354 00:21:47,160 --> 00:21:49,600 right? So there's so many different 355 00:21:49,600 --> 00:21:53,440 things when it comes to like sensory processing that can 356 00:21:53,560 --> 00:21:56,640 impact eating. That that explain a lot and I 357 00:21:56,640 --> 00:22:01,920 can relate very well to this. I mean for the first 2-3 years, 358 00:22:02,720 --> 00:22:07,480 I mean two to three years ago I noticed that if we go to normal 359 00:22:07,480 --> 00:22:11,000 restaurant or food shop, my son wouldn't want to eat there. 360 00:22:11,320 --> 00:22:15,640 Then he will definitely eat when he goes to high end restaurant, 361 00:22:17,120 --> 00:22:21,240 which is the ambiance is a lot better and maybe have background 362 00:22:21,240 --> 00:22:24,400 music that is soft not noisy one and he can eat that. 363 00:22:24,840 --> 00:22:27,520 So it's like dinner and we want to go out with him. 364 00:22:27,800 --> 00:22:31,720 We have to go to places that require us to spend a bit more 365 00:22:32,000 --> 00:22:34,720 the tearingage for the. Kind of places, but. 366 00:22:34,800 --> 00:22:36,640 He eats and we happily goes to there. 367 00:22:37,280 --> 00:22:39,520 Yeah, and I really enjoy also the food. 368 00:22:42,320 --> 00:22:45,800 Lucky boy. But as he grow up older now he 369 00:22:45,800 --> 00:22:49,960 can eat in normal coffee shop. Yeah, yeah, he can do that. 370 00:22:49,960 --> 00:22:52,480 He can eat. So these are the growth that we 371 00:22:52,480 --> 00:22:54,840 see and the wallet also feel better now. 372 00:22:57,800 --> 00:23:00,880 So, Janice, maybe you can share with us some experience or some 373 00:23:00,880 --> 00:23:06,360 case you know that you have worked with that quite typical, 374 00:23:06,360 --> 00:23:11,600 you know, suitable for audience, maybe some example that how to 375 00:23:11,600 --> 00:23:18,040 journey with the child. You know, we have, let's see, we 376 00:23:18,040 --> 00:23:23,560 have a lot of different cases. I think sometimes it's it's that 377 00:23:23,560 --> 00:23:27,280 oral motor skill or that that sensory input in their mouth. 378 00:23:27,480 --> 00:23:33,440 So some kids, they don't have the oral motor skills to be able 379 00:23:33,440 --> 00:23:36,520 to chew properly. And so the food in their mouth, 380 00:23:37,160 --> 00:23:41,440 maybe they have a hard time moving it around and so they 381 00:23:41,440 --> 00:23:44,600 tend to prefer certain textures over others. 382 00:23:46,120 --> 00:23:50,920 Sometimes they need, they need a lot more sensory input so that 383 00:23:50,920 --> 00:23:54,920 crunchy food in their mouth, that feeling as opposed to the 384 00:23:54,920 --> 00:23:57,280 blended food feels better because they know how to 385 00:23:57,280 --> 00:24:02,240 manipulate it in their mouth. And so giving them that type of 386 00:24:02,240 --> 00:24:06,600 texture will help them to kind of map out their mouth, kind of 387 00:24:06,600 --> 00:24:10,000 know what the inside of the mouth looks like, how to move 388 00:24:10,000 --> 00:24:12,880 food around. And then also working on, you 389 00:24:12,880 --> 00:24:16,080 know, the the strength and the movement of the tongue and the 390 00:24:16,080 --> 00:24:21,680 jaw can help with that as well. But we have to go at their pace, 391 00:24:22,360 --> 00:24:24,440 right? So if they're not ready to 392 00:24:24,440 --> 00:24:28,080 progress, you don't want to force them to do these exercises 393 00:24:28,280 --> 00:24:31,480 that feel uncomfortable. We have to kind of take it at 394 00:24:31,480 --> 00:24:35,600 their own pace, yeah. Yeah, and why my son likes to 395 00:24:35,640 --> 00:24:39,400 eat those chips, snacks, all these things. 396 00:24:39,400 --> 00:24:42,680 And he don't like to eat things that are soft in texture. 397 00:24:42,760 --> 00:24:45,000 Yeah. So porridge he has never eaten. 398 00:24:45,480 --> 00:24:47,480 Eat after he passed one year old. 399 00:24:48,480 --> 00:24:50,160 The. The one called what? 400 00:24:51,080 --> 00:24:53,760 Yeah, so and he always look for things to bite. 401 00:24:54,080 --> 00:24:59,960 Yes, yeah. Yeah, no wonder he always eat 402 00:25:00,320 --> 00:25:03,640 any chicken with bones His his touchwood. 403 00:25:03,640 --> 00:25:06,120 Touchwood. It's a it's a sure win when we 404 00:25:06,120 --> 00:25:09,520 give him that drumstick and chicken wing, Yeah. 405 00:25:09,960 --> 00:25:13,280 And I also have seen kids who are Dick toed the other way 406 00:25:13,280 --> 00:25:17,440 around. Only relies on liquid or blends 407 00:25:17,600 --> 00:25:20,960 for a very long time. Yeah, until they've grown up. 408 00:25:20,960 --> 00:25:24,880 But physically they looks OK. I have experience working in 409 00:25:24,880 --> 00:25:29,040 that he looked OK like in terms of weight and high history 410 00:25:29,040 --> 00:25:34,360 growing, but he has never been eating any Sonic before. 411 00:25:35,120 --> 00:25:39,640 So for kids like that who they would also need to be on a 412 00:25:39,640 --> 00:25:42,800 nutritionist, like go on the nutrition assessment and still 413 00:25:42,800 --> 00:25:46,040 working on. Yeah. 414 00:25:46,040 --> 00:25:51,280 We have to really be able to see each individual uniquely and not 415 00:25:51,280 --> 00:25:54,000 have these unrealistic expectations for them. 416 00:25:54,400 --> 00:25:58,840 Some kids may, you know, I think it's not as common here, but 417 00:25:59,040 --> 00:26:04,600 they may need a PEG tube and be fed with formula which can meet 418 00:26:04,600 --> 00:26:06,360 all their nutritional requirements. 419 00:26:07,320 --> 00:26:11,160 And that will give them the time that it takes for them to learn 420 00:26:11,480 --> 00:26:14,000 to enjoy, you know, putting food into their mouth. 421 00:26:14,000 --> 00:26:17,800 And that might be a temporary thing, but sometimes it's better 422 00:26:17,800 --> 00:26:22,280 for them to get that nutrition and not worry about how can we 423 00:26:22,280 --> 00:26:24,720 get it all through their mouth when that feels really hard for 424 00:26:24,720 --> 00:26:27,880 them. So sometimes that that ends up 425 00:26:27,880 --> 00:26:30,280 being the case for. Well, that can be a temporary. 426 00:26:30,480 --> 00:26:32,120 It can be a temporary thing, yeah. 427 00:26:32,480 --> 00:26:35,960 So when they're able to progress, then it can be 428 00:26:35,960 --> 00:26:36,960 removed. That can be removed. 429 00:26:37,040 --> 00:26:38,600 Yeah, I didn't know. I thought it's like. 430 00:26:38,880 --> 00:26:41,720 A forever, No, it's not a yeah, it's not a forever thing. 431 00:26:41,720 --> 00:26:44,760 So I think a lot of times parents are very scared of that. 432 00:26:45,000 --> 00:26:50,080 And it is, I mean, it's a big deal, but it can be very helpful 433 00:26:50,080 --> 00:26:52,920 for some kids who have like a severe oral version. 434 00:26:54,200 --> 00:26:58,080 So does it also can are they also belong to like a picky 435 00:26:58,080 --> 00:27:02,760 eater like in your point of view or how like picky eater has been 436 00:27:02,760 --> 00:27:05,200 a very common terms. You know, I've seen parents and 437 00:27:05,200 --> 00:27:07,720 many of them all my kids are very picky when picky on some 438 00:27:07,720 --> 00:27:10,000 things. But what does it really mean for 439 00:27:10,320 --> 00:27:13,400 from a dietitian perspective? Yeah. 440 00:27:13,640 --> 00:27:17,720 So I think that we're all picky eaters, yeah. 441 00:27:18,720 --> 00:27:21,080 Yeah, I will say I'm very picky eaters. 442 00:27:22,480 --> 00:27:26,680 I think the difference is we've had decades to get used to the 443 00:27:26,680 --> 00:27:30,720 food that we eat. Our kids have like 2345 years to 444 00:27:30,720 --> 00:27:33,720 like, explore all these different foods, and they don't 445 00:27:33,720 --> 00:27:36,200 have all those exposures that we've had. 446 00:27:36,760 --> 00:27:40,240 And I think about, you know, so I grew up in LA and we lived in 447 00:27:40,240 --> 00:27:43,760 New York for a while. Those places have a lot of 448 00:27:43,760 --> 00:27:46,480 different ethnic foods. But when our family moved to 449 00:27:46,480 --> 00:27:49,840 Malaysia, it's still different. It's still different. 450 00:27:50,520 --> 00:27:53,440 Our friends that welcomed us to Malaysia on our very first night 451 00:27:53,440 --> 00:28:02,640 welcomed us with durian. We were not used to durian. 452 00:28:04,000 --> 00:28:07,760 We ate it and it was OK. We had leftovers and we decided 453 00:28:07,760 --> 00:28:14,960 to put it on the balcony for the night, but over time, three out 454 00:28:14,960 --> 00:28:17,560 of five of us are able to eat and enjoy durian. 455 00:28:17,560 --> 00:28:22,240 So it just takes time for us to get used to different foods and 456 00:28:22,240 --> 00:28:25,200 for kids they just haven't had. Enough time, so much. 457 00:28:25,200 --> 00:28:25,960 Time. Yeah. 458 00:28:25,960 --> 00:28:29,480 And so many exposures because especially for picky eaters, 459 00:28:29,480 --> 00:28:32,360 when they're picky, parents may serve them only the food that 460 00:28:32,360 --> 00:28:35,560 they're they like to eat because why would you serve them 461 00:28:35,560 --> 00:28:37,680 something that you know that they're not going to eat? 462 00:28:39,560 --> 00:28:41,680 Yeah. So they just they need some 463 00:28:41,680 --> 00:28:45,680 time. Will the attempt to consistently 464 00:28:45,680 --> 00:28:49,720 offer them something we know most likely they won't accept be 465 00:28:49,720 --> 00:28:52,160 like annoying or something you would discourage? 466 00:28:53,840 --> 00:28:56,800 Yes, annoying. I'll be honest, it's annoying. 467 00:28:58,840 --> 00:29:02,040 It's hard because then you feel like you're wasting food. 468 00:29:03,040 --> 00:29:07,120 I think that it's a good idea to offer them like instead of just 469 00:29:07,120 --> 00:29:09,720 giving them one dish because you know they're going to eat it, 470 00:29:10,120 --> 00:29:13,360 offer them a plate with, you know, maybe like one spoon of 471 00:29:13,360 --> 00:29:17,080 something, one spoon so you don't waste everything just so 472 00:29:17,080 --> 00:29:20,760 that they can see it and you know they can see it. 473 00:29:20,760 --> 00:29:23,320 If they want to touch it, they can touch it. 474 00:29:23,320 --> 00:29:26,880 They can smell it just so that they have that exposure. 475 00:29:27,600 --> 00:29:30,720 But we don't have to have that expectation that they have to 476 00:29:30,720 --> 00:29:38,880 try it if they don't want to. If you want then you can top up 477 00:29:40,440 --> 00:29:44,440 exactly if you OK. We have been talking a lot 478 00:29:44,440 --> 00:29:47,720 about, you know, picky eater and we also definitely have 479 00:29:47,720 --> 00:29:52,280 experience of how the children that tends to over eat like they 480 00:29:52,280 --> 00:29:55,200 will never fool they will. Just. 481 00:29:55,320 --> 00:29:55,560 Stop. Eat. 482 00:29:56,000 --> 00:29:56,840 Yeah. Never stop. 483 00:29:56,920 --> 00:30:00,680 Yeah, maybe 8 meals a day. Yeah. 484 00:30:00,840 --> 00:30:02,720 And they're still looking for more food. 485 00:30:02,800 --> 00:30:05,520 So yeah, maybe you can hear from Jenny's. 486 00:30:05,520 --> 00:30:07,440 What? What's their thought about that? 487 00:30:07,440 --> 00:30:10,880 Yeah. First, I think we need to do a 488 00:30:10,880 --> 00:30:15,080 proper assessment and see, are they, are they overeating or do 489 00:30:15,080 --> 00:30:18,480 they have a really high metabolism or are they in bodies 490 00:30:18,480 --> 00:30:21,680 that are just different, different shape, different size. 491 00:30:22,120 --> 00:30:25,840 So are they really overeating? And if they are, then what is 492 00:30:25,840 --> 00:30:28,480 underneath that surface? You know, why are they 493 00:30:28,480 --> 00:30:30,440 overeating? Is it boredom? 494 00:30:30,480 --> 00:30:35,000 Is it stress? Is it a way to connect with 495 00:30:35,000 --> 00:30:39,360 someone? Is it that they don't they don't 496 00:30:39,360 --> 00:30:41,320 feel? That are they too free? 497 00:30:41,680 --> 00:30:43,400 Too free? Too free to do. 498 00:30:43,600 --> 00:30:44,600 Yes, yes. No. 499 00:30:44,640 --> 00:30:46,560 Routine. Lack of routine, the only thing 500 00:30:46,560 --> 00:30:50,240 they do and so it becomes something to just keep them 501 00:30:50,240 --> 00:30:51,360 busy. It's a hobby. 502 00:30:51,640 --> 00:30:54,920 Eating is a hobby. Maybe like that it's too free. 503 00:30:54,920 --> 00:30:57,720 He will just go to the kitchen and look for because it's so 504 00:30:57,760 --> 00:31:00,160 obvious for him, like a menu. I want this then, yeah. 505 00:31:02,200 --> 00:31:06,800 So then how can we address that? Yeah, you know, maybe more 506 00:31:06,800 --> 00:31:10,240 activities. More activities and also don't 507 00:31:10,280 --> 00:31:14,640 make the food choices so obvious to him behind things that we 508 00:31:14,640 --> 00:31:18,040 know is not good for him because maybe it's too sweet high sugar 509 00:31:18,040 --> 00:31:21,920 content so try to hide it so it's like treasure hunt for him 510 00:31:21,920 --> 00:31:25,200 also because over time he might observe where we take it out 511 00:31:25,200 --> 00:31:30,560 from then the next time he. Yeah, I think that addressing 512 00:31:31,080 --> 00:31:34,080 overeating and picky eating is also very similar. 513 00:31:34,080 --> 00:31:39,880 We kind of want them both to tune into their own body to feel 514 00:31:39,880 --> 00:31:42,920 am I hungry? Am I full to notice that? 515 00:31:42,920 --> 00:31:47,160 And so it would be very similar way to address that, you know, 516 00:31:47,160 --> 00:31:51,160 letting them choose how much they want to eat when they need 517 00:31:51,160 --> 00:31:54,640 to stop. So very similar in that way. 518 00:31:54,640 --> 00:31:59,840 And I think one thing is that shaming them is not going to 519 00:31:59,840 --> 00:32:01,320 work. It's probably going to have the 520 00:32:01,320 --> 00:32:06,200 opposite effect. It they may binge, they may 521 00:32:06,200 --> 00:32:12,200 steal, hide foods because they know that, oh, I, I don't feel 522 00:32:12,200 --> 00:32:15,720 like I can have this. And so shaming them maybe 523 00:32:15,720 --> 00:32:19,360 sometimes that might end up having the opposite effect. 524 00:32:19,360 --> 00:32:23,400 So I think we can be more careful about that. 525 00:32:24,080 --> 00:32:28,600 You think the right support to get diagnosed a better diagnosis 526 00:32:28,600 --> 00:32:33,640 on what is the cost that we again right the reason of of 527 00:32:33,640 --> 00:32:35,880 overeating. Yeah, OK. 528 00:32:36,000 --> 00:32:39,720 I'm just curious, right when we want to know about do assessment 529 00:32:39,720 --> 00:32:42,800 about the nutrition, does it have to be like a medical 530 00:32:42,920 --> 00:32:47,200 procedure to know that what's the nutrition over or? 531 00:32:47,640 --> 00:32:52,360 Or deficiency, yeah. But then it's not really what 532 00:32:52,520 --> 00:32:56,120 it's so you have to work in like probably you'll get a medical 533 00:32:56,120 --> 00:32:59,040 assessment and then bring that assessment to you and then you 534 00:32:59,040 --> 00:33:00,960 would. Yeah, I don't think it's 535 00:33:01,160 --> 00:33:04,920 absolutely necessary. It's, it's helpful like to get 536 00:33:04,920 --> 00:33:09,960 the blood work done so you know, different levels and, but also I 537 00:33:09,960 --> 00:33:13,360 think we can do a lot with what are they eating throughout the 538 00:33:13,360 --> 00:33:15,920 day. Like looking at all those, all 539 00:33:15,920 --> 00:33:18,760 those different aspects, looking at, you know, their growth 540 00:33:18,880 --> 00:33:20,960 trends over time. I think that's very hard. 541 00:33:21,200 --> 00:33:24,480 So that's why you need to have an interview like just now that 542 00:33:24,560 --> 00:33:27,040 you mentioned. The information from the parents 543 00:33:27,160 --> 00:33:30,240 would help you to determine what is the next step. 544 00:33:30,240 --> 00:33:32,240 Yes. Not just the medical. 545 00:33:32,480 --> 00:33:36,160 Report. Janice, can we take a few steps 546 00:33:36,160 --> 00:33:41,440 back to earlier right When you say shaming them is not helpful. 547 00:33:41,720 --> 00:33:44,800 I was just wondering because parents might not aware that 548 00:33:44,800 --> 00:33:48,080 what we say is equivalent to shaming the child. 549 00:33:48,320 --> 00:33:52,200 Is there any example that you can help the listeners to know 550 00:33:52,200 --> 00:33:55,480 more that oh maybe this thing that I do which I thought is the 551 00:33:55,480 --> 00:33:59,640 right thing to do is actually considering a shaming the child 552 00:33:59,640 --> 00:34:04,800 which is not helpful? I think this is also, this can 553 00:34:04,800 --> 00:34:11,760 be cultural too. Yeah, sometimes just saying, oh, 554 00:34:11,800 --> 00:34:14,440 you, you had enough to eat already, you know, like, you 555 00:34:14,480 --> 00:34:16,080 hear that, you look, you look so bad. 556 00:34:16,080 --> 00:34:18,960 Whatever. You know, you're so chubby, 557 00:34:19,199 --> 00:34:22,800 Yeah. We hear that a lot, I think. 558 00:34:24,400 --> 00:34:27,440 And kids are smart. They pick up on these things 559 00:34:27,440 --> 00:34:29,320 even if you're not saying it directly. 560 00:34:29,920 --> 00:34:32,480 So yeah, I think that's really tricky. 561 00:34:32,520 --> 00:34:37,360 Just, you know, let them grow into their body the way the way 562 00:34:37,360 --> 00:34:38,639 that they are. Yeah. 563 00:34:39,000 --> 00:34:42,760 More to discourage them for eating from eating junk food by 564 00:34:42,760 --> 00:34:46,320 saying that your tummy is so big or really something like that. 565 00:34:46,320 --> 00:34:48,560 Right. I was almost doing this 566 00:34:48,560 --> 00:34:56,880 yesterday but I noticed that my my my son's tummy is has grown 567 00:34:56,880 --> 00:35:01,400 up from 2-3 months ago. Maybe it's more obvious like a 568 00:35:01,680 --> 00:35:05,680 mini ball shape. So I wanted to ask my wife, but 569 00:35:05,680 --> 00:35:09,640 he's nearby us. So I just said my tummy. 570 00:35:09,640 --> 00:35:12,360 I point to I tell my wife, do you think my tummy? 571 00:35:12,360 --> 00:35:16,360 But I was pointing at him then he didn't know we were talking 572 00:35:16,360 --> 00:35:19,280 about him. Hopefully like because I I keep 573 00:35:19,280 --> 00:35:22,840 saying that it's my tummy, but my wife aware that I'm pointing 574 00:35:22,840 --> 00:35:24,640 there. So she said yeah, your tummy is 575 00:35:24,640 --> 00:35:29,880 because that's how we felt. You know, it's, it's hard 576 00:35:29,880 --> 00:35:35,680 because you know, as adults, we all have our own insecurities, 577 00:35:35,680 --> 00:35:40,880 maybe our own history with food and when we see our kids 578 00:35:41,080 --> 00:35:45,160 potentially experiencing that, it can be hard. 579 00:35:45,240 --> 00:35:47,720 And so sometimes it takes some self reflection. 580 00:35:49,360 --> 00:35:53,160 We just want to be careful because there is a lot of, like, 581 00:35:53,560 --> 00:35:56,360 eating disorders, which is different from feeding disorders 582 00:35:57,720 --> 00:36:02,200 among, you know, girls is so common, but also among boys as 583 00:36:02,200 --> 00:36:04,600 well. When they have that insecurity 584 00:36:04,600 --> 00:36:07,360 about their body, it can be really challenging. 585 00:36:07,760 --> 00:36:11,000 Yeah. So how can parents introduce 586 00:36:11,000 --> 00:36:14,960 more structure to meal times just now When you start with a 587 00:36:14,960 --> 00:36:19,280 very interesting when when Jenny share sharing that, you know, 588 00:36:19,280 --> 00:36:24,440 meal time should be everybody together and you feel calm, you 589 00:36:24,520 --> 00:36:30,480 feel enjoyable. Like, wow, that's so far away 590 00:36:30,480 --> 00:36:34,360 from a lot of our kids. Yeah, meal time and even 591 00:36:34,360 --> 00:36:37,280 sometimes us, it's like on the phone, you know, we are rushing 592 00:36:37,280 --> 00:36:40,360 and all these things. So maybe you can share some tips 593 00:36:40,360 --> 00:36:43,960 that maybe we cannot achieve the 100%, but we can achieve like 594 00:36:43,960 --> 00:36:50,200 say 5060%, you know, so slowly improve to a very, a very calm 595 00:36:50,200 --> 00:36:54,560 meal time together without creating too much pressure and 596 00:36:54,560 --> 00:36:56,040 stressful. Eating, yeah. 597 00:36:56,200 --> 00:36:59,840 And I think, you know, for kids, families who have kids with 598 00:36:59,840 --> 00:37:04,000 different challenges and needs, that 100% can look different for 599 00:37:04,000 --> 00:37:07,120 every family. So we kind of have to adjust 600 00:37:07,120 --> 00:37:08,920 that first. But one thing that I would 601 00:37:08,920 --> 00:37:11,920 recommend is something called the division of responsibility. 602 00:37:11,920 --> 00:37:14,560 This is something that we've learned about for a long time, 603 00:37:15,280 --> 00:37:19,440 and this is where parents can provide that structure and that 604 00:37:19,440 --> 00:37:20,920 balance of structure and nurture. 605 00:37:21,160 --> 00:37:26,120 So parents are responsible for deciding, or caregivers are 606 00:37:26,120 --> 00:37:29,800 responsible for deciding what they're going to offer the 607 00:37:29,800 --> 00:37:33,400 child. When is meal time and where is 608 00:37:33,400 --> 00:37:36,240 meal time? And then the child can decide 609 00:37:36,560 --> 00:37:39,480 how much they want to eat and whether they want to eat. 610 00:37:39,480 --> 00:37:41,600 So maybe they're not hungry at all, they're not going to eat, 611 00:37:41,960 --> 00:37:44,600 and we're going to let them make that choice. 612 00:37:47,000 --> 00:37:53,840 This is a very simple concept, but in practice, it takes a lot 613 00:37:53,840 --> 00:37:59,080 of discernment, especially when you have a kid with feeding 614 00:37:59,080 --> 00:38:02,160 challenges. And so when I started doing this 615 00:38:02,160 --> 00:38:04,240 in my home, it was really challenging. 616 00:38:04,240 --> 00:38:07,600 But what I didn't realize was when I think about what I'm 617 00:38:07,600 --> 00:38:10,960 going to serve the kid, we have to think about what the child is 618 00:38:10,960 --> 00:38:14,120 capable of. If they're not capable of eating 619 00:38:14,200 --> 00:38:18,440 certain textures or certain smells, I'm going to make sure 620 00:38:18,440 --> 00:38:22,160 that there's at least one. Yeah, at least one thing that 621 00:38:22,160 --> 00:38:24,920 they can eat and that they feel comfortable eating. 622 00:38:25,440 --> 00:38:29,960 Same with with where they eat. Is the environment suitable for 623 00:38:29,960 --> 00:38:33,200 them? So the sounds, the lights, the 624 00:38:33,200 --> 00:38:36,560 seating, is that going to support them so that they can 625 00:38:36,560 --> 00:38:39,880 eat? Well, that postural support is 626 00:38:39,880 --> 00:38:41,640 very important for some of our kids. 627 00:38:43,240 --> 00:38:46,040 And then also timing. When is meal time, you know, are 628 00:38:46,120 --> 00:38:48,240 they good routine? Yes, a good routine. 629 00:38:48,240 --> 00:38:52,160 And sometimes that schedule needs to be adjusted. 630 00:38:52,160 --> 00:38:55,120 So being very in tune with that is going to help. 631 00:38:55,120 --> 00:38:59,160 And then allowing them to decline, allowing them the 632 00:38:59,160 --> 00:39:04,640 freedom to say, oh, I'm not hungry, I don't want this or I 633 00:39:04,640 --> 00:39:06,200 don't want this, then I'm not going to eat. 634 00:39:06,280 --> 00:39:07,880 And that's OK. They will have another 635 00:39:07,880 --> 00:39:11,280 opportunity to eat later on. Yeah. 636 00:39:11,600 --> 00:39:14,520 So it gives a little both of that structure. 637 00:39:14,520 --> 00:39:16,720 So we're not just getting them whatever they want, whenever 638 00:39:16,720 --> 00:39:18,480 they want. They're not just like roaming 639 00:39:18,480 --> 00:39:23,320 around the house eating whatever they want, but also it gives 640 00:39:23,320 --> 00:39:27,120 them a little bit of that autonomy to decide, am I hungry 641 00:39:27,120 --> 00:39:29,440 or am I not? Do I want to eat this or do I 642 00:39:29,440 --> 00:39:31,960 not? They need to be part of the 643 00:39:31,960 --> 00:39:36,320 decision making to encourage them to, you know, feel like 644 00:39:36,320 --> 00:39:38,720 they are in control in their life to a certain extent. 645 00:39:39,440 --> 00:39:42,360 And in this situation, I can see that parents play a very 646 00:39:42,360 --> 00:39:46,800 important role in regulating themselves, setting the right. 647 00:39:46,800 --> 00:39:48,480 Expectation. Correct. 648 00:39:48,600 --> 00:39:50,160 Yeah. So at the end of the day, we 649 00:39:50,160 --> 00:39:53,720 have not doing any changes in the child at the moment. 650 00:39:53,720 --> 00:39:58,800 That is more on parents, yeah, parents expectation, parents 651 00:39:58,800 --> 00:40:03,040 behavior, parents self regulation that actually make it 652 00:40:03,040 --> 00:40:06,000 calm and people. Yeah, I think it begins with 653 00:40:06,080 --> 00:40:09,680 parents having the awareness where the child, if they decline 654 00:40:09,680 --> 00:40:13,160 the food often now does not mean that they don't like the food. 655 00:40:13,160 --> 00:40:17,840 It can be they're really not hungry yet, just like we 656 00:40:17,840 --> 00:40:21,440 ourselves right now is not even 11. 657 00:40:21,440 --> 00:40:25,160 If you ask me to eat heavy food, I will say I'm still full. 658 00:40:25,360 --> 00:40:29,080 But children who are on the autism fashion, they may not be 659 00:40:29,080 --> 00:40:32,920 able to deliver the speech to say I'm not, I'm still full. 660 00:40:33,200 --> 00:40:38,320 So what we learned over this 1-2 year is we asked our son, do you 661 00:40:38,320 --> 00:40:41,280 mean later? He understand the concept later. 662 00:40:41,480 --> 00:40:44,240 So when he say later, we know, OK, this food don't need to 663 00:40:44,240 --> 00:40:48,360 throw yet, keep later. So maybe 20 minute later he will 664 00:40:48,360 --> 00:40:50,920 really come up, come over and he he's ready to eat. 665 00:40:51,440 --> 00:40:53,200 Yeah. So is the awareness. 666 00:40:53,200 --> 00:40:54,920 I think it's very important for us to. 667 00:40:56,360 --> 00:41:00,520 I actually thought of something maybe our listeners would also 668 00:41:00,520 --> 00:41:04,360 be very interested to know. Like nowadays when I go out 669 00:41:04,360 --> 00:41:08,120 restaurants or coffee shop with cafes it's so common to see when 670 00:41:08,120 --> 00:41:11,240 kids will only eat when iPad is presented. 671 00:41:11,520 --> 00:41:15,200 So I even hear from one of my friend who said he wouldn't eat 672 00:41:15,200 --> 00:41:18,560 until I bring it out. So then because we we are 673 00:41:18,560 --> 00:41:22,840 worried that he's not eating so I would just open turn it on the 674 00:41:22,840 --> 00:41:25,120 videos and just feed him while he's in. 675 00:41:25,120 --> 00:41:28,200 He doesn't even, you know, like what is putting inside his mouth 676 00:41:28,200 --> 00:41:31,920 to that extent. What's your perspective or any 677 00:41:31,920 --> 00:41:35,160 views from from about concerns like that? 678 00:41:35,280 --> 00:41:38,920 Yeah. I think if if we can avoid it, 679 00:41:39,040 --> 00:41:42,840 that would be the best, right? We want the child to be engaged 680 00:41:42,840 --> 00:41:47,160 in eating, to experience how food tastes and to be aware of 681 00:41:47,160 --> 00:41:50,360 it. It's totally understandable when 682 00:41:50,360 --> 00:41:53,760 parents do this because this is like the only way they're going 683 00:41:53,760 --> 00:41:56,320 to get their kids to eat, especially when you're eating 684 00:41:56,320 --> 00:41:58,680 out and the environment is more challenging. 685 00:41:59,280 --> 00:42:03,200 So it really is. I mean, I would say it's a 686 00:42:03,200 --> 00:42:07,000 little bit case by case. Some kids need that to be 687 00:42:07,080 --> 00:42:11,400 regulated in an environment that feels overwhelming for them. 688 00:42:12,480 --> 00:42:18,000 But we can also take small steps to kind of move towards not 689 00:42:18,000 --> 00:42:22,240 using it all the time. Yeah, yeah, yeah. 690 00:42:22,240 --> 00:42:24,000 Maybe replace it with something else? 691 00:42:26,560 --> 00:42:31,920 What we do with my son is that he we allow him the iPad because 692 00:42:31,920 --> 00:42:36,480 it's important for that to let him agree to start the ritual. 693 00:42:36,480 --> 00:42:40,320 So it's like part of the ritual. But eventually we will encourage 694 00:42:40,320 --> 00:42:43,680 him that OK, two more minutes. And if he said OK, then it's 695 00:42:43,680 --> 00:42:47,320 very safe already. So 2 minutes later, either we 696 00:42:47,560 --> 00:42:51,480 remind him that we need to remove it or actually now he 697 00:42:51,480 --> 00:42:53,240 actually, he will just shove it away. 698 00:42:53,920 --> 00:42:56,680 So it's like it's just like an appetizer to him. 699 00:42:56,680 --> 00:43:00,520 That is the iPad feeding the mind first with the iPad. 700 00:43:00,800 --> 00:43:04,280 Then when he's really into eating already, the iPad becomes 701 00:43:04,280 --> 00:43:06,800 an obstacle for his between him and the plate. 702 00:43:07,000 --> 00:43:09,920 He will actually shove it away. So that's the thing that it 703 00:43:09,920 --> 00:43:12,960 doesn't happen overnight, but it takes a lot of patience for the 704 00:43:12,960 --> 00:43:17,600 parents and maybe also determination to really set the 705 00:43:17,720 --> 00:43:21,080 ground rules over time. But don't jump straight to 706 00:43:21,440 --> 00:43:26,280 eliminating the iPad totally. And it's very, very individual 707 00:43:26,280 --> 00:43:30,360 for every. Family because I think the 708 00:43:30,360 --> 00:43:34,120 struggle is we know you know, people say screen time is bad 709 00:43:34,120 --> 00:43:37,840 and then but I need him to eat so it's like, you know, which 710 00:43:37,840 --> 00:43:40,040 one is the lesser of the two devils. 711 00:43:40,040 --> 00:43:44,240 We have to be really very intelligently choose how to 712 00:43:44,440 --> 00:43:48,160 proceed first. Right, Janice, we are also 713 00:43:48,160 --> 00:43:53,280 curious about food checking like a situation when a child who 714 00:43:53,280 --> 00:43:57,400 used to like to eat something but just suddenly stop eating a 715 00:43:57,440 --> 00:44:01,360 food that they have been eating for years or maybe for months. 716 00:44:01,520 --> 00:44:04,280 Have you got experience working with clients like that? 717 00:44:04,480 --> 00:44:08,360 Yes, yeah. And I think when that happens, 718 00:44:08,400 --> 00:44:11,600 we continue to offer them a variety because you never know 719 00:44:11,600 --> 00:44:16,560 when they will come back to it. Sometimes when children suddenly 720 00:44:16,560 --> 00:44:21,200 stop eating something that they used to like, you want to pay 721 00:44:21,200 --> 00:44:23,480 attention. So if it lasts for a long time, 722 00:44:24,240 --> 00:44:27,720 kind of that's another clue for us to be curious and to look 723 00:44:27,720 --> 00:44:31,080 under the surface what what has happened maybe in those past 724 00:44:31,080 --> 00:44:35,480 couple weeks? Was there a stressful move, 725 00:44:35,480 --> 00:44:39,000 transition, new school? All these things can really 726 00:44:39,000 --> 00:44:44,480 impact their eating. We did have a child who had 727 00:44:44,480 --> 00:44:47,840 experienced some sexual abuse. Yeah. 728 00:44:47,840 --> 00:44:52,120 And it impacted the way that child was eating the foods that 729 00:44:52,200 --> 00:44:55,040 they normally ate. Didn't, you know, didn't want 730 00:44:55,040 --> 00:44:58,720 anymore. And The thing is, we don't 731 00:44:58,720 --> 00:45:01,480 always have this information, you know, when these things 732 00:45:01,480 --> 00:45:03,520 happen, kids don't always tell their parents. 733 00:45:03,760 --> 00:45:06,960 They don't, you know, always therapist don't always know. 734 00:45:07,520 --> 00:45:10,200 But when these things happen, it's a clue for us to like, 735 00:45:10,240 --> 00:45:14,360 really think like why. And even if you don't know the 736 00:45:14,360 --> 00:45:19,000 why, you know that there's something that's, you know, 737 00:45:19,080 --> 00:45:22,760 leading to it. And so then we we don't focus on 738 00:45:22,760 --> 00:45:25,120 forcing them to eat something that's not comfortable. 739 00:45:27,320 --> 00:45:29,520 Yeah. So, so it's just a reminder that 740 00:45:29,520 --> 00:45:32,360 all behaviour is communication. All behaviour is telling us 741 00:45:32,760 --> 00:45:37,480 there's something else going on. While look while finding out 742 00:45:37,480 --> 00:45:42,480 what is the core issue of it, we still occasionally we still can 743 00:45:42,480 --> 00:45:45,880 offer a choice there and see whether this child will one day 744 00:45:45,880 --> 00:45:49,160 decided to pick it up again and to take it again. 745 00:45:49,400 --> 00:45:54,640 Yeah, and and we can offer, but just not force them to eat it, 746 00:45:54,680 --> 00:45:56,840 you know, like you have to finish this before you can go 747 00:45:56,840 --> 00:45:58,200 play. Yeah, I wouldn't it. 748 00:45:59,080 --> 00:46:01,680 Sounds like making it available. Yeah. 749 00:46:02,040 --> 00:46:04,120 You can have it, yeah, but. Optional. 750 00:46:04,840 --> 00:46:06,680 Optional, yeah. Yeah, OK. 751 00:46:06,680 --> 00:46:10,080 And when, when the child is not eating, the first person to be 752 00:46:10,080 --> 00:46:13,560 concerned definitely is not the child because they are they are 753 00:46:13,560 --> 00:46:16,120 not aware of the importance of eating. 754 00:46:16,600 --> 00:46:20,360 Parents will be very stressful and to a certain extent we just 755 00:46:20,360 --> 00:46:23,320 want the best for them. But a lot of things, not just 756 00:46:23,320 --> 00:46:25,880 eating can be sleeping can be many other things. 757 00:46:26,200 --> 00:46:30,840 Parents will because of the the urge we have for them to be 758 00:46:30,840 --> 00:46:33,680 good, right? We may not slow down to 759 00:46:33,720 --> 00:46:37,120 understand them. We did another episode on 760 00:46:37,120 --> 00:46:43,280 sleeping a couple of weeks ago. So I received comments from a 761 00:46:43,640 --> 00:46:48,000 listener or audience say that after watching this episode, now 762 00:46:48,000 --> 00:46:51,520 I understand that I need to be more patient with my child 763 00:46:51,800 --> 00:46:54,480 because every time the child is not sleeping, we thought that, 764 00:46:54,480 --> 00:46:58,240 you know, this challenging behavior is the child being 765 00:46:58,240 --> 00:47:00,800 challenging. But actually there are many 766 00:47:00,800 --> 00:47:04,720 reason underneath and I hope that just the listeners will 767 00:47:04,720 --> 00:47:10,160 actually get some insights from what you share is that this only 768 00:47:10,160 --> 00:47:14,480 the behavior we need to go down to investigate and be curious. 769 00:47:14,840 --> 00:47:17,440 And I think this is very important because as a parent, 770 00:47:17,440 --> 00:47:21,720 we don't want to just check the boxes of doing the behavior, but 771 00:47:21,720 --> 00:47:23,920 we just want to connect with our child. 772 00:47:24,200 --> 00:47:27,440 And that means you really understand why they behave in a 773 00:47:27,440 --> 00:47:30,200 certain way. And I really appreciate your 774 00:47:30,200 --> 00:47:34,160 sharing, Janice. I'm sure a lot of our listeners 775 00:47:34,160 --> 00:47:37,720 will also benefit a lot because we at least eat three times a 776 00:47:37,720 --> 00:47:38,800 day. So. 777 00:47:39,440 --> 00:47:43,400 If you have challenge one in breakfast, you have three 778 00:47:43,400 --> 00:47:46,800 challenges throughout a day and it's also one of the toughest 779 00:47:46,800 --> 00:47:50,480 thing to juggle to. For a balance for ourselves, we 780 00:47:50,480 --> 00:47:54,560 have to think Monday we order this for lunch and then he only 781 00:47:54,560 --> 00:47:56,600 eat this Saturday. So we have to skip because we 782 00:47:56,600 --> 00:47:59,680 don't want to be too frequent later reject again. 783 00:47:59,680 --> 00:48:03,760 So I only hope that more people are aware that you know, 784 00:48:04,080 --> 00:48:07,800 registered dietitian like you who understand children's was on 785 00:48:07,800 --> 00:48:10,320 the spectrum. Then we can really seek for the 786 00:48:10,320 --> 00:48:13,680 proper help other than, you know, instead of getting 787 00:48:14,360 --> 00:48:16,720 information that baby is not evidence based, not 788 00:48:16,720 --> 00:48:20,520 scientifically back up from variety of social media, you 789 00:48:20,680 --> 00:48:25,520 know, which may or may not soft or help with the load at all. 790 00:48:25,800 --> 00:48:28,280 Yeah. So before we end, do you have 791 00:48:28,280 --> 00:48:33,520 any other key last message that you would like listeners to know 792 00:48:33,520 --> 00:48:35,560 or be aware of or be mindful about? 793 00:48:36,840 --> 00:48:40,880 Yeah, I think, you know, I'm just very blessed to be able to 794 00:48:40,880 --> 00:48:44,360 do this work. I worked as a dietitian for 795 00:48:44,360 --> 00:48:46,360 about 10 years before I became a mom. 796 00:48:46,440 --> 00:48:50,000 And when I became a mom, my oldest son, he, we adopted him 797 00:48:50,000 --> 00:48:54,080 when he was two years old and she was a very picky eater. 798 00:48:54,680 --> 00:48:57,640 So feeding and meal times were just such a challenge for us. 799 00:48:58,120 --> 00:49:01,040 And it wasn't until I started learning about these feeding 800 00:49:01,040 --> 00:49:06,520 disorders that I started to realize like, actually, it's not 801 00:49:06,520 --> 00:49:10,360 because I'm a bad mom. It's not because he's a bad kid. 802 00:49:10,560 --> 00:49:13,640 But we're dealing with a challenge that's different from 803 00:49:13,640 --> 00:49:16,000 what other other families have to deal with. 804 00:49:16,960 --> 00:49:21,360 And so I think that gives us a lot more freedom and grace and 805 00:49:22,320 --> 00:49:26,120 just understanding. And sometimes really parents 806 00:49:26,120 --> 00:49:30,280 like we can do all the right things but still not get the 807 00:49:30,280 --> 00:49:35,520 outcome that we hope for. And I really feel like that's 808 00:49:35,520 --> 00:49:38,880 when I have to remind myself that these are the things that I 809 00:49:38,880 --> 00:49:42,960 have to leave into the hands of the divine, a God who loves my 810 00:49:42,960 --> 00:49:47,640 child and my family and who is capable of taking care of us. 811 00:49:47,680 --> 00:49:53,200 And so that's really what my husband Daniel and I are really 812 00:49:53,200 --> 00:49:56,240 passionate about, supporting families because we know how 813 00:49:56,240 --> 00:50:00,040 hard it is, how frustrating it is sometimes. 814 00:50:00,040 --> 00:50:04,680 And we know that you can know all the right things to do, but 815 00:50:04,680 --> 00:50:07,800 it's still hard to do it, right? Like you might not have the 816 00:50:07,800 --> 00:50:11,080 capacity to do that. You might get frustrated at meal 817 00:50:11,080 --> 00:50:15,400 times, right? We know that we don't do it 818 00:50:15,400 --> 00:50:19,320 perfectly all the time, but I think that the important thing 819 00:50:19,320 --> 00:50:25,080 is that families and parents are supported in a way that, you 820 00:50:25,080 --> 00:50:28,080 know, when you have a really bad day, when you have a really bad 821 00:50:28,080 --> 00:50:31,760 meal and you lose your temper, you can start over. 822 00:50:31,760 --> 00:50:35,880 You can repair and start over and know that you're not a 823 00:50:35,880 --> 00:50:38,400 horrible mom or you're not a horrible dad. 824 00:50:38,880 --> 00:50:42,440 You're a human. I think that is the important 825 00:50:42,440 --> 00:50:47,160 message for all families. Just to wrap it up, I understand 826 00:50:47,160 --> 00:50:52,120 that when our child has eating challenges or picky eating 827 00:50:52,120 --> 00:50:56,120 issues, so-called it might be challenging for the parents to 828 00:50:56,120 --> 00:51:00,280 even think about going out with friends because we are at risk 829 00:51:00,280 --> 00:51:03,480 of you know, having a drama outside or what not. 830 00:51:03,840 --> 00:51:07,000 And especially going for a trip is a lot question mark. 831 00:51:07,480 --> 00:51:11,960 And if let's say we suspect or we really going through a lot of 832 00:51:11,960 --> 00:51:16,320 the signal or it reflects that your child needs additional 833 00:51:16,320 --> 00:51:19,640 support. So just hopefully this episode 834 00:51:19,640 --> 00:51:22,520 can be a first step for the additional support. 835 00:51:22,520 --> 00:51:26,560 But if you do really need extra help, maybe you can we will put 836 00:51:26,640 --> 00:51:29,720 Jenny's contact and what not in the show. 837 00:51:29,720 --> 00:51:32,760 Note, if you really need help, maybe you can consider to reach 838 00:51:32,760 --> 00:51:34,160 out. There are also many other 839 00:51:34,160 --> 00:51:37,840 dietitians out there. So just that have the awareness 840 00:51:37,840 --> 00:51:41,120 that the child is not the problem, the parents not the 841 00:51:41,120 --> 00:51:44,120 problem, it's the understanding what is the problem. 842 00:51:44,200 --> 00:51:46,080 It's the real thing that we need to do. 843 00:51:46,080 --> 00:51:48,280 OK. So thank you very much Janice 844 00:51:48,280 --> 00:51:50,560 once again. And with that, we are signing 845 00:51:50,560 --> 00:51:53,080 off Bye bye.