The slides to accompany this webinar: https://youtu.be/CpnQ_4Iy2fs

1. www.cwmt.org.uk
Eating difficulties in
younger children
when to worry, how to help
Dr Pooky Knightsmith
@PookyH

2. What?
Why?
How to
help?
Aims

3. Healthy?Hungry? Happy?
When should you worry?

4. He would
eat
chocolate,
biscuits
and crisps
but
nothing
else

5. Selective Eating
Fussy / Faddy
Can last months
Social issues
Otherwise fine

6. Things that help
Play it down
Never assume
GP / Dentist
Practical support for e.g. parties

7. He wouldn’t
eat or drink
at school
(unless they
offered him
Jaffa Cakes!)

8. Food Refusal
Places / people
Underlying worry
Control / communicate
Makes up elsewhere

9. Things that help
Support, not anger
WHAT is the message?
Draw and talk
Play therapy

10. She barely ate at all and was very
slender - but always seemed
happy and full of energy

11. Restrictive Eating
Eats very little
Short and slim
May be familial
Otherwise fine
Normal range

12. Things that help
Don’t panic!
Bullying?
Self-esteem / body image

13. It was like
she didn’t
care enough
to eat. She
was so, so
sad, you
could see
just by
looking at
her.

14. Food Avoidance
Emotional Disorder
No fear of weight gain
General behaviour disturbance:
• Sleep problems
• Poor concentration
• Tearfulness
• Hopelessness
Associated with depression and anxiety
May isolate themselves / avoid school

15. Things that help
Trauma support
Support for depression /
anxiety if needed
GP - supplements
Beware misdiagnosis

16. Why
?

17. Coping
Communication
Care

18. www.cwmt.org.uk
She didn’t
have the
words to tell
us how
scared she
felt at school
so she did it
by not eating
there.

19. He
equated
food with
care and
love – so
he tried to
soothe his
pain with
food.

20. You inspire
not by
what you
say but
what you
do

21. It made her so
happy when we
gave her food.
sweets and
chocolates. It was
too much – she
was bingeing and
ballooning but it
was a way to show
we cared.
Every meal
became a battle
ground. We just
wanted him to eat
something.
Anything. There
was shouting and
food throwing. It
was awful.
What messages do we send?

22. I remember this
teaching assistant
from infant school
who sat with me
every day through
tears and tantrums.
Quietly, calmly. It
took a while but I
started to trust her
and began to let
her in.
He grabbed a
bread roll and put
it on his tray like it
was the most
normal thing ever.
We exchanged no
words but the look
we shared said so
much. We just
quietly got on with
the meal but inside
I was partying!
What messages do we send?

23. Sustainable
Support

24. What response is wanted /
expected?

25. Keep a Log

26. Help the child feel heard

27. Match the need…
Coping
Communication
Care

28. We looked
for
alternative
ways for her
to cope and
get that
feeling of
control.
She just
needed
someone to
hear her.
She wasn’t
so good with
words but
drawing
worked well.
We tried to
find a
hundred
different
ways to
show we
cared. Post
its was his
favourite!
Cope Communicate Care

29. The most important
slide of all…
Try to ensure
consistent
care and
support
Try to
Understand
what the child
is trying to
cope with or
attempting to
communicate
Give the child
the time,
space and
means to be
heard
ExploreListen Patient

30. She changed my life in five minutes
by making me realise I mattered to
someone, no matter how broken I
was. For five minutes I felt what it was
to be cared for.
It was a fresh start.

31. Thank
You!
@PookyH | pooky@cwmt.org

32. cwmt.org.uk | @charliewtrust InOurHands.com | @pookyh
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