I heard the most ridiculous thing at a training given by the Department of Children and Families. The session was about health and safety for kids in foster care. The speaker was a registered nurse whose job it was to approve all medical treatment for the foster children in her region. Don’t even get me started on the times she described vetoing a medical doctor’s recommendation based on her shoddy anecdotal evidence.
The comments that irked me into feelings of mild violence were her views on food insecurity. “Oh that’s not really a problem. I don’t why people come to me with this. Just offer a variety of foods at dinner time.” She called this a “food tour” and opined that it always worked.
All of our children, to some degree, suffer from food insecurity. Because they spent large amounts of time without food, without enough food, or without appropriate nutritional fare, they have food insecurities. Two of our children don’t even feel safe unless they have a stash of non perishables in their bedrooms.
When the kids first came home, Carl couldn’t handle family meal times. His behavior escalated to what seemed like bizarre levels. We would sit down to a meal and politely pass the food around from plates in the middle of the table. Carl would grab between 3 and 6 dinner rolls and then scream at anyone else who tried to take one.
“Stop it! There will be none left!!!”
Carl would sit on his feet in a crouch with his arms protectively over his plate. No amount of cajoling or reminding got him to sit on his bottom would last for more than 30 seconds before he hopped up and perched protectively over his plate again.
His pupils would dilate and his heart rate would pick up. His voice got louder and his words were more oppositional. It was like watching someone handle being the victim of a hostage situation. Pure panic.
Inevitably the dinner stress would be too much for Carl. He would start by complaining he hated the food and would never eat it. This would progress to trying to grab all of the remaining food on the table. ALL of it. At some point after that he would throw his plate/cup/meal directly at me and run away screaming that we were starving him. Sometimes he would punch me.
At the same time, Sean would gobble huge amounts of food as if it were a race while Marcus and Mary sat turned away from the table, staring at the floor. They would not respond in any way, even if spoken to. It was as if they weren’t even there.
After everyone left, Mary would take her plate underneath the table, or to the floor, and finally eat her dinner. Marcus would eat whatever was left over when he awoke in the middle of the night.
None of it made any sense to me at the time. We did everything we could think of to manage this behavior. We put limits on the amount of ___ the kids could put on their plate at one time. We proactively switched over to paper plates and disposable plastic cutlery. My apologies to the environment but experience has literally shown me it’s better to have a plastic knife hit you in the face than a steak knife. After Carl’s outbursts he’d have to finish eating in his room. I didn’t know at the time that he felt much safer eating there.
Eventually we learned that our kiddos had a past history of stressful mealtimes. We already knew they spent a lot of time fending for themselves as toddlers and young children. Hence, Mary developed a taste for dog food and would sneak it whenever no one was watching. Apparently when bio mom was manic she’d begin cooking at 2 or 3 AM. Then she’d wake the kids up and insist they eat. Other times they existed on the Monster energy drinks and Jolly Ranchers they stole at the local corner store.
To this day, when Carl is feeling stress or anxiety it flares up. He will binge eat in the middle of the night. There is a far off, unfocused look that comes over him while he stuffs huge amounts of food into his mouth at an alarming rate. He’s often crying at the same time.
Have you ever seen a hamster stuff it’s cheeks full of food? This is sort of what it looks like. Carl will swallow without chewing. His cheeks swell to an unusual size yet still he keeps going. He stuffs more and more food into his mouth even before he swallows what’s already in there. This leads to choking and vomiting. As soon as Carl finishes puking, he immediately resumes guzzling food. Then he vomits more and eats more and so on. He chokes a lot when he gets like this because he forgets to breathe.
Last spring he suffered scratches to his esophagus because of the sharp edges of un-chewed food (think crackers or nuts.) He had also vomited so much that the acid was eroding soft tissue in his esophagus and stomach. He threw up so many times a day that eventually he was vomiting blood. The wait to see a specialist for pediatric GI took forever. We ended up in the emergency room at the children’s hospital four times in one month.
In the meantime we would wake up in the morning to find vomit, blood, and food wrappers of one kind or another all over the house. It was terrifying. This is when we got combination locks for the fridge. Our cabinets were already locked overnight to keep Mary out of the cutlery. Finally we got him in to do a series of tests, including an endoscopy.
The specialist concluded that Carl was reacting to his past, so it couldn’t be medically treated. He asked me, completely straight-faced if we’d ever considered Cognitive Behavior Therapy. He told me that sometimes children who were traumatized need therapy. I burst out laughing. Yes, we’d been working on that for 4 years.
After the first winter together, the snow melted and revealed a surprise. Carl had buried all of his school snacks in the snow. Every day at school he would tell the teacher we refused to give him snacks. Meanwhile, he built up a stock in case he ever ran out of food again.
Carl would ask strangers for food at the store, at parks, at the lake, basically anywhere. While I stood behind him with a rescue-bag of goldfish in my hand I would hear him beg strangers desperately. “Please,” he’d urgently whisper, ” Can I have some of that? My parents NEVER feed me. I’m starving!!!”
Once a well-meaning older lady kindly explained to me that children cannot go for long periods of time without eating. She kindly suggested that I consider snacks for the children. In response I pulled gently on Carl’s outside coat pocket. Imagine her surprise when three granola bars and a bag of almonds fell out!
Some things have helped. We developed a calm dinner routine where we take turns appreciating one person at the table for something they did that day. Our goal was for Carl to feel safe at mealtimes. His therapist, L, helped him develop a self-talk manta. It goes, “I will have enough to eat. I will have these foods again.”
We let him keep boxes of power bars and granola in his room. For years he slept with them in his bed. This was preferable to the chicken drumsticks and other perishables he used to hide in his pillow case!
We got frozen pizzas that Marcus could prepare and eat in the middle of the night. We stopped buying “high-value” foods that would trigger Carl into a binge. This included peanut butter, Nutella, candy of any kind and cream cheese. During the stressful spring season we padlock the fridge to prevent Carl from getting hurt while out of control at night.
Some things have never changed at all. For example, Mary literally does not know how to drink water. If a glass is placed in front of her she will chug it as fast as possible without breaking. It doesn’t matter how much liquid you put in front of her. I tried to give her a huge water bottle once to see if it would slow her down. It didn’t. Instead she threw her head back and guzzled until I was sure she’d drown. Instead she began choking and crying while continuing to gulp. Mary wouldn’t put the bottle down until I physically pryed it away from her mouth.
When chugging her water Mary still tilts her head as far back as she can. She also flings her left arm out straight to grab and hold onto whoever is nearest. She will clutch onto them until she is done rapidly swallowing everything in front of her. It looks exactly like a baby drinking from a bottle. Mary is stuck in this phase.
Unfortunately this also makes her vomit. Because of how unpleasant it is for her to chug liquid down and then puke, she usually refuses it entirely. She claims she is “allergic” to water and it always makes her sick. She physically cannot sip from a cup. That skill simply isn’t in her repertoire.
Eventually we learned to pour out two fingers of liquid at a time for her to drink or else we’d give her a straw. She was able to appropriately use the water fountain at school.
My point is this: food insecurity is terrible. If a professional gives advice on this they should have some actual experience with kids exposed to starvation. Healing takes hard work and years of patience. Even then, that trauma is always with our kids to some degree. Because, really a “food tour” is NOT going to fix the problem.
**Names have been changed to protect the privacy of those involved.