As a continuation of our ongoing conversation from a previous post about what a parent should do if a doctor is advising weight gain and the parent's instincts disagree, two more of my Psychology Today blogging colleagues have offered more excellent advice. And here is the original post, Stop Forcing My Daughter to Eat! that sparked the discussion::
Mikhail Lyubansky, Ph.D.
His blog is: Between the Lines
"I wouldn't advise on specifics, since I'm not speaking to mom directly, but I would point out that doctors aren't nutritionists. If I were concerned about this as a parent, I'd make an appointment with a nutritionist. I'd also try to discern what messages about nutrition and eating might be shared with kids in the ballet class. Along with gymnastics, ballet has a very high prevalence of eating disorders. And as a complete aside, I'd want mom to know that as far as I'm concerned, parenting is the hardest job!"
Bill Ahearn, Ph.D, BCBA-D also weighed in.
His blog is: A Radical Behaviorist
"I've done quite a bit of work with pediatric feeding disorders and some consultation with adolescents with lack of weight gain. In assessing feeding, a necessary step is to analyze the child's growth history and current food intake. Given the family may be on the smaller, lighter end of growth percentiles, she may be coming by this low weight honestly. The message states that the girl eats protein, starch, veggies, and fruits, I don't see variety as an issue (and this is the most common type of pediatric feeding problem). Pushing her to finish a meal, especially in adolescence, could produce counter control. IF, and I mean IF, changes in eating habits would be pursued, I've had the most success in cases of obtaining weight gain by either adding snacks or drinks that have a good amount of caloric content (Carnation Instant Breakfast, Gatorade, milkshakes - but typically avoid juice or soda) or loading up the caloric content of meals.
What this mom might really need is a more supportive doctor. Many people feel they can't change doctors but I've seen such a range of skills in physicians that one should always consider, at the very least, seeking a second opinion. Having worked with many young children with growth issues, over the years I've found it is sometimes important to find a doctor that 1) devotes the time to helping to solve each patient's problems; and, 2) is not quick to blame the patient/parents for those problems. She may also have the need to consult with a nutritionist. As with doctors, nutritionists sometimes vary in quality".
