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Ep 143 – When Should I Worry About my Kid’s ‘Fussy’ Eating? w/ Dr. Katja Rowell AKA The Feeding Doctor

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I’m SUPER excited about this week’s episode because I am speaking to the G.O.A.T of the child feeding world, Dr. Katja Rowell. Katja is an author and child feeding specialist with a passion for supporting parents in helping their children to do their best with eating and to relate to their bodies in positive ways. In this episode, we cover topics like;

  • The difference between regular old picky eating and look at some red flags for when kids or families maybe need a little more support with eating
  • How if you feel like there’s a problem and you could do with support and reassurance then that in and of itself is enough of a red flag that you should reach out for help
  • Whether or not it’s helpful to pursue a diagnosis around eating difficulties
  • Problems associated with some more conventional feeding therapies or programmes and why Katja and I prefer to work in a way that is less prescriptive and more responsive
  • Values of responsive feeding therapy and talk about what they look like in action
  • Some of the pitfalls perhaps in teaching kids to listen to their tummies, if our agenda is to get kids to eat less.
  • Felt safety, what that means and how we can foster it at mealtimes.

Show Notes

Transcript:

Katja Rowell  
There’s so much fear and anxiety. And you know I’ve been there and when we feed from a place of anxiety and avoidance and fear and thinking you’re going to prevent problems that we often can make things worse and that’s just that’s kind of a huge bummer to me that we’re we’re potentially creating or worsening issues when we don’t have to there’s enough to worry about so let’s you know, take some of that off the table if we can.

Laura Thomas  
Hey, team, welcome back to don’t salt my game where we are having conversations with game changers who are flipping diet culture on its head. I’m Laura Thomas. I’m a Registered nutritionist who specialises in intuitive eating and anti diet nutrition. And I’m the author of just eat it and how to just eat it. Today I’m talking to Katja Rowell aka the feeding doctor, all about how to differentiate between just everyday run of the mill picky or fussy eating versus more extreme picky eating. We’ll also talk about when you might want to reach out for help, and what kind of help to look out for. 

All right, so let me tell you a little bit about this workshop. We know that kids are born with embodied wisdom about what, when and how much to eat. They have strong and trustworthy instincts around what feels good in their body. They don’t sit there in their high chairs, calculating macros or judging themselves for how much bread they’ve eaten. And they certainly don’t feel shame about their bodies, and as stewards to these tiny humans it’s kind of our job to help protect these eating instincts. But feeding kids is hard, really hard. And between kiddie food Instagram, body and food shaming public health rhetoric, and celebrity chef comm nutrition saviour is telling us that there’s a right and a wrong way to feed our kids. It’s a lot. So how can we navigate the inferno that is feeding kids in diet, culture, and protect our own sense of self too?

Well, that’s where I’m hoping that my Raising Intuitive Eaters workshop will come in. In this 90 minute workshop, I’m offering you a little bit of background about the ways our kids embodiment gets disrupted by diet culture, and what this has to do with feeding. We’re going to explore why we need to throw the rulebook out the window and let them have ice cream before broccoli if that’s what they want to do, and how we can build trust in our kids to get what they need. I’m going to offer you a framework that can help you feel a bit more relaxed about mealtimes whilst encouraging kids to have a bit more autonomy. And we’re going to explore how we can provide supportive structure and how that can encourage children to remain in touch with their internal cues for hunger, satisfaction, pleasure and fullness. We’ll talk about how so called fussy eating develops and get tools to help move through it. We’ll look at why cutting out sugar and saying things like just take another bite can undermine kids instincts around food. And we’ll talk about how to talk about food and bodies without causing harm. And lastly, and I think probably most importantly, I’ll hold space to chat with other parents and carers about how hard all of this is. If you sign up for this workshop, you’ll be asked to fill out a short questionnaire about your specific situation. And what I’m going to try and do is look for common threads in your responses and try to address some of the specific concerns that are coming up. And so I’m kind of going to try and cater it to the audience as much as possible. I would say that this workshop is suitable for grownups of kids of all ages, but it’s probably best if your kids are sort of 12 or under. And everyone is welcome. Whether you’re a parent, whatever that means for your family, a grandparent, a teacher, a nutrition professional, anyone else working with kids, yeah, you’re more than welcome to come along. And here’s the lowdown. It’s going to be on Tuesday the 28th of June, seven o’clock British Summer Time, we’re going to be doing all on zoom. So hopefully if you’re not in the UK you can still attend or if you’re not in London, and you will be sent the link to join when you sign up. It costs 15 pounds. But if for any reason you can’t afford to pay that right now please email hello@laurathomasphd.co.uk and we will comp your ticket, no questions asked. I trust that if you can afford to pay that you will. And if not, we’ve got your back. You get a 90 minute interactive workshop with time at the end to ask questions to connect with other parents or caregivers. You’ll get a copy of my raising and body teasers PDF booklet to share with friends and family to help support you on your journey to raise an intuitive eater. The session will also be recorded. So if you can’t watch it live, you can access the recording and play it back afterwards. So I’ve put a link to that all of that information in the show notes as well as where you can sign up and complete the registration form. So I really hope to see some of you there. 

So like I mentioned today we are talking with Dr. Katja Rowell. Katja is an author and childhood feeding specialist. And during her time in practice as a family doctor, she was struck by how much suffering stems from the difficult relationships that people have with food and their bodies. Katja is passionate about helping parents help their children to do their best with eating and to relate to their bodies in positive ways. She believes responsive feeding is preventative medicine. Her books include helping your child with extreme picky eating, as well as a picky eating workbook for teens and adults. And love me feed me for fostering and adopting parents and parents dealing with food preoccupation, all of which I’ve linked to in the show notes if you want to check those out. Katja also recently co founded responsive feeding Pro to help train more feeding and nutrition, health and early years education professionals on responsive feeding and therapy. In this episode, we’re going to cover lots of great topics, we’re going to talk about the difference between regular old picky eating, and also look at some red flags for when kids or families maybe need a little a little more support with eating. We’ll also talk about how if you feel like there’s a problem, and you could do with support and reassurance, then that in and of itself is enough of a red flag that you should reach out for help.

We also talk about whether or not it’s helpful to pursue a diagnosis around feeding difficulties. We talk about the problems associated with some more conventional feeding therapies or programmes and why Katja and I prefer to work in a way that is less prescriptive and more responsive. We talk about the values of responsive feeding therapy and talk about what they look like in action. And lastly, we talk about some of the pitfalls, perhaps in teaching kids to listen to their tummies if our agenda is to get the kids to eat less. Oh, and actually one last thing, we talk about one of my favourite concepts that you’ve probably heard me talk about or write about on Instagram before, which is the concept of felt safety. We talked about what that means and how we can foster it at mealtimes. So lots of great stuff that we cover in this episode. I really love talking to Katja. I didn’t tell her this at the time because I was super embarrassed. But I actually was really nervous to interview her because she’s like the G.O.A.T. of child feeding. I’ve admired her work from a distance for a really long time. And I was sort of afraid to meet her because of that thing that they say like about don’t meet your heroes. But actually, she’s really cool. And we stayed on after the after we finished recording the podcast for like an hour, just shooting the shit. And now we’re like Instagram buds. But yeah, I loved nerding out with her. And if you have concerns about your kids eating, her book, helping your child with extreme picky eating is like pretty much the only book I recommend on this topic. So check that out if you need a bit more support. Okay, two other little quick things before we get to Katja’s interview. I don’t think I’ve explicitly said this on the podcast before but it occurred to me that some of you might want to know a bit more about this. But I’m also grappling with my feelings about capitalism. So I haven’t said anything. But I am working as a freelance Registered nutritionist now that LCIE is no longer. And that means that I do have some capacity to take on new clients, and especially families who are experiencing challenges with their kids eating, whether that’s more extreme picky eating, that we talked about in this episode, or whether that’s concerns about weight or growth or appetite. Whether that’s concerns with your child’s sneaking or stealing food, or maybe they seem obsessed with food, whether your kid has sensory processing differences or is neurodivergent and you just want to check in and make sure that you have everything you need in place for them. I can do all of that stuff. And I’m bringing the lens of responsive feeding that we discuss in this episode. Likewise, if you yourself are struggling with your relationship with food and you want some support around intuitive eating and working on your relationship with your body, I’m here for that too. I’m not doing so many eating disorders at the moment I have really limited capacity for eating disorder work, but for anyone wanting to do some work around battling nutrition or just for themselves, then I’m definitely here for that. I offer complementary 15 minute discovery calls, which you can book using the link in the show notes. Basically, I’ll call you up. And we’ll talk about what’s going on for you and think about how I might be able to support Absolutely no pressure to commit to anything. But give me a shout if you think you need some nutrition support. And you just want to kind of talk that through and figure out what that might look like. The other thing that I wanted to say real quick before we get to the episode is that when I recorded this, I was on like, day three of COVID. And I just want to make it really clear that I do not want to glorify working through COVID at all, it’s not a good idea, you will increase your chances of getting long COVID And that’s not cool. I promise you this was literally the only thing that I did for about four days, during most of which I was just flat on my ass. I know that paid leave is a privilege and I didn’t have that luxury as a freelancer so I get it. I get the desire to push through. But also please, please, please rest if you can, because COVID fucking sucks. I’m triple vaxed and that shit still hit me so hard. So anyway, yes, the point is, I did not I didn’t do loads of work. I just did this one off interview while while I was sick and just returned to work really slowly. And you can hear I’m even still a little bit sick now but we’re getting there. Okay, that’s my PSA. Thanks for coming to my TED Talk. Here’s my conversation with Katja. 

Okay, Katja so at the beginning of every episode, my guest and I do a quick fire round. So I am going to ask you a question and I just want to know the first thing that pops into your mind. Are you ready?

Katja Rowell  
I’m nervous? Go ahead.

Laura Thomas  
Everyone always feel so pressured by this is meant to be fun. Maybe I need to rethink my strategy. Anyway, what subjects did you like best at school?

Katja Rowell  
Biology.

Laura Thomas  
I can see that. Most refreshing beverage. Me too. By the way. That was my favourite. Most refreshing beverage.

Katja Rowell  
It’s a grapefruit flavoured fizzy water mixed with a soda called a squirt, which is also grapefruit flavour and I mix them and it’s fantastic.

Laura Thomas  
Oh, that was like, very specific. And you were ready to go with it. 

Katja Rowell  
I’m on. I’m on it. I’m on keep going. 

Laura Thomas  
Great. I like it. tacos or pizza?

Katja Rowell  
Both 

Laura Thomas  
Absolutely valid answer. 

Katja Rowell  
All right. Pizza. 

Laura Thomas  
If you could live anywhere in the world, where would it be

Katja Rowell  
my camper, and then just go everywhere. So I’m cheating. I’m cheating in my camper. And I would go everywhere. I lived in the RV for a year and travelled and wrote a book and it was the best year of my life. So someday, someday. 

Laura Thomas  
I feel like that is absolutely cheating. But it’s also the best answer I’ve ever got. So I’ll accept it. Do you have a hidden talent?

Katja Rowell  
Hidden talent? No, I’m pretty out there with everything. No, no secrets.

Laura Thomas  
So what’s your just what’s your talent? That’s known to everyone? Because I don’t know.

Katja Rowell  
Oh, that’s terrible. That’s terrible. Well, I don’t know. I don’t know. That’s, that’s, that’s yeah, I’m gonna pass on that one. 

Laura Thomas  
Well, we’ll come back to it. 

Katja Rowell  
So I painted the painting behind me which which you can see but your audience can’t see. So I like to paint How about that?

Laura Thomas  
I was gonna ask if that was yours. And then I was like, No, like because it looks it looks super professional. 

Katja Rowell  
Thank you. Thank you the river rocks and yeah, 

Laura Thomas  
I like it. Very colourful

Katja Rowell  
There you go. It’s secret, no one can see it. So it is a secret.

Laura Thomas  
What’s your favourite flavour of cake?

Katja Rowell  
Well, you know I had key lime pie yesterday. So that’s on my brain. So I’m gonna say key lime pie. I’m gonna cheat again.

Laura Thomas  
It’s in the it’s the right shape. Favourite, favourite kitchen utensil.

Katja Rowell  
Favourite, my Santoku chopping knife. I love my little knife and I feel very professional when I like rock the tip on the board and I picked up that tip from a TV show cooking show where you actually like hold the top of the blade so yeah, I feel maybe that’s my secret talent is dicing vegetables. I don’t know. So yeah, my my knife.

Laura Thomas  
I love it. All right. Well, you, we’re done. So you know, hopefully that wasn’t so bad. I enjoyed it. So Katja. I’m wondering for those who don’t know you if you could maybe share a little bit about you and your work? 

Katja Rowell  
Sure. So um, I am a family doctor by training and I was in primary care that’s like a GP in the UK, I suppose. And so I saw really just a lot of struggles and suffering related to the way that people ate and felt about eating and food and their bodies and didn’t really figure it all out or put it together till I had my own daughter. And we had some feeding and weight struggles early on. And that sort of opened this career to me where I’ve now for the last more than a dozen years, 14 years or so, I’m really working just in supporting parents who are having difficulties or worries or struggles around feeding their children. And the two biggest issues I see is more of the avoidant what we’ve called it through in the book now, you know, extreme quote, picky eating. I know that’s controversial term. And we will address that a little bit. And then the flip side of that, that I also see is food preoccupation. So yeah, just I think there’s a lot of anxiety. And to me addressing feeding concerns and helping parents is preventive medicine, it really prevents a lot of suffering.

Laura Thomas  
Yeah, no, I hear you on that. There’s so much anxiety and stress that go alongside any feeding difficulties or feeding differences that kids may have.

Katja Rowell  
Yeah, and even typical eaters, even healthy, typical, no challenges, there’s so much fear and anxiety. And you know, I’ve been there and when we feed from a place of anxiety and avoidance and fear and thinking you’re going to prevent problems that we often can make things worse. And that’s just that’s kind of a huge bummer to me that we’re we’re potentially creating or worsening issues when we don’t have to, there’s enough to worry about. So let’s, you know, take some of that off the table if we can.

Laura Thomas  
Okay, well, I think that you’ve just summarised the entire podcast. 

Katja Rowell  
Are we done? No, I’m just teasing.

Laura Thomas  
We’re done, we can go back to bed now Katja. Both Katja and I are kind of sick at the moment. This is something that I wanted to dig into a little bit more with you because something I hear and see a lot from parents is this concern that their child’s what they call picky or fussy eating is really worrying or problematic. And so I’m wondering if we could start out by thinking about what we would expect as sort of developmentally typical fustiness versus where a child may have more what you would call extreme picky eating, how do we kind of conceptualise both of those and differentiate 

Katja Rowell  
You know, I think it can be tricky to differentiate it and I see it as a continuum of sorts but the main message should be if you as a parent are worried about something then you need support and then determining what that support is I think is important so I see it as a continuum we know that about half of children will be described by their parents as fussy or picky and and that’s not just in the UK or the US these from the Netherlands as well we see sort of similar numbers so what we typically might see is a child who are you know, an infant who did okay with breast or bottle and transitioned all right to solids and, and often you know, you see the the the pictures of you know, baby led weaning or the babies stuffing strawberries and avocado and everything into their mouths and so things generally might be going okay or pretty well and then around a year and a half or even sooner for many. The this is a typical that the toddler starts to have favourites and and reject things and I’m you know, I’m sure lots of folks listening to you are following your work know about this neophobia, so very typical to suddenly, you know, toss something off the highchair that they loved, maybe even earlier in the day. So we see rejection of formerly loved foods, we see them also developmentally at the same time they’re learning to and I say this with respect and all this is appropriate, they’re learning to manipulate or just see what if I do this what happens and I really do prefer pasta or sweeter or, or plainer things. So I’m going to fuss a bit, I’m going to throw the food I don’t want and see if I can get what I prefer and, and so that’s all very typical to see favourites and to see fussy eating, they seem to eat less, they’re not as predictable in how much they eat. And all of these things are very sometimes confusing and confounding and certainly frustrating. You know, the child takes one bite of a of a cracker or piece of you know, one bite of scrambled egg and then they’re busy and they’re running off to play and and I think if parents aren’t prepared for that, it can be very nerve racking. They’re not eating enough for they’re eating too much. And then we layer on that our society sort of obsession with only one kind of right body and then we’re in trouble if we think that our child’s appetite is too big or too small or their weight is concerning, or we worry it might be concerning, or they’re not eating enough vegetables and so we can see even how typical picky eating that I’ve described, when we layer on those worries and anxieties, it can actually move along the continuum. If you weren’t already there, I’m a bit long winded. But then let’s talk about more of this sort of extreme presentation that I see where things generally may not have gone well, from the start, there may have been trouble with breast or bottle feeding, maybe the infant was premature, or there were some sensory problems or differences, and maybe weaning to solid foods was more of a rocky start, or they’re preferring the, you know, pouches, or there’s a lot of emotion or upset around food. So in terms of, you know, when I think it’s problematic is, if the amount or variety they’re eating isn’t enough to support healthy growth. So certainly, if they’re losing weight, that’s a really urgent situation. But if they’re falling off the growth curve, and there’s a feeding problem, or you know, that certainly needs to be looked at, if they seem to be uncomfortable, or in pain, a lot of you know gagging, and choking is is normal, not choking, gagging is a normal thing, as we’re learning to eat solids, certainly choking is not but if a child’s toddlers gagging over and over, or they’re uncomfortable, or they appear distressed with eating, certainly, that’s something to to look at. And then if, if the variety or the textures is not progressing, so if you have a 12 month old, that’s only eating purees. Certainly getting that evaluated, I’ve probably missed some because of you know, like you said, I’m not sleeping too well on the tail end of a cold. But, you know, if you’re worried growth, social development are hampered, it’s worth learning more. And whether that’s starting with a book or your GP or your health visitor, you know, it’s worth getting looked at.

Laura Thomas  
Yeah. A couple of things I just wanted to pull out of what you said there Katja. I really, really appreciate you saying, and I wish more people would say this, in fact that if the parent feels like there’s a problem, then they deserve support, they deserve the appropriate support. So if there’s literally anything in your gut that is telling you there’s something not quite right here, even if you’re just reaching out to get some reassurance. Yes, please do that.

Katja Rowell  
And that’s where a skilled clinician or a practitioner should be able to say, Okay, your worry is they’re not eating enough. I’m going to listen to you. And I’m going to consider what you’re saying. And here’s why. Either A, I can reassure you, and here’s some resources, or, Yes, this is a concern. And so what’s so frustrating to me is that, you know, parents get blown off, oh, they’ll grow out of it, or it’s just typical fussy eating, that may be the case. But if the parents concerns aren’t heard, it’s an ineffective intervention.

Laura Thomas  
I hear a lot of invalidation from clinicians, practitioners, a lot of gaslighting. And that’s not what we’re talking about here. We’re talking about someone, seeing your concerns, holding your concerns and talking you through them and saying, Okay, we see we see what you’re seeing. And actually, I think that’s probably pretty typical for for this stage of development. 

Katja Rowell  
Absolutely. Yep. And then also saying, and, and let’s see, let’s follow up in two months. And if you’re still concerned, let me know. And here are some red flags where if things are getting worse, let me know. And I find that, that that’s what parents want. It’s not, you know, it’s not sort of this demanding, they don’t want something to be wrong with their child, if it’s not, but they have to be heard and validated. And then we can provide the education to say, well, actually, let’s look at the growth chart. And they’re smaller than average at 10th percentile. But it’s, you know, it’s absolutely consistent. And I’ve looked at an intake for a day or two, and they are actually over two or three days getting adequate nutrition. And I’m not concerned. And often that’s very, that’s all that parents need, if if they can get that reassurance and support

Laura Thomas  
To speak to your point about red flags I did a post not too long ago about sort of things that we might look out for that are red flags, and I’m quite clear to say in that post that just because red flags are present doesn’t mean that we will unnecessarily intervene or do anything at that point. It’s still just kind of gathering information, collecting the data, and then, you know, if things continue to get worse, we might intervene then but the red flags in and of themselves don’t necessarily warrant intervention if that makes sense.

Katja Rowell  
Absolutely. And again, intervention could be support and education. So many different things, not necessarily right away jumping to, you know, feeding therapy, which in the US, I understand things are a bit different in the UK, but in the US I see. So often, you know, with primary care, they may not have a lot of time and so you know parent comes and says, Oh, my 10 month old suddenly won’t eat. And so I’ve, you know, we’re battling it and he won’t take the spoon anymore. My, this was an actual phone call, you know, and my feeding therapy appointment isn’t for six weeks, and my child’s not eating, and I was on the phone with that parent for maybe 15 minutes, just saying, Well, this is actually that’s a really typical thing for a 10 month old, they want to feed themselves now. So, you know, obviously ruling out, you know, that the child’s not dehydrated or actually losing weight, but just some simple intervention of hand them a spoon, get rid of the spoon, here’s a resource on you know, cooking finger foods at 10 months. And here’s how you play with that developmental phase of them wanting more autonomy and, and I got an email within three days of mum saying, you know, her child is eating like a champ, I’ve stopped feeding him, just everything goes in his mouth, and I’ve been cancelled that appointment. But if that parent hadn’t had that intervention, and they’d continued for six weeks to battle, and to you know, she was getting, understandably because she was really scared, quite forceful with the spoon. So maybe then he does show up at the feeding clinic. And now he does have an oral aversion. And maybe the weight has now really started to falter. So you can see how that missed opportunity for reassurance and support of just a very typical stage in transitioning to solids really can kick kids into quite severe challenges. And I’ve seen that as well, unfortunately,

Laura Thomas  
Something that I’ve noticed is you often refer to extreme picky eating, rather than some of these labels like ARFID, or PFD. And I was just wondering if there’s a reason for that. And, you know, if you ever think that it is worthwhile to go and get, you know, the label as it were, does that make sense? 

Katja Rowell  
Yeah, yeah. I mean, these are tricky things. I think, you know, unfortunately, I think the labels are what in the US get things covered in terms of insurance, if if families are lucky enough to have insurance. So, you know, I think that the labels are helpful in that sense. The problem is that the labels change. And so, you know, in the last 10, 15 years, we’ve gone from infantile anorexia, to paediatric feeding disorder to all different kinds of names for it in both the literature, you know, the research and in diagnostic manuals. And so, I and my co author, we decided to use what what parents have been saying to me for, you know, since my first webinar, you know, our workshop, rather, there wasn’t weren’t really webinars, you know, 15 years ago, which is well, and I was just doing workshops on typical picky eating and introducing solids, and they’re like, Well, this sounds fine. But my kids eating picky eating is really extreme, or, well, my child has really extreme or severe picky eating. And so we chose to use that term because to us, it’s an umbrella for whether you want to call it ARFID, which is really an eating disorder, you know, term. So that’s a whole other can of worms, as they have different areas of focus and don’t, in my mind, their research doesn’t understand the paediatric experience very much. Or as, as well as I think we need to be considering it. So it’s, it’s kind of an umbrella term for anytime a child is not getting enough variety or volume to support physical, social and emotional well being or the parent and the child experienced a lot of conflict or emotion around it. That’s, that falls to me under the umbrella whether it’s ARFID or not, the terms are so difficult, because I really dislike the term ARFID, avoidant restrictive food intake disorder, because when you have one term, one, quote, diagnosis, I’m seeing a lot of protocols as the answer. So then we can say, Oh, this is the treatment for ARFID. This is the treatment, you know, whether it’s behavioural and I think that ARFID is such an umbrella. ARFID can refer to a two year old who’s been on a feeding tube most of their life. It can refer to a 30 year old who choked on a piece of chicken and now has a phobia of of choking and so now is, you know, only say drinking smoothies to subsist, it can be a teenager who also doesn’t want to, you know, gain weight. It’s incredibly complicated. And to me one diagnosis, we then sometimes lose the individual and the very different ways that individuals can access healing, depending on so many factors.

Laura Thomas  
And I wasn’t trying to catch you out with that question. I also kind of share your scepticism of some of these labels. And I also wonder about folks who are maybe like just beneath the clinical threshold and then if they don’t meet some sort of arbitrary criteria, then where does that leave them in terms of seeking out support? So that’s why I think I know they, you know, you you say that there are there problems even within the extreme picky eating kind of moniker. But that that feels like a more all encompassing terminology for, for what what’s going on feels more accessible in some way? 

Katja Rowell  
Yeah, absolutely. You know, and one last point I want to make with ARFID, since it’s an eating disorder, it now gets lumped in with these other eating disorders. And I hear people being told, you know, eating disorders are lifelong things that you struggle with. And it’s like, it’s like alcoholism, it’s a disease that you have to be careful for, and you’ll be in remission. I think that’s a really scary message to a parent of a three or four year old, when I’ve seen some of these kids with very minimal, quote, intervention become typical eaters. So I really worry about that. And I also never send parents whose children have been labelled as ARFID, I think we’re over diagnosing it, using that label, to eating disorder resources, because almost always, the first paragraph says, eating disorders are among the most deadly of any mental illness. And the data is not there for ARFID, and certainly not for many of the children with the selective eating or avoidant eating. So there’s a lot of fear around the term ARFID and around, you know, calling it an eating disorder that may not, you know, be warranted for a lot of the folks with that label, not to say that there aren’t people struggling who will need support under that term, but I you know, I feel like it ups the anxiety unnecessarily, which is unhelpful.

Laura Thomas  
Yeah, agreed. And I think as well, for some folks, I’m thinking here about adults with ARFID, that can become a very stigmatised condition. It’s a complex conversation to have, and I don’t think it’s necessarily our role. 

Katja Rowell  
No, no, I know, we got a bit, we got a bit down that tunnel, which happens a lot with this work. But I think the point is, is that for me, it’s that the protocol piece is the piece to be afraid of, if someone says, Well, we treat all of our kids with ARFID with X or Y, that’s, I think, a red flag in terms of looking for appropriate support.

Laura Thomas  
So let’s move on to think a little bit about support because an approach that you and your colleagues have developed to support kids and families with extreme extreme picky eating is called responsive feeding and responsive feeding therapy. And I wondered if you could explain the values of responsive feeding and how responsive feeding therapy differs from some other so called treatments that are available, particularly those more manualized therapies that I think you were alluding to in our last question.

Katja Rowell  
So responsive feeding has been around for, you know, a while, 2011 I think the sort of coined the term. And so there are many of us working on responsive feeding therapy, which is grounded in responsively. And I want to mention that we have occupational therapists, paediatric dieticians, eating disorder, dietitians, speech pathologists, psychologists, researchers, involved in developing this model. So it’s not something I sort of came up with, you know, in my, in my corner office here. So responsive feeding therapy, we developed it almost in response to what we were seeing because so many of the kids who came to me had, quote, failed, more traditional therapies for selective eating or food avoidance and most of those therapies were very much we’re going to get the child to desensitise, you know, if they have sensory differences, we’re going to desensitise the child up this hierarchy or this chain. And parents were like, we’ve been doing this for a year and a half, and it’s no better, it’s worse, if anything, there are also behavioural therapies, you know, where children are even restrained. And it’s, you know, an exposure where it’s like, we’re not going to let you escape your child escape eating, which is the task we need. So I should probably do a content warning here. But you know, crying, gagging, thrashing vomiting are, are viewed as behaviours to extinguish and so in the behavioural approach, we’re going to use essentially rewards and punishments to try to get kids to eat. We reject that and while there’s a role for thinking about sensory differences, I also think that you know, we’re going to do food chaining and we’re just going to work on trying to increase their tolerance of different textures or smells, in and of itself. It’s tool we can use but I think that is the sole therapy I, again most of the clients I’ve worked with have have tried and, quote failed. So the values of a responsive approach are, number one is the autonomy. And when we think about the development, what you’re dealing with, with a two and three year old is I do it. And we, you know, when we thwart the child’s autonomy, when we try to get them to eat, they push back, just like with anything else, we want them to tie their shoe or put on their jacket, they’re going to push back. And when we allow that battle, into the feeding relationship, we do have, because of the child’s temperament or negative experiences, we do get children who would rather fight or resist than eat and we can see, you know, weight falter because of that relational piece. So autonomy is super important. The child can always say no, or indicate no, if they’re nonverbal. We want to respect the child’s bodily integrity, and they are in control of what they put in their mouth, chew and swallow

Laura Thomas  

If it’s okay, Katja, it’s, it’s something I’ve been thinking about. And I’d be interested to hear your thoughts on because sometimes the autonomy piece may not look like I need to feed myself, but it may be kind of the converse of that, which is there is this such a push for independence in our children, we want them to be self feeding all the time. And sometimes that autonomy piece might be like, might actually be supporting them in their eating, I’m thinking of my two year old who’s like, Mama’s lap Mama’s lap and wants to sit on me, wants me to put the food on his fork and put it you know, up to his mouth for him. And, and I just want to make it clear that that can still be responsive. And that that can still be helping them meet their needs. It just might not look like this hyper independence that we fixate on in capitalism. I don’t know where exactly that feeds into responsive feeding, but I,

Katja Rowell  
That’s actually, absolutely, that’s really important. And I think that gets it. I don’t know, if I’m, you know, a little bit of the baby led weaning movement that maybe that has now become pedantic, pedantic I don’t know if that’s the right word. But that’s become an extreme as well. So this is what I love about responsive feeding, is, you know, some children want to do it themselves. And others will need more support, whether it’s because of, you know, motor differences, or, you know, you can absolutely spoon feed a child in a responsive way that supports their autonomy. And some children need and want that. And so I’m actually a fan of, you know, there’s some research, I think it’s called the hybrid or modified baby led weaning, which is basically responsive baby led weaning. So we don’t have a one size fits all. I mean, my daughter loved to eat, had this glorious appetite, and she was a chomper. And so she would just anything you put in her mouth or near it, or she would grab it, and she would chomp a huge piece off. And so, you know, the the baby led weaning didn’t work great for us the way it was in that was 16 years, 15 years ago, described in the book. And so we did, we did purees. And we did mashes but by, by a year, she looked like probably most of the children do, who’ve been, quote, pure baby led weaning. So we did what worked for us and what works for the parent is important too. So if you know if a quick meal is spoon feeding an older infant, you can absolutely do that if you don’t have time to sort of sit there for you know, 40 minutes while they play with a broccoli, you know, roasted broccoli spear, whatever it is. So, so one of the things with with responsive feeding is that we also, the parent is part of this. So the value two is it’s relational. And so the parents experience is part of it. And so, you know, there again, when we take any, quote, rule with feeding, and I remember reading the first baby led weaning book, and it was, I’m going to, probably don’t shouldn’t misquote it, but it was something like, you know, a child who was spoon fed can’t decide or you know, you’re taking their autonomy away, and that that felt very, 

Laura Thomas  
That’s ableist, sorry, I’m just gonna, it’s ableist.

Katja Rowell  
Yes, there’s ableism. There’s, you know, and I think, again, the dirty little secret to me about a lot of these accounts that are out there is it’s also fat fearing, you know, and a lot of times what I see with the message with some of these feeding methods, is you need to feed them this way so they don’t grow up to be fat. And, you know, I’ve seen a lot more videos now about pace infant feeding, pace bottle feeding, and I just spend a while sort of watching random YouTube videos, teaching people to pace bottle feed, and a lot of them had pretty implied messages of, you know, make your baby work for that milk and sort of, we don’t want them to get fat. We don’t want to overfeed them. You can bottle feed in responsive ways that honours and supports their ability to tune in to hunger and fullness cues, just like spoon feeding. So the relational piece is also trusting the parent who knows the child best to do what the child needs. So yeah, those are all excellent points. So thank you. I’m not in the infant realm as much, but I think I know exactly when you say that sort of hyper fixation on self feeding. I’m like, Oh, yes, that’s a great point. To talk about autonomy. Yeah,

Laura Thomas  
We could get we could do a whole episode, I think about baby led weaning and the whole like, weaning industrial complex, but I’m having that conversation with with the paediatric dietitian next week. So I’ll spare you. But there’s, there’s a lot of nuance, like even in the connectedness piece, you know, I’m also in the back of my mind, thinking about the romance, romancitization, the glorification of family meals, and, and how there’s some research that shows that children can get that sense of connectedness, and the competence that comes along with that, from meals with their peers. So like in a school lunch environment, for example. And so, I think a there’s a lot of pressure on, on parents to have a family meal. And also, I think it’s really important that in the nutrition profession, as a whole, and I know, Naureen Hunani has talked a lot about this is kind of like just taking family meals down off of a pedestal a little bit. Because, you know, sometimes, there can be some tricky dynamics going on at the family table playing out that can play into some of the the feeding differences and feeding difficulties that we’re seeing. So actually, what might be best is to, you know, go and sit on the couch and have a meal or a snack.

Katja Rowell  
Absolutely, and I’m gonna say yes, and to that. Absolutely. And I think that, you know, if a child I do a lot of work also with children in care, so foster care in the US. And so we see a lot of trauma and sensory differences and brain based differences. So, yes, if a child needs to stand and bounce on their toes, or come back and leave the table, so I absolutely agree, we need to build in more of that responsive piece, what’s best for the child and their nervous system, and, you know, staying feeling safe and regulated, however, and oftentimes, the tables really an unpleasant place to be because of the battles around nutrition and bytes. And, and so, so often, I don’t want to give up on eating together. Now, we don’t have to have a family meal look like everyone, you know, who lives under the household at the table every time, and it’s 25 minutes of bliss and sharing highs and lows. And, you know, there’s a roasted chicken, it can look like different things. But I don’t want to toss out eating in a connected way, if that’s accessible, and especially if, you know, responsive practices can bring that space and open that safe space for connection. And so I wanted to step back for autonomy. So for example, because this relates a bit. Autonomy support means letting your child have more mashed potatoes before they eat broccoli. It’s, you know, and so that’s, that’s autonomy support the child gets to decide. And then if we’re not arguing over that one piece of broccoli, we have space for connection. And so while I agree, we don’t want to shame or pedestal and meals look different for different families, oftentimes, we have lots of opportunities to actually make the family table much more pleasant or the counter or the couch or the floor, you know, 

Laura Thomas  
It’s usually the kitchen floor with my toddler on my lap. Like that’s kind of our snack time routine. And you know, yeah, but I totally I hear what you’re saying is that a lot of the conflict that is making the table feel unsafe can be you know, significantly reduced just if we support autonomy, and there you know, we can we can talk about what that looks like in a second, but I keep interupting your explanations. 

Katja Rowell  
First, well, I think it’s mutual. So yeah, responsive feeding therapy. So we have autonomy and relationships and where, and by relationships the attunement it’s so it is seeing okay, my two year old does need right now to be on my lap or I do need to spoon feed my child with you know, low tone. So it’s it’s the attunement piece and and the warmth, connection, its internal motivation is the other value or, you know, we want to support children to the best of their abilities to eat based on hunger, fullness, curiosity, pleasure, rather than we need x servings of fruits and vegetables or I need to control your portions. So it’s the internal you know, maybe it tastes good or it’s soothing, or whatever that internal drive is. Individualised care is the other value, which we’ve already touched on. So we reject sort of protocolized approaches, and also whole child so that the flip side of that is we need to explore what’s going on in the school environment where they may be forcing them to eat their food before they can go out to recess, which happens a lot. So you have a child sort of gagging and crying and choking down their food, or they’re not able to eat at lunch at all. So they’re really, really hungry and dysregulated when they come home because of food rules. Also, you know, what if a parent has themselves relapsed with an eating disorder, so all and food insecurity, do they have enough food, so so many pieces to consider. And then competence is the last piece and our occupational therapist and speech therapist have brought a lot of you know that into this is that it’s not just checking off, they can do this, they can do that it’s the individual. Do they feel competent, and supported. And also looking at the oral motor skills to eat, and if there are issues there that need support,

Laura Thomas 
Thank you for running through all of those. And I’ll link to the white paper that you and your colleagues have written on this, because it’s really helpful. And I think just for any parent out there, who is, you know, looking for support for their child, I guess just a little, I don’t know, just a gentle word of warning that a lot of people are using the terms responsive feeding responsive feeding therapy, but they don’t necessarily align fully with these values. And so maybe just asking, you know, before committing to something, asking about what training they’ve had, and just probing a little bit around these values, or if you detect that maybe there is no they’re converging from some of these values, and then perhaps question if that if it’s the right approach for you.

Katja Rowell  
Yeah, that’s a great point, I think on our, my co author and I, extremepickyeating.com, we did a blog post on finding the right help for your family, which includes a list of some of those questions. So I’ll make sure you know that, that to get that to you. That’s such a great point. Because I mean, I’ve had parents and children who’ve said, the parent says to me, I’ve been absolutely traumatised by this behavioural usually and I had a fantastic interview with a 20 year old who had a feeding tube, most of her life for my, you know, second edition of my foster and adoption book, who remembers at four and five going through these behavioural feeding therapies. And I won’t get into details, but you know, very physical coercion, and then you look on their website, and they’re like, we’re a family led child centred. And meanwhile, there are two adults restraining a child in a you know, a highchair that is basically circled around them. So the child literally can’t move or escape and, you know, distressing stuff that you can imagine. So that’s a great point. So another thing is, if what you’re asking to do in therapy, or what you’re observing is happening to your child increases your child’s distress or anxiety. I believe that’s counterproductive. If you know if your child is screaming in the car on the way to therapy, or vomiting, or crying, or you know, a lot of therapists here will separate parents from young children, they won’t let you know, you know, you can’t come back with your three year old and parents will say, I was in the waiting room, and I could hear my child screaming. And when I insisted on being in the room, they fired us, right? Oof. So yeah, that’s a great point is to, and that’s the relationship and connection piece of responsive feeding therapy is and the autonomy piece, if your child is screaming, and you’re dragging them in, it’s all related. So good. Good warning.

Laura Thomas  
And I think you know, that just almost from the parents perspective, I think what can be so appealing sometimes about these protocols is that you know, they have a very, they have very clear step by step by step by step, you do this, and you do this, you do this, and you do this. And that’s a little different from responsive feeding therapy, at least as I understand it, where it’s more tailored to the individual. So there’s a lot less kind of, like, you know, we’re gonna do A then B, then C, then D, because it depends, right? It depends what because we’re responding to what happens and what we see. And my experience at least is that that can be a little more unnerving for the parent, like you have to trust the process. It’s like learning intuitive eating, right? Like, there’s a general framework and their general principles, but like, it’s gonna look a little bit different for everyone. And so I just want to, again, acknowledge and validate that if that feels uncomfortable, I see why that that might be and I see the appeal of that like you, you know you do this step and this step, and step, but kind of going back to what we were talking about before, if there’s something that doesn’t feel right about that, then yeah, trust your instinct around it and maybe see if there’s, there’s something that is a bit more responsive.

Katja Rowell  
It’s very tricky. It’s very alluring to have a programme, say we have a 12 week programme. And they will be and here’s our data we have, by the end of the 12 weeks, this kind of programme, we see 75% more mouth clearance.

Laura Thomas  
And we’re gonna expose your child to 60 new foods a week. And I’m like, that’s some major alarm bells for me. 

Katja Rowell  
Yeah, it’s very difficult. The other thing I want to say, though, is that, you know, smiling, playful therapists, or, you know, a lot of times what’s sold as food play, or, you know, some of the hierarchy sensory stuff is very playful and smiling. And sometimes children will go along and in therapy. So, you know, if you’re sitting there going, Oh, we’ve been doing this for a year and a half, that’s very common, and my child eats the stuff in therapy, but never at home. So even playful, happy therapy isn’t always responsive. And that can be even harder to, to sort of parcel out or parse out, because, you know, it doesn’t look coercive, but if it’s not, you know, really driven by the child, if it’s the therapist saying, Okay, here’s our five foods, and we’re going to expose to these today. It’s not truly you know, it’s like authentic play versus an adult, sort of now, I want you to play with this and that. So

Laura Thomas  
It’s not child led, there’s still an agenda there, that is being directed from the adult. And I think that is such an important point, particularly if you know that you have a child who is more like, who wants to please you, who wants to make you happy, make other adults happy. Because what we know can happen is that children, like adults will dissociate, they’ll do the thing. They’ll be there physically, but, you know, mentally they’ve checked out. And ultimately, that’s correct me if I’m wrong, but that will lead to trauma in the long run, or it could,

Katja Rowell  
Yeah, it can lead to trauma. And importantly, it leads to a disconnection between the body signals and the eating. And there are actually a lot of therapies, I believe, that kind of rely on this, and I have parents telling me, Well, they only eat in front of a screen we learned in therapy, you know, from from nine months on till now and the child’s 18 months, we only would eat in front of a screen. And I have very astute, well educated parents, and some are therapists themselves who say, I think he has to dissociate, they actually use the word or they’ll say, zone out or go numb for me to get food in. And so I suppose that’s another red flag, if you’re have a toddler who or a child who only eats, if they’re zoned out on a screen, so you can sort of shovel a few more bites in, that’s concerning, potentially, in that we’re making it more difficult to tune in to or where we’re, we’re not supporting really those internal cues. And, of course, I want to, you know, with everything this is the problem is this model is not sound bitey. So I’m sorry, in some scenarios, actually eating with a screen, I think is appropriate and responsive to that child, particularly if there are sensory differences. So they’re using it to for regulation, and then they actually can almost tune into their body more with the screen. That’s not the majority of the cases. So I hope that nuance was clear. But yeah, you know, if you go into a therapy, that basically the only way they have of getting food into your child is with the screen, and you’re still stuck on a screen a year and a half later. That’s pretty tricky.

Laura Thomas  
Yeah, absolutely. And I really appreciate that point of clarification around, you know, sometimes screens are responsive, if if it’s supporting regulation, and then and then allowing the child to Yeah, to regulate to the point that they can actually tune in with what’s going on within them. And so I know that this piece around interceptive, interception interceptive awareness is something that you’re big on. So that’s kind of a fancy way of saying tuning in with what’s going on internally. So can you tell us a little bit more about what you’ve been exploring around that and some of the things you’ve been thinking about in that realm? Maybe you could start by exploring what your understanding of interoceptive awareness is.

Katja Rowell  
Yeah, no, I think I think you got it. It’s the internal experience and as we all know, that’s everything from hunger, fullness, thirst, feeling your heart beating, whether you have to use the toilet, whether you’re hot or cold. Yeah, fatigue, sure and emotions and and so I think what can be very tricky is our emotions are often experienced in places where hunger and fullness are experienced. So anxiety, fear might be in your gut or in your throat. And so you know, can be very tricky. And then certainly people have differences with, you know, with autism or interoceptive challenges or differences. I want to also really point out though, that I think we are really in danger. And I see this so much. So a child has sensory differences, or they’re autistic. And then a therapist says, well, your child has sensory differences, so they can’t tell when they’re hungry. So you have to do it for them. I do think that there are there are challenges to tuning into those cues. However, I think we’re, we’re far too often assuming that children can’t do it. And I’ve had several cases where the parents have been told they can’t do it. And so they’re, they’re pushing food all day long. And then really, within three or four days of, you know, backing off the pressure, all these other things we do to support the child, you know, I get these emails, four days later, oh, my gosh, my child just asked for seconds of pancakes. And they’ve never and said, I’m hungry, which they’ve never done in their life. And this is a four year old, who had having challenges from the start and worries that they were underweight from the start, their entire life had been sort of pushed and coerced to eat. And we know that that pressure, we’ve there’s good evidence that the pressure to eat and the trying to get kids to eat more decreases their appetite and interferes. So I want to be really clear that while there are differences and challenges, it means we have to be better at supporting the environment. And maybe for some even using external cues. However, I think far too often now I’m seeing parents of, you know, neurodivergent, or whatever the challenge is being told their child can’t do it. And then that’s, that’s just a recipe for, you know, self fulfilling prophecy so. So it’s really complicated, but I think that we can do a lot to support interoception through those values that we talked about. I’m not a fan of and I see this with the food preoccupied kids that I work with, or the especially kids in bigger bodies, where the agenda is to try to get them to eat less. So parents go into and I see dieticians trying to train with worksheets and cognitive sort of top down tune into your tummy. What’s your tummy telling you? Let’s look at this, this you know, pea pod and are you one pea hungry? Or are you five peas hungry? I’m sorry, if that’s a particularly branded one that’s out there.

Laura Thomas  
No. I’m just like screaming internally, because I know exactly what you’re talking about. And it’s given me the ick and I think you’re just about to articulate exactly why.

Katja Rowell  
Yeah, yeah. It’s a very frustrating thing. Because most of the time when adults are doing that, we’re asking it to try to get an outcome that we want, whether it’s to get the child to eat more or less. And it can backfire. You know, when you have a client where the child says, Okay, I listened to my body, my body wants, you know, ice cream for dinner? Well, then what are you gonna say you’re gonna argue with them and say, your body’s not really telling you, you know? And then you have the child trying to guess what’s the right answer? If there have been struggles with food for a while, they have no idea they can’t articulate, they may not even be able to feel it if you’ve been struggling for a while with low appetite or avoiding eating or food preoccupation. So it’s asking them to think and cognition with their brains and rationalise a process that’s experiential and embodied. And I, I almost never recommend it. Almost never and particularly bigger bodied kids. They know, they know that the answer is when you say, Does your tummy really want more mashed potatoes, they know that we want them to eat less, adults, not we, but adults in their lives want them to eat less. So I really, really am not supportive, almost in every case of interceptive training for children especially,

Laura Thomas  
I think it’s such a great point. And something that I think a lot about is how children need to get it wrong, to learn how to get it right, if that makes sense. Like kids need to stuffed themselves so full sometimes that they puke. And I don’t mean that in like a, you know, sinister way just to know like, you know, that that sometimes happens, and that’s okay. And that’s part of the learning process. And sometimes they undershoot the mark and they need to experience what hunger feels like as well in order to be able to learn that that self regulation piece and I think what you’re also naming here Katja is how the term responsive feeding how self regulation, how you know, tuning into your appetite, like all of these things are coded ways of saying we don’t want you to get fat. We don’t want to let your child get fat and so it’s It’s just another way another iteration of anti fatness showing up in this space. And I think we need to be really careful and reflect on okay, why what what am I trying to do here when I’m training you know, hunger and fullness. Is my intention, you know, the broader piece around self regulation, which I think is important and learning develop, like developing trust in oneself, or maintaining trust in one’s self versus trying to control body shape or size. Does that make sense? 

Katja Rowell  
Oh, 100%. And I think that by supporting their autonomy, and through warm attuned relationships, and being in that nervous system place of felt safety and feeling comfortable, and eating time is, you know, not fraught with high emotion, they’re much more likely to tune in to those inborn capabilities. And when we again, this is when we feed from a place of trying to avoid an outcome, we’re actually more likely to get the outcome we’re trying so hard against. And that didn’t quite make sense. But you know what I’m saying. So 100%, I think that if we were to accept that there is natural diversity in bodies, some are bigger, some are smaller, we wouldn’t see the numbers of that we see in terms of weight dysregulation on both ends of the curve over time.

Laura Thomas  
Yeah, yeah. Agreed. Okay, I wasn’t going to ask you this, because we’re close to time, but you said, my favourite words. And so I’m going to have to dig into it a little bit. You said the term felt safety. And I think that that’s quite a kind of an abstract concept. And it’s probably quite difficult to pin down in just a few minutes. But I think it’s, this is maybe my bias, but I think it’s so essential to conversations about feeding, especially when there are challenges that come up in the feeding relationship. And so would you mind just quickly explaining what is meant by felt safety, and then some of the things that we can do to help support health safety? And the caveat that that’s going to look different for everyone.

Katja Rowell  
Absolutely, yeah, 100% and this is something where my work has really evolved as well. And I’ve learned this from, you know, really traumatised, or neglected you know, scenarios or with you know, brain based differences. And so felt safety is critical. And something I want to say, which may be my my being a doctor, I can say it, is that it is the health intervention. So I do a talk that I call felt safety before vegetables. And because felt safety as one, you know, adult adoptee I interviewed said you just know it, when you feel it, you can sort of sink into it, your body, you know, you’re not agitated, and it’s sort of the opposite of fight flight or fawn. It’s sort of when we’re at rest. And you know, we’re we’re, we’re not feeling threatened, whether that threat is, you know, a logical threat or not, we can feel agitated when we’re sitting on the couch, and there’s no logical threat. And the important thing to me is that when our bodies are in felt safety, they function better they are, quote, healthier bodies. So this I think really helps when parents are struggling with picky eating, but I can’t not force the broccoli, well, you get the one bite of broccoli down and your child has a 10 minute sort of meltdown over it, you have totally eradicated any benefit of that broccoli being in their bodies. In felt safety our cardiovascular systems don’t experience wear and tear we have you know, our heart rate, blood pressures, good. We, our digestion works better. Our hormones, you know, our thyroid, our growth hormones, cortisol, insulin, all of these systems work in healthy ways, our immune systems. Whereas if we’re you know, which is unfortunately when I’m dealing with the extreme picky eating or the extreme food preoccupation, there is a huge amount of stress and conflict around these issues. That’s a lot of wear and tear on bodies, that negates benefits of vegetables. So felt safety is the starting point. You know, if you’re dragging your child kicking and screaming into the highchair and they’re bucking and maybe you can get a half an applesauce pouch in them, you need support and focusing on felt safety first, and that’s the relationship piece. That’s the connection of responsive feeding therapy as well as you know, supporting the internal motivation. It’s all related. We can’t sort of tease out one one piece of it but felt safety is really it’s it’s it’s the North Star.

Laura Thomas  
We’ve been talking a lot maybe about the more extreme picky eating presentation, but I think that this felt safety pieces is essential even if you’ve got you know, just a typically sort of particular toddler who, who’s who just doesn’t want like the sauce on their pasta, that is part of their experience of felt safety or it’s it’s antagonising their experience of of felt safety because to, I’m mean it can be autonomy as well. But to that toddler, if they’re really in the thick of that food neophobic phase, that can be like that is a legitimately real phobia to some kids. And so that can throw off that that experience of felt safety. So, you know, if it’s accessible, having the plain pasta and the sauce over here, that that’s supporting that piece around felt safety. This is a really simplified, you know, example, but 

Katja Rowell  
Oh, absolutely, absolutely. I mean, why why not, you know, that’s what the beauty of self serving at mealtimes because the plate comes down. And it’s an empty plate versus if you pre plate it, and they look at it, and they see the sauce on the plate touching the pasta, and they’ve immediately gone into a meltdown, or tantrum or whatever it is. And, and then they’re disconnected from their body cues. And so all of that and from the relationship and so 100% Yep,

Laura Thomas  
I feel like I could probably talk to you all day about all of these, like super nerdy, like little, what’s the word like the nuances of,

Katja Rowell  
We’re in the right careers, then if we can, I agree, I know

Laura Thomas  
If we can geek out on it. But no, I really enjoyed this conversation. And I hope it gives you know, parents who maybe are going through the more typical food neophobia, you know, striving for autonomy, toddler stage that just the reassurance that it will work out. And also, if it’s a bit more than that, then it will help parents find the appropriate support for them. And yeah, responsive support. So I really appreciate that. Before I let you go Katja. I want to know what your jam or your jams are at the moment. You said that you had a couple picked out already.

Katja Rowell  
Well. I’m so contrary. And I was trying to decide do I talk about love? Or do I talk about my airfryer? So those were my two.

Laura Thomas  
Are they not the same thing?

Katja Rowell  
They’re related at is everything but you know, you sort of said what are you really into and I’m totally obsessed with my airfryer I don’t know if that’s, Joe, my colleague in the UK, said it’s not as big of a thing in the UK. But you know, I’ve fallen in love with potatoes again with my airfryer. So tired of mashed potatoes. And also for if you have a child who’s a little bit choosy or selective, it can make a big difference in terms of the texture. So I actually was chatting with Naureen after webinars she did and we both find that it has this really, it gets a crispy texture, that is really great for a lot of kids who want that texture. So it’s not the same as in your convection oven. It’s really kind of fantastic. And so I love it, I can get you know, from from a spud to a basically crispy sort of little french fry type thing in about 23 minutes from you know, from spud, to table so, and frozen foods do really well in there. Little frozen foods. And if you have older children who are learning to cook for themselves, and also it’s an accessibility thing, so love, love the air fryers. And then the second thing is love. It’s such a messed up world you mentioned with the capitalism and ableism and sort of all of these and in the US the gun violence that just continues unabated. And I’m late to the game, but I’m really into Bell Hooks books, what about love and are all about love, rather? And, you know, love sort of makes me feel less powerless to think about, you know, having that ethic of love grounding everything we do. So there you go. Those are my two things.

Laura Thomas  
Oh, well, I don’t know what Joe’s talking about. Because air fryers are definitely a thing here. My parents have one so like if they’re on the bandwagon, then

Katja Rowell  
It’s probably close to being over if your parents have one.

Laura Thomas  
And no, I really I love that message about love as well. And you reminded me I wasn’t going to talk about this. But there’s a great Instagram account called Saved by the Bell Hooks. I don’t know if you’ve read it. It’s Bell Hooks quotes over Saved by the Bell pictures. And it’s as good as it sounds. And they’re all they always I don’t know who runs the account but they always find like the perfect quote for whatever is going on in the world. And it’s always just, you know, like, AC Slater and Zach just, so it’s a little bit of like throwback nostalgia as well.

Katja Rowell  
Excellent, on it.

Laura Thomas  
So I’ll link to that as well in the show notes. But the other thing that I was gonna say is I’m very, very grateful for vaccines right now. So I’m on day three of COVID and I am triple vaccinated and still, as you can hear sound like crap, I feel like crap, I dread to think how much worse this would be if it weren’t for vaccination. So I’m very grateful for vaccinations at the moment. That’s my that’s my jam. So Katja, before you go, can you let everyone know where to find you and your work and your books?

Katja Rowell  
Sure. So on Instagram, it’s @katjarowellmd. So it’s my first and last name, MD. I am on thefeedingdoctor.com is my website and my books are on there. And then also extremepickyeating.com is where my co author and I have some information about that book as well. And we also wrote, If you have parents who are struggling with selective eating themselves, or who are looking or want to address their own eating in terms of variety, we did a workbook for teens and adults called conquer picky eating. So there’s that as well.

Laura Thomas  
Oh, well, I will link to all of those resources in the show notes. And yet your book that you wrote with Jenny is like my go to in terms of anyone who is struggling with feeding your kid and can’t access support or is not being heard by their, their GP, for example, or their health visitor, then yeah, that’s where I recommend they go. So I’ll link to all of those in the show notes. It’s been such a pleasure to talk to you Katja thank you so much.

Katja Rowell  
Thank you, it’s been a treat.

Laura Thomas  
All right, team. That’s this week’s show. If you’d like to learn more about today’s guest, then check out the show notes in your podcast player, or head to laurathomasphd.co.uk for more details or the full transcript from today’s episode. Big thanks to Joeli Kelly for editorial and transcription support. And if you need to get in touch with me then you can email hello@laurathomasphd.co.uk or find me on Instagram @laurathomasnutrition. And if you enjoyed today’s episode, then you can help the show reach more people by subscribing on your podcast player and sharing it with a friend. Alright team. I will catch you next Friday with a brand new episode.

See you there.

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