Grace Wong (1s):

There's this misconception out there that because I have had an eating disorder, I cannot do a good job of off feeding. And I don't think it's black and white like that. I believe is about how to be intentional in observing ourselves in how we facilitate.

Katie (16s):

Hey, there I'm Katie Ferraro, registered dietitian, College Nutrition professor and mama of seven, specializing in baby-led weaning. Here on the baby-led weaning made easy podcast, I help you strip out all of the noise and nonsense about feeding the new with the competence and knowledge you need to give your baby a safe start to solid foods using baby-led weaning.

Katie Ferraro (44s):

And welcome back to another episode of the baby-led weaning made easy podcast. I'm your host, Katie Ferraro and today's guest is Grace Wong. She's an eating disorder, dietitian who also works with pediatric feeding disorder patients. And she's going to speak to parents today. She's talking specifically about parents in eating disorder recovery. What to know before you go to feed your baby. So Grace has a background in working both with adult and pediatric eating disorder, patients and clients, but she's also worked with children who have feeding disorders. So she's going to explain the difference between the two, but we spend most of the time in the interview today talking about how we can focus on the parents, right? Because so often, I mean, our babies are important.

Katie Ferraro (1m 23s):

Nobody's discounting that, but we focus so much on the babies that we sometimes aren't paying attention to. what's happening with mom when the baby turns six months of age, many parents are. It's a very vulnerable stage, especially if you have a history of eating disorder, there's still many body changes going on. There's concerns about mom's mental health. Oftentimes postpartum depression is happening. There's concerns about body changes and body image. So Grace really speaks to all of that with a really nice approach to being sensitive to the needs of both the mom and the baby. And then how baby-led weaning can hopefully be a positive experience for mom and for baby, if the mom is in eating disorder recovery. So I hope you guys enjoyed this episode with eating disorder, dietitian, Grace Wong.

Katie Ferraro (2m 7s):

Well, hello, Grace and thank you so much for being on the podcast today, to talk a little bit to us about parents and eating disorder recovery, and what they should know before they feed their baby. So again, thanks for being here.

Grace Wong (2m 18s):

Hi, Katie. Thank you so much for having me. It's such an honor to be talking to you about this topic. I'm very passionate about this.

Katie Ferraro (2m 23s):

I know you are, it was like just learning so much about the work that you do. And maybe you could share with our audience a little bit about the population that you work with. And I learned a lot in speaking to you about the difference between feeding disorders and eating disorders. And maybe you could share with us how your professional experience has shaped your knowledge and understanding of both of those. And just so we can learn a little bit about who it is that you work.

Grace Wong (2m 44s):

Absolutely. So I started my work in eating disorder as an eating disorder dietitian, and now I work with all ages, but when I started, I worked with particularly children and youth. So that would be the groups that are where you think about an eating disorder. Their eating is quite severely impacted because of their concerns or feelings, how they feel about their body size and shape. And then as I continued to do this work, I start to meet families who present to, as that would what I would say. It's more like a feeding disorder. So eating it's very challenging, but it's not related to, to body concern.

Katie Ferraro (3m 24s):

So, I know one thing that my audience is really interested in, many parents learn about baby-led weaning, and they like the idea. Gosh, my baby will learn to feed themselves wholesome age, appropriate foods, learning to listen, to, and respond to their own hunger and fullness cues. And for some parents that really resonates because as many people in my audience will share openly, they'll say, you know, I want my baby to have a healthy relationship with food because I, myself do not have a healthy relationship with food. And that can look like many different things to many different people. But I was wondering since you do work with the parents and we are talking today about parents in eating disorder, recovery. So much of being a mom or a parent is focusing on the baby and what's the baby doing? And now the baby six months of age, and it's time to start solid foods.

Katie Ferraro (4m 5s):

Could you talk about why this is a particularly vulnerable time for the paren, especially one who may be in eating disorder recovery.

Grace Wong (4m 12s):

I've worked with parents who have all these concerns manage really well prior to the pregnancy or prior to birth, but then after this time sleep deprivation, it just creates these new challenges. So I think it's support what type of supports available. And, and when I talk to parents about feeding, sometimes we look at specifically what is manageable? What do we need to, to bring in? One of the things that we talked about is who is sitting with the baby to eat, you know, as it have to be the mom, maybe when we sta introducing solids. And then another challenge at this time is bodies are changing. Our bodies are changing in that still early time. For example, for our moms were still breastfeeding.

Grace Wong (4m 51s):

We feel things in our body, our breasts are changing. Our entire bodies are changing. So it's very vulnerable in terms of how we feel in our body. And these feelings can get triggered when we start interacting with food, not to say, and I won't keep going going, but you know, there's another thing that I'm thinking about is when we take our children and babies into physician visit, sometimes physicians or pediatricians will discuss with us our children's growth. And sometimes the language that's used in discussing the baby size can be hard for us too when we hear about, you know, babies being too big or being too little, these are words or phrases that are often used and we might not realize what is it like for parents to be hearing that on the other end.

Katie Ferraro (5m 39s):

And I think that's such an important point is that there are so many potential stress points when you're raising children, especially small children, especially if the first time you've done it. And the one barometer of whether or not you're doing a good job, all comes boiled down to the growth chart. And while your baby fell off the growth chart, and last month they were this and that, and parents just convey such a sense of judgment. And so many parents, it is a very high point of anxiety to have to even have the baby weighed or have the baby's height taken announced. Sometimes I, I just hear the anguish in their voices after those meetings, because they're feeling like the entirety of their parenting capabilities are being judged by the growth chart. And while the growth chart is very important. We often times remind parents that the inaccuracies of how babies heights and weights are obtained in your typical pediatrician's office, at least in North America, men, more often than not, it is an error of the weight or the height.

Katie Ferraro (6m 28s):

And oftentimes the person in the office is in a big hurry. They might have something else on the scale, or the baby has a full diaper on or the baby squirms and then the height ends up being longer. So oftentimes these, these major fluctuations in the growth curve, which can cause so much anxiety and parents may just be the function of a simple error in recording height or weight. So we don't want to discount it. It certainly is important, but the entirety of your parenting capability should not be, you know, hanging on where the baby falls on the growth curve, because that can be so anxiety inducing.

Grace Wong (6m 57s):

A hundred percent. And I think there is a culture, or we tend to have these measurements. And a lot of times in practice, when we talk about clinical practice, or professional training, we rely on numbers to gauge, right? And, and we know parenting is so not about numbers.

Katie Ferraro (7m 18s):

And every baby is different. I mean, and parents compare themselves to their previous pregnancy. And you mentioned numbers. I think I was just hanging out with a mom the other day. She's 12 weeks postpartum. It's our fourth child. She said, I've never been this heavy 12 weeks after having a baby. I was like, well, first of all, this is your fourth baby. Congratulations. The baby's still alive. You're doing a fabulous job, but you said I'm 12 weeks out. I should be back to my pre pregnancy weight. I said, where on God's earth did you hear that recommendation? She's like, oh, everybody knows that. And I think, you know, being in feeding, we focus so much on feeding milestones and we'd love to see your baby doing X by Y age. Well, parents put those same milestones on themselves. I want to be back to my pre pregnancy weight by this stage. And or I want to be back at the gym by this stage or however many weeks, and then comparing yourself to your friends or people you see in the media, or even your previous pregnancies.

Katie Ferraro (8m 4s):

The numbers, as you mentioned, can be so limiting and can be trigger inducing. And so I wanted to ask you for parents that do have a history of disordered eating, what benefits do you see in a baby-led approach to feeding that can help them rather than talking about all the bad stuff that's out there?, because we kind of know that. What can be beneficial about adopting this approach to feeding your baby, if you are an eating disorder recovery?, and maybe speak a little bit about the language about what the term recovery even means, because as I understand it in your field, there's even discrepancies as to how we talk about if someone is recovered or in recovery. So, maybe you could give us some tips on language and then talk about the benefits of that baby-led approach to feeding.

Grace Wong (8m 41s):

Right? So maybe I'll just speak to what I mean when I talked about in recovery. I want to recognize that every parent has a story in context, and every person in recovery are where they are in terms of their life journey. So, when I speak to this right now, I want to be as encompassing as I can, and not excluding anyone. I've worked with parents who are really early on in the process and really are struggling to eat or really struggling to connect with themselves and trust them in their relationship with food. I've also worked with parents who have worked really hard and very solid in their recovery and very functional in life and eating.

Grace Wong (9m 21s):

Hadn't been a concern for a long time, but then as they start the journey of pregnancy parenthood and feeding, food start to become challenging again.So, I do want to just speak to that. I think this is something that's relevant for why spectrum of eating disorder, beaking to those who might be a group might be actively receiving service, or maybe meeting certain criteria right now. I think this speaks to all parents who really are struggling in some way in their relationship with food, or maybe trusting, you know, we talked about trust or numbers, right? So, in eating disorder recovery, one of the theme that we often talked about is shifting from external expectation to using ourselves as an internal gauge, using our intuition and trusting ourselves.

Grace Wong (10m 12s):

So, diet culture may tell us that we need certain calories, or you need certain portion, optus macronutrients, or counting macros, or using My Fitness Pal, you know, to guide our eating and recovery. We're really trying to move away from that parallel. Quite often, parents are pressured or if they feel pressure that there's expectations. I need to be providing my child with this teaspoon or this many tablespoons of this food group in a particular feeding. So, I think baby-led weaning it's actually quite, I would say very supportive and conducive to letting the child guide us. So, what parents do, if it's really trying to connect with their voice and intuition and connecting with ourselves in that feeding relationship to our children.

Grace Wong (10m 59s):

So we can trust our child. And my job as a parent is to show up and tune to my child and pay attention, pay attention to their cues and facilitate meal time. So, for example, if they need help with something, maybe unwrapping something. I will help them if they need to grab something. If they're, if they're, let's say if their pincer grip isn't quite ready yet. You know, I can support that. Or maybe, you know, we can help with putting something on a dipper for them to put in their mouth. But what I do, how I show up, it's guided by what the baby's showing me. So this is what we call a reciprocal-responsive relationship.

Grace Wong (11m 40s):

Or if you think about there's another term for the serve and return, like in a tennis match, you serve the ball and I return it based on, you know, I watch how you serve. And then I return as that back and forth, back and forth. And what I think baby-led weaning supports is if I'm here with you and you're feeding yourself and I'm feeding myself and I'm showing up to support you.

Katie Ferraro (12m 1s):

Wonderful. So, you talked a little bit about trust and that one of the important tenants of recovery is reestablishing or establishing trust. And that's so much about the baby learning how to eat also involves trust as well. So, could you give us some guidance perhaps on how preparing a meal or food for a baby. Can it be a positive experience for the parent and how they can help instill that trust that they may be learning about in recovery, into their babies who are learning about food?

Grace Wong (12m 26s):

I think that the relationship is, is it's going to be the key is when we talked about relational feeding, because we would have to trust actually our observation. So, what I often prompt parents to do is to observe the baby, but also observe my own reactions. So, I would see their cues and then, then I ask myself, what am I interpreting? Okay, the baby it's dropping this food. What does that mean? Or if a baby, if the baby is pushing this food to the side of the tray, how am I interpreting that information? I think sometimes they're really quick. We are really quick to say, oh, this means they are rejecting it or that they like the food.

Grace Wong (13m 9s):

We tend to see a very black and white. They either, or they don't eat it. My problem would be to step back and think about how am I interpreting the sign and then think about what am I going to do to support it. For example, some children may found some food, maybe the, the odor is too strong, so they might push it to the side of their tray and they're not throwing it away. They're keeping it there. They're comfortable to keep it there, but it's just that maybe I'm not ready to put this as opposed to myself today. So, if we can reframe that from quite often, we, the first reaction or our interpretation would be that's rejection. But if we can understand it and reframe it, this is not rejection. This is actually babies having autonomy, they're in some control too.

Grace Wong (13m 53s):

They also have autonomy. I know in, in the world of food acceptance or feeding, we talked about, and there's an acknowledgement that repeated exposure or introduction to food, it's part of that process of accepting and learning about new food. It's part of that developmental process, but we don't talk about as much how it's done. How do we actually support that repeated introduction? And quite often I would coach the parents. It's okay to have the baby, allow them to have the body autonomy. So, what baby-led weaning, because they are supported to do what they want with their food. It does allow them to build a positive experience.

Grace Wong (14m 34s):

So, then they have the confidence I can manage. I may not like this folder today and I can manage by moving it out a little bit. So, it's actually a positive experience because I know I can manage. And over time they might actually get used to the same food because they know that they can, they can learn to manage it. Just like how, when I work with older kids, sometimes when I go to a birthday party, I don't eat pepperoni pizza, but I can eat cheese pizza. Okay. I'll see when I take the pepperoni away, can I manage a cheese pizza in a very similar way? I don't, I'm not quite sure about these foods today, but I'm going to just maybe move it or I'm going to like try a little bite and if works I will swallow it, but maybe that other food, it doesn't work.

Grace Wong (15m 21s):

I'm going to spit it out. And children have the capacity and autonomy to do that. And baby-led weaning. I think there's a lot within this practice that actually support this being responsive and supporting parents to support the child to facilitate.

Katie Ferraro (15m 36s):

So for parents that are in eating disorder, recovery, they're getting ready to feed their baby. It's something that they're preparing for and they want to be aware of what are some potential triggers that one should be wary of when starting baby-led weaning? If you are a parent in eating disorder recovery.

Grace Wong (15m 52s):

That's a really good question. I will go back to what I mentioned a little earlier about observe, observe and notice if when we starting this process we observe ourselves and notice also observed the baby. But also, for example, if you notice, sometimes I would hear, I hope examples are helpful. I hear parents say, oh, when I see my child eating this and loving this food, I am worried. I worried is discharges love this particular type of food, but not eating the other food as much. For example, I'm trying not to vilify any food, but for example, quite often carbohydrates foods, they're easy to maneuver.

Grace Wong (16m 34s):

They're some of the foods that are earlier for babies to accept versus maybe vegetables, which are more stringy and require oral skills. So, sometimes I would hear from parents that they worry. So, I find having that conversation to be open and, and that we're observing and we're noticing, and then we talked about it in a nonjudgmental way. So, we would talk about what concerns you about this observation, what are your concerns? And I often explain to parents, there is no shame in being honest. I think they are sometimes guilt or shame around. I shouldn't feel this way anymore. Now that I'm a parent, it's my job to feed this child to have the best relationship with food.

Grace Wong (17m 15s):

And that pressure sometimes prevent parents having these honest conversation. And I think there's also this misconception out there that because I have had an eating disorder or I'm struggling with one, I cannot do a good job off of feeding. And I, and I don't think it's black and white, but like that, I do believe a lot is about how to be intentional in observing ourselves and being intentional in how we facilitate. And for some parents, they can do a fabulous job on their own. And for some parents, they will need some support. Like I said earlier, they might need some relief from being around food. They might need to eat on their own as a meal.

Grace Wong (17m 55s):

So we may need to look at who can we bring in for some parents, we might need to have a conversation about introducing the foods that they're finding it particularly difficult. So, I guess I'm in a very roundabout way of answering your question, Katie, that I don't think there's one particular triggers. And I do believe it is a vulnerable time that triggers would happen. And the key would be to stay connected with ourselves and be really honest about those challenges.

Katie Ferraro (18m 20s):

Well thank you so much Grace! This is really informative and very, very helpful and important topic that I think many of us, again, we're focusing so much on the babies and not always looking at how we're taking care of ourselves, both mentally and you work in the mental health space. So you really understand that. And thank you for sharing with our audience. Could you tell us where the audience can go to learn more about the work that you do in eating disorders? And you also mentioned you work with feeding disorders, ADHD, autism, where can we learn more about your work?

Grace Wong (18m 47s):

Right. I have local practice where I am in Calgary, Alberta, Canada. I also do. I also have a virtual practice and I actually don't have a website, but I do have a Facebook group. This is part of just working and being a parent. I sometimes I'm limited in how much energy I can. I can.

Katie Ferraro (19m 6s):

You have a lot energy, it's impressive. What is the name of the Facebook group? And I'll go ahead and link to it in our show notes. You guys, that's at blwpodcast.com/46. What is the name of the Facebook Group?

Grace Wong (19m 7s):

It's Grace Wong RD MSD. So yeah, I'll do, I'll send you the link, Katie, and feel free. I haven't been really active, but I over the last few months, but I'm hoping to gradually get back into it and share more content. So, I love to hear if there's any feedback, anything that I'm going to be sharing on this podcast link on my page as well. So I'd love to hear feedback if anyone wants to share and chat about that over on my page.

Katie Ferraro (19m 40s):

Wonderful. Thank you so much again for being here, Grace. It was a real pleasure.

Grace Wong (19m 43s):

Thank you.

Katie Ferraro (19m 44s):

Well, I hope you guys enjoyed that episode with eating disorder, dietitian, Grace Wong. As I mentioned, a link to all of her resources on the show notes for this episode, which is at blwpodcast.com/46. If you're enjoying the podcast, if you have suggestions for future episodes, if you love hearing from experts like Grace Wong, please leave me a written review on apple podcasts. It makes the world of difference with helping the podcast to get found by other parents and caregivers who are interested in learning more about giving their baby a safe start to solid foods using baby-led weaning. So, if you go to apple podcast and you find the baby-led weaning made easy podcast, scroll all the way to the bottom, you can rate it, but also a written review again, would mean the world to me.

Katie Ferraro (20m 29s):

And I love seeing all of your episode ideas in the written reviews. I read every single review and I thank you guys so much for listening and for being here today to learn from Grace Wong. Bye now.