I've received a few comments and suggestions re: my last post. Meanwhile, I've continued to see this child and her family. They are scheduled to see one of my staff dietitians next week, then we hope to meet together to decide on next steps. I will continue to post as our process unfolds.
Your advice to date has been helpful; no one suggests that leaving out the child and focusing exclusively on her parents makes sense. All are in agreement that parents are a vital part of the process; but at least one professional who has worked with young children is encouraging me to see her alone occasionally as a way to hear her thoughts and feelings without her parents present. Parents and I have already agreed that a more consistent schedule and a plan to approach mealtimes will be helpful; it seems too often now eating gets delayed, or squeezed in between the pick up from day care and after work errands. Parents also tend to approach the struggle around eating in slightly different ways, and I've encouraged them to use the strengths of each approach to find a more consistent model. We also see that their daughter has some nutrition myths which will need to be challenged by more accurate information.
I've been reminded that young children can sometimes develop medical complications, and therefore need hospitalization, more quickly than our older patients. I plan to have the dietitian monitor weight here, and have the pediatrician monitor other vital signs as needed so that we avoid the need for emergency intervention. It's still my hope to be able to help this family without inpatient treatment.
I will welcome ongoing comments from other professionals; and from parents who've had a young child in treatment. What was most helpful to you? Until next time, Gail