If I am being honest, I first learned about responsive feeding principles from my mother. Of course, back then, she and others didn't have a name for it. When I ask her about it now, she says she fed our family in a way that "felt right". During the 1980's, when I was growing up, responsive feeding was not the preferred way to feed children. Fortunately, today, it is well accepted and quickly becoming "best practice" when recommending feeding children.
What is Responsive Feeding?
Responsive feeding is an approach that prioritises child autonomy in the context of a warm, attuned relationship and appropriate structure.
Recently, a group of specialists in paediatric feeding and nutrition came together to define Responsive Feeding Therapy as an overarching approach to feeding and eating interventions applicable to multiple disciplines and across the lifespan. It facilitates the (re)discovery of internal cues, curiosity, and motivation while building skills and confidence. It is flexible, prioritises the feeding relationship, and respects and develops autonomy."(1)
This differs from non-responsive feeding practices, in which parents or caregivers remain under-involved or adopt controlling feeding practices such as restriction or pressure to eat.
In many ways, Responsive Feeding is similar to Satter’s Division of Responsibility in Feeding (sDOR).
For those unfamiliar, sDOR has been seen as the “gold standard” in feeding children for many years. Simply put, it states that a parent and caregiver’s role in the feeding relationship is focused on feeding your child, and a child’s part is eating. Therefore, aspects involving the what, where, and when of feeding are areas for which parents and caregivers should take responsibility. Things like how much and whether to eat are what we should trust our children with. As children mature into teenagers and independent adults, the decision about what and when to eat gradually becomes more shared.
However, responsive feeding differs from sDOR in small yet significant ways. For example, responsive feeding highlights the importance of individualised care and prioritises the parent-child relationship, making it more inclusive and less rigid (3).
5 Reasons why I like the Responsive Feeding Framework
1. It is a flexible framework.
When I had my children, I quickly realised how rigid previous feeding guidelines were, and the parents I worked with agreed that it just doesn't work in every situation. Instead, the responsive feeding approach encourages parents and caregivers to make decisions about feeding based on their unique family environment, culture and specific situations.
2. It acknowledges that every child is different and is more inclusive.
It encourages parents to accept their children for who they are and provide support to enhance their well-being instead of aiming to turn everyone into perfect little "typical" eaters. Therefore, it is more inclusive of body diversity and, with some careful considerations, can be applied in supporting children with neurodivergent development.
3. It is a parent (or caregiver) -led approach.
What makes responsive feeding therapy so different from many other feeding strategies is that it focuses entirely on the behaviour of parents or caregivers. You, the parent or caregiver, will never be required to pressure or "get" your child to do something they don’t want. Because let’s be honest, if that approach truly worked for everyone in the long run, we wouldn’t be here having this conversation.
4. It honours the parent as the expert and doesn't blame them for feeding challenges.
A common myth around feeding challenges such as "picky eating" is that parents or caregivers cause it. When a child has feeding challenges, parents often experience shame and stigma.
What is true is that feeding challenges can significantly impact a parent and the rest of the family. Also, parents and caregivers are extremely powerful in influencing the feeding relationship. However, this is not the same as saying parents cause feeding challenges. A responsive feeding approach honours and supports your role as a parent and caregiver, knows you are the expert on your child and gives you the tools to feed your child well.
5. It is supported by research and considered best practice by the WHO (World Health Organisation) and the American Academy of Pediatrics (AAP)
Responsive feeding strategies have been found to have a protective effect on maintaining a child’s ability to self-regulate (refers to babies' ability to know how much to eat, when to eat and when to stop). Whereas non-responsive feeding practices, especially pressure to eat, are associated with increased avoidant ("picky") eating.
One of many
Although I often use the responsive feeding approach or elements thereof, it is not the only one. For example, although certain elements will always be applicable, it is not an appropriate strategy when working with someone with an eating disorder characterised by body size and weight concerns such as anorexia nervosa. Also, using this approach in the context of adolescents and adults still needs to be explored.
In summary, I like the responsive feeding approach as it is the closest evidence-based approach to describe the art of balancing being in charge of feeding and not controlling your child's eating (4).
References:
Rowell, K., Wong, G., Cormack J., Morelan, H. (2023). Responsive Feeding Therapy: Values and Practice (version 2). Retrieved September 20, 2023, from https://responsivefeedingpro.com/wp-content/uploads/2023/03/WhitePaperVersion.2.pdf
Cormack, J., Rowell, K., & Postavaru GI., (2020). Self-Determination Theory as a Theoretical Framework for a Responsive Approach to Child Feeding. J Nutr Educ Behav; 52:646-651
Sole-Smith, V. (2023). Fat Talk: Parenting in the age of diet culture. New York: Henry Holt and Company.
Brooks, S., & Severson, A. (2022). How to raise an intuitive eater. New York: St Martin's Essentials.