Meet Sadie


What do parents do when their six-month-old daughter stops eating? When nothing is found to be physically wrong with her, yet she refuses to let anything come near her mouth?

Sadie was always a challenging child to care for…she slept poorly and was difficult to comfort. However, she took to the breast right away and nursed contentedly. At six months, when breast milk alone didn’t provide all the nourishment needed, solid food was introduced. The rejection was almost immediate.

The downward spiral was a rapid one. Not only did Sadie reject the solid food, she would no longer take a bottle or let a toothbrush near her mouth, and gave up her beloved pacifier.

Meals dragged on for hours as Shannon and John, Sadie’s parents, tried everything they could think of to get their daughter to eat. All attempts were met with screaming, crying and throwing whatever she could get her hands on. Meanwhile, she was not gaining any weight, she was quite literally starving, and their pediatrician referred them to Hasbro Children’s Hospital where a feeding tube was put in to help Sadie get the nutrition she needed.

Sadie got stronger, but that was just a short-term solution. Why had their daughter stopped eating? “I felt like I shouldn’t be her mother,” said Shannon recently. “I couldn’t even take care of her most basic needs. We were desperate.”

Hasbro Children’s Hospital recommended that the family take Sadie to Bradley Hospital’s Pediatric Partial Hospital Program. The Pedi Partial Program treats infants, toddlers and preschool children who have serious emotional, behavioral, feeding, sleeping or relationship problems. These are children who typically would have to be in a traditional hospital setting.

The program takes place during the day Monday through Friday, allowing the children to be home evenings and weekends with their parents. It was here that Sadie and her family began to heal. Sadie was just a little over one year old when she was admitted to Bradley. The family also learned that Sadie’s feeding disorder was part of a broader anxiety disorder that presented itself almost at birth.

Clearly, food had to be reintroduced to Sadie in a way that would break down her anxiety about eating. It also needed to be a method that her parents could make work at home.

The method is called Contingency Contacting, and Sadie’s milieu therapist, Mia DeMarco, explained how it works: “We do 3 meals a day with the child: breakfast, lunch and a snack. We begin slowly with a small spoonful of food that we bring close to the child’s mouth for few seconds. Because of her anxiety, we know she will cry and be very agitated, but we help her learn to relax while gently bringing the spoon as close to her mouth as she can tolerate. We do this 20-30 times in a 20-minute mealtime session. During and after the sessions we offer fun activities that help her develop positive expectations about food and eating. We never force the child to eat. After time…it could be days, even weeks…the crying subsides and the child allows the food to touch her lips. From there she ventures a small bite. That first bite is the start of the road back.”

Shannon and John at first observed the feeding sessions to see how the therapist’s demeanor stayed calm no matter how much Sadie fussed. Later on, they participated in the sessions. It was no easy task, but Sadie’s parents knew they had to train themselves to bring that kind of calm to the child’s meals at home. The parents’ therapy sessions with John Boekamp, PhD, director of the Pediatric Partial Hospital Program, gave them the understanding of their daughter’s behavior that made it possible for them to modify their own behavior to help Sadie eat and thrive.

“There were some rough patches along the way, but Sadie is now four years old and has blossomed. She has friends. She is obsessed with princesses. And we don’t have to beg her to eat. She likes pizza and cheeseburgers. She’s a happy little girl,” said Shannon recently. John added, “I don’t know what we would have done without Bradley Hospital. They saved Sadie. Without a doubt, without Bradley, she would have a surgically implanted feeding tube today.”


 

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