After six weeks on a fat-free diet and a week on a low-fat diet, my eight-year-old daughter Sammi was officially released from all her food restrictions by her cardiothoracic surgery team. Her chylothorax — a leak in the thoracic ducts that process fat — had completely healed.
The two of us had decided to spend the day together in downtown Chicago, starting with a visit to the Hershey Store. After all, it had been nearly two months since she’d had free rein to eat anything she wanted. I thought that surely she would gorge herself on candy while I watched gleefully.
Instead, she nibbled timidly and said, “I’m full for now.”
It was heartbreaking to realize that, as far as she’d come — years of false diagnosis with reflux, then eosinophilic esophagitis, then a revelation that her swallowing problems stemmed from a structural obstruction in her chest, culminating in major cardiac surgery — she still had more hurdles to jump. Of course we couldn’t undo eight years of her experience of eating in one day at the candy store. Why had I been so naive?
The body has lessons for us. As adults, we learn to ignore them — to subvert the ache in our legs and run another mile, to have another cocktail even as our heads are beginning to spin, to convince ourselves to push past our painful cough and get to the end of the work day — but children have not yet absorbed that tendency toward self-delusion. They listen to their bodies by instinct, as anyone knows who has ever seen a tired child flatten themselves on the sidewalk and refuse to walk another foot. Children weep when they are sad, jump and laugh when they are happy, and use their bodies as an extension of their aspirations. As toddlers, they literally cannot stop themselves from touching something once they have begun to reach for it — hence their parents’ grabbing little hands away from hot stoves, sharp knives, and electrical outlets.
Children connect to their bodies instinctively. Sammi was no exception.
As a baby, Sammi pulled her head away from my engorged breast as the milk flowed too quickly for her. No matter her hunger, her infant brain recognized that she could not manage the flow without choking, and she refused to nurse until I had let down the fastest sprays into a washcloth. As a toddler, she pouched quartered blueberries in her cheeks, knowing that her esophagus was simply too small to manage them. The older she got, the more slowly she ate, knowing instinctively without being able to explain it to us that her esophagus was being stuffed full from its bends up to the back of her throat, and that she had to wait for food to press its way past the kinks before she could take another bite.
She knew. She protected herself from choking for years.
Now, when she was eight and only seven weeks past the surgery that had unkinked her esophagus, I had somehow believed that she would magically unlearn those skills she’d been practicing since birth. She had not, and she was simply not used to filling her belly all at once. Though I reminded her that she didn’t need to drink so much with her food anymore, that it was safe for her to eat more, that I understood that she had been struggling before but she didn’t have to struggle anymore, she continued to eat slowly and unsurely. She maintained the same enthusiasm for food and flavors that she had always had, willing to taste new things and excited for her favorites being served at the table, but she still ate as she always had: slowly, and not very much.
I was heartbroken, beginning that first day at the Hershey’s Store and continuing for weeks afterward. It seemed our relationship with food, as a family, was forever broken as we sat at the table, night after night, and watched her continue to pick at her food. Though she agreed that food was easier to eat now and went down much more easily, her behavior did not reflect that understanding. I took her to her pediatrician.
“Well, mom, she’s doing great,” the doctor said. “She’s just going to need time.”
A few days later, after watching Sammi take two hours to eat one slice of pizza, I called and asked for a referral to a feeding therapist. I could not help Sammi unlearn her body’s lessons alone. Some lessons become too ingrained for even a mother to un-teach.