5 Mistakes Parents Make With Picky Eaters

eating-watermelon-1-1324695I dislike beets. I have tried them 7 times. To me they taste like dirt. The 20 bite rule is hard for me when it comes to beets (I really want to give up). For those of you who aren’t familiar with the 20 bite rule, it just means you really don’t know if you like a food until you have tried it at least 20 times. It only took me about 5 times to know I actually did like sushi (not all of it, but the one I was persistent with trying, and even though it has fried tempura shrimp on top, it still counts as sushi). The point is that we all have foods that we don’t like, don’t want to try, or even make us go “eeeewww”.

When it comes to getting children to eat, most caring, wonderful parents that I have met tend to practice the same strategies with no success. I call them “old school” strategies because they are the same old things we have always done to try to get our kids to eat. Although I have shared a few posts on feeding kids and picky eating, I recently read an article in the Hartford Current(January 3, 2016) about Kids and food, and saying the right things. It brought up some great points and made me realize this stuff is worth repeating.

Parenting is not an easy thing, and we all look back with some regrets at the way we did things. But if you want to raise a child who grows up to be an adult with a healthy relationship to food, read these 5 common mistakes parents make, along with a better way.

Mistake #1. Making a child sit at the table until he finishes the peas (or meat, or green beans, or heaven forbid, the beets). If you have done this, you know what happens. Some kids will sit for hours and make a scene. Others will stuff the peas in, gag, and sometimes vomit or spit out the food. If you were forced to eat that one food you despise, what would be your reaction? I would be pissed! Is it no surprise that your child does not behave that well when forced into this situation? The down side of this is the table becomes a terrible place to be. It would not increase the likelihood of trying that food in the future and actually, due to the terrible experience, could turn off someone for good.

Instead, feeding therapists often use a “food scientist” approach to non-preferred foods. For example, the food will be on the table, or even a small amount may be on the child’s plate, but just for “exploration”. What color is it? purple. Is it hard or soft? a little soft. What does it smell like? dirt. Can you lick it? Yes, it is a little sweet, hhhhmmmm. No pressure. Just exposure in a fun, non-threatening way. and the good thing is the table is still a fun place to be.

Mistake#2: Making a child finish his plate. Or refusing seconds to a child. Imagine it is one of those days you ate a late lunch out with friends, and then came home and your husband decided to make an early dinner. You sit down to this beautiful dinner but you really are not that hungry. He piles your plate high with mashed potatoes and gravy, a large slab of turkey, stuffing and a big salad on the side. You tell him you just aren’t that hungry, however he says you have to finish the entire plate. Not a morsel can be left. How would you feel? Again, your body is giving you an appropriate message that you are not that hungry, yet your husband is telling you not to listen to your own natural body signals. You feel you have to force that food down, you feel stuffed and not good, and again, the table is not a fun place to be. The same holds true if the opposite occurs. Imagine you missed lunch and come home famished. The same lovely meal is waiting for you, however this time your husband says “that’s enough for you”. You wanted more potatoes but he won’t give them to you. You leave the table feeling hungry and still thinking about food (and when he goes to bed, because you are an adult, you probably would just go heat some up. But for a child, this triggers sneaking food, which then leads to feelings of shame, clearly not good for a kids self-esteem).

Instead, encourage a child to “listen to your tummy”. Start with smaller portions so you don’t end up throwing away food, then give more if a child finishes. Or simply save the leftover food for a snack for later. This prevents drama, and guess what…..makes the table a more fun place to be, along with teaching the importance of honoring your hunger and fullness. Kids usually have this internal mechanism that will keep them growing normally  until we adults ruin it with forcing them to over or under eat.

Mistake #3: Allowing a child to graze or nibble all day long. When kids are picky and refuse meals, or don’t eat much at a meal, parents worry. They think their child is not getting enough nutrition and they really want them to grow. So, if the child asks for some crackers in between, mom is going to give them. Sometimes, a bowl of the snack is left on a coffee table so a toddler can go help herself. The end result is a child who is nibbling all day long on foods that don’t typically provide much nutrition, and then when dinner rolls around, the child has no appetite. Sometimes, the pressure starts, the scolding, the forcing, again, all leading to a negative experience. Imagine picking on food all day long. Are you really in the mood for a full meal when you can’t really tell if you are hungry or full?

Instead, parents should provide 6 opportunities to eat. Breakfast, a morning snack, lunch, an afternoon snack, dinner and one evening snack. If the child refuses lunch, then, without fanfare or pressure, the food is removed from the table (typical meal times are 20-30 minutes). If she comes around asking for food 30 minutes after lunch was offered, the answer needs to be NO. Water could be offered, but that is it. Yes, kids will cry, it is not fun, but they usually do much better at the next meal. Eventually kids get the message that they better eat at meal times or snack time because the kitchen is closed.

Mistake #4: Catering to a picky eater. Short order cooking. This is when you make that macaroni and cheese, or pick up those chicken nuggets because you know Johnny does not eat meatloaf. Or pasta. Or soup. Or fish. And on and on. And why would he? For his entire life he has gotten his nuggets. I have seen teenagers who are stuck on 3 foods because their parents catered to their picky eating. I sometimes joke that if I refused to eat unless it was lobster, I could probably get my husband to make me lobster every night ; ) People who care about us want us to be healthy, but catering to a child does not lead to healthy eating.

Instead, Ellyn Satter (see ellynsatterinstitute ) suggests offering a few “go to” foods that provide nutrition yet do not make you go out of your way. For example, most kids will eat your basic bread and butter, and will drink milk. If you are making meatloaf, potatoes and peas, don’t make a separate meal but have a basket of rolls or bread, a glass of milk and maybe some fruit. Let your child eat as much of these go to foods but do not give in and make that mac and cheese. Instead, have mac and cheese for a meal for everyone in the family once in awhile (we all like our favorite foods on the menu). If you do this along with the food scientist approach, it will be much more likely that your child will try something new. Again, this makes the dinner table a much more fun place to be.

Mistake #5: Forcing food, yelling, belittling, comparing or any other “not nice” behavior at the table. I have heard horror stories from parents about what they do to get their kids to eat. They literally have held down arms and stuck food in mouths (and you wonder why someone would hate sitting at the table?). Parents compare “your brother ate it, why can’t you?” They threaten “if you don’t eat, you won’t get dessert”. This of course could be it’s own mistake because holding back dessert to force a child to eat veggies just teaches them that something is wrong with veggies and sweets are the reward. This can stick with a person forever (when they grow up, have a job, and can afford to reward themselves whenever they want…..a big contributor to emotional eating).

Instead, set an example for your children regarding not only cooking and eating healthy food in a healthy manner (at the table, no TV, no electronics, etc) but also with using polite language. Don’t threaten. It is ok to remind children that it will be a few hours until snack time so be sure you had enough, listen to your tummy, etc. Involve children with menu planning, cooking, setting the table and clean up. Don’t use food for anything other than what it really is: something to enjoy and fuel us and keep us healthy so we can do fun things.

In the end, dinner times can create the most wonderful memories yet. Just keep it happy if you can. I miss those days with 3 kids chatting away around the table, then teenagers, and even the additional friends. It was a blast and even today, when I make certain foods, I think of them. Jen loved stuffed shrimp. Kara loved pesto pasta. Dan loved everything (beef stew for his friend Nick, banana pancakes for half the football team-rumor has it that I made the best of all the moms…just saying).

So start making precious memories of your own. The table is not the place for battles.

And I am going to keep trying beets. At least 13 more times.

 

 

 

 

Cornell Study on Junk Food: Does it affect weight?

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You will soon be hearing about a new study about “junk food” that has been conducted at Cornell (see summary: Study on Junk Food)  Because the press and the public tend to want to draw some huge conclusion and generalize findings of studies such as this, I wanted to be sure to share my thoughts.

According to a Summary by Katherine Baildon researchers reviewed “a nationally representative sample of adults in the United States and found that consumption of soda, candy and fast food is not linked to Body Mass Index (BMI) for 95% of the population. The exception is those who are on the extreme ends of the BMI spectrum: those who are chronically underweight and those who are morbidly obese. Given that there was no significant difference in consumption of these indulgent foods between overweight and healthy weight individuals, the researchers concluded that the overwhelming majority of weight problems are not caused by consumption of soda, candy and fast food alone.”

What does this mean for you? I have noticed the tendency for people who diet to lose weight is to be a bit “black and white” in their thinking. People want to think there is a specific reason they can’t lose weight. They are typically searching (some for many years) for the perfect “diet” or plan to solve their weight issues. The diet industry makes a lot of money taking advantage of the importance of body shape, size and weight in our culture. We jump on anything new (just in case it could be the answer).

The same holds true for when people are tired of dieting. Dieters often break out of their Diet Jail just by having one bite of a forbidden food (aka junk food). Does this study mean that healthy eating does not matter? Does it mean you should stop caring about what you eat?

The good message of the study is that your weight is not affected by any single food (not a chip or carrot has any power over your body size). No, you won’t gain weight by eating french fries with you burger. Actually, this study provides more fuel for the “non-diet” approach to weight. There are many more factors than food that contribute to health (and yes, body size). For instance:

  • Genetics-if high cholesterol runs in your family, you are more at risk. Nothing to do with body size.
  • If you are sedentary, chances are your body is not the healthiest it can be (and you are less likely to be at your natural body weight). This does not mean you have to join a gym or work out like a lunatic. It just means that your lifestyle matters and doing fun active things that you love is more important than having (or trying not to have ) a candy bar when you really crave one.
  • Sleep-if you don’t get enough, your body just plain won’t function the way it is supposed to. Again, your weight will be affected because lack of sleep messes with your appetite (increases it).
  • Stress-mental health is just as important as physical health. Many people overeat or under-eat because they are stressed. This does not promote a healthy body.
  • Nutrition-yes, you need your fruits and vegetables and protein and water and fiber and vitamins and minerals. Focusing on health verses counting calories, dieting, weight and never eating junk food is what gives you your healthiest body.

So the bottom line is, yes, you can have junk food. We have been saying that all along. A perfect diet is not normal eating. Keep on the path of listening to your body, healthy eating, enjoyable movement, decreasing stress in your life, and accepting where your weight falls wherever it may be.  Feeling good and having energy and being happy are possible, even if you have a french fry.

Having Your Cake and Eating it too….what to do about “junk food” for you and your family

IMG_7692Let’s face it. Do you really and truly think you should live the rest of your life without having a good old homemade chocolate chip cookie? The cookies pictured here were baked by my mother-in-law for a recent family gathering. I was fortunate to grab some that I packed away in a freezer bag for later cookie cravings. Anyway, after a recent post about childhood obesity and the damaging repercussions about an unhealthy food environment, I got some feedback about how children should not be restricted as this will likely contribute to binge eating, and an increased focus on food.

While I totally agree with the principles of hunger-motivated eating and “intuitive” principles of eating, I also know that it is not as simple as it sounds. My husband has always joked when I have said “listen to your body” because his body says to eat the entire bag of Lay’s! Of course this is not exactly true, and I have never seen him consume an entire gigantic bag of chips, however this is an issue that comes up often when “intuitive eating” and “listening to your body”is promoted. What is a parent to do when a child does appear obsessed with whatever sweets are in the home and can’t wait until he or she can get a hold of it? What is an adult supposed to do when they are dieting and truly craving something sweet? or salty such as chips?

We are a culture of “all or nothing” thinking. You have heard it before….the dangers of being “on” a diet, then “off” a diet. People follow the craziest and most restrictive diets for a variety of reasons, but when, inevitably, they can’t maintain the restriction (usually due to a powerful physiological response to starvation coupled with an environmental trigger, such as exposure to a particular food), well, after they break the diet, everything changes.

After having that cookie, or eating a handful of those chips, total mind games take over. The “all or nothing” mindset kicks in and people lose control (who wouldn’t?)

The problem is that if we want to encourage our children to eat healthy, but also don’t want them focused too much on eating and food, then we need to be careful about the messages we send. We want them to make healthy choices, however, we don’t want them to feel guilty about having a cookie. What is the best advice to promote a healthy relationship to eating and especially, to “fun food”? Here are my 5 Tips for Having Your Cake and Eating It Too….

  1. Never withhold food from a child, especially a sweet or dessert, until they have finished the main meal. This serves to reward them with sweets and teach them that something is very wrong with the food they are being served and something is very special about the sweet they are being rewarded for. Instead, let them have the sweet right along with their meal. This bothers many parents because they were brought up back in the day when sweets were used as reward, or withheld for punishment. Many of those brought up this way tend to continue to reward themselves with sweets when they are finally adults and can do what they want. I remember one patient I saw for binge eating. She had gained and lost hundreds of pounds over the years. Her mom used to restrict her to make her lose weight, so when she finally was out on her own, she was all about getting back at her mom and started to use food (sweets especially) as a reward for almost everything. Now as an adult, her mom still made comments about her weight and eating, and it bothered her, even though she was 50 years old.  I remember her telling me after her mom passed away that she still was feeling restricted and it was hard for her to accept now that her mom was no longer alive, she did not have to sneak or get back at her. It still was hard for her as she had been doing this for so long (binge eating sweets). So the message is, beware of restricting sweets or making them special as it will likely mess up your child’s relationship with eating (or if YOU have been restricted, maybe it is time to think about sweets in a different way?)
  2. Pay attention to your child’s reaction around food (and pay attention to your own feelings when food is around). Accept that everyone is different. You may discover that your child has little interest in eating (I see these kinds of kids all the time in the Feeding Team, where children are referred for feeding issues). Or maybe the opposite is true, and your child seems obsessed with food. This sometimes is due to a child’s food intake being restricted, or too much attention placed on a child’s eating or weight. Other times, I have seen it just be that the child simply enjoys food and eating.  Even as an adult, some people seem to be bored with eating (“eat to live”) while others are somewhat obsessed with it, love cooking, love eating, and spend lots of time on it. This is not a bad thing necessarily, however if it is due to previous restriction, or dieting as an adult, then this kind of eating and food obsession tends to come with guilt, not pleasure and enjoyment.  The bottom line is you need to pay attention and accept that everyone is different. If you have a child obsessed with eating for whatever reason, or if you are for whatever reason, then it is important to create an environment where everyone is able to enjoy food and eating, but not be triggered into binge eating. This means having those fun foods on a regular basis because you enjoy them, but not going to Costco’s to buy the mega cookie tray to leave on the counter where there is a child who is not going to be able to stop. Or do what I do, and put them in zip lock freezer bags so you can take out what you want when you want it. No one is deprived and no one is triggered. Yes, I have had patients who are not able to do this as they will binge on them frozen. Know yourself, and do what you need to do to have balance in your eating.
  3. Again, I have said it before and I will say it again. Don’t treat children (or adults for that matter) differently when it comes to sweets, or what foods you allow them to eat. If you want to make sweets or some other fun food (chips, fries) a part of a meal, let everyone, no matter what their weight or body size have it. Don’t make comments like “that is enough”. Let everyone have what they want and need. Encourage listening to your “tummy”. How do you feel? Do you feel satisfied, stuffed, still want more? It is important to help children, and also important for adults to learn how to eat ALL foods in amounts that make them feel good. Not stuffed, not uncomfortable, but good. Satisfied. The only way to do this is to have these foods on the menu.
  4. Talk about being healthy, and not about how “good” or “bad” a food is. I personally think it is ok to educate even children a bit about nutrition. It is ok to say “milk makes your bones strong!” or “this broccoli has lots of vitamins and makes us feel good” or “that has a lot of sugar in it, so we need to brush our teeth so we don’t get a cavity”. But is it not ok to talk about food and weight. Don’t say “cookies are bad for you! If you eat too many you will get fat!” Instead, have cookies as a part of a meal that provides some good nutrition (such as a dinner with meat, vegetables, grains, a glass of milk). It is really amazing how children will not devour all the cookies first as you would expect when they are given in a neutral manner, without judgement along with the rest of a healthy meal. Yes, if you have been restricting sweets, kids will go to them first. But after awhile, they won’t be special anymore. This will work for you, too. Although if you have been dieting or restricting excessively, you may need the help of a dietitian and therapist to guide you. Don’t feel bad if this sounds impossible. For many who struggle with eating disorders, it is. That is why knowing when you need help is important.
  5. Realize as a parent or as an adult, you make the decision about what your food environment will be. You go to the grocery store and you bring home whatever you buy. It is not restrictive or wrong to decide to predominantly have healthy foods in your home. If you know how to cook, healthy meals are really yummy! You are the one to decide if food is left on counters or in cabinets where children can help themselves. Don’t villainize the food, but instead, have it be a part of your normal healthy meals when you really feel it fits (and you want it). We all have our family favorites. When I grew up, ice cream was our thing. We would go every Sunday on long drives in the country and eventually stop at the same farm where they made their own ice cream. We all got what we wanted (I always asked for the green ice cream, also known as pistachio…still my favorite). In my husband’s family it was Grandma Harmon’s cinnamon buns. They are a pain to make, but when my husband does, he makes a lot, and we freeze them. We make them last!

So the bottom line is that it is smart to normalize “fun foods” so they are not so special after all. There is less need to be obsessed with them when they are treated neutrally, and when we get to have them. At the same time, we want to feel good. Therefore, it is smart to have our favorite fun foods as part of our normal healthy meal. It does not mean we need to have these fun foods at every meal. It could be once a day or a few times a week, or even a few times a day. As long as everyone gets the nutritious foods we all need to survive, that is what matters.

Also, it is imperative that we don’t talk about any foods in harmful ways (“this will make you fat”). Instead, talk about how yummy it is and enjoy it. With a focus on a healthy lifestyle (adequate sleep, fun physical activity, balanced healthy eating, relaxation) a normal amount of sweets, chips or other fun foods is fine.

So what is YOUR family traditional fun food?

5 Things You Should Never Do if Your Doctor Tells You Your Child is Overweight


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We all have heard it a thousand times. We have an obesity epidemic among our children and we need to do something. Back in July of 2013 when the American Medical Association declared obesity a “disease”, pediatricians took action. If a child’s Body Mass Index (BMI) was equal to or greater than the 95th percentile on a growth chart the child would be labeled “obese”. If the BMI was equal to or greater than the 85th percentile then they were “overweight”. Parents needed to be informed so they could do something about it.

There is lots of controversy about using BMI as a criteria to determine health. To calculate BMI all you need is a height and weight. Unfortunately, although this is what pediatricians use to diagnose and label “obesity”, BMI has little to do with health. Check out this BMI article for some great scientific background on why BMI is not a useful tool.  Anyway, if you are a parent, and you take your child for a yearly check up, you may be informed of your child’s BMI (especially if your child is out of range according to the Center for Disease Control (CDC) growth charts) See CDC Growth Charts.

What should you do if your pediatrician tells you your child is overweight or obese? Here is my advice on what you should NOT do:

  1. Never assume your pediatrician is correct to have any concerns about your child’s health due to his or her BMI. Instead, ask to see your child’s growth chart. Typically, children tend to follow along a curve. So, if your child has always plotted around the 50th percentile for weight, that is their “norm”. If they have always plotted along the 95th percentile for weight, then that is their “norm”. If their length or height has always plotted along a certain curve, the same holds true. Therefore, if a child happens to genetically be on the lower side for height and on the higher side for weight, their BMI may fall into a range that is above normal for BMI. Does that mean something is wrong? No! In fact, I have had several children come to see me who were referred for “overweight” who were actually very healthy and growing normally. One case I clearly remember is a little boy, about 10 years old I will call Johnny. Poor Johnny looked terrified when he came into my office. When I asked what brought them here, he blurted out “The doctor said I am overweight! Am I going to die? Am I too fat?” It was sad to me how frightened he appeared. When I looked at his growth chart, it was clear he was one of those kids who was a bit shorter and a bit higher on the weight chart. He was an athlete who played several sports and appeared very muscular and was definitely very fit and healthy. I had to tell him “your doctor made a mistake! He forgot to look at your growth chart! You are growing perfectly! But let’s go over what you eat anyway so I can be sure you are getting everything you need, ok?” He showed a visual sign of relief as he let out a big breath and sighed. I thought, this is so wrong. This athletic young boy should never have to worry about his weight. The doctor should have looked at the growth chart and known that this kid will probably never have a BMI that falls in the “normal” range and that his healthy lifestyle was what mattered. So the bottom line is be sure to ask your doctor to see your child’s growth chart. If, on the other hand, your child has veered off of his or her normal growth that may be a different story. Sometimes when there are big changes in lifestyle (that are not conducive to health, such as getting a new video game and discontinuing playing outside everyday to sit on the couch and play videos), well, weight can increase in a way that is not normal for the child. In that case, working on decreasing screen time and going back to healthy outdoor play is what is important. Again, working on having a healthy lifestyle is what matters, not the number on the scale, and certainly not a child’s BMI.
  2. Putting your child on a diet. Yes, after getting the news your child is overweight, a good parent wants to fix it. Often, a parent will come to me and ask for a “diet” for the child. Because of all of the cultural emphasis on dieting to lose weight, parents fail to stop and think that these are children, not adults we are talking about. And, the ironic thing is that research has proven that even adults are not able to diet successfully. Dieting leads to binge eating. Why would we think children can do it?Don’t you think if an adult ends up sneak eating and binge eating after restricting that the same thing will happen to children? It will.  Diets don’t work, not for adults and definitely not for children.
  3. Expecting your child to do something you can’t or don’t do. Do you expect your child to eat vegetables and fruits and salad, yet you don’t eat them? Do you drink soda yet expect your child to just drink water? Do you sit for hours in front of the TV yet expect your child to go exercise on the treadmill? Children do as we do. You can talk until you are blue in the face about the benefits of eating fruits and vegetables, and about how good exercise if for your body, but if you have an unhealthy lifestyle, glued to the TV, bringing home fast food every day, then your child is likely to be just like you. If, on the other hand, you have a healthy approach to eating and moving, with a focus on being healthy, then your child will likely adopt the same healthy attitude and lifestyle. This does not mean living on health food and driving yourself into the ground with exercise. It means using a healthy guide such as My Plate to help make your meals healthier. It means taking your child to the park to run around and have fun instead of handing them a video game to sit in front of a screen for 4 hours. It means planning some outdoor play and limiting the use of screens (TV, cell phones, video games) to less than 2 hours a day (yes, it is easier when they are occupied in front of a screen, but not healthy for their bodies if it is excessive). So work on this instead of thinking your child is going to be able to diet.
  4. Treating children differently when it comes to food depending on their body size. This is a pet peeve of mine. When a family says they have cookies in the house, or chips, or soda, because “her brother is skinny, he needs it”, this drives me crazy! What typically happens is the child who is overweight sits there in my office looking guilty. Their head is down, no eye contact. The mom goes on to say how little Cindy is sneaking her brother’s cookies. Mom also caught her sneaking some of her brother’s Doritos. Could I please tell her that she does not need them? Maybe she will listen to the dietitian! So what do you imagine my response is? I whisper (loudly), and look straight at the sneaky little criminal “you know what? I would be sneaking those chips too!” Now at this point, the mom usually looks at me like I am crazy, until I explain. How would you feel if your very favorite food were in the home and yet you were the only one who could not have it? It simply is not fair. Instead, I believe in trying to have a healthy food environment. This means having healthy snacks in the home, not having soda around (since most kids might fill up on it and say heck with the milk). Have soda when you go to parties, don’t restrict it, however be smart about it. The same goes for chips. Make them a part of a meal with other healthy foods (like a tuna sandwich, you really do need a few chips with that). Just because brother Johnny is skinny does not mean he does not deserve to be healthy too. He should also be eating fruit and vegetables and not filling up on soda. Everyone needs to care about health. It has nothing to do with body size. So stop treating children differently depending on their weight. It does not help anyone and it only serves to make the labeled child feel bad. It also usually increases a focus on food and sneaking. This is not a way to move toward healthy eating.
  5. Talk about weight at all. Your child’s weight, your weight, your friends weight. Just stop talking about it. In fact, I would also recommend you have a talk with your pediatrician to request he or she avoid commenting about BMI or weight at all in front of your child. If there are any concerns, ask that they talk to you privately. You do not need your child worrying about weight. This is not a good thing at all and only serves to make them feel bad. Instead, get the details about their growth chart (ask to see it, ask them to explain it and why they are concerned). If your child truly has gone way off of the chart then don’t talk about it. Instead, look at your entire family and the habits you have fallen into. Work on getting more physical activity for the entire family. Look into healthier cooking and less eating out, and other strategies to promote a healthy lifestyle. Seek the help of a registered dietitian by going to Eatright and finding a dietitian in your area. Or check out the My Plate link above and work on it yourself. But don’t talk about weight in front of your child. It is not helpful and will most likely be harmful. Think about it. How would you feel if everyone was watching every morsel that you ate, and pushing you to exercise when everyone else in the family was sitting on their butts playing video games? It is simply not fair.

So there you have it. There are also many things you definitely should do to promote the healthiest body possible for your child. Stay tuned for that. In the meantime, give your child a hug and accept them for the beautiful blessing that they are in your life.

Should you worry about a picky eater?

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Growing up in an Italian family where food was a big part of most celebrations and meal time an important time for families to be together, I have no memory of anyone who suffered from picky eating. So when I started to work on the “Feeding Team” at a children’s hospital, I was very surprised by the children that were brought in to be evaluated. The team consists of a Psychologist, Occupational Therapist, Speech and Language Pathologist and Dietitian who all play a role in evaluating the patient. The team evaluates issues with chewing or swallowing, texture and sensory issues, behavioral issues and of course nutritional deficits and growth adequacy. A common scenario is the toddler whose parents are concerned because he only eats 5 foods. These limited food choices vary from child to child however we do see many children refusing most meats (except for chicken nuggets!), all vegetables, most fruits and sometimes even dairy. Of course every child is different, and the reasons for the picky eating and food refusal are different also. It could be a sensory issue the child was born with, or maybe a choking incident which left the child fearful of eating some foods, or a history of reflux and feeling bad after eating. Whatever the reason, the parent’s reaction is often predictable: pressure the child to eat! It feels like the thing to do if you care about your child, they need to grow, right? How can they be healthy if they don’t eat?

Sometimes parents are so afraid for their child they may actually force feed them! You can imagine the child’s reaction. This does not lead to a pleasant feeding experience! It is more likely the child will dig in his heels and become even more resistant. The affect on health if left untreated (and if parents do not learn appropriate ways to deal with this problem) is the child may grow up to continue to eat just starches, no fiber, inadequate protein, vitamins and minerals and end up not having the healthiest body they could have had. Even worse, their relationship to eating and food can develop into a disordered one.

What should you do instead of forcing? First, tell your pediatrician or doctor about any extremes in your child’s eating. They should be able to refer you to a specialist for an evaluation (such as an Occupational Therapist who specializes in feeding issues, or psychologist or feeding team). Or, you can educate yourself as there are plenty of great books on the topic. One of my favorites is by Kate Samela, MS, RD, CSP who is an expert on the topic. Check out her book “Give Peas a Chance: Give Peas a Chance by Kate Samela, MS, RD, CSP

Another expert, Anne London, MS,RD has a wonderful website with great resources. Check it out at: PetiteNutrition

Finally, check out Ellyn Satter’s Website which is filled with great information on helping your child develop a healthy relationship to food and eating.

So if you child won’t eat his vegetables, don’t worry. It is most likely a phase. But if he starts to eliminate more and more foods over time and eventually entire food groups, don’t ignore it! You can help your child be the healthiest he can be!!

If your child is overweight…

mom cooking with child

Has your pediatrician informed you that your child is overweight or obese? With all the focus on the “obesity epidemic” pediatricians are now required to address the issue if a child’s Body Mass Index (BMI) falls above the 85th percentile (overweight) or 95th percentile (obese). A good parent’s natural instinct is to do the right thing which usually means take action.

Unfortunately, the first logical thing is to restrict a child’s intake,  which most parents don’t realize is the worst thing you can do! Recent research actually identifies three major contributors to childhood obesity: (1) lack of sleep, (2) parental lifestyle and eating habits and (3) parental restriction. This means that the more a parent tries to stop a child from eating more, or withholds food from a child, the more likely they are to seek out food and overeat. It backfires.

What should parents do instead? Childhood obesity is a very complicated issue with many contributing factors. I recommend seeking out a pediatric registered dietitian for guidance. You can also start now to work on being the healthiest you can be as a parent! This means work on being active, cooking healthy balanced meals, and focusing on health and NOT weight. More on this important topic to come!