I have never met a parent who does not want the best for their children. From day one, most parents have researched how to feed their new precious babies, and even if they feel prepared, it isn’t always easy. I have witnessed new moms who have persevered through initial breastfeeding struggles (having nursed three babies myself, I can tell you from experience it sure as heck is not fun in the beginning!). Some moms who choose to bottle feed instead also struggle. It’s not easy washing all those bottles right after having a baby, with little sleep, exhaustion, and all that goes with giving birth…yet, we get through it. Not to mention kids with digestive issues who struggle with reflux, constipation, you name it. Yes, feeding a newborn takes a lot of work, energy, and sometimes trial and error. But we never give up.

And then we start with foods. Baby cereal, pureed fruits and vegetables, Stage 1, Stage 2 and then finally on to table foods! We feel relieved when our child meets their goals for growth and weight gain, and happy when we see them joyfully eating a good variety of foods. Yes, getting through this stage is really important, and a giant first step towards a healthy child. Most of us tend to reflect on the types of foods we are preparing for our children. We read every label, we try to avoid foods with chemicals and sugar and food dyes because we just want our children to be healthy, right? The big mistake many parents make, though, is focusing way too much on the actual food itself and not enough on the crucial behaviors they are slowly instilling as habits around feeding. You can be feeding your children the healthiest foods you can find, but if you are neglecting to reflect on the big picture, it may not be enough. In fact, I dare say, feeding your child the perfect diet while neglecting the creation of lifelong healthy habits may be meaningless when it comes to supporting a healthy relationship with food.

I am not saying that what you feed your child does not matter, of course it does. That actually is one of the “habits” we might pass on to our children if we are not aware of what is happening. Babies and children, teenagers and we adults need a certain flow of specific nutrients on a regular basis to grow, function and feel our best. But I know you can get all the information on what your child needs hopefully from your pediatrician or a registered dietitian. Check out The Academy of Nutrition and Dietetics website or KidsHealth for evidenced-based information on feeding, nutrition and more.

So, instead of giving you the specifics of nutrition, I am going to give you some important tips that I not only learned from talking to and observing thousands of families, but also from the experts and research. It’s the stuff you typically don’t think of or pay attention to, but is so much more important than you think.  It is more about the “big picture”, the gigantic, complicated, intertwined factors that all influence your eating habits…..and ultimately your health (and your child’s health) in the end. The hard part is that it may involve some changes for YOU. Most parents are pretty stuck in their ways, and have fallen into their own eating habits and practices, some promoting health and some not so much. I never ever try to tell someone what to do (except “listen to your body”, the standing joke in our family). However, if there are some eating habits you have fallen into over your lifetime that you didn’t realize may be harmful to your child’s health in the future, now may be the time to reflect on those and make some changes. Also, some very typical beliefs and attitudes around feeding that have been around for decades and that we don’t tend to question but, rather repeat from generation to generation need to change (the old adage “clean you plate” for example goes totally against instilling intuitive eating). We just didn’t know then what we know now.

Ready for the challenge? Here are some scenarios that have the capacity to affect eating and health in a negative way. See if you recognize any of these in your own life:

1. Eating in Front of a Screen. We all have done it.  You just can’t get away from them. Think smartphone, IPad, laptop, computer, TV, DVD, video games. Add in the likelihood that most of us just have way too much on our plate. We have deadlines to meet, laundry to do, grocery shopping, cleaning, sports to play, people to visit, church, you get the picture. There is no time. I just retired 5 months ago, yet it is taking me weeks to finish this one blog! Where does the time go? Of course we need to eat while we are watching TV. Of course we need to eat at our desk. We need to multitask. I am sipping my coffee while eating a muffin as we speak.                               I am thankful that when my kids were little I didn’t have a computer. Truth be told, I didn’t even own a cell phone. The only screen in the house was the TV for quite awhile…..something to be said as I think about it for the good ole days. But things are different now, and young parents have an added challenge I did not have growing up in the 60’s and 70’s, and my own children did not have in the 80’s. These days I see babies just loving their parent’s cell phones. They turn into great portable devices to distract an unhappy baby, but when you pair it with food, it becomes a complicated mess. Then of course we have the TV with its on-demand features, binge-watching (which wasn’t even a word back in my days….if you missed a show, you missed it. Imagine that). Parents are eating in front of TVs all the time, and so are their kids. We all know people who own a dining or kitchen table but never use it (instead it becomes a landing place for mail, backpacks, projects, etc). No, people aren’t sitting at the table, they are sitting on the couch to eat. So what is the big deal?                                                                                                                                                   Lots. First of all, when you don’t look at your food while you eat (and enjoy it), it kind of disappears. Well at least it feels like it does. And, when you don’t actually LOOK at your food while you are consuming it you miss out on the sensory satisfaction eating is supposed to provide. The joy of eating, the appreciation of how good it tastes (depending on who cooked it I suppose), all of these factors contribute to truly feeling satisfied after eating. What happens when you simply watch the screen, and fail to look at the food you are putting into your mouth? You need more…..because it sometimes feels like you never even ate it (have you ever experienced this? I have!).                                                                                                          Secondly, when you eat in front of a screen, chances are you are not eating the healthiest of foods. Who grabs an orange they have to peel (and actually look at) when they grab a snack to have while working or watching a show? You are more likely to grab a handful of something or bowl of something dry (think of anything?) Research (see Watching TV While Eating and Diet Quality) actually shows that eating while watching TV “is associated with poorer diet quality among children, including more frequent consumption of sugar‐sweetened beverages and high‐fat, high‐sugar foods and fewer fruits and vegetables…….the cumulative effect may contribute to the positive association between eating while watching TV and childhood obesity”(the research tends to focus on “childhood obesity” because everyone is obsessed with it, I personally rather focus on health, but the information is still useful).  Even if you actually are eating as a family and eating together, it doesn’t help if the TV is on.    Consequently, research shows that intake of fruits and veggies (healthy foods) actually will be less if children eat in front of a screen (see article Screen Time and Eating Behaviors )Finally, eating if front of a screen contradicts “intuitive eating” goals. If you want to help your child achieve their own natural body, the one they are genetically born with and meant to have, then teaching them to follow their own cues of hunger and fullness is critical. We want children to stop eating when they are full, and to eat more when they feel hungrier to help them trust their little bodies and develop good intuitive eating skills. Watching a screen while eating disconnects them from what their bodies are saying just as it disconnects us. Who hasn’t finished a giant bowl of popcorn in front of a Netflix movie when they weren’t even hungry? Not that this is a big problem, it is a fun family thing to do, however repeated on a daily basis with all meals and snacks is certainly contributing to the development of an eating behavior that is not supportive of future health.
2. Picky Eating Parents. It was always a bit hard for me to hide my chuckle when a parent would complain that their teenager did not eat vegetables…..then when asked what vegetables they ate and wanted their child to eat, they would respond “well, I don’t eat them, I don’t like them, but she needs them”.  Doesn’t that strike you as unfair? After all, parents serve as role models and eating is no exception. Children WILL eat what you eat, eventually. They just won’t buy it when you try to convince them green beans are delicious but they won’t pass YOUR lips! It is hypocritical.                                                                                                                                    So here is some advice. Let me introduce you to what we dietitians call “The Rule of 20”. This means that it actually takes AT LEAST 20 tries to truly know if you like a food. It could take more or less, depending on the person (for example, children with sensory issues may have to try 60 times). But let’s assume you are a typical parent who just does not like vegetables. You truly believe you would gag if you had to take a bite of a green bean. You don’t have to down an entire serving to expose your taste buds and your brain to the green bean experience. Just one bite. We sometimes suggest parents put out a “taste test” plate with a small amount of a vegetable or fruit that we would like our children (or ourselves) to eat. Then, have fun with it. Have dips (preferred tastes) such as ketchup, sour cream, maybe flavored yogurt if you are taste testing a fruit, melted cheese, honey, etc. Then have fun. Avoid pushing a child to try something and instead, just work on having a fun and positive experience with the food.  Even getting a child to touch and smell a food is a huge step. Increased exposure is what we are looking for, as well as creating a positive interaction with the foods (so the old “you are not leaving this table until you eat your green beans) is never appropriate as it creates a very negative (and somewhat horrifying) eating experience. It does not work.                              Another trick is to use “food chaining” to help make foods more acceptable. You can add some diced green beans to soup or pasta, or melt cheese on top (if cheese is a preferred food). This is not about “disguising” a food or “hiding” a food, since doing that will only create distrust. Instead, be open and honest with your child and say something like “let’s see how green beans taste when we melt cheese on top! Yum!” Of course you can also try vegetables prepared different ways. Some people just love raw veggies but dislike the same vegetable when it is cooked. I am not a fan of beets, however I have found that when they are roasted with olive oil in the oven I just absolutely love them. Get creative. And be a role model. This means being brave and taking a bite yourself. Remember, there are some foods that you may not like the first time, but if you continue to expose your child (and yourself) to healthy foods, eventually you develop a taste for them. It literally took me over 30 years to get to the point I am at now with beets, and that’s no lie. Also, just as we adults don’t feel like eating a food sometimes (have you ever been in the mood for eggs one morning, but the next morning the thought of eggs makes you gag?), well, kids are the same way. I have had parents offer a food once or twice and a child accepts it. Then, they offer it again, and that day the child refuses it. “They don’t like eggs any more”, and so the parent stops offering them. Remember, a young child is not able to verbalize “sorry mom, just not it the mood for eggs this morning”, but their refusal is telling you they don’t want it. Don’t force it, and don’t give up on eggs. Just offer them a few days later, or at another time, over and over and you will see, just like us adults, their preferences change day to day, meal to meal. Try to honor that.
3. Unreasonable Expectations: Daddy’s Food. I often wanted to shake my head in disbelief when parents would come in and expect me to scold their child for sneaking “daddy’s soda” or “mommy’s chips”. The conversations would go like this:   Me: “What brings you here?”                                                                                                     Parent: “Johnny needs someone else to tell him, he needs to stop sneaking food. He needs to stop taking his father’s soda, and his sister’s cookies. She is skinny, she needs them, he doesn’t”.                                                                                                               Me (looking straight at Johnny): “So you are sneaking your sister’s cookies? (shameful head nod from Johnny). Me: ” Well, I don’t blame you, I would too! Cookies are good!”  At which point the parents would look at me as if I were crazy. Johnny would smile (he knew I was on his side). I would then ask the parents if they could tell me their very favorite food in the entire world. They would think for a minute then answer “lobster!” or “chocolate!” I would then ask how they would feel if that specific food were in the house and everyone else could eat it but them. Does that feel fair? Not when it is you. It is way too much to expect a child to resist helping themselves to a yummy food that everyone else gets. This creates a “sneak eater” and also instills lots of shame in a child. They of course don’t want to do anything wrong, they want to please their parents, yet, food is a necessary part of life, and it is unfair to expect children to resist what is in the home. So my advice was focused more on creating a healthy home for everyone, not just the child who is sneaking the cookies. If you don’t want your children drinking soda, don’t bring it home (have it at work, keep it in your car, anything but drinking it in front of your child unless you are going to share). Nothing wrong with having some soda here and there, but drinking soda on a daily basis in large quantities isn’t a great idea for anyone (if you are full on soda, not much room for other things that you need to eat to be healthy). Same goes with cookies or chips or ice cream or anything else most people typically consider “bad” foods. I don’t use that term, I just don’t believe any food is bad, especially if you like it. But we need to be smart about it. If you have cookies in the house, make them be a part of a meal (not nibbled on throughout the day where they are likely then to interfere with appetite for meals, when more nutrient-dense food is typically served. And remember, if you nibble, your child will nibble). Whatever you do, don’t discriminate on who gets what depending on their body size. This is a sure way to create a closet eater and a child who is more likely to develop a very unhealthy relationship with food.                                                                 The bottom line is that what you eat as a parent is probably one of the most important influences on what your child will eat. For a recent review, see The Influences of Parental Practices
4. Double Dinners. Experts recommend sitting at a table for “family dinners” to promote healthy eating and a good relationship with food. Unfortunately, this is often easier said than done. I have encountered many families where parents work different shifts, mom or dad may get home at 8 pm, a few hours after the kids have had dinner. An issue I have seen is when a parent gets home and needs to eat dinner at some unseemly hour, children who have waited up to see them may end up eating another dinner. This was quite common in the outpatient nutrition office where I worked, mostly dealing with children who gained weight above their growth curves (triggering a referral to outpatient clinical nutrition).  Parents and children being on different feeding schedules can indeed cause some issues.  Parents tend to focus on their children, often neglecting themselves. They may do a wonderful job scheduling regular meals with a structured snack time in between meals (just what we recommend, 3 meals with a planned snack in between). We don’t want children nibbling all day and then being too full to eat regular meals. You may know some individuals who “graze” and it works for them as they nibble throughout the day, somehow getting what they need. But this is more risky for children, as we have learned that nibbling throughout the day often interferes with appropriate weight gain (they may not gain enough, or sometimes gain too much).  But what happens to mom or dad when they just plan for their children’s meals but don’t sit down and eat themselves? This typically leads to a need to snack, just to keep up energy. Just as when a parent gets home late and needs dinner, a child seeing you nibble is going to want some. Eating becomes chaotic and sporadic and children’s little bodies get confused. Natural hunger and fullness is difficult to detect with constant nibbling (vs 3 meals, a morning and an afternoon snack, and a bedtime snack).                                                                                                                              What is the answer? Each family is unique, but in general, I suggest parents plan ahead. They should try to plan for foods they also enjoy so they can eat at the same time as their children. Granted, feeding kids is often chaotic in itself, never mind feeding yourself. Having more than one child myself, feeding three made it more confusing than ever. But, breakfast and lunch can be simple, and even if you aren’t a fan of cheerios, you can sit down and have whatever it is you enjoy. The same with lunch, keep it simple and sit with your child. You don’t have to eat exactly what your child is eating (who really likes applesauce?), but taking a few spoonfuls of whatever counts. Sitting down and eating, even if it is towards the end of the meal (due to having to get everyone settled truly prevents parents from sitting down the entire time, unless you have a live-in helper which most of us don’t). And when it comes to dinner, perhaps save some fruit for eating with mommy or daddy when they get home to have their dinner. It is important to sit together and have that time together. If your child wants a few bites of whatever it is, that is no big deal. I have seen it become a problem only when a child is truly not hungry, but wanting to connect with the parent, they end up eating another entire meal, leading to unnatural weight gain. Another solution I have seen work for some parents is to have a snack together and then eat their dinner when their child goes to sleep. Whatever works for your family. Just be aware that eating with your child is the most important thing of all. Check out Give Peas a Chance by Kate Samela, MS, RD, CSP for some excellent information on dealing with a picky eater, ideas for menus, important nutrition information and the importance of avoiding “short order cooking”.
5. Bad-Talking Food. Jen, our psychologist on the Feeding Team where I used to work, dealing with children with all types of feeding problems had a saying: “Don’t Yuck My Yum”. That means that no matter how horrifyingly disgusting a food appears to you, you need to keep your mouth shut. The person eating the food loves it. This is easier said than done. Trust me, down here in Florida, people eat some weird things. Gator bites. Conch fritters. Oysters. These all make me cringe, but people love them. When I have been out to eat at a restaurant and someone orders gushy oysters, I think of Jen and try not to make a face. I don’t say “eeeewwww!” because that violates the rule. So, when it comes to your dinner table, when you offer broccoli alfredo for the first time and someone makes a face and a comment, this would be a great time to introduce the rule: “Don’t Yuck My Yum!”
6. Body Shaming  It blows me away how so many people apparently think it is A-ok to talk about someone’s body right out loud, with zero concern (or awareness) of how words can hurt. Not only hurt, but affect someone for years to come. I can’t even begin to tell you how many times I have heard from the eating disorder patients I have worked with in the past stories about their experiences with body shaming. I am not saying that telling your child he can’t have a second cookie because he is too fat will definitely trigger an eating disorder, but it might. Even if it doesn’t, talking about a child’s body certainly isn’t good for self-esteem. You would think we would get it by now, but lots of us don’t. I see adults joke about other adult’s bodies, about beer bellies, and weight gain, even jokes about being thin, it seems to be socially acceptable (which makes me sad).  Anyone’s body is open game it seems. The problem is we just don’t know how fragile a person may be. Besides being plain rude, it can be dangerous (this will sound ridiculously silly to some, but to others it will make sense because they have experienced it). I have seen children literally stop eating after a visit to the pediatrician’s where BMI was discussed openly in front of the child. I have seen adults binge eat in secret because of spouses commenting on their food intake. Making a big deal out of body size, or allowing any family member to talk about bodies like this is just plain wrong. And, it goes both ways. Insulting a person by calling them a name (chubby, fat, etc) is wrong, but so is calling a child skinny or whatever other name someone thin is called. Yes, I know, most people think being “skinny” is desirable, but to the child who is self-conscious, it is just as mean and hurtful (and believe it or not, thin adults don’t take it as a compliment when you praise them for being thin….it makes them uncomfortable). I have seen people praise others because of their thin body types. This is also harmful as it instills in children that being thin matters. It sends a message that body size matters, and it shouldn’t. Make a rule in your house (discuss with your spouse or partner, or any other adults in the home) that you don’t allow talking about bodies. Stress it to other family members and nip it in the bud if anyone who visits your home talks about your child’s body. I may sound a bit dramatic here, but remember, this post is about promoting a healthy relationship with food, and instilling a healthy lifestyle for your child. Focusing on body size, weight and/or shape is damaging.
7. Toxic Food Environment.  This concept incorporates a bit of the previous points. It simply means that your family will eat what is there. Period. Therefore, if you want to promote healthy eating, there needs to be some healthy foods within reach. This does NOT mean you should not have other kinds of foods in the home (such as cookies, ice cream, chips, etc.). In fact, it is important to send the message to children that foods are not “bad” just because they might be sweet or salty, and/or may not have much to offer nutritionally (other than energy, which, by the way, is really important for all of us). The key is your attitude, and balance. Common sense. Serving only french fries and cookies for dinner every day wouldn’t be a great idea. Having fries with your fish sticks and salad sounds like a decent dinner for a kid. Only having cookies in the house and never having fruit is not a good example of balance and variety. Kids need to be offered a variety of fruits and vegetables on a regular basis since exposure contributes to acceptance. But, restricting sweets, for example, only makes them more desirable. Labeling foods as “bad” only instills guilt when kids actually do eat them (and they will, at school, at friends, at family gatherings, etc.). Making kids feel bad or guilty for eating these foods does not promote a healthy eating relationship. Research actually suggests that parents who restrict their children so they won’t gain too much weight actually make kids more focused on food, contribute to overeating and sneak eating, and may result in excessive weight gain (see review article: Food Parenting and Child SnackingI personally have seen countless examples of children gaining excessive weight once their parents started to focus on weight and limiting foods. Intentions, of course, are good. These parents love their children and want them to be healthy, so when their pediatrician informs them of a BMI that is not in a certain ranges, most parents do what they think is right, but instead it backfires. Due to the health community’s focus on “the obesity epidemic” researchers have been looking into what influences eating habits in order to know how to foster better habits that promote “healthier” weights (Note: you CANNOT look at a BMI chart to decide if a child’s weight is a healthy weight, you have to look at individual growth charts). If your child appears to be tracking somewhat normally for THEM then it is good. If, however they fall off or jump up way above what is typical for THEM it should be looked into. DON’T go by one simple number such as BMI no matter what anyone tells you. I advise parents to ask the doctor to see the growth chart and to explain it. If your child is following a certain percentile, chances are that it normal for them.        

The take-home messages is this: you have a huge impact on your child’s eating habits. You can structure meals (3 per day) and snacks (2-3 per day) and you can try to eat meals with your children as much as possible. You can insist on turning off any screens while eating (easier to start this when your kids are young, it may be a hard habit to break when they are older, but don’t give up). You can promote positive body image and a healthy relationship to foods by avoiding talking about weight and body size and by supporting your child’s natural growth. You can provide the nutrients your child needs with healthy foods (offering fruits, veggies, dairy foods, protein foods and grains) on a regular basis. But you can also “normalize” all foods by refusing to treat foods such as cookies, ice cream, chips, etc as anything special. Just don’t have them as the only option. Oh, and don’t use sweets (or any food ) as a reward…read them a book, play a game, anything but food. And yes, you might have to learn to cook, but you can still keep it simple. Most of all, remember, you know your child best. You may feel differently, and you need to do what is best for you and your family. You should never feel bad or guilty just because you may go weeks without a family meal or vegetables. We all have days (and weeks) like that. It is only important to keep trying. Check out the references and the book Give Peas A Chance. Reflect on your own eating habits and food preferences, but remember, judging yourself doesn’t help either. Simply reflect, be honest, and work on it.

Don’t forget, it took me decades to make my peace with beets. I wish I tried earlier. Just think of all those years I could have been enjoying them…….you can, too.