Tales of a Challenging Eater (My Son)

Happy Birthday to my sweet son, Evan, who turns 5 today!

As a practicing pediatric and family dietitian, many people have this picture of my children being perfect little eaters.  Here I am as the “Mrs. Cleaver” role getting a well-balanced dinner on the table with the kids eager to dig into the wholesome goodness that was prepared with lots of love.  Floral apron on.  Kids smiling and waiting for their colorful plates to be served.  Kids digging in and eating a variety of flavors.  Nope.  Not exactly my reality.

I truly believe that the good Lord has used my son, Evan’s eating habits to further increase my empathy for my patient families with challenging eaters.  I have blogged about him before, although I don’t know how much I detailed his apprehensions with food.  Evan has been much different than my daughter, Hannah, right from the beginning.  He is one of those kids that really challenge the repeated exposure rule on food acceptance.  His food preferences are milk, yogurt, cheese, bread/bagels and fruit.   I hear you, parents.  I do everything that is recommended and yet my son has been slow to progress.   

But there is good news!   Now that Evan is getting older, he is listening more about the positive effects of eating “super power” food.  You see, he started a new soccer team and he really wants to run fast, kick harder and well, score goals.  I explained to him that eating the same foods over and over won’t give him the power he needs on the soccer field.  In the last 6 months, he has started eating new foods that he had shunned for so long including salmon, salads and broccoli.  He even told me the other day that he wants to eat a big bowl of broccoli before he plays his soccer game so he can make sure he plays well.  No kidding!  I said, “Sure!  I can make that happen.”  As kids get older, their reasoning part of their brain also develops a bit more so it is important to keep a dialogue going with them.

So, let’s list just some key behaviors in feeding your little people that will set them up to be good eaters for a lifetime:

·         Serve a variety of foods and keep healthy food such as whole grains, fresh fruits, veggies, low-fat dairy and lean meats easily accessible at all times.

·         Eat as a family as often as possible.  Eliminate distractions and serve one meal.  Avoid short order cooking or serving their favorite foods over and over!

·     Serve your children what you are eating even if you think they will reject it.  Avoid thinking of certain foods as “kid’s food.”  This is so important.  Repeated exposure of a rejected food is key to promoting eventual acceptance of that food.

·       Avoid making blanket statements like, “My child doesn’t like (insert rejected food).”  Verbalizations can solidify those rejections longer than usual.  Instead, keep an open mind that your child may eventually like that particular food.

·       Discuss the positive aspects of eating healthy foods instead of talking about the negative aspects of less healthy foods.  Kids want to hear the “why” behind healthy eating.  They want to know that healthy foods will keep them from getting a cold, will help their runny nose or even help them run faster or jump further.  They respond to knowing how eating healthy will help them accomplish the goals that are important to them right now.

·       Create non-eating scenarios with food like visiting a pick-your-own food farm or taking a cooking class so your children can be more comfortable around food.

·       Last, but certainly not least.  Your child’s only responsibility at a meal is to eat or not eat.  It is your responsibility to make the healthy meal and eliminate the distractions for a pleasant eating scenario.  If your child does not like what you fix, that’s ok!  They do not have to eat.  Get it?  It’s that easy.  I promise - they won’t starve.  (But keep that plate just in case they get hungry - later because they will try and get their preferred snack afterward!)

I have not only found in my practice that all these things work, I have found it to work in my own home.  Consistency will eventually yield results.  So, take the pressure off yourself and your children.  Your kids will come around if you provide them a healthy feeding environment. 

Parenting Styles and Child Feeding: What Does It Mean?

Health professionals were reminded in a great study that came out in the Journal of the American Dietetic Association back in 2008 that we must address parenting styles and family dynamics if we want to be successful in implementing dietary change in families. This study is consistent with many others published.  So with that, what is your parenting style? (If you haven’t yet, take the quiz in my previous post: Parenting Styles & Family Feeding: Take the Quiz!)

The good work started by psychologist researcher, Diana Baumrind, in the 1960’s helped us identify these 3 types of parenting styles – authoritarian, authoritative and permissive parenting. Now there are psychologists adding other styles, but we will zero in on the original three. The research I have done along with my own experiences with many family interventions reveal that authoritative parenting correlates to the best family feeding practices and lowest incidence of childhood overweight. Why? Because authoritative parents have a tendency to do the things pediatric dietitians and feeding experts recommend: monitor unhealthful child behaviors such as sugar and fat consumption; positively monitor, and take responsibility to promote child health and well-being through limit setting. They also have a tendency to model healthful lifestyles, which is a key component in your child’s learning process. On the other hand, authoritarian parents tend to food restrict and/or pressure children to eat regardless of the child’s desires. Permissive parents have a tendency toward poor healthy lifestyle modeling.  Therefore, it is not surprising that authoritarian and permissive homes produce the most overweight children.

The right parenting style may make your meal
times even more enjoyable.

So what’s the take home? It is clear that children need structure and clear guidelines when it comes to all kinds of behavior. But they also need and desire to have choice in matters. So, combine clear limits with the allowance of your child to make their own choice within those guidelines. Many child feeding specialists believe that regular and consistent times for meals and snacks promote feeding confidence in a child. The choices you give your child need to be age-appropriate as well. As an example, I allow my 6 year-old daughter to choose from a large selection of healthy snacks in our refrigerator and/or pantry during snack time. They are all there for her choosing. She feels empowered to make her own choice within the acceptable selection, and I am pleased that she is having a healthy choice.

If you took the quiz and found that you lean more towards a parenting style other than authoritative, don’t be upset. Many times our parenting styles fluctuate between the three styles. For instance, I notice that I sometimes deviate towards permissiveness when I am really tired, or more authoritarian-like when I am angry. So, take heart and know that knowledge is power. This information is designed to remind all of us as parents to be invested, consistent and clear about parenting for the sake of our home atmosphere as well as for the future of our children – in all areas, including feeding. If you want to read more about Diana Baumrind’s work on parenting styles, go to UC Berkeley's Institute for Human Development page.

More Reading:

Kyung E. Rhee, Julie C. Lumeng, Danielle P. Appugliese, Niko Kaciroti and Robert H. Bradley. Parenting Styles and Overweight Status in First Grade. Pediatrics 2006;117;2047-2054.

Hubbs-Tait L, Kennedy TS, Page MC, Topham GL, Harrist AW. Parental feeding practices predict authoritative, authoritarian, and permissive parenting styles. J Am Diet Assoc. 2008 Jul;108(7):1154-61.

Wake M, Nicholson JM, Hardy P, Smith K. Preschooler obesity and parenting styles of mothers and fathers: Australian national population study. Pediatrics. 2007 Dec;120(6):e1520-7.

Kyung Rhee. Parenting Style, and Family Functioning. The ANNALS of the American Academy of Political and Social Science 2008 615: 11

Three E's For Optimal Child Nutrition - Educate, Expose & Empower

My children, almost 3 and 6 years of age, are at an age where they are curious, but cautious about the foods they eat. This is a natural and normal state for their ages and I am reminded to utilize my education to train my children to choose healthy foods on their own. Just like anything else in life, we would all agree that we want to train our children to eventually be able to do life on their own and it is no different with food choices. But how do we go about doing that? This is the challenge, and I fully realize it's a challenge, because I am living it out myself. But stay encouraged. we can do this together!

Educate. This requires us to be tapping into accurate and reliable informational resources. If you have inacurrate or undeveloped nutrition knowledge, then your children will naturally have the same. There are so many governmental, reputable origanizational and university websites that you can count on to bring you unbiased, reliable information. A great portal of information can be found starting on the U.S. Government's Nutrition landing site that connects to other governmental nutrition sites. The American Dietetic Association, which is the national association for Registered Dietitian and Dietetic Technicians, has a wealth of information as well. Start there. Obviously I am biased to say you should consider getting individualized guidance from a Registered Dietitian in your area as this is the best way to get off to the right start. But actively become educated so you can educate your children.

Educate, Expose & Empower Your Children!

Expose. Let's be honest. We all come to the food table with certain likes and dislikes. Are you a picky eater yourself? Do you dislike most vegetables? Do you eliminate certain food groups altogether? These things can directly impact your children's exposure to foods. Even if we would categorize ourselves as "healthy eaters," we all have a tendency to gravitate toward our favorite foods. This can also limit our children's food exposure because even healthy repetition is limiting. Head to a new grocer or even visit your local farmers market to investigate new foods.

The biggest thing I want to say about exposure is that we all need to remember to serve our children foods that they have already rejected. I know, I know - food wastage comes to mind - but if we remember that children are curiously cautious to new foods, we will gain patience. I have seen this many times with my daughter and continued exposure has lead to eventual acceptance much of the time. My son is at an age where he is rejecting most vegetables, and that's OK! I still serve them to him knowing that most likely he will accept some of them. Exposure is a big topic when it comes to child nutrition because we like to make the foods that we already know our children like because we want them to eat! Let's take the school lunch, for instance. Many of us commonly think that sending a school lunch with your child is the healthier option. I would challenge you by saying that is not always the case. The typical "healthy" brown bagged lunch has maybe a sandwich (primarily peanut butter and jelly, but also lean lunch meat), baked chips and a fruit cup or a fruit snack along with a juice or maybe even a milk. Where is the vegetable? Most children either do not have a vegetable or they get the same baby carrots everyday. Maybe your child will get the lettuce and tomato on the sandwich and that is good. But what about the next day? Is the lunch something different, or will it be more of the same? You see, the typical school lunch always provides the option of a vegetable and in most cases, provides variety from the home food. That is why I feel comfortable allowing my daughter to purchase school lunch mulitple times per week. This way I know my daughter will have the opportunity to take in a variety of nutrients by eating a variety of foods. But will she choose the vegetable, you say? That's where empowerment comes in.

Empower. This is another big one. It is essential that we teach the "why's" behind good nutrition. Let's not stop by saying "because it is good for you." And certainly, I do not encourage any talk, particularly with young children, about eating certain foods to avoid being "fat". This is sure to cause poor relationships with food, so please refrain from talking about your own fad diets and dieting practices around your children if at all possible. We all need to be healthy. And kids want to be strong and smart. I teach my children that healthy foods such as whole grains, lean meats, fruits, vegetables and milk provide "super powers" that will give them all they need to run fast, read better and can even make their skin nice. My daughter loves that eating vegetables makes her skin look like a princess. See, she gets that and it encourages her to make that healthy choice much of the time. I tell her that eating candy is fine when it is eaten sometimes, but when you eat it all the time, it does not give you the fuel her body needs to be all that she can be. So, right now she thinks she is carrying around the "secret" that healthy foods have "super powers." The other day, she asked if it was OK that she tell her best friend the secret. I told her it was OK. You can go ahead and share the "secret" with your kids, too. :)

End Mealtime Struggles with Children

Are you the parent of a picky eater? If so, you know how stressful mealtimes can be. I counsel many parents that are up to their eyeballs at getting their children to eat balanced and have ample variety. Having young children of my own, I have had to deal with the challenges and opportunities of modeling good eating behaviors.

There are several things that we need to remember about children when it comes to eating. The first thing is that research shows that children need to be exposed to some foods 15-20 or even more times before they find them acceptable. Where parents go wrong often times is that they see their child rejects certain foods while preferring others. They take that information and create future meals with the preferred foods only. Why? I believe much of the reason is our innate drive to nourish our children and wanting them to eat. The problem is that we will do this over and over again until one day you find that your child only likes 7-10 foods. Hence, he/she is now the "picky eater." Instead, what we should do is to make a family meal that includes a variety of food - including some of your child's favorite foods - and serve all those foods on each plate. Even though you know your child might reject some food items, that is OK.

The other thing we need to remember is that children are extremely good at eating when they are hungry and not eating when they are not. In general, they do not eat according to any clock or time schedule. You'll notice that a normal child's eating pattern usually involves waves of high hunger - i.e., eating a lot at meals - to waves of low hunger where they don't eat much at all. These waves can last several days. This is very normal. Again, with our desire to nourish our children in the back of our minds, we get concerned because they are not eating as much as we think they should eat. So, we might do things such as make separate meals for them that includes all their favorite foods or we might force them to eat. Some even force them to eat the "good for you" foods such as vegetables. All these actions come from a very good place, but they are not recommended.

We need to get back to the basics. Include a variety of foods in your home with emphasis on lean meats, whole grains, fresh produce, healthy fats and low-fat dairy. Eat as many family meals as possible with the absence of distractions and controversial conversation. Fix one meal for all and get back to allowing your children 2 choices of drinks - milk or water. I love Ellyn Satter's very easy-to-understand Responsibilities in Feeding:

- Parents are responsible for what, when and where of the feeding
- Children are responsible for how much or whether to eat

I was taught this information in dietetic school and once I had children, I fully appreciated the challenge of living this out. However, my 5 year old, Hannah, is living proof that this works. She is now at a point where she loves all different kinds of foods and will try almost anything. My 2 year old, Evan, is still learning to "trust" different foods. But I continue to serve him everything, and I am much more confident in the process with him. He is slowly adding foods as he watches me, my husband and his sister enjoy the variety on our plates. It works!

By the way, Ellyn Satter is a dietitian and social worker that is an expert in child feeding. She's got a ton of free information on her website and has written many books on the subject. Check her out!

One last note about children and eating --> I re-discovered a book on my office bookshelf entitled, "The Healthy Luncbox: How to Plan, Prepare & Pack Stress-Free Meals Kids Will Love." It's a great book for parents looking to revamp their kid's school lunches! I got some ideas for Hannah's lunch and am excited to fix them.