*This post was originally published on The Tender Foodie Blog. The original article can be found here.
DO YOU DINE OUT?
Many parents feel overwhelmed at the thought of bringing their child with food allergies to any restaurant for fear of exposing him/her to an allergen that could make them horribly ill or worse. Yet, according to Restaurants USA Magazine, Americans eat out for 4.2 meals per week! Dining out with our families and friends is part of our social routine. It’s possible to enjoy this time together as a family, but it requires a bit of planning. One strategy that may soothe some fears is assembling your own “Restaurant Backpack” filled with everything you need to create a safe and fun dining experience for your entire family.
While it might be tempting just to wrap the chair in your coat, as this parent has done (above picture), start instead with a washable highchair cover to shield your little one from those germy, possibly allergy-laced wooden restaurant highchairs. Fisher Price™ makes a padded version that includes tether straps to attach to toys so they won’t fall on the equally dirty floors. The carry pouch is included. Tuck a package of sanitizing wipes in the carry pouch so that when you arrive at your seat, the first thing you do is wipe down the table, highchair and anything that is within reach of your child. Then add the cover, then add the kid. Speaking of toys, it’s ideal to bring quiet toys that won’t disturb the other patrons, lightweight toys that keep the backpack manageable and socially interactive toys that focus on you and your child being together and enjoying the moment. My top three favorites?
Aquadoodle Travel N Doodle is a soft, mess-free, portable and foldable drawing mat that includes a refillable “water pen” that magically makes red appear on one side of the mat and blue appear on the other. The most your child gets on him/herself is a bit of water. One suggestion: store the pen in a re-sealable plastic baggie or empty it before going home. It can leak in the backpack.
Helping Your Large Child Thrive in a Fat-Phobic World
by Julie Dillon, MS, RD, NCC, LDN, CEDRD
“As a parent of a larger child, the difficult challenge is the voice inside my head telling me that I am doing something wrong. It’s telling me I am ‘letting’ her get fat and not doing something about it.” —Jennifer, mom
We live in a world where fat bodies are discriminated against, bullied, and considered unacceptable. What if your child is larger than what society deems ok? It is important for you to teach your large child how to respect his or her body since our society will not. You will be your child’s advocate for healthy ways of experiencing food, exercise, and body image. Where do you start?
Let your child know through your words and actions you accept him or her unconditionally. If your child comes to you upset about his/her large body, let your child know you love them as he/she is, that you love them no matter what and no matter what size. Do not suggest a diet or exercising together. If you were to do so, the suggestion sets up a condition. It says, “No, you are not ok as you are. I will help you change.”
Meals and Snacks
Set up regular meal and snack times so your child knows when food will be served. Older children and teens may start to feel ashamed of eating enough in public. They may restrict themselves to low-calorie foods when eating with friends. This way of eating is often referred to as “eating for show.” It means that even though your son or daughter is hungry for a variety of foods, he/she may feel like he/she should be restricting in order to repent for their large body. This leads many kids (and adults!) to eat more in private and even binge eat.
If your child knows your meal and snack times and falls into this “eating for show” trap, he/she can avoid binge or secret eating by consuming enough at the next meal or snack time.
Consistent eating times also offer the opportunity for every child in your home to learn how to detect, respect, and satisfy hunger and fullness cues. Besides promoting healthy eating, this also promotes positive body image.
High-Calorie Fun Foods
By banishing certain fun foods, you may set your child up to sneak foods or binge eat. Be sure to stock your house with a wide variety of wholesome nutritious foods. This variety will include fun foods too. Fun foods include cakes, cookies, and chips. I encourage all families (no matter what body size) to offer cookies at snack time once a week. I also encourage a few fun sides such as potato chips a couple times a week with meals. Offering fun foods alongside nutrient-dense foods helps in many ways. It satisfies cravings, models moderation, and prevents shame and binge eating high-calorie low nutrition foods.
Jennifer has found strength thanks to professionals and others who have gone through the same thing. “I have to get grounded by people who understand. While I know my family is concerned, their way of ‘shaming’ her or me because of her food choices or size and trying to manipulate her diet makes helping my daughter so hard. Having other parents to talk to that have been there, BUT also agree with the Body Positive philosophy is essential for support. I also have needed the support of a Registered Dietitian Nutritionist to help me let go of my anxiety about this.”
Every body is meant to move—not just fat bodies. Encourage all of your children to find activities they enjoy. If time and finances allow, let your children pick one organized physical activity per week. Maybe they will enjoy soccer, tae kwon do, salsa dancing, or ice-skating!
Do not make your large child do an activity that he/she does not feel comfortable doing. Avoid “no pain no gain” cliché philosophies. Instead of motivating, they will only shame your child more. Also do not single out any child and make him/her do an exercise while others do not. Moreover, don’t encourage more exercise in relation to foods consumed nor discuss completing a certain amount of exercise to burn off calories consumed. Thinking about food in this way is disordered and could set up genetically predisposed children to start practicing an eating disorder.
Jennifer states: “I try to listen to my daughter’s sadness and frustration about not fitting into ‘skinny jeans’ and not tell her she is wrong for feeling that way. But I also talk to her about how her body is going to change and grow forever and how learning to love it is the best gift. I talk to her a lot about how strong her legs are and how graceful she is when she is figure skating. Not about what her body looks like but the amazing things it can do.”
Your large child needs you to communicate unconditional acceptance in order to thrive in a world stereotyped against his/her body type. Avoid shame-based language, singling out, or punishment. Rather engage in modeling healthy eating, pleasurable movement, and respectful body image for all your children, no matter their size.
One of the things I like best about teaching courses on feeding to parents and professionals around the United States is learning what new trends are evolving around family mealtimes. Over the past year, one of the common questions I’m asked is, “What about Baby Led Weaning?”
Baby Led Weaning (BLW) is a term coined by Ms. Gill Rapley, co-author of “Baby-led Weaning: The Essential Guide to Introducing Solid Foods.” Rapley graciously chatted with me about her philosophy and explained that although she did not invent BLW, she found the method to be successful in her work as a former health visitor and midwife in the United Kingdom and continues to study the topic today while earning her PhD.
In a nutshell, BLW centers on the philosophy that babies are developmentally capable of reaching for food and putting it in their mouths at about 6 months of age. As stated on the BLW website “You just hand them the food in a suitably-sized piece and if they like it they eat it and if they don’t they won’t.” Please note that the word “wean” is not referring to weaning from breast or bottle, but instead refers to a term commonly used in the United Kingdom for adding complementary foods to the baby’s current diet of breast milk or formula. According to the BLW website, ideas for first foods include “chip size” steamed vegetables such as a broccoli spear with the stem as a handle, roasted potato wedges, meat in large enough pieces for the baby to grasp and chew, rice cakes, cucumber, celery and dried apricots.
As a SLP who focuses on pediatric feeding, I view feeding as a developmental process. Whether I’m working with a child experiencing delays in development or offering advice to a parent whose child is meeting milestones with ease, I always ask myself “How can I respect and support this family’s mealtime culture while guiding this child safely through the developmental course of learning to eat?” Thus, for families who are interested in following the BLW method, whether their child is in feeding therapy or not, I try to support their wishes if the child is capable, while offering the following BLW points to consider:
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Parenting is all about guiding, providing, teaching with unconditional love. And it’s also about allowing our kids the space to try, explore and figure things out so that they can eventually trust themselves to make supportive choices. Not only these overall developmental themes, they are also completely relevant as kids personalize their own relationship with food, eating and connection with their bodies. When our children are young, we are the gatekeepers of the food: providing, preparing and presenting it in a reliable, and consistent manner 1. And while we may still be paying the grocery bills and answering the age-old question, “What’s for dinner?!” as long as our children are under our roofs , our kids pretty quickly begin to practice more and more independence and autonomy with their food. Imagine, if you were still cutting your 15 year olds steak at the dinner table! That seems ridiculous, yet we want to make certain that we are also giving our kids the space to explore and take charge in other ways with their eating experiences. Particularly as our children explore the middle- and high-school years, there are endless opportunities for us to give them room to make more of their own food decisions.
Give suggestions not solutions
Our hormonal little teddy bears (often disguised as grizzly bears), typically don’t respond well when we try to solve things for them. They may ASK us for the answers, but they really want to be able to make their own decisions, and yet know they need some input from us.
Instead of: “Why don’t you ever eat breakfast in the morning? “
Try: “I notice you’ve been talking a lot about how tired you are, is there anything you think might make getting up less brutal?” . Then, rather than firing off 5 things you know would work, simply ask if he would like some suggestions. Not only does this give you an opening to discuss simple breakfasts that can be ready crazy fast and keep his energy up, it also gives you some space to discuss time management and ways the family can work together to support each other.
Capture teachable moments
We may be acutely aware that certain patterns aren’t working well for our kids. An extremely common pitfall is the post-school slump. Not only do our kids come home worn out from thinking, they’re also really, really hungry. Getting them to connect how the first half of their day plays a role in the second half is a really big deal.
Instead of:“How come you’re raiding the pantry the second you walk in the door?” which is not only shaming, it completely cuts off communication.
Try:“I’m not going to bombard you with questions since you seem like you don’t want to talk right now. Do you need any help putting together a snack?” Then once she has some food in her system, you might explore the timing of lunch and foods she could add to it or to breakfast to keep hunger from building to the tipping point after school. Discussing food or patterns that aren’t quite helpful will NOT go well, if her brain is irritable and famished.
Give options and reinforce you trust them
If you have a child who struggles to make her own decisions, or turns to you for permission, practice turning the question back on her. Remembering that there is no perfect eating choice can really take the pressure off. If she asks, “Mom, can I eat something else?”….
Instead of: And absolute “yes” or “no”
Try: “You’re the best one to know if you’re still hungry, so go ahead and listen to what your body’s asking for. There is absolutely more food, so help yourself.”
Encourage your kids to take an attitude of curiosity. Since we know that calling foods good or bad creates an onslaught of judgment and distorted eating, it’s helpful to teach them to explore what’s working for them or not so much. This can include them choosing a different / new food from the grocery store or getting curious about how long a bowl of cereal satisfies after breakfast, and how that’s different than eating an egg sandwich. Their first-hand experience is priceless and will speak volumes over our well-intended lectures. And this experience is precisely what helps them launch as well-adjusted, balanced and connected young adults.
One of the fascinating aspects of being a feeding therapist that works with children in their homes is that I get to see first-hand the variations in parenting styles.
One particular family was memorable because both parents were security guards and they seemed to bring an element of their jobs to the family dinner table. They contacted me because their 5-year-old daughter, Elizabeth, wasn’t gaining weight and was a “very picky eater.” When I arrived at their home, both Mom and Dad were completely engaged with their little girl, all three laughing and playing together on the living room floor.
Interestingly, the atmosphere shifted the moment everyone sat down at the table. There was practically no conversation except to announce what was for dinner and how much the little girl was expected to eat “Remember to eat all your corn, Elizabeth,” her father stated. The parents watched over her vigilantly and occasionally reminded her to “keep eating.” When the couple had finished their meal, and Elizabeth was staring at her not-so-empty plate, her father reprimanded her for “not eating her corn…again.” Noteworthy to me was the fact that both parents felt the need to set stringent eating rules, enforce them and remind Elizabeth if she did not follow dinner time guidelines. Clearly, their concern for her growth and nutrition were in the forefront of their minds, but why did they feel this directive style of parenting was going to be helpful? What happened to those engaged, interactive parents I had just witnessed playing so beautifully with their little girl in the living room?
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While not easy, I somehow launched my children into college and beyond. With fellow empty-nester friends who are also health professionals and moms—one a nurse, one a psychologist—I took a walk down memory lane. We reflected on teaching children good self-care, particularly when they have health concerns related to food.
Carpooling was challenging enough, but when I thought three-year-old Thomas had shared my son’s peanut rice cakes, I panicked! Thomas was severely allergic to peanuts as well as tree nuts. Still parked at the nursery school, I hoisted Thomas like a football, screamed for the teachers, and rinsed his mouth, hoping I did not have to administer his EpiPen. He never ate any of the rice cakes, but I learned a valuable lesson on scrutinizing food items when you have or care for a child with allergies!
According to Hildie Kalish, RN, an elementary school nurse whose child has a severe nut allergy, “Keep your child safe by constantly checking and then rechecking ingredients in food products. Never assume an item is safe as it is not uncommon for food manufacturers to change ingredients or processing techniques. As soon as children are old enough to understand, teach them to read labels and avoid sharing food with other kids. When they are responsible enough, have them carry Benadryl and their own Epi-pen or Auvi-Q, and make sure they know how to use them.”
My nutritional skills were put to the test when I rescued ten-year-old Luke, my son’s friend, who was dizzy from playing baseball in the summer heat. Driving up with hydrating sports beverages and a mom’s wisdom, I remembered that Luke had an endocrine condition that made dehydration particularly dangerous. When a child exercises, their muscles generate heat, which in turn raises body temperature. The body cools itself through sweating, which must be replaced by fluid or the body will overheat.
Dehydration is more common in children, and young athletes are particularly prone to dehydration. Encourage your young athlete to drink fluids before, during, and after sports to prevent heat-related illnesses. Recommend fluid-rich foods such as fruits and vegetables and have your youngster carry a water bottle and drink a sports beverage when his/her physical activity level exceeds one hour.
I became a celiac expert when Rachel, a good friend of my daughter’s, was diagnosed. From that day forward, I stocked my cabinets with gluten-free items and helped her mom educate other parents about which foods to keep on hand for play dates.
Merle Keitel, Ph.D, counseling psychologist and parent of a child with celiac, says,
“It is important to establish a support system that is aware of your child’s dietary restrictions and has food on hand that your child can eat if at their homes for an extended period of time. In the case of celiac, fruits and vegetables work but if other children are having sweets, it is helpful for there to be chocolate or other gluten-free sweets so the child does not feel cheated and self conscious about being ‘different.’ Friends and extended family who are educated and willing to help can be a gift to the child with special dietary needs.”
These real-life scenarios portray what can happen when a child has a chronic health condition. Says Kalish, “At school I work with families of kids newly diagnosed with Type 1 diabetes. I always say that education is key. I see parents overcompensating with extra treats for fear that their child will feel deprived. Diabetic children do not need extra treats. It is important to treat them like any other child and learn the merits of a healthy balanced diet with plenty of ‘everyday’ foods and occasional ‘sometimes’ foods.”
While we can try to protect our children from all types of threats, educating your child, caregivers, schools, and trusted friends about a chronic health condition is essential. Allow your child to take the reigns and manage his/her own health as soon as he/she are emotionally and intellectually ready. We want our kids to remember the lessons that we teach them at home, as they will eventually leave the nest.
My everyday mealtime chaos includes my six-year-old daughter singing at the top of her lungs while my two-year-old son eats one bite then jets from the table. I think that it would be much easier if he still used his high chair, yet he rejected that contraption as soon as he could walk. This makes mealtime a bit messier and acrobatic in nature. In the blink of an eye, he goes from noshing on dinner to dancing in the living room. “We sit to eat” crosses my lips throughout the meal, and I lead him back to the table. Toddlers are distracted by nature, so we try to keep distractions to a minimum (no TV) and give him a high five when he sits safely at the table. We are clear about when meal time is over so he can get his fill, and he will sign “All done!” when his body communicates fullness. Sometimes this happens with a bite or three helpings.
Recently I received a text from a dear friend. She is raising her children to be intuitive eaters and modeling healthy ways of relating to food. With intention, this family neutrally represents food and teaches kids to eat when their tummies have the amount they need.
Luckily, our children are born intuitive eaters—yet our world is not. My friend and I often lament about how hard we need to work in order to shield our children from learning body distrust and body hate.
So imagine her surprise when my friend’s daughter finished dinner and announced that it was now a “happy plate.” I felt sadness when she texted the details. After getting clarification, my friend learned the Happy Plate practice exists at her daughter’s childcare center.
What is the Happy Plate? Often at daycare and family dinner tables, “Make it a happy plate!” can be heard when a child wants to leave the meal with food remaining. I have been told that it is done to encourage children to eat enough and be sure they won’t ask for more food shortly thereafter.
As a pediatric dietitian and eating disorder specialist, I strongly discourage this Happy Plate nonsense. My top three reasons include:
The Happy Plate mantra encourages children to discount hunger and fullness cues. When we plate a child’s food or pack his/her lunch, we are not in his/her body nor are we able to predict with 100 percent accuracy the exact amount of energy he/she will need at that meal. If a child is full, do we really need to encourage him/her to eat more? What’s more, teaching a child to ignore hunger and fullness cues lays a foundation of negative body image and body distrust.
“Make It a Happy Plate” cajoling teaches a child to eat to please rather than fueling his/her body. Eating to make another person happy normalizes disordered eating while omitting innate hunger and fullness wisdom.
Happiness feels good and easy, so of course we prefer it. On the other hand, the human experience includes sadness, frustration, boredom, loneliness, anger, and a myriad of other emotions. Some feel comfortable while others do not. Discounting the fullness experience in favor of a Happy Plate transforms the eating relationship—and not in a good way. It spells out that eating past fullness can make us feel happy. It also makes our loved ones happy. Do we want to teach children to eat in order to make happiness?
What’s the alternative to the ease of the Happy Plate? Here are things to consider:
Be sure to structure consistent meal and snack times. This helps a child respect hunger and fullness while tolerating hunger if he/she is hungry a bit before an eating time. When a child says he/she is all done, kindly remind her when the next eating time will occur. Do not provide between-meal handouts besides planned snacks.
Children make mistakes when plating their own food. In order for a child to become a competent eater, you will have food waste. Save the starving children comments and acknowledge when a child listens to his/her body. An example: “You served yourself, and you decided you didn’t need all of it.” Keep it neutral because food decisions are not good or bad.
If a child eats little at a meal and requests food outside of mealtime, kindly remind him/her of the next meal or snack time. If the child says he/she is hungry, teach him/her what to do. Say “Your tummy is hungry, so remind it that food will be available soon. It is just not time to eat.” NOTE: Need to consider child’s age and time until next meal.
Hold back the praise when a child eats everything on her plate. A child who ate all of her food and another child who ate half of the food served did an equally good job at that meal. This may feel unnatural, but it is the way to promote healthy ways of relating to food and positive body image.
While surfing my mailbox dedicated to RD listservs, my eye caught “Paleo for Kids.” I was getting ready to be upset when instead I happily found Michele Redmond, MS, RDN, at The Taste Workshop’s comments.
She shared with my peers that “restrictive eating and fear of foods is inherent in any diet but particularly paleo which, depending on which paleo model you follow, promotes eating beans and grains as actually dangerous for your gut and health. Involving kids in these eating patterns and beliefs raises lots of nutrition and social-eating questions.”
Michele highlighted the three links below. They are worthy of your time. The TED talk is a must watch!! While the articles are not specific to our children, parents must be aware of the mental rigidity and consequential nutritional deficiencies that are likely to develop if you impose any diet on your children.
Dr. Heather Maguire is a Board Certified Behavior Analyst (BCBA-D) and the author of the parent training manual, Get Ready… Get Set… Go! It’s Time to Create Behavior Change! As the mother of two young children, she applies her knowledge of behavioral science to everyday parenting. Visit her website www.drheathermaguire.com for more information.
Help! My Child is a Picky Eater! By Dr. Heather Maguire
Kids, food, and behavior… Where should I even start? A story from my own childhood comes to mind. When I was a toddler, I decided that the only food I wanted to eat was saltine crackers. Being a stubborn individual even at such a young age, I gave my mother a run for her money. She offered me peanut butter and jelly, but I said, “No!” She put cereal in front of me, but I refused to touch it. At dinnertime I refused to even look at the spaghetti she had made. In situations like this, what’s a parent to do?! Now that I’m a mother myself, I have come to realize that food can be one of the most challenging parts of parenting. As parents, we are charged with caring for the health and wellbeing of our kids, but it is not possible to force children to eat what they do not want to eat. No parent wants his or her children to “starve,” so we are tempted to cave in to our their requests. Recently I overheard a mother explain that her pediatrician recommended letting her toddler snack on whatever he wanted during the day, as long as she supplemented his nutrition with a popular meal replacement beverage. I’m not saying there aren’t cases where extreme measures are warranted, but to me this sounded like a horrible long-term solution to picky eating! Looking through the lens of applied behavior analysis, here are six strategies that have helped me tame the beast of the picky eater in my own home. I hope they will help you, too!
Say goodbye to packaged snacks
You’ve probably heard the old saying, “If they’re hungry, they’ll eat.” This is very simple, but very true! One way to encourage children to eat is to make sure they’re actually hungry when mealtime comes around. This may mean eating less during the periods in between meals. Now I am not suggesting that you cut out snacking all together, but you can control what snacks you offer your children. Personally, I have made the decision to only offer fruits and veggies as snack options in between meals. As opposed to snacks like chips, cookies, and crackers, fresh produce is less likely to curb one’s appetite for more than a short while. I am not saying you have to cut out packaged foods completely, but it may be better to serve these items right after meals or just occasionally as a special treat rather than as snacks.
As parents, we often have to be strategic in interactions with our children. If Sofia is feeling under the weather, didn’t sleep well the night before, and had a rough day at school, it is probably not be the right day to offer her a new food or try to get her to eat a food she has previously rejected. Sounds obvious, right? Well, let me share where parents often go wrong. Rather than using this strategy proactively, they use it reactively. Once they place food in front of Sofia and she refuses to try it, then they give her a preferred food. Unfortunately this often results in a pattern of food refusal that can hang around long after the bad day has been forgotten. Therefore, try to prevent food refusal by offering preferred foods on the hard days, but do your best not to cave in once undesired behavior has been displayed.
Dangle the carrot
This is a simple, yet scientifically verified truth that can be applied to several areas of life. In food terms it equates to, “After you eat your vegetables, then you can have dessert.” Now, this does not mean that you need to offer dessert or other junk food to your children on a daily basis. Rather, choose foods that you feel comfortable offering to your child on a consistent basis (e.g., juice, crackers, popcorn, etc.). In order for this to work, there are two key things to keep in mind. First, the food has to be something your child really likes. Second, this strategy will work best if you keep your “carrot” valuable by not offering it to your child in other circumstances.
Sometimes easier is better
This strategy is specifically geared towards younger toddlers who are still developing fine motor skills. As a human species, we are more likely to do things when they are easier, and it takes more motivation to do things that are difficult. Therefore, even if your son or daughter can independently eat, you may want to help them… at least with their first few bites. You may find that after the first few bites your child eats independently. Why is that so, you ask? Without getting too technical, food is naturally rewarding when we are hungry and so our bodies encourage us to keep eating until we are full.
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Children require guidance in all areas of their lives— how to tie their shoes, when to speak in a quiet voice, and, of course, when, what and how to eat. As a parent, I know it is my job to think carefully about the messages I send to my child regarding food to start her on the path towards healthy self-regulation. But even as a dietitian who counsels others on developing a balanced relationship with food, I struggle to navigate this with my toddler.
My daughter loves food. Meal times are not stressful, and in fact are usually very enjoyable. She usually finishes everything I give her (and that she often picks out) without an issue. If she doesn’t finish a meal, I just assume she wasn’t that hungry to start. But, it is a different story when we are around others. She often asks for food just because she sees friends or family eating it and, unlike most kids who do this but lose interest in the food once they get it, she will usually finish whatever she is given. Sometimes this results in her not feeling well. This is where it gets tricky. Do I give her food every time she asks, so as not to “restrict her,” or do I try to limit excess snacks and food outside of meal times to help her learn to identify her hunger and fullness cues?
Some parents may think I am too strict with my daughter. The parent of a picky eater, for example, is likely to have different struggles than me – and to arrive at different solutions. Parenting is hard enough without us judging one another. Instead, perhaps we can learn from one another. Because although young, our children are certainly capable of starting to learn about their body and to establish healthy habits, and we must lead the way.