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Preventing Food Jags: What’s a Parent to Do?

Preventing Food Jags: What’s a Parent to Do?
By Melanie Potock, MA, CCC-SLP

*This post was originally published on ASHA’s online blog. The original can be found here.

Photo Credit: r.nial.bradshaw via Compfight cc

As a pediatric feeding therapist, many kids are on my caseload because they are stuck in the chicken nugget and french fry rut…or will only eat one brand of mac-n-cheese…or appear addicted to the not-so-happy hamburger meal at a popular fast food chain. While this may often include kids with special needs such as autism, more than half my caseload consists of the traditional “picky-eaters” who spiraled down to only eating a few types of foods and now have a feeding disorder.  I  even had one child who only ate eight different crunchy vegetables, like broccoli and carrots.  Given his love for vegetables, it took his parents a long time to decide this might be a problem. The point is: These kids are stuck in food jag, eating a very limited number of foods and strongly refusing all others.  It creates havoc not only from a nutritional standpoint, but from a social aspect too. Once their parents realize the kids are stuck, the parents feel trapped as well. It’s incredibly stressful for the entire family, especially when mealtimes occur three times per day and there are only a few options on what their child will eat.

It’s impossible in a short blog post to describe how to proceed in feeding therapy once a child is deep in a food jag. Each child is unique, as is each family. But, in general,  I can offer some tips on how to prevent this from happening in many families, again, keeping in mind that each child and each family is truly unique.

Here are my Top Ten suggestions for preventing food jags:

#10: Start Early.  Expose baby to as many flavors and safe foods as possible.   The recent post for ASHA on Baby Led Weaning: A Developmental Perspective may offer insight into that process.

#9: Rotate, Rotate, Rotate: Foods, that is.  Jot down what baby was offered and rotate foods frequently, so that new flavors reappear, regardless if your child liked (or didn’t like) them on the first few encounters.  This is true for kids of all ages.  It’s about building familiarity.  Think about the infamous green bean casserole at Thanksgiving.  It’s rare that hesitant eaters will try it, because they often see it only once or twice per year.

#8: Food Left on the Plate is NOT Wasted: Even if it ends up in the compost, the purpose of the food’s presence on a child’s plate is for him to see it, smell it, touch it, hear it crunch under his fork and  perhaps, taste it.  So if the best he can do is pick it up and chat with you about the properties of green beans, then hurray!  That’s never a waste, because he’s learning about a new food.

 

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Help, My Daughter Is Overweight.

By Real Moms: Guest Blogger Elyse Falk, MS, RD and Laura Cipullo RD, CDE

Real Mom Question: How do I help my 13-year-old daughter who is overweight?

Real Moms Answer: For females, there are a lot of hormonal prepubescent changes that happen around this age.  The body is getting ready for menstruation and womanhood.  Weight gain is normal during this time. Don’t get overexcited by this increase in weight or body fat. This is normal and necessary.

Avoid diets

If your daughter is sensitive to her recent weight gain or her body image, sit down and have a heart to heart conversation with her. Recognize she may want to try different diets at this point in her life. Many tweens or teens choose to try vegetarian intakes around this point (See our article in the Publication Tweens and Teens).  For us, as women and especially as mothers working in the field of eating disorders, the word diet conjures only negative feelings such as deprivation, restriction, sadness, failure, and being “bad” when you “cheat” on the diet, etc.  The list goes on and on. There are too many girls and moms that feel badly when they eat a food that would be forbidden on a diet. Therefore, at all costs, discourage your daughter from dieting. Instead, help to foster body acceptance, balanced eating and lifestyles changes if and when needed.

75-90 % of the Time, Eat Healthy

Teaching our children, tweens and teens to eat in a healthy and balanced way is of utmost importance.  What do we mean by healthy?  Eating when one is physically hungry and recognizing when one’s stomach feels full; Not eating for emotional or behavioral reasons like many tweens and teens do. The idea is to eat foods that help our physical body work properly and prevent disease while eating adequately and varied to encourage mental wellness.  A healthy attitude is to eat the foods that help our body about >/=75 – 90 percent of the time; the other 10 – 25% percent of our intake can include the foods that Elyse calls “yum yum” foods or Laura calls “sometimes” foods: ice pops, candy, baked goods, fried foods etc..

Make it a Family Affair

It’s important for our tweens and teens to have positive role models for eating and movement. Parents and caregivers have a great influence on this, so think about how you eat and exercise.  Think about how your family eats and moves? The goal is to have the entire family eating a varied intake of everyday foods and moving regularly for fun and for heart health. Be sure to try for family meals, plan family activities such as walks, bike rides and even hikes. If your teenager always wants to snack, keep fresh fruit, veggies, lean proteins and low fat calcium foods in the house at all times.  A whole grain low sugar cereal with low fat milk is always a great option as well.  Don’t try to control or restrict your child. Rather provide food and active opportunities and let them make the choices

Forget the Scale

Be aware of your 13 year old’s behaviors and mood. If your teenager is skipping breakfast, it can lead to an over-hungry state, which can result in overeating later in the day.  It can also lead to mood swings. Talk to your daughter about behaviors and mood swings but never say you are fat, too heavy or need to lose weight. And please never put them on a scale.

Avoid Guilt

Recognize, sometimes your daughter may feel bad about eating “too” much after having restricted all day. Then this guilt results in future restriction, meaning skipping meals or eating very little calories over a long period of time. Again, this only leads to being over-hungry and then over eating again likely binging. Unfortunately, this has the potential to turn into vicious dieting cycle.

Prevent Skipping Meals

To help prevent your daughter from restricting her food intake be sure to keep fast and easy breakfast options in the house: an organic yogurt smoothie with extra protein powder, ¼ cup almonds and fresh fruit, hard boiled eggs with a toasted pita, low sugar protein/nut bars, pbj sandwiches, whole grain waffles topped with nut butter and bananas are all great options to start the day.  Ensuring breakfast is eaten will help to guarantee meals are not being skipped and the day is heading in a proactive direction.

Encourage Internal Self Regulation

Make a conscious effort to see if your teenager is eating regularly for physical reasons.  Educate them to adhere to a feeding schedule for meals and snacks to prevent restricting and binging.  Eating every 3 to 4 hours is normal and helpful.  If you feel that your child is eating immediately after a full meal, encourage her to use a hunger fullness scale to identify internal cues for portion control. Maybe she is eating because she feels stressed, anxious, or nervous.  If this is the case, help your daughter learn new coping skills and or offer hugs and your listening ear when she needs you.

Eat for Physical Hunger

So the message is avoid having your daughters diet regardless of your concerns or your daughter’s concerns for her body weight. Allow her body to go through puberty and encourage all foods in moderation and moving for energy. Provide varied foods and a safe place to talk about food and body. Avoid judging your daughters body and instead focus on behaviors and moods. If weight loss is needed, lifestyle behavior changes and eating for only physical reasons usually helps to make your teen grow into the body they were born to have.

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"My Body, My Food, My Way"

Moms and daughters, teens and tweens: Read with love and follow with care…This week’s post features a piece entitled “My Body, My Food, My Way”

 

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Tolerating Your Children's Boring Palates

Photo Credit: Leonid Mamchenkov via Compfight cc

Do you ever get frustrated with the monotony of your children’s meals? Are you bored preparing the same chicken dish every night? Do you feel that you and your husband are limited in restaurant variety as well as quality due to your children’s picky palates?
If you answered yes to any or all of these questions, then welcome to my world. Because whether you spend all day working in an office or at home caring for your tots, there is nothing more heart-breaking than laboriously preparing an elaborate and flavorful meal that is received without enthusiasm.

 

 

 

My boys’ food preferences seem to rotate. Although they are gradually expanding upon what they’ll tolerate, this process can be painfully slow at times. Exposure therapy, while valuable, often works at a snail’s pace, and there are days when getting your children to try—and actually enjoy—a new food can feel drawn out and downright frustrating.

Just tonight, I had to “go with the flow,” and be sure not to make a big deal about my little guy’s refusal to try a measly nectarine. While he looked absolutely adorable in his attempt to give me a big ol’ orange-hued smile, he never actually consumed the fruit.

The beautiful—albeit incredibly vexing—part about raising children is that their reactions to different foods can be so misleading. Though Billy didn’t technically eat the fruit, he was at least open to making silly faces with the peel in his mouth. That’s progress, right? In a way, I was thrilled by his openness; but internally, I was conflicted. I guess, like all moms, even registered dietitians can get irritated when trying to understand why the introduction of new flavors is such a challenge.

Just when I was about to give up, my older son, Bobby, gave me the answer I’d been searching for.

“I don’t like the red part of the nectarine,” he said (which, of course, happens to be my favorite part).

Bobby added, “Mom, I just like everything the same! I like to have the same thing every night.”

As he often does, Bobby brought me back to reality. Kids like monotony. They like structure and knowing what their days—and their meals—will bring. Bobby understands the basic concepts of eating nutritiously, and so he makes an effort to eat a fruit, a vegetable, and a protein along with his favorite box of Annie’s Mac and Cheese. The last thing he wants, however, is to be adventurous in the kitchen. He just wants the same nutritious foods every night.

Billy is only three-and-a-half and is still unable to verbalize his needs and wishes. As moms, we sometimes become subjective and emotional, mistaking this lack of communication for something it isn’t. If we step back for a moment, observe (or in my case listen) to our children, it is possible to find clarity.

Boring food can be safe and predictable in an overly stimulating world ripe with change. Children relish in what they know, whether food, their school day or their bedtime ritual. If their plates are filled with nutritious and wholesome foods, be thankful. Continue exposing your children to new food, and try to enjoy the process rather than just endure.

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Guest Blog: Keeping Multiple Children Happy at the Dinner Table

I have three children and one wants nothing but meat, the other won’t eat anything that hasn’t been on a television commercial, and the last only likes certain colors of food. What is a mom to do? Well, here are some strategies to keep in mind that may work for your family:

  1. Unhappy – First of all, you should understand that you will not be able to make all the kids happy at once. Don’t get upset about it. Children need to learn to eat a balanced meal, even if they do not get served their favorite meal every day. If you try to cater to their whims, you will end up with spoiled children that are even more dissatisfied and now probably unhealthy too. A good thing to do might be to have a little bit of something that everyone enjoys.
  2. Set standards – In order to make sure your kids eat balanced meals, you have to set standards from the get go. Something like: at least one serving of fruit and veggies for every serving of carbs and meat. That doesn’t mean they can’t leave the table until they finish their peas, but it does mean they won’t get dessert if they don’t eat at least two food groups before that. Eating balanced meals means different things to different people, so you can change it around to fit with your family.
  3. Be flexible –If every one of your kids hates peas, then don’t serve them peas! Don’t get it stuck in your head that they have to consume specific foods. Just make sure they have a balanced diet, even if it sounds gross to you. You may not think a chicken, kiwi, and spinach tortilla roll sounds good, but nutritionally it is not bad, so quit fighting it.
  4. Take turns – If your kids do have a favorite meal, then serve it to them. Just make sure to take turns so that everyone gets an equal number of favorites. And don’t let your kids slack off on the standards, either. Even if Mac and Cheese is their wow meal, make sure they have a serving of veggies alongside it.
  5. Be sneaky –You can add fruits, veggies, and whole grains into your meals without your kids throwing a fit if you are sneaky about it. Cut the veggies very small and mix in with pasta, serve whole grain bread with your sandwiches, and add smashed banana and apple sauce to your cupcake recipe. Eventually they will get used to the tastes and even grow to prefer it, which is what you want. However, if this is not your style, then just include the veggies and your children will get used to having them present, making it more likely that they’ll eat them.

Having more than one child means striking a balance. You want to be fair to everyone, but you don’t want to sacrifice nutrition. Give your kids a taste of the world of sharing and taking turns, and make sure you are more concerned about their health then their preferences. Every family is different, so make your own dinner-time rules to make sure your children grow up healthy and nutritionally well-balanced.

 

About Guest Blogger Monta Fleming:

Monta is the mother of three children serves as an Expert Advisor on multiple household help issues to many Organizations and groups, and is a mentor for other “Mom-preneurs” seeking guidance.  She is a regular contributor of “nanny jobs”.  You can get in touch with her at montafleming6@gmail.com.

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Is Your Child Hiding Food?

You asked Mom Dishes It Out “What can I do if my child is hiding food?” Read on to find out how this mom and RD would handle the situation. Thanks for asking. Keep the questions coming!!

My answer: First of all, don’t assume your child hid the food from you just because it is in the garbage. Food can be considered hidden when you find candy or wrappers under the bed, in the closet, in a shoebox or behind books.

Once you determine whether the food is actually hidden, don’t be reactive. Calmly sit down with your child and ask why they are hiding the candy or whatever wrappers you have found. Try to let your children use their own words to voice their feelings. You may need to help them, but wait until they give you some direction. Otherwise, the child may just say, “yes,” with the hope you will leave them alone.

You may also want to ask yourself a few questions. Does your child think they are not allowed to have it? What has led them to believe this? Do they think they need more food than they are getting? Are you perhaps restricting your child’s intake because you are worried about their weight?

Most importantly, assess your feeding style and whether there is anything that you can do to help your child eliminate this sense of shame around the particular food. Let them know that if they want a certain type of food like candy, it’s okay. However, they should let mommy or daddy know, and the food should be consumed in the kitchen.

Keep in mind which wrappers you have found. To neutralize this food, serve it to your child one day as a side with their lunch or as an afternoon snack. If you incorporate it into your child’s intake, they will no longer feel as though it is forbidden, and therefore the food itself will have less appeal. Remember, when you tell a child they cannot have something, they will want it more. Do the reverse here!

Question 2: What can I do if my child is sneaking food and hiding the wrappers?

My answer:  If your child is sneaking multiple pieces of candy and you “catch them in the act,” stay calm. Quietly assess the entire situation; what else has the child eaten that day? Are they giggling or embarrassed? If the child is giggling, they are most likely just enjoying themselves, meaning this behavior is not typical.

Photo Credit: 藍川芥 aikawake via Compfight cc

Whatever you do, make sure not to shame your child. You can laugh with them. You can ask if they are hungry and would like a snack or their next meal earlier. When given the opportunity without being shamed, a child will most likely share their true feelings. If this is at a random time during the day, assess whether eating these foods will interfere with the child’s meal intake.

Is there a good reason to forbid this food, besides the fact that it may be less nutritious than you’d hoped? If the only reason you can come up with has to do with nutrient density, and your child typically consumes high-quality, wholesome foods anyway, then you may want to let your child simply enjoy it. Allowing them to consume it will help to ensure that this type of food remains neutral, and no morals, labels or values, like “good” or “bad,” become associated with that item.

If you think that allowing your child to eat this specific food at a particular time may affect their snacks or meals, you have two choices. The first option is to let them eat the food, and later, to point out to them why they are not hungry for their next meal (because they ate too closely to dinner, if and when this actually occurs). This is a good way to reinforce internal self-regulation, enabling them to recognize hunger and fullness cues and identify how a food can fill them up.

Choice number two is to tell your child that they need to save the rest of the food until snack time. Explain that a meal or snack is coming up, and you want to be sure they have met their nutrition needs before they consume a “sometimes” food (aka a less nutrient-dense food).

Have any other parents experienced this? How did you resolve the issue? Did you hide food as a child and how would you have like the situation to be addressed? Again, thanks for asking Mom Dishes It Out your feeding and eating questions.

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Mom, I don’t want to be fat.

As I was walking home from Chelsea Piers last week, my 5-year-old son said, “Mom, I don’t want to be fat.”

I thought about how to answer this. “Why do you say that?” I asked. “Were you talking about this at school last week or holiday camp?” He said no to the above, so I asked him what he thought it meant to be fat and how he thought someone could get that way. “You get fat from eating too much food all the time,” he replied, to which I responded, “Right, so just eat when you are hungry and stop when you are full. Keep active and you will be fine.”

Meanwhile, I was pushing Bobby and his brother in the single stroller—Bobby who was standing on the stroller frame and leaning against me rather than walking as his brother slept inside. I assumed he couldn’t be all that worried if he let me push him home despite what his new concern.

As we walked along the city streets, my thoughts swirled. I began to wonder whether I should have explained to Bobby that bodies come in different shapes and sizes. Should I differentiate between healthy and fat? Should I take advantage of the moment and give him a reason to eat more fruits and veggies, which he tends to veer away from? Should I stress that some people are just destined to be larger due to genetics?

As parents, we need to think about how to answer these questions before they come up—something that would make addressing them when put on the spot a whole lot easier. I’m not sure that I ever considered that Bobby would make such a statement, especially since we don’t allow words like ‘fat’ in my household—but he did.

While we’ve discussed that it’s not nice to call someone fat, especially to his or her face, I know that both my boys are exposed to the word all the time; we even heard it used in the Muppets movie. He hears his cousins and friends use it all the time. And just, the other day, his friend called our cat fat. (Bobby made sure the child knew we don’t identify things by that term in our house.)

It’s both funny and frustrating, because sometimes, even when we try to raise our children one way, the world around us doesn’t necessarily let us. Ban certain kinds of language in your home, and they’ll pick it up in the park, in the supermarket or on a play date. But whatever we decide to allow (or not allow), I encourage all caregivers and parents to think about this: What message do you want to send to your child?

Have you ever had to discuss weight issues with your child? How do you view the word “fat” in your family, and what words do you use to facilitate a positive body image in your household?

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Guest Blog: Using Words, Not Food to Help Kids Communicate

Helping Our Kids to Identify Their Feelings:

Anonymous

One of the things I appreciate most about Laura’s blog is the honesty she demonstrates in discussing the difficulties of applying her professional body of knowledge to real life situations that affect her children. As a psychotherapist, I can very much relate with that struggle.

As parents, I find that it’s important to help our children to put their feelings into words and to understand and identify their feelings during any given situation. The world can be an overwhelming place for children. Honestly, it can be overwhelming for adults too. Yet children, unlike adults, are challenged with a limited frame of reference, making it particularly difficult for them to govern their present experiences by past ones.

Children need adults as teachers to help them narrate life, especially early on, so that they can learn to identify their emotions. By helping them to do this, we can hope to gain a better understanding of what they are feeling.

Earlier this week, for example, my daughter Rachel expressed that she had a great time during a play date with a new friend. As we were leaving, however, she started to act out, putting her shoes on and kicking them off, which she did about three times. Then she relaxed all the muscles in her foot so we couldn’t get her shoe on at all. And then her sock came off. She was laughing the entire time this was happening, while I was most definitely not.

It felt to me like Rachel was intentionally making it impossible for us to leave, so I said to her, “Boy, someone had so much fun they don’t want to leave and go home!” And with that, like Cinderella, I was magically able to slip her sock and shoe on. Rachel grabbed her backpack and said goodbye to her friend without creating a fuss. As I saw it, once she understood what she was feeling, she no longer needed to act it out.

Something else I try to do is to let Rachel know what I’m feeling internally when I’m having a rough day or losing my footing. When she tests my patience or disregards what I am saying, I verbalize my frustration and express my waning tolerance.

I also do my best to explain to her why I say the things I say (I was feeling tired) and apologize if it’s appropriate. As Harry Stack Sullivan wrote, “We are all much more simply human than otherwise,” and I think it’s more than okay to let our kids see that too.

A great resource for helping children identify their feelings is “The Way I feel Books,” by Cornelia Maude Spellman. In it, Cornelia writes about anger, sadness and jealousy in a way that makes it easy for children to understand and relate to.