It Takes a Village – And Then Some!

It Takes a Village – And Then Some!

by Erica Leon, MS, RDN, CDN

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.

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Peanut Allergy:

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.”

Dehydration:

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.

Celiac:

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.”

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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.

The Harmful Happy Plate

The Harmful Happy Plate

by Julie Dillon, MS, RD, NCC, LDN, CEDRD

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:

  1. 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.
  2. “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.
  3. 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:

  1. 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.
  2. 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.
  3. 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. 
  4. 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.

Kids and the Paleo Diet, Not!

Kids and the Paleo Diet, Not!

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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.

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1. There is no one right diet—Paleo debunked by archeologist:

Debunking the Paleo Diet: Christina Warinner at TEDxOU

 2. From strict and obsessed to balanced:

     My Ever Changong Viewpoint on Paleo and CrossFit

3. From the trenches of Crossfit and Paleo to the gray zone:

     Don’t Be a Fanatic 

 

You can learn more about Michele Redmond, MS, RD at www.thetasteworkshop.com.

10 Ways to Say I Love You

 

So Valentine’s Day is coming up. How are you thinking of showing your love? Do your children celebrate in school? I ask you to take some time to think, “Does your child equate Valentine’s Day with chocolate hearts?” or the message of “We show love with candy?” If your child associates holidays or even birthdays with food/candy, especially “treats,” now is the time to create a new healthy association.

So why I am saying this? Because when kids equate food with love, they may eventually look to food for love when they are lonely, feel empty, and/or feel sad. This situation can domino as an adult and even turn into emotional eating and binge eating. Ideally, we teach kids that food and feelings should not be merged, well not all of the time anyway. Rather, food is fuel for wellness, and feelings are feelings that are best managed with coping skills.

This holiday, show your love with hugs and kisses! Plan a special night for the whole family.

Give your child a card that lists all the reasons why you love them. Gift them a heart picture frame with a family picture. Can you share some chocolate? Well, of course you can! The idea is to teach your child how to express love and celebrate in meaningful and truly special ways. Ideally you want your child to equate love with family or something kind, but not just food.

Here are some ideas to create new Valentine’s Day traditions!

  1. Create construction paper flowers with your children: on each petal, you and your child can write what makes him/her special and unique.
  2. Practice kindness for the fourteen days leading up to Valentine’s Day. Remember that actions speak louder than words.
  3. Frame and gift a picture of the family doing something together that everyone loves.
  4. Plan a family outing on Valentine’s Day to go ice skating or bowling in honor of celebrating your love and the love of life.
  5. Hang a chalkboard in your kitchen with all the ways that your family can express love.
  6. Think of what makes you feel good inside and incorporate that into your family.
  7. Ask teachers at school to have parents come in to read books about love and kindness rather than giving bags of chocolate
  8. Send cards to family and friends listing all the fun times you have shared.
  9. Turn off you iPhones, screens, and mind! Just devote the night to your child/children. Play games, read, and just be together.
  10.  __________________________________________________________________

You can fill in the rest. Let us know what #10 is for you.

The above may not be for everyone, but it is definitely one of the many things I want to do for my kids and clients, with the hope that they never have to experience disordered eating and/or an eating disorder.

Peanut Butter-Banana Spirals

We love these peanut butter-banana spirals as a mid morning or afternoon snack.  It’s the perfect recipe to get your little chefs involved in the kitchen!  

 

Photo Courtesy of Cooking Light

Ingredients

  • 1/2 cup of natural peanut butter
  • 1/3 cup of vanilla yogurt
  • 1 tablespoon of orange juice
  • 2 ripe bananas, sliced
  • 4 (8 inch) whole wheat tortillas
  • 2 tablespoons of honey-crunch wheat germ
  • 1/4 teaspoon ground cinnamon

Preparation

1.  Combine peanut butter and yogurt, stirring until smooth.

2. Drizzle orange juice over banans, toss gently to coat.

3. Spread about 3 teaspoons of peanut butter mixture over each tortilla, leaving 1/2 border.

4. Arrange 1/3 cup of banana slices in single layer over peanut butter mixture.

5. Combine wheat germ and cinnamon and sprinkle evenly over banana slices.

6. Roll up tortillas and slice each roll into six pieces.

The recipe and photo used in this post were courtesy of Cooking Light. To see the originally posted recipe please click here.

Raising a Child to Love Their Body

Raising a Child to Love Their Body
By Jennifer McGurk, RDN, CDN, CDE, CEDRD

I was recently out with a group of “mom friends”, having one of those conversations talking about anything and everything related to our kids, all under 1 year old.  Our conversation turned into an honest discussion about raising our children to be anti-dieting, body image-loving, positive self-esteemed individuals.  My friends were worried about being a good example to their daughters, teaching self-esteem, and hoping that their girls will learn to love their bodies.  These moms were especially worried about raising girls, but this is a topic for every mom- mothers of sons included!  I claim to be an expert in this area but it’s honestly something I’m concerned about too.  I had just talked about losing the last few pounds of my post-pregnancy weight 10 minutes before this part of the conversation came up.  My point is that my advice for moms and dads is something I am going to be working on as well.  I think moms can all learn from one another and support each other to raise confident children.

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Here are my favorite tips:

  1. Eliminate fat talk:  Take a good look at yourself and your environment.  Do you criticize yourself in the mirror?  Do you complain about being “fat”?  Your kids will learn from you.  Eliminate this kind of dialogue in your life to other people and especially to yourself.
  2. Feel good about your body:  Replace the fat talk with positive talk.  Do something each day to make you feel good about your body.  One of my favorite tricks is something I heard from a therapist:  Take a tube of red lipstick and write on your mirror “I am beautiful because…” and everytime you look in your mirror, you have to answer the question.
  3. Model healthy behaviors with food:  Show your child a healthy relationship with food by eating balanced meals and snacks.  Don’t restrict and binge.  Have a wide variety of food in your diet, including food from all food groups, including nutritious and less nutritious foods.  Have desserts and fruits and vegetables in your life, and teach your child how to enjoy these foods in a healthy way.
  4. Make time to move with your family:  Exercise as a way to feel good, not just burn calories.  Pick an activity you love and make time for it.  Treat this as part of your self-care routine.
  5. Introduce the concepts of “hungry” and “full” as early as possible:  Children are born with the skill to stop eating when they are full but gradually lose this with environmental influence.  In order to prevent the dieting “restriction” mindset, it’s important to teach children it’s natural to eat when they are hungry.  Therefore, it will be natural to stop eating when full and satisfied.
  6. Do not label food (or yourself) as “good” and “bad”:  Every food is included in a healthy lifestyle, no matter what.  Restriction of “bad foods” can lead to bingeing.  Don’t say “oh I had a good/bad day” because nutrition is not all-or-nothing!
  7. Never force your child to clean his/her plate:  This will alter kid’s perception of how much they should eat.  If they don’t eat at this particular meal, there is always the next meal or snack to make up for missed food.
  8. Talk about how bodies come in all different shapes and sizes:  Respect other body types and talk about how people look different because everyone is unique and special.
  9. Spread the word:  I love movements like “Operation Beautiful”, which spread the message of positive self-esteem and self-worth.  Teach children to participate and have fun doing so!

3 Reasons Why Kids Get Hooked on “Kids’ Meals"

3 Reasons Why Kids Get Hooked on “Kids’ Meals”… and How to Change That
By Melanie Potock, MA, CCC-SLP

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

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Let me say this up front: I’m not condemning the American Kids’ Meal that is so common in fast food chains and family restaurants, but clearly I’m not keen on eating that type of food when there are other choices.   My own kids have certainly had their fair share of chicken nuggets, mac n’cheese and French fries, just to name a few of the comfort kid foods that predictably reappear on kids’ menus day after day.   This is not a blog about good vs. healthy nutrition, because most parents (including me) know that the traditional fast food fare is not healthy…and that’s exactly why parents want to change the statistics that 15 percent of preschoolers ask to go to McDonald’s  “at least once a day.”    The millions of dollars spent on advertising and toys to market kids meals certainly makes many of us frustrated when much less is spent on marketing a culture of wellness.  By hooked, I don’t mean addicted, although there is research that suggests that food addiction may be a serious component for a subset of the pediatric population Plus, the added sugars in processed foods have been found to be addictive in lab experiments.  But, for the purposes of this short article, let’s keep kids’ meals in this very small box:  Most kids love them.

Why am I writing about this for ASHA? As a pediatric SLP who focuses on feeding, one of the frequent comments I hear from parents is “As long we’ve got chicken nuggets,  then my kid will eat.”   Besides the obvious “just say no” solution, what parents truly are asking is,  “How do I expand my kid’s diet to include more than what’s on a kids’ menu?”  Whether we are considering our pediatric clients in feeding therapy or simply the garden-variety picky eater, that is an excellent question with not a very simple answer.

In feeding therapy, therapists take into account the child’s physiology (which includes the sensory system), the child’s gross motor, fine motor and oral motor skills  and also behaviors that affect feeding practices.  Therapists then create a treatment plan designed to help that specific child progress through the developmental process of eating.  While the nuances of learning to bite, chew and swallow a variety of foods are too complex to cover in a short blog post, here are just three of the reasons why kids get hooked on kids’ meals and some strategies to avoid being locked into the standard kids’ menu and begin to expand a child’s variety of preferred foods:

  1. Kids barely have to chew.  The common fast food chicken nugget is a chopped mixture of …well, if you want to know, click here.  Warning: it will ruin your appetite for chicken nuggets, so if your kids can read,  clicking might be the first solution.  However, in terms of oral motor skills, bites of chicken nuggets are a first food that even an almost toothless toddler can consume with relative ease.  Simply gum, squish and swallow.  Macaroni and cheese?  Oily French fries?  Ditto.  There’s  not a lot of chomping going on!
    • In feeding therapy, SLPs assess a child’s oral motor skills and may begin to address strengthening a child’s ability to use a rotary chew, manage the food easily and swallow safely.  Many of the families we work with eat fast food on a regular basis and we might start with those foods, but slowly over time, more variety is introduced.
    • For general picky eaters or those progressing in feeding therapy, the key is to offer small samplings of foods that DO require chewing, as long as a parent feels confident that their child is safe to do so.  Starting early with a variety of manageable solids, as described in this article for ASHA, is often the first step.   For older kids, the texture (and comfort) of “squish and swallow” foods can contribute to food jags.  Here are ten tips for preventing food jags, including how to build your child’s familiarity around something other than the drive-thru.

 

To continue reading, please click here to be redirected to ASHAsphere.

Starting Solids in a Positive Way

Starting Solids in a Positive Way
By Jennifer McGurk, RDN, CDE, CEDRD, CDN

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If you ask a hundred pediatricians or dietitians how to start feeding your baby, I can almost guarantee you’d get a hundred different responses.  Some professionals believe in baby purees, while others believe in baby-led weaning.  Some professionals say start with rice cereal, others say avocado or even sweet potato.  Even when to start feeding your baby solid foods is debatable (although most people would agree between 4–6 months).  I felt confused as a new mom—and I’m a dietitian!!

I got the go-ahead to start feeding from my pediatrician at my son’s four-month checkup, and we started a week later.  I knew with my mom’s intuition that it really didn’t matter what food we started with—we would eventually figure out a good plan.  However, I really wanted to start off with feeding in a positive way, knowing that these were amazing habits to keep for the whole family. I’m definitely not perfect, but here are some guidelines I’m attempting to follow:

1.  Just like breastfeeding or bottle feeding, I’m trying to learn his hunger and fullness cues when it comes to solids.  I remind myself that when he gets annoyed and doesn’t open his mouth, he’s full and the meal is over (even if there is a lot of food left).

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2.  I’m doing my best to limit distractions like having the TV on in the background or toys nearby.  Just like adults, children get distracted by their surroundings.

3.  I’m usually eating with my baby during a feeding.  When he sees me eat, he tries to grab what I’m eating.  It’s never too early to start sharing meals together, even if (for now) we’re eating different foods.

4.  I’m dedicated to spreading positive messages about food, including what I say about my own food choices and my own body in front of my child. My five-month-old may not understand this, but other people I’m with everyday certainly do.  I want my son to grow up learning about health in a way that makes him feel good about his choices and confident about his body.  It’s never too early to make this a priority.

You must read this interview with the one and only, Dr. Linda Bacon!

Health at Every Size and Body Respect—a Discussion with Dr. Linda Bacon
By Erica Leon, MS, RDN, CDN, CEDRD
Certified Eating Disorders Registered Dietitian
Certified Intuitive Eating Counselor

 

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With the ever-present discussion of the “childhood obesity epidemic,” I asked Dr. Linda Bacon[i], an internationally recognized authority on topics related to nutrition, weight, and health metabolism, to describe exactly how best to approach weight concerns among parents and practitioners alike. Dr. Bacon proposes a major paradigm shift from conventional weight management practices to what is now referred to as “Health at Every Size.”

 

Body Respect

According to Dr. Bacon, the Health at Every Size message starts from respect.

She summarized it by saying, “This respect is for our own personal lived experiences as well as those of our children, as there is no objective truth to what we are ‘supposed’ to eat or ‘how’ to eat it. What is going to work best for our bodies can be learned by developing a critical awareness of our own bodily sensations [emphasis added].”

She offered the following examples of this concept: “‘Eat your fruits and vegetables because they are ‘good for you,’ and stay away from junk foods’ is a parenting message that takes the child’s inner body trust and awareness away from him/her. Instead, allow your child to discover the positive benefits of added fiber (from fruits and veggies) such as easier digestion.”

 

Another common example of body respect that she discussed with me is insisting that your child or teen eat breakfast. “With body respect,” Bacon says, “we allow our children to discover on their own what the consequences of missed breakfasts are. They may notice difficulty concentrating in school and have low energy. Rather than nagging, we can allow our children to keep checking in with their bodies and connect eating with improved energy.”

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What Does “Healthy Weight” Actually Mean?

“‘Healthy weight’ means different things to different people,” according to Bacon. “There is natural weight diversity across the spectrum.” According to Dr. Bacon’s most recent book, Body Respect, research shows that trying to control or manage weight (through caloric restriction or dieting), may work in the short term but more often results in rebound weight gain. Our bodies can undermine efforts at weight control because the body is enormously successful at regulating its weight. It’s not something we need to “work at”—in fact, this “control” approach ends up being counterproductive.

She explained that diets affect self-esteem as we eventually blame ourselves for not being able to maintain a restrictive diet or not losing weight. Her “Health at Every Size” philosophy is based on the idea that a better way to reach a good state of health is to manage behaviors that favor health, for example, good self-care, meaning learning to eat according to hunger and fullness cues, as well as satisfaction, choosing physical activities that are pleasurable, managing our levels of stress, and getting enough sleep. With better self-care, our bodies are more likely to stabilize at their own natural healthy weight. Bacon stated, “often the parents with the best of intentions blame themselves when things go wrong. This helps no one.  Recognize that you can’t control your kids—you can only practice and model good self-care for yourself, so you can in turn support your child.”

 

Help for Big Kids

When asked how best to help bigger kids, Dr. Bacon explained that “weight tells us little about kids’ health or health habits, but it does tell us a lot about how that kid will get treated in the world. The best way to help kids is provide support: let them know that the problem is in society, not their bodies. The perpetual stereotyping of fatness affects children of all sizes with fat children as the direct targets. When fatter kids are bullied, and many of them are, there may be nobody in their lives telling them that the bully is wrong and that everyone everywhere is loveable just as they are. It takes a strong sense of self-worth to feel safe in your skin in a world where some bodies are dubbed ‘good and acceptable’ and others are dubbed ‘bad and unacceptable’.”

 

She summarized her overall philosophy: “We need to make this a world where all bodies are good bodies, where children can feel good about themselves in their own unique and precious bodies in all of their glorious diversity. We have the opportunity to stop this self/body hatred and to help kids learn to respect and celebrate body diversity.”

 


[i] Dr. Linda Bacon, author of Health at Every Size: The Surprising Truth about Your Weight and Body Respect: What Conventional Health Books Get Wrong, Leave Out, or Just Plain Fail to Understand about Weight, is changing lives through her teaching, research, writing, public speaking, and the transformative “Passing the Message On” multi-day Health at Every Size® (HAES) workshops. Dr. Bacon combines academic expertise and compassionate clinical experience to bring together scientific research and practical application. She shifts the focus from weight to well-being, giving doctors, dietitians, therapists, and people of all shapes the tools for achieving better fitness, health, and even happiness—all without dieting.

Self Care For Your Teen and Tween

6 Strategies To Prevent Eating Disorders and Substance Abuse in Youth
By Laura Cipullo RD CDE CEDRD CDN and Mom

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Start the New Year, with self care! Moms and Dads, here are 6 tips to help your tweens and teens create a healthy self-care regimen that will decrease the likelihood of developing eating disorders and substance abuse.

  • Focus on overall self care, not weight.
    • Ask your children: “How does your food choice make your body feel? Energized or tired? stable or shaky?”
  • De-emphasize dieting.
    • Health is achieving mental and physical wellness through lifestyle changes.
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  • Encourage expressing negative feelings via words, art, and music.
    • Gift journals or crafts for your teen to use to express their feelings when upset.
  • Help your child expect and accept body changes during adolescence.
    • Educate them on hormones, body changes and social changes in a neutral tone. Honor each individual’s body shape and help buy clothes to suit their individual shape.
  • Educate your children on feelings and coping skills during puberty.
    • Encourage your children to sit with feelings even if they are uncomfortable doing so – this helps to teach resilience.
  • Involve the family.
    • Allow family members to lend a listening ear or give a hug when needed. Parents do not need to have all of the answers.