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Guest Blog: Breastfeeding versus Bottle-feeding

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Moms may differ in their opinions and or choice to breastfeed or bottle-feed. I personally think it should be the woman’s right to choose. Breastfeeding and bottle-feeding both have pros and cons. We hear the many pros of breastfeeding such as less illness, possible greater intelligence of the child and so on. Many organizations including the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) promote breast-feeding here in the USA and abroad. However, I question whether this is always appropriate especially if the mother is deficient in micronutrients, deficient in essentially fatty acids, malnourished, stressed, had multiple births in a short period of time or perhaps is not the right choice for the mother. I was breast fed for 3 months and choose to bottle feed my children.

Below, guest blogger Allison Brooks shares her point of view at an international level. Allison studies biomedicalization in Bolivia. Here she presents an example of biomedicalization on breastfeeding versus bottle-feeding in third world countries. Allison shared with me that she too was bottle-fed.  Feel free to comment and share your opinions as well. All are welcome.

Biomedicalization of BreastFeeding: What is healthy here, might not be healthy for all

Biomedicalization is a term used to describe the way in which natural life processes, human conditions and problems are defined and treated as medical conditions. Aging, childbirth and breastfeeding are good examples of normal life processes which have come under the authority of doctors. Biomedicalization may bring benefits, but there are also costs. Philosopher Ivan Illich was one of the first to use the term “medicalization,” which he argued actually caused an increase in social and medical problems as a result of medical intervention. One example is the drive by manufacturers of baby formulas to supplant breastfeeding with formula.

When a mother dies in childbirth or cannot breastfeed for some reason, infant formula may be the only choice. However, in the underdeveloped nations of the world, breastfeeding serves a number of critical purposes. Breastfeeding protects babies from infection, provides them with near-perfect nutrition and acts as a natural birth control for the breastfeeding mother. Breastfed babies are less likely to develop diarrhea, bacterial meningitis, ear infections and respiratory infections than infants who are fed formula. Breastfeeding also triggers beneficial hormone secretion in the mother, and the milk changes in amount and constituents to meet the needs of the individual infant.

The Nestle baby formula promotion of the 1970s urged mothers in less-developed countries to forgo breastfeeding in favor of formula, stressing convenience and nutrition. Nestle used strategies such as sending a new mother home with free samples; once the samples ran out, the child was habituated to formula and the mother’s milk had dried up, so the family had to buy formula.

Problems with this sort of infant nutrition quickly became apparent. Formula must be mixed with water and water in poor countries is often contaminated. Mothers could not read the instructions on water sterilization, or did not have the means to boil the water. Formula-fed babies were much more likely to die of diarrhea or pneumonia as a result of infections. Poor mothers would often mix inadequate amounts of formula for each feeding to make the expensive formula last longer, resulting in malnourished babies.

Nestlé’s marketing activities were considered so unethical that a boycott was launched by a group called the Infant Formula Action Coalition. In 1981 the World health assembly adopted Resolution WHA34.22, which bans the promotions of breast milk substitutes. Although Nestle agreed to accept the code, in 1988, formula companies were accused of repeating the unethical tactics and the boycott, which was still in force as of 2011, was launched. Other companies such as Borden, Similac and Wyeth have come under similar criticism for marketing methods that imply formula and breast milk are nutritionally equal. Most physicians and international organizations such as WHO and UNICEF recommend now breast milk exclusively for the first six months of life.

But the effects of biomedicalization do go way beyond the idea of breastfeeding. Pharmaceutical companies push new rules on societies regardless of their cultures, everyday. This is easy to see in America, because we are the only country that allows pharmaceutical companies to run ads and develop an image for people to follow. Without regards to the culture, the environment and so on, sometimes these “better” medications/therapies can actually be harmful for the people. With new drugs entering the system to promote beauty or health, or a better life-expectancy for cancer, traditional practices are be dropped by the wayside, and people and cultures are being negatively affected.

 

About Guest Blogger Allison Brooks:

Allison says “I was bottle-fed too, that’s why I say what is healthy to you might not be healthy to others (cultural relativism). Thats why I don’t push my beliefs onto people, I state what I know and allow you to do what you please, with no judgment.”

Allie went to the University of Mississippi. She earned her degree in biomedical anthropology and  is now studying in the field to finish an ethnography on the effects of biomedicalization on Bolivian cultures, but as it relates on other societies as well. She loves to guest blog on her time off to past time and spread the word. When she is not at her computer, Allie enjoys riding her  horse, Lilly and playing with her ducks, Alvin and Shirley.

 

 


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Too Much Weight on BMI

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Too Much Weight on BMI
By Laura Cipullo, RD, CDE

A few weeks ago I was asked to share my thoughts on Michelle Obama’s “Let’s Move” initiative with radio host Rita Cosby. I researched the campaign at length while watching the boys play soccer, and what I came up with is that the movement is generally positive. I do believe that a bit of tweaking is in order, however, and that certain ideas could be rephrased. (Check out the complete podcast here.) As I continue to think about America’s “obesity epidemic” I think the measurement called Body Mass Index is overrated and has the potential to misdiagnose ourselves and our kids.

At the end of the day, it always comes back to this same question: “What can we as parents do to prevent disease?” This includes obesity-related disease.

I recognize we need measurements for statistic purposes and possibly diagnostic tools. However, I think BMI should be emphasized less and instead we can focus on behaviors and a cluster of measurements. BMI is only one measure, and it’s not always reflective of a person’s state of health.

BMI is based solely on height and weight. (You can read the official definition from the NIH here.) Weight can be a funny subject though. After all, the number on the scale is not always reflective of how healthy a person is. Therefore, one’s body mass index is not going to accurately reflect a person’s health status.

As parents, healthcare facilitators and makers of change, we must remember that obesity does not always equate with overeating, high cholesterol and/or inactivity. A dear client of mind, for example, has a BMI that would qualify her as overweight, and yet she is a shining example of good health. She runs marathons, eats a balanced intake of food, and has an ideal cholesterol ratio.

Let me let you in on a little secret: I, too weigh more than the black and white number recommended for my height, otherwise known as my “ideal body weight.” Me—a registered dietitian, certified diabetes educator and “paragon of health (by all other measures)”!

Granted, there is a ten percent range above and below IBW. I fall into the range above my IBW, as many people do. That being said, you can see how easy it can be for someone above their IBW to assume they are overweight, even when it’s not true. I’m by no means overweight, rather I am the weight that is appropriate for me.. If someone were to slap a label on me based on weight alone, or to use Weight Watchers’ recommended weight, I would be over my goal number.  Well, I don’t need to lose weight, so the point is, using these means to determine a person’s health with a Body Mass Index are somewhat antiquated and inaccurate.

Remember that muscle weighs more than fat. Otherwise, most hyper-muscular football players (even Tom Brady!) would be considered overweight too, if only by their BMIs. Some people are also more densely built than others. My nephew, who is visually lean and bony, qualifies as obese according to his doctor, though if anything, he could stand to gain a few pounds.

Whether lean and dense or round and curvy, we are all decidedly beautiful. We must remember that BMI is not a measure of self-worth. Rather, it’s merely one tool that aims to measure health—and a flawed tool at that.

On the flip side, I also work with a number of clients who have extremely low BMIs. These individuals are struggling with their health.  They may use unhealthy behaviors such as skipping meals or starving themselves to keep their weight down and or BMI low. So you see, a low BMI may not be indicative of health either. What we need to be sure of is to take our focus away from the body mass index and to instead consider healthy behaviors as a whole.

So if weight isn’t the ultimate measure of health (nor is one’s appearance), then what is? Blood pressure, liver function, Total Cholesterol/ HDL ratio, endurance, energy and other daily habits are much better ways to gage a person’s physical condition. As parents, political pundits and health care professionals, we must move toward size-acceptance, promoting confidence and self-esteem in our children. I propose to start with the following:

  • Foster a positive opinion of food in the household.
  • Feed your children a balanced intake of whole grains, lean proteins and heart healthy fats.
  • Tell your children you love them. Have them look in the mirror and tell themselves they are loved. Tell them they are  more than a number.
  • Encourage healthy behaviors by setting an example.
  • Focus on your children’s efforts and behaviors, not on outcomes or measures. Praise them for trying a vegetable or sport rather than for being a veggie eater or a great baseball player.
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Quick Tips For Moms on Helping Cultivate Healthy Habits

Whether it’s Michelle Obama’s Let’s Move Campaign, my friend’s talk in Westchester to the PTA or the development of a new Food and Nutrition Committee at my son’s school, Moms and Dads are advocating for positive change for health promotion. We walk a fine line while doing this as we don’t want to create more problems in regards to the already challenging job of feeding our children. Here are five simple tips to include in your “lunch box” of tools.

 

Teaching Not Preaching to Your Kids, Healthy Habits

Laura Cipullo, RD, CDE

Laura Cipullo Whole Nutrition Services (www.LauraCipulloLLC.com)

www.MomDishesitOut.com

 

 

 

 

 

 1. Don’t preach instead lead by example:

  • Let your children know you are off to spin class or pilates
  • Plan active vacations whether it be skiing or hiking in Colorado

 

2. Practice exposure therapy

  • Try new foods with your children especially on vacation or during the holidays. St Patrick’s Day and Mardi Gras offer different cuisines to tantalize your taste buds.
  • Leave the veggies on the table even if you know the kids won’t eat them.

 

3. Take your child food shopping

  • Shop at the farmer’s market or a food store that emphasizes sustainable, local agriculture and wholesome foods such as Whole Foods.
  • Limit shopping at grocery stores that offer more colorful, child focused boxed and processed foods.  There marketing sucks your kids in.

 

4. Encourage Trying, Not Winning

  • Tell your child you are proud of them for trying a new food or a new activity. It’s not whether they like the veggie or if they played the game correctly.
  • Focus on the great effort and fun your child had at trying a new sport like roller-skating not how they didn’t fall.

 

5. Practice self regulation

  • Let your child choose how much of the dinner to eat. No clean the plate the club!
  • Ask your child “Are you hungry, thirsty, bored or tired?”

 

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A Therapist's Changing Body – Guest Blog

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Today’s guest blog from Psychotherapist Jessica Aronson touches on a question that many working women and expecting moms often wonder. What can we do as parents or professionals to teach others (kids and adults alike) to both respect and feel comfortable with the inevitable physical changes as they grow, from puberty to pregnancy? How can we learn to cope with our bodies through different stages of life?

As you know, this is a topic I hold near and dear to my heart. Her account is decidedly honest, and I hope you enjoy. Please feel free to join in the conversation in the comments section below.

A Therapist’s Changing Body

By: Jessica Aronson, LCSW-R, ACSW, CGP Psychotherapist http://www.wmhcnyc.org/aronson/ www.jkpassages.com

As I anxiously and joyously await the arrival of my second child, another boy, I am reminded of the process all over again. It’s no longer just my client and I sitting in the room; with my son growing inside of me, there are three of us now.

My clients in particular are heightened to these changes. Having worked with eating disorder patients for more than 10 years, I’m familiar with—and prepared for—the comments: “You look great, did you change your hair?” or “You’re so little,” or “You’re wearing colors today.”

So it wasn’t all that surprising that the comments continued as I too continued to grow and change. People have remarked on how big I’ve gotten; how my skin has broken out; how uncomfortable I must be (and am). The list goes on.

At eight months pregnant, there is no way to hide my belly. It now shares the sacred space of a therapy session, a place that’s otherwise reserved solely for my patient and myself. That being said, I nevertheless try not to talk about my pregnancy or my changing body with my patients at great length, as it leaves me exposed and vulnerable as their therapist.

When the situation seems appropriate, however, I do push myself to inquire as to what thoughts and feelings my changing body and unborn child brings up for them. Clients have shared feeling uncomfortable by the size of my belly. They’ve expressed sympathy as well as the desire to take care of me by offering me a seat on the couch. They’ve expressed fears about my maternity leave.

Of course, there is no way to avoid these changes—or the physical changes any woman experiences during the course of their pregnancy. And while I know it is so important to use my own position as an opportunity to help my clients explore their own feelings and fears about pregnancy and weight fluctuation, I am also honest when I say that, as a therapist, I feel very exposed and vulnerable in doing so. Sure, I am happy to make this sacrifice to benefit my clients. I’m just far less enthusiastic about sharing it with strangers.

Many of my clients stayed with me through my first pregnancy, but I still struggle to cope with my own discomfort (as the baby kicks and moves inside me), as well as anxieties and fears that arise while in sessions with patients. Like any transition or change in a therapist’s life, this too is major. We just can’t hide or cover this one up.

 

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A Moment of Momzilla!

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Last winter I took my eldest son, Bobby, and my nephew skiing for their very first time. When Bobby did great on his first run, I decided to take my nephew down the mountain too. Of course, it was ridiculous to think I could handle 2 beginners. Bobby ended up falling.

I was convinced I had ruined skiing for Bobby forever; he was resistant to sports to begin with. I had already scheduled private lessons for the boys 2 days later, so I sent them anyway.

Bobby was not exactly excited to get back on skis after his initial spill. He resisted. He acted out. It was ultimately a failed attempt.

Hoping he’d maybe forgotten about his first experience, I tried to get him back on skis on another weekend at a different mountain. This time, he was like a limp noodle, refusing to as much as stand upright let alone listen to his instructor. Bobby only wanted to ski with me, but that was impossible since I had unfortunately been in a ski accident the week before and was forced to sit on the sidelines for the rest of the season. I was so distraught.

Maybe it was the concussion speaking, but I just couldn’t understand how my son—my own flesh and blood—didn’t love skiing as much as I did. I was looking into buying a ski house. What would I do with Bobby if he hated skiing? To add insult to injury, my nephew, whose parents don’t ski, was having the time of his life. I couldn’t stop thinking how reversed the situation was.

To me, this was a catastrophe. Sad to admit, but I even cried about this to my therapist. It wasn’t so much that Bobby hated skiing or that my dream house was quickly becoming a nightmare. No, it’s because I was suddenly becoming this mother that I didn’t want to be—a momzilla of sorts.

Refusing to accept Bobby’s athletic distaste (how can a dietitian’s son be physically inactive?), I gave the whole sports thing one more shot (he refused to play soccer too)—this time with mother-son rock climbing. The result? Bobby thought that scaling the smaller wall was fun, but when faced with the full rock wall, he went running for the hills. (Well, really, he hid under the mat as though he were a small animal.) I, of course, said all the wrong things—and hated myself as each word escaped my mouth. I offered rewards. I made threats. I knew I was completely out of line.

Both my therapist and husband said I was overreacting. They said when my son was ready, he would participate in whatever physical activities he wanted. So, heeding their advice, I dropped it. No more sports classes, no more private instructors, no more pushing or comparing or dreaming. I needed to let Bobby be himself and grow into someone different than who I may have thought he’d be, at least at that age.

Well, guess what? This fall, I enrolled Bobby in a school soccer program. I know you’re thinking, “Here she goes again.” But my husband and I send our children to progressive schools that encourage self-exploration, teamwork and learning through activity, and I hoped he would react differently in a more supportive environment, especially now that Bobby was older. I sent him to a soccer program that focuses on having fun—not on drills—and it worked. He loved the class and never complained.

Since turning five, Bobby has taken to a few other sports too. He smiles through swim lessons (my husband initially taught him to swim since he hated the classes), has started skateboarding (and is doing well) and has even attended a 2-week sports camp with a classmate over winter break.

Apart from giving him enough time to acclimate to new athletic endeavors, I think that Bobby’s peers have positively influenced him as well. As a colleague of mine, a pediatric development specialist, taught me, when kids try new activities, they don’t have to do them well. It’s more important to offer encouragement and praise for trying. So this is what I have been doing and I think it is effective in building self- esteem and acceptance.  After his first swim lesson, Bobby said to me, “I know why you are proud of me. Because I was scared, but I tried it and I had fun.”

As parents, we need to focus on building our children’s self-worth as they learn to cope with their environment. Give your child time to be who they are, not who you want them to be. I caught myself being a momzilla and changed my ways. It’s a delicate issue, but as parents we have a responsibility to handle it with care.

Have you ever found yourself facing your inner momzilla?

 

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How Do You Answer, "Is this healthy?"

 

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Recently, both of my boys have been asking the question, “Is this healthy?” Billy asks, “Is hummus healthy? Are hummus and pretzels healthy?” Bobby asks, “Is yogurt healthy? Is pizza healthy? Is Gatorade healthy?”

Kids ask so many questions, and the way we answer them shapes the development of their beliefs and habits.

I’m not exactly sure why both boys have started to ask this question. I just know they keep asking. And it can be hard to give a simple “yes” or “no” answer when my primary concern is trying to instill them with a moderate view of food. Here’s how I go about answering their questions quickly, yet also with thought.

Hummus? Yes, hummus is healthy. It helps your heart. (FYI, Billy eats hummus almost daily for dinner. He loves it so much that he eats it with a spoon at times.)

Hummus and pretzels? Yes, hummus and pretzels are healthy—if you also eat other foods like chicken and pasta. (I say this because Billy refuses to eat chicken, pasta and other seemingly normal foods. It’s my small trick for getting him to try new ingredients.)

On a related note, I can honestly tell Billy that pretzels are healthy because the ones he eats (unknowingly, of course) are made of either whole wheat or spelt. When we refer to chicken, again, it’s organic and hormone-free. And pasta is organic and whole wheat. The kids don’t need to know these details, and I don’t specify this regularly. Healthy ingredients are simply the norm in our house, and I think the boys will get this message over time. I do not want to inundate them at ages 3 and 5.

At times, I think parents and teachers can make children overly—and unnecessarily—anxious about the food they’re eating when using complicated details such as ‘whole wheat,’ ‘antibiotic-free,’ ‘hormone-free,’ ‘saturated fat,’ etc. Kids need to first understand the basics, like the difference between an everyday food versus a sometimes food. It’s okay to eventually teach them about the aforementioned specifics, but at the right time. Otherwise, your children could eventually rebel.

Keeping this in mind, I try to answer Bobby’s questions in this same manner. Greek yogurt is an everyday food in our home. The protein in yogurt helps us build muscles and strong bones. Pizza is a sometimes food, as long as we eat other foods like fruits and vegetables. Gatorade is a sometimes drink for athletes, like someone who is training for the Olympics or exercising at an intense level for more than hour.  Yes, you can have a sports drink, but not every time you swim or skateboard.

So, as I’ve discovered, and as I hope you can see, the answer to, “Is this healthy?” is not a straightforward one. But you can use these small tricks for helping your children to understand what they’re eating in a positive and healthful manner. How do you answer your kid’s questions about healthy and not healthy foods? Do you use words like “everyday foods” and “sometimes foods” in your household?

For more information on everyday foods and sometimes foods, read A Blueprint for Your Child’s Nutritional Intake.

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3 Strikes and You Are Out!!

 

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Don’t let food be your child’s voice
Laura Cipullo, RD, CDE and Mom

While in session this week, my client expressed frustration, disappointment, and anger toward her parents, in particular her mother, when recalling the holidays. My client, a vegetarian, is recovering from an eating disorder. Upon returning home for the holidays, her mother tells her, “I bought you food. It’s in the other refrigerator.” Excited, my client feels respected and goes to make lunch. But when she opens the refrigerator, she only finds one red pepper—and there’s mold growing on it.

Strike 1.

Next, her parents tell her to choose a restaurant by a famous chef they all adore, that way everyone will be satisfied.  She makes a decision and tells her mother. Mom’s response: “Oh, no one will like it there. We are going to a different restaurant.”

Strike 2.

At the restaurant, mom orders for the family even though the kids want something different. My client ends up with a dish that contains cheese. She is lactose intolerant. Now she needs to order a new meal, wait for it and eat while everyone else waits for her to finish.

Strike 3.

You’re out, mom! Thankfully, my client practiced patience and used her coping skills, and before long, she returned home to her own apartment where she reigns over the refrigerator.

In this instance, it’s clear that my client lost her voice among those of the rest of her family and developed an eating disorder to express her lack of recognition and pain. This is a perfect example of how sometimes we may not truly be listening to our children. Sure, we may hear their voices, but there are moments when we simply miss the boat.

As mothers, parents and caregivers, we are all busy and consumed. It’s not just my client’s parent; it could be any one of us. But, whether a child is 3 or 30, we all need to recognize that they have their own needs and personalities. They need to be heard, respected and acknowledged in order to build their self-esteem and prevent them from using food to numb, to cope, to ask for help, or to ask for more love.

What do you do to let your children know that you hear them? How do you acknowledge them and prevent food from becoming their voice?

 

 

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A note to my readers:

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A note to my readers

 

As I continue to share my stories, experiences and other “food for thought,” I am realizing that at times my entries extend beyond the experiences of my personal family. Each lesson is, however, always relevant to my family, since I am constantly applying what I learn toward raising my children.

 

I see my blog as an opportunity for all moms, dads, and caregivers to unite, bond, and learn to become moderate in our parenting and the feeding of our children. The goal is to raise happy, healthy, moderate children who eat all food in moderation, respect their bodies no matter what shape they may be, and enjoy life. Health promotion and disease prevention are of course at the core of what I do too.

 

So, instead of limiting our children’s perspectives on food and life to that of a black and white way of thinking (i.e. good and bad, skinny and fat, right and wrong), we should be pioneering this mindset of moderate parenting and feeding.

 

Thank you for your support over the past few months. I look forward to sharing more entries, and I hope you too will contribute your experiences, lessons, and “food for thought” on the trials and tribulations of raising “moderate” children. I would love to have at least one guest blogger a month. Please email me if you are interested: cipulloRD@gmail.com.

 

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Potty Training without M&M's

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Many of you probably know that food shouldn’t be used as a reward. If you didn’t already know this, then, from the prospective of an RD, I am telling you now.

As a mom, however, I also know that this is easier said than done. Food to a child can, after all, seem somewhat rewarding. Yet through my own experiences, I’ve slowly picked up on a few tricks on how to prevent food from becoming equated with success—and I think I can make it relatively easy for you moms out there too.

It all started with Billy, who will be three in a few weeks and just finished potty training. And guess what. We did not use food as a reward during this process.

Since Billy is my second child, I felt a lot less pressured to potty train him than I did with Bobby. Right before the school year began, Billy asked if he could go potty on the big boy toilet, and so I immediately pulled out the kid potty and we started training.

Billy sat on the potty a few times and then on the toilet. He went potty with the kids at school, but he refused to wear underwear or use the potty any other time. I figured I’d just let him be. As my Australian friend Maureen advised, they’ll learn at some point. (As it turned out, Maureen’s advice from down under was great. I just let Billy do as he pleased, and while he was still wearing diapers, at least he was content. And so I was happy too.)

As the holidays approached, the boys and I decided that sport and ski camps could be a fun way to stay busy during their time off from school. But Billy could only participate under one condition: he would need to be potty trained in order to be eligible for the program. I explained this to my three-year-old and offered him a small token to forgo his diapers and, voila—he was willing to concede.

Everyone tells you to bribe your kids with M&M’s. Instead, I opted to present Billy with handmade wooden animal ornaments for our Christmas tree—presents that actually benefited the entire family, though Billy was all too excited to receive them as gifts.

When I ran out of ornaments, Billy picked out a presidential brigade box of cars, limos, security cars, planes and other trinkets. The box cost about $30, but it was filled with 15 to 20 potential presents inside. Each time Billy used the potty, I allowed him to pick out a new vehicle from the box.

I am very happy to report that this ploy worked like a charm. Now, Billy has been using the potty without gifts for the past week and a half. We still have toys left in the box, too.

So, instead of making food seem special and putting what we nourish ourselves with on a pedestal, opt for non-edible rewards like Matchbox cars, temporary tattoos, stickers, cool underwear, or Polly Pocket pieces. If you use food as a reward, you may end up sending the wrong message: that you have to earn food or that food is a treat for good behavior.

Remember to teach your children that food is food—nothing more, nothing less. As parents, it is our responsibility to make sure our children understand this concept if we want to prevent disordered and/or secretive eating in their future.

Do you offer your children rewards for certain behaviors or accomplishments? If so, what do you typically reward them with that could be useful for other moms out there?

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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?