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News Flash: The AND Recommendations Feature Ellyn Satter's Model

News Flash: The Academy of Nutrition and Dietetics Reports Their Latest Recommendations and Ellyn Satter’s Model Is Part of It.

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We are all inundated with nutrition messages. Messages range from our pediatricians to our mom friends, and of course from the media. Just last month, AND released their position paper on nutrition guidance for healthy children ages two through eleven. Well in 1999, I was introduced to the works of Ellyn Satter called Feeding with Love and Good Sense and Treating the Dieting Casualty.  I was stumped on how to be a RD if diets didn’t work. Well, a more seasoned RD recommended this three-day workshop in Madison, Wisconsin, taught by Ellyn Satter who was both a RD and a LCSW.  So of course I attended the three-day intensive led by Satter called “Treating the Dieting Casualty”. It changed my life and that of my clients. I was hooked and then went on to study her approach on feeding children. The most amazing thing is that upon reading the Academy of Nutrition and Dietetics’ position paper for “Nutrition Guidance for Healthy Children Ages 2 to 11 Years,” I see that Satter’s recommendations are being officially incorporated. This is a great achievement for all.

 

Now, fifteen years later, many RDs know her work but not all parents do. I have cut and pasted some of the important highlights from the position paper that is associated with her approach. Most of the contributors on Mom Dishes It Out follow a similar approach, but if you want the original real deal, buy one of Satter’s books.

 

Encourage Internal Regulationi:

When parents assume control of food portions or coerce children to eat rather than allow them to focus on their internal cues of hunger, their ability to regulate meal size is diminished. In general, parental control, especially restrictive feeding practices, tends to be associated with overeating and poorer self-regulation of energy in-take in preschool-aged children and was predictive of overweight. This may be problematic among girls with a high BMI and may contribute to the chronic dieting and dietary restraint that has become common among American girls and young women.

 

Responsive Feedingi:

Use of a responsive feeding approach, in which the care provider recognizes and responds to the child’s hunger and satiety cues, has been incorporated into numerous federal and international food and nutrition programs. A “nonresponsive feeding” approach (i.e., forcing or pressuring a child to eat or restricting food intake, indulgent feeding, or uninvolved feeding) has been associated with overweight and obesity.

  

Food Environmenti:

Although children seem to possess an innate ability to self-regulate their energy in- takes, their food environment affects the extent to which they are able to exercise this ability. Offering large food portions (especially energy-dense, sweet, or salty foods), feeding practices that pressure or restrict eating, or modeling of excessive consumption can all undermine self-regulation in children.

 

Division Of Responsibilityi:

 As early as the 1950s, recommendations for allowing young children to self-regulate were being made. Ellyn Satter, MSSW, RD, advocates a “Division of Responsibility” approach to feeding children. These premises, which incorporate principles of responsive feeding, have now been adopted by many national groups, including the American Academy of Pediatrics and USDA (MyPlate). With this approach, the role of parents and other caregivers in feeding is to provide structured opportunities to eat, developmentally appropriate support, and suitable food and beverage choices, without coercion to eat. Children are responsible for determining whether and how much to eat from what is offered.

 

The Food Relationshipi:

Early parental influence is associated with the development of a child’s relationship with food later in life. For example, young-adult eating habits, such as eating all food on the plate, using food as an incentive or threat, eating dessert, and eating regularly scheduled meals were related to the same feeding practices reportedly used by their parents during their childhood.

 

For Further Reading:

 

[i] Ogata BN, Hayes D. Position of the Academy of Nutrition and Dietetics, “Nutrition Guidance for Healthy Children Ages 2 to 11 Years.” (Academy of Nutrition and Dietetics, 2014), 114:1257–76.

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Formula Fed—Me and My Boys

Formula Fed—Me and My Boys
Not every mom must breast-feed.
By Laura Cipullo RD CED CEDRD CDN 

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I know as a registered dietitian I am supposed to encourage breast-feeding, but there are enough dietitians indoctrinating “breast-feed only.”  I am here to share the flip side. I don’t want moms to feel guilty for not breastfeeding because they cannot or simply because they choose not to. I have formula fed both of my sons, who are now ages five and seven. Neither have food allergies, and neither have been on antibiotics (recently, however, it was necessary for the eldest to take them). I, too, was formula fed and am a healthy individual. Opining for formula is based on my personal experience and not science.

 

But it can be heartbreaking to want to breast-feed your child and be unable to do so. Moms, please don’t feel guilty. Formula feeding is not to the detriment of your child. You can still bond, and you can still provide your child with nutrition. As a matter of fact, the first six months post birth are important, but our job as mothers is even more important as our babies get older. Providing pure nutrition goes beyond the breast and the bottle. How we feed the baby, what we feed them as their first foods, and the relationship between us and our food—and our child and his/her food—is a lifelong balancing act that is more crucial than breastfeeding.

 

There are also other times when it may be to the mom’s or the baby’s advantage to choose formula rather than breast-milk.

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Why it may not always be better to breast-feed:

  1. Mom may be malnourished and unlikely to give baby adequate nutrition.
  2. Mom may be decreasing her bone density, sacrificing her health in order to give baby enough calcium.
  3. Mom may not be eating fish, and therefore baby is not getting enough DHA, the essential fatty acid obtained through eating fish.
  4. Mom may be drinking diet soda and eating diet foods to lose the baby weight. (But do you want to bottle-feed artificial sugar to your baby? Is this different healthier than sugar in formula?)
  5. Pump and dump?? Let’s face it, many moms imbibe in drinks such as wine, while others even smoke tobacco and proceed to breast-feed!
  6. Baby may not be getting enough nutrition, and formula may be better choice.

 

Consider, are you doing this to benefit baby or yourself? If you do breast-feed, make sure you take a multivitamin with minerals, drink enough water, and eat enough real, wholesome food. If you choose formula, know your baby is getting calcium, DHA, and the necessary macronutrients. The sugar in formula is not ideal, but remember milk is a form of carbohydrate, which is sugar. The focus for you and all moms and dads can and should be on what you feed your child for the rest of his/her young adult life rather than on the first year alone.

 

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