Several months ago we saw a dietitian/nutritionist for the little dude, and I meant to write a summary of some of the stuff. We did a food log for a week and had it analysed to check if his failure to gain weight was due to any nutritional inadequacies. It wasn’t, it was caused by sleep apnea from swollen tonsils and adenoids, which interfered with release of growth hormones. Completely unconnected to diet! And the food log showed he ate a good diet for a two year old, but the dietitian’s views on toddlers and eating were really interesting and useful anyway.
The file of notes and info fell off the shelf in the earthquake, and I looked over it again and decided to write it up today as a distraction from worrying that another big quake is going to happen any minute and/or Donald Trump is going to turn the USA into a fascist dictatorship.
Starting point: food empathy
Before we talked about her advice on kids and eating, we started with some food empathy exercises. For example, think of a time when you’ve been in a situation where there’s huge social pressure to eat something you find disgusting. Think of a time when you’re really really hungry but the only food available is something you strongly dislike. Think of a time when you take a bite of something and it’s completely different to what you expect it to be. Think of something you don’t like, despite having had plenty of opportunity to learn to like it, and imagine someone cajoling you into having a bite. Think of a time you’ve been full, but pressured to keep eating. It doesn’t happen often to adults (which is the first insight!). You can probably think of a few times though, maybe you’re travelling, or at someone else’s house. Maybe you even have to think back to your childhood. For a kid, it could happen several times a day. One of these experiences could be happening at every meal. Yeah – let that sink in. Wow.
Kids can self-regulate their food intake
Most kids aren’t as picky as their parents think they are. It’s normal for little kids to prefer a few foods. That’s not a worry. We’d done the food log, and based on that we did a list of the little dude’s “safe foods”, things he will usually eat. Then the dietitian pointed out that even if he only eats his safe foods, he’s getting a balanced diet. It seems so hard to believe because adult dietary advice hammers the point of variety! But kids need energy-dense foods and they like familiarity. Their dietary requirements are quite different from adults, they need more fat, less fibre. So she was like, look to be honest if he has porridge for breakfast and a piece of fruit at some stage in the day, you don’t need to worry about how much he’s eating for lunch and dinner, he’s pretty much covered. And I’m like, really? I mean I know porridge is good, but really? And she’s like yeah, really – so long as he’s not filling up on low-nutrient food, you can trust him to decide when he’s had enough lunch and dinner, it’s important for him to listen to his cues for feeling full.
Attitude towards presenting food
Based on the food empathy stuff, and the trust that they will self-regulate, she recommended that adults need to massively lay off kids when presenting food. You know that thing you see in tv and the movies all the time, “just one more bite”, etc? Don’t do it. No need to do it. Leave them be. Here’s how she framed it: whatever he’s eating, and however much of it he’s eating, and at whatever time of day, have the same attitude you’d have if it was a few nuts and raisins for morning tea. Something a bit boring but also appealing, that he might finish, or not, and you wouldn’t care either way, because it’s not a main meal time and you didn’t put any effort into preparing the snack. Tempted to try and coax them to eat some of this or that or the other? Just don’t! Tell them what it is, offer it to them, but then leave them be.
What to do: This one is watermelon, you haven’t had that since last year. It’s sort of juicy and crunchy.
What not to do: Do you want to try some of this watermelon? It’s REALLY YUMMY!! Here, try some of it. Just one little bite? You’ll like it! It’s delicious, try some! It’s watermelon, everyone likes watermelon! I’ll put some on your plate. You haven’t tried any of your watermelon, c’mon, don’t you want to try some? Watermelon is the best! If you try some watermelon, I’ll give you a strawberry as well!
Shaping the food environment
So how do you create a positive eating environment? Here are the tips. (We’re still working on some of these things.)
The big picture
- Parents are responsible for what is on offer and when, kids are responsible for whether they want to eat it and how much.
- If they ask for food, including asking for a specific food, try and bring the next snack or meal forward slightly and offer something substantial.
Some specific things
Focus on breakfast
- Most kids wake up hungry and it’s relatively easy to create a good routine for breakfast. We normally eat porridge together anyway, so this was a free shot for us. And now bub is bigger he can join in with the porridge! Ah, porridge, such a comfort food for me. My husband hates porridge and he rolls his eyes at us every morning.
- If you struggle with the timing of sitting at the table to eat with your kids at dinner, breakfast together is a good opportunity for a meal where they can see adults eating.
Focus on snacks
- Kids need snacks. Kids who don’t get regular, reasonably big snacks will want to graze constantly between meals, and that means they’re less likely to be filling up on nutritious food and more likely to be filling up on whatever is to hand when they want to graze. So either you embrace the grazing but try do it without over-reliance on things that are high in salt and low in protein, or you boost the snacks and have a mini meal at morning tea and afternoon tea (she recommended the second option).
- Snacks are a good opportunity to try new foods – for example a plate with three things, two familiar, one unfamiliar, and they can choose how much. Snacks are also a good time for treats, because then the treat doesn’t detract from a main meal.
- A “supper” of a cup of milk can be a good way to make sure that they have enough to eat before bed without worrying too much about dinner.
Offer some of the “safe foods” at every meal
- This is a mid point between the option of “that’s your dinner, I don’t care if you don’t like it, it’s all you’re getting” and “ok fine I’ll make you scrambled eggs”. It’s something we’ve been doing, and it takes the stress away nicely. It’s not complicated, it can be as simple as a dish of nuts, some cut up apple, and some bread on the table with whatever else we’re eating. So if he decides that he doesn’t want falafel tonight because it is too spiky, that’s ok, he can fill up on bread.
Don’t expect them to like everything
- If they say they don’t like something, don’t make it a big deal. You don’t even have to comment! But if you do, make it low-key, e.g.”Maybe when you’re bigger.”
Role-model convivial enjoyment of food
- Give them the option to join in on what the adults are eating, when the adults are eating.
- Eat as a family. Obviously this is a good thing to do. We don’t do it for dinners very often because my husband gets home too late – but all the more reason to prioritise it on weekends. I try and eat something with the little dude when he eats during the day though and this is increasingly possible now that bub eats solids too.
- Be aware that every role model is important. She really emphasised this point, that it is common for kids to see only the main caregiver eat, and then when they get to adolescence and they are pulling away more from the main caregiver, they stop eating well because they haven’t seen other people eat regularly.
- It’s good to have kids eat with adults at family events, etc. We always did this in our house when I was a kid, and I expected it and felt indignant whenever kids were (in my mind), ostracised from the real action. Once a friend’s dad tried to give me tinned spaghetti when the adults were eating salmon and several years later when he separated from the friend’s mum I was like “yeah well he was always a dick, remember the tinned spaghetti?!” (Harsh, twelve year old me. Very harsh.)
Eating at the table, rather than snacking on the run.
- Meh, yes, this is a good idea, and I aspire to do it most of the time but it’s not yet a priority.
Similarly: not having meals in front of a video as a general rule
- Fail grade. I do this at least once a day. If he has a snack and a video, he will stay in one place for 20 minutes and I can give bub a breastfeed and put bub down to sleep.
- But yeah, it’s obviously a good idea for meals to be their own activity most of the time. But also, done better than perfect. Let not the child starve because I want him to turn off Peppa Pig.
- Don’t be a food puritan. Let them enjoy sweet things or fried salty things, while being mindful about how often they’re on offer.
- Don’t use negative words about treats. There are no “naughty foods”. We enjoy different foods in different ways and should be able to enjoy them all without baggage.
- Double no no: don’t make treats conditional on eating something else first. This puts treats on a pedestal and it is pressure to eat, both of which should be avoided.
- The big issue is for us is how to manage treats that aren’t really treats – we spent a while talking about this because the little dude is a fiend for fruit. He LOVES fruit. To the point where he’ll give himself diarrhoea and he’ll still want more frozen berries. So far, he’s still too little to learn from that experience, maybe next year! Lots of kids have something in this category, a food that is great in moderation, but they like it so much they don’t moderate their intake. A common one aside from fruit is something high in fat and salt like cheese. Some tips include cutting things up small, to help them pace themselves (remembering that children are small – a banana is the size of his forearm!); and making sure that there are other things on their plates as well as the favoured item.
- If they ask for treats, a good neutral-ish response is “that’s not what’s on offer this time”.
Solid, boring blog post that isn’t about disasters, natural or political.