During the process of writing Fearless Feeding, I’m going through an immense amount of research. I’ve been interviewing researchers and want to bring some of their wisdom and perspective to you. Today we have Dr. Lucy Cooke, Senior Research Associate at UCL Department of Epidemiology and Public Health in London. Her expertise includes the development of children’s food preferences and eating habits and childhood obesity. She has a PhD in Psychology and MSc in Health Psychology from the University College London and has published numerous research articles in various peer- reviewed journals.

1. What is the one thing you want parents to know (about feeding/research) that you don’t think they know now?

That what they themselves eat is the strongest predictor of what their child will eat. If a parent doesn’t like or eat plenty of fruit and vegetables, then their child is unlikely to do so.

2. In your professional opinion, what is the biggest feeding mistake parents make with their children?

There are a few, but one important thing is the use of food as a comfort, as entertainment or as a reward. A child who is given food for these sorts of reasons may learn to associate food with those feelings so that in future they will seek food when they are bored or sad, rather than just when they are hungry.

3. Research shows that taste exposure is beneficial but pressuring kids to eat isn’t good either. How can parents get kids to taste food without it being a negative experience?

Only ever offer very small pieces of a food to begin with and give lots of praise for tasting. If parents try the food at the same time, that often encourages their child to do likewise. If all else fails offer a small non-food reward…a sticker, maybe…if the child tastes the food.

4. What does the research say about rewards for trying new foods?

If a child will not taste a food, then it appears that offering a small non-food reward is beneficial in the short and long term in terms of increasing both liking and intake. However, using foods as a reward (e.g. “If you eat your peas, you can have some ice cream”) can have unintended results in that children may dislike peas more and grown to like ice cream even more.

5. Exposing babies and toddlers to a variety of tastes appears to be important for future food acceptance. Any advice on how parents can do this?

When starting a baby on solid foods, giving them a variety of vegetables as first foods seems to be beneficial and best of all, giving something different every day. It’s important to realize that for a very young baby all tastes are unfamiliar and apparently negative facial expressions in response to new foods may indicate surprise rather than dislike. Keep offering lots of different foods in small amounts and babies will become accustomed to a variety of different tastes.

6. Anything else you want to add about your research? Something to say to parents?

If a child appears to dislike a food today, it does not mean they won’t like it tomorrow. Keep trying!

Even though it was over 5 years ago, I’ll never forget my first experience feeding my daughter.  The nurse helped her latch and I couldn’t help but feel how unnatural it all felt.  We had to wake her up for feedings, it was excruciatingly painful and she seemed to hate it.  And I absolutely dreaded every single feeding.

One of the lactation consultants I hired (long story, but I went through many) told me that my daughter didn’t like to breastfeed because it wasn’t a place she wanted to be.  In a hormonal sleep-deprived fit, I thought to myself “so in addition to getting her to latch, dealing with sore nipples and making sure she get enough to eat, I also had to make this fun?”

But now I understand what the lady was saying.  In hindsight, Big A’s refusing to breastfeed at 7 weeks was the best thing that happened to us.  I still gave her breast milk through a bottle but we finally got to enjoy and connect during the feeding process. 

Problems then = problems now

Even after she refused to breastfeed I kept offering Big A the breast.  But this time there was no pressure and I even stopped caring if she would take it or not.  And then, when she was 4 months old, she started to breastfeed.  I couldn’t believe it!

When it came to feeding solids, I made sure to let Big A take the lead and keep feeding pleasant.  But had I not learned that lesson, I wonder if things would have been different for us.  This is what happened to Lori and her daughter.  They went through an experience, early on, where her milk supply was low and her daughter wasn’t gaining weight.  Even though that problem got resolved, feeding continued to be a game of cat and mouse in order to get her thin but normal growing 3-year-old to eat.

The thing about early feeding experiences is that they tend to color later feeding experiences.  Once Lori realized this, she was able to let go of pushing food on her daughter and the dynamic around feeding greatly improved. 

What gets missed in the right and wrongs

I’m in the process of researching infant feeding for Fearless Feeding and all of the decisions that go along with it.  There’s whether or not to make baby food, when to start solids (4 vs. 6 months) and the new option of baby-led weaning where purees are totally skipped (see this post for a review).

But what I think gets lost in the quest for the perfect food for baby are the most basic needs of feeding. Babies need their nutritional needs met and they need to be challenged with texture and have opportunities to transition to self-feeding but they also need to feel in sync with the person feeding them.

So a mom can spend hours making the perfect purees, but if she’s shoveling food in without looking at her baby for signs of hunger, fullness and enjoyment, feeding is not going so well.  And another mom can be hell-bent on baby-led weaning to find her baby isn’t thriving this way and is one of those “late to self-feed” kids (this was my son!).  Or the baby may want to self-feed but the mom doesn’t want to lose the “nutrition control” that spoon feeding offers.

The mistake that is often made early on is forgetting (or simply not being told!) that feeding is about much more than getting the right foods into our children — it’s about connection and having both child and parent be part of the process.  Even when little one’s desires and needs fail to match our expectations. 

The good news is it’s never to late to change the feeding relationship to one that’s positive and reciprocal.

I’m sure you remember (or you may be doing it now) what it was like when you starting feeding solids.  What resources or information did you need that you didn’t get?  What would’ve really helped you? If you want privacy contact me here.

Thanksgiving is over. The holidays are here.  It’s official.

You are going to see articles about eating healthy and how to avoid overindulging this holiday season.  I can almost rehearse the tips: Avoid creamy sauces, choose fruit for dessert and cut calories where you can. 

I don’t like the eat-healthy-during-the-holidays advice because it feeds the illusion that people can’t trust themselves around food.  And when people hear something enough, they start believing it.

So while I won’t tell you to eat healthy, I do have some advice about getting through the holiday season.

1. It’s a good time to evaluate your eating: If you feel like overeating and indulging all season long, it may be a sign that you relationship with food needs some work. 

I used to this exact thing: look for an excuse to eat food that I thought didn’t belong in my diet.  Whether it was vacation, the holidays or the weekend, those were times I was “allowed” (and stuffed myself with) less-than-nutritious foods. 

I believe this is an overlooked culprit to overeating and weight problems.  People go back and forth between eating healthy and indulging.  If they could live happily somewhere in the middle– and listen to their hunger and fullness — their desire to overindulge would decrease.      

2. Go for the Balance: Rather than eat healthy, I tell people to balance their eating this time of year.  So continue meal planning to keep your family on track with nutritious meals and snacks while including your share of holiday food. 

I find that people who are able balance their eating in most situations have made a mental shift.  They don’t overly restrict what they eat, they simply prefer to eat well most of the time. 

This mental shift changes the language in your head.  So instead of saying I “should” or “shouldn’t” eat something, you eat food that you “want” or “don’t want” to eat.  I have found that since I’ve made the mental shift years ago, there are less indulgent type foods I really want to eat, and many more nutritious ones I crave.

3. Don’t graze, eat meals. In his research, Brian Wansink, author of Mindless Eating, finds that the average person has already met 90% of their daily calorie needs before sitting down to their holiday meal.

So instead of grazing, fill a small plate with your favorite appetizers, sit down and enjoy every bite. Remind yourself that you need just enough to hold you over (but not to spoil your appetite) until the main meal is served.

4. Be active. Exercise is your secret weapon during the holidays.  It’s a stress reliever and it gives you the additional energy you’ll need.

And there really is no better time to be active. The weather is crisp and the gyms are free of crowds. I try to sign up for a walk/run in late December/early January. This way, I’m more motivated to run all December long.

5. Cut back on the to do’s. The stress of the holidays makes matters worse. Families aren’t eating together, food is grabbed in a hurry and many parents stay up late doing more stuff.

Ask yourself if you really need to do everything this year. Maybe it’s time to cut back, be choosy about how you spend your time and focus more on enjoying the season.

Any thoughts?  What do you do to stay balanced during the holidays?

I pretty much steer clear of guarantees when it comes to children’s eating.  But while sitting in on an educational session at the American Dietetic Association’s Food and Nutrition Expo — a big light bulb went off after hearing “Kids are dynamic and constantly changing.”

I knew this was true for kids’ eating but somehow hearing it struck a nerve — in a good way.

So here’s my guarantee: your child’s eating will change.  Depending on where your child is in their development, this may be a good thing, a not-so-good thing or something in-between.  And I’m going to tell you why it matters.

Being able to see past today is a sanity saver

No matter what feeding stage you are in, you were probably never taught to look beyond it.  If you’re focused on  what foods to feed your baby or how to handle picky eating, it can be all-consuming.  But looking ahead is not only vital to your child’s future eating habits, it’s important for your sanity.

Knowing that my reluctant-to-try-new-foods 5-year old is at the tail end of her food neophobic peak (2-6 years) helps me tremendously.  That means all the food exposure she’s getting now will translate to more and more food diversity in the not-so-distant future.  But if I thought she was going to be this way forever, this stage would be much tougher and no doubt our feeding interactions would suffer.    

Understanding that things will get better down the road doesn’t solve everything– you also need to anticipate the next major challenge so you can focus on prevention and be prepared.

Being prepared is half the battle

I hate to be the bearer of bad news, but there is never going to be a time when you are free and clear of challenges when it comes to feeding.  That’s because kids’ brains and bodies are constantly changing — and they learn something different at each stage. 

Much of the advice given on this blog such as providing regular meals and snacks at the table, allowing children to choose whether and how much to eat and managing sweets wisely, helps prepare toddlers and preschoolers for the outside food influences they encounter during the school years.  After all, you will not always be there to tell your child how much to eat or what type of foods to choose.

Once children hit the school-age years, you’ll want to anticipate the I-want-to-get-away-from-my-parents teen stage by building on your child’s food independence skills.  I asked Jill Castle, expert pediatric dietitian and mother of 4 kids between the ages of 10 and 15, for some advice.

“Allow school-aged children the liberty to assemble snacks, pack lunch (with a template to guide), decode ads and images, and help with meal planning and preparation, ” she says. “Family-style meals, self serving and keeping in line with the Satter Division of Responsibility allow for test-driving independent food selection.”

Fortunately for us busy parents, preparing and preventing problems in the next stage helps us to do a better job today.

When you’re not prepared it’s worse

Diane Welland, MS, RD, author of The Complete Idiot’s Guide to Eating Clean, had a son who ate well from the very beginning and she had no reason to think it would ever change.  She was surprised when his eating habits took a complete nose dive in the teen years when he gained a new kind of independence that included a car!

“While I was not prepared for my son’s eating habits to change so drastically, I knew this is one way teens assert their independence and try to find themselves.” she says. “I understood why he was doing it and the fact that it was a phase but swallowing it from a mom/dietitian’s perspective is still hard to take.”

Diane tried her best to not force or nag her dietary habits on to her son, which wasn’t always easy.  Instead, she tried to focus on being a good role model and teaching her son by showing. 

“It’s the long term that counts — think of your child’s diet as a cycle with ups and downs,” she adds. “If this is a down period, hopefully, with time, it will go up again.”

Being unprepared for the next stage doesn’t always mean you did something wrong in the previous one, it’s just easier when you expect the challenges.  So if they don’t happen, or aren’t as bad as you thought, that’s even better.

Each feeding stage is linked

One of the reasons I don’t focus on one age-range for this blog is because all of the feeding stages are linked and that includes adulthood.  If you are struggling with feeding your child today, it can help to look back to what they learned, or didn’t learn, in a previous stage — and course correct if necessary. 

And it’s never too early to think about how what’s going on today affects your child’s eating tomorrow, ten years from now and into adulthood.

Soon, I’ll be announcing a new project that I’m working on to help parents navigate feeding kids of all ages with more ease and confidence, so stay tuned. 

What worries you the most about your kids’ eating future and are you doing anything to prepare for it?  Or are you just trying to survive the here and now?

 I wrote this post as a participant in the Eat Better, Eat Together Balancing Act blog carnival hosted by MealsMatter and Dairy Council of California to share ways families everywhere can make time for family meals that include foods from all the food groups. A list of other registered dietitians and moms who are participating in the Balancing Act blog carnival will be listed at the bottom of this post or can be found at MealsMatter.

I’ve been cooking family dinners for a little over 3 years now. I’m not a natural cook or foodie, just a mom who wants to teach her children the value of family meals — and expose them to good tasting and nutritious food.

In that process, I’ve learned some important lessons. These lessons, that I’m listing as commandments, have helped me keep things in perspective, lessening the guilt and adding more enjoyment to every meal.

I don’t get it right every time, but I sure do try. Because guilt is one of the most de-motivating emotions out there — and parents certainly don’t need more of it.

1. Thou shall not compare yourself to others: It’s easy to compare your cooking to others’ and feel inferior. Just visit some top mommy food bloggers and you might get that feeling that you’re not doing enough.

When I start to feel inadequate, I remind myself that I’m in this race alone. I have my own preferences, cooking abilities and am doing the best that I can. I look back and remember how far I’ve come — and use those talented food bloggers for inspiration, not another way to feel guilty!

2. Thou shall value food exposure: Let’s be honest — it’s hard when children don’t eat what you cook. It’s enough to make any parent question his or her cooking abilities.

Stop.

Research shows that continued food exposure is the most effective strategy for increasing food variety in kids. So if your child doesn’t eat broccoli, again, feel good that they were exposed to it. With each time they see it — it makes that food familiar and more likely to be eaten in their future.

3. Thou shall care about thine own eating: I think it’s important to put more value on what the adults in the house eat. Hey, if my kids don’t eat veggies, at least my husband and I do — and that counts. And research shows kids eventually eat what their parents eat.

I’ve even started making my husband’s lunch after realizing that I’d been ignoring him. And guess what? It always come back empty!

4. Thou shall not make eating healthy boring: I always consider nutritionwhen making and planning meals but I’ve let go of the “shoulds.” The goal, instead, is to consider taste along with nutrition and learn to blend the two.

I used to serve steamed broccoli but realized I didn’t even like it. Now I roast it or sauté it in olive oil and garlic. They key is to make healthy tasty — and drop the boring standard nutrition fare.

5. Thou shall drop the food agenda: Having kids help you in the kitchen and saying “yum” really loud while eating green beans are all fine if you’re doing it for the right reasons. In her books Ellyn Satter always says kids can smell an agenda a mile away — and I think she’s right.

Whenever we do something to get our kids to eat, they can see right through us, and tend to rebel. Make it a habit to check in with your real reasons for doing something — and when it comes to feeding, keep your eye on the prize.

6. Thou shall not blame thyself for picky eating: When I see a kid my daughter’s age eat the very foods she shuns, those negative voices pop up:

“Maybe there’s more I could be doing?”

“His mother must be a natural in the kitchen.”

“She –” (I try to stop at this point)

I remind myself that much of kids’ eating, including their fear of new foods, is inherited, age appropriate and different for every child. Yes, parents have great influence over their child’s eating but each person learns at their own pace.

After all, how your kid eats at 30 is a better indicator of the job you did feeding, than how they eat at 5.

7. Thou shall not fix it if it isn’t broken: I was talking to a friend who was saying she should change things up in the kitchen.

Her: I see what all those moms are doing and it makes me feel guilty — I should try new recipes and meals

Me: Do you serve a variety of food?

Her: Yes.

Me: Is your cooking low stress?

Her: Yes, it’s only three of us — and my daughter has really stepped up the eating since starting kindergarten.

Me: Maybe there’s nothing to fix.

Her: You think?

Me: Yes. Try new meals if you want to, but don’t do it out of guilt.

8. Thou shall plan meals ahead: Nothing makes me feel guiltier than starting to cook a meal only to find the main ingredient missing or having to run back to the store all week long.

Bottom line: When do a good job of planning meals for the week, everything seems to goes better.

9. Thou shall take time off: We all need a break from the grind of feeding. Whether it be date nights, takeout on those stressful days or opting for the easy meal, little breaks from cooking — and feeding kids — is essential.

I’ve come to know those days that I just can’t cook — and I don’t feel guilty for it because the next day I’m back stronger and better.

10. Thou shall remember that meals are about connection: When all is said and done, and the meal is on the table, or you’re staring at your beautiful baby getting ready to spoon feed him, feeding is really about connection.

I can honestly say that I’ve had the most memorable times feeding my kids. Just yesterday morning at breakfast Little D was saying his numbers, making us all crack up. One, Two, Thee, Sik, Nine, Even. He was purposely messing them up to make us laugh.

When my kids are out of the house, I won’t remember the work or stress it took to make meals happen. Surely, the memories of uneaten meals will fade.

What I’ll remember is the connection it allowed me to have with them — laughing, talking, singing and watching those beautiful faces change as the years go by. When I look at it this way, being the perfect cook and taking the emotional hits that go along with feeding pale in comparison.

How about you? Are you able to enjoy family meals or is the guilt getting the best of you?

Don’t stop here! Other bloggers share their stories and tips on how they juggle the balancing act of getting a well-balanced meal on the table!

10 Commandments for Guilt-Free Feeding – Maryann Tomovich Jacobsen, MS, RD
Beating the Lunch Box Blues – Katie Sullivan Morford, MS, RD
Dinner Time – Michelle Rowe, RN and Health Educator
Eat Better, Eat Together– Jessica Fishman Levinson, MS, RD, CDN
Family Dinners Fuel Healthier Kids – Susan Weiner, RD, MS, CDE, CDN
Families that Cook Together Eat Together – Kia Robertson
Making Time for Family Meals: How I’ve Earned My “RDH” – Trina Robertson, MS, RD
Meal Planning: Taking the Stress Out of the ‘What’s for Dinner’– Laura Everage
Pressed for Time? Moms Know Best: Tips for Getting Food on the Table – FAST! – Samantha Lewandowski, MS, RD, LDN
Roasted Cinnamon Apple Oatmeal – Cheri Liefeld
Sunday Night Family Dinner, In the Dining Room – Jill Castle, MS, RD, LDN 
The Balancing Act – Ann Dunaway Teh, MS, RD, LD
The Power of Family Meal Time & How to Squeeze It In! – Bridget Swinney MS, RD, LD
The Truth About Family Dinner – Sally Kuzemchak, MS, RD
Toughen up: Give Two Choices for Dinner – Take it or Leave it! – Glenda Gourley

Every day Maria served her 5-year-old son the same old thing for lunch. While it was decently healthy — a turkey sandwich with some fruit — she knew his variety was lacking.

Every time she tried something different he threatened her with ”I won’t eat it.” Working out of fear, she resolved herself to making turkey sandwiches.

What Maria didn’t realize was that her son was holding her hostage when it came to food. He threatened not to eat certain items and she gave in. The result? This kid was allowed way too much control over what he ate and his picky eating was getting worse, not better.

4 words that make kids rebel
Most kids start out life eating what we give them — and once they transition to finger foods it’s even better, although messier. Take them to a restaurant and just chop up what you’re having. Steam some veggies, cut them up, and watch then go at it.

This is bliss for any parent.

Around the age of two, but sometimes not until they are a bit older, when growth slows and kids become more mentally aware, they get selective and start refusing some of the food that is offered — and it drives parents crazy.

This is when many of the food battles start. Parents often respond to kids saying they don’t want to eat with 4 words: “Oh yes you will!” Often followed up with, “or else you won’t get X.” And often X is some food that they really want to eat.

This makes the mealtime dynamic a hostile one — and kids naturally rebel. Eating no longer becomes about hunger, fullness and enjoyment but who will get their way. The struggle for power is constantly in play — and nobody wins.

5 words that keep kids and parents stuck
Parents instinctively know food battles are not good — and may give in to their child’s demands. So in this case, instead of fighting with their child, the parent responds with the 5 words: “What else do you want?”

Or in other cases, the parent may stop offering new or previously refused foods and simply makes items that they know their kid will eat. This gives children little opportunity to expand their palate — and it leaves both the parent and child stuck.

So what’s a parent to do?

6 words that get kids eating (or at least changes the dynamic)
When Big A isn’t happy with the meal or snack I’ve prepared she sometimes tries to hold me hostage.

“I won’t eat that,” she says. And I say six words that instantly change the dynamic: “You don’t have to eat it.”

This usually calms her down, reminding her she has some choice in the matter. And if she’s hungry she’ll eat at least something of what I’m offering.

Honor kids’ food preferences without catering
As I’ve written before on this blog, you don’t have to choose between foods your kid likes and foods they don’t like. You can provide both and make everyone happy.

Children do better with eating when they feel like their food preferences are being honored. But this is very different from catering to them. Let your child know that you will provide the foods they like throughout the week but that you will also be serving other foods.

When Big A wants (shall I say demands) cereal every morning I tell her that “we don’t eat the same thing every day, but we’ll have cereal again soon.” And then I remind her that she gets to decide whether or not to eat it.

It’s important to remember that without a bargaining chip, a child can’t hold you hostage. The truth? Kids don’t have to eat the same amount (or at all) at every meal — this is the biggest myth around.

Bottom line: when it comes to feeding, take control of what you can — the food that is offered in a pleasant environment — and let go of the rest.

How do you deal with it when your child tries to hold you hostage?

We were out at our favorite Mexican restaurant when the conversation at the next table caught my ear. A young boy, probably about 4, had only eaten half of his rolled taco and declared he was full.

“You have half of it left, look at all that meat inside,” the mom said. “Finish it!”

The boy went on to finish the rolled taco and the dad chimed in with “I’m proud of you, son.”

What these parents didn’t realize was that they are teaching their son that his fullness doesn’t matter — and that eating more is better.

Do parents really want kids to eat like adults?
I understand why these parents did what they did. I’m sure the boy, like a lot of 4 year olds, doesn’t eat many protein foods so the mom feels better even when he eats items like rolled tacos. He probably has days he barely eats and days he eats a lot — they want his eating to be more “normal.”

The problem with normal eating, at least in this country, is that most people have difficulty navigating the current food environment without over-eating.

Yet most kids do well naturally. Research show that kids under 5 regulate their intake very well. Food intake may vary greatly from meal to meal, but young children are masters at getting the right amount of food for their bodies.

That is, if parents served balanced meals and allow children to be in charge of how much they eat.

Why it’s so hard to raise an intuitive eater
I’m the first to admit that raising an intuitive eater is hard. Society tends to accept the story above — it’s pretty commonplace for parents to get kids to eat more, or less if it’s unhealthy fare. According to a 2007 study published in Appetite, 85% of parents they try to get their child to eat more at mealtime by using reasoning, praise and food rewards.

The biggest challenge, I believe, is the psychological one. As parents we want so badly to nourish our kids that we often get lost in that desire. We fail to see the big picture and the negative consequences that our actions can have over the long-term.

I work hard to make sure my 4-year old (Big A) has an appetite for meals at home. But when we go other places, like out to dinner with friends or parties, she often snacks on what I call “appetite killers.”

When this happens — and it’s finally time to sit down to dinner she usually takes a few bites (or none at all) and is done. People often give me the look that says, “You’re going to let her get away with that?!”

But if I make her eat more of the meal, what am I teaching her? It’s better to over-eat? I do talk to her, ahead of time, about saving her appetite for the meal. And when she says she’s done I make sure to ask her if she’s full.

The bottom line: I make a point to honor her hunger and fullness, even the times I’m disappointed she didn’t eat better, because I want her to grow into an adult who does the same.

Use your kids’ eating behavior as a mirror
We are role models for our kids…they are watching us. Big A will usually come up to me and ask, “Why did you stop eating ice cream.” or “why aren’t you eating.” And I tell her it’s because I’m satisfied or preserving my hunger for the meal.

How often do you fill up on food when out, only to go and finish your meal anyway? Maybe these little kids are on to something.

While kid’s eating-behavior can drive us crazy, the emotion it stirs in us can be used as a mirror to what’s really going on. Maybe we are too controlling with our own diet or eat past fullness and ignore our body’s signals?

Either way, we need to remember that we live in a crazy food environment where single food (restaurant) portions are big enough to feed a family of 4 — and appetite killers are everywhere.

We need, more than ever, to preserve kids’ natural ability to regulate food — and to adopt this approach ourselves. We’ll be much better equipped for eating well in the modern world. And if enough people do it, maybe portions (and appetite killers) will shrink too. I can dream, can’t I?

So tell me, how do you handle your child’s ever changing appetite? Any challenges?

References
Orrell-Valente et al. “Just three more bites”: an observational analysis of parents’ socialization of children’s eating at mealtime. Appetite. 2007;48 (1):37-45

I recently wrote about my 4-year old who only drinks milk from her straw sippy cup wondering when to give them up. A number of you mentioned you had no idea either. So I asked around, did some investigative work and discovered 5 important things parents need to know about starting, using and stopping sippy cups.

1. Start them early: Babies usually start solids by the time they’re 6 months. This is also the time it is okay to introduce water and (diluted) juice. It’s a good idea to get a few starter sippy cups, with handles, lids and a hard spout, to get your child used to the idea that liquids (including milk) can come in something other than a bottle or breast.

While babies will have fun throwing these cups for a while, by 9 months many will start drinking from it. The American Academy of Pediatrics (AAP) recommends children stop the bottle and drink from sippy cups by one year of age.

2. Use sippy cups wisely: Once your child is using a sippy cup you need to use them wisely. According Healthy Children, a website powered by the AAP, avoid using sippy cups as a pacifier or allowing kids to sip on them throughout the day unless its filled with water. Sprout sippy cups filled with milk, juice or juice drinks, allow sugar (even natural sources) to stay in the mouth longer and increase the risk of tooth decay.

This may be why cavities have increased by 15 percent from 1994 to 2002 in children 2-5 years old according to the Centers for Disease Control and Prevention (CDC).

3. Drop the sprout cups ASAP: Traditional sippy cups are only supposed to be used as a short transition to real cups. Overuse of sippy cups can cause more than dental caries, they can also contribute to speech difficulties.

Because children suck on sippy cups the way they do bottles, if used too long, it can change the position of the tongue and teeth, potentially causing lisps and articulation problems. According to this Web MD article, the traditional sippy should only be used for about a month. Using cups with a straw are much better for speech development and dental health.

Bottom line: switch to a straw cup as soon as you can.

4. Encourage kids to drink from regular cups: The AAP recommends teaching children to start drinking from regular cups between 12 and 15 months. Once children master this, you might want to use regular cups at meals and straw cups for water on the go.

Another drawback to young children sucking for too long is something called Oral Myofunctional Disorder (OMD). According to the International Association of Orofacial Myology’s website, the symptoms include one of the following:

1. abnormal thumb, finger, lip, and tongue sucking habits
2. an inappropriate mouth-open lips-open resting posture problem
3. a forward interdental rest posture of the tongue problem
4. a forward rest position of the tongue against the maxillary incisors problem
5. a lateral, posterior interdental tongue rest posture problem
6. inappropriate thrusting of the tongue in speaking and/or swallowing.

These abnormal habit patterns, functional activities, and postures can open the dental bite beyond the normal rest position. This can result in a disruption of dental development in children and over-eruption of selected teeth in adults.

A prime example of an OMD, familiar to all pediatricians and dentists, is a retained sucking habit or use of a sippy cup. While it is tempting to ignore such habits since some children do outgrow them, many children do not spontaneously discontinue noxious habits and will need help in eliminating the habits.

5. Part with sippy cups between 2 and 3 years: According to the AAP Pediatric Nutrition Manual, children are developmentally ready to give up sippy cups by 2 to 3 years of age. Will it hurt to use them to prevent spills once and awhile? Probably not. If your child uses an open cup and some sippy cups with straws it is probably okay.

But just like we advance textures with our babies and let toddlers use utensils, we have to do the same with drinking. It’s an important and overlooked part of development.

Anyone having trouble getting your child to give up the sippy cup habit?

Resources/References

AAP Pediatric Nutrition Handbook — 2008

Preventing Tooth Decay in Children

So long Sippy Cups Hello Straws

IAOM — Dentists and Physicians

I recently took Big A to the hairdresser, and, as usual, she didn’t want to get her hair washed. The hairdresser kept pushing it until I finally said, “Maybe there’s something we could entice you with, sweety.” While I was quickly brainstorming a reward, like a book, the hairdresser quickly chimed in with, “A lollipop — you can’t have a lollipop unless you get your hair washed.”

Before I could say anything Big A moved (more like sprinted) straight into the hair washing seat. As she was getting situated she got scared and told me she didn’t want to do it. The hairdresser said in a sing-songy voice, “Well, then you won’t get a lollipop.” And then Big A checked in with me: “Mom, can I still get a lollipop?”

“Yes, sweety,” I replied. The hairdresser glared at me, with a look of disbelief, and I told her that as a dietitian I can’t use food as a reward and then apologized.

What’s the big deal?
I touched on this topic of using food as a reward in my managing sweets series but I see it happening so often that it bears repeating. The truth? If I didn’t know what I know about nutrition, food and behavior, I would probably reward Big A with food. No doubt it would work. I’m sure she would do lots of things to get the sweet treats she loves — eat broccoli, do chores, be calm at the grocery store and even get her hair washed at the kid salon.

While I think a lot of parents know that using food as a reward isn’t the best strategy – they do it because it works in the short-term. As I discuss in my Best-Kept Secret to Raising Healthy Eaters, when we are short-term focused with feeding, we are more tempted to employ feeding strategies that are counter-productive for kids’ eating down the line.

We know from research that using palatable foods as a reward makes them even more appealing to kids. And on the opposite end, using healthy food as punishment, to get the reward, makes kids less interested in the healthy food.

But the real question, and the purpose of this post, is what does this do for kids’ relationship with food in the super long run?  You know, when they are adults making their own food decisions.

Kids who see food as a reward may turn into adults who seek food rewards
A 2003 study in Eating Behaviors, 122 adults were asked about their current eating habits along with their memories about food rules as kids. The adults who recall parents using food to control behavior through reward and punishment were more likely to use dietary restraint (restricting food practices such as dieting) and binge eat.

As a dietitian who has worked with adults for many years, I’ve seen how this plays out in adulthood. Many of the people struggling with eating and weight often see food as a reward for their hard work and stressful life. In fact, nights, when the busy day is finally done, seem to be the toughest. After dinner, people find themselves back at the fridge often grazing all night.

Is using food as reward or punishment during childhood the cause of this? No. While there is some research showing a link, this doesn’t prove cause and effect. But it makes you think about the association kids make with food, beyond hunger and enjoyment, and how they take this with them into their adult lives.

As parents, we help our kids develop the lens through which they see food. Will they see snacks as something to do when they watch TV or are bored or will they snack as a way to refuel between meals? Will they seek sweets as a reward for their hard work or look for other constructive ways to feel good?

The more frequently parents use food as a reward or punishment, the more likely it is their kids will grow into adults who eat in the absence of hunger. For more on this subject see 5 Times You Should Never Feed Your Kids.

Sometimes parents need a free pass
But just like anything, if we reward or punish children using food once and a while, it probably does little harm. When I was visiting some close friends up in the Bay Area awhile back, I had Big A with me. The kids were done with dinner and getting antsy while the adults wanted to hang out and talk. One of my friends mentioned getting ice cream to hold off the kids. I totally agreed and they joked that Ellyn Satter wouldn’t approve.

I told them she would totally understand that these things happen from time to time. But instead of telling Big A she had to be “good”to get her ice cream, I gave her the choice. I told her we could leave now or we could stay and talk….and get some ice cream of course. And she made the choice to stay.

So tell me, what have your experiences been with rewarding your kids with food? Did your parents do this when you were a kid?

References

Puhl RM, Schwartz MB. If you are good you can have a cookie: how memories of childhood food rules link to adult eating behaviors. Eating Behaviors. 2003: (4) 283-293.

I wrote this post as a participant in the Eat, Play, Love blog carnival hosted by Meals Matter and Dairy Council of California to share ideas on positive and fun ways to teach children healthy eating habits. A list of other registered dietitians and moms who are participating in the carnival will be listed at the bottom of this post or can be found on Meals Matter. Don’t miss the free Webinar on May 18th as we talk about the fundamentals for raising healthy eaters. I’ll be speaking along with Janet Helm, RD, Jill Castle, MS, RD and Andrea Garen, MA, RD. It will be a feeding bonanza!

If there’s one thing that I’ve learned since starting this blog two years ago and becoming a mom, it’s that I don’t have all the answers. I can’t give you the exact formula for turning kids into healthy eaters. But I can, as Oprah says, tell you what I know for sure.

There’s one very under-rated strategy for increasing the chances that your child will grow into an adult who eats well. And by well, I mean someone who eats a balanced diet, eats the right amount of food for their body type, eats sweets in moderation, prepares meals for themselves and is healthy because of it.

What’s the secret?

It has nothing to do with starting them young or hiding veggies or any of the stuff you always hear about. Instead, it’s keeping your eye on the prize and not wavering.

Short term vs. long term
When it comes to feeding, parents have two areas to focus on — short term needs and long term goals. The first, is making sure your kids are fed and meeting their nutritional needs. No doubt this is important. But if you use how our children are eating today as a testament to how you are doing as a feeder, you are likely to be miserable and guilt ridden a lot of the time.

In fact, this pressure to get kids to eat perfectly is what leads to many feeding mistakes. Parents are more likely to pressure kids to eat certain foods or give up entirely. I recently met a mom of a four-year-old who was on the brink of giving up on her child’s eating. (I gave her a really quick pep talk and thankfully she changed her mind).

But if you can keep your focus on the second area, the long-term goal, it changes the game. You will be less tempted to do things to get your children to eat healthy today, but have negative effects long-term. (For more on strategies that back-fire long term, see this post.) In other words, you need to check in with your daily feeding rituals to make sure they are in line with your long-term goal.

Case Study
Maureen K Bligh, MA, RD, is a registered dietitian and mom of two teenage boys, 17 and 18. She remembers all too well what it was like when they were younger and wouldn’t eat meat, rice or veggies (or any mixed dish), but they did eat fruit, milk and bread.

Maureen recalls viewing a video from Ellyn Satter, before having kids, that made a lasting impression. The video showed 5 scenarios of parents forcing kids to eat food and she couldn’t believe her eyes. Her takeaway: “If you force kids to eat they won’t choose to eat those foods in the long run.”

Even though Maureen was not picky when she was a kid — she had two boys that were. And she knew exactly what to do.

She followed the Division of Responsibility of feeding, letting her children decide what and whether to eat of what she decided to serve. Dinner was the toughest meal, as it is with many children, and she made sure to serve it family style, encouraged a pleasant environment, and as a result, heard many, “No thank you mommy, not tonight,” responses.

“I served milk, fruit and bread with each meal,” she adds. “I figured that way they were not going to die.”

When asked if it was difficult she said, “Not really.” It was clear she believed in what she was doing and trusted that one day her children would branch out in the food department.

Then that day came. Her eldest and most picky son, around the age of 8, said four words that made her do the happy dance on the inside: “I’ll have the broccoli.” Maureen says this was the start of his gradually trying more foods, which really took off during middle school.

“I know the experts say it takes 10-15 tries before kids learn to like a food,” she points out. “But I think it takes many more times for some kids, at least that’s how it worked for mine.”

But most importantly her kids will now try anything, are fit, regulate their intake well, eat a variety of foods (from all the food groups) and really seem to value family meals.

Expectations, beliefs and trust about kids’ eating matter
Most parents believe their kids will learn to read novels, drive cars and do other things adults do every day. But when it comes to eating, many lack the same confidence that their kids will eventually learn to eat well. That’s probably why there is so much pushing and giving up and outright frustration about children’s eating.

Maureen admits that if she had not been prepared, or had the right information, she may have been more pushy with her kids’ eating. Instead she kept her eye on the prize – and believed that, using the division of responsibility, eventually her kids would, of their own volition, choose to eat healthy foods – and it has paid off.

Yet Maureen makes it clear that life at home isn’t perfect. Her boys eat more fast food than she would like and deal with peer pressure when it comes to eating. “It’s still a leap of faith in many respects,” she admits.

Yet she is reminded that her children always return to the foundation of healthy eating she has spent years building in her home. When her youngest son was being hassled for having a dietitian mom he responded, “I like it, mom. I like that you feed us healthy food.”

No doubt you will weather many storms when it comes to your kids’ eating because they are in the process of learning — and have a lot of mistakes to make. I certainly don’t love it when my four-year-old responds to an unfamiliar dinner at a friend’s house with, “Do you have any ice cream?”

I know that for her, ice cream (vanilla) always tastes the same and satisfies. The day will come when she eats more of the food in front of her. The belief and trust that my daughter will grow into a good eater is so strong, that it keeps me going, even on the worst days.

How do you keep perspective when it comes to feeding your kids?

Don’t miss the free Webinar: Eat, Pray, Love: Raising Healthy Eaters on May 18th.

Don't stop here! Join the carnival and read other Eat, Play, Love blogs from dietitians and moms offering the best advice on raising healthy eaters. And if you don't get enough today, for more positive, realistic and actionable advice from registered dietitian moms, register for the free, live webinar Eat, Play, Love: Raising Healthy Eaters on Wednesday, May 18.

Feeding is Love, Jill Castle, MS, RD, LDN
5 Quick Ways to Prepare Veggies with Maximum Flavor, Dayle Hayes, MS, RD
The Art of Dinnertime, Elana Natker, MS, RD
Children Don’t Need a Short Order Cook, Christy Slaughter
Cut to the Point – My Foodie Rules, Glenda Gourley
Eat, Play, Love – A Challenge for Families, Alysa Bajenaru, RD
Eat, Play, Love ~ Raising Healthy Eaters, Kia Robertson
Get Kids Cooking, Jessica Fishman Levinson, MS, RD, CDN
Kid-Friendly Kitchen Gear Gets Them Cooking, Katie Sullivan Morford, MS, RD
Kids that Can Cook Make Better Food Choices, Glenda Gourley
Making Mealtime Fun, Nicole Guierin, RD
My No Junk Food Journey – Want to Come Along? , Kristine Lockwood
My Recipe for Raising Healthy Eaters: Eat Like the French, Bridget Swinney MS, RD, LD
Playing with Dough and the Edible Gift of Thyme, Robin Plotkin, RD, LD
Picky Eaters  Will Eat Vegetables, Theresa Grisanti, MA
Raising a Healthy Eater, Danielle Omar, MS, RD
Putting the Ease in Healthy Family Eating, Connie Evers, MS, RD, LD
Raising Healthy Eaters Blog Carnival & Chat Roundup, Ann Dunaway Teh, MS, RD, LD
Soccer Mom Soapbox, Sally Kuzemchak, MS, RD
Teenagers Can Be Trying But Don’t Give UpDiane Welland MS, RD
What My Kids Taught Me About Eating Mindfully, Michelle May, MD