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 broke down sobbing at my daughter’s pediatrician when she was 4 weeks old. She had lost interest in breastfeeding and the good doctor confirmed what I already knew: she was not gaining enough weight.

We struggled through each feeding — and I still couldn’t get my arms around how something so natural could be so painstakingly difficult. I was learning an important lesson in motherhood: feeding my child would take more time, energy and emotional investment than I had ever imagined.

She wouldn’t take the breast and I wanted her to — and therein lies the struggle.

We got through this first crisis thanks to a pump and sheer determination on my part. But the fear that my child wasn’t getting enough to eat, or the right nutrition, would continually rear its ugly head and tempt me to feed in ways that are counterproductive for my kids.

The questions every parent asks
Ultimately every parent asks themselves the following questions: Is my son getting enough to eat? Is my daughter getting too much to eat? Is my son meeting his nutritional needs?

When these questions are confirmed with a low or high body weight, certain food groups that are left uneaten, barely touched meals for days or plates wiped clean with begging for more, the panic sets in.

It’s almost like parents (especially moms) have an alarm that goes off when their child’s eating gets off kilter.

Not getting the right answer
Ultimately when feeding goes wrong we find ourselves in the position I was in at the pediatrician’s office: in search of answers. When I asked the doctor what to do she said to give formula. And that was not the right answer. For me.

You see, I had already done my research. I knew that if I supplemented with formula that my milk supply would go down. But my doctor was trying to save me the time of pumping and even tried to tempt me with more sleep. But I didn’t care about sleep — I just wanted to save our breastfeeding relationship. If I did everything I could, and it still didn’t work out, then I would give formula.

Think of all the not-so-helpful answers you get when you inquire about your child’s eating:

“He’s fine, all kids are picky”

Doesn’t help.

“He’ll grow out of his weight — did you see pictures of me when I was a kid?”

Doesn’t help.

“Don’t worry about it — he won’t starve.”

Really doesn’t help.

One of the reasons these questions arise in the first place is parents are not prepared for feeding. We are usually told to give “kids a healthy start” and “breastfeeding is best” but this advice doesn’t always translate to the real world. Like a lot of pregnant women I spent my time agonizing over my baby registry and the birth itself instead of the thing that would consume me for years after the birth — nourishing my child.

Following intuition doesn’t always work
Without the right preparation and answers to feeding problems, parents make decisions on their own. But what I have found with feeding is that what seems like the right answer at face value often is not. Once you dig in and find all the information, the right answer is usually counterintuitive. Here are some examples:

Your baby/toddler all of a sudden eats less at meals and you immediately offer something else. A better strategy? Because growth slows around 1 year children may not be as hungry, feed regular meals and snacks but let them decide how much to eat.

Your toddler in preschool is a picky eater so you put pressure on them at mealtime. A better strategy? Because pressure makes kids less interested in eating, make mealtimes pleasant and not about what and how much they are eating.

You child has a low weight so you let them graze and eat whenever they seem slightly hungry. A better strategy? Grazing on food means kids never get hungry.  Feed them at regular intervals so they have an appetite for meals (and eat better).

Your school-aged child is obsessed with sweets so you limit them and keep a very tight control when eaten. A better strategy?  Because restricting feeding practices are associated with eating more and increased weight, keep the structure of regular meals at the table but let your child decide how much to eat so they get back in touch with their hunger and fullness cues.

The weight of your school-aged child or teen drops, and you say nothing in the hope that it’s just a stage and will get better on its own. A better strategy? Because early detection means the best chance of success, seek help right away to rule out a possible eating disorder.

Being prepared
Each of the series I’ve written is aimed to help prepare and educate you on feeding, so you can make the best decisions for your family. They include: Meal Planning, Eating Disorder Prevention, Picky Eating and Managing Sweets.

My next series, very timely with National Nutrition Month coming in March, is on Kids’ Nutrition. I believe it’s important for parents to have a basic understanding of their child’s nutritional needs at different stages.

A good understanding of how a variety of foods, and supplements if needed, meet kids’ growing needs can keep that alarm from going off.

So if you have a friend struggling with feeding, send this along. And if you have an idea for a series or article, leave it in the comments.

Most children prefer to eat with their fingers by the time they reach their first birthday.  While the mess is not easy to watch (or clean up), it’s good for toddlers’ development — and it frees up mom and dad to eat right along with their little ones. 

While I’m still in the messy-eating toddler stage, I wanted to compile a list of my all time favorite finger foods.  This list takes into account nutritional needs at this stage, appropriate textures and ease of preparation.   

1. Sweet potatoes: High in both vitamins A and C, sweet potatoes pack a nutritional punch and sweet taste.  To prepare, poke both sides of a washed potato several times with a fork.  Cook in the microwave for 2-5 minutes on each side.  Smaller potatoes take less time while bigger ones take more time.

When done cut the potato in half and let cool.  Spoon out the soft insides and top with butter if desired.  Cut into small pieces and serve.

2. Frozen peas:  A good source of fiber and several vitamins and minerals including iron, green peas make a great food for growing toddlers.  To prepare either cook according to the package directions or let the peas thaw on their own.  It doesn’t get easier than this.

3. Soft meat:  The American Academy of Pediatrics recently released a report saying 15% of kids under 3 don’t get enough ironwhich is essential during the first few years of life.  It’s important to remember that the type of iron in meat is highly absorb-able making it an ideal food for little ones.

Tough meats are not only a choking hazard but are not appealing to small children.  Try cooking meat in the slow cooker to keep it moist.  Good choices include drumsticks, pork and ground meat.

4. Fish: A child’s developing brain needs essential fatssuch as omega-3s DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid).  Since these fats mainly come from marine sources such as fish, it’s an important part of a toddler’s diet. 

Try low mercury sources of fish like salmon, light canned tuna and tilapia, which are also soft and easy to break up into little pieces.  You can also look for fish sticks made with salmon such as these from Happy Baby. For more on feeding kids fish safely, see Kids Safe Seafood.

5. Eggs:With high quality protein, iron, choline, B12, riboflavin and other key nutrients, eggs are the perfect food for toddlers.  You can scramble them with added veggies like sautéed spinach and mushrooms or boil them ahead of time.  Either way, eggs make a quick and nutritious protein source for growing children.

6. Soft fruit/veggies: Fruits and veggies make great additions to any meal.  Cut soft and ripe fruit into small pieces.  Make sure to include at least one vitamin C-rich fruit and veggie daily such as cantaloupe, papaya, mango, kiwi, broccoli, cauliflower and strawberries. 

Steam veggies until they are soft and cut up into small pieces, season and serve.  Make sure to include at least one vitamin A-rich veggie or fruit daily such as winter squash, carrots, cantaloupe, sweet potatoes and spinach. 

7. Grated apple: Apples are usually left out of toddlers’ diet because of their hard texture.  But by peeling the skin and grating apples, you get a nice finger food that, thanks to its soluble fiber content, helps boost kids’ immune systems.

8. Grated cheese: Add grated natural cheese to veggies, beans, eggs and fruit to round out a meal or snack.  Cheese is a good source of protein and calcium and it contains fat which is especially needed the first 2 years of life. 

9. Beans: Rich in protein, B vitamins, iron and fiber and easily picked up by little fingers, beans make an excellent substitute for meat at meals.  Make sure they are soft and cut larger beans in half.  Serve with avocado and a vitamin C-rich fruit or veggie to help increase the absorption of iron.

You can cook straight from the can or soak dried beans overnight and cook them in the crock pot.  Either way, beans are so nutritious and filling, you’ll want them to be part of your child’s diet for years to come.

10. Whole grains: From pastas to iron-rich cereals (like Cheerios) and pieces of bread, there are many whole grain choices to include at mealtime.  Remember that whole grains contain all parts of the grain including the germ and bran, which contain fiber and plenty of nutrition.  Look for “whole grain” as the first ingredient and the Whole Grains Council stamp to let you know you have a winner. 

And please don’t forget about choking hazards.

So tell me, what are your favorite healthy and easy finger foods you feed your toddler?

This may be my last weekly meal plan for the rest of the month — and part of November too.  We will be moving into our new place by the 1st of November and I’m going to be getting to work (I really, really, really want to use this move to get organized). 

That means it will be super-simple meals for our family.  Our new place’s kitchen may not even be ready by the time we move in so we may have to rough it.  But when it’s done it will be nice.

I’m trying some new meals this week.  I’m going to make bean and rice burritos and freeze some for easy lunches.  I’m also going to finally make baked chicken nuggets.  My 4-year old really likes breaded chicken so we’ll see if she goes for the homemade version.  And I found this easy recipe for lentil soup with kale for slow cooker day. 

Don’t forget to check out Org Junkie for more weekly meal plans around the web.

What’s Cooking this Week?

Monday: Bean, Rice & Cheese Burritos

Tuesday: Baked chicken Nuggets,sweet potatoes and green beans with parmesan cheese

Wednesday: Marinated Wild Salmon, mac and cheese and broccoli

Thursday: Slow Cooker Lentil soup, bread, green salad and fruit

Friday: Leftovers/potluck

American Academy of Pediatrics (AAP) Iron Recommendations

One of my goals with this site is to keep my readers informed of the latest public health recommendations.  Last week the AAP released its new policy statement on iron for infants and toddlers.  This report is a revision of their 1999 statement on iron-fortified infant formulas.  The AAP regularly publishes policy statements on nutrition-related topics.  

Background

Even though Iron deficiency (ID) and iron deficiency anemia (IDA) has decreased significantly since 1970, it’s still common in infants in toddlers.  While there are no statistics for children under 12 months of age, according to the AAP report, 6.6% to 15% of toddlers (1-3) may be iron deficient. 

The problem is both ID (iron deficiency without anemia) and IDA (more severe form — iron deficient with anemia) are believed to adversely affect long-term neurodevelopment and behavior that is sometimes irreversible.  That means a child is at risk for not developing normally those critical first years of life.

When babies are born, 80% of the iron stored in their bodies is accumulated in the third trimester. So premature babies, anemia during pregnancy, maternal hypertension with intrauterine growth restriction and gestational diabetes all can cause babies to be born with less-than-adequete  iron stores. 

Healthy term infants with ideal circumstances have iron stores to last them the first 4-6 months of life.  The RDA during the first 6 months is quite low, .27mg/day.  This jumps to 11mg from 6 months to 1 year and then goes back down to 7mg from ages 1-3.

In the first year of life babies go through phenomenal growth where their weight almost triples.  Iron is essential as it transports much-needed oxygen to cells in the body.  While it is absorbed well, the amount of iron in breast milk is not enough to support the rapid growth that takes place when iron stores begin to dwindle.   According to the AAP, iron in breast milk is highly variable and there is no guarantee that it will meet the needs of the baby long term.

AAP Recommendations

The AAP’s aim with the following recommendations is to help prevent ID and IDA from happening in the first place.  Remember to check with your pediatrician.

Preterm Infants (born <37weeks gestation): Should be get 2mg iron/kg* body weight, starting at 1 month and extending through 12 months.  Iron-fortified formula meets these needs but breastfed babies will need to supplement with this amount until they are weaned to formula or can get enough through complementary food.

Term breastfed or partially breastfed infants: Breastfed babies will need to supplement with 1mg iron/kg weight starting at 4 months until iron-rich complementary foods can be started.  Many health organizations recommend waiting until babies are 6 months before starting solids.

Infants 6-12 months: Babies need 11mg of iron from iron-fortified cereals, red meat and vegetables high in iron (see list below).  Whole milk should not be introduced until one year due to its low iron content.

Toddlers 1-3: If unable to get the recommended amount of iron (7mg/day), parents can give liquid supplement or multivitamin with iron.

Screening at one year: AAP recommends pediatricians screen for iron deficiency at one year.  Make sure to check with your doctor at your child’s one year well visit or at any other doctor’s visit if you suspect your child is at risk for iron deficiency.

*to figure out weight in kg divide weight in pounds by 2.2

What do I think?

I think these recommendations are reasonable.  If you have a child under three, become familiar with the iron content of foods and try to meet their needs.  I will be discussing more about this in my upcoming series on helping kids meet their nutrient needs. 

Below is a chart that is in the public AAP paper with iron content of common foods for babies and toddlers along with sources of vitamin C that increase absorption.  It’s especially important to include vitamin C sources if baby is receiving iron from vegetable sources (non heme) as those aren’t absorbed as well. 

Got any questions?  Leave it in the comments!

Amount of Iron in commonly eaten foods — from the American Academy of Pediatrics Clinical Report

Baby food, heme iron (better absorption)
Baby food, lamb, junior, 1 jar (2.5 oz) 1.2
Baby food, chicken, strained, 1 jar (2.5 oz) 1.0
Baby food, lamb, strained, 1 jar (2.5 oz) 0.8
Baby food, beef, junior, 1 jar (2.5 oz) 0.7
Baby food, beef, strained, 1 jar (2.5 oz) 0.7
Baby food, chicken, junior, 1 jar (2.5 oz) 0.7
Baby food, pork, strained, 1 jar (2.5 oz) 0.7
Baby food, ham, strained, 1 jar (2.5 oz) 0.7
Baby food, ham, junior, 1 jar (2.5 oz) 0.7
Baby food, turkey, strained, 1 jar (2.5 oz) 0.5
Baby food, veal, strained, 1 jar (2.5 oz) 0.5

Commercial baby food,a nonheme iron
Baby food, green beans, junior, 1 jar (6 oz) 1.8
Baby food, peas, strained, 1 jar (3.4 oz) 0.9
Baby food, green beans, strained, 1 jar (4 oz) 0.8
Baby food, spinach, creamed, strained, 1 jar (4 oz) 0.7
Baby food, sweet potatoes, junior (6 oz) 0.7

Cereals
Baby food, brown rice cereal, dry, instant, 1 tbsp 1.8
Baby food, oatmeal cereal, dry, 1 tbsp 1.6
Baby food, rice cereal, dry, 1 tbsp 1.2
Baby food, barley cereal, dry, 1 tbsp 1.1

Table food, heme iron
Clams, canned, drained solids, 3 oz 23.8
Chicken liver, cooked, simmered, 3 oz 9.9
Oysters, Eastern canned, 3 oz 5.7
Beef liver, cooked, braised, 3 oz 5.6
Shrimp, cooked moist heat, 3 oz 2.6
Beef, composite of trimmed cuts, lean only, all grades, cooked, 3 oz 2.5
Sardines, Atlantic, canned in oil, drained solids with bone, 3 oz 2.5
Turkey, all classes, dark meat, roasted, 3 oz 2.0
Lamb, domestic, composite of trimmed retail cuts, separable lean only,
choice, cooked, 3 oz 1.7
Fish, tuna, light, canned in water, drained solids, 3 oz 1.3
Chicken, broiler or fryer, dark meat, roasted, 3 oz 1.1
Turkey, all classes, light meat, roasted, 3 oz 1.1
Veal, composite of trimmed cuts, lean only, cooked, 3 oz 1.0
Chicken, broiler or fryer, breast, roasted, 3 oz 0.9
Pork, composite of trimmed cuts (leg, loin, shoulder), lean only, cooked, 3 oz 0.9
Fish, salmon, pink, cooked, 3 oz 0.8

Table food, nonheme iron
Oatmeal, instant, fortified, cooked, 1 cup 14.0
Blackstrap molasses,b 2 tbsp 7.4
Tofu, raw, regular, 1⁄2 cup 6.7
Wheat germ, toasted, 1⁄2 cup 5.1
Ready-to-eat cereal, fortified at different levels, 1 cup _4.5 to 18
Soybeans, mature seeds, cooked, boiled, 1⁄2 cup 4.4
Apricots, dehydrated (low-moisture), uncooked, 1⁄2 cup 3.8
Sunflower seeds, dried, 1⁄2 cup 3.7
Lentils, mature seeds, cooked, 1⁄2 cup 3.3
Spinach, cooked, boiled, drained, 1⁄2 cup 3.2
Chickpeas, mature seeds, cooked, 1⁄2 cup 2.4
Prunes, dehydrated (low-moisture), uncooked, 1⁄2 cup 2.3
Lima beans, large, mature seeds, cooked, 1⁄2 cup 2.2
Navy beans, mature seeds, cooked, 1⁄2 cup 2.2
Kidney beans, all types, mature seeds, cooked, 1⁄2 cup 2.0
Molasses, 2 tbsp 1.9
Pinto beans, mature seeds, cooked, 1⁄2 cup 1.8
Raisins, seedless, packed, 1⁄2 cup 1.6
Prunes, dehydrated (low moisture), stewed, 1⁄2 cup 1.6
Prune juice, canned, 4 fl oz 1.5
Green peas, cooked, boiled, drain, 1⁄2 cup 1.2
Enriched white rice, long-grain, regular, cooked, 1⁄2 cup 1.0
Whole egg, cooked (fried or poached), 1 large egg 0.9
Enriched spaghetti, cooked, 1⁄2 cup 0.9
White bread, commercially prepared, 1 slice 0.9
Whole-wheat bread, commercially prepared, 1 slice 0.7
Spaghetti or macaroni, whole wheat, cooked, 1⁄2 cup 0.7
Peanut butter, smooth style, 2 tbsp 0.6
Brown rice, medium-grain, cooked, 1⁄2 cup 0.5

Vitamin C Sources to Increase Iron Absorption

Citrus fruits (eg, orange, tangerine, grapefruit) Green, red, and yellow peppers, Pineapples, Broccoli, Fruit juices enriched with vitamin C, Tomatoes, Strawberries, Cabbages, Cantaloupe, Potatoes, Kiwi, Leafy Green Vegetables, Raspberries, Cauliflower

The previous article in our series on picky eaters discussed why kids eat the way they do. Now it’s time to step back and consider how the way we feed children impacts their eating habits and food preferences over time.

One quick caveat. This article is not to meant to add to the already overwhelming guilt parents face when it comes to feeding their kids. Instead, the goal of this post is to help parents understand why certain feeding strategies fail and others flourish. When you understand the why behind feeding, it’s easier to make a change.

So with that in mind, let’s review the 10 common mistakes parents make when feeding picky eaters:

1. Catering to kids: Board Certified pediatric dietitian Angela Lemond, RD who blogs over at Mommy Dietitian, said the common feeding mistake she sees in her practice is short-order cooking. These are parents who make another meal when their kids say they don’t like what’s being served.

“Parents are so concerned kids won’t get the nutrition they need that they operate out of fear,” she says. “They don’t realize that letting their kids decide what to eat exacerbates the issue.”

In Child of Mine, Ellyn Satter’s explains it clearly: Making an alternative food so readily available tells your child louder than words can say, “I don’t expect you to learn to eat your meals.” Remember that your child wants to grow up with respect to eating, but she will take the easy way out if it is offered.

2. Not considering children’s food preferences: In our last article we talked about how truly scared kids can be when it comes to trying new foods. So while you don’t want kids to dictate the menu, you also want them to look down at their plate and see something that is familiar.

Christina over at Spoonfed blog said it perfectly in one of her comments: I’m not a fan of “eat-this-or-eat-nothing. So by offering the new items in addition to items you know the kids like (as part of the family meal, not by special order), you avoid that ultimatum while still exposing them to new foods.

3. Asking kids what they want: Does this sound familiar?
Parent: Do you want a turkey sandwich for lunch?
Child: No
Parent: Do you want a quesadilla?
Child: No
Parent: What do you want?
child: The same Chicken sandwich we have at grandmas.
Parent: We don’t have time for that. What do you want???

Young kids exert their independence whenever they can which may be why they tend to reply “no” to food offerings when asked. It’s much better for parents to decide what’s for lunch. Giving picky eaters the choice between two items works well.

4. Feeding on demand:Feeding babies on demand makes sense but it doesn’t work for older children. First off, toddlers don’t always know how to communicate hunger until a meltdown implodes and older kids can use pretend hunger to get what they want (my daughter is always conveniently hungry when we go to Vons where they have free cookies). This type of feeding can also lead to grazing and poor behavior at mealtime.

Jennifer from The Mommy Archives implemented planned meals and snacks with great results: One of my biggest issues with my little guy is that he would literally get up from the kitchen table and exclaim ‘I’m still hungry, can I have a snack?’ The first time I explained to him that I had a snack planned for him later he said ‘OK’ and walked out of the kitchen. It was literally that easy. Planning the snacks has set his expectation that next meal would indeed come and that he couldn’t just snack when he wants to.

5. Over praising healthy eating: If you’ve been following the parenting literature, you’ve probably heard that over-praising kids can have negative effects on their motivation.

An article in Parenting Science does an excellent job of summarizing the research in this area. In the article, Gwen Dewar, PhD, makes this interesting point about praising kids for doing what they love to do anyway.

…suppose that Adam loves to eat broccoli. But every time he eats broccoli, his mom praises him for it. Consciously or unconsciously, Adam starts to question his motivation. Is he eating broccoli only for the praise? Adam changes his attitude toward broccoli-eating. It’s a chore, not a pleasure. If the praise ends, Adam loses interest in eating broccoli.

6. Pushing veggies: When I asked Jennifer Orlet Fisher, PhD, Associate Professor in the Department of Public Health at Temple University, the one thing she wants parents to know about feeding, she said: “The goal should not be to get kids to eat vegetables, it should be to make sure they like them.”

As she discussed in the last article, vegetables are not naturally preferred by kids and take time to be accepted. Instead of pushing the veggies, parents can focus on making them attractive and available to kids.

After all, studies show pressuring kids to eat healthy foods decreases their preference for such items. And which salesman are you more likely to buy from? The one who is in your face, pushing his product or one that sits back with an attractive looking product enjoying it himself?

7. Using food as a reward: A while ago I was reading a blog where the writer admitted to making her kids eat more food, like veggies, in order to get dessert. She said she knew “the experts” say not do this but she does it because it works. Her kids eat their vegetables and that makes her happy.

The question this mom needs to ask herself is will her kids eat vegetables when she is not around? Will they grow up liking vegetables or viewing them as obligation foods, like so many Americans do? 

Research shows that this feeding strategy not only decreases kids’ preferences for the food they are made to eat (usually healthy fare) but it increases their fondness for the “reward” food.

8. Keeping children on separate meals too long: When I recently told a room full of parents that by one year of age babies can eat meals with the family most of the parents looked at me like I had two heads. I told them that the kitchen table is where children learn to eat and the sooner kids can get there the better.

One of the moms from the class sent me an email after making the switch: My daughter is 13 months old and I was shocked to hear she should be eating with us, since she was still eating completely separate meals, very bland, usually pureed. I thought about what you told us and one night figured “what the heck” and gave her a chopped version of our adult food- she ate every single bite and loved it! Now we eat the same food every night, from curry to talapia to tacos.

9. Serving food naked: A reader wrote to me about making meals for her, her husband and her toddler: I need to realize though that a two year old probably will not be interested in plain, broiled fish fillets with steamed, unadorned broccoli.

You may like your food cooked with little fat and sauces, but your child probably doesn’t. Remember, kids prefer energy-rich food so adding dips and sauces (even butter) can aid their acceptance of such foods. We’ll save specific strategies for our next post.

10. Labeling kids as “picky eaters:” The other day at the grocery store I saw a young girl pick up raspberries asking her mom to buy them.

“Why do you want these? You NEVER eat raspberries when I buy them,” the mom replied in a stern tone.

What the mom didn’t understand was that this is how children learn to like different foods. They see it several times, they show interest, they don’t eat if for a while, they try a bite, they don’t eat it for a while, they try it again and so on. She was telling her daughter she didn’t like raspberries but that wasn’t true. Her daughter was going through the process of learning, the same way kids learn to do other things like read and write.

Lemond recently relished watching her picky-eating son take the last step in learning to like a food. Her daughter was eating carrots with dip and her son dug right in. “The process works but it takes time and patience,” she said.

This is why I like the Ellyn Satter Division of Responsibility so much. It keeps things simple — parents decide the what, when and where of feeding and kids decide the whether and how much of eating. Feeding problems typically occur when parents try to take over the kids job or children are allowed to take over the parents’ job.

Don’t miss our next — and final — post in our picky eating series where we’ll go beyond the Division of Responsibility and discuss specific, proven ways parents can help their kids grow into good eaters.

Previous: 8 Things Picky Eaters Wish Their Parents Knew

References/Resources:

Tanofsky-Kraff M, Haynos AF, Kottler LA, Yanovski SZ, Yanovski JA. Laboratory-based studies of eating among children and adolescents. Curr Nutr Food Sci. 2007;3(1):55-74

Picky Eaters — Ellyn Satter, MS, RD

Q: After trying for 6 months, my 2-year old daughter refuses to drink milk or eat yogurt.  I’m worried that she’s missing out on nutrients by not drinking milk.  Can you please let me know what the impact of her not drinking milk is and provide some suggestions as to what I should be providing her via vitamins and/or food to make up for any deficiencies? 

A: The most important nutrients in milk are calcium and vitamin D.  Milk also has potassium, phosphorus, vitamin A and B vitamins but those are not difficult to find in other foods.  At age 2 your daughter only needs 500mg of calcium daily.  Because 1.5 oz of cheese contains 300mg, 2 ounces of cheese would almost get her there.  See this list for nondairy sources of calcium.

You can also try fortified orange juice and smoothies with yogurt/milk.  But because your daughter is only a toddler, I would continue to offer her milk with meals and with her cereal.  When she gets older her calcium needs will go up and dairy is a great way to help her meet her needs.

Even kids who drink milk may not get enough vitamin D so talk to her pediatrician about supplementing with vitamin D ( 400IU).  I like the Carlson D drops because you can just put it in food or drink and it has no taste.

I plan to talk more about the calcium needs of kids and adults in my upcoming “Nutrients Even Healthy Kids Miss” series.

The information on this site is for educational purposes only and does not take the place of medical advice. Please verify with your healthcare provider.

“I know what to do, I just don’t do it.”

As a dietitian of almost 15 years, this is what I’ve heard most often from clients. Many people feel guilty for not following the healthy eating advice that is virtually everywhere.

What most people don’t realize is that “what” they eat is the wrong place to start. It’s more important, in my opinion, to focus on “how” to eat first.

For those new to Raise Healthy Eaters, this is our parent tip series. The idea is to help parents become more positive role models for their kids — one of the three essentials for raising healthy eaters. For more details see Parent Tip #1.

How you eat is vital in helping you develop a healthy relationship with food, eat well and maintain a healthy weight. But as a parent you have the added advantage of having kids to learn from. Let me show you what I mean.

Do Parents or Kids Know Best?
In our society it is generally accepted that parents know what’s best when it comes to nutrition and eating. I believe this is only half right. Parents are better equipped than children to make value judgments for food choice meaning we consider nutrition, taste and variety.

But what young children do very well is eat the right amount of food that they need. Research shows that infants and toddlers are particularly good at regulating food intake. But as kids get older they tend to lose this skill. No one knows exactly why but it probably has to do with feeding practices, the environment and a whole slew of other factors that teach children to eat for external reasons (eat in the absence of hunger, finish what’s on the plate, visual cues etc.).

In a 2007 study published in Appetite, 85% of 142 families interviewed said they try to get their child to eat more at mealtime by using reasoning, praise and food rewards. The authors argue that parents may be teaching their kids to eat past their internal hunger and satiety cues.

A Case Study
I had the pleasure of talking to Katja Rowell, a physician whose mission is to help families bring peace and joy to the family table (see Family Feeding Dynamics). When her daughter was born almost ten-pounds, she was worried and wasn’t quite sure how best to prevent weight problems.

“I struggled with how best to feed her,” she says. “But once I understood the feeding process and got the right information it helped me relax and feed her from love, not worry. I learned what I had to do to support her internal skills. She knew how much she needed to eat so that she could grow in a healthy way.”

Rowell trained with Ellyn Satter and applied the Division of Responsibility of feeding. But she didn’t stop there. She took what she learned about feeding her daughter and applied it to herself.

Even though she wasn’t overweight, like a lot of adults she struggled with her favorite “forbidden” foods that she found hard to eat in a healthy way. She explains how, pre-kids, a bag of Tostitos wouldn’t last in her house for more than two days. She denied herself sodas as “empty” foods, only to crave them and drink more when she had the chance. Her vices: coke and salty foods.

But that changed when she saw her daughter intuitively eating and stopping when she was full – even with favorite foods.

“I’d watch her turn down food when she was full and leave cake unfinished,” she says. “I thought to myself, if she can do it why can’t I?”

So Rowell stopped denying herself salty foods and soda and allowed them back in her diet in a non-judgmental way. At first she often ate chips for lunch and drank a soda most days. It wasn’t long before she found that they could sit in her fridge or cupboards for weeks. She paid more attention to hunger and satiety cues, continued to eat regular meals and found herself more at peace with food.

“I’m a more comfortable and competent eater now,” she says, “and my daughter was the inspiration.”

What to do?
As Rowell demonstrates, learning how to focus inward may be as easy as using your kids for inspiration. Here are some tips and things to think about:

-Instead of zeroing in on what and how much your kid is eating, give your meal your full attention. Are you eating slow enough to enjoy every bite? Do you stop when you’re full or go past that signal?

-When your child goes too long without eating he or she might throw a tantrum. Recognize your own adult-like tantrums. Do you forget to feed yourself only to have hunger come back with a vengeance at night time?

-Notice how your kids enjoy foods like sweets without guilt and do the same. If you crave a non-nutritious food, have it without judgment but sit down and be present for each wonderful bite.

-Watch out for food associations that cause you to eat in the absence of hunger such as eating while watching TV, when bored or for comfort.

Has having kids changed the way you eat? Do you focus on your internal or external cues to tell you when you’re done eating? I’d love to hear from you.

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 spoke with a woman recently who told me that she was a skinny, picky-eating kid. Food was always an issue at her home and her concerned parent constantly brought her to the doctor (who had her take a slew of vitamins). Now, many years later, she’s battling her weight right along with her siblings.

Lately I’ve been talking to a lot of moms about picky eating. While some toddlers are more prone to being finicky, most children will go through this stage to some degree. It’s a very normal part of development. Luckily, there’s a book to help moms deal with this challenging stage of development.

Child of Mine: Feeding with Love and Good Sense is the last of the Ellyn Satter books I plan to review. And it happens to be my favorite. Satter explains each stage of development as it relates to eating starting at infancy and moving through the preschool age. Unfortunately she stops at age five so moms of older children miss out.

In addition to being a dietitian, Satter is a Licensed Clinical Social Worker (LCSW). Her real-life accounts of families struggling with a variety of eating problems help the reader immensely. While most of her advice comes down to the Division of Responsibility of feeding (parents decide the what, when and where of feeding and children decide the how much of eating), understanding the big picture of childhood eating will certainly enlighten any mom.

This book taught me that how I feed my kids is as important as what I feed them. While following her advice has not been easy, I’ve already seen it pay off. I have to admit there have been times when I’ve wanted to tell my daughter “come here and finish your dinner missy!” But if I did that enough, she’d learn to eat for the wrong reasons.

The downside to Child of Mine is that some of the nutrition information isn’t up-to-date because it was published in 2000. But the advice on how to feed is right on.

Have any picky-eating stories to share? We want to hear from you!

Subscribe to Raise Healthy Eaters (or tell a friend) for more product and book reviews.

You hear a report about school-aged kids’ poor nutrition and think “that’s so far away” for your little baby or toddler. But because most food learning occurs during the first 5 years of life, what you do from day one can affect your child’s health – and what they eat – when they get older.

So let’s go through each of the stages of growth and see how you can increase the odds that your kids will grow up to be healthy adults.

Infants: Birth to 6 months:
Everyone knows that infants need breast milk or formula the first few months of life. While breast milk is still the preferred nutrition source, formula is a good second choice.

Nutrition highlights: The AAP recommends 400IU of vitamin D* daily for breastfed infants. Nursing moms who don’t eat fish should consider fish oil supplements that contain at least 300mg of DHA* because levels in breast milk are directly related to mother’s intake. Many formulas are fortified with DHA to enhance brain health.

Feeding Tip! Try not to overfeed or underfeed your baby. If baby is crying and feeding time was recent, try other ways of soothing before feeding. On the other hand, if nothing else will calm your baby, by all means see if they need milk. Basically, let baby – not a schedule– guide you in how much milk he or she needs.

Infants: 6 to 12 months
At 6 months babies’ iron stores deplete and they need nutrition from additional sources. This is a time of rapid food transitions starting with watery-textured food, gradually increasing to puree, advancing to lumpy puree and finally moving up to soft, cut up finger foods. See our Infant Feeding Guide for step-by-step advice.

Nutrition highlights: After 6 months, babies will need more than half of the following nutrients from complementary foods: Iron (iron fortified cereals, meat), vitamin D (supplements, formula), B6 (cereal, whole grains, enriched grains), niacin (cereal, egg yolks, turkey), zinc (some cereals, meat), vitamin E (vegetable oils, avocado, cereals) and phosphorus (cereal, fish, meat and eggs).

Feeding Tip! Most babies are accepting of a variety of tastes and textures so take advantage of it. Research shows that the more flavors introduced early in life, the more likely it is children will accept new foods later. Remember, this is a rapid transition time so when your child is doing well step up the texture to guide him or her to the next stage (without forcing of course!).

Toddlers: 1 to 3 years:
Toddlers under 2 still need a high fat diet (30-45%) including whole fat dairy products. After one, children are either drinking whole milk (2-3 cups per day) or breast milk (after 2 they can switch to low fat dairy). If a toddler has progressed to finger foods, he or she can eat what the whole family eats, but watch for choking hazards. Gradually increase the consistency of food as they get older, cut up food into small pieces and always supervise at mealtime. See Toddler Feeding Section for more detailed guidance.

Nutrition highlights: Children under 2 are still at risk for iron deficiency so include iron-fortified cereal with a vitamin C-rich fruit or veggie (cantaloupe, tomatoes, strawberries, oranges, kiwi and broccoli), green veggies and meat. After turning one, growth rate decreases. Somewhere between 18 months and two years of age, toddlers get skeptical of certain foods. Babies no longer drinking DHA-supplemented formula or breast milk can get the DHA** by eating fish including salmon, light tuna and halibut.

Feeding Tip! Eating a variety of foods takes time and repeated exposure just like other learned behaviors (like reading and writing). Protect your child’s natural ability to self-regulate food by providing regular meals and snacks and letting them decide “how much” to eat. Instead of eating special food, toddlers greatly benefit from eating with the family.

Preschoolers: 3 to 5 years
If you’ve continued to expose your little ones to a variety of foods without trying to get them to eat less or more, you’ll watch them grow in to more adventurous eaters. On the other hand, if there’s been ongoing tension at the table their eating habits may get worse. For more specifics on what to feed see MyPyramid for Preschoolers.

Nutrition highlights: This is a time when kids become more independent, notice what their friends are eating and start to eat food outside of the home. Studies reveal that children at this stage are more likely to eat higher quantities of fat, saturated fat and sugar from sweets and sweetened beverages. It’s important to maintain balanced meals and snacks at home to reinforce the foundations of healthy eating.

Feeding Tip! Preschoolers want to be just like their parents so eat with them as often as possible. This is the perfect time to have your child help pick out food and prepare dinner – skills they will need later in life!

School-aged Children
Once your child is in school full time they will be eating more meals outside the home. Much of the work you’ve put in will start to pay off. If you’ve made mealtimes pleasant and provided your child with a variety of foods – without being controlling – they are likely to be competent eaters outside of the home. For more specifics on nutrition needs at this stage see MyPyramid for Kids.

Nutrition highlights: Research surveys reveal the five nutrients most likely to be low in school-aged children are vitamin E (nuts, seeds and vegetable oils) calcium (dairy products), magnesium (nuts, whole grains, beans), potassium (dairy, fruits, veggies and whole grains) and fiber (beans, whole grains, fruits and vegetables). After age 8, calcium needs increase (e.g., 3 cups of milk products daily). 80% of school-aged children do not consume the recommended amount of fruits and vegetables. Sweetened beverages often replace milk as the beverage of choice.

Feeding Tip! Adolescents who eat dinner with their family on a regular basis have better diets and lower weights than those who don’t. Serve fruits and vegetables with every meal and have the family eat together most nights.

*The AAP recommends all kids drinking less than 4 cups of milk day be supplemented with 400 IU of vitamin D.

**Most children and adults do not consume enough DHA and EPA from fish sources. If you and your children do not consume fish a couple of times per week talk to your doctor about supplementation.

Subscribe to Raise Healthy Eaters (or tell a friend) for more child-feeding tips.

References
Butte N, Cobb J, Dwyer J, Graney L, Heird W, Rickard K. The start healthy feeding guidelines for infants and toddlers. Journal of the American Dietetic Association. 2004;104(3): 442-450.

Krebs NF and Habidge MK. Complementary feeding: clinically relevant factors affecting timing and composition. American Journal of Clinical Nutrition. 2007;85(2):639S-645S.

AAP Vitamin D Recommendations

Birch SR, Daniels MW, Gilman AH, Lichtenstein KT, Steinberger J, Stettler N, Van Horn L. Dietary recommendations for children and adolescents: A Guide for Practitioners. Pediatrics. 2006:117:544-59.

Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal by Ellyn Satter, MS, RD, LCSW.