Addressing common concerns about children’s eating habits and weight
Many parents are eager to acquire and use nutritional knowledge to benefit their child’s eating and weight. The reality is that a healthy child has an inborn ability to eat and grow in the way that’s best for him. The first and most important step you can do to help your child’s nutrition is to nurture this ability. In this series, you will learn how to give your child the gift of being able to naturally and easily eat nutritiously and maintain a healthy weight.
Every child is born with the innate ability to self-regulate their food intake. Hunger, appetite, and fullness cues are three naturally occurring mechanisms which can healthfully guide eating choices. Hunger signals when to eat, appetite signals which food category and flavors to eat, and fullness signals when to stop eating. These signals are in sync with one’s biological needs – when a child eats according to her inner cues, she will naturally eat the right amount and balance of food groups.
As long as a variety of foods are available, a child who eats according to her inner wisdom will instinctively and effortlessly consume a balanced diet that promotes her health and growth. The parent must trust the child’s ability to regulate food. This means relinquishing all controlling and manipulative tactics of getting the child to eat specific foods and specific amounts. The parent should take leadership by having set times for eating, serving a variety of foods and eating together with her children. When that structure is in place, the parent should allow the child to choose from what’s available.
Minna, a new mother, tried to manipulate her tiny infant into eating and growing more. Minna increased the concentration of his formula by 30% to provide more calories per ounce. The clever infant clearly knew his fullness point and proceeded to consume an average of 30% less of his formula the following week. Minna stopped concentrating the formula and let her baby eat according to his inner wisdom, and he grew slowly and healthfully in accordance with his genetic makeup.
Your child was created with the innate ability to self-regulate food and instinctively eat an adequate and balanced diet just like Minna’s infant. If your child appears reluctant to eat well you might resort to manipulating your child’s diet as Minna had done. Perhaps you feel your child only likes eating carbs and junk food, or you may feel you have a child who has no desire to eat at all.
These situations are distressing for parents. In some cases, a child truly isn’t eating or growing the way he should. All too often, parents will think their child isn’t eating or growing properly when in reality their child is eating and growing just fine. Therefore, it is important to clarify common misconceptions about how children ought to eat and grow. From there, we determine actual improper eating and improper growth. If your child isn’t eating or growing the way he should, then we need to investigate what is interfering with your child’s natural ability to eat and grow properly.
Common misconceptions about how a child ought to eat can create unnecessary concerns and label non-existing problems. For example, eating a balance of food groups at each meal or over the course of the day is not a realistic or necessary expectation for a healthy child. A child can balance her protein, fat and carb intake over the course of a day or week. Meaning, a child may gravitate to carbs for a few days and then gravitate to proteins for a few days. Over time, most children get all the nutrition they need. Commonly, children will compensate for occasional periods of undereating or overeating. For example, your child might overeat during Chanukah and then instinctively eat less the following few days. A child might eat very little at a meal where she doesn’t like the food and instinctively eat more than usual at the next meal. These patterns are typical and acceptable.
Common misconceptions about how a child ought to grow can also create unnecessary concerns and label non-existing patterns. People come in all shapes and sizes. Your child might be naturally stocky, average, or slim. It is common for larger children to slim out during later childhood. Children under the age of seven who are overweight are more likely to slim down than to remain overweight. It is only at age 9 to 13 that the likelihood of remaining overweight pulls even with the likelihood of slimming down.
If your child’s larger body size persists, this may be her natural size. Ellyn Satter, RD, a childhood feeding expert, has discovered how to analyze children’s growth curves to distinguish unhealthy growth from healthy growth. Unfortunately, misinformed parents and healthcare providers will initiate weight loss for an overweight or obese child who is otherwise healthy and has a healthy growth trajectory. This may backfire because a person’s body will fight to maintain a pre-determined weight range at which it functions optimally. These harmful attempts at weight loss often fail. Weight loss is often regained, many times to levels higher than before.
Additionally, this approach may harm the child’s self-esteem and body image, and possibly contribute to an eating disorder. Research shows that restricting a child’s food intake harms the child both physically and emotionally, and in the long run will likely make the child heavier, not thinner. If a child has unnatural, unhealthy weight gain (or loss) with no medical explanation, the correct approach is to examine your feeding tactics and your child’s resulting thoughts about food, and implement changes in this area.
Poor Feeding Tactics
Poor feeding practices are those which cause a child to ignore inner cues of appetite, hunger or fullness. If you often interfere with your child’s food choices by pressuring her to eat certain foods or amounts, the child will eat in response to you instead of in response to her inner cues. When this happens consistently, the child loses touch with her inner cues and relies on external cues to guide eating. One study on 98 college students found that those whose parents were controlling of their eating when they were children had higher BMI’s as adults. This study demonstrates that manipulating your child’s diet can cause obesity instead of preventing it.
Poor feeding practices can begin as early as infancy. Habitually misusing feeding as a way to calm an upset baby teaches the infant to ignore hunger and fullness cues. Allowing your toddler to access food whenever she wants can cause her to use food for emotional reasons (i.e. boredom, sadness, or anxiety). Constantly coercing your toddler to eat protein and vegetables will cause her to dislike these foods as a response to you nagging her to eat them. Restricting nosh in your house can cause your child to be pre-occupied with nosh and overeat it whenever the opportunity arises. A healthy alternative is to grant your children a healthy dose of freedom with food choices so that they can connect with their inner cues of appetite, hunger and fullness and eat accordingly.
Ellyn Satter’s division of responsibility in feeding states that the parent is in charge of the what, when and where of feeding, and the child is in charge of the how much and whether of eating. This brilliantly defines the parent’s domain of leadership in feeding and the child’s domain of choice in eating. The parent uses her leadership to create an environment where the child can best connect with her inner cues and therefore eat well. In the next series, we will discuss practical tips and insight as to how you can create this ideal environment in your home.
Brochi Stauber is a Registered Dietitian Nutritionist whose goal is to make healthy living a lifestyle reality for individuals and families. In her practice, Brochi combines clinical nutritional knowledge with an understanding of the behavioral science of food, enabling clients to sustain healthy habits which benefit both mind and body. She can be reached at 732-731-9340 or firstname.lastname@example.org.
Shira Francis is a Licensed Marriage and Family Therapist in private practice in Chicago, IL. She provides guidance and counseling in relationships and self-development. Contact her at 773-971-3388 or email@example.com.
 Serdula, M.K. et al. “Do Obese Children Become Obese Adults? A Review of the Literature.” Preventative Medicine 22 (1993); 167-77
 There are some medical conditions and medications that can interfere with appetite, food regulation and growth. This possibility should be addressed by a qualified clinician.
 Galloway A., C. Farrow, D. Martz. 2010. Retrospective reports of child feeding practices,
current eating behaviors, and BMI in college students. Obesity, 18, 1330-1335.