Part 3. The Rule
As we’ve seen, the problem isn’t the picky eating, per se. Kids are getting enough calories, and they’re certainly growing big enough. Even the skinniest kids in today’s world are far healthier and have far better nutrition than most of the kids from previous generations. And I certainly haven’t seen health problems in the slender kids in my practice. What I see very commonly, though, are health problems from overweight: diabetes, high blood pressure, depression, and social isolation.
So, no matter what else, the first principle of healthy family eating should be to help foster a child’s own normal sense of appetite and hunger. This is The Rule of mealtimes. It’s The Truth, and The One Ring to rule them all:
- If you’re hungry, eat.
- If you’re not hungry, don’t eat.
(OK, so it’s two rules. Close enough.)
Humans have a built-in mechanism to control food intake, and it works well at every age. It’s called “hunger.” Often, though, we unintentionally raise our kids in ways that teach them to ignore their appetite cues and eat for all sorts of other reasons.
Think about it. In American culture we don’t just eat when we’re hungry. We eat to celebrate. We eat when we watch a movie, we eat when we’re on the phone. We eat when we’re upset, and we eat when we’re bored. We eat when we’re happy and we eat when we’re sad. Often, we eat because others encourage us to eat. Family and friends ply us with food, and mom loads up our plate. We also have to contend with an ever-present marketing effort to get us to eat even more. Most two-year-olds already recognize “The Golden Arches”, and TV and computer banner ads are a near-constant barrage encouraging us to eat. And eat. And eat.
In a way, I’m surprised obesity isn’t more common.
Let’s not make matters worse. From a very early age, encourage your children to manage their own appetite. This means that a nine-month-old who becomes less interested in nursing should be allowed to wean. And a two-year-old who wants to explore instead of cleaning his plate should be allowed to leave the table. When a child doesn’t have an appetite to eat more, do not try to trick or fool or guilt or otherwise “get him” to continue eating. Lacking hunger means the child has eaten enough. Meals shouldn’t end when mom or dad thinks Junior has had enough; meals should end when Junior thinks he’s had enough.
In fact, from The Rule flows two other rules which guide the roles of children and parents at mealtimes:
- Parents should offer healthful foods in an appropriate manner.
- Children decide which foods to eat, and how much to eat.
Simple! Or at least simple to say, and simple to understand. That doesn’t necessarily mean it’s always easy to do!
Part 4. The jobs of parents and kids
There are things you can do, and things you can’t do. Among the fundamental things that parents cannot do are three things that drive us all crazy.
- You can’t make ‘em sleep
- You can’t make ‘em poop
- You can’t make ‘em eat
It’s just true. If you’re looking for a power struggle, go ahead and try to fight one of those three fights. I’ll wait here.
Back so soon? Don’t be discouraged. Remember: the point of parenting isn’t to win, and it isn’t to dominate, and it isn’t actually to make your child do The Right Thing. The point is to raise a child—to help him or her become an adult, capable of making decisions (hopefully the right ones!) To make a decision, it has to be possible to make the wrong decision. Children need to learn to make even the wrong decisions on their own.
This series of posts started with Melissa’s simple question about what to do with her picky eater. In this part, we’ll focus on what the parents’ and kid’s jobs are at mealtimes. Remember: our goal is to reinforce good habits that will help Junior continue to make good eating choices for the rest of his life. The parent’s job is to offer healthful foods in a appropriate manner, following these steps:
1. Parents set the menu.
Choose a handful of different food items for the meal. Once your child is old enough (usually around nine months of age), he or she should be able to eat most of what mom and dad eat (it’s messy, but fun!) If one or more of the items is in the category of “foods Junior usually likes”, that’s fine. For instance, if your child really likes yogurt, it’s perfectly fine to make yogurt part of most—or even every—meal. Just put it on the table. Don’t make any of the foods belong to any of the people at the table—there should be no “Junior food” or “Mommy food.” If Junior wants some of mom’s anchovies, or mom wants a few of Junior’s chicken nuggets, that’s fine. All food comes out of shared serving dishes.
2. Parents sit and eat with their children.
You can’t expect your child to learn table manners and good eating habits if he’s eating alone at the breakfast nook. Mealtimes are together times.
3. Parents turn off the TV and talk with children during mealtimes.
Don’t talk about the food, unless it is to thank the preparer. Talk about other things.
4. Parents set a good example.
Put a variety of things on your plate, eat slowly, and drink water with your meals. Use a fork. Smile and enjoy yourself. Do the things you want your child to do—but remember, you’re teaching by example. Don’t nag your kids during meals.
Kids have it a little easier. They have only three jobs:
1. Children decide which food items to eat, and how much of which to eat.
As long as it’s on the table at the start of the meal, kids can choose to eat it: a lot of it, a little of it, or none of it. What children should not expect is to get things that are not on the table. Parents choose the items in the meal, then kids decide which of those and how much to eat.
2. When old enough, kids should help with the prep and clean up.
This can include shopping for foods, picking out menus, cooking, clearing the table, cleaning the dishes, everything. Get them to help in the vegetable garden and take scraps out to the compost pile. It’s all work for the family to do.
3. Kids should say “thanks” afterwards. A kiss for the cook is nice, but not required.
There are other benefits to the “family meal.” In addition to reinforcing good meal habits, preventing obesity, and encouraging a variety of foods, family meals help kids be more successful in school and help prevent drug use and family violence. Don’t turn meals into a struggle over whether your child is getting enough rhubarb. Enjoy your meals together by not focusing on just how much is being eaten. You’ll have a better time—and you’ll end up with a healthier-eating child, too.
Part 5. Special circumstances, vitamins, a backup plan, and a muffin bonus
We’ve been talking about how to handle mealtimes to help prevent and deal with food pickiness—but without really concentrating on getting the child to somehow eat more of the foods he doesn’t want. That’s because 1) you can’t actually make a child eat something he doesn’t want to eat, and 2) even if you could, it’s still not a good idea. We’re trying to develop healthy habits to last a lifetime, and we’re no longer really worried about how many brussels sprouts are consumed at an individual meal (if you are still worried about that, start over.)
There are some special situations that ought to be mentioned. This discussion has been about developmentally and neurologically normal children. If your child has autism or other developmental challenges, some modifications of these instructions may be needed (though philosophically, it’s even moreimportant to reinforce and teach independent feeding skills to children with developmental disabilities.) Likewise, some medical problems can lead to problems with eating that are beyond the scope of these posts. If your child is not neurologically typical, you ought to get more-specific instructions from your pediatrician or other health expert who knows your child well.
One issue that seems difficult to work around is parent’s worry that a lack of vegetables will lead to serious health problems from vitamin deficiencies. As it turns out, so many foods in the USA are fortified with vitamins that deficiencies are almost unheard of—but still, there’s a worry, and it’s led to a proliferation of overpriced, overhyped supplements that supposedly replace fruit and vegetable intake. Don’t fall for the advertisements. If you can’t help but worry that your kids aren’t getting vitamins, have them take an inexpensive generic multivitamin every day. There is zero benefit to any premium or expensive vitamin—a chemical is a chemical, and your child’s body doesn’t care how much you paid for it.
There also is an understandable need for some parents to have some kind of “back up plan” when a meal completely falls apart. As I’ve said, I think it’s fine for a child to choose anything they want off the table—so if a meal includes spaghetti/meatballs/sauce/broccoli/garlic bread, and all the child wants is plain spaghetti or plain bread pulled off the back of the garlic bread, it’s OK with me. Still, it can be difficult for many parents to let a meal go by without Junior eating much. So, if you’re one to worry, you can offer the following “standing rule”: IF Junior wants to, he can go get a backup meal himself.
The backup meal must be a single item that’s always available, and it should be something the child can prepare himself. A bowl of cereal is a good choice, or plain bread with butter. The backup should be one simple thing, and it’s crucial that mom or dad not have to be the one to get up and deal with it. That would ruin the parents’ meal, and that’s not fair. I’m not sure a “backup” is even needed—kids will in fact eat when they’re hungry—but if parents feel that they need a backup, that’s the way to do it. By the way, we’re talking reasonably-healthy cereal, here. Not one with little marshmallows.
This series started with a question about picky eating, and ended up becoming something much more: a short guide to how to feed your children and your family in a way that will help your children make good food choices for the rest of their lives. At the same time, the “family” meal plan, with separate jobs for parents and kids, should help make mealtimes more enjoyable and fun for everyone. Remember: picky isn’t the problem, and your job is not to get your kids to eat more! Now go cook something fun and enjoyable with your kids, like our family favorite: Banana-Chocolate Chip Muffins!
- Cream together 1 stick butter and 1 cup sugar
- Mash into the bowl 3 over-ripe bananas
- Mix in: 2 eggs, ¼ cup yogurt, 2 tsp vanilla extract, 1 tsp baking soda, 1 tsp baking powder, pinch salt, 1 ½ cups whole wheat flour, a good handful of chocolate chips (cook’s helpers get to eat a few)
- Pour batter into about 18 muffin cups. Bake @ 350 for 16-20 minutes. Enjoy with milk!
© 2012 Roy Benaroch, MD
(These blogs were originally posted on http://pediatricinsider.wordpress.com/
