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E22 Kids and eating - Can they be trusted? Considerations, challenges, and solutions with picky eaters, intuitive eating, and the current food environment with Jennifer House, RD
50 Plays1 year ago
On this episode of EBTL, we are diving into the complexity that is TRUSTING your kids and HOW to do so with the many caveats that arise as a kiddo engages with food in this world.
My guest Jennifer House is a Registered Dietitian, mother of 3, author of “The Parents’ Guide to Baby-led Weaning” and founder of First Step Nutrition in Calgary, Alberta.
Jen believes raising happy, well-nourished eaters who have a healthy relationship with food doesn't have to be a battle! She helps parents teach their kids to try new foods without yelling, tricking, or bribing.
This is such a hot topic and such a challenging course to navigate for so many parents - it is a must listen to get some guidance and next step solutions to help create clarity and ease with the obstacles that arise around kids and a healthy relationship with food.
Please remember everything you hear on the EBTL podcast should not be taken as medical advice and to please consult your practitioner before making changes to your healthcare plan.
theresemartinezrd.com - get your FREE guide on how to improve your hunger cues!
Find Jen here:
Picky Eater Action Guide: How to use nuggets & fries to teach your kids to try new foods: https://jennifer-house-7cf2.mykajabi.com/food-chaining
Website and blog: https://www.firststepnutrition.com
Instagram: https://www.instagram.com/firststepnut
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Transcript
Introduction to Breaking Free from Diet Culture
00:00:01
Speaker
Hello and welcome to Eating Between the Lines. I am your host, Therese Martinez, and I am so happy to have you here. If you want to untangle yourself from diet culture conditioning and get appropriate, actionable options to nourish your unique life and body, I'm going to dive deep into the nuanced spectrum of health to help you figure out what to prioritize in your journey
00:00:25
Speaker
without getting trapped in the extreme ideology of health optimization or total complacency. I am here to help you apply the science effectively, not rigidly, and get you feeling better in your body and mind.
Guest Introduction: Jennifer House on Raising Healthy Eaters
00:00:40
Speaker
Here is how to eat between the lines.
00:00:46
Speaker
Hello, everyone. Welcome back to Eating Between the Lines. Today, I am very excited to dive into a topic that is a little bit less familiar for me, but very familiar for so many of you. And I'm going to be doing this with a very special guest.
00:01:09
Speaker
Welcome, Jennifer House. How are you? I'm great. Thank you so much for having me. Of course. So Jennifer is a fellow registered dietitian, mother of three, author of The Parent's Guide to Baby-Lead Weaning, and founder of First Step Nutrition.
00:01:30
Speaker
She lives in Calgary, Alberta. Jen believes raising happy, well-nourished eaters who have a healthy relationship with food doesn't have to be a battle. She helps parents teach their kids to try new foods without yelling, tricking or bribing.
00:01:47
Speaker
I am so excited to dive into this today with you.
Why is Raising Children with a Healthy Food Relationship Important?
00:01:52
Speaker
How are you doing on this Tuesday? I'm doing great. The sun is shining here in Calgary. We have a bit of snow, but I love talking to fellow RDs. And I think that this topic of feeding pick eaters or feeding children can work really well with your work with adults.
00:02:09
Speaker
not that I don't want you to have clients, but you know, the goal is for parents to raise kids who are naturally intuitive eaters when they grow up. Yes, yes, totally. Such a fascinating and interesting topic. Well, we were just talking about this too, where I have so many patients that have themselves struggled with their own
00:02:30
Speaker
knowing essentially when it comes to food, you know, there has been an evolution of distrust with their own food choices. And it's created a lot of turmoil for their psychology, their relationship with food, their relationship with body, all of that. And I know that
Social Media Pressures on Parenting Healthy Eaters
00:02:48
Speaker
so many of them that have kids
00:02:51
Speaker
are really trying to understand how to best support a healthy relationship with food for their children to the best that they can influence prevention of those types of conditions and relationships from what they experienced.
00:03:10
Speaker
I think so important. So so so important, especially with the nature of the world right now. And at least like what I have seen on social media, and the pushing of certain ways of eating and the pressures and oh my gosh, just parents in general, I find like, what a
00:03:31
Speaker
What challenges that come raising kiddos in the way that you would deem the best to? I don't know. There just seems like so many external influences in this realm.
00:03:45
Speaker
Anywho, let us get into this.
Jennifer's Background and Personal Influence
00:03:48
Speaker
So talk to us a little bit about your background, how you got into working with kiddos. Sure. I went into university to become a dietitian right out of high school. I just thought it would be useful knowledge and career to have throughout my whole life, you know, for personally, no matter my life stage, which is proven to be accurate.
00:04:09
Speaker
And after graduating, I worked part time at a children's hospital and outpatient. So I was seeing a lot of failure to thrive babes or picky eaters. And then I have three kids myself.
Challenges with Picky Eaters and Solutions
00:04:20
Speaker
So once I had my first child, I decided to stay home, start a private practice for more flexibility, but still working in that pediatric field where some of my background was. And also now I was personally interested in now that I had my own kiddos. Um, and one of them turned out to be a picky eater, of course, right?
00:04:38
Speaker
don't just come off easy just because we have the training. So that was, you know, some good practical training, absolutely. But I just see how, how many parents do struggle with this, you know, over 50% of kids can be picky, and the most common tactics that parents use
00:04:58
Speaker
probably that we were raised with, just don't work towards creating those peaceful dinner times, you know, those good memories where everybody wants to come to the table, they do the opposite. And they can also harm the child's relationship with food and their body.
00:05:14
Speaker
for the rest of their life. So obviously, that's a lot of pressure, right? But there are lots of simple things that we can do to help raise kids who have a healthy relationship with food and love food and their body. And that's, I guess, my mission to help parents do that for their kids. Yeah, absolutely. So how old are your kids now?
00:05:39
Speaker
The eldest is 16, 13 and nine. Okay, okay. Have you noticed shifts in your approach through the years kind of like from child one to two to three and then kind of the evolution? I'm just kind of curious what you've seen change over the years in terms of maybe your own personal approach too.
00:06:05
Speaker
Yeah, absolutely. So I think back to those days before I had kids, and yet I was counseling parents on pick eaters. And you know, some of my recommendations are kind of cringy. Because if you haven't been there, like we were mentioning, it is hard to know. And as I've worked in this area for, you know, 15 years, I've been able to learn so much, some of which I did learn from my daughter, right? Like I found out eventually when she was four years old, she was low in iron.
00:06:33
Speaker
And that can cause picky eating. So now I make sure to do a deep dive into maybe underlying reasons why the child might be picky.
00:06:42
Speaker
implementing the Division of Responsibility, which we can talk about, but I've always taught that. And then sometimes going beyond that as well. So I have extra training in some feeding therapy like food chaining or sequential oral sensory food play, which is just play with the purpose. So we can also go beyond the Division of Responsibility, which not all children will need, but can be helpful for some.
00:07:05
Speaker
Yeah. Okay, so I would love to kind of get into this a little bit, maybe with first just painting a picture for some folks with maybe some case study types of examples.
00:07:20
Speaker
and approaches you would take to kind of help a person with peak eating. And I'm really curious too on the angle of trust that parents can also have with their kids to make the appropriate decisions for themselves. So if we kind of do maybe a play by play, say you have a patient that comes in
00:07:42
Speaker
And, you know, is having a hard time consuming and what would you say would be maybe most common, like consuming enough food, consuming a variety of food? What would be like kind of top concerns that would be commonplace?
00:07:59
Speaker
Probably both. Parents are concerned their children aren't eating enough, which isn't always necessarily the case. And again, they're often concerned their child's not eating enough variety or getting in enough nutrients, which sometimes is true and sometimes it's not. So, you know, kids don't eat meat, they don't eat vegetables, but sometimes you get a child that comes in and they only eat, you know, five different
How to Assess and Address Nutritional Concerns in Children
00:08:21
Speaker
foods. So it can be extreme as that, or it can be a child who is actually getting in enough
00:08:26
Speaker
volume and nutrients, but the parents are just, you know, a little bit concerned, or maybe healthcare providers told them their child is on the 25th 25th percentile for weight. So you know, they're worried that their child's not eating enough. So it can definitely be a wide variety of concerns.
00:08:44
Speaker
Yeah, so how would you first kind of get into assessing that? So say someone comes in and I think what I would see, what I do see often is that parents get very concerned about the variety because I think the influence is so often as adults, like healthy eating needs to have all of these
00:09:11
Speaker
different nutrients and whole foods. And if a child is consuming fish crackers and exclusively and only sweets, they get very concerned. I'm kind of wondering, so I'd like to get into that, but I also, if we back it up a little bit, I think I'm getting ahead of myself. If we back it up and kind of dive into what this looks like in kind of an evaluation process to maybe help parents understand
00:09:41
Speaker
where a professional is coming at, like through your lens, what would be questions to ask to kind of actually understand if a kid is getting enough intake? Like what does that look like first and foremost?
00:09:56
Speaker
Well, of course the food records or diet records are always useful tools for us as dieticians. And I think a lot of parents have these grand expectations of how much or what a child should be eating. And we can help reassure them often by looking at the food records. They think that it's not nearly adequate, but you know, if the child's drinking two cups of milk a day, they're meeting their minimum protein intake, even if they don't eat meat.
00:10:23
Speaker
Iron might be another concern, but if they eat fruit and don't even touch any vegetables, not that we stop offering the vegetables, but they have the same nutrients. Most kids are getting the nutrients they need, even if their diet's limited, but sometimes they do need some supplementation to fill in some of those gaps, whether it's iron or calcium, while we teach them to try new foods.
00:10:48
Speaker
And then beyond the food records, again, I'd always want to look at why the child is picky. Is it that broken division of responsibility? So are the parents pressuring them? Are they allowed to snack all day? Or is there maybe some underlying physical cause like oral motor weakness, sensory sensitivity,
00:11:08
Speaker
I think I mentioned a little iron, pain when eating, if they have reflux, constipation, cavities, allergies, that pain can override their hunger signals.
Understanding Picky Eating Behaviors and Family Dynamics
00:11:19
Speaker
So I think we need to ask a lot of these questions to figure out if there's some reason why the child's having difficulty eating or if maybe it just is normal or maybe a behavioral stage or some things that the parents can tweak at home that would help the child naturally expand their diet.
00:11:38
Speaker
Yeah. Okay. So as you were talking too, I was kind of thinking about ages. So, um,
00:11:50
Speaker
What are, what would be like the age range you're referencing kind of when you're generally talking right now, like, and then does it kind of vary with these recommendations, but just so that I can kind of have an understanding with these questions to follow and sort of for folks to also understand how this applies to their kids in different ages.
00:12:12
Speaker
Great question. So yes, between ages one and two, often children can start to become more selective in their food intake. One reason is because their growth rate slows down. So their appetite naturally decreases a little bit and they start to become independent. They like saying no. So that around two can be the normal age for picky eaters between two to five, just developmentally.
00:12:36
Speaker
If the child is older than that, then there probably is some underlying reason that hasn't been addressed, whether it's sensory or a motor. But if the child is a bit older, I would definitely dig a little bit further to see why this is happening because a lot of kids will naturally just outgrow, like eating on their own with time and hopefully some good practices at home. But others, if they don't, then there's probably some reason for that.
00:13:05
Speaker
Okay, so if we then take a step back and kind of summarize a little bit here. So so far, we have kiddos that come in based off of their age, we can kind of do an assessment of appropriate intake, which you just as a professional you are you can kind of look at a diet recall and understand
00:13:24
Speaker
Okay, does this seem like sufficient nutrition for this individual? And so if you kind of say, yes, there's education to the parent that kind of may be a little bit more reassuring, and if it seems inadequate, then there can be exploration of potential reasons why they may be a little bit pickier. Those considerations, so one, I think I also want to tack on with
00:13:51
Speaker
sufficient intake or insufficient. The other ways that you evaluate that, you had mentioned other symptoms and this I just wanted to highlight in case there were things parents could also look at. So if they're not really sure about the sufficient intake, is there anything that you would maybe recommend for parents to look at with their kid in terms of how they may manifest insufficient intake?
00:14:16
Speaker
Yeah, in terms of, you know, those underlying reasons or maybe some red flags that parents could watch for in terms of knowing that they need to get extra support with this or seek healthcare professional assistance.
00:14:31
Speaker
I mentioned iron briefly, so you know the signs of deficiency, right? If the child is tired, if they're pale, if they're not sleeping well, if they're not growing well, getting sick a lot, and my daughter's hair was really thin and falling out, then they need to go get an iron test. And that can be really common in picky eaters because they often don't have that wide variety that they need to meet their iron needs for growth.
00:14:57
Speaker
also I remember going to do a home visit with an occupational therapist and she looked in the child's throat and he had huge tonsils and that's not something I've ever considered but if the child has difficulty breathing so maybe they're snoring at night or they mouth breathe all day might be some signs then you'd want to go see an airway centric orthodontist or dentist because they're going to have difficulty doing everything including eating
00:15:23
Speaker
In terms of oral motor, you know, if they're past two and don't have kind of a round rotary chew, if they seem to not be able to control the food in their mouth, you know, it falls out of their mouth, they can't close their lips, occupational therapists or speech language pathologists can definitely help. And they can also help with with sensory as well. So if the child, and you'll notice this beyond,
00:15:49
Speaker
eating, but eating is the most difficult sensory task we do, it involves all eight of our senses. The child can be an over responder or really sensitive to the look of food, the smell, the taste, the sound, the feel, or they can be under responders where they actually need a little more stimulation. So those kids often actually really like crunchy foods, spicy foods, and they're sensory seekers. So there's a lot
00:16:19
Speaker
you know, that can be going on and they all require different support from different healthcare professionals, but you know, a good
00:16:30
Speaker
VP or doctor should be able to help direct you or a dietician or somebody that's trained in pig eating and works in a multidisciplinary team. It's amazing if you, you know, work in that area or you can find that support. Yeah. Okay. Okay. Yeah. That makes sense. It sounds like, okay. So I'm all about summarizing for mostly for my own self, but potentially others too. So.
00:16:54
Speaker
Based off of the kiddo that comes in, there's kind of this evaluation with diet recall just to kind of get an idea of sufficient intake. There may also be evaluation of manifestations that may indicate insufficient intake because we do also know that diet recall has its limitations as well, right?
Creating Positive Mealtime Environments
00:17:14
Speaker
And so potentially reported energetics, paleness, things that may indicate very specific nutrients.
00:17:21
Speaker
And then we kind of go into considerations that the parents may have and the child as well when it comes to the actual experience of eating and how then manifestations arise with the pickiness, right? So what do you usually see
00:17:42
Speaker
here when it comes to how this plays out. I know you've kind of mentioned things already, but again, just with summarizing things for me, it's helpful. So you mentioned textures, preferences with limited variety of food. Is there anything you would highlight specifically when here?
00:18:06
Speaker
Yeah, if I can get a video of a family meal time, that is gold because then you can see a lot of the dynamics, the family meal dynamics that often play into a child being picky. And in terms of the foods they are eating, you can kind of keep an eye on that. You can maybe take a brief look at their oral motor skills. And I didn't mention this, but for the extreme picky eaters, like beyond the food records, I love to get a list of all the foods they eat.
00:18:32
Speaker
And then I can take a close look at that with the details, like do they eat chicken nuggets? All chicken nuggets are only chicken nuggets from McDonald's, how specific does it get? And then you can look at that and see if there's some commonalities, like are they only eating crunchy food? Are they only eating white food? Are there specific sensory properties they can eat? Or are they only eating soft food? Because maybe that's all they can physically eat if they have oral motor challenges. So food records and
00:19:02
Speaker
that accepted food list, if the child is a little more limited can definitely help to piece. It's a puzzle, right? Piece together the puzzle pieces. Yeah. Yeah. So that makes a lot of sense. So you're kind of finding commonalities within the foods that they
00:19:19
Speaker
do like the foods that they don't like. And then it also kind of sounds like environmentally, you had mentioned this a little earlier, too, where it's, there is a lot to consider just in terms of the comfort, like the situation, is that correct, of the environment for the kid?
00:19:34
Speaker
Yeah, absolutely. It can make a huge difference. So speaking of case studies, I remember this one mom that came to me with a 15 month old, so quite young, younger than I usually see them. And they were struggling because their doctor, a healthcare provider had told them that their daughter was too small, so they had to get her to eat.
00:19:55
Speaker
So what that led to is the mom feeling really pressured to get her child to eat. And that included, you know, catering to her. So being assured of her cook, it included kind of feeding her as small bites throughout the day, whenever she could get in some food, it included pressuring her when she was at the table, which led to tears, fights, and meal times weren't pleasant for anyone. And then after we made some changes, including,
00:20:25
Speaker
So the parents are in control of what the foods offered instead of being the shorter to cook, implemented a bit of feeding schedule, and then took the pressure off of her to eat, which was a big one. Things totally turned around. She, both the mom and the child calmed down. She actually started eating more and more variety. She started gaining weight.
00:20:44
Speaker
because she came to the table and she wasn't stressed out. And if we're stressing out our cortisol, our adrenaline spike and our appetite goes down. So a huge part is just trying to make that dinner time right pleasant without pressure and without those battles. And that's actually the best atmosphere for the child to be able to comfortably out of their own free will, try new foods and learn to enjoy them.
Trusting Children with Food Choices
00:21:09
Speaker
Yeah, which, you know, I, I guess it, it makes sense, right? Like, like to me, I'm kind of thinking like, Oh yes, of course. Like that, that makes total sense. And I get kind of like, try to put myself in the parents position too, where.
00:21:31
Speaker
It just also feels very stressful when you have these concerns with your child not consuming either A, the foods that you want them to, you know, in terms of like the variety, et cetera, or B, the maybe like the quantity or the timing. Cause I feel like that would be another issue with, with parenting and kind of correct me if I'm wrong here too. But like if the meal time is,
00:22:00
Speaker
At these times, it's the time where it's the most appropriate for the parent to prepare the meal. It's when you're sitting down, et cetera. But that's not when the child wants to eat. I don't know. It seems like I personally would get a little agitated, you know, as a parent to like encourage the child to, I don't know, consume at the right time, work to consume the right foods. What are approaches here where
00:22:27
Speaker
where parents can maybe be encouraging and not forceful. Like what is this, this balance of letting your child have their autonomy while also trying to do your best promoting appropriate food intake? Well, generally I prefer not speaking about the food at all.
00:22:49
Speaker
At least not the please take a bite or please try this or you know the no thank you bite or whatever parents may attempt because we know that that leads to the child actually eating less, disliking that food more and becoming pickier.
00:23:05
Speaker
But you can do some things, you know, depending on the child's personality, if they'll take this as pressure, but it can be okay to talk about the sensory aspects of the food. Like if you eat a carrot, say, wow, do you hear how crunchy that is when I chew it? Because then the child knows what to expect when they do eat it. And maybe it'll pique a little bit of interest in trying it. And that's different than saying, you know, you have to take a bite of your carrots or please try a bite of your carrots.
00:23:32
Speaker
And if the child really doesn't like carrots for some children, a learning plate will work. Like they'll freak out if it's on their plate and run away and not eat anything. But if you have a learning plate to the side, they can put a small piece of carrot there. They don't have to touch it. They don't have to eat it. But maybe they eventually do. It's an extra exposure, right? Just having the food there for them to look at.
00:23:57
Speaker
If they would freak out, I would avoid that as well, but the learning plate can work for some children. And then family-style meals are a great tactic as well, which is where everything is in the middle of the table and everybody gets to decide what to put on their own plate. And that gives the child a little bit of autonomy to decide what goes on their plate. Again, rather than being pre-plated, they don't like something they see and then they have a big fit and run away. So family-style meals are something to try too.
00:24:26
Speaker
Yeah, yeah. Okay. That's interesting. Do you have thoughts on like verbiage around food like utilized as a
00:24:42
Speaker
I don't know, like reward potentially, but I'm just kind of thinking about classic examples of you can have this if you eat your broccoli or like that kind of eat this before this or you need to like, what are your thoughts with that kind of verbiage around like quote, quote encouragement, but also is that more in the forceful and influential with relationship with food realm?
00:25:09
Speaker
Yeah, I would throw that probably in the bucket of pressuring and pressuring can look lots of different ways and bribing is a common tactic and it can work. Bribing with dessert is that one common tactic parents use to get kids to clean their plate or eat their vegetables. But essentially what that's telling the child is that their vegetables are their dinner or
00:25:31
Speaker
gross and they require some kind of incentive or reward to eat
Balancing Food Restrictions and Exposure
00:25:35
Speaker
them. And it puts that reward or that dessert up on a pedestal as well, you know, perhaps creating a sweet tooth for life. So we want kids to have that internal motivation to eat rather than external. So we don't have to reward them or pressure them
00:25:52
Speaker
And naturally, kids do want to learn. We can trust them. The Division of Responsibility is also called the trust or competence model, and we have to trust that our kids, you know, if they don't have an underlying reason or difficulty with eating, they will naturally want to try new things, have interest in new things. You know, if we don't pressure them and just allow them that ability to
00:26:18
Speaker
learn that on their own. And we can give them lots of opportunities, you know, in the kitchen, cooking at the farmer's market, picking out a new vegetable at the store. Those are all great learning opportunities. But if we can just, you know, take care of our roles of providing the food on the schedule and letting them choose if or how much to eat it without the bribing, the rewards, the pressure, the praise, whatever comes along with that, then the child will end up better in the long run.
00:26:46
Speaker
Yeah. Yeah. That's just sounds so challenging. I think part of it too, like trusting your child, like, especially with arguments I've seen where it's like, and I actually, now that I'm thinking about this, I see this all the time with adults too, like people not trusting themselves around certain foods. And so.
00:27:09
Speaker
When a kid, for example, this would be something I would see as an argument from parents that have this fear of not trusting their children. If they get exposed to all of the deliciously hyper palatable foods, these sweet foods, these high fat salt sugar foods, these ultra processed foods, and you try to set a piece of cauliflower down next to it,
00:27:39
Speaker
Like.
00:27:40
Speaker
it seems like a child would not opt for the cauliflower, like pretty naturally. And then over and over and over again, this conditioning and this training of your palate, of your gut microbiome, of like these types of, this type of wiring basically that can come with, you know, the chronic intake of this food seems like it may be problematic then long-term.
00:28:09
Speaker
What are your thoughts with this? I think there's, we can definitely delve into trying to take those foods off of a platform where the child is craving them more. But I think first of all, we need to keep in mind that the parent is responsible for the what, what foods are offered. So your child isn't saying, I want chicken nuggets every meal and getting it, although that
00:28:38
Speaker
sometimes happens when the child realizes they can do that and then the parent becomes a shorter to cook and is making two or three different meals. But the parent is responsible for what foods are brought into the house and what foods are offered to the child. And I think it's
00:28:54
Speaker
useful especially with a child with limited diet to at least have one food on the table that they can eat. So one of their safe or familiar foods so that if you know they're hungry, they have something they can fill up on without having to experience a bunch of anxiety about trying these new or scary foods. But that's something that's offered to everybody as part of the meal. Maybe it's bread, maybe it's a plain pasta, maybe it's sliced cucumbers, but it's not chips because the child likes chips.
00:29:23
Speaker
And right, so they're not really the ones that are determining what foods are offered for them to eat, especially when they're young. Like as they get older, obviously they do get more autonomy in this.
00:29:35
Speaker
And that's where it actually is good for the kids to have some exposure to these foods. Because just like an adult, like if they've been totally restricted, if they've been a sugar free kid, they get to the birthday parties and they're the one that eats 10 pieces of cake and barfs because they don't know how to regulate that and it's just so exciting and special to them.
Normalizing Sweets in a Child's Diet
00:29:58
Speaker
Yeah.
00:29:59
Speaker
I was just thinking about this with a friend of mine, kind of used to be a colleague of mine, with kiddos that they were choosing to raise, I would say, you know, with certain dietary approaches, right? And all parents have that decision too. So definitely no judgment here. It just made me curious around
00:30:22
Speaker
what the behavior of the kids would be. So for example, in like a gluten-free approach with like very minimal sugar at their homes, you just mentioned this where it seems like then when exposed to birthday parties or otherwise, and I see this all the time working with patients as adults, would they say that they have that restriction younger
00:30:46
Speaker
then they just have the anxiety around the food where it's like put on a pedestal and or because it was never really allowed so much in the house. But I I just find it kind of I don't know like again like a frustrating thing for parents because it seems like trying to regulate sugar intake seems like it makes sense as like an approach to parenting, you know, but then how does a person
00:31:16
Speaker
A parent, I don't know, trust their kid to regulate that because it also sounds like what you're saying is some exposure is probably beneficial too. So how did you really talk to parents around like, what's the amount or like, is it just really trying to encourage a full spectrum of food all the time? What's that look like?
00:31:44
Speaker
Yeah, this is a tough balance and parents do really struggle with when and how much to offer for the sweets in particular. And
00:31:54
Speaker
I think we do need to work hard at taking it off that pedestal so the child has a healthy relationship with sweets and all foods for the rest of their life. And the way to do this is just to include it as part of the diet. And Ellen Satter, the Division of Responsibility creator, actually suggested if you do have dessert, you don't have to have dessert every day with every meal, but actually include it with the meal.
00:32:19
Speaker
And for children who this is normalized for, it's interesting to watch them because they'll actually go back and forth between their dinner and maybe the bite of cookie. Or maybe they don't finish their ice cream cone, right? Because it's a normal part of their diet and they know that they're going to get it again in the future.
00:32:41
Speaker
And then maybe pick snack time a couple times a week and include as part of their snack, like those homemade brownies or Oreo cookies or whatever, or chips, and put them in the middle of the table with whatever, glass of milk or fruit, whatever else you want to include, and let them decide how much to eat.
00:33:01
Speaker
And if this is new or your child has really experienced this, they might over-consume for a little while. But once they can trust that this isn't going to be taken away from them or restricted from them, then they will start to listen to their body signals and trust their body.
00:33:21
Speaker
Because just like adults, like you mentioned, the more we restrict something, the more we crave it. And it usually leads to that binging cycle and that diet roller coaster that so many parents are, are just, you know, living themselves, unfortunately. So.
00:33:42
Speaker
This is going to sound maybe like a little bit of an obvious answer, like a question that has an obvious answer to you. But I think I just like to kind of get concrete with this and have clarity.
00:33:58
Speaker
So with the exposure to these sometimes hyper-palatable foods in conjunction with exposure to other foods, I honestly don't really like to categorize like healthful foods in like a less palatable way because I feel like they can be very tasty too. But the contrast essentially, maybe some foods that might have a different type of nutrient profile
00:34:27
Speaker
that can be categorized a little bit more healthfully. Kids can be trusted to self-regulate, like that's true. I find that like, okay, okay. So yes. For the vast majority of children, that is absolutely true. And what parents do when they pressure their kids to eat more or restrict them is
00:34:51
Speaker
kind of take away the child's innate ability and skill and talent for being able to listen to their appetite, which really does go up and down for kids. You know, for adults, we eat pretty much the same thing every day or same amount every day, but maybe a child's going through a growth spurt and they eat three times more one week than the next week. And parents feel like they have to control that by forcing them to eat more or restricting them. And both of those
00:35:20
Speaker
methods, whether it's restriction or pressure, are actually totally counterproductive and absolutely wildfire. And it is hard to trust your child's appetite when we don't trust our own. So that's why, you know, the work you do and parents working on their own relationship with food is really important too.
When to Seek Professional Help for Picky Eating
00:35:41
Speaker
That's a really good point, actually, just kind of that coupling the trust situation. I still get so curious around this with, I think part of it is just because of what I have also seen too with working with adults and kind of working on composition of meals and how to incorporate in more nutrient dense options into their
00:36:08
Speaker
meals, creating more balance within their meals and how that can naturally help their regulation of appetite. Just for example, adding, you know, more protein at breakfast versus, you know, a very refined carbohydrate breakfast. So we might have more blood sugar stabilization and more regulation, um, impact mood, things like that. So as a parent, you know, wanting to help their kiddo.
00:36:37
Speaker
I think like just bringing it back to how to really do that. I guess it just kind of keeps coming back to trust, I guess. So it is just like providing the, like the variety of foods at the meal, let them kind of decide what they're going to have and trust that they will end up self-regulating even if they don't opt for the foods that you would prefer them to have like on a regular basis.
00:37:06
Speaker
And that can be stressful for parents to watch the child just choose to eat buns and butter for supper. I totally understand that, but it really does come down to that mind shift where we have to realize that it's not our job to get our kids to eat more or different foods. That'll backfire. It is our job to offer them a variety of foods at each meal and snack time. So those opportunities are available to them.
00:37:35
Speaker
Um, but beyond that, knowing that the best thing that you can do to get, I don't want to say get your child to try new food, but to have a child who has, eats a wide variety of foods is just to again, expose them to these foods over and over in positive ways, you know, using neutral language about food rather than that, you know, demonizing certain foods or putting them up on a pedestal and then just not pressuring them and letting them choose and, um,
00:38:05
Speaker
just trusting that even if they're just choosing buns to eat for dinner, that for breakfast tomorrow or maybe next week, they'll choose a different option, maybe an egg or a piece of fruit and gradually learn how to expand their diet and enjoy these foods on their own.
00:38:27
Speaker
Okay, okay. It's hard for me to even accept it. I'm not even a parent, but yeah. If we were to explore other considerations then, so say like this is something parents have been working on implementing, but they're just kind of curious if there are other reasons behind the picky eating. So we talked about the environment earlier.
00:38:52
Speaker
Would there be other, can you specify some of the other considerations and things to maybe ask oneself and or a reason maybe to bring it up to another professional with why they may also be picky when it's not necessarily just the food or maybe there are other considerations with the food, but can you expand on that?
Multidisciplinary Support for Feeding Disorders
00:39:19
Speaker
Yeah, I think that if a family is stressed out about the child's eating, that that in and of itself is enough of a reason to seek support, whether it's asking your doctor or asking for a referral to a dietician or seeking one out, just to make sure, you know, to help reassure you or make some small tweaks.
00:39:41
Speaker
Of course, if your child is cutting out like one food group, two food groups, if they have a very limited diet, of course, that's the reason to seek support and help. And we want to make sure we look at these underlying reasons or implementing those feeding roles at home. And then maybe your child needs some of these extra supports like food play or feeding therapy. It's often called like play with the purpose where
00:40:08
Speaker
They're just systematically desensitized to these different foods and smells and tastes and colors just by playing with them, not necessarily eating them, right? That's actually the final step in eating. Dr. Keitumi created the sequential oral sensory program with a 32 step hierarchy of eating. And for some kids, just being able to tolerate the food is a good step. And then we work towards interacting with it, which might just be like passing it to somebody else at the table.
00:40:35
Speaker
might be feeding your teddy bear all the way up to like touching it, smelling it and tasting it. For some kids, it's not just as simple as just eating it. They need to kind of work their way towards feeling comfortable to do that. Interesting. Okay. It's almost like a variation of mindful eating, but like I've had some of my own patients go through, right? With just kind of getting back into the experience of
00:41:04
Speaker
Like we've used, you know, opening like Hershey Kisses or something. So like getting into the smell, the sound, the like really taking the time kind of with the food. So it makes sense. It's so interesting, the parallels, right? It's like
00:41:21
Speaker
Teaching a kid or letting a kid kind of be more intuitive are many of the same things that I am working with more adults on to get back to, essentially. So yeah, kind of fascinating.
00:41:37
Speaker
Do you work with folks with ARFID? For folks that don't know what ARFID is, it's Avoidant-Restricted Food Intake Disorder. So is that something that you also work with with folks? I'm sure I've worked with some children who might meet that diagnosis yet don't have it.
00:42:00
Speaker
And there are multiple reasons why kids are diagnosed with ARFID. They could have a fear of eating, maybe they're terrified to choke, they could have extreme sensory sensitivities, or they could have a lack of interoception so they don't sense their hunger.
00:42:17
Speaker
So kids with ARFID, they need a full team. It's actually mental health diagnosis, so primarily a psychologist would be working with them, probably an occupational therapist, at least one form of doctor, and then a dietitian would be part of that team. So right now I'm working independently, and I do have other experts I refer to, but I think that ARFID is best treated in a multidisciplinary clinic setting.
00:42:43
Speaker
Gotcha. There are a lot of dietitians, well, through another company that I work for, Nourish, that specialize in ARFID, and it is not super familiar. Yeah, it is not super familiar to me. And so just talking to you, I'm like, a lot of these things seem kind of comparable, but they are actually a bit distinct from that particular diagnosis. Like there might be overlapping types of behavior, but the kind of disorder is a little bit
00:43:11
Speaker
more diagnostic, I suppose. Yes. And there is another diagnosis now called pediatric feeding disorder, which is a bit newer.
Impact of Social Media and Parental Modeling
00:43:21
Speaker
And again, I'd still recommend you know, multi-disciplinary teams are always great. So sometimes I think ARFID is maybe misdiagnosed. And for some people having that diagnosis is helpful and empowering and for other people it isn't. So yeah, it's a difficult thing.
00:43:40
Speaker
Yeah, yeah, for sure. I think I just like to kind of highlight that just because there are there can be layers to to kids behavior, right? And so I just
00:43:57
Speaker
Again, it's sort of like, parallels again, when we work with folks with adults, we work on foundations first and foremost. And sometimes there will still be manifestations of conditions that do not get remedied with those interventions. And so I think it's helpful to know that there are potentially other
00:44:24
Speaker
realms that could be addressed and areas that could be discussed, I suppose, with other practitioners and professionals when parents may be a little bit lost with what might be going on with their kid. So, okay.
00:44:42
Speaker
So last question here, I did want to touch on this before we close up. So what are what are your fears and or considerations in the day and age of social media and concerns with you have with messaging with adults, but I would say definitely like more so with with kids. I kind of talked about this before with
00:45:09
Speaker
Like messaging in social media to parents and the shooting that gets pressured on parents and how they need to be raising kids. So do you have certain things that you really flag and get kind of concerned about?
00:45:24
Speaker
in that realm, and then maybe also direct messaging to kids. So kind of both routes. Yeah, in terms of the parents, I think there is a lot of pressure on parents when they see those Instagrammable lunch boxes, right, that are full of a variety of foods that maybe we don't have the time to prepare or the resources or a kid wouldn't eat any of that food. And then the
00:45:49
Speaker
the clean eating, GMO, organic, sugars, toxic. So all of these messages that are not correct, but fill parents with a lot of fear and guilt are not helpful. And then in terms of the kids, I mean, just like adults, I think there's a lot of unhealthy body image stuff out there, you know, on Instagram and social media and as parents, I think we can help
00:46:19
Speaker
our kids to help analyze that and also be good role models ourselves because they're always listening to us. So if they hear that mommy is not eating carbs because they make you fat, or if they hear you're not wearing a bathing suit because your thighs are too big, they're going to internalize that and grow up with those same beliefs about themselves. So we don't necessarily have control about
00:46:41
Speaker
social media or everything that's out there, but we do have a lot of control over how we deal and talk with food and our bodies in our own homes.
The Role of Family Meals in Healthy Eating Habits
00:46:53
Speaker
Yes. So, so true and very, very important. I love it. I love it. I love it. Is there anything else that you want to touch on that we did not get to today?
00:47:09
Speaker
One quick thing that I think that families can do to help raise competent eaters is family meals, right? Like if we can start when our child's a baby, by the time we get to adolescence, if they're still having a couple of family meals a week, we know the children not only have a more nutritious diet,
00:47:29
Speaker
But they're less likely to be involved in drugs and alcohol. They are more likely to have healthier relationships. And it's not necessarily about the food you're offering them. It's more about that family connection. So I think coming back to family meal times,
00:47:44
Speaker
again, that are pleasant, like without the pressure and nagging, maybe using some conversation starters when conversation starts with the kids and just keeping up those meal times as much as we can, you know, as much as our schedule allows is going to have huge benefits for your family and your kids. Yeah, I love that. That just made me think of one more question. Do you think that
00:48:08
Speaker
distraction, like if a family is eating a meal together with the TV on, do you find that to be problematic and influential in a certain way? For most children, like some children who are neurodiverse, like maybe they require that food to be, or that iPad to be able to focus and eat. But for most of us, adults and children, as you would know, it's
00:48:33
Speaker
best to be able to focus on the food we're eating. Um, you're talking about mindful eating, right? Like enjoying it allows us to listen to our appetite instead of, I mean, it's okay to have family moving out with pizza every week or some of those things, but ideally as much as we can kind of focus on connecting with our food, um, connecting with other people at the table, that would be the ideal. Yeah.
00:48:58
Speaker
Definitely.
Resources for Parents and Episode Conclusion
00:48:59
Speaker
I'm a huge advocate to not have, you know, the TV on and such for the bulk of intake, right? A hundred percent. Don't get me wrong. I can veg out and watch TV for sure. But I do think I didn't. So I was just kind of curious if that like would have an impact. And I am like just even in the sense of the type of show, like the energy of the show kind of too, if it's like I don't just depending on the age of the kid too, but
00:49:28
Speaker
I don't know. My mind just went in some directions there. So never thought of that. That interesting question. Yeah. Okay. Well, Jennifer, where can people find you? And do you have anything you want to note if people can learn a little bit more?
00:49:49
Speaker
Sure. I think the best place to find me is my website, which is firststepnutrition.com. And there is a blog there with lots of information. I'd probably answer all of your feeding questions there. And then there's a freebies tab as well. So I have different freebies depending on if you have a pig eater that's under five or age six and up. So people can go check out that. And if they're on Instagram, I'm there at firststepnet.
00:50:16
Speaker
Awesome. Oh, this was such a wonderful conversation. Thank you so much for your time and I will catch you guys later. Thank you so much for listening today. If you found this information valuable, please share this episode and give it a review. They truly help a ton. If you want additional support and information, you can head over to my website, teresmartinezrd.com.
00:50:44
Speaker
where you can snag my free guide on how to improve your hunger signals, get on my email list for regular juicy content, or apply for the next round of my signature program, Restoring Nutrition Intuition. Otherwise, Instagram at Teresa Martinez RD or my Facebook group Fed Fit and Fad Free Nutrition with Teresa are always places for more content and support. Until next time.
00:51:15
Speaker
you