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post #41 of 55

I can't remember if Satter says anything about it. We decided that nothing would be on offer after dinner, partly because I saw the awful nightly struggles that a relative and her kids had over their "night night treat." Bedtime at their house was always associated with screaming tantrums, and part of the fuss involved these tense negotiations over what the night night treat would be and whether you could lose it for rotten behavior. I think they might have adopted "night night treat" as a currency to negotiate a peaceful bedtime with, but it kind of had the opposite effect. Using food in any bribe/punishment scenario is definitely anti-Satter. Anyway, in our family, we decided dinner would be the last food before bedtime. Occasionally an exception if circumstances are truly strange that day - we're talking maybe three times a year.

post #42 of 55
So if they choose not to eat dinner and then tell you they're hungry later, how does that conversation go?

I'm asking because like I said, we sometimes direct DD back to her dinner plate when she does that, but also we do allow a piece of fruit before bed if they want, whether they ate dinner or not.
post #43 of 55

To be honest, I can't really remember the last time we had a conversation like that. Maybe it's because bedtime and dinner aren't very far apart for us. As time goes on and bedtimes get later, things might change.  I know in younger years we had conversations that were answered by "There is no food after dinner, but we'll have breakfast right after you wake up."  But you know,  we did used to have bottle of milk at bedtimes as a sleep cue. So I guess my rule was just a solid food rule.

post #44 of 55
Satter recommends 2-3 snacks a day, so one of those can be a bedtime snack.
If you know your dk doesn't eat much for dinner, you could serve a smaller portion. She can always have seconds..
post #45 of 55

We follow the Satter method. My kids are 7 and 3.5, they eat dinner about 5:30 and go to bed about 7:30 (the 3.5 year old straight to bed and the 7 year old reads until 8). I don't feel like wanting a small snack two hours after dinner is unreasonable and it's not a battle I want to fight. When they ask, they get a piece of cheese, it has no crumbs and some protein and fat to fill their belly and help them sleep. It's never been an issue or interfered with dinner eating.

 

When my ds7 was going through his pickiest stage was when I learned about Satter, prior to that he had been eating a lot of pb&j (which was actually not a bad replacement). I started including bread and butter or cheese at dinners that I knew he was going to struggle with, and always fruit and a veggie he liked (breakfast and lunch had never been an issue). I also would separate ingredients for him, meals that were mixed were hard for him. He has some sensory issues so I have to be careful to not push too hard.

 

I really feel like it helped, it gave him the choice within boundaries, and I knew he was eating healthy foods because that's all I was offering. Now he eats a much larger variety and I do believe it's because I did not make it a source of tension.

post #46 of 55

This is timely for us. We are facing a food conundrum. My 3.5 year old has always had a small appetite, seeming to only eat the bare minimum required to get her through the day. We eat healthy, whole foods for the most part, and I'm home with her so she has the opportunity for three meals and two or three snacks throughout the day. She is not a very picky eater -- she likes lots of vegetables, fruits, legumes, dairy -- she's not so big on bread, pasta, meat or other very "filling" foods but she will eat a small portion of almost anything.

 

We've always followed a simplistic version of Satter's method: I decide what and when, she decides how much. But lately, we find ourselves having to resist encouraging her to eat more. She's always been on the "tall and slender" growth curve, and while we've been a bit concerned at times that she was too thin, her pedi assured us that her curve was consistent, and that as long as she is hitting all her milestones, is active and energetic, and isn't getting sick frequently that we shouldn't worry. Recently, though, she's started eating even less, and is now down to a BMI in the 3rd percentile, which makes her clinically underweight. While she still fits her pedi's definition of healthy, we find ourselves encouraging her to eat "just one more bite" before she leaves the table, and doing more lecturing than we'd like on topics like "food is like fuel that makes our bodies go." I also find that we've become so happy to see her eat something that if she only eats two bites of carrot for dinner, but wants ice cream later, we sometimes have a hard time saying no. (She only eats a little of the ice cream, too, but she definitely has a yen for chocolate and will usually eat more of that than of other things -- and I'm stuck between "not micromanaging her food choices/bargaining about eating healthy foods before other stuff" and "not wanting her to subsist solely on ice cream.")

 

So, for those of you who prefer a hands-off approach to eating, and allow children autonomy in choosing how much to eat - how would you handle an underweight child? Would the idea that, perhaps, some children don't eat all of the calories they need all by themselves change your practices, and if so, how?

 

We already have some strategies that we've always used with her, which are: offering nutrient-dense foods, adding extra calories (peanut butter in her oatmeal, cheese in her eggs, cooking her foods in olive oil, etc); finding what times and places she will eat more and taking advantage of that (she's more willing to eat her snack at the park, where it's fun to have a picnic, or at home she will sit still to eat more while we play a game or read a book). Anything else?

 

I know many kids this age go through a phase where they don't want to eat much, and it passes. She's always been like this, so I don't think it's a phase. FWIW, she has no other sensory issues at all, texture doesn't seem to be a problem, she has no GI problems or any apparent health issues, and is generally a happy, easygoing, very neurotypical kid.

post #47 of 55
Quote:
Originally Posted by grethel View Post
 (She only eats a little of the ice cream, too, but she definitely has a yen for chocolate and will usually eat more of that than of other things -- and I'm stuck between "not micromanaging her food choices/bargaining about eating healthy foods before other stuff" and "not wanting her to subsist solely on ice cream.")

 

So, for those of you who prefer a hands-off approach to eating, and allow children autonomy in choosing how much to eat - how would you handle an underweight child? Would the idea that, perhaps, some children don't eat all of the calories they need all by themselves change your practices, and if so, how?

 

We already have some strategies that we've always used with her, which are: offering nutrient-dense foods, adding extra calories (peanut butter in her oatmeal, cheese in her eggs, cooking her foods in olive oil, etc); finding what times and places she will eat more and taking advantage of that (she's more willing to eat her snack at the park, where it's fun to have a picnic, or at home she will sit still to eat more while we play a game or read a book). Anything else?

 

 

Here is my opinion as a mom, assuming your dd doesn't have any health problems (as your pediatrician assured you).

I see some glitches in the division of responsibility (you decide what food and when / she decides what and how much). First, you are trying to make her eat more calorie-dense food and my opinion is that if they feel pressured, chances are they'll eat less, not more.

Secondly, Satter mentions that sweets or desserts are not to be treated as regular food because they have an advantage over regular food, so she recommends one portion only, assuming that you actually enjoy having dessert. So I wouldn't let her fill up on ice cream or chocolate.

We have dessert every day after dinner, but I don't offer seconds, so I know they can't survive on sweets. I don't link it to how much they eat, or whether they eat for dinner, so we don't have any fights over it.

 

Here's a quote that I like from Satter's website, that can help identify pressure:

"Pressure on children's eating always backfires. Keep in mind that all children are more-or-less picky about food. Trying to get a child to eat more than she wants makes her eat less. Trying to get her to eat less than she wants makes her eat more. Trying to get her to eat certain foods makes her avoid them. Trying to get her to be neat and tidy makes her messy. Putting up with negative behavior in hopes she will eat makes her behave badly but not eat. What to do instead? Follow the division of responsibility in feeding!

  • Pressure can seem positive: Praising, reminding, bribing, rewarding, applauding, playing games, talking about nutrition, giving stickers, going on and on about how great the food is, making special food, serving vegetables first.
  • Pressure can be negative: Restricting amounts or types of food, coaxing, punishing, shaming, criticizing, begging, withholding dessert, treats, or fun activities, physically forcing, threatening.
  • Pressure can seem like good parenting: Insisting on "no thank you" bites, encouraging or reminding her to eat, taste, smell or lick, making her eat her vegetables, warning her that she will be hungry, making special food, keeping after her to use her silverware or napkin, hiding vegetables in other foods, letting her eat whenever she wants to between meals.
  • Pressure can be hard to detect: Ask yourself why you are doing something with feeding. Is it to get your child to eat more, less or different food than he does on his own? If so, it is pressure."
post #48 of 55

Thanks! Food for thought. I like the reminder of all the different kinds of pressure.

 

A couple of things: When I mentioned offering calorie-dense foods, it's only things she likes and actually prefers (ie, she likes her oatmeal better with peanut butter... she prefers cheese in her eggs... etc). It's not that I'm trying to make her eat more nutrient-dense foods. I just make sure those are on offer, instead of offering something less -- similar to offering whole wheat bread instead of white, I guess would be a good comparison. I offer the same kinds of things I always have since she began table food.

 

Also, maybe I wasn't clear - we also only have one treat or sweet food per day. So when I mentioned subsisting solely on ice cream, I didn't mean that I'd give her seconds or allow her to have as much as she wants. I meant that, if she chooses not to eat anything else that day or only has a little handful of veggies, and then she does choose to eat her daily treat of ice cream, the ice cream is all she's eaten all day. Thus, she's solely subsisting on it. I'm concerned about something like that happening on a regular basis, but it seems like the alternative is to say "no, you may not have the ice cream because you haven't eaten anything else," which feels like managing her food intake. Would you be okay with it if your child chose to eat nothing but a scoop of ice cream each day on a regular basis? I guess I'd like to say I would be, but really I don't think I am, because even with vitamins, that doesn't feel like suitable fuel for her growing body.

 

I've always been very hands-off -- we did baby-led weaning from infancy, so she's always had control of what she chose to eat. It's only very recently, as her weight has dipped from her usual "skinny but healthy" to "clinically underweight," that I've started to feel the urge to encourage her to eat more. For that reason, I'm not sure her habits are due to me pressuring her, though I'll certainly keep it in mind when I'm tempted to ask her to take a few more bites.

post #49 of 55
Quote:
Originally Posted by grethel View Post

 

Also, maybe I wasn't clear - we also only have one treat or sweet food per day. So when I mentioned subsisting solely on ice cream, I didn't mean that I'd give her seconds or allow her to have as much as she wants. I meant that, if she chooses not to eat anything else that day or only has a little handful of veggies, and then she does choose to eat her daily treat of ice cream, the ice cream is all she's eaten all day. Thus, she's solely subsisting on it. I'm concerned about something like that happening on a regular basis, but it seems like the alternative is to say "no, you may not have the ice cream because you haven't eaten anything else," which feels like managing her food intake. Would you be okay with it if your child chose to eat nothing but a scoop of ice cream each day on a regular basis? I guess I'd like to say I would be, but really I don't think I am, because even with vitamins, that doesn't feel like suitable fuel for her growing body.

 

I've always been very hands-off -- we did baby-led weaning from infancy, so she's always had control of what she chose to eat. It's only very recently, as her weight has dipped from her usual "skinny but healthy" to "clinically underweight," that I've started to feel the urge to encourage her to eat more. For that reason, I'm not sure her habits are due to me pressuring her, though I'll certainly keep it in mind when I'm tempted to ask her to take a few more bites.

Honestly, I don't think that a child, barring medical issues, would starve themselves. We offer dessert after dinner and there is no way my dk would subsist with nothing until 6pm. So I think if your dd is given the choice, she would eat something else other than ice cream, without you encouraging her to eat. She might not eat as much as you want her to, but she will eat as much as her body requires for her to grow.

 

You can try two things in order to get some reassurance that your dd is eating well.

 

Firstly, consider how much she eats (without interference) during the course of a week, not a single day, or a single meal.

Secondly, look your or your dh's pictures as children; her being slim might be just genetics.

 

I have one skinny kid (8), and a chubby one (4). When I stepped back and let them regulate their own intake I was amazed to see how well and balanced they eat, although they have their preferences.

I wouldn't worry about percentiles, if your doctor doesn't. Being in the 3 percentile means that out of 100 normal kids, three are your dd's weight or less.

My dd was in the obese percentile last year and I freaked out. I took her to several doctors which reassured me that she was growing well. I was fortunate enough to read Satter's book and I stopped worrying. Now a year later she has the same weight but grew in height, and her BMI is normal.

 

HTH

post #50 of 55

OK, thanks. I don't think she will literally starve, either, but I guess our hope is that she gets enough for optimal health and growth. She does seem healthy and energetic (and yes, dh and I were both slim kids, though not to her extreme). She is anemic, but she takes iron for that, a multivite for other essential nutrients, and fish oil when we can.

 

I have a teenager, so I'm not lacking experience with feeding kids - but my older dd, while more choosy about what foods she would eat, always has had a healthy appetite -- not too much, not too little. I never thought much about it. I haven't had experience with one who just chooses not to eat.

post #51 of 55
Quote:
Originally Posted by grethel View Post

 I haven't had experience with one who just chooses not to eat.

I've had 2 of those out of 2 kids.  Food is not motivating for either one.  DD2 has a tender tummy (possible food intolerances) and suspected (mild) sensory processing difficulties.  DD1 failed to connect eating with the sensation of hunger until she was 4.5, probably stemming from severe pain while nursing as an infant.

 

From ages 3 to 5 I think some kids survive on air.  I did have dd2 tested for anemia at one point, and she was fine.  If this child's hemoglobin was normal, then something much more severe must cause anemia than simply being a picky eater and not eating much.

 

 

Quote:
So, for those of you who prefer a hands-off approach to eating, and allow children autonomy in choosing how much to eat - how would you handle an underweight child? Would the idea that, perhaps, some children don't eat all of the calories they need all by themselves change your practices, and if so, how?

For my first daughter, I pretty much let her eat what she wanted, when she wanted.  That even meant sugar if she wanted, to a large extent though not endlessly even though I was encouraged that I could do just that if need be.  That was the biggest change.  The goal was to get her to connect eating with positive experiences.  

 

For dd2 coming up close behind, well, she got a fair amount of that by default.  I'm afraid all the conventional wisdom flies out the window in our house.  We love our sugar, but the girls regularly graze raw veggies from the garden, and dd1 just had lentils and sauerkraut for lunch, along with some orange juice.  DD2 is still a monstrously picky eater, even at nearly 7yo, and is still the skinniest girl down on the gym floor, but I try to take the long view of things, and I see her relaxing a little, especially in regards to food she dislikes being on the table at dinner.  She tried a few things when she was at day camp, though she still didn't eat more than a flea's serving.  Like I said, food and being hungry has never been a motivator with my girls.

 

I am a short order cook and I don't see what the big deal is (that is another thing that has changed-- I resisted until it was pointless for me to resist and now I wonder what the fuss was all about.)

post #52 of 55

I am similar to SweetSilver. I have one child with severe feeding issues, I don't care what he eats as long as he eats. I will and do frequently drive across town to pick up a food item if he asks for it because the other alternative is that he won't eat, sometimes for days at a time. 

post #53 of 55
Quote:
Originally Posted by SweetSilver View Post

I've had 2 of those out of 2 kids.  Food is not motivating for either one.  DD2 has a tender tummy (possible food intolerances) and suspected (mild) sensory processing difficulties.  DD1 failed to connect eating with the sensation of hunger until she was 4.5, probably stemming from severe pain while nursing as an infant.

 

From ages 3 to 5 I think some kids survive on air.  I did have dd2 tested for anemia at one point, and she was fine.  If this child's hemoglobin was normal, then something much more severe must cause anemia than simply being a picky eater and not eating much.

Thanks for sharing your experience. I'm interested that you mention nursing pain possibly being a factor for your 2nd dd. Mine had silent reflux, until she was about 1.5. She took medication that kept it mostly under control, but her first couple of months of life, there was a lot of crying related to eating. (Didn't stop her from being a devoted nurseling, though - she weaned at 3).

 

As for the anemia, it's mild and her pedi said it's not uncommon in toddlers/preschoolers. I suspected it because she doesn't care for meat. She'll occasionally eat a little chicken or bacon, but no red meat. She actually really likes other high-iron foods, like tofu, edamame, nut butter, and beans, but plant-based sources are less bioavailable and I think she simply doesn't eat a large enough portion to get enough. She also loves milk, and too much milk is bad for iron absorption. It's not a big deal for now, since we found an iron supplement she will take without a fuss. (We have weird iron issues in our family anyway -- I have a genetic disease related to iron storage. Though it's the opposite problem to hers, it might be related in some way.)

post #54 of 55
Quote:

Originally Posted by grethel View Post

 

 I'm interested that you mention nursing pain possibly being a factor for your 2nd dd. Mine had silent reflux, until she was about 1.5. She took medication that kept it mostly under control, but her first couple of months of life, there was a lot of crying related to eating. (Didn't stop her from being a devoted nurseling, though - she weaned at 3).

 

For my first.  Yes, I was told by the OT that infants who experience severe pain associated with nursing sometimes can fail to connect hunger with the need for food because it is first associated with pain.  Most people think the hunger/food connection is something that is built-in, but it isn't.  It really is something that is learned (very, very early) and that connection can get hijacked by things such as severe reflux, allergies and physical pain from nursing.  In my daughter, I really did notice this, and I told the OT during our introduction that it didn't seem like my (then 2.5yo) daughter knew that food and hunger are related.  

 

Sure enough, she not only agreed with me, she even had a handout on the very subject for me.  Clearly this was a myth she had to counter often in her line of work.  It was really obvious to me that my daughter didn't make the connection, but everybody kept saying "if they are hungry enough, she will eat".  But mine didn't and I was confused and second guessed my intuition because, yes, I had always heard that as well and "believed" that, even though it was being contradicted before my very eyes.  Believed, that is, until I met with the therapist--one that specifically studied eating disorders of a mechanical nature.  I've told this story before, and it ends when she was 4.5yo and she looked up at me wide-eyed at the lunch table and said to me "Mom!  When I eat, my tummy feels better!"  She had finally made that connection!  At 4.5yo!

 

Between this revelation and one final revision to her diet after we diagnosed a new food allergy, and she has been eating well ever since, though, again, never particularly motivated by food.  I watch in awe and slight envy those families with kids who will happily eat Whatever, and eat until they have to be told they'd had enough-- the kids that are always hungry or really will eat if they get hungry enough.

post #55 of 55
Quote:
Originally Posted by grethel View Post

Thanks! Food for thought. I like the reminder of all the different kinds of pressure.

A couple of things: When I mentioned offering calorie-dense foods, it's only things she likes and actually prefers (ie, she likes her oatmeal better with peanut butter... she prefers cheese in her eggs... etc). It's not that I'm trying to make her eat more nutrient-dense foods. I just make sure those are on offer, instead of offering something less -- similar to offering whole wheat bread instead of white, I guess would be a good comparison. I offer the same kinds of things I always have since she began table food.

Also, maybe I wasn't clear - we also only have one treat or sweet food per day. So when I mentioned subsisting solely on ice cream, I didn't mean that I'd give her seconds or allow her to have as much as she wants. I meant that, if she chooses not to eat anything else that day or only has a little handful of veggies, and then she does choose to eat her daily treat of ice cream, the ice cream is all she's eaten all day. Thus, she's solely subsisting on it. I'm concerned about something like that happening on a regular basis, but it seems like the alternative is to say "no, you may not have the ice cream because you haven't eaten anything else," which feels like managing her food intake. Would you be okay with it if your child chose to eat nothing but a scoop of ice cream each day on a regular basis? I guess I'd like to say I would be, but really I don't think I am, because even with vitamins, that doesn't feel like suitable fuel for her growing body.

I've always been very hands-off -- we did baby-led weaning from infancy, so she's always had control of what she chose to eat. It's only very recently, as her weight has dipped from her usual "skinny but healthy" to "clinically underweight," that I've started to feel the urge to encourage her to eat more. For that reason, I'm not sure her habits are due to me pressuring her, though I'll certainly keep it in mind when I'm tempted to ask her to take a few more bites.
I am having the exact same problem with my 3 yo - only it's just fruit she'll eat. The pedi recommends loading her up with desert but she doesn't like it so her calories are extremely low. I'm worried its affecting her height
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