As we dive into summer and are approaching my daughter’s 2nd birthday, I feel so many emotions: excitement, pride, sadness, and mostly nostalgia for when she was a baby. But there’s also this little nagging fear about that 2nd year check up at the pediatrician that I know is looming ahead of us. Recently, I have heard far too many stories of pediatricians scaring parents into thinking that something is wrong with their toddler’s growing body because the child hasn’t followed a perfect growth curve or is “above average,” or that weight fluctuations are something to worry about, control, or a reason to implement “diets.” And while there are legitimate reasons to monitor growth and development from a medical standpoint, small deviations or one-time deviations are hardly a reason to overhaul a child’s intake.
The most disheartening story I heard recently was an account of a provider telling a breast-feeding mother to no longer nurse her child on demand because her infant had gained “too much weight” between just two appointments… not trending upwards significantly over many, many months, but a simple one-time higher gain than usual. The mother intuitively felt this could harm her child and that the child truly needed to nurse, but also felt at a loss because a medical professional was telling her to limit the baby’s intake. This advice throws all conventional wisdom about nursing out the window, and makes me nervous for how other pediatricians interpret growth charts and how my own doctor will interpret my daughter’s growth at our next appointment. What if she’s moved from the 50th percentile to the 75th? What if she has dropped? Should we worry immediately, or trust that her growing body will adapt and change the way it’s supposed to if her dad and I provide her with a variety of nutrients and food choices, including fun foods?
Parents sometimes feel so torn by how to feed their children. Feeding is an act of love, something we often take great care in planning and something we pay close attention to, making sure the food served is both nutritionally balanced and tasty too. But feeding can also be very haphazard when we’re stressed out or on the go. These scenarios are both normal, and believe it or not, O.K! There exists between parents and children a “division of responsibility” in feeding, identified by Ellyn Satter as distinct responsibilities that parents and children play in the feeding relationship. A parent’s job is to provide the “what” of eating: adequate food and fluids to meet the child’s dietary needs. The child’s job is to determine the “how much” and “whether” to eat. This means that sometimes, children will eat a lot in one sitting or barely anything at all. Sometimes they might eat vegetables and the next day may not. Sweets and desserts might be really appealing for a few months, then lose their novelty. Kids have the innate ability to meet their bodies needs and are in tune with hunger and fullness signals in a way adults are not. These signals only get muddled if interfered with by external forces controlling food intake. If children are offered a wide variety of choices and don’t feel deprived or fearful that they may not get enough, overeating is unlikely. And while kids can be picky and fearful of trying new fruits and vegetables, offering those new foods continually and repeatedly increases the likelihood that someday, the child might try them and actually enjoy them, rather than be forced to finish them in order to “earn” a dessert. This might sound scary to trust the child’s body, but that’s likely because we as adults aren’t so great at trusting our own bodies. In practice, feeding along the lines of the division of responsibility has endless benefits to both parents and children and can really decrease stress at meal times.
If you’d like to learn more about the division of responsibility in feeding or specific strategies to feed with love and care, we’d love to meet with you and/or your child to see how we can help you reach that goal. Some other excellent resources include Ellyn Satter’s work in the following books:
“Your Child’s Weight: Helping without Harming” and “Secrets of Feeding a Healthy Family”
Or at http://www.ellynsatterinstitute.org/
I can only imagine how I will react if the doctor tries to tell me I need to control my daughter’s intake at our next appointment. Deep breaths... but my plan is to respond with research-backed information about the division of responsibility in feeding, the evidence for feeding with love and care, and to share with her the resources listed above so that she can hopefully spread this message to other families as well. By trusting in my daughter’s body to grow the way it was meant to, I can teach her love and self-care rather than self-loathing and body shame while also helping her learn to love food rather than fear or restrict it.
Enjoy the gorgeous weather, and we hope to see you soon!