Child of Mine: Feeding with Love and Good Senseby Ellyn Satter
Widely considered the leading book involving nutrition and feeding infants and children, this revised edition offers practical advice that takes into account the most recent research into such topics as: emotional, cultural, and genetic aspects of eating; proper diet during pregnancy; breast-feeding versus; bottle-feeding; introducing solid food to an infant's diet;… See more details below
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Widely considered the leading book involving nutrition and feeding infants and children, this revised edition offers practical advice that takes into account the most recent research into such topics as: emotional, cultural, and genetic aspects of eating; proper diet during pregnancy; breast-feeding versus; bottle-feeding; introducing solid food to an infant's diet; feeding the preschooler; and avoiding mealtime battles. An appendix looks at a wide range of disorders including allergies, asthma, and hyperactivity, and how to teach a child who is reluctant to eat. The author also discusses the benefits and drawbacks of giving young children vitamins.
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Child of Mine
Feeding with Love and Good Sense
By Ellen Satter, Mary Ray Worley
Bull Publishing CompanyCopyright © 2000 Ellyn Satter
All rights reserved.
Feeding is Parenting
When feeding is going well, it's like a smoothly flowing conversation. The parent offers food skillfully, and the child takes it willingly. Parent and child are in sync, each taking pleasure and reward from being together and from the feeding process. It looks so easy and natural that it's hard to detect how much goes into it. In my experience, if children are fed in an age-appropriate way that respects their feeding cues, they eat to the limits of their ability, and you have every reason to expect that you and your child will be able to establish a positive and rewarding feeding relationship.
For many parents, feeding goes so well that when I tell them about my work and writing, they seem puzzled and ask, "what's to know? I didn't ever have any trouble with my child's eating." I certainly applaud that. Such parents may have such good intuitive senses that they were able to establish a positive feeding relationship with their child. On the other hand, they may have just been lucky in the child they got! A child may be born competent, and we can do well by following her lead and playing a supportive role. However, even with a competent child, feeding is hard to do well in today's culture. There is much negative and unhelpful information floating around out there — much of it controlling, telling parents that it is their job to get their child to eat and telling them they are responsible for raising a child who is slim, smart, healthy, and resistant to degenerative disease. Although I have written a book called How to Get Your Kid to Eat ... But Not Too Much (Bull, 1987), please understand that the message of that book is this: "the way to get a kid to eat is not to try" (page 31), and that's what I still recommend.
When it comes to feeding, common sense isn't common any more. Feeding practice and advice is so negative and controlling that it causes struggles between parents and children, and much of it is misguided and even detrimental to your child. Putting infants on feeding schedules is wrong. Starting infants on solid foods at 3 months — or even 4 months for many — is wrong. Putting children on low-fat diets is wrong. Letting toddlers graze for food or providing them with special foods to get them to eat is wrong. Making preschoolers eat their vegetables in order to earn dessert is wrong. I will explain more about why these practices are wrong in the upcoming chapters.
Our attitudes and behaviors about feeding reflect our behaviors and attitudes about eating. Given all the concern with weight control and avoidance of dietary fat, it begins to seem that not eating is far more respectable than eating. As a consequence, this most basic of human needs, supported by the most powerful and compelling of drives, gets treated as an afterthought. Feeding our children and ourselves is no longer a priority, and eating and feeding become an offhand endeavor that one turns to when driven by hunger. Social trends and attitudes, work demands, and community scheduling patterns make it hard for us to remember that children are our priority and that nurturing our children is simply the most important thing we do.
Some of my data are old and hard to come by, but it is still clear that feeding problems are common. According to parents' complaints in health care settings, at least 25 percent of children have feeding problems, and the figure rises to 33 percent of children in specialized centers dealing with children who have developmental disabilities. Problems include bizarre food habits, mealtime tantrums, delays in self-feeding, difficulty in accepting various foods and food textures, and multiple food dislikes, as well as other feeding disorders such as infant rumination, childhood obesity, and eating disorders. Half of mothers complained about their toddler's and preschooler's poor food acceptance, preference for "junk" food, and poor behavior at the table. Almost half of parents said they offer alternative foods to their toddlers when they don't eat enough, and 10 percent said they force or bribe them to eat. A third of surveyed parents of preschool-aged children described their child's appetite as fair, with vegetable and meat items most frequently reported as disliked by children. These are serious problems, not only because of the distress they cause right now, but also because of the distress and incapacity they cause in the future. Children want and need to feel competent with their eating. To be comfortable in the world, they have to be able to eat the food there. To relegate eating to its proper place as one of life's great pleasures, they have to be successful at it.
Indications from my clinical work, consulting, and teaching are that the situation isn't getting any better. Family meals are eroding, and children absolutely depend on family meals to do a good job with their eating. Children learn to eat a variety of food and take responsibility for their own eating when they are regularly offered a variety of nutritious food in a no-pressure environment. No pressure means getting a meal on the table and eating with a child rather than feeding her. Generating food especially for a child makes pressure an unavoidable part of the equation. Pressured family mealtimes are not rewarding for children or parents. In many cases parents have come to dread them and complain that they are a struggle in which nobody has any fun. What is the problem? There are many problems, really, and to identify them and head them off will require the rest of this book. The short version, however, is that parents and children are crossing the lines of division of responsibility in feeding.
MAINTAIN A DIVISION OF RESPONSIBILITY IN FEEDING
Successful feeding demands a division of responsibility.
Parents are responsible for the what, when, and where of feeding; children are responsible for the how much and whether of eating. Put another way, parents are responsible for what food they serve to their children, and when and where they serve it; children are responsible for how much of that food they eat and whether they eat any of it at all. That division of responsibility plays out in different ways at different ages and for different children, but the principle is the same. Parents provide the food, children eat it. Parents get into trouble with feeding — and children get into trouble with eating — when parents take over the child's responsibility, like trying to get children to eat certain types or amounts of food, or when parents don't fulfill their own responsibility, like failing to regularly and reliably provide their child with appropriate food.
Knowing what you are doing with feeding and applying positive feeding principles does make a difference. Many people have written to me about their experiences applying the advice I gave in my earlier books. To encourage you that what you read here can make a difference to your feeding relationship with your child, let me tell you about a few of those letters. "I have raised my children according to Ellyn Satter's guidelines, and their eating habits are so good my coworkers comment on them," wrote one young mother of a toddler and a preschooler. Another said she had used the same principles with equally good results. She added, "My daughter's eating has always been wonderful. She has learned to like many foods, and now, at age 4 years, she likes almost everything. She even likes her vegetables, and her favorite is spinach!" Another had had a few more challenges. "My son is cautious in all things, and offering him new foods wasn't much fun at first. If I am careful not to push him, however, I have found he ever so slowly pushes himself along to learn to like new foods. He is so proud when he tries something new!"
Some parents know what a difference it can make when they have crossed the lines, gotten into trouble, and then changed their approach to feeding. Parents who are worn out and fed up with generating three or four meals to get their child to eat comment about what a relief it is to them to realize that it isn't their job to get food into their child. They also are surprised at how much better their children eat when they stop their short-order cooking. One mother wrote that she had two toddlers with what she saw as two growth problems — one wouldn't eat enough and grew poorly, and the other ate too much and was too fat. She had tried to overfeed the first and underfeed the second, and her life had been one long struggle of trying to manage her children's eating and dreading feeding times. Then she had read about the principle of the division of responsibility in feeding, and it made sense to her. Applying it was helping. "Today I provided my children with good food and company and a pleasant atmosphere, and I believe it is paying off. I feel better knowing that I did my part and have fulfilled my responsibility to them. And they ate! Not a lot, but enough to satisfy my worries. And they certainly seem happier."
Another mother wrote of her struggles getting her fully breastfed daughter to start eating solid foods. "She was growing and doing well, but beginning at 5½ months, I was anxious because she wasn't interested in solid foods. She sensed this, and when I offered food she sealed her lips and looked away. Mealtimes became a struggle for me to get her to eat a couple of mouthfuls of cereal or fruit while she resisted or gagged on whatever I was able to slip past her defenses. Finally I discovered your principle of the division of responsibility in feeding. It was such a relief! I wasn't a failure for not getting her to eat! As a matter of fact, I could have caused future problems if I had kept on forcing her. So I relaxed and waited for her to tell me what she wanted. I discovered that I had to be careful not to put the spoonful of food too far into her mouth, because she didn't like it. Now she eats as much or as little as she wants, and I stop feeding her when she closes her mouth and looks at me."
One more story, and we will move on. A mother of a 2-year-old was exhausted and frustrated with power battles over food. The division of responsibility made sense to her, and she could see how her child's fighting back had become more important to him than eating. She wrote, "We have stopped trying to force our son to eat and have been practicing letting him eat by himself. Sometimes he eats a lot and sometimes he doesn't eat much. But that's okay. We don't put pressure on his eating anymore. He seems to enjoy his meals, and he likes to try new foods, especially vegetables. My husband and I are very happy now, especially at mealtime."
Why the Division of Responsibility in Feeding? With my own children, I knew and practiced the division of responsibility intuitively, but I wasn't able to say what I was doing. In feeding my children, I had observed that there were some things I could control and some I couldn't. While I could choose nutritious food, cook well, and make our mealtimes pleasant, there was no way I could get my children to eat when they didn't want to. Nor could I restrict their food intake. I had, in fact, greatly enjoyed the enthusiasm and delight with which my chubby sons approached their eating, and I was thankful that I didn't feel I had to restrict them. Even back in the heyday of sounding the alarm about fat babies and predicting they would be fat for life, I didn't worry about it. I had fed them well, and they had done the eating. Since I have always assumed that my children knew more about their eating than I did, I felt curious, amazed, and delighted as I watched the pleasure they took in their eating. Restricting them would have taken the joy out of it for all of us.
I first put my feeding intuition into words in the midst of a difficult nutrition counseling session 30 years ago, back in my dietitian-in-a-medical-clinic days. I was struggling to help a mother of a child who continued to be chubby despite her attempts to restrict his food intake and get him to slim down. I was giving her food selection and menu-planning information. To her credit, she knew there was more to it than that. Finally, exasperated, she burst out, "I am already doing all that! What am I supposed to do?" she demanded. "I have one at home who is too thin, and this one is too fat. How am I supposed to get that one to eat more and this one to eat less?" Well, she had me there. What in the world could I say? After a pause that seemed to go on forever, I blurted, "You don't have to worry about how much either one of them eats." The mother looked startled, and I rushed on. "That's not your job. Your job is to put the meals on the table. After that, they are the ones to decide how much to eat." The mother glared. Her little boy, who until that moment had been slumping over in his chair and looking perfectly miserable, smiled and straightened. I gulped. "Holy smokes," I thought. "Where did that come from? That is pretty revolutionary. Is it really true?" But it was better than anything else I had said that day, so I let it stand.
I don't think I helped that mother and child as much as they helped me and helped other people. The part that I didn't say, the part that would have made it come together, was this: "You don't have to take responsibility for how your sons' bodies turn out. That is up to them and mother nature. Do your job with feeding and the rest is up to them." By the way, that session, and others like it, also taught me to do a careful evaluation before I start giving such specific advice.
Since then, I have tested the division of responsibility with all kinds of families with children of all ages and applied it to a variety of feeding problems. I have taught it to many professionals, and they, in turn, have used it to work with parents and children to enhance feeding rather than just applying rules of food selection or using their ingenuity to try to get children to eat. I have written about it in three books and heard from parents like the ones I just quoted, who say that applying it has completely changed their relationship with their child around food. I have taught the division of responsibility to lots of professionals who work with children and their eating in lots of settings. I have held my breath while I read the careful research that people in universities have done with children and their eating — and seen the principles confirmed. The principle is widely accepted and widely quoted — sometimes with the recognition of my authorship, sometimes not. And I have seen it enter the public consciousness. "It is a traditional principle of feeding well-known in the child development world," said one government publication, "to observe a division of responsibility in feeding."
Applying the Division of Responsibility at Different Stages. Feeding demands a division of responsibility. This deceptively simple principle incorporates what we know and understand about children, parent/child relationships, feeding, and nutrition. You will discover as you read Child of Mine that the division of responsibility in feeding applies no matter the age of your child, but the way you play it out varies. With the infant, the division of responsibility is simple: You are responsible for what your child is offered to eat, she is responsible for how much she eats. From there on, you follow your child's lead in feeding and do what she needs to keep her comfortable and happy. However, if you try to keep your toddler comfortable and happy, you will be treating her like a baby and not giving her the structure and limits that she needs to grow and develop properly. Feeding on demand is no longer appropriate, because in the hands of the toddler feeding on demand turns into panhandling for food. To learn to eat a variety of food and to join in with the sociability of family meals, a toddler needs regular and structured meals and snacks and limits on her between-time food begging. Mastering the food and sociability of the family table as a toddler allows the preschooler to get ever better at eating as she learns to like an increasing variety of food and eat comfortably in more and more settings.
The division of responsibility in feeding is based on the assumption that if you do your tasks with feeding, your child will be competent with eating. When your child is an infant, your tasks are the moment-to-moment reading of your baby's cues, being responsive to her and feeding on demand. When your child is a toddler, preschooler, and older, your tasks are to choose and prepare food, provide regular meals and snacks, make eating times pleasant, and provide your child with the opportunities she's ready for and the expectation that she will learn. Your child comes equipped with certain capabilities with regard to eating, and if you do your job with feeding by giving her opportunities to learn, structure, and limits, she will hang on to those capabilities as she gets older. She will eat, she knows how much to eat, she will eat a variety of food, she will grow predictably, and she will mature with regard to eating.
Excerpted from Child of Mine by Ellen Satter, Mary Ray Worley. Copyright © 2000 Ellyn Satter. Excerpted by permission of Bull Publishing Company.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Meet the Author
Ellyn Satter, MS, RD, CICSW, BCD, is an internationally recognized authority on eating and feeding. She is an author, trainer, psychotherapist, and eating therapist with more than 30 years' experience in helping people of all ages learn positive and natural ways of becoming competent with their eating.
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