Recap: A child is born with strong attunement to cues of appetite, hunger and fullness, and will therefore naturally eat well if raised in a supportive food environment. A mother?s role is to nurture this inborn ability by creating the right environment. Beginning with infancy, emotional development evolves in stages, and understanding these stages can help a mother nurture her child physically and emotionally so her child can thrive. In the following articles, we describe a healthy parent-child dynamic as it applies to ideal feeding, so that the mother can support her child?s natural ability to eat and grow well.?
Excitable and strong-willed, Esty is an eight-year-old who loves to eat?she?s been chubby since she was a baby. Lately, Esty has been eating more than ever, and her doctor noted that she went up from the 70th to the 90th percentile for weight. Esty?s mother?fit, slim and health conscious?is uneasy about her daughter?s voracious appetite, obsession with sweets, and recent weight acceleration. Nosh is scarce in the home, and sweets are only allowed on Shabbos. Esty?s snacks at school typically consist of sliced fruit, nuts, pretzels, or low-fat yogurt.
Longing for potato chips, sandwich cookies and other sweets, Esty will trade and beg friends to get the foods her mother never buys. Esty visits all the neighbors? homes to receive Shabbos party handouts. Esty?s mother is embarrassed when she finds Esty parked at the dessert buffet of every birthday party and kiddush, tasting pastries and treats long after the other kids her age have gone off to play.
When Esty was younger, she seemed content with eating the healthy snacks, vegetables and protein-rich dinners her mother prepared. In truth, however, Esty?s mother would play tricks to get her daughter to eat. She would slide food into her mouth when she wasn?t looking or pretend her fork was an airplane.
Currently, at age eight, Esty is no longer obliging as her mother begs her to eat more protein and vegetables at dinner. Esty puts up a great fuss, and she seems to want only pasta, cereal and milk, or mashed potatoes. Frustrated, Esty?s mother takes her to see a child-friendly nutritionist who instructs Esty to limit sweets, and increase protein, fruits and vegetables. Esty tries to comply with these diet rules and succeeds for a couple of weeks, but then she loses interest, and her eating becomes worse than ever.
Esty is a school-aged child, working to achieve the developmental task of industry.She is striving tolearn, master and achieve, in order to feel a sense of ?I can do this. I am capable.? If her feelings and desires are minimized, she will not develop a sense of achievement, and instead will feel inferior. Since Esty?s mother and nutritionist are significant adults in her life, Esty feels inferior when she cannot live up to their expectations. In addition to harming her relationship with food, Esty?s self-esteem is negatively impacted.
Esty?s mother is prone to the common pitfall of feeding during this stage: pressuringchildren to eat specific foods and specific amounts. This pattern began when Esty was a toddler and is now becoming more noticeable and problematic. Food has always been restricted by Esty?s mother, but as Esty gets older and becomes more resourceful, she is rebelling and accessing the foods she wants. At the same time, Esty senses her mother?s disapproval and feels guilty and shameful after breaking her diet rules. These feelings contribute to her pronounced tendency to overeat. Misunderstanding the cause of overeating, Esty?s mother tightens food restrictions, which triggers her tendency to further overeat, and then causes her weight to accelerate.
Esty is overeating because she feels deprived of the foods she wants, and is frustrated with her lack of autonomy with regard to food choices. A weight-loss plan is not effective in this case, because it creates more deprivation and removes more autonomy. It results in Esty?s heightened preoccupation with food?her mind is continuously thinking of where and how she can get nosh, because the pantry at home is devoid of it!
From a scientific viewpoint, diets designed to reduce food intake below the body?s daily needs are prone to failure. To prevent self-induced famine, the brain increases appetite and heightens the reward and pleasure received from food. In other words, the mind and body become food seeking! Cravings and pleasure are especially strong for foods high in simple sugars and fats, which are high in calories and deliver quick energy to the cells. Examples of these foods include pastries, pasta, and processed foods. The appeal for such foods becomes so intense that some dieters feel vulnerable to the point they believe they have a true food addiction.
Instead of trying to manipulate Esty?s diet and weight, Esty?s mother needs to trust that her daughter can eat and grow in the way that is right for her. She needs to stop criticizing and pressuring Esty about her eating. This will help her daughter develop healthier thoughts about food, so that Esty?s eating transforms from the inside out. To accomplish this, Esty?s mother needs to serve nosh often enough so that Esty doesn?t feel deprived of it. For example, she can serve cookies with milk for an after-school snack once a week, and allow Esty to take as much as she wants.
Secondly, during meal times, she needs to allow Esty to decide how much protein, carbs and vegetables she will have from the dinner table without shaming her for her choices. For example, she can serve chicken, pasta and grilled veggies for dinner, and give Esty the choice of how much and which foods she eats from what is provided. Esty?s mother?s job is to provide the food and let Esty choose from what was served. At first, Esty will likely gorge on nosh and choose mainly carb foods at dinner, but as time goes on, she will feel secure that nosh and carbs are available to her, and her obsession with these foods will likely diminish.
The above recommendations are effective because they meet the needs outlined in Ellyn Satter?s ?division of responsibility in feeding? (sDOR)approach. This model demonstrates the roles of both parental leadership and child autonomy with regard to developing ideal eating habits in children.
The sDOR model suggests that theparent provides limits by being in charge of the what, when and where of feeding, and the child exercises control by being in charge of the how much and whether of eating. This eliminates the food battle, decreasing a child?s anxiety around food and creating an environment where Esty can tune into her inner cues of appetite, hunger and fullness. These inner cues are in sync with her biological needs, so she will naturally rediscover her comfortable stopping point when eating, and develop an appetite for a variety of foods from all food groups.
In the above-mentioned example, Esty will likely feel that after having too much nosh, it no longer tastes as good. She will also start to recognize discomfort with an overstuffed stomach. Knowing that she can always get nosh another time, Esty will stop eating when she senses her inner cues of fullness. It will take time for this transformation to happen, but Esty?s eating will likely normalize. Esty?s overeating and weight acceleration are not the problem. Rather, they are symptoms of poor feeding dynamics which her well-meaning mother needs to resolve.
Eventually, Esty will learn to eat in response to her inner cues, instead of eating in response to feelings of deprivation and her mother?s pressure.
The School-Aged Picky Eater
A school-aged child who has previously been pressured to eat may develop picky eating habits as she becomes older and more assertive. Typically, the parent reacts by increasing pressure on her child to eat more, but such a child will rebel against this imposition and tighten her refusal to eat.
Furthermore, this pressure increases the child?s anxiety during meal time, which makes it difficult for her to experience her inner feelings of appetite and hunger. This inhibits her ability to eat appropriate amounts of food.
If a parent wants to help her child, she should avoid pressuring or critical comments about her child?s eating and follow a division of responsibility in feeding instead. Doing so will eliminate the food battle, decreasing the child?s anxiety at the table so she can tune into her hunger and appetite cues and naturally expand her food choices.
Healing a child?s built-up resentment towards food takes time. However, creating a supportive, non-pressuring food environment will lead to your child having healthier thoughts about food and better eating behaviors.
How is a parent to guide their teenaged child who wants to diet or lose weight? This tricky topic will be discussed in the next article.
 Geleris, J., Mehra, M. R., & Doremalen, N. van. (2012, January 26). Long-Term Persistence of Hormonal Adaptations to Weight Loss: NEJM.
 Excessive weight gain or poor nutrition isn?t always due to poor feeding dynamics. A full assessment is necessary to consider all possible underlying causes.
 If a parent is concerned that her child isn?t eating enough to support his/her growth she should seek the help of a qualified professional.
Brochi Stauber is a Registered Dietitian Nutritionist whose goal is to make healthy living a lifestyle reality for individuals and families. She combines clinical nutritional knowledge with an understanding of the behavioral science of food, enabling clients to sustain healthy habits. Contact her at 732-731-9340 or email@example.com.
Shira Francis is a Licensed Marriage and Family Therapist in private practice in Chicago, IL. She provides guidance and counseling in relationships and self-development. Contact her at 773-971-3388 or firstname.lastname@example.org.