Here’s part two of my interview with family doctor and childhood feeding expert Katja Rowell, M.D., who owns and operates Family Feeding Dynamics. She also writes a fantastic blog by the same name.

I truly admire Dr. Rowell, and I think she’s doing amazing work! I’m really honored to be able to share her insight with Weightless readers.

If you haven’t already, please read part one of our interview about Dr. Rowell’s feeding approach and why she believes that we have a feeding crisis on our hands – not an obesity crisis.

Q: What are some common misconceptions about healthful feeding?

A: That it has to be low fat, or rigid, or that you need to eat the food pyramid every day, that trying to limit portions will help your child grow up to be slim, that pressuring your small child to eat more will make him bigger or stronger, that trying to “get” your child to eat more or certain foods will help…

Q: On your blog, you’ve mentioned that one of the most common issues you help parents with is picky eating. What’s some advice on the best way to approach picky eating with kids?

A: Enjoy eating a variety of foods and do it with your children. Offer a variety of foods in a pleasant, neutral way. I commonly see children who are growing at the smaller end of the growth curve have more problems with picky eating. There is a general worry about size in former-premies, or children who are small that they have to “eat something!” It is a natural impulse for a parent to try to GET a small child to eat more, to feed them something special. This invariably backfires.

Many parents were given this very advice from doctors, “do whatever you have to to get food into that kid!” It can really undermine the feeding relationship and bring serious power struggles into feeding. Some kids really would rather fight than eat, and intense struggle and emotion makes it hard to tune in to internal cues.

Kids who are small who are pressured to eat, grow and eat less well. It’s a vicious cycle. Catering makes for picky kids. Worry about nutrition leads to feeding that promotes picky eating. For example, one mom of a one-year-old was worried her child wasn’t eating enough protein. She knew he would reliably eat chicken nuggets, so she served it several times a week as it made her feel better that he was at least getting “some” protein.

The sad thing is that he was then being given far fewer opportunities to learn to like other proteins. Most parents give up after three tries, and it takes often 10 tries, or many, many more for very sensitive or cautious children. Mom’s unnecessary worry about protein (children that age generally need far less protein than we think) fueled her pressuring and catering and made matters worse.

Keep serving the foods you want to eat as a family. Consider, but don’t cater, meaning, you might serve an accepted side dish like corn with a new protein…

Basically the advice is the same for any child. It’s what I love so much about this feeding model. It works for big kids, small kids, and cautious or adventurous kids. Serve meals family style, offer variety, back off on all pressure (including praise) and wait. It’s tough because it takes longer than parents would like, and they often lose their nerve and resort to pressuring and bribing.

Turning things around takes perseverance. For a toddler, it might only take a few weeks, for a school-aged child it may take a few months to really see “progress” in terms of eating more foods, but the immediate benefit of enjoyable family meals with less conflict can help you stick with it.

Q: What are your thoughts on the “war on childhood obesity” and how it’s affecting feeding?

A: Ugh, this is really a downer. What amazes me is that we have study after study showing that restriction in children tends to make them food-obsessed and likely to overeat. Yet, the majority of the official recommendations still recommend limiting, avoiding and essentially dieting, and rely on external control (portion limiting) vs. optimizing feeding.

A large study showed that early feeding problems were more predictive of unhealthy adolescent weight gain than breast-feeding was protective. Breast-feeding is awesome, but I get mad that the feeding aspect is almost completely ignored by physicians, and public health programs.

I also find that the hysteria around obesity causes incredible anxiety and makes parents feed out of anxiety, fear, and control vs. nurturing and supporting the child. I think we are doing more harm than good.

There is also a huge push to label kids as “obese” or “overweight.” Aside from the fact that BMI in children is often being misused and misunderstood, the assumption that the parents’ knowing the BMI will help the health of the child is not at all a given. In fact, studies are showing that the labeling makes kids feel flawed in every way, makes them less likely to be physically active and more likely to engage in or have a diet foisted on them. It’s malpractice as far as I’m concerned.

OK, wow. Thanks so much, Dr. Rowell! Be sure to check out the last part of our interview tomorrow!

A Free Webinar

Just thought some of you might be interested in a free webinar about eating disorder recovery from The Renfrew Center. Specifically, you’ll learn coping skills for maintaining long-term recovery.

You can attend the webinar on Tuesday, September 21st at 12:00 p.m. to 1:15 p.m. EDT or Wednesday, the 22nd at 8:00 p.m. to 9:15 p.m. EDT. See here for more information on the webinar.

 


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    Last reviewed: 16 Sep 2010

APA Reference
Tartakovsky, M. (2010). Picky Eaters, The Obesity Crisis & Healthy Eating: Q&A with Dr. Rowell, Part 2. Psych Central. Retrieved on October 25, 2014, from http://blogs.psychcentral.com/weightless/2010/09/picky-eaters-the-obesity-crisis-healthy-eating-qa-with-dr-rowell-part-2/

 

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