Eating behavior in babies/toddlers - what to support, when to actively intervene?

[son_of_belial]

As father of a nearly one year old and with a strongly food related background, I wonder about eating habits in my daughter and other toddlers in my surrounding.

I know there are rough suggestions like a food pyramid for kids a.s.o., together with "each kid is different, don't push anything too much".

I've heard stories from a colleague about her son only wanting milk for 4 weeks, picky eaters, and heavy feeders.

In my case my daughter started eating a lot lately, but she is rather thin. She eats nearly everything, including fish, chicken and beef in small portions 2-3 times per week

Example one day at 8 kg and 78cm, 4 meals:
1 slice of bread (whole grain, no salt), partly with cream cheese and pure almond cream.
A half khaki
4 servings (1 serving equals what would fit in both her hands) of vegetables like broccoli, carrots and parsnips
1 egg
Half a beetroot waffle (no sugar)
1 banana
2 lentil-zucchini-apple pancakes (35 g each)
1 slice of cheese (20g)

That seems a lot, but she eats that much 5 out of 7 days.

Right now she gets a plate with some selection close to our meal, and when she wants even more, we would give it to her.

So, my question regarding the bigger picture:

How much self regulation and stimulation what to eat, how much and when does a kid have at what age, when and how much should we intervene?
And, if she would enter a phase of nearly or not eating, when's the point where we try to convince her to eat?

 

[guevaraj]

@son_of_belial You might enjoy reading some of Ellyn Slatter's work, particularly division of responsibility.

 

[son_of_belial]

@guevaraj Wow, that's actually very much what I was looking for.

 

[javier_is_life]

@son_of_belial Yep seconding that her work is exactly what you're looking for

 

[lozzymagoo]

@son_of_belial Let your daughter eat her fill. If she’s still eating, she’s still hungry, even if it seems like a lot to you! It’s best not to restrict your child from eating if they still want more

 

[leighguevara]

@lozzymagoo Absolutely! But it seems like they do that, OP wrote that “when she wants even more, they would give it to her”

 

[fromissouri]

@son_of_belial Our daughter turned 3 in August.

She was a surprise IUGR baby. We were told to "encourage her" to breastfeed more... She developed a nursing aversion (we didn't know it existed back then, so we didn't recognise the signs).

We had to transition to bottles. She wasn't eating the amount she "was supposed to" and once again we were told to "encourage to eat more"... She developed a bottle aversion. It was SO severe that even us, FTP noticed it wasn't normal. At the worst of it, she refused to eat when awake. At all. She was 4 months and was going 16 hours without eating ANYTHING. She was pale, with dark circles on her eyes, her fontanelle was caving... We called the emergency number several times, asking about taking her to the hospital. They told us they would only give her fluids and send her back home. Back to refusing to eat.

We were lucky to find a specific book about how to overcome bottle aversion written by a nurse. That and introducing BLW at 5 months honestly saved our daughter's life.

But it was too late, in a sense. Even if she was eating something now and no longer pale and visibly struggling... She was never hungry, she never asked for food, she ate what looked like the bare minimum.

At 1 she was diagnosed with infantile anorexia. The paediatrician told us that, after so many anxiety inducing episodes around food when she was a baby, her body had learned to suppress her appetite as a self-preservation technique. Her body had learned to endure hunger in order to avoid cortisol.

The recovery has been long and it has impacted how we parent, how our whole extended family needs to behave about food around our daughter. All paediatricians we have consulted have been crystal clear:

Focus on quality over quantity.

Quality of the food we offer, ensuring it is as varied as possible. They see malnutrition in kids who eat "a lot" just because they only eat potatoes and nuggets. A kid who eats a balanced diet will be healthy even if they eat (what it looks like) minimal portions.

Quality of the social interaction while eating. Make an effort to have as many family meals as possible. Meals where there is ZERO pressure about trying/eating. Forget about "just one bite", "grandma cooked this for you you need to try it" or, even worse, "if you don't eat X, then you don't have Y".

Promote healthy eating by offering a healthy diet and showing a healthy relationship with food:

• Make a point in saying things like "I'm feeling hungry still, my tummy needs a bit more" and "no thanks, my tummy is feeling full. I don't want anymore right now". You want to teach your kids to read their hunger cues, so they can self-regulate efficiently
• Make a point to try new things/recipes in front of them. Show interest and curiosity. "Oh! I've never had that. I wonder if it's crunchy! Can I try some?".
• Share all your food (assuming you are eating healthy/balanced to lead by example) as a way to reward their curiosity. We even share "unhealthy" snacks, because we don't want her to fixate on forbidden food.
• Do not make (nor allow) any comments about dieting or body shaming in front of your kid. Don't comment on anybody's weight.This was a huge one to fight with both grandmas. Weight alone is not a good indication of health: I can assure you a weightlifter is heavier and healthier than my mum/MIL who are skinny because they have a terribly unhealthy relationship with food.
• Never, EVER, pressure them to eat. Or to try anything. "One more bite" will not radically change your kid's diet, but it can really mess their relationship with food. At the table, focus on talking about other things, share your day, have a laugh, etc.

Overall, more often than not, it's not our kid's diet that needs changing... But our expectations around it. What is your concern?

That she eats too much... And she becomes overweight/obese? As long as your kid is getting regular/natural exercise, it is not possible for them to be overweight when eating healthy food. Nobody who runs for hours on broccoli and sauté chicken gets obese.

If your kid is not getting enough exercise, then you need to focus on providing that instead of restricting their diet. Kids need lots of exercise to self-regulate.

However, if your concern is like ours was and you are worried about her not eating enough, remember our paediatricians words: kids don't starve if food is available. For it to affect growth, they would need to be deeply malnourished for a substantial time... Which is simply not possible when a healthy/varied diet is offered.

As long as your kid is:

• Growing and gaining some weight.
• Happy and active, both physically and cognitively.

They are OK. They are perfect.

 

[son_of_belial]

@fromissouri Thanks a lot for your story and sharing your insights and expertise here!

My main concern is/was on a broader level to unconsciously stepping into something that might lead to a story like yours and somehow make it harder for us/our daughter to move through the world of nutrition.

Between pointing my one year old towards the kitchen and say "here's the fridge and there the stove, have at it!" and measuring every onion cube and shouting "Spit out this crumb, you already had 3 calories too much!" lies a broadly right approach towards eating habits. The mentioning of Ellyn Slatter here was very helpful already.

As I didn't know exactly how and what supports the kid to somewhat "self regulate", I was searching for inputs from here to broaden my knowledge and thusly reducing the chance of good intentioned wrong doings.

We already, from the beginning:

• Only eat together at the dinner table, not phones, no tv (which she hasn't seen on since she is alive anyway)
• We have 4 meal times per day, breakfast, lunch, snack and dinner, as much at the same time windows as possible
• She gets a broad variety of healthy foods, similar to ours as much as possible
• Every plate contains at least 3 different options and at least 2 different food groups
• I prepare most warm meals myself fresh
• We regularly pre-produce things from scratch to freeze and give her like bread, muffins, fish cakes, rice paddies, chicken sticks, a.s.o., so next to no processed foods

She can eat as much as she wants, and when she no longer eats and only plays with her food, we ask her if she wants to eat anything more, and if not, we take it away, she gets cleaned and we take her out of the chair.

As we want to have a mostly normal and healthy approach to eating, I found out that information and knowledge helps a lot to stay relaxed and not repeat the learned approach from our own childhoods with "one more bite" and "but I prepared that only for you!".

 

[olivemcr]

@fromissouri Thanks for sharing your expertise! Your situation sounds like it has been so hard, but you’ve gleaned so many lessons. I appreciate you telling us your story.

 

[ezzeking]

@son_of_belial The AAP recommends 1000 calories a day for one year olds. My pediatrician told me that as parents all we can do is offer a wide variety of foods, and it’s up to our kids to eat it. He basically said some meals will be a success and others won’t and that’s typical of toddlers and unless a significant weight issue occurs we shouldn’t worry about it.

(I used an AAP recommendation on calories because I’m American, but if that doesn’t apply for you you can always look up your local pediatric authority’s recommendation)

 

[kowon]

@son_of_belial I believe this advice is best: The parent decides what goes on the table and the child decides how much to eat. Now if you do end up with a picky eater there are some tips and tricks but your daughter seems fine.

Children’s appetites (and adults) ebb and flow. Scrutinizing her every meal will eventually make you absolutely crazy because there is no rhythm or reason with the exception of illness and growth spurts.

If her food intake drastically decreasing for more than a few days it may be worth checking in with the pediatrician but other than that I try not to intervene knowing that it will go back to normal.

 

[dcg]

@son_of_belial I just wanted to say, purely anecdotally, that I’ve worked with quite a number of kids who ate around or more than what your daughter is eating right now and they’ve all been perfectly happy and healthy on the nutrition front.

My nephew, certainly ate quite a bit more than your daughter, even when you factor in that he is a bit bigger, and is perfectly proportional and thriving, so it personally wouldn’t have even jumped out at me as unusual if I had been working with your family.