Kids & Nutrition Part 3: Tips and Tricks for Creating Healthy Relationships with Food

I was recently on a call with a nutritionist who went into business the year I was born (!!!). She was amazing to speak to and I learned a lot from her just in the 30 minutes I had her all to myself. Of all the things she shared with me, the most concerning one was that the majority of her pediatric caseload consists of children with eating disorders, particularly anorexia.

Children.

Our babies.

As young as 11 years old.

While my passion has always been working with children with unique healthcare needs, I began to reflect on how knowing this information, might impact how I support adults as well.

I know I’m guilty of not always saying the “right thing.” I’ve been known to label foods as “bad” or “not good for you” in my past (or yesterday). And I would be lying if I didn’t say that those labels sometimes still creep into my head, even though I advocate for not thinking about foods in that way.

How we talk to kids about food starts with how we talk about food to ourselves.

My #1 recommendation to parents and caregivers of little ones is to first work on your relationship with food. You will see dramatic changes in how your child sees food if you heal how you see food. Addressing any internal messaging you have around foods and what they are or are not will make my recommendations today all that more impactful.

Here we go.

Before Age 1: Food is not JUST for play

You’ve likely heard the mantra….and maybe even from me! “Food before one is just for fun” it goes. While this is true, food before age serves a TON of purposes. Let’s explore how playing with our food as babies can help with so many other developmental skills.

Let’s start with signs of readiness.

• Both the World Health Organization and the American Academy of Pediatrics as well as the new dietary guidelines all recommend waiting until 6 months of age before introducing solid foods. This is when their gut (and enzymes) are mature enough to be able to break down foods efficiently in the digestive tract. Risks are associated with early introduction of foods before 4 mo and after 7 mo, including Type 1 Diabetes, celiac disease, and delayed motor development. Even with this guidance, 32% of infants are introduced to solids before they are 4 months old! Could this be playing a role in the significant health crises our kids are experiencing? Maybe. (PS: giving your child solid food does NOT help your child sleep longer or better. We can dive into this another time).

• Signs that your child may exhibit to indicate they are ready for solids include interest in food, they are able to hold their head and neck upright with good control, his or her tongue thrust is gone, they can grab large objects with their hands and can maintain an upright positioning (even if some additional support is needed in the high chair).

Ok, so your child is ready! Now what?!

Let’s first establish how much food and what types. We talked a little bit about types of food in part 1, but let’s expand here.

• Amount of food: this is where it can get confusing. Resist! Start with small amounts that can fit in the palm of the hand, generally ~3”. Ideas include slices of avocado or sweet potato. Even steamed broccoli spears that a 6 mo can hold in his or her hand. Following your kiddo’s lead is key. Respect if they aren’t interested or take a lick and are done. Keep exposing them to that food—just because they don’t love it right off the bat, doesn’t mean they won’t love it eventually! I mean, I didn’t like mushrooms until I was 20. At least. If you remember from part 1, purees are NOT a required developmental feeding stage. Other foods to start with are mashed berries, wedges of tomato (child has to be able to hold the wedge), or cooked halves of apples. My favorite resource for families is on Instagram at SolidStarts. This group also has an app, which I highly recommend. It’s full of ideas on how to introduce just about any food you could imagine.

  • This Baby-Led Weaning approach is supported by research to actually prevent choking, not increase it. This is a common misconception. This is because if a kiddo is holding a piece of food in their hands, it can only go so far into his or her little mouth. If your child is “stuffer,” meaning that he or she loves to stuff food by the palm food, using bigger pieces of food is actually often the answer. But you can also go to using mashed-up pieces of things to help your child slow down.

  • It’s important that at any time, but especially for kiddos under the age of 1 who are trying new foods, to resist the urge to force them to “finish” the food you have prepared for them. Doing this teaches children to not trust their body cues.

• Frequency: This can vary when they are little. At 6 months old, you can offer just once a day. As kiddos get closer to 9-10 months, you can start to offer 2-3x/day. Because food isn’t necessarily nutritive in these stages, whether you offer foods before or after nursing or bottle-feeding is up to you. If you have a kiddo who likes to shove food into his or her mouth, nursing or bottle-feeding first is a good idea.

• Allergy prevention: One of the other really important jobs that early food introduction has is preventing allergies. This is relatively new information and very different from how I was taught to introduce foods to my babies, BUT early introduction of allergens can be really helpful in preventing food allergies.

  • I recommend starting with nutrient-dense foods first, such as eggs, followed by nuts, fish, tree nuts and sesame, and finally wheat and dairy (and soy, if you choose). Let’s walk through how you might introduce eggs:

    • Start with a hard-boiled egg mixed with breast milk or water

    • Another early way to introduce the texture is with tender cooked egg noodles

    • Then try scrambled eggs cut into thick strips that can fit in the palm of your child’s hand

    • Try a hard-boiled egg quartered

    • For kiddos closer to 1 yo, you can try an omelet or quiche with sheep’s milk cheese and cut into strips.

  • Do you recognize the progression? Start with a mash if you want (not puree) and quickly move into textures. Why is this important? Foods have textures. The sooner we can help kids to manage foods with varying textures the better.

• Sensory exposure: Another really important part of early feeding is helping kids to see and taste a variety of tastes, textures, smells, and temperatures. Kids adapt rapidly. That can work to our advantage, but it can also create challenges, such as getting stuck on purees or developing adverse reactions to certain textures. This is where those of us that don’t like to be dirty can get stuck. I hate food on my hands (or really any texture). So, playing with food is not my fave, BUT making it fun for your kiddo is important and actually not that bad once you commit! Allowing your child to get messy (think hands, face, clothes) helps them learn to integrate a variety of sensory experiences. If your baby is resistant to playing with textures, follow their lead, but continue to offer and provide opportunities to explore. If you feel like this is becoming a limiting factor to trying new foods, seek help from a feeding therapist or nutritionist. The sooner you can get support around this the better.

Toddlers and Preschoolers: Navigating Opinions and Independence

• Amount of food: during this stage, the amount of food needed is increasing and the reliance on nursing/formula/milk is decreasing. You can continue to make pieces of food smaller and smaller as they are able to manage. Keep introducing different tastes and textures—and keep it easy on yourself and feed your kiddos what you are eating. If you are making fried chicken, save some of it unfriend and cut strips or small pieces for your kiddo to eat. If you are having a salad, deconstruct that salad and give them cut-up pieces of tomatoes, croutons, cheese, etc.

• Avoid “forbidden” or “bad” words for foods, or even the word “treat”: Ok, I am really so guilty of this. Using these negative words associated with food is like eating disorder 101 of what not to do. I don’t recommend giving kids processed sugar before age 2, but honestly, I know that most kids get some sort of exposure before then. The reasoning behind my recommendation is that sugar is VERY addicting and hits the parts of the brain that gives that “sugar rush.” Sugar also can negatively impact behavior and the immune system. The greater variety of foods we can expose kids to before we introduce sugar the better. Jumping off the soapbox now.

• Once sweets have been introduced it can, for some kids, make it more difficult for them to try none-sweet foods (bitter foods, vegetables, etc). Babies palettes (and humans in general if we are being honest) are wired for sweet things. When presenting sweets, and this will feel counterintuitive, one strategy is to present the item (small cookie, piece of chocolate) with the meal. Yes, you heard me. Right there next to the broccoli. This takes away the power that a food may hold for a child (or for you). It makes it neutral. In a world where binge eating and obesity, along with body shaming and guilt runs rampant, changing how we view certain foods, particularly at such a young age can be powerful.

• This is also a great age to get kids involved in the grocery shopping and cooking. Have them pick out a new veggie from the store or have them dump the tomatoes on the salad. There are a hundred ways to get kids involved early in the food-making process, and this will actually help with their interest in trying new foods!

• My last tip for this age range is that it’s ok to set expectations and boundaries. Unless your child has a specific diagnosis that requires specific attention, not becoming a short-order cook to appease all the preferences at the table is OK! It’s ok to say “no” to extra cookies, it’s ok to let the child know there is no more food available after dinner. It’s ok to tell your 3-year-old that while they may not like what is for dinner, maybe they could give that piece of broccoli a smell or kiss! Make it silly and fun, you might be surprised what happens!

If you have a child that is very limited in their food repertoire, the types or textures of foods he or she will eat, it’s time to meet with both a nutritionist and a feeding therapist. Even if there are no growth concerns. I cannot stress this enough.

As usual, that ended up being longer than intended. Please let me know if you have any questions! This concludes the 3-part series on Kids & Nutrition. Please pass this on and share if you know someone might benefit from taking a read.

To your health,