toddler eating + ellyn satter

December 5, 2013

at annabel’s 18 month checkup, our pediatrician looked at me somewhat sternly.  she was still on the curve for weight, but riiiiight at the top.  and at 65% for length [somehow], this apparently put our MD on guard a little bit.

and for a while after this visit, i have to admit that i was too.  for the record, i think that annabel is the cutest, most beautiful child i have ever seen [not that i’m biased or anything 🙂 ].  i love her squeeze-ability, her sturdiness.  and i know her diet is quite healthy!  she isn’t terribly picky [though getting pickier . . . ] and drinks zero juice, loves water, and eats the same things that josh and i eat [no mac ‘n’ cheese habit!].  but after our ped commented, i did start to get a little worried.  i think that this is because i happen to work in a field where i see frighteningly overweight children quite often.  10 year olds pushing 200 lbs who are debilitated by their size.  6 year olds who outweigh me [or they did in my non-pregnant state].  depressed teens who are physically and emotionally paralyzed by an extra 150+ lbs.  i’m not saying that this is true for every overweight 17 year old — perhaps some are well-adjusted and healthy, and they just don’t get referred to an endocrinologist.  but many that i have seen make me incredibly sad.  treatment often feels incredibly FUTILE, too.

and after that visit, i thought — is our ped implying that MY adorable toddler is headed in that direction?  is it even remotely possible or likely?

it turns out that:

a) it isn’t likely [this relatively well-regarded calculator gives her about a 4/1000 — 0.4% — chance of ending up with a true obesity issue during childhood]

b) it will be better for everyone — EVERYONE — if i just follow normal toddler eating recommendations, without worrying about it.

i learned this from reading child of mine, by renowned pediatric RD ellyn satter.  her book made so much sense to me and i felt so much better after reading it.  the guidelines are laid out for EVERY child – those on both sides of the spectrum, and also right down the middle.

the main guise of the book:
parents are in charge of deciding what, when, and where children will eat.

children [from infants to teens] are in charge of whether and how much.  satter believes [and i do, too] that with a variety of healthy food provided, kids [and even adults, but that can be tougher] will self-regulate and find their natural set-point.  some kids will be smaller, and others bigger.  and both are ok!  but most likely, they won’t self-regulate to an unhealthy point.

some of her more specific recommendations included:

— offering 3 meals and 2 snacks [where ‘snack’ does not have to mean unhealthy – often can be just as nutritious as traditional ‘meal’ offerings] daily, in a predictable fashion

— meals and snacks should be eaten at the table, not while playing

— keeping mealtimes casual and never pressuring a child to EAT MORE / EAT THIS / STOP EATING / etc.

— always provide at least one item on the plate that the child likes — even if it’s bread, rice, a fruit, whatever — but do NOT cook/cater to the child or do any short-order cooking.  [i have always been against the idea of ‘kid food’ and continue to be, so i loved this one.]

— have family meals whenever possible.  i wish we did this more – it’s the one area where i am failing a bit.  we always have breakfast together, and of course lunch and most dinners on weekends.  but weekday dinners are tough.

— sometimes allow for treats, to avoid them becoming ‘forbidden fruit’.  we don’t give annabel dessert-type foods regularly, but maybe one treat-type food [a cupcake, cookie, whatever] something like weekly.  [it’s worth it alone just to hear her pronunciation of ‘cupcake’ = ‘tup-tate.’  omggg.]

i really just loved her overall tone, and for me the absolute best part was that i realized exactly what were my responsibilities [see above] and what i truly should not worry about.  in the absence of a syndrome or endocrine disorder [which i can say quite confidently that annabel does not have 🙂 ], children will learn to self-regulate.  in the end, all i can hope for is that she has a healthy and happy relationship with food to stay with her forever.



#1: just for the record, i was quite a chubby baby/toddler, too.  i was also TALLLLL – my 18 month stats put me at 95% height!!  josh as a child was super short and super scrawny [sorry babe, you were!  but you were still cute], and grew like 4″ after graduating from high school.  so parents – don’t assume that your kids will look the same as adults as they do as toddlers.

#2: one issue i did have with the book was that satter does not really address the potentially bad habits that are out there today — candy/junk in classrooms on a daily basis [not just as treats], juice as default beverage, etc.  for the records, i DO think there are things that can interfere with self-regulation and they are not always easy to avoid.  but that tends to be more of an issue for older children.

#3: i am now trying to bring these recommendations to my practice when appropriate, and have recommended satter’s books to a few parents.  i’ll have to let you know if i get any feedback.


and on another note:
YOGA.  a knows tree [shown below], warrior [sort of – she forgets the arms] and down dog.  omg, i love this age.

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