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Course Sample:
Introduction
Fostering Positive Eating Habits and Attitudes: Toddlers (18 months to 3 years)
Child nutrition often focuses on the "right" kinds of food and beverages to provide children. However, just as important are the parent?s (and caregiver?s) attitudes and behaviors regarding eating, nutrition, and physical self esteem. In fact, being a good role model may be the most important thing parents can do to raise healthy eaters (Patrick, 2005). But first, parents must learn how to eat healthfully and have a positive relationship with food and their own bodies before they can pass these attitudes and behaviors on to their children.
Children acquire most of their eating attitudes and behaviors by the time they are six years old. Food preferences are established early in life and may predict later eating habits. Therefore, efforts to foster the development of healthy eating habits should begin very early in life (American Dietetic Association, 2001; Fox, Pac, Devaney, & Jankowski, 2004). Also of note is that children can learn to misuse eating beginning at birth when parents may use feeding to comfort, distract, or entertain. This learned behavior is cemented in the toddler years and may lead to overeating (Satter, 2005).
What is a parent to do? The goal is to foster healthy eating attitudes and behaviors in their children, or in other words, to raise healthy eaters. But, what is a healthy eater? According to Ellyn Satter, a registered dietitian, clinical social worker, and expert in child nutrition and feeding dynamics, some of the characteristics of a healthy eater are:
Child nutrition often focuses on the "right" kinds of food and beverages to provide children. However, just as important are the parent?s (and caregiver?s) attitudes and behaviors regarding eating, nutrition, and physical self esteem. In fact, being a good role model may be the most important thing parents can do to raise healthy eaters (Patrick, 2005). But first, parents must learn how to eat healthfully and have a positive relationship with food and their own bodies before they can pass these attitudes and behaviors on to their children.
Children acquire most of their eating attitudes and behaviors by the time they are six years old. Food preferences are established early in life and may predict later eating habits. Therefore, efforts to foster the development of healthy eating habits should begin very early in life (American Dietetic Association, 2001; Fox, Pac, Devaney, & Jankowski, 2004). Also of note is that children can learn to misuse eating beginning at birth when parents may use feeding to comfort, distract, or entertain. This learned behavior is cemented in the toddler years and may lead to overeating (Satter, 2005).
What is a parent to do? The goal is to foster healthy eating attitudes and behaviors in their children, or in other words, to raise healthy eaters. But, what is a healthy eater? According to Ellyn Satter, a registered dietitian, clinical social worker, and expert in child nutrition and feeding dynamics, some of the characteristics of a healthy eater are:
- The child likes to eat and feels good about eating.
- The child is interested in food and takes charge of her own eating.
- The child is relaxed about picking and choosing from the food on the family table and eating what she wants without making a fuss.
- Given the support of the family table, the child can eat a variety of food. Over a week or several weeks, that variety will add up to a nutritionally adequate diet.
This isn?t something that happens overnight. It takes years to raise a healthy eater (1999).
Unfortunately, society has lost sight of the importance of healthy eating attitudes and behaviors. Adults are often restrictive with their own food intake and may also be restrictive when feeding their children. Increasing attention is given to limiting and even banning certain food and beverages. The focus on child overweight has made parents and health professionals too concerned and confused to believe that fostering positive eating attitudes and behaviors is a viable solution. Many feel that children can?t be trusted to eat what and how much they need. According to Satter, "Today?s crisis is not one of child overweight. It is a crisis of parenting and feeding" (2005, p. 8).
Food is not the enemy. Food helps keep us healthy and strong, gives us energy to do the things we want to do, tastes good, and is to be enjoyed. To be mentally, socially, and physically healthy, parents must nurture themselves and their families ? and feeding is one of the most basic ways to nurture.
This module provides an overview of how parents can instill good eating habits and attitudes in their children beginning at an early age. This module also explains how to make meal and snack times an enjoyable experience for the entire family, setting the stage for life-long healthy and enjoyable eating.
Health professionals are encouraged to adopt these healthy attitudes and behaviors about feeding, eating, weight, and physical self esteem and pass these concepts on to parents and caregivers. "Professionals who work with children are in a powerful position to teach and support parents in effective, stage-appropriate feeding" (Satter, 1996). Parents need to know: enough about child development to understand what children are capable of eating, enough about nutrition to offer food that is developmentally and nutritionally appropriate, and how to foster a positive eating environment.
Developmental Changes
Where do parents begin? Parents need to know a little about what makes toddlers tick. The psychological, social, physical, and behavioral development of toddlers should be taken into consideration. Parents need to understand what children of this age are thinking, feeling, and experiencing in order to understand and cope with the way toddlers behave during meals and snacks.
In general, toddlers approach eating situations in much the same manner as they approach other activities of daily life ? with a mixture of curiosity, fear, willfulness, and limit-testing.
Psychological, Social, and Behavioral Changes
Toddlers want to be independent and successful. During the toddler years, children make their first attempts to assert their independence and begin to separate themselves from their parents. A well-known example is that toddlers say "no" to their parents often and with vehemence.
Toddlers also need to explore to learn about themselves and the world around them. They test limits and battle for control with nearly everything in life, including issues surrounding food and eating. When toddlers? abilities don?t match their ambitions, they can become embarrassed and frustrated. The result is that toddlers may vacillate between wanting to do everything themselves and wanting to be fed. But, they need and want limits from their parents and caregivers so they feel secure and learn appropriate behavior. These conflicting desires can be confusing and scary for toddlers. To help toddlers feel more secure and also have a sense of accomplishment, parents and caregivers need to set limits without being controlling.
Although toddlers are naturally inquisitive, they are often afraid of new things (neophobic). This includes new foods. Parents can be supportive by allowing toddlers time to get used to new foods. The wary toddler will watch others eat a food, maybe move it around on her plate, smell it, or taste it ? many times ? before she attempts to eat it. Parents who are aware of this tactic are more likely to be patient and continue to offer new foods even when faced with repeated refusals.
Toddlers also need to be included so they feel that they?re a contributing part of the family. Enjoying meals as a family respects this need and teaches toddlers to conform to family dynamics and expectations of appropriate behavior. For example, toddlers can learn to behave well enough at the table for parents to enjoy having them there.
Physical Changes
During the toddler years, growth slows to about half the rate of previous growth (during the period of infancy to 12 months of age). Because of this, toddlers are often not very hungry. However, they need enough nutrients to promote growth and health, and enough calories to fuel active play, learning, and the next stages of growth. Because toddlers? stomachs are small (about the size of their own fist), they need to eat small amounts and to eat often to meet these nutrient and energy needs.
At this age, children are becoming more skilled at manipulating objects. Toddlers are gaining more dexterity in their hands and can learn to drink from a cup and manipulate eating utensils. However, they will rely mainly on their hands to eat, so spills and messes should be expected. Parents can make accommodations such as placing a plastic mat under the highchair and putting a large bib with a pocket on toddlers before meals and snacks. Parents should not scold toddlers for being messy eaters unless, of course, children are being deliberately messy -- such as throwing food against the wall.
The Division of Responsibility
So, how do parents deal with eating situations when toddlers are going through so many changes that affect how and how much they eat? Satter?s philosophy for child feeding, the Division of Responsibility, helps parents set appropriate limits and, at the same time, promote children?s independence. This model was developed by Satter through clinical experience and validated by research (Hoerr, Utech, & Ruth, 2005; Satter, 1995). Parents who adhere to the Division of Responsibility raise children who are better food tasters and eaters, behave better at the table, and are much more likely to have a healthy relationship with food and their bodies.
The Division of Responsibility assigns some of the jobs related to eating to the parent, and some to the child. The parent decides what food to offer, when to offer it, and where it should be eaten. The child?s jobs are to decide what to eat of the food provided and how much to eat -- or even whether to eat at all (Table 1).
Table 1. The division of responsibility for toddlers through adolescents.
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Parent?s Feeding Jobs |
Child?s Eating Jobs |
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Choose and prepare the food. |
Children will eat. |
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