family meals

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Persistence. The key to combatting toddler fussy eating?

I’ve had lots of people say to me, “You’re lucky your kids are good eaters. It must be easy because you are a dietitian”. Thankfully, my kids do love to eat – now. And I genuinely feel more happy and relaxed at family meal times now with 4 kids at the table than ever before. But I will be honest – it’s still not “perfect” (is there even such a thing?), and it was a long road to get to where we are.

We haven’t exactly had things easy in the feeding department. All 4 of my kids have had food allergies – 2 still see the Allergist regularly. One had the most sensitive gag reflex as toddler, she would eat an entire meal, vomit then immediately ask to be fed again. And one had a horrible run with enormous tonsils and adenoids, having multiple infections, speech difficulties and feeding aversions before needing speech therapy and surgery. All of these are minor issues in comparison to the complexities faced by many other families – but they were enough to add stress to an already gorgeously chaotic family life.

So while I haven’t had the easiest run with feeders, I do feel incredibly blessed that our issues were small, that my training allowed me to see what was happening, and that I had the knowledge to know where to get help, and what to do at home.

But as I said, it was a long road to get here, particularly with Mr Tonsils. In all honesty, how we ended up here was not through luck, or my profession, but through sheer persistence.

There were so many times when I wanted to just give him pasta, again, while we ate something else. Times when I picked up food from all over the floor, screaming on the inside, but calmly outwardly saying “Food stays on the table”. Countless times when I lamented the huge waste of food as I throw the veggies in the bin, again. But it was the persistence with calmly offering without expectation, giving only brief and gentle encouragement, and most importantly, family role modelling that led to where we are today.

Recently, he, the fussiest of my four, finally bit into a cherry tomato (albeit in a effort to squirt his sisters with the insides – but thats how we encouraged him to put it in his mouth) and said “I tasted the juice!”. A few months ago he would’ve pouted “I don’t eat tomatoes, take it off my plate!!!”.

He also ate black charcoal noodles – “Mum, black is my favourite colour”- when they arrived unexpectedly in his beloved ramen noodle soup at a new restaurant. He randomly picked up the broccoli I was preparing for his sisters’ school lunch boxes and said “Mum, I eat this now, I’m strong”. He then proceeded to pop it in his mouth and walk away – the rest of us stunned into jaw dropping silence. He picked up chicken breast of the plate and ate it without a word, after months of not eating it. He drank a green smoothie and called it “hulk juice”, flexing his biceps as he drank.

So, you can safely say we had an amazing week at the dining table that week (cue champagne!), which reminded me that all that persistence with our feeding plan was worth it. We were winning.

I know I’m not alone in this sort of feeding experience. I’ve met so many parents over the years who have faced the same thing. The ongoing trials, but then finally the successes.

This year Julia and I will be putting together a package to help families with their in home feeding issues; so watch this space. We will share the training and experience we’ve had as Paediatric Dietitians, and the trial by fire we’ve had as parents. We’re aiming to provide families with scientifically sound, but genuinely practical advice. It works if you work it. We’ve got proof!

Find this, and more family eating, health and wellbeing stories in our Bloom quarterly nutrition newsletters. And to subscribe to future updates, click here

Angela @ Bloom 🌿


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The toddler years can make you feel desperate. One minute they enjoy food, the next they’re rejecting everything you offer them, and the word “yuk” and “no” feel like they’re on repeat. 

It is often during this time, that I see parents using “distraction” techniques in an attempt to get their child to eat. By distraction I mean doing things like allowing them to watch their favourite TV show, propping an iPad up at the table, or allowing books and toys to be played with whilst they eat their meal. 

And do you know what? It can work for a while, but what are the consequences of doing this, and what are you really teaching them?

Did you know that all children are born with the ability to regulate their appetite and consequently their energy intake? Studies in healthy young babies have shown that if you increase the calorie strength of their infant formula, they will simply decrease the amount of formula they take. It makes sense really. To survive as a species, our bodies need to have some inbuilt ability to know how much energy we need. This is what our appetite is. What’s interesting, is that whilst we know babies can self regulate their appetite, studies have shown that by the pre-school years many children display “non hungry” eating behaviours. In other words they have learnt to eat in the absence of hunger and are not responding to their appetite. How does this happen?

Non hungry eating is a learnt behaviour that evolves from the environment around us. It occurs when we learn to associate eating with other things. It can come from very simple experiences. For example has your child ever hurt themselves and you’ve soothed away their pain by offering up an ice block or some other treat? Or perhaps you’ve had the opposite experience and rewarded your child with a treat because they excelled at something? These simple experiences repeated over time start to teach us to use food in a way that isn’t linked to our appetite.

Going back to using distraction techniques at the dinner table, what you are really teaching your child is to eat to an external cue, not to their appetite. Your child is learning to eat mindlessly and is far more focussed on the tv or iPad. But I can hear many of you crying “but it works, they stay at the table and they eat!”. Well yes it can. Providing something enjoyable at the dinner table (tv) will certainly be more likely to get them to stay there. But let’s be clear, they’re there to watch tv, not to enjoy the food or your company. If your long term goal is to have your children willingly coming to the table and participating in the family meal, this approach isn’t going to solve it.

Far and away the biggest concern with offering a distraction at the dinner table is the fact that it doesn’t allow the child to properly listen to their appetite. As I’ve already explained, young children can be very good at self regulating and will eat when they’re hungry and stop when they’re full. Allowing them to watch tv or do other activities whilst they are eating, erodes this ability, and over time contributes to non hungry eating. This is a risk factor for becoming overweight or obese. Teaching your child to listen to their appetite is probably one of the best things you can do early on to set them up for a lifetime of healthy eating.

So how do you get your child to come to the table, stay there and eat? This is the million dollar question isn’t it? First of all you need to think about the reasons that your child is not coming to the table or wanting dinner. For young children the reasons for this can often be that they are simply not hungry or they are just too tired. If your child is healthy and growing, you need to trust that they know how much they need to eat. Our expectations as parents often need checking as well. Most parents I have interviewed serve their child far too much food. Toddlers are strange creatures and can adopt all manner of eating patterns. One Mum recently told me that her 2yr old eats breakfast and then doesn’t eat again until dinner. Many toddlers are very good at going for several days eating very little to then have a few huge days of eating. These are all frustrating experiences for us as parents.  As always I recommend that you adopt a “division of responsibility” around feeding. That is you decide what, when and where your child is going to eat and then it’s over to them as to whether they are going to eat it at all, and how much of it they are going to eat.

You have no way of knowing how hungry or full your child is. Don’t ask them to have a prescribed number of bites or “clean their plates”. This is reinforcing not eating to their own natural appetite and over time can erode their ability to tune into it. 

So if your child only eats a teaspoon at dinner try not to obsess over it. I’m going to finish by quoting the guru of infant feeding, Ellyn Satter “Be happy with what you serve, not what they eat”. 

A word on feeding disorders in infants and children…

I’ve written above that all children are born with the ability to regulate their appetite, there are however, some exceptions to this.

Infants or children that experience medical problems early in life can often get off to a horrible start with feeding. These experiences can completely destroy their ability to regulate their appetite. 

For example I have worked with many premmie babies who have required nasograstric feeding from birth to survive. Being in a hospital environment, these babies are usually fed to a schedule with quantities and times dictated by dietitians and nursing staff. Whilst every effort is usually made by staff to try and adapt the feeding regime to how they see the baby responding, it is simply not the same as feeding the baby on demand and to their appetite. There may also be traumatic oral experiences such as orogastric or nasogastric tubes being inserted multiple times, oral medicines, ventilators etc etc, all of which can contribute to making a child what we call “orally averse”. That is, they don’t want anything (even things we think of as pleasant such as food), anywhere near their mouth.  Other children with severe sensory issues or Autism, can also find eating such a challenge that this overrides their instinct to tune into their appetite.

These children are HARD work to feed. Whether you are trying to wean your child off a feeding tube or avoid having one inserted, it has probably made you stressed and anxious, and willing to try anything to get your child to eat. In many instances, parents find they can get a little more in if they let their child watch tv. Unfortunately while this appears to work in the very short term, it’s not solving the underlying problem, which is allowing this chid to reconnect with their natural appetite. If you are struggling with a child with extreme eating behaviours, we would still recommend not using tv or other distraction techniques at the dinner table. This just puts another barrier in place which prevents your child from learning how to self regulate their appetite. 

If you are struggling with a child with a severe feeding disorder get in contact and we will try and point you in the right direction for help.

Julia @ Bloom


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Sugar. There’s been an explosion of interest over the past few years, but how many people actually know why we should be limiting it, and how much exactly should we be limiting our children to?

When I ask most parents why they believe we should avoid sugar I usually get answers such as “It’s bad for you” or “It causes Type 2 diabetes”, neither of which are really correct. With so much hype and hysteria over sugar, the real evidence and concern with it’s intake has been lost, such that people now think it’s mere consumption is going to do them harm.

Back in 2015 the World Health Organisation (WHO) released their Guideline: Sugars Intake for Adults and Children. You can read the full document here: http://apps.who.int/iris/bitstream/10665/149782/1/9789241549028_eng.pdf?ua=1

This guideline specifically looks at what we call “free sugars” in our diet. That’s sugars (monosaccharides and disaccharides – e.g. glucose syrup, white sugar, brown sugar, rice malt syrup etc..) added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates” (WHO, 2015).

This guideline reviewed all the current evidence (at the time of publication) as to why we should be avoiding sugar and went on to make recommendations as to how much sugar adults and children should be limiting ourselves to. You may be surprised to learn that the evidence for avoiding (or rather limiting) sugar relates primarily to obesity and dental caries. Sugar is often cited as a cause or risk factor for developing a wide range of diseases ranging from Type 2 diabetes, heart disease and cancer. However the fact of the matter is that that evidence simply doesn’t exist (yet). What we do know is that overweight and obesity are independent risk factors for chronic or non communicable diseases such as Type 2 diabetes, heart disease and some types of cancer. Going back to the WHO guideline, they found a MODERATE level of evidence that lower intakes of free sugars was associated with lower body weights in both adults and children. Please note that this does not mean that sugar causes you to become overweight or obese either. It simply means that people who consumed a diet higher in sugar, were more likely to have a higher body weight. The development of overweight and obesity is a complex issue and trying to narrow it’s cause down to one single nutrient is misguided, but that’s a discussion for another day.

The WHO guideline specifically recommends trying to reduce the intake of free sugars to 10% or less of your total daily energy intake (this is for both adults and children). There is a further recommendation to reduce it to 5% of total daily energy intake, however, the evidence for this recommendation was stated as WEAK, so for the purposes of this article, we will stick with 10%. I’ve represented this below as the number of teaspoons of sugar an “average” sized child with a light activity level, would need to limit their intake to each day.

So I wondered how I was fairing with my own children in relation to this guideline? I have always been well aware of which foods contain added sugars and done my best to limit their intake. I’m no sugar nazzi though, and my personal opinion is that if sugar is packaged up in a food that also contains many nutrients that are beneficial, then I’m fairly happy to include that food in our diet. We certainly limit our intake of foods that are high in sugar but offer little other nutritional benefit (think lollies, cakes, biscuits etc..). That said, we still enjoy a slice of home made cake, ice cream and chocolate in moderation. But day to day with my children’s typical diet, how was I really doing? Was I anywhere near the guideline, or had I totally blown it without even realising? I have to admit I was a bit nervous to take a closer look. Maybe I wasn’t doing as well as I thought I was?

I present to you my 4 yr old’s intake on a typical kindy day. All of the free sugars he consumed are listed in bold.

Breakfast: Rolled oats and 1 tsp of honey with reduced fat milk and a glass of unsweetened orange juice


SUGAR: 4 teaspoons

Lunch box: coco cranberry bliss ball, apple + carrot muffin, wrap with roast chicken, carrots, cucumber, rockmelon, plain milk and an apple (to be shared at fruit time)


SUGAR: 2.5 teaspoons

After kindy snack: Strawberry smoothie (frozen strawberries, strawberry yoghurt, water), he also then asked for another coco cranberry bliss ball

SUGAR: less than 1.5 teaspoon

Dinner:

Spaghetti Bolognese, bread and olive oil spread and a fruit platter (he only ate the watermelon)

SUGAR: none

Total: just under 8 teaspoons

Well I have to say I was pretty relieved to see that I’d just made it under the 10% guideline, but I certainly hadn’t made it any lower! I’d also have to admit they we certainly do have “blow out” days from time to time where my child’s sugar intake would be much higher. For example earlier this week I treated the family to a homemade dessert of chocolate self saucing pudding which I served with 1 scoop of ice cream. A dessert like this would have around 3 teaspoons of sugar in it.
I have to say on the whole I feel pretty happy that I’ve got my child’s typical diet fairly much where I want it to be. Sure, I could improve a little by not offering orange juice at breakfast, but he enjoys this and the vitamin C also helps him absorb the iron from his oats (a serve of whole fruit would offer the same benefit).

Calculating your child’s sugar intake is tricky business. It was difficult for me and I’m a dietitian! That’s primarily because our food labels don’t currently require manufacturers to separately list added or free sugars independent of any naturally occurring sugars. So at home, rather than focus on how much sugar your child is currently consuming I’d focus on just minimising fee sugars where you can.

If you want to try and reduce your child’s sugar intake my top tips would be:

1. Watch your child’s intake of sweetened beverages, don’t offer soft drinks or cordials, keep juice to no more than 1/2 a cup per day (unsweetened at that), alternate offering sweetened milk drinks with plain milk or sweeten with fruit (smoothie style)

2. Reduce your intake of processed/packaged snacks – most store bought snacks have a surprising amount of sugar added. Better to make your own and experiment with reducing the sugar content of some of your go to recipes

3. Avoid sugary breakfast cereals and opt for wholegrain “plain” varieties, rolled oats, weetbix and shredded wheat biscuits are go to’s in our house.

3. Keep occasional food as just that, occasional

4. Read labels on the food you buy. Ingredients have to be listed from most to least, if sugar is high up on the list you probably want to avoid it.

On that note, maple syrup, honey, rice malt syrup, glucose syrup, coconut sugar and rapadura sugar are all sugar. Yes some contain more glucose and others more fructose (or other mono or disaccharides), but they ALL need to be counted as sugar. You may have noticed a surge in popularity of so called natural or less refined sweeteners in the community. I see many recipes labeled as either “sugar free” or “refined sugar free” only to see they contain a LOT of honey or maple syrup. Whilst it’s true that many of these “natural” sweeteners do contain other nutrients (for example 100ml of maple syrup contains 89mg of calcium and 1.6 mg of iron amongst other things) whereas white refined sugar offers nothing beyond its carbohydrate content. The point I’d make, though, is that if we are actively working on trying to reduce our intake of sugars, I wouldn’t be focussing on these products for adding extra nutrients into my diet. They are also very expensive. Whilst I do personally use of these “natural” sweeteners, I do so more out of taste more so than for any nutritional benefits they confer. That said, it you can afford it, there’s no harm using honey or maple syrup as your sweetener of choice at home.

How do you think you’re fairing with your child’s sugar intake?

Julia @Bloom x