(This is Part 3 in this weeklong interview series with Dr. Katja Rowell whose consulting service, Family Feeding Dynamics, focuses on helping families learn about healthy, happy eating. Be sure to become a Family Feeding Dynamics fan on facebook, too!)
For parents struggling with their own disordered eating, what’s the first step to stopping this cycle before it’s passed on to their kids?
There are some great resources out there. I think the best is Secrets to Feeding a Healthy Family by Ellyn Satter. Other pieces of the puzzle might be in intuitive eating books, or Gina Kolata’s book Rethinking Thin. Read Secrets and learn to provide for and love yourself. The beauty of working with kids’ feeding issues is that parents are highly motivated to do well by their children. I know I have been much kinder to myself since having a daughter. I would be upset if she wasted her time and energy hating herself if she weighed five pounds more than she wanted. I have to extend that same love to myself. Fake it in the beginning if you have to. Change those neural pathways. I have found that about half the moms I work with have histories of an eating disorder. What is so lovely is that watching the children eat and trust themselves can be an eye opener for the parent. Kids have the potential to be a part of the healing process, but the trust model of feeding is essential to that in my opinion. The current control model with its emphasis on restriction and worry about weight for even very small children is I think, very damaging and triggering for moms with a history of an eating disorder. I’d really love to see this model taught to more moms who are struggling or who have struggled with food or weight. There is also an adult model called Eating Competence that I can do with clients that really walks through the process of learning to tune in to hungry and full for adults. Find someone trained in that model that can work with you, or find a therapist who has worked in this area with mindfulness etc.
How can we tell if our kids ARE too heavy or too thin?
This is so important, and something that even many health care providers mess up. The focus now is on using BMI to “diagnose” a child as being overweight or obese. The problem is, it is inaccurate and was never intended to diagnose based on a single point. A child can be at the 90th% and be very healthy while that is officially “obese.” A child at the 50% may be sedentary and have a very poor diet. What is important is looking at the rate of growth. Is your child holding steady at roughly the same percentile? Is he falling off the growth chart, or is there rapid acceleration? Unfortunately right now a whole lot of healthy larger kids are being mislabeled as having a problem and this then starts the unnecessary and sometimes harmful interventions. Simply by labeling a kid as “overweight or obese” means they will feel flawed in every way, be less likely to be physically active and more likely to diet and thus gain weight. Words really matter. Also, small children who are growing steadily need to be fed with the Division of Responsibility. Too often these kids are labeled as having a problem, and docs say things like, “Do whatever you have to to get food into that kid.” I literally have clients who chase their kids around with sausage and Ensure in Sippy cups. Those kids grow less well. Life then revolves around getting more food into, or taking food away from children. It can be pretty miserable. And my heart really goes out to families who have a small and a large child who are being advised to feed one kid one way, and the sibling another. It’s hell and it doesn’t work. Imagine how two sisters will feel as one is getting food slapped out of her hands and the other one is getting milk shakes pushed on her? The trust model works for every body-big or small.
(From Dawn — I had this with Noah. When he was nine months old his growth curve slowed a whole lot and started to slim way down. He was always a skinny baby anyway but he started walking a week before he was nine months old and wasn’t nursing as much. Between getting more mobile and eating less, the kid got skinny and our then pediatrician FREAKED THE HELL OUT. He said exactly what Katja quotes here, “Do whatever you have to to get food into that kid.” Seeing as how the only food Noah was interested in was breastmilk, I knew this was a lost cause and I went home and cried. Then I got out Brett’s baby book and saw that Noah’s curve was Brett’s curve and I switched to the other pediatrician in the practice. The next pediatrician watched Noah tumbling around the exam room and said, “He’s small but he’s mighty. Keep nursing him and don’t worry about it.”
Fast forward to chubby baby Madison. You might recall this post where the doctor said I was over-feeding her and she even made allusions to my obvious inability to parent Madison, saying that many parents (me included, she implied) grab the bottle “and it may make then stop crying but then the parent isn’t really meeting the baby’s needs.” So I spent 24 hours meticulously measuring every ounce of formula I was giving her and then I did the math to see if I was over-feeding and found out that Madison wasn’t even eating enough calories to — theoretically — maintain her growth. I switched doctors then, too, to another more experienced doc in the practice. This one said, “Do you have any info on her bio parents? Oh, her mom was a chubby baby, too and her dad is a big guy? Don’t worry about it.”
If I’d listened to either of the docs instead of sitting down and really looking at our on-demand feeding, I’d have two majorly disordered eating kids. I can’t imagine how awful it would have been if I’d started both my kids on “diets” meant to change their natural body shapes before they even hit a year old.)
I often check into your blog because I find it valuable for alternative families like mine. I birthed my son but he doesn’t have a dad, he has a donor. So first, thank you for your work.
I’m finding these entries on food and weight to be enormously powerful. I am a fat woman–and I mean really fat (200 lbs, under 5′) and I know I got here due to an unhealthy relationship with food (food = love, comfort, and care). My son has always been slender and active, although he’s become much more sedentary in the last year or so (he’s almost 13–Bar Mitzvah in a month and a half) and has begun to get a bit of a belly. And when I said “a bit of a belly,” I mean a little roundness that may be there so he can store up what he needs to grow! But he knows that I’m fat and worries that he is becoming fat. He’s always been a grazer. Even as an infant, he had a hard time nursing until he was really full and now he regularly eats small meals and wants to snack (mostly he wants chips or other salty foods) before and after. He’s begun to mimic my habit of non-stop stress-grazing, though. These three posts are pushing me to reconsider my behavior as a model for my son’s behavior. I’m not concerned about his weight, but I am concerned about the relationship with food that I’m modelling. I want him to have a much healthier relationship, so I guess I’ve got to develop one, too. Thanks again for making me think!
Hi Sydney, You’re right kids often do get a little soft before they grow with puberty. A great book for parents and families is Secrets to Feeding a Healthy Family if you want to learn more. I am so thankful that I found this info for my family, and now hope to share it with others. Good luck!
When we were going through the worst of the Tongginator Failure to Thrive bit, I felt such intense guilt. Then a very, very wise friend told me, “it is not your job to make the Tongginator eat. It is your job to present her with healthy choices at appropriate intervals. It is HER job to eat.” Such a simple thing to say… but what a world of difference it made.
We didn’t freak (okay, we did a bit, but who wouldn’t when your child is 13 months old and less than 14 pounds?)… and we gave it time… but one thing I am very glad we avoided was chasing her around, trying to get her to eat something, ANYTHING. What a way to foster unhealthy eating habits and develop a taste for unhealthy foods.
Anyways, it DID take a long time, but the Tongginator went from not even being on the Southern Chinese girls growth charts to being in the 50% on the American charts for height and 35% for weight. She’s remained steadily there for a year or two now. Most importantly, she looks healthy and has plenty of energy. She’s still a tad obsessed with all things food (Food Network, anyone?), but she’s learning to control it and has a very healthy attitude towards eating, all things considered.
Loved these posts, Dawn (and Katja). Few social workers warn you about the food issues you will likely face as parents, especially if you adopt internationally, as we did. Thank you so much.
Tonngu Momma, good for you, and glad your friend was there with the message you needed to hear! She saved you all from a lot of heartache potentially. My friend adopted two children who were both under six pounds at six months when they came to live with her. She was very frustrated with the information she got from the medical community in terms of feeding, and figured this out on her own. (It was in the 80s) She says she “trusted” them to know how much they needed and they are both very healthy and happy now.
I did a lot of research around adoption and feeding. I’d love to do some classes about this method around feeding when size, development and feeding history is such a concern. I am so glad you were able to support your daughter as she grew. This model of feeding is so trusting, nurturing, respectful,and ultimately I think fosters attachment.
It’s kind of a leap of faith isn’t it? We think we are so much in control of everything, and are often encouraged to think we can control our child’s appetite, portions, and ultimately weight.
Thank you so much for sharing your story!
I can attest to the BMI fallacy. My oldest is in great shape at 5, and his BMI = obese. The doctor agrees it makes no sense.
Really enjoying this series. It’s got me thinking.
That you so much for doing this series and introducing me to some new blogs and books on this topic.
I hate the Well Baby visits with my children (both are open adoptions, which is how I originally found your blog). My son, who is now 18 months old, has always been very thin. He’s in the 97% percentile for height, but varies from 12 – 20% percentile on weight. I hate getting the tsk-ing and shaking head from the doctor if it’s nearer to the 12% than the 20%. And this child literally eats all day long. He eats 3 full meals a day and I leave healthy snacks (fresh fruit & vegetables, cheddar cheese chunks, whole wheat pasta, etc.) where he can reach it throughout the day so he can snack as he wishes. He’ll snack up until a meal time and still eat a full meal.
The doctor routinely makes me feel as if I am neglecting him by not feeding him enough. I would change doctors, but there are only 2 pediatricians in town and the other doctor is worse!
Thank goodness my 5 month old daughter is smack dab in the middle. No head shaking or tsk-ing required!
This series is very reassuring.
I’m glad it’s reassuring! Would you have the courage to ask your doctor to read Chapter 2 of Child of Mine from Satter’s website? go under resources, and you can download a pdf.
http://www.ellynsatter.com
It would be so helpful for her/him be a better provider. Remember that this method of feeding is endorsed by the American Academy of Dietitians, it’s not some out there theory! Might help!
I’ll suggest it, but as we live in Switzerland he may not be impressed by an endorsement from the American Academy of Anything!
Ha! Love it! I speak German, maybe I can come over there and do a workshop…
Dawn, thanks for doing this series, it’s been a great reminder.
We read Child of Mine a few years back and it was such an eye opener, after Liam also went the way of dropping off the bottom of the chart once he started to walk (and was still barely eating solids at 12 months).
Luckily my GP didn’t worry much, just asked if we were small babies (Chris – I don’t know; but my and my sibs -yes). But the nurses doing the weighing were a different matter, and we did get into a pattern of trying to get him to eat solids, by doing things like a) standing in front of a light switch letting him play with it while we spooned food into his mouth, or b) letting him eat chicken nuggets just to get some calories into him. Setting up some eating control/resistance patterns which I believe haunt us to this day, seven years on. Lately some of that control/power struggle has crept back in, to the point that I’d been considering giving in to the ‘just one bite’ school of thought. So this series came at a really good time for me.
I spent most of today with a half sleeping baby on my lap, unable to type but able to scroll, so after I finished here I went to Katja’s blog and read the whole picky eat category, LOL,