(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.)
