Food for Thought: Eating Consistently

Follow our series on the who, what, where, when, and how of feeding our children of all ages!

Our Readers Ask:

My 16-month-old son used to be a very laid-back and cooperative eater. He ate enough and was always happy to try any new food item we gave him. Lately, though, he has become uncharacteristically fussy. This has happened right on the heels of my getting promoted at work, which means I am working many more hours than before. I've been able to have my nanny bring him to my office at my lunch hour most days; without this arrangement, I would go without seeing him for twelve plus hours every day, since I arrive home so late and usually miss dinner. On the weekends my husband and I are much more relaxed and we spend all of our time with our son, but we still have difficulty getting him to eat the way he used to. All he seems to want now is milk, plain noodles, or Goldfish crackers. How can we get him to eat again? 

Regardless of how you nursed or bottle-fed your baby, during that time you probably got a good sense of how critical a schedule is to developing good feeding behaviors, and this continues to be true especially throughout his toddlerhood. The unfortunate downside to the change in your work schedule is that it has probably  Simply put, a major part of developing healthy eating habits is maintaining as much consistency as possible with regards to when and where he eats. Even on the weekends, try as much as you can to mirror the same schedule you have on weekdays. Scheduling meals so that they are predictable will help your son learn to regulate his appetite, as well as anticipate and delay gratification. You can reinforce his eating schedule by providing foods typically associated with breakfast, lunch, snack, and dinner for these meals, respectively. He will have a stronger grasp of how his day is ordered and what is coming next if he knows that certain foods appear mainly at certain times of the day. This kind of consistency will also make it easier and more comfortable for him to enjoy a wide range of foods, identifying her favorite things to eat but also being open to trying new tastes and textures.

Besides maintaining a schedule of when your child eats, it is also important to be consistent for the most part about where you feed your child. Your little girl will be free to focus more on the social aspect of eating if she doesn't also have to struggle with a change of eating environment. By now you have probably noticed how difficult it is to feed a child in a place that is strange to them, like a restaurant or a relative's home, no matter how comfortable you are. To a point, when the child is not thoroughly aware of her surroundings, she will eat as long as you are there to feed her. Somewhere around 15-18 months, a child begins to notice differences between you and other people, and herself and you. It will be more difficult for the next year and a half to feed her anywhere besides her own little highchair.

 Watch Your Baby Play

Our Readers Ask:

I have a two year old boy who gets into the bathtub with his toys and completely shuts me out! He runs his cars and boats up and down the edge of the tub, humming to himself or talking to the toys, and pays no attention to me, even though I'm sitting right there on the floor next to him. If I try to join in the play, he acts like I am an evil witch intruding on him! He pushes my hand away and just turns further around. I feel left out, and honestly, sometimes my feelings are hurt. He does this when we play on the floor, too, but it isn’t so obvious, because I'm not usually sitting so close to him as I am at bath time. But, despite all this, if I move away for an instant, he gets really cranky. Should I be upset? Should I insist he include me? 

Your question comes up with nearly every parent of a toddler, believe it or not. In fact, we have termed this behavior “watched play,” because it is so universal. Until recently, it wasn’t really labeled, and parents like yourself became distressed and resentful, or worse, would retaliate by leaving to attend to other things when their toddler became absorbed in playing in his own world.

There are two kinds of play: the kind you are used to, called "reciprocal play," in which you and your child take turns participating in activity or game together, like feeding each other in the toy kitchen, building a block tower, or playing back and forth with cars. Meanwhile, the kind of play that is upsetting you, “watched play,” is a state of play wherein a child is absorbed in creating a play world in his own imagination, but still needs you to be there next to him to help him regulate his feelings. 

Although it's not readily apparent, your child is using you as an anchor for the feelings he is expressing in his play. Having you near to him while he plays in this way is very important, especially if the feelings in question are negative ones—this may look like competition between cars, or aggressive impulses that he imagines the cars to have, or fears of retaliation between the imaginary figures or vehicles. 

At this age, children are forming their ability to manage their feelings, and play is a way of regulating them in which they can practice self-control through controlling their cars or baby dolls. Because of their cognitive immaturity, children between 2 and 3 years old can’t really understand when they will be punished for their bad thoughts, as may happen during the proverbial “terrible twos,” and when they won’t. (Parents are often equally confused!) Play helps them work this out, a process that begins to take hold from ages 3-5.

If you experience this, by no means abandon your child to use the phone or the computer! He really does need you to sit there, quietly, competently monitoring those feelings you can’t see, as difficult as it may be to do so. There will be plenty of reciprocal play at other times. 

And, by the way, a young child who feels safe playing “alone” due to the silent presence of his parent nearby becomes the older child who will be able to do his homework "alone” with you near to him in a similar fashion. At that point, he’ll probably feel safe enough to let you read a magazine!

-- Dr. S and Dr. G

Tantrums and a Toddler's Sense of Time

Our Readers Ask:

My son is approaching the period often associated with great difficulty. I know toddlerhood is widely described as a time of rapid growth.  I am trying to understand my child’s temper tantrums and frustration—I understand why he may have a tantrum when I leave him, but why does he tantrum when we are out together?

One of the major reasons a toddler begins to tantrum is exactly what you pointed to- he becomes acutely aware of leave-takings, both yours, and his! He has no control over when you leave or come home, nor does he have control over when he goes out or comes back, or whether you will be there or not. For example, you could be at the park together, having a “good time.” From his point of view, he has some sense that as long as you are in the park together, he has you to himself. But when he gets home, you will suddenly become busy with chores, get on the phone, or reunite with his siblings. He may feel torn: he is happy right now in the park with you, but he also misses home, and he can’t know how long you will be out, how much time will elapse before he gets home, nor how long you will stay with him when he gets home. What to do? Throw a fit!

Why? A two-year-old thinks of time in two categories: “now” and “not now.” He does not yet have a concept of “two more minutes,” “yesterday,” or “in 2 weeks.” Even if he knows these words, he will often use them incorrectly: “yesterday” was actually earlier today! He derives no comfort from Mommy telling him, “Don’t worry, I’m only going out for half an hour,” or even “I’ll be home to give you a bath.”

In addition, the tantrums come about because toddlers (18 month olds – 2 1/2 year olds) are notoriously bad at regulating themselves. They feel emotions strongly and have little ability to control them. In addition to lacking the cognitive skill to tell time, they also lack something we call “object constancy.” This term refers to the ability on the part of a child to hold in mind where Mommy is, as well as where “home” is. A 15 month old will be content to be in a strange environment, as long as all of his people and things are the same; his “home” has come with him. A 2 year old both “knows” he is out of the “home,” and can miss his home, but without being able to say so. However, a 3 year old can say, and understand what he means, when he says, “I want to go home.”

At almost exactly 3 years to the minute, a toddler undergoes a salient cognitive change based on the progressive advances in myelinization of the fibers in the cognitive centers of his brain, advances that give him the ability to understand “the bigger picture” in every respect. He suddenly can understand “time” and days of the week, and sequences, like “I’ll read to you in 15 minutes, as soon as I’m done feeding the baby,” make sense to him. What’s more, he has increasingly developed the ability to control his emotions, and has learned to express himself more clearly. All of these developmental changes give him more control over himself, and the opportunity to make more sense of separations. 

-- Dr. S & Dr. G

Food for Thought: Modeling Healthy Eating Patterns

Follow our series on the who, what, where, when, and how of feeding our children of all ages!

Our Readers Ask:

My daughter is nine months old, and soon she will be ready to eat exclusively solid foods. I am feeling extremely anxious about this transition, and about her subsequent eating patterns. I struggled with an eating disorder for many years, and while I'm working on my own issues, I'm terrified of unwittingly imposing food and body anxieties onto my daughter. It seems like there are so many extreme perspectives on how children should eat and so much judgment from other parents. Even reading some of the online parenting forums on food are sometimes enough to trigger my old negative thoughts. How can I make sure she is getting the nutrition she needs without making her (and myself) anxious about food?

 First of all, kudos to you for making an effort to untangle your own anxiety from your daughter's needs. So much of the judgment that you so acutely experience stems from the fact that not many adults make this same effort, and ultimately project their own health concerns onto their children. Unless they have witnessed adults expressing anxiety about fat, sugar, and gluten, or whether their thighs are too big or their belly is too round, children do not naturally express the same fears. So one of the most important things you can do to help your daughter eat healthfully and enjoy food is to maintain this separation between you and her. If you're having negative feelings about your body, don't verbalize them in front of her. Try not to talk about food and eating in terms of vice and virtue; eating and loving vegetables doesn't make you "good," nor does eating a lot of cookies at a party make you "bad." And if you do notice yourself starting to slip back into some of your old thoughts or behaviors, have patience and compassion for yourself, so that you can be patient and compassionate with your daughter, and allow her to cultivate these same qualities. 

You will help yourself and your daughter best by demonstrating that balance and variety are healthier than extremes. From the moment you put your little girl in her highchair, it's a good idea to also have an overview that you intend to make it easy and comfortable for her to enjoy a wide range of foods, identifying her favorite things to eat but also being open to trying new tastes and textures. It is even more important when serving her to offer small amounts at a time. This way if she wants more, she can ask for it and learn what fullness means to her- "to her" being the operative term here. As long as she is eating something, it is her prerogative to decide how much or how little of it she wants to eat. This is true of all food groups, including and especially desserts. Prohibiting desserts or using them as a bargaining tool ("I'll get you ice cream if you behave at the store") gives desserts power, and causes children to fixate on them. If you allow your daughter to enjoy desserts in small amounts after her lunches and dinners, she will learn that it is totally possible, and even normal and healthy, to enjoy a treat without losing control. Keep in mind that "dessert," like any other food group, should vary- it can mean anything from fruit, ice cream, cookies and cake. (The French even enjoy fruit and cheese as a dessert!) 

This is a valuable lesson to learn while she is young. You must trust your daughter's awareness of her appetite and her ability to regulate it. Don't comment on how much she eats, and if other family members or friends say anything to that effect, shoot them down by firmly saying something like, "She knows when she's had enough," and then changing the subject. If she can sense that other people (especially you) are having anxiety about her eating, she in turn will develop anxiety about eating.

Let us reiterate that children are much more likely to develop eating disorders in homes where there is a culture of deprivation and food as punishment or reward, and where food is endowed with loaded social and emotional value.  

-- Dr. S & Dr. G

Food for Thought: How to Handle a Picky Eater

Our Readers Ask:

My 4-year-old son's picky eating habits are driving me slowly insane. On a good day, he will eat three things, usually of the white toast with butter, chicken nugget, and plain noodles variety. The only exception, of course, is for desserts. If I try to add any vegetables to his meals or God forbid substitute brown rice for white, he will scream bloody murder. I end up feeling really frustrated when I've put in the time to prepare a balanced meal for the whole family and it results in a battle of wills with the 4-year-old until I finally relent and make him something else. How can I get him to eat new things? Aside from being concerned that he's not getting enough vital nutrients, I don't want him to be a 30-year-old who only eats chicken nuggets.

Let us assure you that some degree of neophobia, literally a fear of novel things, is completely normal and even adaptive in toddlerhood. Whether or not your son will become interested in expanding his palate actually depends largely on your reactions to his eating and to food in general. The most salient happy memories of family mealtimes have more to do with the atmosphere at the table than what food is being served.  It is difficult for a child to develop positive associations with food when he repeatedly experiences mealtimes as a source of conflict and anxiety. To that end, before you start implementing strategies, take a look at your own behaviors and perceptions during these strained interactions. 

Sibling Spacing

Our Readers Ask:

I have a 10-month-old and would like to plan the ideal spacing between our children.  My husband and I have been given so much conflicting advice!  We think it’s better for our kids to be closer in age, and get all of the bottles and diapers out of the way, but we worry that  spacing them 2 years apart or less will cause more sibling rivalry. 

There is no one way to do this---if there was, everyone who could control their reproduction would have caught on by now! There are pros and cons to each degree of spacing, and the solution depends, in part, on which of the issues is more important to you, to your life style, and,  believe it or not,  to where you fit into your family of origin. Did you—maybe, do you-- fight like crazy with your little sister, who was only 18 months younger than you? Or do you feel too distant from your 4-years-older brother? Ironically, we often try to undo the mistakes we think our parents made by doing the opposite with our children.

 Let’s start with how your child will react to the introduction of a sibling. As wonderful as it is to have a sibling, for a child under 3, the experience of adjusting to a baby is primarily stressful. Think about it: he is giving up a great deal of mother’s time and attention, he has to share his space with an extremely needy and disruptive other person (who may be keeping the whole house, himself included, up at night), and despite probably having expressed a wish for a little brother or sister, he could not have anticipated what that actually would mean to his everyday routine.

Often, in fact, parents respond in desperation to their first-born whining about having to share Mommy, "But you wanted a baby sister! " Needless to say, that can only make her feel more terrible about having unwittingly brought this doom upon herself and her tired, cranky, overwhelmed mommy!

Children under 3 are not yet cognitively equipped to understand that Mommy is occupied with another little being who needs her just as much or more than they do. Plus, toddlers (18 month olds – 2 1/2) are notoriously bad at regulating themselves. They feel emotions strongly and have little ability to control them.  They don’t have enough language skills, either, to express their feelings, and may let you know how they feel by refusing the potty, or regressing to hitting, biting, or throwing.

But, there is a plus side to spacing children closer together, in addition to the practical reality of getting the diapers and gear out of the way. Firstly, on the other side of the cognitive coin, children under two have not really formed a concrete sense of themselves as separate little beings. This lack of differentiation between “self” and “other” can make the older child feel more like a twin to the younger one. This can foster a much closer relationship, more intense and mutually gratifying, making them into “buddies” and “best friends” for life. They share the same toys right from the start, more or less, can enjoy each other’s play-dates and friends, be more on the same wavelength in school and in their ongoing everyday experiences. They also share the same view of their parents; children who are spaced very far apart often see their parents differently, as parents evolve themselves –emotionally, financially, educationally, even politically, over the course of their adult development. 

In our next blog, we’ll talk about pros and cons of spacing your children further apart!

--Dr. S & Dr. G

Your Baby's Learning Patterns

Our Readers Ask:

I've noticed that you refer to patterns and routines a lot when you talk about infants. I, myself, prefer variety, and have presumed that it would be a good idea to keep changing things up to keep my little one amused and interested, rather than bore him with the “same old, same old.” Am I missing something?

Not exactly. Human beings are “programmed” to flourish on both predictable patterns and on novelty. From early childhood through old age, we thrive on regular times for eating, sleeping, moving our bowels, and recreation that are determined by our biological systems and monitored by hormones and brain chemicals. These systems tell us when we are hungry, tired, and even what time of day we should do something as specific as strength training versus cardio training! One exception is that infants thrive equally well during their first months regardless of whether they are fed on a schedule or are fed on demand.

Our minds begin organizing in the early stage of toddler hood, and you can see this take place in both language development and in play. Children learn language patterns from repeating sounds they hear from their parents—at birth, a child can learn any language, or even multiple languages, all based on what she hears in her environment.

However, the ability to learn a language is embedded in the brain, and is just one component of a child's innate expanding mental organization of her experience. Similarly, at about the middle of a toddler's second year of life, you can see another example of the organic momentum toward "organization" in the development of a new kind of play. Typically, at about this age, children have moved away from their fascination with putting toys into their mouths, or dumping out their toy bins, and have begun assembling their toys together in “collections,” lining them up, or grouping them together.

You can see this as well in animal life, whether your dog is collecting bones in his bed or trying to herd your "family" together. So, with all due respect to our genetic endowment, we, as parents, also realize that infants need to learn patterns and rhythms of daily life so that they can feel safe, can learn, and can have a basis from which to reach outside of their patterns and learn new things.

Herein lies the importance of novelty. All human beings are programmed to respond to“curiosity” or “novelty” above all other factors in any given situation. This is apparent to you when you can distract your baby or 5-year-old with something new—a new toy, a new experience, a new expression on your face, or a new change of scenery.

In fact, we rely on this to soothe the tantruming 2-year-old, or the tantruming 7-year-old,for that matter. “Changing the subject” by some sudden introduction of novelty almost always works for any one, of any age. And, as you may have experienced,the “new" thing doesn’t often work a second time, or you'll get an “I know what you're up to!” reaction from your child. Or, if the experience wasn’t pleasant, you won’t get an opportunity to try it again. So, novelty has to be used carefully and wisely to put it to best advantage.

We can see this difference demonstrated in quality of reaction in a baby or child when exposed to music or art. Through brain receptivity, babies instinctively prefer music that has regular rhythms, where the next beat can be anticipated, like Bach, Mozart, or popular music that has repetitive, predictable rhythms. Babies do not respond well to Prokofiev. Similarly, babies prefer some decoration, but not overstimulating decoration; they will enjoy having some toys or mobiles they can reach, but not so many that they cannot discriminate between the individual parts.

Adults, too, often feel more soothed by rhythmic music or paintings with familiar motifs,and are excited and stimulated by less predictable music and by demanding abstractions. Babies are notoriously fascinated by commercials on television because all commercials are pitched to the  brain’s unconscious receptivity to the repetitive patterns in the sounds and “beat” of the commercial.

Many of the truisms of child-rearing are predicated on our innate sense of the familiar versus the novel. For example, when we want to introduce a new food to a baby,we typically feed her only one new food at a time. The rationale for this is not only to keep an eye out for allergic reactions, but also because it is easier on the baby to add just one food to her repertoire to allow her to become acclimated to it before introducing another one.

As a final point, babies are fundamentally different from both adults and older children in that their concept of the world is changing literally every single day. It would be as if one day you could see only outlines of objects, then make out shapes the next, then discern colors, then to three dimensions, and then on to x-ray vision! You wouldn’t need the subject you were looking at to do anything dramatic to remain interesting, because the interest for you, as the beholder,lies in your rapidly changing capacity to behold.

Mothers can take some comfort in this. Instead of forcing yourself to provide novelty for your baby all the time, turn your attention to the small differences in how she reacts to the same things. And by all means, if she is bored by something, and is ready for a change herself, she will let you know!

--Dr. S & Dr. G