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Eating-Related Challenges in Childhood

14/6/2018

 
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There are many reasons you might feel frustrated if your child is experiencing eating-related challenges. For example, when your child:
  • ​Is refusing to sit at the dinner table during meal times;
  • Is not open to trying non-preferred food items;
  • Is hiding food around the house;
  • Is asking for dessert late at night or refusing to go to sleep without dessert;
  • Refuses to eat healthy food packed in their lunchbox; and,
  • Is preoccupied with their body or continuously scrolling through sites promoting unrealistic body image goals
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Preparing for Healthy Eating Habits

Here are some things to consider as a way of developing healthy eating habits in the home environment:
  • Model healthy eating at the dinner table;
  • Involve your child in the preparation of meals/shopping lists;
  • Aim for mealtimes to be around the same time each night;
  • Eliminate distractions such as screens;
  • Allow around 20-30 minutes for the family meal;
  • Encourage your child to remain seated at the table until other family members are finished. Do this by engaging them in conversation or by introducing a gratitude ritual. 
  • Don't talk about food as good or bad, healthy or unhealthy. Instead, discuss how we eat some foods because they help us grow strong and we eat other foods because they taste good (and these are sometimes foods).
  • Encourage your child to set up the table with you;
  • ​Avoid giving dessert as a reward for eating fruits/vegetables. Food shouldn't be used as a reward as it gets in the way of a child's ability to regulate their eating. It also encourages them to eat when they're not hungry as a way to reward themselves.
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Professional Support for Eating-Related Challenges

It is important to check-in with your child and explore the reasons your child may be experiencing eating-related challenges. Young children may be experiencing power struggles at home. Pre-teens might be preoccupied with their body or friendship groups as they develop and become exposed to unrealistic body goals. Children may also be preoccupied with screen time during meals or feeling stressed about upcoming tests or social events at school.

An alternative to constantly reminding your child to ‘just sit and eat’ or ‘finish everything on your plate’ is to take a skill building approach. A psychologist or paediatric dietitian can help the child build on the following skills that may be linked to eating-related challenges:
  • Handling novelty
  • Persisting on challenging tasks
  • Maintaining focus
  • Regulating emotions when feeling distressed
  • Seeking attention in appropriate ways​
Speaking with a psychologist may help you to identify and support you through age-related challenges that your child may be experiencing, and which skill development areas can be considered in a treatment plan.

Children can learn to practice relaxation and eating new food mindfully in sessions with the psychologist or dietitian. Parents can also be provided with helpful resources around mealtimes and addressing challenging behaviours.

I'm worried about my child's weight. What can I do?

24/1/2018

 
By Shu-Lin Pook, Paediatric Dietitian
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25% of children in Australia are either overweight or obese, and although the proportion of children getting bigger has remained stable, it is still 1 in every 4 children that is either overweight or obese. Weight management is not easy, and for a lot of families, it can be an unfavourable experience. Here are some of the statements or questions I tend to get when I see a child who has weight issues:

Why is my child overweight/obese?

When a child takes in more energy (from food and drinks) compared to the energy used for growth and daily activity, the excess energy will be stored in the body as fat. Most people will eventually become overweight or obese when they chronically take in more energy than what the body needs. It is something that is usually long term, as excessive weight gain is not something that happens overnight.  

But my child eats healthy!

​Yes, eating healthy is important. The definition of “healthy food” can have so many different meanings for different families. I am always hearing different opinions about what makes food “healthy”. Is it Organic? Vegan? Gluten free? Sugar free? Preservative free? Natural?

Everyone is entitled to their opinion as to what is “healthy”, but more often than not it is not just the type of food that makes one overweight. It is also the portion that plays a big part on a child’s health.

It is too hard to eat healthy

Healthy eating is not something that you try for a week or for a month like a diet. Healthy eating, should really be part of your everyday lifestyle. I agree that fast food is cheap and convenient. BUT living on diets is not sustainable and therefore not likely to be successful in the long run. Part of healthy eating is having a positive relationship with food, and eating according to your hunger cues: eat when you are hungry, and stop when you are just full.

It is genetics. My child is big because of me (or partner)

Genetics certainly plays a role; there are some children who do have genetic or metabolic disorders that can increase their risk of being overweight or obese. However, genes alone do not explain why the rate of overweight and obesity is increasing at such an alarming rate.

I feel like I am depriving my child when I restrict *junk food / chocolate / lollies, etc*
Parents sometimes feel guilty for not providing their chid with discretionary food (food high in energy with very little nutrition). Remember, you are not depriving your child of love from not giving them discretionary food. There are many other ways and means to provide your child with love. It can be riding a bike together or going to the beach as a family and enjoy the time spent together. Think of food as something to nourish your child’s body rather than a treat or a reward.

How much weight my child needs to lose?

​A child’s weight is different to an adult’s weight. Children are supposed to grow and gain weight, whereas the weight of a healthy adult should remain idle. For this reason, I do not recommend that children should lose weight. Rather, allow your child to grow into their weight by allowing their height to catch up to their current weight.


Why does it matter? As long as my child is happy, that’s the most important thing.
Unfortunately, it DOES matter. When a child carries too much weight, complications can occur. Medical complications such as developing fatty liver, diabetes, having sleep issues, respiratory issues (e.g. exacerbation of asthma), and pain in joints are just some of the complications. What about the psychological impact? Well, children who are overweight/obese are more likely to develop lower self-esteem, depression, negative body image, be discriminated against, and so forth.

Ultimately, children who are overweight have a very high chance of being overweight as an adult. As a parent, you can make a difference!  Here are somethings you can try right now at home:
  • Next time your child has a meal, watch and see if the portion is appropriate for their age.
  • Use this calculator to work out how much your child needs in a day https://www.eatforhealth.gov.au/node/add/calculator-servings .
  • Using the above calculator, fuel up your child’s body with what they need to grow well.  Discretionary food is not something the body needs on a daily basis.
  • Start moving more! Decrease time spent in front of a screen, and get up and about as a family. Choose to buy a bike as a Christmas present instead of an iPad. Go out for walks in parks instead of sitting in front of the TV.
  • Be a role model. Pay attention to having better, nutritious food for the family. Make sure there are fruits and vegetables that are readily accessible to your family. Have fruits as dessert for something sweet to finish the meal.
  • Eat your vegetables. You as a parent are responsible for what is served at a meal. Your child should be eating the same family meal as you are. So if you are not eating vegetables at every lunch and dinner, make it a point to serve some vegetables for the whole family to enjoy as part of a meal.
  • If your child is full, trust them. Don’t force your child to finish everything that is on their plate. Allow your child to eat according to their hunger cues. BUT be careful not to offer something that they like (example: ice-cream or cake) after the meal because you feel like they haven’t had enough food. Re-present the unfinished meal if they are hungry.

Remember, your role as a parent is to provide your child with nutritious food and to make sure they grow well. If you would like to learn more about healthy eating and weight management, speak to an accredited practising dietitian who has experience working with children. Contact us if you would like to speak to me about how to manage your child’s weight, or how to get your child to build a positive relationship with food.  
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​​​Shu-Lin Pook is a Paediatric Dietitian at Hopscotch & Harmony. She supports the nutritional needs for children, from infancy through adolescence. She understands that management of complex food allergies/food intolerances can often be difficult, and also works with young people who have prior negative feeding experiences, autism, or poor/negative body image.

5 Tips to Promote Healthy Relationships with Food in Children

12/4/2017

 
By Shu-Lin Pook, Paediatric Dietitian
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Instilling positive relationships with food in children can reduce the risk of long term health issues including obesity, negative body image and type 2 diabetes. 
 
Here are some tips to help children build positive relationships with food:
  1. Do not use food as bribes. Instead, use other positive reinforcements such as verbal praise or spending quality family time together (such as going to the park or playing a game) as motivation. 
  2. Allow children to eat according to their hunger cues. This means allowing children to eat until they are full, but not stuffed. Encourage them to listen to their bodies.
  3. It is better for children to learn about food as “everyday food” and “sometimes food” rather than “good food” and “bad food”.
  4. Children tend to use parents as role models from a very young age. Having a variety of food available at family meals can help children to enjoy a wide range of food. 
  5. Talk about food as food groups and the nutrients the food provides, rather than talking about the calorie, sugar and/or fat content. 
 
Ultimately, all food can be and should be enjoyed in moderation. The only time you should actively avoid a food is when you have a specific food allergy or food intolerance.
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Shu-Lin Pook

​​Shu-Lin is a Paediatric Dietitian at Hopscotch & Harmony. She supports the nutritional needs for children, from infancy through adolescence. She understands that management of complex food allergies/food intolerances can often be difficult, and also works with young people who have prior negative feeding experiences, autism, or poor/negative body image.
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