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Obesity Prevention Begins at Birth: Cultivate a Positive Feeding Relationship with Your Child
By Ann Sears, Northeast Georgia WIC
March 2004

Promoting healthy eating and exercise is one of the best ways you can influence your child’s health both now and in the future. Childhood is a critical period for shaping the dietary and life-style behaviors that will have implications for adult health.

Overweight among Georgia’s children aged 2-5 years on the Women, Infant and Children Program increased 60 percent over the past decade. Thirty percent of middle school students aged 11-14 are overweight or at risk for overweight. Twenty-seven percent of high school students aged 14-18 years old are overweight or at risk for overweight. Obesity contributes to other medical conditions, including diabetes, heart disease, high blood pressure and arthritis. Healthy eating and exercise are the keys to preventing obesity. Obesity prevention should begin at birth.

Over the years there has been much debate on whether obesity is predominately caused by genes or by environmental factors. In fact, whether we stay lean or become obese is not ultimately determined by our genes or our environment but rather by our behaviors. Much research has been done in recent years to learn how parents mold and influence their child’s eating behaviors. Many studies are suggesting parenting strategies that interfere with infant’s and children’s innate ability to self-regulate when they are hungry and when they are full.

You may know that what you feed your children is important. What you may not know is promoting healthy eating is more than just feeding your child the right foods. The way children are fed is just as important to their well being as what they are fed.

Ellyn Satter, a registered dietitian, therapist and author of many books on feeding children, including her most popular book “How to Get Your Child to Eat, But Not Too Much” proposes these four primary causes of children being overweight:
• Normal fatness,
• Restrained feeding,
• Reaction to emotional stress, and
• Developmental causes
Parental behaviors can greatly impact each of these.

Children come in all shapes and sizes and have different rates of metabolism. It is important to remember that body size is not necessarily an accurate reflection of food intake. If your child’s weight and height are progressing smoothly, their eating and activity patterns are healthy, and your child’s psychosocial situation is stable, then the child’s size may be normal. It is important to encourage and support the child’s healthy lifestyle behaviors. However, it is very important to refrain from commenting negatively on your child’s size. Calling attention to a child’s size (small or large) can impact their self-esteem and cause harmful eating and exercise behaviors. We need to teach our children to like the bodies they have.

Food should not be used to reward behavior, nor should you reward children for eating. Research has shown when food was used as a reward for doing something else, it increased the value of food. Research also has shown that children who were allowed to approach the food more on their own were more likely to go back to it than those who had been rewarded to try it. Therefore, parents need to relax when exposing children to new foods. Studies have shown the more a toddler is exposed to certain foods the more they will like them. Serving the food over and over again to the entire family will increase the likelihood of a child trying a new food.

Children who are more accustomed to high fat, high sugar foods at home are more likely to overeat. This leads to long term consistent overfeeding which is another cause of overweight children. Children at age 3 can compensate for high energy intakes by eating less later, but children at age 5 are more likely to eat normal to large portion sizes and not compensate for the high caloric foods. Child-size servings are small. Children are overwhelmed if they see a lot on their plate. Put just a spoonful of food on a young child’s plate. The child can always get more.

Emotional stress can interfere with a child’s ability to self regulate eating. Therefore, eating time needs to be as stress free as possible. This is one of the reasons it is recommended that a parent or caregiver eat with the child and limit distractions. A prayer or other ritual at the beginning of each meal can also help everyone to relax. Mealtime should be a peaceful time away from the television.
Providing time in the day for physical activity can also help a child relieve stress and at the same build muscle and strengthen their metabolism. Parents also influence the nature and amount of physical activity in which children engage. Parents have been found to have influences by providing an environment that nurtures physical activity in the child and by modeling physical activity. Children 4 to 7 years old whose parents were physically more active were six times more likely to be physically active compared to peers whose parent were physically inactive. Get out and exercise with your children.
Cultivating a positive feeding relationship is one of the best ways you can prevent your child from being obese. If you are one of those many adults struggling with your own eating/exercise relationship, then you may want to get help. Your behavior will impact your child’s behavior. Eating and physical activity should all be part of life’s pleasures.

In summary, the parent’s job is to plan what is to be served and when it will be served, prepare what is to be served (as child gets older she/he can help in preparation), and provide the food with patience. The child’s role is to choose to eat or not eat (when food is offered), choose what to eat (from the table not the cabinet or refrigerator), and choose how much of the food they want to eat (amounts limited by what is on the table). While these rules may seem very simple, it is often a real challenge for parents. If these rules are followed from the beginning they become easier. It requires you to be firm when they beg for certain foods they like or when they don’t want to eat what you have on the table. If meals and snacks are served at a routine time, your child will know they cannot have any other food until the scheduled meal or snack. If you can stick to these principles you should be able to cultivate a positive feeding relationship with your child.

Help Available for a Stress Free Feeding Approach
The nurses and the nutritionist with Public Health’s Women Infants and Children Program are recommending a “Stress Free Feeding Approach” designed by Children’s Health Care of Atlanta and adapted from Evelyn Satters’ work. “Stress Free” feeding teaches the parent or caregiver how to translate what your child is communicating to you so that you can help her become a good and healthy eater, without stressing you out. This approach helps to maintain a positive feeding relationship, allowing your child to feel relaxed and comfortable about eating and in touch with his internal cues of hunger, appetite and satiety. This will allow your child to grow up and get the body that is right for him. You may get a copy of these handouts from WIC by calling 1-800-4PD-Help.


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