Promoting Healthy Eating Habits Right from the Start
The relationship that parent and child (or caregiver and child) establish around food is called the feeding relationship (Satter 1992). The feeding relationship dynamic is about much more than providing nutrients to a child.
by Rebecca Parlakian and Claire Lerner
Carlyle’s teachers are concerned. At 35 months, Carlyle is an extremely heavy toddler. He has some difﬁculty keeping up physically with his peers, though he is well liked and has several good friends in the group. Carlyle’s parents regularly pack him lunches that include candy, cookies, and chips.
Childhood weight gain has received much attention recently because so many children are overweight, and today’s overweight children are significantly heavier than overweight children in the past. Researcher Julie Lumeng (2005) reports that among children ages 6 to 23 months, the prevalence of over-weight increased from 7 to 12 percent between 1976 and 2000. And the percent-age of overweight has more than doubled (from 5 to more than 10 percent) among children ages 2 to 5 years (Ogden et al. 2002). This acceleration is quite recent, with most of the increase occurring between 1990 and 2000.
Interestingly, the research finds that for children under three years of age, a child who is overweight has no greater likelihood of being overweight as a young adult than a child who is not overweight (Lumeng 2005). However, a child who is overweight at three years or older is nearly eight times as likely to be overweight as a young adult than a three-year-old who is not overweight (Whitaker et al. 1997). The reality is that children learn healthy eating habits from birth—from their first suckle of milk.
The relationship that parent and child (or caregiver and child) establish around food is called the feeding relationship (Satter 1992). The feeding relationship dynamic is about much more than providing nutrients to a child. This relationship is, in large part, about sharing power. And the nature and quality of this relationship has a significant influence in shaping the child’s lifelong eating habits.
For a child to develop a healthy approach to eating from birth, adult and child must share responsibility during feeding. The parent or teacher is responsible for providing a selection of healthy foods at meals and snack times. The child is responsible for deciding what he will eat and how much (Satter 1992). This approach teaches children to respect their bodies, to recognize the signs of hunger and fullness, and to choose accordingly when and what to eat.
Mealtimes and snack times are also opportunities for parents and caregivers to learn more about children’s temperaments and personalities. They do so by tuning in to how a child approaches food and feeding. For example, when children transition to solids, some babies begin to show sensitivities to foods with certain textures and will reject these foods. Sometimes children will adapt and accept these foods over time and with repeated exposure, but other children may retain their texture preferences as they grow. Some toddlers—those with feisty, “me-do-it” temperaments—may seem like fussy eaters but, in reality, are simply eager to feed themselves. Creative responses, such as offering the child a spoon to hold in each hand, show respect for children’s temperaments and preferences and build on their strengths (see “Infants and Toddlers and Healthy Eating: Information to Share with Families” for suggestions).
In a child care environment, there is much that early childhood professionals can do to support healthy eating habits of babies and toddlers:
- Offer three or four healthy choices at each meal (if your program provides food) from a range of healthy options—for example, turkey lunch meat, whole-wheat bagel slices, cheese slices, watermelon slices—and allow toddlers to choose what, and how much, to eat.
- Begin to establish regular meal- and snack times for children between 9 and 12 months old. As children age, create reasonable mealtime routines, such as allowing young toddlers to set and clear the table or play special music during meals. These routines can make children feel loved and secure and help them anticipate and enjoy the mealtime experience.
- Have relaxed conversations with children about what has happened during the day. Meals are about more than food; they are a time to connect with children (see Selman 2001).
- Be flexible. Let babies stop feeding when they indicate they are done, and allow older babies and toddlers (those children eating at the table) to get up from the table when they finish eating. Young children cannot sit for long. Plan for 10–20 minutes of sitting at mealtime and 5–15 minutes at snack time. Follow children’s cues about when they are done, and give them a choice about what they can do until everyone is finished eating.
- Make the most of peer pressure. Research confirms what we all know from experience: even children as young as age two seem to learn food preferences from their peer group (Lumeng 2005). When a child sees other children eating healthy food, she is more likely to try that food herself.
- Ensure that babies and toddlers have plenty of opportunities to engage in active play. U.S. dietary guidelines for children (DHHS & USDA 2005) recommend that toddlers and older children engage in 60 minutes of physical activi-ties most, if not all, days of the week. The National Association for Sport and Physical Education’s guidelines for toddlers recommend 30 minutes of structured physical activity and 60 minutes of unstructured physical activity a day (Story, Kaphingst, & French 2006).
Feeding is a time when a caregiver or parent and a young child can focus on each other and share an intimate connection. Mealtimes are opportunities to help children learn self-regulation and recognize their bodies’ cues, skills essential for developing healthy eating habits. Meals are also times when adults can make children feel safe, secure, and loved—key elements for children’s overall healthy development.
Adults’ thoughts, feelings, and experiences with food and eating inﬂuence the way they feed the children they care for. Think about the following questions and how they may shape your approach to feeding young children:
- What were mealtimes like when you were growing up?
- How did you feel about your body?
- How do you feel about your eating habits and body now?
- What foods have special meaning in your family or culture?
Choose two or three of the suggestions below to try with the children in your care.
- Be sure to offer children three or four healthy choices, including fresh fruits or vegetables, at mealtimes.
- Seat children with different food preferences next to one another so they are exposed to peers enjoying a range of healthy choices.
- Make time for toddlers to engage in one-and-a-half hours of physical activity every day (you should see differences in children’s energy or attention levels).
- Create and maintain a mealtime routine—and allow children to help. Even young toddlers like (and are able) to set a table, sing a special song before eating, or place a plastic vase of artiﬁcial ﬂowers on the table to signal mealtime.
- Make a point of having at least one meaningful interaction with each child during every mealtime: “Jonah, tell me about your visit with Grandma.” “Jesse, what were you and Sasha playing this morning?” With nonverbal children describe what you see: “Olivia, you picked up the Cheerio and got it in your mouth!” “Eric, you really like your strained carrots.”
- Watch closely to learn babies’ “all done” cues. Teach older toddlers to say “I’m all done,” and show them how to clear and clean their places.
Briefel R.R., K. Reidy, V. Karwe, L. Jankowski, & K. Hendricks. 2004. Toddlers’ transition to table foods: Impact on nutrient intakes and food patterns. Journal of the American Dietetic Association 104 (Jan., Supplement 1): 38–44 (7).
Carruth, B.R., P.J. Ziegler, A. Gordon, & S.I. Barr. 2004. Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food. Journal of the American Dietetic Association 104 (Jan., Supplement 1): 57–64 (8).
DHHS (U.S. Department of Health and Human Services) & USDA (U.S. Department of Agriculture). 2005. Dietary Guidelines for Americans, 2005. 6th ed. Washington, DC: Government Printing Office.
Lerner, C., & R. Parlakian. 2006. Healthy from the start: How feeding nurtures your young child’s body, heart, and mind. Brochure. Washington, DC: ZERO TO THREE.
Lumeng, J. 2005. What can we do to prevent childhood obesity? Zero to Three 25 (3): 13–19.
Ogden, C., K. Flegal, M. Carroll, & C. Johnson. 2002. Prevalence and trends in overweight among U.S. children and adolescents, 1999–2000. Journal of the American Medical Association 288: 1728–32. Quoted in Lumeng 2005, 14.
Satter, E. 1992. The feeding relationship. Zero to Three 12 (5): 1–9.
Selman, R. 2001. Talk time: Programming communicative interaction into the toddler day. Young Children 56 (3): 15–18.
Story, M., K.M. Kaphingst, & S. French. 2006. The role of child care settings in obesity prevention. The Future of Children 16 (1): 143–68.
Whitaker, R., J. Wright, M. Pepe, K. Seidel, & W. Dietz. 1997. Predicting obesity in young adulthood from childhood and parental obesity. New England Journal of Medicine 337: 869–73. Quoted in Lumeng 2005, 14.
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