Doctor’s ℞: Tired of Food Fights?  Here’s a Simple, Fool Proof Approach to Feeding Your Kids!

by Jennifer A. Gardner, M.D. on June 11, 2013

Part 1  The Division of Responsibility (DOR)


You are probably aware that our country has an obesity crisis. But do you know that this is likely the result of a feeding crisis?
 

Poor feeding practices in the home set the stage for dysfunctional eating in childhood and adulthood (either overeating or under-eating). Establishing healthy eating patterns in childhood is probably the single most important thing you can do to ensure a healthy future for your child!
 

Talk to almost any parent, and they can recite a list of feeding challenges they have encountered along the way. As parents, it is how we choose to approach these predictable feeding challenges that set the stage for our children’s future health! I think this warrants the time to learn the best feeding practices for kids.


In this three part series, your will learn:

Part 1: The Division of Responsibility (DOR) and how to use it to bring structure and order to feedings

Part 2: The most Common Feeding Mistakes and how the DOR avoids them

Part 3:  Ten Important Feeding Tips for any family struggling to improve their child’s diet.

What is a simple, healthy approach to feeding kids?

The Division of Responsibility is an eating system developed by registered dietician Ellyn Satter. It promotes feeding competence in children. On the Healthy Kids Program, I recommend parents follow this because it takes stress and pressure out of the feeding relationship by establishing very specific roles for parents and kids. It brings much needed structure and order to feedings!

And because it teaches children to preserve (or reestablish, if needed) internal feeding or hunger cues that are present in all of us since birth, it puts children back in charge of eating when hungry and stopping when full. Once they master this, kids are set up for a lifetime of healthy eating.

What is the Division of Responsibility?

The DOR establishes healthy feeding roles for parents and kids that when followed, avoid most mistakes in feeding!

The parent is responsible for what, when, and where to eat
                                          and
The child is responsible for if and how much to eat (from the food choices offered)

Once these roles are understood, parents can feel good knowing they have provided regularly scheduled, healthy meals and snacks. Children can feel good knowing meals and snacks will come on a predicable schedule in adequate amounts with no pressure to eat or not eat.

In other words, once the lines are drawn, they are not crossed because each family member knows his or her role. Stress and pressure leave the feeding relationship and more peaceful, harmonious and structured meals result. In a nutshell, food fights take a hike!

But, for the DOR to work

Parents must: (and this is a big list, I know)

  • TRUST the child to decide if he or she is hungry and how much to eat to satiate the level of hunger felt.
  • Let the child follow internal feeding cues (the body’s “hunger meter”). If previous feeding tactics have blunted these internal cues, the parent’s job is to help reestablish them.
  • Choose and prepare the food, while providing regularly scheduled meals and snacks. Snacks should occur midway between meals.
  • Make meals and snack times pleasant and stress free. 
  • Table talk should be about anything but FOOD!
  • Be considerate of children’s food preferences, without catering to them.  You do this by including at least one food the child can “get by or fill up on” for all meals and snacks. This might be bread, rice, applesauce or any other food the child will eat. Notice this does not say a “favorite” food, just one that you know is tolerated.
  • Provide enough food—but not force them to eat it— at regularly scheduled meals and snacks so that children do not seek food at other times. Children do not need anything between meals and snacks except for water to quench thirst! Do not allow kids to “panhandle" for food, they must learn to stick to a schedule.
  • Never introduce more than one or two new foods per meal. When offering a new food try pairing it with a familiar food the child already eats, but sometimes “test the waters” and do not have this safety net available!
  • Understand that if a child is hungry between scheduled meals and snacks, especially if it is because of food refusal at the last meal or snack, then water is offered and nothing more! If a child is getting regularly scheduled snacks and meals then food is coming every 2 to 3 hours, which is perfect.
  • Never “Short order cook.” Once a meal is served nothing else is brought to the table. Parents must not prepare “extra food” for any child.
  • Never try to please everyone at every meal! Some meals one person gets lucky and finds a favorite on the menu, and other meals someone else does!

Children must:

  • Eat when hungry and stop when full. This means they must be allowed to self regulate by listening to and then following internal feeding cues. If the child has lost this internal hunger gauge, it must be re-established.
  • Come to the table hungry. When kids are hungry, they are more willing to try something new.
  • Listen to their internal feeding/hunger cues to eat the proper amount of food needed to grow and thrive.
  • Learn to accept at least one of the foods served at meals or snacks to avoid hunger. If he cannot find anything to eat, he must wait until the next regularly scheduled meal or snack, no exceptions. After 2 or 3 poor meals, most kids will show up to the table with their A game and be more willing to try other foods!
  • Observe table manners and never bad mouth food. You went to a lot of effort for the meal and being polite recognizes this.
  • Put a small amount of all foods offered at the meal onto the plate (just allowing the food on the plate is a subtle form of acceptance).
  • Try One Polite Bite (many parents call this a "No Thank You Bite") if a new food is served or if a previously rejected food is prepared a new way. This means putting it in the mouth and chewing. Notice no mention of swallowing. Kids must not be forced to swallow food as this provides a safety valve for the child and preserves willingness (even if reluctant), to try new foods in the future. Forcing children to swallow a food they do not like causes physical discomfort (gagging). Its negative effect lasts far longer then the tiny ‘benefit’ gained from forcing a child to eat.
SO, what do they do if they don’t swallow the food?

This is where I lose some parents... the child politely places it in a napkin and folds it discretely. Of course, you might suspend the one polite bite at holiday meals or when eating out! But when in the safe environment of home, kids should feel confident that if they sample a food and do not like it, nothing more is expected at THIS meal. (More on this in part 2!) This gives them the confidence and freedom to try new foods in the future.

Why does the DOR work?

The DOR works well because it allows parents to avoid making the two biggest mistakes regarding feeding: pressuring children to finish food and restricting food (type and/or amount).

Is this it?

This is a good summary, but our program provides more details and scenarios to help parents become more comfortable with this (often new) feeding pattern. In addition, you can get more information directly from Ellyn Satter.

Coming Up: Part 2, top feeding mistakes nearly all parents make

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