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pediasure, picky eating, low weight and desperate parents

A reader called me out on some lazy writing (excerpted with permission from a private email) on the Pediasure post... This is long, but if you are struggling with feeding, picky eaters or low weight concerns, read on...

"Hi, I just recently started following your blog. It was miraculous to me. My daughter (5) is an extremely limited eater. The amount of stress and despair this was causing in our household cannot be underestimated. Feeding your child is primal, it is a fundamental responsibility of parents to provide food, and when your child won't eat, it is devastating.
The "division of responsibility" and taking the pressure off was a godsend to us. I borrowed Ellyn's book from the library, and we are working at removing the pressure, tweaking our mealtimes etc. and we are seeing progress. (Little bits, her commenting on food smelling good, her moving to eating grilled cheese sandwiches that have a little bit of mozzerella mixed with the other cheese etc.)
We take full responsibility for how our daughter ended up such a poor eater. She was a tiny baby (not premature, just small), she didn't breastfeed well, and didn't move to solid food well. She was and probably always will be skeptical of new food. So we made the classic mistakes, we were so concerned about the amount she was eating, that we "coned" down her food to only serve foods she ate a lot of, which, of course, are now the only foods she eats. We were so freaked out about variety that we tried again and again to get her to try foods, laying on the pressure, lots of fighting. Exhausting and stressful for everybody.
The information that I could find or that was available in magazines, and books that I read (unfortunately, I didn't stumble upon Ellyn's book) was completely unhelpful. Hide veggies in her meatballs (she won't eat meatballs, and it is hard to hide veggies in plain noodles with butter on them.) Just "make them eat" --- that one just gets me every time ...
Parents today are really pressured. 'Make sure your child is getting enough of all the nutrients.' (One book I read said that children (aged 4-8) should eat 8 to 10 servings of vegetables a day, a serving size being 1/2 cup - my child doesn't eat that much food in a day, let alone of vegetables!)
So today, when I read your post, I have to say that I was hurt. I was hurt that you described parents who use Pediasure as lazy, as wanting to take "the easy way". I don't use Pediasure, I've considered it but they only sell it in big expensive packs, and I wasn't sure she would like it. Plus, I wasn't sure that I wanted to have her drinking some sweet concoction, I want her to eat, and be healthy and enjoy food.
But those parents who do ... they aren't lazy, they are desperate and they are worried, and they love their children as much as you love yours. They want their child to be healthy, and they feel the weight of the pressure. *(I totally agree)
I'm sure some of them are making feeding mistakes, but I'm sure that lots of them do meal plan and have regular meals and snacks, and have children that are "underweight" or "problem eaters" and they talked to a doctor or nutritionist or a grandmother or a neighbor who suggested they try Pediasure. So all these people, myself included, love their children and are trying to do what "experts" tell them is "best" and end up more screwed up.

Couldn't Pediasure (or like products) be used by parents to help them take the pressure off? If they were feeling more confident that nutritional needs were being met somewhat, would that help them take the pressure off at mealtimes? My daughter enjoys vegetable muffins (healthy, low-fat, high-fiber, muffins. I make them with pumpkin or carrot or zucchini, she enjoys them and takes them in her lunch to school.) This helps me, and my husband, not panic when at dinner she decides not to have a carrot stick or only nibbles the flowerets off one piece of broccoli, I know she is getting some vegetable nutrients in her day.
Anyway, I just wanted to say my piece. Thank you for your blog, it is really helping us. Progess is slow, and of course we messed her up so much that it is probably going to be a really slow go to getting her on track. But I used to look ahead and know, in my bones know, that she was going to be anorexic some day, that the amount of power struggles around food was going to be our doom, and not know what to do. And now, I am starting to feel hope, hope that someday she will eat normally, have some likes and dislikes, eat too much one day, and too little another, and most off all not stress about it.

P.S. I was a picky child (though really just a mostly normal child who liked a fair amount of things, as long as they were plain). My husband was an extremely picky child (only ate grilled cheese and chicken noodle soup for about 10 years). Now we both eat a huge variety of foods, lots of different vegetables, grains, fruits and meat. My husband's favourite food is sushi! I don't care for it though ... I don't like the taste of seaweed, and I still don't care for fish even after all these years."


Dear Reader,

Thank you for your thoughtful email.
I am so sorry that you felt hurt by my comment. I am sorry for all the worry you have gone through around feeding. I am sorry that the system failed you and did not provide help (and likely heightened your anxieties) all along the way– when your daughter was born small, had trouble with breast-feeding, trouble with solids etc. I see so many times when you could have been helped perhaps...

Back to my post. I write my posts quickly and not often with the most thorough thinking! I am angry and upset precisely because desperate parents are tossed a bottle of Pediasure, with no help, no direction on how to really address or solve the underlying problem. As my friend said, "We felt like we were circling a black hole. Things were getting so bad and we just needed someone to pull us out of it." We shouldn't just be throwing bottles of Pediasure down that hole!

Another reader illustrated my concerns:
"Pediasure was recommended to me from a physician when I tried to discuss my child's picky eating issues. We used it at meal times. It filled him up. He didn't want or need to eat any other foods at dinner. Almost two years later, I have banned it from my house and am now struggling with an even older and pickier eater thanks to that ill advice. Wish I had learned about D of R long ago. We're almost 3 months in to D of R and he's yet to try something new, but my 5 year old has and that gives me hope..."

This is precisely what I am upset about. The family goes in for help. The untrained expert "helps" the best she knows how and problems continue and worsen...

I do what I do because I know parents are desperate, are trying hard, are consumed with worry, are scared beyond belief. I did not mean to call parents lazy who use Pediasure.

Parents are desperate and will do what they can to help their children.
I do think that the medical professionals are ignorant and pressed for time in that they recommend Pediasure without a thorough understanding of the situation. They have no knowledge about how to even ask about the feeding atmosphere. It's simply not on their radar (I generalize based on my own experiences, experiences with teaching those in the profession and my client and reader experiences...)

These parents are not lazy at all. In fact they are consumed with worry and expend huge amounts of energy, often in a counterproductive way to help kids with eating. It doesn't have to be so hard!

My anger, disappointment and accusations are almost 100% directed at the health professionals and the advertisers for Pediasure.

I hope that clarifies things...

I do think there can be a role for Pediasure but with extreme caution. If children will drink it without pressure, if it helps parents relax and back off pressure, if there is a real concern about nutrients (you would be amazed how many really picky eaters are actually meeting nutritional requirements when there is a full 7 day intake analysis) and if it is given within a framework of addressing feeding in the best way possible, meaning sit-down snacks and meals and no grazing, DOR etc. It's simply not fair for desperate parents to be given half-measures that may actually make matters worse.

Please let me know if I didn't get to your concerns, and thank you for writing. I am so glad that you are seeing progress with your daughter. Your words help me keep doing what I do.

I hope my laziness with my blog today won't put you off from reading my blog!

Hang in there, and great news that you and your husband have expanded your tastes! Your daughter is lucky to have two such loving and considerate parents.

Katja

readers, what do you think?

Pediasure-the answer to all your feeding worries!

I'm a little more than dismayed at the ads recently for Pediasure. It plays on the worst fears of parents. "Be 110% sure!" (My goodness, Timmy didn't eat the food pyramid yesterday. That could effect his brain development! I need to do something! Or Becky is at the 3rd percentile, and the doctor is threatening me with a 'failure to thrive' diagnosis! Help!)

On TV, a pyramid of wholesome foods float in the air. Slowly, foods disappear from the pyramid as little Ashley refuses to eat more and more foods. Phew! Thank goodness there is Pediasure which magically floats in and fills the holes!

Did you watch the ad? Please do, then answer these questions:

How do you feel about your kids eating? Anxious? Worried?
Do you want to "feed your child's potential?"
What if your child IS missing some nutrient. It can't hurt can it?
What emotion are they attacking? Guilt? Are they reassuring or fear-mongering?
What if my child's development is being effected!

OK, and why is it that in all the ads (I watched them) the kids don't eat any real food, but all LOVE the taste of Pediasure...

How could you NOT "feed your kids potential."

The quick fix. The prescription (literally) for picky or small kids. Many physicians who don't have the time or training to address feeding problems, will recommend Pediasure. WIC (supplemental food assistance for women, infants, children) participants need a prescription.

At a recent WIC workshop, a nutritionist mentioned that there are "great recipes" using Pediasure. When asked if she had ever tried any, she said, 'no.' I wouldn't either. The dietitians bemoaned that fact that the docs all rush to Pediasure and don't address feeding at all.

Yummo! Cooking with Pediasure! (Sarcasm in case you missed it.)

Here is an example of a recipe...
Banana-Chip Muffins (not endorsed by FFD...)

Ingredients

1 14-oz package Pillsbury^® Banana Quick Bread & Muffin Mix

1 8-fl-oz bottle Vanilla or Banana PediaSure
1/2 cup vegetable oil
2 large eggs
1/2 cup miniature chocolate chips

Are the recipes balanced, or a way to sell more products owned by the umbrella company...

I don't deny that there are some children who really do need nutritional support or even exclusive or supplemental tube feeds (those with certain rare medical or physical conditions,) but that is not who Pediasure is marketing to. They are marketing to the average parent who worries about nutrition, who struggles with feeding and likely a picky child. I would also guess there is an army of attractive sales reps making the rounds with free lunches to pediatricians offices too...

My friend, who's child fell of the growth curve after a GI illness was instructed to offer food all day long with Pediasure being the central food. She literally chased her toddler around with a sippy-cup full of Pediasure for weeks. It didn't help and intake continued to suffer. A feeding clinic work-up later, and they were basically sent home with a list of recommendations from Ellyn Satter's work: structure, no grazing, sit-down meals and snacks, no pressure, Division of Responsibility...

Because in fact it is less work- for the physician and for the parent (less effective I might add) to reach for the quick fix, the "pill" in bottle form to fix the problem rather than to delve into feeding. Less work to have a sippy-cup of Pediasure than it is to shop for, plan and prepare 3 sit-down meals and 2-3 sit-down snacks. It is less work to hand the child a bottle than to sit with them and eat.

What could my friend have done (she didn't ask, so I didn't offer...) First, grazing, or drinking supplements all day in small quantities doesn't work. Kids don't develop a proper appetite and studies show that they will eat less well and grow less well.

(Note, this is general info, and is not intended to replace an evaluation or work-up. In other words I don't want to recommend stopping Pediasure in case you, gentle Reader have a child who really needs it.)

So, if you are using Pediasure, start by bringing it into sit-down meals and snacks every 2-3 hours for smaller children and every 3-4 for older. Offer balanced foods with those meals and snacks. Sit and eat with your child as much as possible. Don't let them graze in between. Allow them the opportunity to get hungry. Not too hungry, but come to the table with some hunger. Stop pressuring or bribing. In other words, follow the Division of Responsibility in feeding.

OK, that's it. My mini-rant on Pediasure, a whirlwind bit of advice.

Folks, what have your experiences been with Pediasure?

some decent books at Target

After raling about a book I saw at Target, I wanted to give them props for these gems. At $1 each, they are lovely looking, printed in the USA and well-written. My 5 yo loves hearing the stories of Peter Pan, Wizard of Oz, Secret Garden etc. There are illustrations every other page or so which helps keep her interest as well since she tends to be a wanderer. I was a fidgety kid and I didn't get read to as much (it can be annoying to have a kid who is playing with the cat while you're reading, but she is taking it in...) Don't give up on reading to your kids, even if they are sitting there playing with Legos or the cat while you do it :)

I'm a little torn about recommending a Target product, with the controversy around the political stuff, but they're a home-town company that gives away 5% of its earnings to charity, sponsors tons of cultural stuff in the Twin Cities and is a big local employer. I can imagine there are lots of other companies doing as much or more egregious political donating so I'm going to stay out of it...

Warning, Oliver Twist, is NOT a kid's story... Murder, mayhem, multiple kidnappings, moms dying in childbirth...

new blog/website coming soon...

Hello all-
Sometime this week this blog site will disappear (I think!) I am consolidating to one site with website and blog all at one address, www.familyfeedingdynamics.com.
I hope you are enjoying the blog and will follow to the new location. I'm not sure how your SRS readers etc will work. If you FAN Family Feeding Dynamics on Facebook, you will get updates automatically. Please let me know if you have any trouble, and I apologize for any inconvenience. The old content should be there though there may be some formatting issues, but the comments will be new and improved, and I hope will make things easier for readers and clients alike.
I am working with someone on this and we are on a deadline with the domain so it will be a little sloppy at first, but hey, I have to keep the family dinners going! Thanks for hanging in there with me!

physical activity for kids– but someone could get hurt!

Hi! I'm back. It feels good, but also lots to catch up on, and my email seems to be swallowing things, so if you're the mom from Colorado who emailed a while back, I think I have a contact for you :)

So, part of having a healthy relationship with our bodies is moving them. Kids often do this more spontaneously than adults. I marvel at the energy level, the sheer joy many children have as they run, or dance. Even my relatively sedentary child (compared to some of the little guys I know!) has such a clear joyful abandon when she's moving.

So, on a recent day off school, I took M and a friend to the Como zoo (a local zoo that is donation-entry) to burn off some steam. It was a beautiful fall day and the zoo was almost empty. I wanted to give them the opportunity to run and play. (Just as with food, there is a Division of Responsibility with activity. I provide the opportunity for M to move her body in joyous and unpressured ways and she takes it or leaves it...)

Anyway, so they are running from one thing to the next. As I said, there are very few people there. I asked them not to run if there were others around, but otherwise was thrilled that they were having fun and getting exercise.

Then an employee shouts at them to "walk! No running!" There was literally no one around. I said kindly, "May I ask what your concern is?" She looked at me like I was crazy. "Well, they can get hurt! We had a kid split his lip here before!"

Really!? I didn't quite know what to say. "OK, well thanks, yes, kids do get hurt I suppose!" I wandered off and let them run at will. A child can split a lip falling from a walk as well. It seemed odd. I could understand if they were running into people, or if it was crowded. I wanted to say, "I am willing to accept that risk," or, "Are you kidding me? Of course some kids will get hurt. That is unavoidable." (Will we soon be signing liability waivers at public places?)

What does this mean? Will we outlaw running, climbing etc because of liability concerns? Already, the playgrounds of our youth with merry-go-rounds are gone. The high-dive at the swim-club is long gone and climbing structures barely get off the ground. (In contrast, in France, where they have 10% of the lawyers we have here, the playgrounds I have seen look like something out of Fear Factor...)

I felt bad encouraging my child to ignore an adult authority figure- but come on.

What do you think? Do you think our caution, our fear of injury is making it harder for kids to find enjoyable ways to be active? Have you had similar experiences?

Hummus, really!?

Note: I will be out of town from the 13th-23rd, so expect another posting towards the end of the month!

So, M has seen hummus with meals at least 100 times in the last 3 years. I love it (local Hollyland hummus is the bomb) and it is often there for lunch with other options. Out of the blue, she asked for hummus yesterday morning for breakfast. It was in the fridge right in front of her (I was making French toast from left-over bread.) I was curious so I said, "sure!" (Those of you paying close attention note that I was letting her do the job of deciding 'what' to eat, I hope you'll go with it for now....) :)

She pulled out the hummus, I peeled a carrot for her and she nibbled on that while we chatted and I tended to the French Toast.

"This is good hummus. It's just like Freddie's!"

Well, bowl me over and Thank You Freddie!

You know the line about kids needing to "try" foods 10 times before they decide they like it? Well, they may need dozens and dozens, and sometimes 100 exposures before they decided to even try it! I think they had hummus for snack at school, and Freddie occasionally had it at lunch time.

So, don't despair, don't pressure. I know how tempting it is to ask kids to try it, or to eat something they are reluctant to eat. I firmly believe that almost all kids, when exposed over time to a food in a neutral and pleasant setting will learn to like it.

Like my client who called after six months saying her son tried cauliflower and sushi all in one week, or the child who declared he might try a chicken nugget next time... It takes time, lots of it for some kids. Having a positive attitude about eating and food is critical.

Your 5 year old doesn't have to eat or love everything (nor does your two or eleven year old.) I wasn't even exposed to most 'exotic' cuisine until college and beyond. Trust that if you love eating a variety of foods and you provide your children with that opportunity, with time, they will learn to like those foods.

What if I had MADE her try it, or pressured her? Might she have taken a few bites to please me? Might she have refused and had the 45 minute stand-off? Would she have been as positive about it so soon?

What was it like to be pressured to try new foods for you as a kid... I know I didn't even TRY my mom's red cabbage until I was in my mid-twenties. They always wanted me to try it, but it was my line in the sand....

Are there foods you were encouraged or forced to eat that took you a long time to be open to? ( I still haven't even tried my dad's home-made green tomato chutney...)

Oh, and this was the 3rd time we had French Toast, and M at 2 smallish slices, while she only nibbled the first few times...