How to help your child develop a healthy relationship with food

By Amanda Regan, registered dietitian and certified lactation educator-counselor at CHOC Children’s

In a culture filled with fad diets and mixed food messages, it can feel confusing to try and be healthy. Today, we find so many labels on food telling us how we should already feel about what we’re eating —good, bad, clean, or guilt -free. These mixed messages about food can feel even more confusing for young children and teens.

Those at a vulnerable age can be more susceptible to triggers, such as product labeling, that could negatively affect their relationship with food or even contribute to the development of an eating disorder. Unfortunately, eating disorders have become increasingly more prevalent among all kids of different genders, race, shapes and sizes. Eating disorders also have the highest mortality rate out of any mental illness.

We as parents have an opportunity to help our children develop a positive relationship with food. A person’s relationship with food starts as young as infancy, so it’s important to make mealtimes as pleasant as possible from the very beginning. Here are some tips on how to help your child not only feel good about everything they eat, but also feel good about themselves.

Avoid putting your child on a diet

Research shows that dieting behaviors are most commonly linked to eating disorders in kids. Growing children should not be put on a diet unless it is deemed medically necessary. According to the American Academy of Pediatrics, if a child is overweight, the recommendation should be to encourage a healthy lifestyle, rather than focusing on weight. Although we don’t always realize it, our children are always listening to us. So, try not to talk about weight, calories, or dieting in front of your child. Even if you, yourself, are on a diet.

Avoid attaching labels to food

Try not to think of food as either bad or good, but instead focus on nourishment for you and your child. Labeling food is a way of telling your child how they should already feel about the food they are eating, instead of letting them decide for themselves. Let your child know that all food can fit in a healthy diet, as long as the majority of their diet is a balance of all the food groups. This means that yes, even treats can have a place in a healthy diet.

 Refrain from body talk

Avoid talking about appearance or body image in front of your child. Your child’s body is constantly changing and developing — especially during the adolescent years — and it can leave them feeling awkward and self-conscious. Children are sensitive to comments about body image.

 Have family meals

Frequently eating meals together has been shown to prevent disordered eating behaviors such as restricting, binging and purging. Family meals provide opportunities for you to model healthy behaviors in front of your child. They have also been associated with overall improvement in dietary quality. When having family meals, try to provide the same food for everyone and avoid making separate meals.

 Know your role in the feeding relationship

With food, your role job as a parent is to provide nutritious food for your child; their job is to decide how much they eat. Try not to pressure your child in any way when it comes to eating. Helping your child build a positive relationship with food involves trust. Trust in your child to finish their meal when they are full and eat more when they are hungry. Force feeding or restricting food intake can turn mealtimes into a battle ground.

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  • How to support someone who is breastfeeding
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Healthy meals for your family: Tips from a registered dietitian

By Mary Sowa, registered dietitian at CHOC Children’s

Looking for help to plan healthy meals for your family? Choose My Plate, a program of the USDA, is a great place for recipe ideas and tips for meeting your nutritional goals.

Start Simple with MyPlate:

This page offers tips on how to incorporate each food group into your diet. You can also find information on the foods that should be limited in our diets, including salt, saturated fats and added sugars.

More tips include ideas for preparing meals ahead of time, snack ideas for kids, and how to incorporate different foods to help meet vegetable goals.

MyPlate Plan:

On this portion of the website, you can enter gender, weight, height and activity level, for a calculation on your specific energy needs. Once you have that information you can select the calorie level, along with the servings and suggestions for each food group to meet those calorie requirements. You can also enter information on behalf of your child, to see their specific calorie needs. See an example MyPlate Plan.

Action Guide:

Action guides are specific to adults, parents/caregivers, kids/teens, and teachers/health educators. These guides offer tips for enjoying local foods, growing your own food, tips for picky eaters, activity sheets for kids, recipe ideas and more.

Healthy eating on a budget

This section will help you create a grocery store game plan and stick to your budget and help you prepare healthy meals. The kitchen timesavers tip sheets offer advice for organizing your kitchen, clearing the clutter, chopping extra, doubling your recipe and more tips to help you maximize your time in the kitchen.

These are just four features of Choose MyPlate to explore. This resource offers endless tips, plans and recipes to help improve or maintain healthy eating habits.

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  • How to help your child develop a healthy relationship with food
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  • Do I need a lactation consultant?
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Do I need a lactation consultant?

By Cindy Baker-Fox, registered nurse and international board-certified lactation consultant at CHOC Children’s

In addition to the proven health benefits for mom and baby, breastfeeding can be a wonderful experience that fosters bonding. But in some cases, breastfeeding and breast milk production can be challenging for both mom and baby, and may require assistance from a lactation consultant. The most common concern among moms new to breastfeeding is, “Is my baby getting enough milk?” The process can be difficult or confusing for new moms who are looking for support and education. As a result, some moms may stop breastfeeding earlier than they had hoped. In these cases, it may not be necessary to stop breastfeeding, but rather work with a lactation consultant who can evaluate milk supply, a baby’s breastfeeding skills, and any other factors that may be resulting in breastfeeding issues. They can also provide interventions and follow-up care until the problem, or concern, is resolved.

The difference between lactation consultants and lactation educators

Lactation specialists with the title IBCLC (international board-certified lactation consultants) are clinicians who have received advanced education and training in the fields of lactation, breast anatomy and physiology, infant feeding development, infant oral anatomy, and complex lactation issues and challenges. They have hundreds of hours of experience working with breastfeeding moms and babies. Lactation consultants are usually registered nurses, registered dietitians, feeding therapists, or doctors. Others working in the field of lactation may be trained as lactation educators or lactation counselors. These individuals have more limited training in lactation and breastfeeding than lactation consultants, and they focus mostly on education and support, rather than diagnosis and treatment of complex breastfeeding and lactation issues. A lactation consultant can assess, diagnose and treat many breastfeeding issues. When medications or special therapies are required, the lactation consultant will refer the mom and baby to a specialist who can provide additional care.

Common breastfeeding problems

 The most common breastfeeding problems moms encounter that might require lactation services include:

  • Difficult or painful latching
  • Low milk supply or too much milk supply
  • Infant weight loss (more than 10% loss from birth weight) or inadequate weight gain after two weeks post-birth
  • Fussiness at the breast, breastfeeding refusal, and nursing strikes
  • Breast or nipple pain and/or infections
  • Babies with special feeding needs including premature infants; twins and multiples; infants with medical issues that make latching and sucking difficult; or newborns with hyperbilirubinemia, yellow skin from too much bilirubin in the blood
  • Preparing to go back to work or school
  • Weaning and formula use
  • General breastfeeding education, support and follow-ups

How to find lactation services

Insurance companies, including Medi-Cal and Cal-Optima, are required to provide lactation services and supplies for the mom and baby in the hospital as well as at home. Services may be free or fee-based depending on the lactation provider and the family’s insurance coverage. Many birth hospitals offer free or low-cost breastfeeding clinics and services specifically designed for new moms, newborns and growing infants. Support groups are also common resources provided by birth hospitals. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), a federal program of the USDA, is another critical resource for many moms, and they too provide in-depth breastfeeding services, including consultations, classes, support groups and nutritional services. La Leche League support groups are also a good resource for education and support. They are available in most communities and provide a vital connection to lactation specialists and other breastfeeding moms in the community.

What to do if you need help breastfeeding:

  • Talk with your baby’s pediatrician who can evaluate if your baby is gaining weight properly and assess his or her mouth to determine if there are any conditions that might be causing sucking or breastfeeding problems. Many pediatric offices have lactation educators in their practice, or they can refer you to a lactation consultant in the community.
  • Contact your insurance company to determine your benefits for lactation services. They may require a referral from your pediatrician.
  • Contact your birth hospital or local community hospital to determine if they offer a breastfeeding hotline, breastfeeding workshops, classes or private consultations.
  • Call the National Women’s Health and Breastfeeding Helpline: 1-800-994-9662. Offered through the U.S. Department of Health and Human Services, this hotline is designed to address breastfeeding women’s questions. The hotline is available Monday through Friday, 9 a.m. to 6 p.m. ET.
  • Call your local WIC office to obtain information about their services and to determine if you qualify for their breastfeeding and nutrition programs.
  • Check with your local public health department, county health office, or any special mother/baby program to which you belong to determine if they offer breastfeeding education and support.
  • Reach out to a family member, friend, neighbor or co-worker who has breastfed. They may be able to provide you with the help and encouragement you need. You might be surprised to hear that they too had breastfeeding issues, and they might be able to share their tips and wisdom with you.

Breastfeeding help is often just a phone call away. Never hesitate to reach out for help. Working with a lactation specialist may be just the thing you need to help achieve an enjoyable successful breastfeeding experience and reap the benefits associated with breastfeeding.

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Related posts:

How to support someone who is breastfeeding

Laura Mize, registered nurse, international board-certified lactation consultant at CHOC Children’s

Each year, World Breastfeeding Week is celebrated in early August  to raise awareness of the benefits of  breastfeeding. This year’s theme,  “Empower Parents, Enable Breastfeeding” was chosen to be inclusive of all types of parents in today’s world. Breastfeeding is a team effort and involves more than just the baby’s mom.

Here at CHOC, we want to help empower parents and enable breastfeeding by providing support if your child is in the hospital. We understand that having a child in the hospital is stressful, and we know that our pumping and breastfeeding moms may need extra support during this time. Your baby’s bedside nurse and the lactation team will work together to help your family achieve feeding goals.

The mom’s support person is an important part of the team too! Helping mom takes many forms and families come in many different varieties. The mom’s support person may be the baby’s dad or mom’s partner, or it may be a friend or family member. The support person has a unique role that provides needed help to mom and increases the support person’s bond with the baby. The CHOC team provides education and guidance for mom and her support person.

Here are some examples of how the support person can help on a day-to-day basis:

  • Skin-to-Skin with baby is not just for moms! The support person can also do skin-to-skin, as tolerated by baby. Ask your nurse for details.
  • Diaper changes and temperature taking at care time if it is ok with baby’s bedside nurse.
  • Serve as a gatekeeper for family and friends. Everyone wants to know how baby is doing! The support person can provide updates and guide family and friends that want to help.
  • Help mom by keeping track of when it is time to pump or breastfeed.
  • Make sure the pumping/breastfeeding mom is getting proper hydration and nutrition. Ask your bedside nurse about meals available for  pumping and breastfeeding moms.
  • Getting mom and baby into breastfeeding position can feel awkward and challenging at first. The support person can help guide mom and baby. CHOC lactation consultants can teach you what you can to do to help.
  • Wash pump parts so they will be clean and ready for next pump session.
  • Love the baby! Babies can never have too much love.

The support person plays a valuable and important role that benefits both mom and baby. Please ask your bedside nurse what you can do to support mom and baby during their hospitalization.

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Healthy drinks for kids this summer

By Christina Wright-Yee, registered dietitian at CHOC Children’s

Heading into summer in Southern California means anticipating the above 100-degree temperatures, but we know what we need to do: hydrate, hydrate, hydrate! While registered dietitians and doctors encourage you to drink plenty of fluids throughout the summer, we also want to help you make healthy decisions. Sodas, juices, slushies, iced coffee and sports drinks may be fluids, but they can be full of calories and sugar that can lead to weight gain, heart disease and cavities.

The World Health Organization (WHO) suggests limiting our added sugars to less than 5% of our calorie needs. For kids ages 2-8, this is about three teaspoons per day. For kids older than age 8, it’s no more than six teaspoons per day. New research suggests even 100% fruit juices are similar to the sugars added to the soda and other sweetened beverages, meaning juice is no healthier than soda!

The amount of sugar in your favorite beverage may surprise you! One teaspoon is equivalent to one sugar packet like the ones you might find at a restaurant or café. In the below table, the serving size for all beverages is 12-ounces, even if the average serving size is typically larger.

Sugar content in your favorite drink
Type of beverage Number of packets of sugar
Water 0
Diet sodas or sugar-free drink mix 0
Powerade Zero or Propel 0
“Light” Sodas 0-2
Unsweetened tea 0
G2 Gatorade 2.5
Sports drink (Gatorade/Powerade) 5
Lemonade 6.25
Orange juice 7.5
Snapple iced/sweet tea 8-8.5
Powdered drink mix (with sugar) 9
Cola soda 10.25
Fruit punch 11.5
Root beer 11.5
Grape juice/cranberry juice cocktail 12
Orange soda 13
Starbucks Frappuccino 14
Naked/Odwalla Juices 12-14

Remember to always read the nutrition facts label to find out the actual amount of sugars and added sugars. When choosing a drink for you or your kids this summer, you might see the terms sugar-free, reduced sugar or no added sugars. Here’s what they mean:

  • Sugar free: less than 0.5g sugar per serving
  • Reduced sugar: less than 25% less sugar than the typical brand, but this doesn’t mean it is always the healthiest option. There still might be other beverage options lower in sugar.
  • No added sugars or without added sugars: no sugar added during processing, but the product may have naturally occurring sugars.

What can you do to stay hydrated and healthy this summer while quenching your thirst?

  • Swap out your favorite drink for one lower in sugar
  • Eat nutrient-rich juicy fruits and vegetables that contain more than 90% water, including: watermelon, cantaloupe, honeydew melon, frozen grapes, pineapple, grapefruit, berries, cauliflower, bell peppers, broccoli and tomatoes. Just watch portion sizes!
  • Make your own popsicles using fresh fruits and veggies
  • Add mint and lemon to an ice cube tray and freeze with water, then pop them into water or sparkling water for added refreshment!
  • Add lemon, lime, mint, strawberries, cucumbers or berries to sparkling water or water to boost the flavor.
  • Make homemade lemonade to cut back on the amount of sugar found in store-bought lemonade!
  • Try making a watermelon slushy. Mix two cups watermelon, 1-2 cups of ice, and 1 sprig of fresh mint in a blender and blend until smooth. Add ice to reach desired consistency.

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