Healthy Living in the North

A sigh of relief: trusting kids to eat enough

An adorable child, with food all over it's face, smiles into the camera and holds a peanut butter and jam sandwich.

Children of all ages have the ability to regulate their food intake. The division of responsibility in feeding trusts, respects, and protects this ability.

Many parents of young children worry that their kids don’t eat enough. As a dietitian and a mother of a young child, I totally get it. We want the best for our children; we want them to be healthy and to get the nutrition they need.

Mealtime struggles

Parents and caregivers often tell me about the strategies they use to try to get kids to eat. We keep them at the table, prompt them to take a few more bites, chase them with spoons (“airplane!”), praise them when they finish their plates, negotiate with them, and entice them with dessert. It’s a lot of work. Kids often resist these efforts, and parents get frustrated. And kids are frustrated too! It’s an exhausting experience for many families.

Is there a different way?

Fortunately, yes. Ellyn Satter’s division of responsibility in feeding (DOR, for short) is the recommended approach to feeding children. This approach helps prevent and manage a lot of common feeding challenges. It’s based on trusting that children of all ages are capable of determining how much to eat to grow and be well.

Adults’ roles and kids’ roles

In short, the DOR outlines adults’ roles with feeding, and kids’ roles with eating.

Adults are responsible for deciding what foods to offer, and when and where to offer them. Ideally, they would provide a variety of foods over the course of the day, offered at regular meal and snack times, in ways that support eating together. Once adults have done these pieces, their job is done.

Then, it’s up to the kids – they decide how much to eat from the foods provided, or whether to eat at any meal or snack time. Adults don’t have to do, or say, anything about how much is eaten – this is left up to the child.

Learning to trust

In my experience, at first, parents can find it hard to trust the DOR (also known as the “trust model”): “Letting kids decide how much to eat – is that a responsible thing to do? Won’t they starve?” In fact, right from birth, children can eat the amount they need to grow well. A hungry baby will let you know! And when they are satisfied, they’ll let go of the nipple, turn their head away, lose interest, and/or fall asleep. As they grow older, children continue to have the ability to regulate their food intake. The DOR is all about trusting, respecting, and protecting this ability.

A shift

It can be quite a shift to learn to trust kids to eat enough. There’s also a bit to learn about how to apply the DOR; however, in my experience, when parents and caregivers start to apply this approach, many feel a huge sense of relief. They’ve been working so hard – too hard – and they can finally take a step back, and learn to trust their children to do their part with eating. In turn, children will start to become more relaxed at meal times as well, eating the amounts they have appetite for, and (eventually) exploring a greater variety of foods.

Learn more

Interested in learning more about the division of responsibility in feeding? Consider the following resources:

It might also be helpful to connect with a dietitian:

  • There are dietitians in various communities across Northern Health. A referral may be required.
  • BC residents can also access Dietitian Services at HealthLink BC, by calling 8-1-1 (or 604-215-8110 in some areas) and asking to speak with a dietitian.
Lise Luppens

About Lise Luppens

Lise is a registered dietitian with Northern Health's regional Population Health Nutrition team. Her work focuses on nutrition in the early years, and she is passionate about supporting children's innate eating capabilities and the development of lifelong eating competence. She loves food! You are likely to find her gathering and preserving local food, or exploring beautiful northwest BC on foot, bike, ski, kayak, or kite.

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Milk and young children: what you need to know

A child with a cup of milk.In a recent post, I explored how milk and fortified soy beverages fit into the new food guide. Did you know that Canada’s food guide is intended for Canadians two years of age and older? Guidance for feeding infants and toddlers is more specific. Today, let’s take a closer look at feeding advice related to milk and young children.

Breastfeeding is recommended to two years and beyond

For as long as children continue to receive breast milk, they don’t need milk from cows (or goats) or other alternatives. Moms can be assured that their own milk is the best choice for their child, for as long as they and their child wish to continue breastfeeding.

Formula? When to switch to cow’s milk

Older babies who do not receive breast milk can usually switch from a store-bought infant formula to cow’s milk between 9-12 months of age (if you have questions about infant formula, speak with your healthcare provider).

Introducing animal milk

Do you want to offer your child cow’s or goat’s milk? Consider these tips:

  • Wait until your baby is 9-12 months of age and eating iron-rich foods
  • Choose a pasteurized, full-fat (homogenized or 3.25% M.F.) milk that is not flavoured or sweetened. Goat’s milk should be fortified with vitamin D.
  • Offer milk in an open cup, at meal or snack times.

Beverages to avoid for children less than two years old

Lower fat milks (i.e. 2%, 1%, and skim milk) are too low in fat and calories for young children. Plant-based beverages, such as soy, almond, rice, coconut, and hemp drinks, are also low in calories and other important nutrients. The Canadian Pediatric Society and Dietitians of Canada released a statement advising parents against providing these drinks to young children.

Fortified soy beverages are an option for older children

For children two years and older, fortified soy beverage is the only plant-based drink that is nutritious enough to be an alternative to milk. If your child doesn’t drink milk, consider offering about two cups per day of an unsweetened, fortified soy beverage.

Be cautious with other plant-based beverages

Beverages made from rice, almond, coconut, oat, hemp, cashew, etc. are low in protein and many other nutrients, though some store-bought products have vitamins and minerals added into them. If you choose to provide these drinks to children two years and older, make sure that they are eating a variety of nutritious foods and are growing well. Also, choose products that are unsweetened and fortified.

The bottom line

That’s a lot of nitty-gritty details about milk and young children! The table below organizes information by age group.

Age Recommendations
0-9 months · Breastfeed your baby.

· If you do not exclusively provide breast milk to your baby, offer a store-bought infant formula.

9-24 months · Continue to breastfeed your toddler.

· At 9-12 months of age, non-breastfed toddlers can transition from formula to pasteurized whole cow’s milk (3.25% M.F.) if they are regularly eating iron-rich solid foods. Offer two cups per day (no more than three cups). Full fat goat’s milk fortified with vitamin D is also an option.

· Vegetarian babies who drink formula, who will not be receiving cow or goat’s milk, should continue to receive a follow-up soy formula until 24 months of age.

2+ years · Continue to breastfeed for as long as you and your child wish.

· Children that no longer breastfeed or who don’t breastfeed very often can be offered pasteurized cow’s milk (whole, 2%, 1% or skim) or goat’s milk (fortified with vitamin D). Offer two cups per day (no more than three cups).

· Fortified soy beverages (unsweetened) also become an option at this age.

 

A dietitian can help you find ways to support your child’s nutritional needs.

  • There are dietitians in various communities across Northern Health. A referral may be required. Talk to your health care provider to learn more.
  • BC residents can also access Dietitian Services at HealthLink BC, by calling 8-1-1 (or 604-215-8110 in some areas) and asking to speak with a dietitian.
Lise Luppens

About Lise Luppens

Lise is a registered dietitian with Northern Health's regional Population Health Nutrition team. Her work focuses on nutrition in the early years, and she is passionate about supporting children's innate eating capabilities and the development of lifelong eating competence. She loves food! You are likely to find her gathering and preserving local food, or exploring beautiful northwest BC on foot, bike, ski, kayak, or kite.

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