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.

Share

Talking to our kids: having a conversation does more than you know

(Editor’s note: This article first appeared in Northern Health’s Healthier You – Fall 2018 edition on Youth Mental Wellness. Read the full issue here.)

A man and child throwing rocks into a lake.Lately I’ve been hearing from my colleagues that they don’t know how to talk to their children about mental health issues or suicide in our community. I can relate to their struggle because, although I trained as a clinical counsellor and facilitate mental health workshops, everything I know seems to go out the window when it comes to my own kids and their struggles (and I end up doing the very things I advise against).

One thing I am sure of though, is that there is great value and importance in talking to our kids about the truth of the world. Our boys are 6 and 12 now and my husband and I have talked to them since they were toddlers about all manner of topics that affect them and their community. We have discussed residential school and colonial history, racism in our Northern community, the fentanyl crisis, youth suicide, domestic violence, LGBTQ2 language, social media dangers – the list is endless. I believe that there is a way to talk to kids about challenging topics, in an age appropriate way – and that we should! It’s important to prepare yourself for the emotional impact of discussing a topic that you have a lot of feelings about, for example, self-harm or suicide.

You may have different levels of knowledge about all of these topics, as we do, but I think even if you’re starting from the beginning, you can do so alongside your child (coming from a place of not knowing together is okay!). Find out one or two facts on an issue, and give them some language, so that they can ask questions. Let them know that you’ll share what you know; and if you don’t… you’ll find out.

There may be opportunities in your community that you haven’t considered attending that can spark conversation or ideas with your family about important topics, which may help them shape their opinions on community issues. We’ve taken our children to anti-violence rallies, anti-racism rallies, and Aboriginal rights marches. As always, I’ll run into someone I know there who says, “I should’ve brought my kids!” Even a young child will undoubtedly learn something by attending community events.

For example, domestic violence is something we want our boys to learn about as it’s a reality in our community. Now they have joined the Moosehide Campaign – a campaign to end violence against Aboriginal women and children. If they consider where they stand on issues like this now, and grow up surrounded by people who will stand by these values, we’re hopeful they will hold onto these values as youth and adults.

Kids notice what is going on around them and will ask questions. They may not need to know every detail of difficult topics, like suicides or violence, but you can discuss some of the reasons behind people’s actions, for example, why people take their lives. If we open the door to these conversations, and your children believe you have something to offer and can support them, they are more likely to speak up if they or their friends are going through difficult times.

If you’re not sure where to start, just listen. Your children will give you the opportunity needed to share your ideas and knowledge about the world. Ask them what they know about these things, and share what you are willing to share, in a way that doesn’t frighten them, but gives them a starting point to frame the information.

About Erin Anderlini

Erin Anderlini is the Health Director with the Prince George Native Friendship Centre. The Prince George Native Friendship Centre is a non-profit, non-sectarian organization dedicated to servicing the needs of Aboriginal people residing in the urban area and improving the quality of life in the community as a whole.

Share

Everyone needs routine: eat, sleep, be a healthy kid, repeat

Young boy posing, wearing his backpack.(Editor’s note: This article first appeared in Northern Health’s Healthier You – Summer 2018 edition on Healthy Schools. Read the full issue here.)

Routine is something we all have, whether we admit it or not. We all have our own morning wake-up routine, transportation routes planned, or our bedtime wind-down. It might sound monotonous to think about, but routine actually benefits us in many ways. Having scheduled, planned, and predictable ways of doing everyday tasks takes the thinking out of “What’s next?”

Children and adults both benefit from daily routine. Routines lower stress levels, decrease anxiety, and also improve mental health and sleep. All of these benefits are linked to each other: if you’re less stressed you will sleep better; if you sleep better your mind is sharper; and if your mind is more clear you are more productive – you get the picture! There are physiological benefits from the above too, such as decreased risk of heart disease. Children also benefit from routine because it makes them feel safe, secure, and helps develops independence!

Young girl smiling, holding a Welcome to Kindergarten bag.Routine doesn’t have to be cumbersome and should have some flexibility – it can actually be fun and bring your family together! The best way to create a back to school routine is to start before the first day of school. This allows kids to adapt to it, make changes and, most importantly, make it a habit! When creating the routine, include your young ones! Help guide them to make their own healthy choices for the school year, and listen to their feedback! Everyone is different, so what works for some might not work for others!

When planning your kid’s school routine be sure to consider the following:

  • Make bedtimes and wake-up times the same times each day and night.
  • Plan for healthy meals and snacks.
  • Plan the same active transportation and safe routes for each daily commute.
  • Let kids engage in physical activities for at least 60 minutes per day.
  • Create after school routines including chores, homework, and fun activities.
Taylar Endean

About Taylar Endean

Taylar is an Oncology Nurse in Fort St John. Taylar was born and raised in Prince George and studied at UNBC to earn her degree in Nursing in 2011. She's still living in the North where she tries to embrace everything it has to offer. In her spare time, Taylar loves being outdoors, spending countless weekends at Ness Lake, walking, snowshoeing and skiing. Taylar also enjoys spending time with family and friends, coaching skating, volunteering at community events and just started to learn to crochet. The north is her home, though she does like to take those sunny vacations!

Share

Talk spots

Adult and child outside

What are your family’s talk spots?

What is a “talk spot”?

A talk spot is literally a spot to talk to someone. The idea behind talk spots is to remind people of times and places where it is ideal to be present in the moment and communicate with those around us. We get to the spot and it’s our incoming reminder: time to stop and talk!

Why do we need designated talk spots to remind us to stop and talk?

We live in a busy world that is driven by technology. We have a million things to do and are constantly distracted by screens, incoming texts, phone calls, and emails demanding our attention. More and more of our communication is happening via technology and there is less face to face conversation. All of these things can prevent us from recognizing the communication opportunities that are right in front of us.

Where can my talk spots be?

Here are a few examples of talk spots I suggest:

  • The table: Mealtimes are natural opportunities for conversation. You are sitting face to face and looking at each other, which is ideal for communication. Mealtimes provide opportunities to expand on your child’s vocabulary. You can label the food items (e.g., apple), describe the food (e.g., hot, cold, soft, crunchy), and talk about actions at mealtime (e.g., pouring the milk, cutting the meat). You can chat about what will be happening that day or what happened that day.
  • The car: When you are driving, you are forced to sit and slow down. It gives us the time to talk with our children and wait for a response. Slowing down and waiting are important elements for language development. Driving also provides new vocabulary opportunities: you can talk about the objects you see (e.g., garbage truck, hospital, school, dog, snow), the places you are going (e.g., preschool), and the people you are going to see (e.g., grandma).
  • Waiting rooms: You are waiting anyway, so why not put away the phone and talk? Talk about what is happening in the waiting room (e.g., “we are waiting for our turn”, “that boy is sitting and waiting, too”). Talk about what is going to happen in the appointment (e.g., “the dentist is going to look in your mouth”).
  • The bath: Baths need to happen and naturally create face to face interaction. At bath time, you can talk about body parts (e.g., feet, toes) and use action words (e.g., wash, rinse, splash, pour).
  • Change time / getting dressed: Talking when you are changing your child can help distract you and your little one from the task at hand :) It is a time to use descriptive language, clothing vocabulary (e.g., shirt on, pants on) or use sequencing terms (e.g., first we put your diaper on, then your shirt, your pants go on last). It is a time to offer choices (e.g., “red shirt or blue shirt?”). Offering choices can promote language development. You are providing a model of the words you would like your child to imitate, making it easier for them to repeat. Choices also help children recognize that words have power and give children a sense of self control.
  • The grocery store: The store provides many opportunities for vocabulary growth. You can talk about the different food items or describe their attributes (e.g., red apple or green apple), you can talk about quantity concepts (e.g., one cabbage, a few pears). You can also work on social skills, like saying “hi”/”bye” to the cashier.
  • Bedtime: A wonderful time to sit and talk with your child. It is also a good time to read to your child. Books expose children to new words and provide repetition, which is key for learning language.

The month of May is Speech and Hearing Month. It is a time to raise awareness about the importance of communication. As the Speech-Language and Audiology Canada website states: “The ability to speak, hear, and be heard is more vital to our everyday lives than most of us realize.”

Get out there and try some of the suggested talk spots! Try coming up with your own talk spots that may be better suited for your family. Have fun being in the moment, talking and connecting! Remember that to learn to use language, children need to have someone to talk to.

Trisha Stowe

About Trisha Stowe

Trisha was born and raised in the north. She started her career with Northern Health as a Speech Language Pathologist in 2012. In her current role, she supports children who have communication difficulties and their families. In her spare time, she loves exploring the north and everything it has to offer with her family.

Share

Helping your child embrace the open cup

Caribou mascot in front of oral health poster

For a lifetime of healthy smiles, let your child drink from a lidless, regular cup.

Sippy cups are popular with parents and preschoolers alike. Many parents find comfort in knowing that there will be less mess with these spill-proof cups. They sure are handy for families on the go!

But did you know that drinking from an open cup, rather than a sippy cup, helps kids develop good tongue movements needed for speech? It may also encourage more communication and interaction, helping kids learn new sounds and words! There are also worries about dental health and nutrition if kids have regular access to sippy cups with drinks other than water. When kids carry around their sippy cups (as they often do) they tend to sip their drink over long periods of time, leading to cavities and ruined appetites.

So, how do families balance this information with the realities of everyday life? Adults play an important role in deciding what drinks to offer kids and the manner in which they are offered. Many parents find it helpful to try limiting the use of sippy cups for times when mess is an issue, like on your neighbour’s new white carpet! Or, try filling sippy cups with plain water rather than juice or milk to help prevent cavities. Whether it’s an open cup or a sippy cup, children do best with regular, sit-down meal and snacks and water in-between to satisfy thirst.

Here are some tips to help encourage the use of open cups:

  • Remove the valve on the sippy cup to help children learn to drink without sucking.
  • Use small cups that are easier for children to hold.
  • Bring home a new, special cup or let your child pick one out from the store.
  • Sit and eat with your child so they can see you drink from an open cup.
  • Avoid distractions such as toys, TV, or computers when eating or drinking to help your child focus on the task at hand.

With your example, and lots of chances to learn, children will master and enjoy drinking from an open cup in no time!

Emilia Moulechkova

About Emilia Moulechkova

Originally from the Lower Mainland, Emilia started her career with Northern Health as a dietetic intern in 2013. Since then, she has worked in a variety of roles as a Registered Dietitian with the population health team. In her current role, she supports schools across the north in their efforts to promote healthy eating. Emilia is passionate about food’s role in bringing people and communities together, and all the ways it can support physical, mental, and social health. Her overall philosophy on healthy eating can be summarized by this Ellyn Satter quote: “When the joy goes out of eating, nutrition suffers.” In her spare time, she loves exploring the beautiful northern outdoors by foot, skis, bike, or canoe!

Share

Baby teeth: Why they are important

Spirit mascot in front of poster

You can keep your child’s teeth healthy by brushing them in the morning and before bed, starting as soon as those teeth erupt. Use a little smear of toothpaste that has fluoride in it.

They eventually fall out and are collected by the tooth fairy anyways, so why are baby teeth so important?

Healthy baby teeth are important for many reasons:

  • Baby teeth hold the space for the replacement adult teeth.
  • Baby molars will not fall out until your child is about 12 years old.
  • Early loss of a baby tooth may cause the movement of the other teeth, possibly resulting in crowding or bite problems.
  • Baby teeth are important for appearance, proper chewing of foods, and speech.

But, since those baby teeth are not meant to last a lifetime, their outer covering (enamel) is not as thick or hard as the enamel on adult teeth. The enamel in the first 18 months after a tooth erupts is fragile and can decay very quickly.

Why does this matter? Just like in adults, tooth decay in our kids may cause pain, infection, difficulties chewing, problems sleeping or concentrating, and poor self-esteem. Tooth decay is largely preventable. Health care providers, child care providers, and parents can all work together to spread healthy messages regarding oral care and we can all model behaviours that can lead to a reduction in tooth decay and oral health problems.

You can keep your child’s teeth healthy by:

  • Brushing your child’s teeth in the morning and before bed, starting as soon as those teeth erupt. Use a little smear of toothpaste that has fluoride in it.
  • Do not put your child to bed with a bottle or, if you do, offer only water in the bottle.
  • Help your child to learn to drink from an open cup (not a sippy cup). This can be used for small sips of water starting at 6 months and for milk starting between 9-12 months.
  • Limit how often your child gets sticky, sugary foods and drinks. Children one year and older benefit from 3 meals and 2-3 snacks per day. These should be spaced 2-3 hours apart. Choose a variety of healthy foods that do not stick to the teeth.
  • Make an appointment for your child’s first dental appointment by their first birthday or about 6 months after their first tooth erupts.
  • Lift your child’s upper lip once a month to check for any whitish marks on the teeth which may be the start of decay.
  • Avoid saliva sharing habits like using the same spoon.
  • Parents should have any decay treated to reduce the chances of passing on the cavity causing bacteria to their child.
Brenda Roseboom

About Brenda Roseboom

Brenda was born and raised in Terrace. She has worked in the community first as a certified dental assistant and then as a hygienist. After being in private practice for many years, she joined the Northern Health dental team in May of 2016. Brenda enjoys gardening, quilting, and many other crafting hobbies. The beauty of B.C. continues to amaze her and keeps her rooted in the north.

Share

Are “picky eaters” just “eaters in training”?: Tips to help build kids’ food acceptance skills

Child eating a cherry

Kids are often unsure about new or unfamiliar food. With time and practice, they can learn to eat a variety of foods.

It’s lunch time. You prepare a meal and sit down to eat with your kid(s). They eat all of the [food x] but leave [food y] completely untouched. What’s the deal? Is it always going to be like this? Why can’t they just eat a bit of everything? How do kids go from here (“rejecting” certain foods) to there (accepting a wide variety of foods)?

Come on a little trip with me!

Imagine you take a trip to an unfamiliar place. Somebody presents you with bread, cheese, and a bowl of … green, lumpy, semi-solid something. They gesture for you to eat it. You hesitate. You feel anxious. You don’t know what this is – you certainly don’t feel like eating it!

Stay on this trip with me. Imagine now that you eventually learned to like that green, lumpy, semi-solid something, and now you even look forward to when it might be served again! Whaaaat? How could it be? How did you come to accept, and even like, that food?

It could look like this:

First, you looked to see that other people were actually eating it. But you looked at the “semi-solid something” and decided that you were not yet ready to try it. The next week, it was offered again, and now it was a little less scary. Maybe you poked at it with your spoon. Later, you gave it a sniff. Then, you stuck your finger in it. Maybe someone told you what was in the dish. Maybe you had the opportunity to see it being prepared, and you even got to help. Eventually, you put a little in your mouth but then spit it into a napkin. You decided it was tasty, and that you wanted a little more of this … broccoli soup or green jello or guacamole or whatever this dish is in your mind.

Back to reality. Think of a time when you learned to like a new food. What helped you to learn?

Kids are often unsure about new or unfamiliar food. With time and practice, they can learn to eat a variety of foods. We can help to make this learning process feel safe.

Here are some things to try to support your kids to learn to eat a variety of foods:

  • Make the same meal or snack for everyone. Sit and eat together. Seeing others eat a food is a great way to learn about it.
  • Offer new foods with familiar foods. If they are not yet comfortable with one food, kids can eat from the other items at that meal or snack.
  • Serve new foods over and over, without pressure or praise. Kids may need to see a food 15 to 20 times before they decide to eat it.
  • Be honest about what you are serving. Kids need to experience foods in order to learn.
  • Teach your kids to politely turn down food they aren’t yet ready to eat.
  • Respect tiny tummies. Serve a small amount to start and allow seconds. Kids’ hunger and appetite change from day to day, meal to meal.
  • Involve kids in growing and cooking food, and in packing their lunch.
  • Praise kids on their table manners, not on how much or what they eat.
  • Expect that in time your “eater in training” will learn to accept a variety of food. They will learn at their own pace.

For more information, see: Coaching Kids to Become Good Eaters and The Picky Eater.

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.

Share