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Have Patience, You've Got a Picky Eater!

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Linda Jonides
By Linda Jonides R.N., C.P.N.P.
"I have worked as a pediatric nurse practitioner (P.N.P.) for over 30 years," says Linda Jonides. "I continue to thoroughly enjoy forming new relationships with parents and newborns and working with them through infancy, childhood, and adolescence."

Linda Jonides is a pediatric nurse practitioner in a private pediatric practice in Ann Arbor, Michigan. She received her Diploma in Nursing and Certificate as a Pediatric Nurse Practitioner from The Johns Hopkins Hospital. She is a past recipient of the Michigan PNP of the Year Award. She has a B.S. in Nursing from Eastern Michigan University. She has published articles and lectured on childhood obesity, infant colic, role of the P.N.P., growth and development issues, and infectious diseases. She was an author of "Clinical Insights Column," published biannually in the Journal of Pediatric Health Care for nine years. Jonides is past president of NAPNAP. Currently, she is a steering group work member of NAPNAP's HEAT (healthy eating and activity together) project. One outcome of this group's work is the clinical practice guideline, "Identifying and Preventing Overweight in Childhood," that was published as a supplement to the March/April '06 issue of the Journal of Pediatric Health Care.

Ms. Jonides has been married to John, a university professor, since 1971.
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Many preschoolers are now actually good company at mealtime. They generally view eating as a natural response to hunger and meals as a pleasant social experience and a time to show they are grown. Sounds great, doesn'™t it? That'™s putting the good news first.

  The Potato Chip Diet

  Control and More Control

  Mealtime Strategies That Work

  Eating for Life






The Potato Chip Diet

It is also common for 3- to 5-year-olds to develop (”seemingly overnight) ”specific food preferences, meaning in some cases they'™ll eat only yellow foods or foods covered completely by applesauce. They are very insistent about what they will eat. In other cases, the selection shrinks to five foods total, one of them potato chips. Then there are the ones who can'™t get enough of something on Wednesday and reject the same food absolutely on Thursday. That can be frustrating, to say the least.

One thing a parent needs to accept: Inconsistency rules the day, so don'™t get flustered. Your child may be less hungry some days because she was less active the day before. Or she may be the victim of a whim. Or she may have seen another child eating something you'd never think of feeding her for dinner, such as a jelly doughnut. But take heart: When children are stubborn about eating at this age, it is part of learning to be independent and in control.

Control and More Control

Ah, there'™s a word. Children often use food to display control, which is natural in a preschooler. Even at the height of these difficult periods, children will not starve themselves and they rarely lose weight. However, if you do suspect weight loss, or if you notice other symptoms of illness such as fever, nausea, or diarrhea along with a sudden change in appetite, you should consult your health care provider.

Mealtime Strategies That Work

Here are some strategies to help you and your child have more pleasant mealtimes:

    • Offer your child nutritious foods and let her decide what and how much to eat. You are the supply agent, and she is the eater. You are in control of what'™s in the house and on the table; she'™s in control of what goes in her mouth.
 
    • Anticipate that she will imitate her peers with regard to likes and dislikes and that these will change constantly.
 
    • Battles about food are common, and eating gets lost in the struggle. These are really about control. Know what you can and cannot control.
 
    • The best advice is for parents and other frequent caregivers to be good role models. Children will eat  in whatever way their family does, ”eventually.
 
    • Practice healthy eating behaviors, including serving/choosing a variety of foods, trying new foods, and not overeating.
 
    • Try to eat meals together as a family whenever possible.
 
    • Foster a relaxed atmosphere at mealtimes, and try not to rush your child. On the other hand, if she takes longer than 30 minutes to finish, she'™s not really hungry, so give it up.
 



Eating for Life

The basic eating habits your child develops now will probably stay with him the rest of his life. The following are general guidelines to help your child get enough (”but not too much) ”food. Remember that quantities and selections may vary from day to day.

1. Offer small portions, with seconds only if your child asks for them. A few acceptable œchild-sized portions include:

4-6 ounces of milk or juice

1 slice toast

1/2 cup yogurt or cottage cheese

4 tablespoons vegetables

2 ounces hamburger

1/2 cup cereal

2. Limit snacks to three per day, stressing lower-fat foods, fruit, and fresh vegetables over soft drinks, candy, pastries, and salty or greasy items. Additional snacks may decrease your child's appetite for meals. Plan the time for snacks and avoid grazing. 

The more healthy choices you give your child, the more likely he will be to take one of them (he can feel good about rejecting two or three!). If you keep snacks for yourself or other adults that you don'™t want your child to eat, you should expect those snacks to be the only ones he'll settle for. 

Nutritious snack foods for preschoolers include:

Fruit

Fruit juices (limit juice to 4 to 6 ounces a day)

Carrot, celery, or cucumber sticks

Cheese sticks

Yogurt

Toast or crackers with cheese

Oatmeal cookies

Finger sandwiches (meaning 1/8 of a sandwich), or bran muffins

3. Don'™t use food as a reward for good behavior.

4. Make sure your child is actually hungry or thirsty when he asks for food or a drink. He may just want some attention, so try talking or playing first. Try not to use food as a pacifier.

5. Limit milk intake at this age to 16 ounces a day. Milk is a very important food, but too much of it may reduce your child's appetite for other important foods. He should be on milk that contains 2 percent or less fat at this age.

6. Encourage your child to try new foods by offering small amounts to taste, not by insisting that he eat a full portion of an unfamiliar food. It takes seven tastes, on average, before a child will accept a new food.

7. Discourage eating while watching television, playing, or listening to stories. These other activities are distracting. In addition, television advertising is influential in the choices your child makes about food.  Children this age are receptive to plugs for sugary cereals and sweets, especially after they'™ve visited other homes where these foods are served. Less than 5 percent of food ads during the daytime are for "good" foods such as fruits and vegetables. The more commercial television children watch, the more likely they are to demand less nutritious snacks and be less interested in healthier alternatives.

8. When time allows, include your child in the selection of foods and in some preparation. Kids love to help and will feel proud to have contributed.

9. When everyone's at the table, encourage conversation. Nothing like a pleasant atmosphere to aid digestion!

Consistent weight gain and proportional height and weight are the best markers of good nutrition. Keep up regular child health checkups and look at the growth charts at the health provider's office for reassurance. Or check the charts on this site to see how your child'™s growth measures up.

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Picky Eater
This article really gave me some relief from the stress I was causing myself by worrying about my so..

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