By: Cristina Moreno, Bilingual Outreach Specialist, Penfield Children’s Center

Reviewed by: Natalie Alcaraz, Health Project Coordinator and Registered Dietitian for the City of Milwaukee Health Department WIC Program

We all love seeing our children grow. Watching the ruler stretch and the scale go up at each doctor’s visit reassures us that we are doing a good job giving our kids what they need to get bigger and stronger. This is why we may feel concerned when we see that their weight gain, which seemed to have shot up during the first 9 months or so, suddenly begins to slow and starts increasing by ounces instead of pounds. My son’s pediatrician informed me that as babies become more mobile and active as they get older, it is normal for weight gain to slow, and they are perfectly fine and healthy as long as their growth stays on track on their growth chart. However, despite this reassurance, I can understand why this change can feel alarming to many parents and they may feel the need to overcompensate for the low weight gain or picky eating by giving their child more and more food or supplementing with high calorie drinks like Pediasure.

Some cultures, including mine, may have a misperception of what a healthy weight looks like. They may see a plump child as being healthy and a child who may be at a perfectly fine weight as being undernourished, and in cultures where food equals love, you do not want people telling you your child is looking thin. I came across this quite often as a medical interpreter. Many times concerned parents would ask their pediatrician how they could get their child to gain more weight, and more often than not, the answer was that the child was not underweight at all and additional weight gain was not necessary, and may even be unhealthy. I also often heard cases in which a child was such a picky eater, that the parents would let them have whatever it was they could convince them to eat, even if their choices in food were less than nutritious. As a parent myself, I am no stranger to the extreme frustration of when a child refuses to eat anything you give him and you must resort to letting him have whatever it is he wants as long as he eats! Whether this happens due to pickiness, teething, or feeling under the weather, this habit of giving them what they are willing to eat, even if it means macaroni and cheese for breakfast, lunch, and dinner, can be a slippery slope that may contribute to even more picky eating.

While we know it is a good idea to limit high-sugar and junk foods for children because they do not offer much in terms of nutrients, here are a few things you may not know and may want to keep in mind when trying to teach your children healthy eating habits while ensuring they are getting the calories they need:

• The calories you drink count too! Milk and fruit juice are often believed to be healthy for kids, so it may come as a surprise to many parents when they are told that their child is drinking too much. Even if you give your child 100% natural fruit juice, that juice contains a lot of sugar and calories. We may feel there is nothing wrong with giving our child a cup of juice at lunch and dinner, but the problem is we often serve them too much. Pediatricians and nutrition experts often recommend no more than 4 ounces of juice per day for children. If you give your child even just two “small” cups of a juice a day, they may be drinking up to 4 times the recommended amount! While giving fruit juice is not necessary, if you do want to offer some to your child, you can make those four ounces a day stretch by watering it down (they probably will not even notice). Milk is important for healthy teeth, bones, and brain development, but this is a case where there can be too much of a good thing. Children over one year of age should drink whole milk because they need that extra fat to help their brains develop, but usually by age two they should switch to a milk that is lower in fat. The recommended amount of milk for most children over the age of one year is about 16 ounces per day. This can be a difficult transition if your child is accustomed to drinking a lot of milk, but you can gradually decrease the milk you offer each day over the course of a few weeks until you reach the recommended amount. You may find that once they stop drinking all of those extra calories, they are willing to eat more food.

• They will eat when they are hungry. When your child pushes away food after food, it can be very frustrating, and if it continues to happen regularly it can become worrisome. This is often when we fall into the trap of letting them eat whatever it is they want as long as they eat something. This approach takes some time and you may not see immediate results, but the key here is to keep giving healthy options and maybe get a little creative with the way you present food. Instead of giving them pudding for dinner because they refused anything you offered at breakfast and lunchtime, try some yogurt with bits of fruit instead. My son really had me on edge for a while because he refused to eat anything I gave him. The more I offered him different foods, the more I realized that the issue was not that he did not want to eat, but rather that he did not want to be fed. As soon as I started putting finger foods on his tray that he could grab and eat on his own, I was surprised by the variety of foods he would happily eat without making a fuss! It may take some problem solving in order to figure out the best way to get your child to eat what you give them, but patience and persistence will pay off in the long run. In the meantime, you can repeat the words of my coworker, “They will not let themselves starve.”

• Pediasure can do more harm than good. If you have a child who is a really picky eater or who truly is losing some weight because they do not want to eat what you are offering them, it can be very tempting to give them meal replacement supplements like Pediasure. While these products are good for children who are severely underweight or malnourished, offering them to a picky eater or a child who has thinned out a little but is still healthy can lead to worse eating habits. Natalie Alcaraz, Health Project Coordinator and Registered Dietitian for the City of Milwaukee Health Department WIC Program, helps us understand why this is.

“These kinds of drinks contain a lot of sugar and can cause a child’s taste to adapt a preference for sweeter beverages. It can also lead to a child drinking a large amount of his calories, which further limits the amount of food he eats and encourages more reliance on these types of products.”

It is better to first try to find ways to add in foods that are higher in healthy fats, such as avocado for babies, or snacks like apples with peanut butter, or other nut butters, for older children. If a parent or caregiver feels their child is too thin or not gaining weight properly, they should discuss the issue with their pediatrician or a nutritionist before offering their child any sort of nutrition shakes or supplements.

Have you ever had concerns that your child was not eating enough? How did you help him become a better eater and teach him healthy eating habits?