This article was published in the August/September 2009 Wedge newsletter. The following information may be outdated.

Feeding Children Without Pressure

Your son asks for another pancake. You remember the story on the evening news about childhood obesity and that your pediatrician recommended smaller portions and skim milk. Looking down at those pudgy cheeks you snap, "No, that's enough," and the whining begins...

Meanwhile, his sister has had two bites of banana and throws the pancake on the floor. Your husband pleads, "Sweetie, just two more bites, then you can watch some Sesame Street!" Sarah was born small, and still is. You are just so worried that she'll lose weight if you don't push her to eat!

As a doctor, families came to me with their "overweight," "underweight" and "picky" children. Officially I was doing all the right things: I was up on the latest medical guidelines, dedicated, nonjudgmental, and cheerfulâ"and I wasn't helping.

Our culture's obsession with obesity and thinness has led to increased rates of obesity and an equally distressing rise in behaviors such as dieting, vomiting, diet pills and laxative abuse. Some experts even claim that 20% of children have "diagnosable feeding disorders." (A little exaggerated, perhaps, but concerning nonetheless.)

After experiencing feeding struggles with my own daughter, I saw how worrying about her future health and happiness drained the joy from our time together, and was making things worse. I stumbled upon Child of Mine by dietitian and therapist Ellyn Satter. It was an epiphany. Satter's common sense, low-stress approach, called the "Division of Responsibility in Feeding," is effective and supported by an increasing number of studies.

Here is the basic message: Parents manage the what, when and where of feeding, then trust children to decide how much and whether to eat. If I provide mostly nutritious foods most of the time in a pleasant setting, I am doing my job. High-fat, flavorful foods are part of the eating experience, not gobbled in secret, and sitting down to the family meal is critical.

Feeding, for many parents, now comes from a place of fear, anxiety, and worry over their children's health. This very anxiety and worry is distorting the feeding relationship. Feeding with an agendaâ"whether trying to get kids to eat less, more, or the food pyramid every dayâ"creates struggle, stress and the very outcomes we are trying to avoid: unhealthy weight gain, picky eating, poor body-image, and dieting. One mother of a healthy nine month old described her fears, "I feel like I'm on a knife-edge between anorexia and obesity every time I feed my daughter!"

I wish I knew then what I know now (don't we all at some point!). I am lucky enough to practice the most powerful preventive medicine I can imagineâ" giving children the gift of a healthy relationship to food and their bodies. My very first client was a nutritionist who loved to cook whole and healthful foods, while her son mostly ate plain pasta. It goes to show that though we often know what we should feed our children, as a culture we have forgotten how. The trust model of feeding respects the child's inner cues of hunger and satiety, decreases conflict, and improves nutrition. If we can get conflict and stress off the table and restore the loving, nurturing essence in feeding, our children will eat better and we'll all be a whole lot happier.

Katja Rowell is a former family doctor and founder of Family Feeding Dynamics. Her mission is to help all children, especially those labeled "picky," and "under- or overeaters" find confidence and joy in eating. She is offering her class at the Wedge this fall.