June 23, 2006
FAMILY MEALS FOCUS #13
Interpreting the news and research about feeding and eating

''I honestly tried not to let Martha eat so much,'' explained the distraught young mother after giving up on following her physician's advice to restrict her ''at risk'' chubby infant. ''But it was spoiling things with us. I hated letting her cry instead of feeding her when she got hungry, and it hurt her feelings when I stopped feeding before she got full. If she grows up to be fat like me, it will have to be. But I won't treat her that way.''

Martha's physician assumes that she is at risk of overweight because she is a relatively large child of a relatively large mother. As will be discussed in FMF #14, his intervention is not supported by research. Rather, Martha is at risk because the seed of doubt about her ability to grow properly has been planted in her mother. Data clearly shows that when parents perceive a child as overweight, are concerned about it and restrict food intake, children tend to get fatter.^1,2 Clinical experience shows infant food restriction to be disastrous, promoting feeding struggles that can last for years and make children fatter, not thinner.

How can we help parents,especially relatively large parents,protect themselves against what is essentially a self-fulfilling prophecy?

Teach optimum feeding Encourage parents to let their baby eat as much or as little as she wants, when she wants. To feed based on information coming from their infant, parents need to understand and trust their baby's feeding cues and sleep cycles.³ Such understanding also allows parents to sort out feeding cues from social and distress cues and avoid inadvertently overfeeding to comfort.

Address risk and diffuse weight concern From day one, reassure parents of big, enthusiastically eating babies that such characteristics do not predict overweight in later life.⁴ Avoid the overweight label,it will stick. Perceiving their child as overweight frightens parents into restricting. Perceiving themselves as overweight makes children feel flawed in every way,not smart, not physically capable and not worthy.⁵

Help parents with their own eating Neutralize the idea that at risk parents eat more and overfeed their children. There is no evidence. But heavier people do diet more, and there is evidence that parents who go on and off diets raise fatter children.⁶ Neutralize parents' tendency to weight-reduction dieting by helping them learn to feed themselves well.⁷

Teach parents to protect themselves against interference Parents of large children are targets for comments and criticism. Help parents toughen themselves up and find ways to reassure themselves about their child's size and shape. The task for them is raising an emotionally healthy large child, the same as raising any other child who is different.⁸ Your support can help immensely.

For more information for parents about optimum feeding and protecting themselves against interference, see Your Child's Weight: Helping Without Harming.

References

1. Faith MS, Berkowitz RI, Stallings VA, Kerns J, Storey M, Stunkard AJ. Parental Feeding Attitudes and Styles and Child Body Mass Index: Prospective Analysis of a Gene-Environment Interaction. Pediatrics. 2004;114:e429-436.

2. Faith MS, Scanlon KS, Birch LL, Francis LA, Sherry B. Parent-Child Feeding Strategies and Their Relationships to Child Eating and Weight Status. Obes Res. 2004;12:1711-1722.

3. Satter EM; Chapter 4, Understanding your newborn. Child of Mine; Feeding With Love and Good Sense. Palo Alto, CA: Bull Publishing; 2000:111-132.

4. Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Preventive Medicine. 1993;22:167-177.

5. Davison KK, Birch LL. Weight status, parent reaction, and self-concept in five-year-old girls. Pediatrics. 2001;107:46-53.

6. Hood MY, Moore LL, Sundarajan-Ramamurti A, Singer M, Cupples LA, Ellison RC. Parental eating attitudes and the development of obesity in children. The Framingham Children's Study . International Journal of Obesity. 2000;24:1319-1325.

7. Satter EM; Chapter 2, You and your eating. Secrets of Feeding a Healthy Family. Madison, WI: Kelcy Press; 1999.

8. Satter EM; Chapter 9: Teach your child: Be all you can be. Your Child's Weight: Helping Without Harming. Madison, WI: Kelcy Press; 2005:291-322.

Family Meals Focus by Ellyn Satter, MS, RD, LCSW, BCD. discusses trends, research and clinical issues in eating and feeding and interprets other research from a feeding-dynamics, eating-competence perspective. For past issues of Family Meals Focus, click here.

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