Our 2-year-old daughter has always been small, hovering around the 5% mark of the growth chart. Even after we introduced her to solid foods at 6 months, she continued to plod along on her own line, slowly growing but never getting above that 5-7% mark. Food and feeding became central to many daily conversations in our family during which my husband and I would vacillate from feeling like we weren’t doing nearly enough to thinking we were overreacting and that everything was fine.
As our daughter moved from infancy to toddlerhood, she remained small no matter how many “tricks” we tried. Toast was slathered with butter so thick teeth left marks. Broccoli and carrots were sautéed in olive oil and finished with parmesan cheese. Apple slices were dipped in peanut or almond butter. We tried to squeeze as much energy as possible into each bite. Still, at her two-year wellness check, she was a hair under 20 pounds, pushing her off the growth chart entirely. It was then that our pediatrician finally recommended that we see a nutritionist.
Maybe you have a small child, or maybe yours is on the other end of the growth chart pediatricians reference so frequently. Maybe it isn’t about size at all, but just that with daycare or school closed you’re feeling overwhelmed because you’ve had to take on a much bigger role in planning and executing meals for your kids. Maybe you’re panicking because you think your kids only eat three or four foods, or they’re in the kitchen snacking all day while you’re trying to get through Zoom meetings. What exactly does normal look like for a kid, and when should you be concerned?
As it turns out, many parents worry about what their kid is or isn’t eating. Megan McNamee of the company Feeding Littles says that when it comes to kids, food and nutrition is almost as big an industry as sleep.
“We’re in a culture that’s so obsessed with food and nutrition that people feel pressure to get it right,” McNamee says.
McNamee is a registered dietitian nutritionist who specializes in pediatric nutrition, food sensitivities and disordered eating. Feeding Littles — which McNamee runs with occupational therapist and feeding specialist Judy Delaware — offers online courses that help parents of babies and toddlers learn how to feed their kids. They also offer support groups and the option for one-on-one consulting.
The duo met in 2014 and released their first online course in 2017. They now have over 800,000 followers on Instagram. McNamee says most of her clients are “millennial moms who are very active on social media.” And they’ve gone global, hearing success stories not only from parents in Scottsdale, Arizona — where McNamee is based — and cities like Seattle and San Francisco, but from countries in Europe, Africa and regions of India.
She says, “We hope to teach [parents] that there is a huge element of flexibility, and the more neurotic we are, the more harm we can do in the long run.”
That’s the thing. Unless your child has been previously diagnosed with a disorder related to food and feeding, “normal” as relates to kids’ eating habits encompasses a wide range.
As Lisa Holman, a clinical pediatric registered dietitian at Seattle Children’s hospital says, “Most kids are so elastic, for toddlers there’s such a wide range of typical or normal. Between 5-20% of typically developing children will be diagnosed with a true pediatric feeding disorder, that means around 90% are normal.”
So, if you have a kid who can crush an entire can of beans at mealtime, that can be normal. The kid who will only eat white food can be normal. And the kid who will only eat one bite of everything can also be normal.
The key in trying to maximize the nutrition they’re getting is to help guide them to what might be a “new” normal.
The nutritionist we spoke with suggested we limit beverages to after our daughter finished meals or snacks, to maximize stomach space for food instead of liquid. She also suggested offering smoothies or nutritional drinks like PediaSure or Carnation Breakfast Essentials to help up calorie count.
“There is nothing more satisfying than seeing your kid eat … there is nothing more devastating than knowing your child isn’t eating and you don’t know what to do,” says Delaware of Feeding Littles.
There are some basic benchmarks that can help you gauge how your kid is doing. By the time your child is a year old, McNamee says they want to see kids “drinking from cups, have experience at the table, are self-feeding, and have experienced a wide variety of smells, textures and flavors.”
Holman adds that she often gets referrals for kids who aren’t able to move past pouches to solid foods, show no interest in food, or have an incredibly limited food repertoire that goes beyond “picky.”
As kids get older, know that fear of new foods is typical for children ages 11-30 months. Also know that from birth to age 1, kids can double or even triple in weight, but energy needs can drop after age 2 and they might not want to eat as much, says Holman.
“I know I need to really work on trusting my son to know that he’ll get what he needs. Children are able to regulate their intake on internal cues until age 3,” Holman says.
It’s our job as parents to trust the intuitive eating sense our kids are born with, try not to override it and offer them choices within it. That means the idea of “finishing your plate” is an outdated one.
Our daughter can sit at the table with us for about 15 minutes before she’s ready to push the plate away and go play. Instead of making her sit there so we can coax a few more bites into her, the nutritionist suggested we let her go play for a few minutes, then ask her to come back and offer her dinner again.
When it comes to counteracting pickiness, McNamee has a post on the Feeding Littles Instagram page that says, “It can take 20-plus exposures for a child to eat a new food.” That can mean offering carrots shredded, cut into sticks or coins. They can be blanched, pureed, mashed, roasted or raw. Eaten plain or dipped into anything from hummus to ranch. The main objective is to keep offering a wide range of ingredients (barring any allergies) to our kids over and over but not pressuring them to eat each one.
The nutritionist we met with also suggested giving my kid a mix of familiar or favorite foods, as well as foods that she doesn’t like as much, or ones that are new to her, while talking about all food in a positive way.
Also important is modeling behavior. If you want your kids to eat the rainbow, they should see you doing the same. If having no phones or screens at mealtimes is important to your family, parents should also leave phones off the table — no excuses.
For parents of toddlers or even older children who are snacking all day, devoid of the structure provided by school or daycare, McNamee says to remember that we are living in different times.
“There’s something to be said about eating together, even kids relate to that. They want to be with their peers,” McNamee says.
Try to carve out time to eat lunch or snack with your kids. And don’t stress too much about what’s on the plate every single day.
“You’re going to feed your kid what you have in the pantry and it’s going to be OK,” Delaware says.
We’ve got another check-in soon to see how our daughter has been responding to the recommendations. Things have gone fairly smoothly so far, and mealtimes seem low-stress overall.
Above all, we’ve kept in mind the one thing Holman, McNamee and Delaware all touched on: Trust your gut. You are your child’s expert.