low fat diets for picky eaters

so welcome everyone, thank youfor coming out tonight to our lecture. my name isfelice stonestrom and i manage the community programs atstanford children's health. and just a couple of thingsbefore we begin you probably noticed the lecture'sbeing videotaped tonight.

low fat diets for picky eaters, so we do ask that you hold allyour questions to the end. at which point we'll turn offthe cameras and you can ask your questions anonymously. sotonight's lecture is titled, how to avoid picky eaters frominfancy to early childhood.

and we're honored to havethree speakers tonight, with a combined experienceof 55 years working here at packard children's health.amy fahey is an occupational therapist with advancedpractice in feeding and swallowing. she has worked atstanford children's health for the past five years, and alsohas many years of experience in private clinics andschool systems. she currently works with bothinpatient and outpatient pediatric patients, witha focus on infant feeding. for

tonight's presentation,amy will give and overview of the developmentof infant feeding skills. gretchen flanagan isa registered dietitian with over 20 years ofclinical experience, working with infants, children, and teens at packardchildren's hospital stanford. she currently is workingwith the outpatient gastrointestinal team,where she collaborates with physicians, nurses,occupational therapists and

parents to solve difficultfeeding problems. tonight, she will address thenutritional needs of healthy, growing children. and annette van boldrik is anoccupational therapist who has worked at packard children'shospital stanford for 24 years. she has advancedpractice in feeding and swallowing. she has workedin all areas of occupational therapy here, buther current focus is, is with infants andtoddlers with feeding and

swallowing issues. she alsoperforms video fluoroscopic swallow studies in conjunctionwith radiology when indicated. she enjoys mentoring andcollaborating with her peers, and tonight she will discusshow to manage picky eating. so please join me in welcomingour speakers tonight. [applause] >> okay, so, my name's amy. i'm an occupational therapisthere at packard. i'm going to start out by talking about theoral motor portion of feeding.

from there, we'll havegretchen talk about nutrition, and then anette will wrapthings up by giving some specific tips and strategieson how to avoid picky eating. so this is a photo bya photographer and mom, caitlin domanico thatshows the relationship of feeding between moms andtheir babies. you'll notice that these babies are beingfed in many different ways. they are being breastfed,bottle-fed, formula-fed. moms are pumpingand tube-feeding.

the purpose of this photo isto show you that there is no right or wrong way to feedyour baby, as long as you have a positive and healthyrelationship with your child. you're gonna hear lots ofinformation from us tonight. so if you question anything,just talk to your doctor, and know that not every tip andstrategy might be right for what works foryour specific child and family needs, andthat's okay. so moving on to oral motordevelopment, as infants,

they are working oncoordination with nippling, with breast milk or formulaas the primary nutrition. at four to six months old, mostbabies are developmentally ready to try their firstsolid foods. lots of changes are happening at thatage. baby's jaw is elongating, their mouth is getting bigger.they are showing more interest in the stuff that we'reeating. babies are much more alert and interactive at thisage. they might reach out for food. they might smile ordrool when they smell food.

and babies head controlis also improving, they can hold their head up. they don't need to be able tosit completely unsupported, but they need to sit in somesort of feeding chair without tipping over to the side. thefirst foods are a thin puree, and it's still very normal forbabies to suck the food off the spoon, andwith that sucking you're gonna have some tongue protrusion.so the tongue is gonna push some of the food out still,and that doesn't mean that

they don't like the food whenit comes out of their mouth. it's just a normaldevelopmental stage at this point.so we're gonna show a video. this is this baby's firstexperience with solid foods, which is sweet potatoes.>> yummy, it's so good. good girl, good girl. mm, good girl,do you want some more? >> [sound] >> allie's very first food.

five months old, yum. yeah, there it is. so good. >> [sound]>> okay, from six to eight months old,babies show more and more interest in solid foods.you might start offering foods twice a day towardsthe end of that time period. babies will startto eat a thicker puree. and they also have the abilityto hold a large piece of food, like a cracker or teethingbiscuit, and bring it to their

mouth. they're stillmunching with an up and down jaw motion withtheir tongue and jaw, not quite chewing yet. at ninemonths, the tongue starts to become much more involved.it's moving side to side, which allows for muchbetter control of textures. babies at this ageare managing lumpy and mashed foods quite well.and soft foods like steamed vegetables, breads,pastas, and soft fruits, can start to be introduced.babies

start chewing at this age,to the sides of their mouth, even if they don't have teeth.which is really important to, to know that you don't have tohave teeth to do all of this chewing and managingof these softer foods. they also are workingon their pincer grasp, starting to pick things upwith their fingers like this, like blueberries orcheerios, and bring those types of foods totheir mouth so well, as well. so this is a video atnine months, of broccoli.

and so she is self-feedingherself, she can bring it to her mouth. she stillrequires to be fed from a caregiver. she's not gonnaeat a whole entire meal with her fingers by herself. butthis is a good experience for her to have,to practice with. and this baby didn't have teethuntil after 12 months. any teeth, actually. so she's managing the texture.>> is that good broccoli? do you want more broccoli? allie,do you want more broccoli?

do you have enough? yum.>> and she really liked it.at 12 months, most toddlers at this point are capable ofeating solid foods and table foods that the family'seating in smaller portions and cut up into smaller bites,but chewing is more refined, they're using a morediagonal chewing pattern, again even without teeth theycan handle most textures. once the molars come in, they can handle hardertextures like an apple,

or carrot stick, ora tougher piece of meat, so this is a 12 month-oldeating some pasta. and this toddler was alsoeating regular meals, meatballs, soft meatballscut up into cubes, cubed vegetables, soups, things like that.so at this age is when things start toswitch over to being more of a food-based diet withliquid supplements, which gretchen will talkmore about as well.

and then we'll letthis video finish. okay, so from that pointforward, toddlers are working on independence infeeding skills, they're working on usingutensils, using a spoon, using a fork, bringingthe food to their mouths and variety is key, they'reexperiencing new foods all the time. so this slide talks about the importanceof sensory development, babies need experiencetouching, smelling and

tasting new flavors. this babyis not eating a pickle for nutrition but she isbringing it to her mouth. she's has it inside her mouthto desensitize her gag reflex. she's tasting a new flavor.she's has pickle juice on her hands. a lot a times babiestry to get into things and mouth toys and mouth thingsand we're often saying, no, don't touch that, that's dirtyor you're gonna choke or that's a bag of diaper wipes.food is a great way to do this in a safe and developmentallyappropriate way. they also

need experiences withtouching food and feeling it, experiencing it frommulti-sensory angles rather than just being forced to havesomething that they've never tried before. if you thinkabout having a new food that you've never had before, maybeyou're at a new restaurant or a different country,somebody gives you something you've never seen,you're not gonna just eat it, you're gonna poke it with yourfork, is it hard, is it soft? you're gonna bringit to your nose and

smell it, maybe bring it toyour lips and take a little nibble before you put thewhole thing in your mouth and even then you're probablygonna take a small bite just to start with. babies need those sameexperiences with foods. it's very normal for themto want to explore and, and smell things, and feel thingson their hands before they feel comfortable withit in their mouth. so that's all i have, hopefullythat gives you a good,

basic understanding of someoral motor development and expectations for this age.so i'm gonna hand it over to gretchen, who's gonna talkmore about the nutrition. >> all right, put this here. well, as parents,grandparents, and perspective parents, we are concerned aboutthe foods we feed our kids. we wanna be sure that we'reproviding the healthiest foods possible.however, we're confused,

we don't understand whatmakes a food healthy, does that mean it's organic?is it, are there, should i be concerned aboutpesticides? how about gmo's? don't worry i don'thave the answers, but our food market is explodingwith new food products designed to convince us thatwe should be purchasing these foods. okay, so let'stalk about real food. [laugh] as we know,food fuels the body, and food is composed ofthree main ingredients,

carbohydrates, proteins andfats. the ideal fuel containsthe majority of carbohydrate with a fair amount of proteinand a sprinkle of fat. so let's look at the toddlerplate, the plate method is a way to put that ideal fuelmixture into real foods. as you look at the plate, the carbohydrates are providedby the fruits, vegetables and grains. you can see that'sthree quarters of the plate is carbohydrate. the protein isrepresented by the meats and

you can see that looks likeabout a quarter of the plate. the meats are the buildingblocks of for growth and development. and fats are how weprepare the food, they are not a food groupin and of themselves. so that plate providesthe ideal fuel in the ideal quantities ofthose essential ingredients. now milk can provide thatsame mixture of carb, protein, and fat andcan be a stand-alone or

an accompaniment tothe plate itself. so that is the ideal blend of nutrition.now let's keep in mind that the earlymonths in an infants' life, they're primarily takingbreast milk or formula, and both breast milk and formulahave this ideal mix of carb, protein, and fat,uniquely designed to meet the needs of the rapidlygrowing infant. however, as the child grows andwe introduce other foods, keeping that balancegets a little more

difficult to manage.so it is a very gradual, building in these new foodsis a very gradual and individual process. there'sno one right way to do it. so we're gonna skip ahead andtalk about the toddler, diet. now, this is the partwhere i'd like to talk about. i'll see if i can find this. how toddlers eat, andwe know that toddlers are not consistent eaters. that meansthey don't eat the same amounts at the same timesfrom one day to the next. and

in fact, they eat whenthey're hungry and they stop when they're full. most adults don'thave this down. so, it is unique tothis country that, that we talk about feedingour children every three hours because they needfuel every three hours and we named that three meals andthree snacks. so, six opportunities a dayto eat. now, with that three meals and three snacks,there is a misconception among

most kids and some adults.that meals are opportunities where you get foodsthat are good for you and snacksare opportunities to eat the foods you wanna eat.and those are the ones that mostly you tear open.so, unfortunately, our children need fuelevery three hours and they need this balance ofcarbohydrate, protein, and fat every three hours foroptimal nutrition. so, we, i'm wondering if we need torethink this whole meal and

snack concept, andturn it into mini meals. so, if we give kidsopportunities five or six times a day tohave a mini meal, we may be getting betternutrition for our kids. they may learn a style ofeating that helps them prevent some of the negativeconsequences of the style of eating that many of us havetoday. something to think about. so now, that we knowwhat constitutes a mini meal, let's look at portion sizes.now,

this slide representsthe same meal for four different ages,age 1, 2, 3 and 4. and what you'll notice is thatthe plate sizes are the same, the only thing that changesis how much food, and slight textures,is appropriate for the different years.so, a good rule of thumb, and many folks are kind of shockedby this recommendation, a good rule of thumbis one tablespoon per food item per year of age.

so if we look at the portionsize for a one-year old, that would be onetablespoon of strawberries, one tablespoon of green beansand two tablespoons of mac and cheese. cheeserepresenting the protein, the pasta representing thegrain. and the milk portion is about one to two ounces.now that's not to say that that's what your child'sgoing to eat. but that's a good place to start. if wesit down with a young child, a young one-year old and

give him the amount thatis more appropriate for a four-year old, we may notfeel that we are parenting and getting our kids to eat whatwe think they should eat. sometimes our expectationsabout what a child needs to eat do not match with the realnutrition needs of a child. the one nice thing abouthaving five to six opportunities to eat like thisis that it gives the child the opportunity to keepthat balance of nutrition. whether they eat all of ofit one day or one meal,

or eat none of it, one meal. it will balanceitself out if we allow it to. your child may not besatisfied with the amount that you present them and that'sfine too. they can have more. this just represents a goodplace to start. now, keep in mind that thisplate is quite small. this is about a fiveinch diameter plate and it's up on the table in theback if you wanna take a look. so if you're dishing yourchild food onto an adult-sized

plate, you may bemissing the mark. because what we tend to do,and it's human nature, we put appropriate portionsaccording to the size of the plate. so most adultseat on too large a plate, as a good place to start.most adults need no more than a nine inch plate. sosomething to check out at home and see how you're doing withyour own plates. so let's see. now, another important role of theparent is to offer variety.

as a dietitian with lotsof years experience and two children, i can guaranteeyou that if you ask a child what they want to eat,they will tell youthe same three foods, cheese pizza, chicken nuggets,and mac and cheese. i can also guaranteeyou they won't ask for broccoli, cauliflower orbrussels sprouts. now, we know thatit takes about 15 to 20 exposures ofa new food before

a child will accept that food.now notice how i didn't say, will like that food, butthey will accept it. so, one of the biggestresponsibilities of parents is to offer those mini mealswith a balance of food groups to achieve that ideal fuel andmix it up all the time. that is one of the biggestkeys to avoiding picky eating.parents are responsible for putting the food on the plate.kids are responsible for whether they eat or not.and sometimes it's not and

that's okay.so what can you do, to create a healthy feedingenvironment at home? well, we can start withestablishing those mini meals, every three hours. or so. we can build inthe healthy balance of nutrition in appropriate portion sizes. so here's wherei really think it's important to take a look at the amountof food you're expecting your child to consume. it no,it may not need to be as

much as you're offering.the child may feel overwhelmed if they'regiven too much food, and may not wanna even begin.so portion size is key. so establish those regularmini meals and take a break from activities, and enjoya mini meal with your child. so that means, you know, havea picnic in the backyard or on the living room floorto make it interesting and fun. stop what you're doing. maybe it's sit atthe dining room table or

at the toddler table and havea tea party with your child. one of the biggest concerns ihave are busy parents that do majority of their snackmeals in the car and they need convenienceto not mess up the car. i'm gonna recommend that youpull the car over, and climb in the back seat, and havea mini meal with your child. family meals, we need tojoin them. we need to make the environment conducive toleaving food on the plate, to finishing it all andasking for more.

whatever we want ourchildren to do, whether it's have good table manners orlearn to enjoy new foods, we need to do it with them.oops, and then one last thing iwanted to say is that if you have provided the right fuelin reasonable portion sizes, your children will be able toeat the amount they need and we don't need to worry aboutit. okay, i'm going to now pass off the presentationto annette who's going to talk about if all of our goodintentions have gone awry and

we, we have ended upwith some picky eating. >> picky eating. hi, everybody,how you doing? all right let me just get intomy slide as well. so i've, i'm gonna showyou three videos and i want you to just reactto them. some of you have experienced this if youalready have a baby. some of you, i saw somepregnant women in here, may be experiencingit in the future.

i've just pulled thesedown from youtube and i, being a little bit of afeeding nerd, i have looked at lots of baby's first mealvideos on youtube and i find them enlightening.>> make sure to think about this.>> okay. >> it's avocado. >> avocado. >> but it's cold. >> [laugh]

>> [laugh] [inaudible] is it not good?>> she doesn't like it. >> okay. [laugh]>> first comment on this one is this baby's not choking.this baby's not dying. this baby, i actually reallylike hearing the parents laugh in the background, okay.so let's look at the next one. let's see if i do a better jobon this myself, here we go. >> watch her eyes,

where's she looking?she's looking at her parents. she is like my gosh,what the heck is this? >> the parents are laughing.>> i'm sorry. >> it's the right response. >> [noise] >> and watch. it's okay. and i'm just gonna do one moreand show you this one and then we'll talk aboutit a little bit.

these guys are all adorable.>> peas. >> do you see the shudder? >> watch the eyes. he's looking at the parent.>> do you want another bite? [laugh] >> there you go. >> you see another big reaction like.>> [laugh] >> he's not choking,

he's not dying.>> do you not like peas, buddy?>> [sound] >> he could barely breathe. >> they're still just kind of hanging out in there.>> [sound] >> he's still opening his mouth, he has not shut down,he is still accepting this even thoughit makes him shudder. >> that's good stuff.

>> he's crying, it's so good. >> [laugh]>> [sound] >> you're taking it down. >> try some more? >> and he has probably hit his limit.>> i don't think he like peas. [laugh]>> [cough] >> jeez!

>> [sound]>> okay. >> so i've just a couple of points to make about this.he's not loving this food. this is not his favorite food.but what i appreciate very much that these parentsdid is they kept it positive. i've looked at an equal numberof these kind of videos where the parents are goinghe doesn't like it and you could just hear and the baby is making eye contactwith these parents and

shutting down. i can't tellyou how wonderful it is when i see this kind of videowhere the parents are not freaking out about these gags.babies will gag. they will gag if the textureis really strange. they will gag if this taste issomething that they have just not gotten their heads wrappedaround yet. his whole body was reacting, his breathingchanged, he shuddered, but he kept opening his mouthand that was in large part because of how the parentswere approaching it.

would we ask this baby toeat very many more bites? probably not. butthat was a successful feeding, believe it or not. i mean,the baby trusted the parents. what happens, this is likewhen your, your little one is starting to learn to walk, andthey're walking along, and they trip and they fall down.they fall down, and then they look at you, and go,am i okay? and if the parents are going, my gosh, you felldown, the baby will cry. and if the parents are going,you fell down,

let's get up,the baby won't cry. and it's kind of a similarapproach that i take with these kids that are gagging.if you keep it light and have reasonable expectations,it was a slow pace of feeding, they weren't going [sound].they weren't putting big giant spoonfuls in the baby's mouth.and all those things together. the baby still trusts theparents. and that's the really key part of the relationshipwith feeding and introducing some of these foods. now,going forward, was that peas?

i can't remember. does thatmean i'm not gonna get it, get the peas because they reallyweren't that successful. you don't wanna create,excuse me, [cough] the mental list of mybaby likes these foods and my baby doesn't likethese foods because, i'll only work on these foods.i literally had a friend whose baby, i walked in and isaw her one time, and the baby had a perfectly orange circleon the tip of her nose. it was perfectly round, i'dnever seen anything like it.

i was was like, what's wrongwith her nose? she was on a carrot binge. and they werejust feeding her carrots. and i went backthree weeks later, and there was no moreorange nose, and she wasn't eating carrots atall. it's like okay [laugh]. what you want, what your attitude aboutintroducing foods, should be is, i know there are foodsthat my baby will eat more of, will eat more rapidly, willeat without all this going on,

but that doesn't meani don't reintroduce these foods that are a littlebit more challenging. could i, so i had a baby thatwouldn't eat avocado. and we all know avocado'sjust this wonder food and we all like our babiesto eat avocados. and so i worked with a mom andi said, okay, what's the food the baby does like? andi think it was pears, and so we were feeding the babysome pears, and then we took a teeny bit ofavocado and mostly pears, and

we introduced that, andwe gradually changed the proportion ofpears to avocado. and then, the baby really turnedinto an avocado lover. so, there's these differentthings that you can do to help the baby accept more andmore foods but, you don't say that's on thelist of foods i'm not gonna do again. that mental listthat you have is the list that's called i will try thisagain maybe a little bit differently. okay? but,not that food is off the list,

that food is off the list.we had a baby that was, came in to us eatingtwo white things, coconut, water andpear because the parent and this is extreme but, theparent was trying things and this list was just gettingsmaller and smaller and finally, we had this veryundernourished child come in living on nothing.so, what do you fear? you know, when you start tohave struggles with a picky eater, there's usually somelittle voice in the back of

your head that is making youworry. maybe they're saying, your baby's not gaining weightenough, and it's like my gosh, i have to feed thisbaby more and more and more.maybe your baby's a gagger. maybe you just feel like everytime you sit down, it's like, i have got to engage in thisbattle again to get this child to eat, or to take thesefoods, or eat something besides french fries.maybe it's being ostracized. maybe like your mother-in-law[laugh] or your mom is saying,

why can't you feed your baby?i could feed you. or some family member. there'sa lot of social stigma to children that don't eateasily, and that one's actually huge. and then a fearof inadequate nutrition. i can't get my childto eat vegetables. i can't get my child to eatthis mini meal balanced diet, you know? so be aware ofwhat's driving you with your potential meal issues. okay, so eating should bea messy experience.

you can't expect that everymeal is gonna be like this, because you will go through 20sets of clothes in a day, and life will be impossible.but, you know, one meal a day like this, it'skind of awesome and you'll notice that these are reallyhuge hunks of avocado. and even if she puts some of thisin her mouth she'll manage. if she takes too big a biteshe'll spit it out, okay? i think a lot of parents arevery afraid of their babies and afraid of choking andthat sort of thing. so

we need to, we need tobe aware and this one, it looks like she died butit's beets. and she likes beets and it's justthis horrible messy meal. but playing with food actuallyis really important. i have a lot of kids i see in therapywhere i will put a cracker on their tray, and they'll pickit up and they'll eat it. but i'll put something wet like apiece of fruit, or a piece of, a vegetable on their tray.and they touch it and they literally recoil. theirhands go [noise] like this.

it's like i'm nottouching that. and i just can'tencourage you enough to, you know, that the idea behindbeing messy with food is to interact with it, to smell it,touch it, taste it, and be familiar with it here.because you're not gonna put something in your mouth thatfeels gross here. if it feels gross in your hands, it'sgrosser in your mouth, okay? so that's what thisis all about. okay, so there, let's say youalready have a picky eater,

there is a concept calledfood chaining. and the idea with food chainingis, you take baby steps, this is not giant steps.you might, you have a child who eatsa lot of french fries. you're not gonna go from frenchfries to sweet potato fries. that is a giant leap. butyou might go from french fries from mcdonald's, to frenchfries that are home made, to french fries that are cutin a different length. and work your way in those tinybaby steps to accepting

a wider variety of frenchfries. in this example, it's like the kraft, sorry,[cough] i've been talking too much all day, kraft mac andcheese, you know? it's like, that's the only one.it has to come in the box. it can't be homemade.none of that. so how are we gonnachain this food so that we break it open a littlebit and have a wider variety? and you might do somethinglike same sauce, different pasta shape. same pasta baked,or baked in a muffin shape.

and finally working so thatyou can put some vegetables mixed into the pasta. but thisis baby steps. and there's a lot more steps to get towhere the vegetables are. but this is just to introducethe concept of food chaining. and like gretchen said before, don't overwhelm with hugeportions. keep it small and unintimidating. when i'm doingfeeding therapy, i'm, i'll put two cheerios on the tray andmaybe start there and work my way up. because if you put alot on, they'll go [sound] and

it's all on the floor, soyou have keep it manageable. one of the things that ican't tell you, is it's so important is listen toyourself. listen to the message. okay, how manyof us have said you're not getting off the table tillyou've cleaned your plate? or, you can't have dessert ifyou don't finish your peas? or some of these directiveassertive messages that set you up for a power struggle.if you set up a power struggle, you lose. i'm sorry,there's just no way around it.

if you say you must do this,this will happen. you could tell me that i have to eatgoat cheese. i have tried, i have tried. i can not tellyou how hard i've tried. i've eaten little bitsof goat cheese, and it's finally to the pointwhere it's like i'm done. i'm not doing goat cheese.and if you say i can't have dessert until i eat mygoat cheese, sorry, i'll skip the dessert.because for me it's just, i can't do it. and i'm reallydigressing right now, but

i have to tellyou a fun story. i did a picky eating talk fora group of foster parents, and we asked them two questions.the one question was, what's your favorite food? andwhat's a food you won't eat? so everybody went around theroom. and one guy said, i hate peanut butter, and another guysaid, that's all i eat for lunch every day, peanutbutter and jelly sandwich. you know, and sowe had people, same food, polar opposite, andthere was one person there,

who was panamanian, and whenwe asked her what her favorite food was, it was chicken feet.[laugh] it was like, we all kinda went really?and she said, it is wonderful, it's my favorite thing.so we have to understand that within our goal of havingthis great variety, there are sometimes thingsthat just don't appeal to us and that's okay. so whenyou're talking to the child, you can say when they try abite of a new food, good bite, you've tried that andyou never had broccoli before,

good bite. you can model,and i can't tell you to say, i love this broccoli.that is my favorite thing and i love this. you're gonnakinda model that behavior. you can say let's try this.if the child's older, you can kinda have the thing,you know, we can try it and we can say we like it a lot orwe don't like it very much or we really don't like it.but, let's try it, let's see what we think. eatyour colors is a concept like you know, a bell peppermight be green or

red or orange orcauliflower might be white. or a pear or a peach mighthave their own colors and just kinda encouraging theconcept of we should eat food of many colors. what colorsdid you eat? golden, french fries, nuggets. you know,let's work on another color. and then really my favoriteone is when you're ready, you will eat this.and the idea behind this is there are foods andi'm jumping ahead to my tips a little bit buti'll just talk about it here.

you don't wanna bea short order cook. you don't wanna cook fries andnuggets for this one, and you know the, this one overhere only eats whatever and you know, you are justpreparing individual meals for everybody in the familyinstead of you're making your family a balanced meal. a lotof times, you have the green beans and the strawberries andthe whatever on the plate, and the child's going i don't eatgreen beans. the message is when you're ready, you'll eatgreen beans. it could take

months or whatever, but thegreen beans are on the plate. it's not, i don't wantgreen beans on my plate. when you're ready, you caneat the green beans, but the green beans needto be on your plate, because we all have greenbeans on our plate. okay, it's a very positive message.it’s not a, you know you have to eat yourgreen beans kind of message but it's when you’re ready,you will eat the green beans. that was me andthe artichokes.

i thought they were kind ofweird and i love artichokes, you know. you just never knowbut they keep reappearing, it's not i can't put this onthe plate, i can't put that on the plate, it appears on theplate, okay? okay, so grazing. if you are having that fear,my child is underweight, i'm not gettingthe nutrition in and there's this compulsion tosay, let's have a snack, lets-. i had a friend who wewere having their child's birthday party and while shewas unwrapping the presents,

they were shoving hersippy cup in her mouth. it's like take a break.now, cuz i can't say that to my friends always butyou know, relax, have a meal, and a break,and a meal, and a break. don't come at them with littlesnippets of food all day long, okay? limit choices anddon't be a short order cook. so the idea again behind thisis, you present the meal, the meal has options within itand this is what we're eating. ellyn satter has the approachof saying, put the desert

there. don't say, you can'thave this until you have that, it's all there. if youplan to serve a dessert, have a dessert, do you have tohave a dessert every night? no, but don't save itas the carrot out here. try dips and condiments. so i can't tell you broccoli,broccoli is trees, right? say, look, there's a tree!let's put snow on the tree, and now we have ranchdressing, and my gosh, we're gonna eat the broccoliwith this, you know, trees and

snow, trees and snow. youknow, kind of be creative with it. humus, ketchup,mustard, i don't care. but if it takes addinga little something extra onto the fruit or vegetable, that'sfine. that's totally fine. once again, i can't tell you,variety, variety, variety. what happens is we havebetween six, nine months and two years of age to makeall the you know, offer all the variety that we can. whenwe hit the two year age range, that's gonna shrink.it's normal behavior,

two year olds kinda go whoop,like this and it's like, i'm not eating that,i'm not eating that. but you know what? if you're calm,you're relaxed and you keep offering the foods,it comes back out. but if you start froma variety like this, instead of a varietylike this, it's a lot less intimidating togo from here to here, instead of from here to here.it's not, not so scary. include them in a food prep.they'll handle food, they'll

learn about cooking, they'llhave a really good time. so what do you do withthe little one? you've chopped upthe vegetable or the whatever, and it's here, let's get thoselittle hands picking it up and putting it in the bowl, orthe pot, and you're gonna stir it. one of my favorite thingsis this learning towers that they've got for little kids,where they can stand and they have the littlecage around them so that they're notgonna fall off.

pull them up to the counterand it's like okay, what can we do together? youknow, and just see if there's an element of that. if you'reworking and you're exhausted, you're going i am notgonna do this after work, do it on the weekends youknow, that sort of thing. i'm not saying this all hasto be all the time but, but be very inclusive in termsof what you're doing with, with meal times. they'lllearn to be good cooks and eat together.

[cough] i would say one socialmeal a day where you see mommy's eating the brocc- i'mpicking on broccoli today. mommy's eating the broccoli,daddy's eating the broccoli, baby's eating the broccoli.you know, just model, model this, andgo this is delicious or whatever. take a picture, sothis is kind of a fun one that you might do if you reallyhave a picky eater. you know, capture a positive,a little video snippet, or a little photo, of thechild putting that new food up

to their mouth and tryingthis new food. and go look, do you remember whenyou tried that, what a good adventure thatwas, wasn't that? you know, that sort of thing. kidslove to look at themselves, it's their favorite subject.it is, i don't kid. set a realistic goal. if it'ssomething like those peas, one or two or three bites isa huge success. it's not like this big amount of food.don't have a clean plate rule. don't have a list of foodsthat you can't can't feed.

keep the keepthe fears out of this, become be encouraging. don't bring your stressinto this like we said it can take 15,20 times sometimes. i had a friend who was an otand a feeding therapist and her little guy would noteat cottage cheese. and she was really like, i can'tget him to eat cottage cheese, it was very funny. and shekept putting it on the plate, and one day, she decided thatshe wouldn't call it cottage

cheese. she'd just called itcottage. here's your cottage, he ate it. who knows? was itcuz she changed the name, was it cuz she triedit enough times? who knows? but after thathe ate cottage cheese. so keep your stress low, maybebe a little bit creative, but keep the power struggles outof, out of the equation, you don't wanna do that.skip the baby aisle, so this [laugh] this is gretchand i, we've both kinda feel a lot my thing is, it usedto be pureed baby food and

that was kinda it. and thenthey came out with stage one, stage two,stage three toddler. nobody should be buying toddler babyfood, in my opinion, feed them something that you're eating.you can you can make your own baby food like you'rehaving a sweet potato for dinner, make a little toomuch, put it in your blender, put it in ice cube tray,make little portions. once it's frozen, break itout of the ice cube tray, put it in a ziplock bag. and

then go i'll have a cube ofsweet potato, a cube of this, a cube of that,there's your meal. so it's not even that you have tomake it fresh every minute. but you can, it's not thathard to take a sweet potato, cook it up, andmake something delicious. babies can have no,babies can have seasoning. six month olds,maybe not so much. single you know, we're kind ofin the single foods stage but if you are eating something,you're eating spaghetti. and

your child's going like this,put a dab of spaghetti sauce on your finger and give hima lick, okay. let them kind of have these flavors. don't gothis is my food, this is your food. if they're interestedin what's on your plate, figure out a way, fork mashit, do something to it, put, finger mash it, go here,have a little taste. incorporate them intowhat you're eating, it makes a big difference.have fun. you know, laugh like these parents.

have a good time with it andjust kind of enjoy and make it as positive an experienceas you're able to, okay.