elevating child care

Parenting To Prevent Childhood Obesity (Guest Post by Kiyah Duffey)

Infant specialist Magda Gerber’s feeding recommendations made perfect sense to me and have “served” my children well. She encouraged parents to be observant and responsive to cues, pay undivided focused attention during breastfeeding, bottle feeding and all mealtimes, trust infants and toddlers to know their bodies and communicate their needs. As the result of these practices, my children not only continue to be healthy eaters, they are also focused learners, secure, emotionally healthy.  I’m sold. Still, it’s gratifying to know that there is substantial research corroborating Magda’s advice. Obesity researcher Kiyah Duffey, Ph.D., generously shares it here …

Research Supports RIE’s Infant Feeding Practices

“You have to finish what’s on your plate before you can have dessert.” It’s something that many of us likely heard as children, and have possibly even used with our own kids. Wanting our children to learn not to be wasteful (or ungrateful) with their food is understandable, but it turns out that ultimatums like this may have some unintended, and possibly lasting negative, consequences.

Parenting Style & Self-Regulation

The ways in which we interact with our children, our parenting style, has the broadest influence on a child’s behavior because it creates the emotional climate within which practices can be accepted or rejected by the child1.

Parents, and the ways in which they interact with their child, influence the development of self-regulation, the ability of a child to govern him/herself, in very specific ways2. Studies have shown that self-regulated children have parents who show positive versus negative emotion3-5, who are accepting (not dismissing) of their children’s emotional expression6,7, and who are not overly controlling of their children’s behavior8,9. These are many of the basic principles of RIE, championed by Magda Gerber, which teaches parents to be responsive to their child’s needs using sensitive observation, to be fully engaged in activities when the child indicates readiness otherwise letting their children explore and play freely, and to be consistent in their behavior, clearly defining limits and expectations to develop discipline.

The Link to Health Eating Habits

Healthy self-regulation is key to healthy eating habits in children. Certain types of behavioral feeding practices, which are often closely linked to parenting style, have been shown to diminish a child’s ability to self-regulate food intake. Over time, this inability to self-regulate (to listen to internal cues of hunger and satiety) can lead to overeating, eating in the absence of hunger, and ultimately to health consequences like overweight and obesity: parents’ short term food goals end up having lasting and negative consequences down the road.

Specifically, numerous studies have shown that highly directive and/or controlling feeding practices are linked to lower self-regulation and higher weight status among children10,11.Children who are instructed to “clean their plates” tend to be less responsive to energy density cues than children who were taught to focus on internal cues of hunger and fullness12, and in general children whose parents were more focused on external cues of consumption, rather than trusting their children’s ability to accurately identify feelings of fullness, had lower self-regulation and greater eating in the absence of hunger13,14. Low maternal support (which measured four dimensions of emotional support using the Relational Support Inventory[1])


[1] These dimensions were (1)  emotional support: warmth versus hostility (e.g., “This person shows me that he/she loves me”); (2) respect for autonomy versus setting limits (e.g., “This person lets me decide as often as possible”); (3) quality of information versus withholding of information (e.g., “This person explains or shows how I can make or do something”); and (4) convergence of central and peripheral goals versus opposition of goals (e.g., “This person criticizes my opinions about religion, philosophy of life, or social engagement”).

paired with high levels of psychological control (which measured the degree to which parents use emotional feedback to control behavior, and was measured using questions such as “My father/mother makes me feel guilty when I fail at school’’) was associated with emotional eating which extended all the way into young adolescents15.

What You Can Do

  1. Serve small portions: It is important for parents to have informed and realistic expectations about their children’s food intake. Remember that children have small stomachs. Serving the same portion size to your toddler as you do to yourself sets everyone up to experience failure at the dinner table; your child may fight eating more and you’ll feel like they have hardly touched their food. So start small with portions. Allow your child to finish what’s on her plate and learn to ask for more food, or better yet let her serve herself (at least one study has shown that children consume 25% more energy when given age-inappropriate portion sizes compared to self-served portions16). This gives her a sense of independence and control and provides another opportunity for her to listen to her internal cues.
  2. Focus on eating and remove distractions: Studies have shown that eating while distracted leads to over consumption and reduced feelings of fullness (even when more calories are consumed)17, so when it’s time to eat, whether it’s a meal or a snack, take time to sit down and really enjoy your food. Stay present and attuned to the task at hand and use meal/snack time as another opportunity to connect with your child. All of these behaviors will help your child (and you!) develop a healthy respect and relationship with food.
  3. Take your time: Parents of young children have probably observed that kids tend to take longer to eat than adults, and this might actually be a good thing as it takes our body time to register those satiety signals telling us that we’re full. In children, shorter attention spans (at 1 year old) have been associated with a greater chance of being overweight at age 618, so take time to focus on the task at hand…and on enjoying the company.
  4. Trust your children: It’s important to remember that caloric needs are met over the course of a day, not at any given meal and that children’s appetites will vary depending on what else they’ve eaten that day, how active they have been, and whether or not they are going through a period of rapid development or growth. It’s difficult to keep tabs on everything your child has consumed, especially if you’re not with him all day, so trust that he knows when he’s through eating. Teach him to identify that feeling with words and to tell you that he’s full.
  5. Model the behavior you want to see: Children often need repeated exposure to foods before they are willing to even taste them, let alone willing to eat them. But be patient. Continue to present the food at the dinner table, each time offering it without forcing them to consume it. Then take some yourself and let your child see you enjoying it. And don’t feel the need to trick your child into eating his vegetables, for example smothering the broccoli in cheese in the hopes that he forgets the green stuff is there. These efforts will only back-fire in the long run. Parental modeling and availability of fresh fruits and vegetables at home have been positively associated with fruit and vegetable consumption in children19, even years later 20!

 

 

References

1. Darling N, Steinberg I: Parenting style as context: an integrative model.  Psychol Bull 1993, 113:487-496.
 2.  Power TG: Stress and coping in childhood: the parents’ role.  Parent Sci Pract 2004, 4:271-317.
 3. Dennis T: Emotional and self-regulation in preschoolers: the interplay of child approach reactivity, parenting, and control capacities.  Dev Psychol 2006, 42:84-97.
 4. Feng X, Shaw DS, Kovacs M, Lane T, O’Rourke FE, Alarcon JH: Emotion regulation in preschoolers: the roles of behavioral inhibition, maternal affective behavior, and maternal depression.  J Child Psychol Psychiatry 2008, 49:132-141.
5. Garner PW, Power TG: Preschoolers’ emotional control in the disappointment paradigm and its relation to temperament, emotional knowledge, and family expressiveness.  Child Dev 1996, 67:1406-1419.
6. Eisenberg N, Fabes RA, Shepard SA, Guthrie IK, Murphy BC, Reiser M: Parental reactions to children’s negative emotions: longitudinal relations to quality of children’s social functioning.  Child Dev 1999, 70:513-534.
7. Ramsen SR, Hubbard JA: Family expressiveness and parental emotion coaching: their role in children’s emotion regulation and aggression.  J Abnorm Child Psychol 2002, 30:657-667.
8. Calkins SD, Johnson MC: Toddler regulation of distress to frustrating events: temperamental and maternal correlates. Infant Behav Dev 1998, 21:379-395.
9. Spinrad TL, Stifter CA, Donelan-McCall N, Turner L: Mothers’ regulation strategies in response to toddlers’ affect: links to later emotion self-regulation. Soc Dev 2004, 13:40-55.
10. Clark HR, Goyder E, Bissell P, Blank L, Peters J: How do parents’ child-feeding behaviors influence child weight? Implications for childhood obesity policy.  J Public Health (Oxf) 2007, 29:132-141.
11. Faith MS, Scranlon 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.
12. Birch LL, McPhee L, Shoba BC, Steinberg L, Krehbiel R: “Clean up your plate”: effects of child feeding practices on the conditioning of meal size. Learn Motiv 1987, 18:301-317.
13.  Fisher JO, Birch LL: Restricting access to palatable foods affects children’s behavioral response, food selection, and intake. Am J Clin Nutr 1999, 69:1264-1272.
14. Fisher JO, Birch LL: Restricting access to foods and children’s eating. Appetite 1999, 32:405-419.
15. Snoek HM, Engels RC, Janssens JM, van Strien T: Parental behaviour and adolescents’ emotional eating. Appetite 2007, 49:223-230
16. Orlet FJ, Rolls BJ, Birch LL. (2003) Children’s bite size and intake of an entrée are greater with large portions than with age-appropriate or self-selected portions. Am J Clin Nutr. May;77(5):1164-70.
17. Oldham-Cooper RE, Hardman CA, Nicoll CE, Rogers PJ, Brunstrom JM (2010). Playing a computer game during lunch affects fullness, memory for lunch, and later snack intake. Am J Clin Nutr. Feb;93(2):308-13.
18. Faith MS, Hittner JB. (2010). Infant temperament and eating style predict change in standardized weight status and obesity risk at 6 years of age. Int J Obes (Lond). Oct;34(10):1515-23.
19. Hanson NI, Neumark-Sztainer D, Eisenberg ME et al. (2005). Associations between parental report of the home food environment and adolescent intakes of fruits, vegetables and dairy foods. Public Health Nutr 8, 77–85.
20. Arcan C, Neumark-Sztainer D, Hannan P et al. (2007). Parental eating behaviours, home food environment and adolescent intakes of fruits, vegetables and dairy foods: longitudinal findings from Project EAT. Public Health Nutr 10, 1257–1265.

 

Kiyah Duffey, PhD is a research assistant professor in Nutrition at The University of North Carolina at Chapel Hill. Her research focuses on the relationship between dietary patterns and long term weight gain in U.S. adults, but as a mom (soon to be of two!) with a love of cooking and interest in supporting sustainably raised and locally grown foods, the intersection of her research and real passion is in making healthy eating more accessible and in helping others understand how dietary habits established early in life are associated with overall well-being in both parents and children. You can read more about Kiyah’s thoughts on parenting and nutrition at kiyahduffey.com.

(Photo of my daughter at the child-sized table she adored was taken by me.)

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21 Responses to “Parenting To Prevent Childhood Obesity (Guest Post by Kiyah Duffey)”

  1. avatar Marie, Jack's mom says:

    So, how about that cookie? How do you handle the cookie request of the little guy that did not finish his dinner plate?

    • avatar Kiyah Duffey says:

      Marie,

      Thank you for your thoughtful question. It is an important one, and one that you are not along in facing.

      With my daughter, it is popsicles. She likes them (and her dad loves them) and with the weather hovering near 100 degrees each day this summer it’s often been difficult to say no to this request.

      Your question is compounded by the fact that he’s asking after dinner. I would caution against making a judgment about his getting a cookie tied too closely to finishing his plate- because adults often misjudge how much a child has eaten or needs to eat (and thus we put more on their plate than they can handle).

      In general, you might try talking about certain foods (like cookies) as “sometimes foods.” (Which, coincidentally, is how the USDA wants us to see them too- as discretionary calories.) Talk to Jack about how some foods are foods that are important to eat all the time, everyday, while others are treats. Anytime there’s a special occasion (i.e. a birthday) you can reinforce this idea with him. Especially as your children grow, let them have a “treat” (however you define this), but make them active participants in choosing when and what they will have. Ultimately, you want to empower them to make these kinds of decisions.

      More specifically to your question, though, try telling Jack that if he is still hungry he may have a piece of fruit (a banana or applesauce), but that cookies are not an option (it helps, as Ania says, to have them out of the house or at least hidden). Give him just a little of the food to start with, in case this is really not what he wants at all so you don’t end up feeling badly about wasting food. You could also try offering that you do something else together. My daughter loves taking walks after dinner; which is a great activity for everyone in the family. Removing him from the space associated with cookies may result in his forgetting about his request.

      In the end, however, remember that there are times when it’s okay to give into these requests. I would encourage you to talk about it with Jack- when he requests one ask him why he wants it, when you say no explain (in a calm and firm manner) why the answer is no (or yes!). The important thing is not necessarily that he never gets a cookie after dinner, but rather that you help him develop a healthy relationship with food. Which keeping an open dialogue will do.

      Good luck, and keep me posted.

      Best,
      Kiyah

  2. avatar shana says:

    Janet, we have so many issues as of late, I have so many questions.

    I haven’t introduced cookies, I think our equivalent is crackers… Our equivalent to candy is fruit and bananas are probably ice cream … But if he sees these things on the counter or sees me buying or packing them up, he’s begging for them. They aren’t bad foods so I often give in, but I feel like if they were bad foods, we’d be in trouble. How do I teach him to wait for the meal?

    Also, when he teething, he’s a mess (which is always lately) Wants nothing to eat, wont touch his milk. Its a nightmare to feed him and he goes hungry and cranky. Because he’ll beg for a snack after meal time or instead of the meal. I guess this is like the question Marie asks. What about that cookie? (even if its not really a cookie, but just an unplanned meal)

    My mother says “feed him in front of the tv, so that you can sneak some real food in or else he’ll starve” my instinct tells me this isn’t the way, and I’m relieved that RIE backs me up. But I’m not sure if giving him snacks all day is instilling good eating habits.

    • avatar Kiyah says:

      Shana,
      My heart goes out to you. It’s one thing to have to say no to cookies and candies, but to have your little one asking for fruits and “healthier” foods knowing when and where to draw boundaries is even more difficult.

      I have a few thoughts. First, trust that it will not always be like this (especially the finicky eating due to teething). Be consistent, continue to offer (at least at the start) to include him in mealtimes and he will come around. Because I was living in Africa when my daughter was still young I breastfed until she was two. When teething there were days when all she wanted was milk, and try as I might to give her other foods she just wouldn’t eat them. But my husband and I were persistent. She always started the meal at the table with us and was given an option of what else she could do if she wasn’t going to eat (“Okay. If you’re not going to eat dinner with us you may play with your blocks or read books. But Dad and I are going to finish dinner.”…or something like this.) These days, she readily eats Brussels sprouts, tells me how much she likes broccoli, and helps set the table each night. Of course, behavior like this is not a guarantee, but it is a possibility.

      With that said, last night she wanted nothing to do with dinner. After serving herself some of the bread salad with chicken, she promptly put it all back in the bowl and wanted to get down from the table. She tried to engage us in playing, going outside, sitting on my lap, but I consistently said “No, not right now. When I’m done eating we can go for a walk.” Eventually, because I knew she was going to be hungry, I offered her yogurt, and she sat at the table with us to eat.

      Second, to your question of snacking (even if they are healthy snacks!); this is a little more difficult to know what to do with. I agree with Ania, that your child will not starve, and I agree with your instincts that simply putting your child in front of the TV to “get some food in him/her” is not a behavior or practice you want to start. Stick with your gut on this one. Many lines of research (from various fields including psychology and neuroscience) have shown that our brains responded differently to food when we are eating while distracted, so establishing this behavior at an early age- when brains are already so plastic and those neuronal connections forming at such a rapid pace- is not the way to go. I also don’t want you to be so worried about ‘snacking’ that you feel you can’t give into your child’s request for food. I have often worried about this myself- my daughter wants to eat something when she comes home from daycare when I know we’ll be eating again soon- but especially at such a young age (you said he’s teething) children do not necessarily have clocks that are set up around the same eating schedules as we do and their eating behavior often resembles the advice to eat “many small meals throughout the day” rather than “breakfast, lunch, and dinner.” If he hasn’t had much to eat, and he’s asking for something that you can live with him eating, I think it’s okay to trust his hunger signals. If he’s just eaten and he sees you putting crackers into the cupboard and asks for some, it’s okay to explain to him that those are for later. Regardless, you should still include him at meal time (or offer him his regular meal, however you approach meals at your house), giving him the option to eat as usual. Given time, he will begin to adjust to these rhythms.

      In short, I think your son is too young (again, I’m assuming his rough age from your teething comment) to worry about establishing poor snacking habits just yet. You and the other members of your family are going to be the most important influence he has in establishing life-long, healthy eating habits and the constant requests for food will likely not always be there. Trust your gut, model good behavior, engage your children in discussions about food- when and why we eat- and you will do right by them.

      Good luck to you,
      Kiyah

  3. avatar Ania says:

    I had that problem with oatcakes with mixed berries.They are not that bad: whole oat + some dried fruit, sweetened with cane sugar.Still she didn’t want to eat anything beside them.I stopped buying them.When she wanted one I was showing her empty press and saying ‘we have no biscuits’.I let her not eat and eventually she was hungry and ate whatever she was given.
    Also my daughter was breastfed on cue and we skipped jar food and started baby-led weaning which principles are basically the same as Magda Gerber’s principles.
    I always involved my child in meal preparation – when she was an infant,she sat in her high chair with baby knife and I was giving her chunks of whatever I was using.When she was older I let her put cereals into her own bowl (grains,seeds,dried fruit).i let her pick where she wants to eat, except breakfast and dinner which we eat together.
    I never used sweets as treats.Never said ‘you’ll get chocolate after you finish your dinner’.I was just giving it as I felt like without mentioning it before.I strongly disagree with making sweets and snacks something that is worth waiting for or doing something,a reward.
    Shana,your child is not gonna starve as your mom says.He has better self-preservation instinct than most of adults have.What I would do – don’t know if it is right or wrong – I would get rid of unwanted food and cut on snacking (kids don’t have time to get hungry if they snack all the time).I’d stop saying about getting whatever dessert after dinner.let it happen like normal part of day.Involve your kids in making food (there are lots cooking books that show how to cook together).If they want banana instead if dinner,let them have it at the table where everybody eats without a word of judgment or sighs or any comments.They have a right not to want something as we do.Let them feel part of a process,let it be family time with no strings or stress attached.If they want something from your plate,share.If they want to eat with their hands,why not?If they want to go,let them go.
    My daughter sometimes didn’t have time for sitting and eating.Never forced her to do so.I was leaving food in a place she can reach it easily when she started walking for example.After a few weeks she wanted to eat with us again.And we made her feel very welcome at the table.
    I hope I helped a bit.

    • avatar Kiyah says:

      Ania,
      Thank you for sharing your experiences, and the ways in which you have dealt with them! I agree with many of your points, especially your reassurance to Shana that her child was not going to starve and that treats should not be used as rewards. Getting dessert for finishing your plate sets children up for many eating issues later down the road. “Treats”, however you choose to define them, should not be relegated to certain times of the day, or allowed *only* under certain conditions (banning foods has been shown to lead to over consumption later), BUT children should understand that they are not foods to be eaten all the time. I, like you, had my daughter in the kitchen wit me from a very early age- I also took her grocery shopping and to the Farmers’ Market- and I believe (although I don’t have any research to back me up) that these things have helped to contribute to her general interest in food and cooking. She wants to do what I do, so it only makes sense.

      Thanks again for sharing!
      Kiyah

    • avatar Kay says:

      I am absolutely loving baby-led weaning, and am so glad I tried it at a whim. No jars, no purees and no spoon feeding (maybe a tad bit). My 11-month old now sits with us at the table, has her own plate and gets “real” food to eat. How much to eat and what (from what’s on our plate) is up to her. No struggling or arguing.

      • avatar Kiyah says:

        Kay,

        I love to hear this; eating this way causes less stress for you, introduces your baby to a world of foods that baby food companies are not going to, and allows your daughter to be a part of the family. So glad that it’s working for you.

        – Kiyah

  4. avatar shana says:

    Kiyah, wonderful advice. Thank you!

    • avatar Kiyah says:

      My pleasure, Shana. I hope that it’s helpful…if not now, then someday! I find it helpful to remember that stages like this are just that- stages- and that they *will* pass helps make those difficult times a little easier. (Personally, I find this helpful even when things are going great…this too shall pass and we will all get through it.)

      Be well,
      Kiyah

  5. avatar Marie, Jack's mom says:

    Thanks so much for your response.

  6. avatar Rebekah says:

    The way we approach food/mealtimes at our home is consistent with just about all the RIE practices, except that my 13 month old daughter will deliberately drop food down on to the floor as she’s sitting in her chair. How do I interpret this? She will usually continue eating other foods, even the same food that she has let go of. How would you suggest that I discourage this behavior?

    • avatar janet says:

      Hi Rebekah. I’d just be really honest and say, “I don’t want you to drop food. That tells me you’re not hungry. If you drop the food I will put it away.” Try this for snacks first, (when you don’t care at all whether she eats or not) since she isn’t used to this rule. But she is perfectly capable of understanding as long as you are clear, consistent, and follow through. This might be the beginning of you getting comfortable with setting limits. 🙂

    • avatar Kiyah Duffey says:

      Rebekah,
      Not that you need me to weigh in here (since Janet is the expert on RIE’s philosophies on these kinds of issues!) but I would have given the same advice that Janet did: Tell your daughter that dropping (or excessive playing with) food is a signal to you that she’s done eating and that you’re going to take the food away. If she protests you can give her one more try, but if the behavior persists, as Janet says, follow through and stick with your rules. I had to do this very thing this evening with my daughter!

  7. avatar Lauren says:

    I have a question about this! When you are trying to put weight on a child (she’s 14 months and only 19 lbs, so her pediatrician wants me to try to get more weight on her), and yet trying to lose weight yourself, how do you model good eating habits and still keep to your diet plan? I don’t want my daughter to think that restricting is the best way to lose once she’s older, but at the same time I know I need to limit my own caloric intake. Should I not eat in front of her? I know that at 14 months, she won’t have a concept of what’s going on, but I worry that when she is older we’ll still have to make sure she eats enough, and I’ll likely still be watching what I eat.

    Thank you!

    • avatar Kiyah Duffey says:

      Lauren,

      Thank you for this question; it is a very important topic (especially for the parents of daughters). I am leaving for a trip early in the morning but will respond in detail just as soon as I am able. Until then, know that you CAN model healthy eating habits and still loose weight yourself- you will not set your daughter up for thinking that restriction is the only way to go.

      More to come on this important topic. Thank you for sharing your experience!

      Best,
      Kiyah

    • avatar Kiyah says:

      Lauren,

      Again, thank you for raising this important question. The first thing I would encourage is you is to try to think of this as an opportunity to teach your daughter about how to lose weight healthily, rather than being so afraid you will damage her with the knowledge of dieting. Sometimes caloric restriction is necessary (trying to lose weight is not always, or not necessarily, a “bad thing”), and you now have a chance to teach her about how to do this mindfully, respectfully (with respect to your own body), and in a balanced manner. You can do this in a couple of specific ways:

      1. Continue to serve everyone healthy meals and snacks; when it’s time for meals serve yourself smaller portions and when it comes to snack time just don’t take any. You do not need to resort to feeding pre-made, processed, snack foods to try to encourage weight gain. As with meals, continue offering whole foods, you just might need to offer them more often to her than you would otherwise. This may be difficult for you, since you are trying to lose weight, which is another reason that increasing the amount of physical activity you get will help.

      2. Balance caloric restriction with increased physical activity, and find ways to include your daughter if you can. This is will do two things, it will help you feel like you don’t have to be quite so restrictive with your own dietary intake, and show your daughter that (healthy) weight loss doesn’t come just from dieting alone. It will also help provide the foundation for healthy physical activity as she grows (as with eating, modeling is one of the best ways to encourage these kinds of healthy habits in kids).

      She is still a little young to understand that you are dieting, the way we think of dieting, so don’t worry yet that she will begin to internalize this as *the* way to eat. Plus, dieting in this way (eating what everyone else in the family is, but just less of it) might help make your own dieting feel less restrictive.

      I hope this is helpful. Keep us posted on your progress, and any concerns you might have as your daughter gets older.

      All the best,
      Kiyah

  8. avatar Skyfire says:

    My oldest is anosmic; she has no sense of smell. She’s never had much of an appetite, and it’s been hard to keep her from being underweight. Her favorite foods are based on how they look, their texture, and basic taste (she prefers sweet or salty to bitter or sour).

    We didn’t know this about her until she was about 7. We did have some fights about food, we’d encourage her to eat more, make her sit at the table until she’d eaten a certain (always age appropriate) amount. We didn’t know about REI at that point, and it may have made some difference. It’s easy to say in retrospect that you would have done things differently.

    She’s ten now, and she will still go all day without eating if she’s distracted. She’s learning to recognize other signs in herself that she needs to eat; for example, her energy level, her emotional sensitivity. We’re teaching her about serving sizes and nutrition so that her mind and will can help make up for her lack of appetite.

  9. avatar Kiyah says:

    Skyfire – thank you for sharing your experience. I think it’s wonderful that you’re teaching your daughter about all the others ways to recognize the need to eat. These are lessons that we could all stand to learn I think!

  10. avatar Kirsten says:

    Great post, and thank you for responding so thoughtfully to all of the comments.

    I’ve wondered for a long time, though, how seconds should work and hope you can advise.

    What should I do if, as an example, I offer my 3-year-old bread, cheese, and a piece of fruit at lunch time, but he only eats the bread and continually asks for more of it? Should I tell him to finish his other foods before he can have seconds, or should I let him keep eating what I would consider to be the least healthy item on his plate (or at least I would consider it unhealthy if these starchy carbs were all that his diet consisted of)? I try to plan each of his meals so that he gets some protein, carbs, and fat, with a variety of micronutrients from different fruits and vegetables, but I feel like he mostly just focuses on the carbs.

    And what about when it’s a pre-packaged serving size like yogurt? I’ll often give yogurt and some fruit at snack time, and he almost always asks for more yogurt despite only taking a few bites of fruit. It can get expensive to go through two albeit kid-sized yogurts a day, but I also am trying to not put conditions on his eating habits.

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