Thanksgiving for Picky Eaters

​​Thanksgiving — a holiday full of elaborate food traditions—can be extra challenging for parents of picky eaters. Who wants a holiday dinner turned into a battle zone filled with whispered bargaining? Fortunately, with a little planning, you can create a balanced Thanksgiving meal the whole family will enjoy! Here are some tips to appease picky eaters without sacrificing nutrition, straying from Thanksgiving traditions, or creating a lot of extra work.

Choose at least one food you know your child will like. Whether Thanksgiving will be served at your house or if you will be going to someone else’s home to celebrate, make sure to offer or bring at least one food that you know your child will like. This way, your child is guaranteed to eat something during the meal; it also shows your child you care about his or her preferences when planning meals.

Engage your child in meal planning. Ask your child if he or she would be interested in helping you plan the Thanksgiving feast. Let him or her know you plan to offer at least one protein, a grain, a vegetable, and fruit. You can tell your child about any foods you are definitely planning to include (i.e., turkey as a protein and stuffing as a grain), but ask if he or she has ideas for the other food groups. For example, “What kind of vegetable do you think we should include? How about a fruit?” Then, together find recipes that use those foods as ingredients. A child who helps choose a food that will be offered is much more likely to actually eat it.

Engage your child in meal prep. Invite your children in the kitchen to help prepare your Thanksgiving meal. For example, ask your toddler to help clean the vegetables, or your school-aged child to help mash the potatoes, or your teenager to boil the cranberries. When kids help cook food, they often sample what they are preparing, and are more likely to eat their masterpieces later.

Use food bridges. Once a food is accepted, find similarly colored, flavored, or textured “food bridges” to expand the variety of foods your child will eat. For example, if your child likes pumpkin pie, try including mashed sweet potatoes on his or her Thanksgiving plate.

Make it look, smell, and taste delicious. Many times kids think that they won’t like a food before they actually try it. By making a Thanksgiving dish look, smell, and taste delicious you up the odds that your child will try it out, like it, and come back for more. Do this by adding fragrant ingredients such a nutmeg and cinnamon to cooked apples—for example—or preparing a veggie tray with the vegetables arranged in the shape of a turkey.

Keep the mealtime relaxing and enjoyable. Focus on enjoying your time together celebrating this day of gratitude. Know you have prepared a balanced meal and taken many efforts to engage your children in the process—increasing the chances of there being at least one food they will like. You have done your job. Try not to worry if and what your child is eating.


Source: Section on Obesity (Copyright © 2016 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


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Breakfast for Learning

​Nearly half of all American families regularly skip breakfast. Is your family one of them? When it comes to getting your children to school, a healthy breakfast is just as important as gym shoes and sharp pencils.
How Breakfast Betters Your Child

Breakfast has been associated with everything from:

  • Better memory
  • Better test scores
  • Better attention span to decreased irritability
  • Healthier body weights
  • Improved overall nutrition

Rise & Dine
It’s easy to see how breakfast has come to qualify as one of the nutritional challenges of parenthood. Whether it’s your own parental time constraints or your child’s busy schedule, getting the whole family ready to set off to child care and/or school in the morning, play dates, or any of a whole host of other common early-in-the-day commitments, breakfast is often neglected.

If the words “slow” and “leisurely” don’t exactly describe your morning routine, we’d like to suggest that you commit a little extra time and effort to protecting the nutritional integrity of your child’s morning meal.

Breakfast-Made-Easier Tips for Parents

Whether you opt for a simple breakfast or a more elaborate one, any effort to make it nutritious is better than no breakfast at all. Whether that means a glass of low-fat milk and a piece of wheat toast or an all-out feast, the following breakfast-made-easier tips will hopefully help you rise to the occasion and overcome some of the most common barriers to a healthy breakfast.

Schedule accordingly. While we’d like to remind you that sitting down and sharing family meals is beneficial, we’re willing to bet that sitting down to a leisurely breakfast with your kids each morning simply isn’t realistic for most of you. What is realistic, however, is making sure you carve out enough time to allow your child to eat without pressure. Especially for infants and toddlers, this includes factoring in enough time in the morning’s schedule to allow for both assisted- and self-feeding.

Fix breakfast before bedtime. In other words, plan ahead. As with just about all other aspects of feeding your child, a little advance planning can go a long way toward having a wider range of healthy foods on hand. Simple examples such as hard-boiling eggs ahead of time or having your child’s favorite cold cereal dished out the night before to pair with some presliced fresh fruit can mean the difference between time for a balanced breakfast and running out the door without it (or, as is often the case, with some commercially packaged and far less nutritious alternative in hand).

Grab-and-go breakfasts. If the reality of your schedule is such that you and your kids routinely run out the door with no time to spare in the morning, then try stocking up on a variety of nutritious foods that you can prepare and prepackage for healthier grab-and-go convenience. In addition to hard-boiled eggs, consider other fast favorites like sliced apples, homemade muffins, or a bagel with low-fat cream cheese.

Make sure sleep is on the menu. Applying the age-old adage, make sure your child is early enough to bed that she rises early enough to allow time for breakfast. No matter what their age, tired kids tend to be cranky, and cranky kids are far less likely to sit down for a well-balanced breakfast. Not only that, but sleep has proven itself to be a crucial ingredient in children’s overall health.

Broaden your horizons. You’ll certainly want to keep safety in mind when figuring out what’s age-appropriate to offer your child for breakfast, but don’t let yourself be constrained by artificially imposed labels to determine what is good to serve for a morning meal. Think protein, think fruits and vegetables, and think outside the box when it comes to expanding your breakfast horizons beyond just breakfast cereals and milk.

Look for child care and school support. Be sure to check out what breakfast options your child’s school or child care provider offers. With much-deserved attention now being paid to the food our children eat in out-of-home settings, you’re more likely to find balanced breakfast options on the menu, and your child may well be more receptive to eating them if all of his friends are eating alongside him.


Source: Healthy Children E-Magazine, Back to School 2012. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Choosing Healthy Snacks for Kids

While meals make up the majority of a child’s nutritional intake, most children eat at least one snack per day. While many of the most commonly offered kids’ snacks tend to be of lower nutritional value than meals, snacks still can support—or even enhance—your child’s overall healthy eating plan. Here’s how:

  • Use snack times as a way to increase fruits and vegetable intake. Most kids do not eat the recommended amount of fruits and vegetables. Snack times offer a great opportunity to increase access and exposure to these nutrient-dense foods. Consider pairing them up with dairy products or dairy substitutes (such as grapes and cheese) lean proteins (such as celery and peanut butter), or whole-grain cereals and bread (such as a banana sandwich on whole grain bread).
  • Keep a range of healthy foods handy at home. It is much easier to make easy, healthy snacks when you keep a few key items stocked at home. Ideas include different types of raw vegetables and fruit, yogurt dip, hummus, and cheese sticks.
  • Avoid processed foods and added sugars. Processed foods (made in a factory and sold in bags and boxes) do not have many nutrients and often have a lot of added sugar and salt. In addition, children may become hungry faster after eating processed foods.
  • Teach your children to eat a rainbow of colors. Arrange your children’s foods to show the beauty of fresh, brightly colored foods. Talk about the farms where food comes from and the farmers who help grow it.

Source: Section on Obesity (Copyright © 2016 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

School Lunches: You Can Make a Difference

Meal planning for schools is a complicated process. Menus have to allow for a wide range of tastes and restrictions. Budgets are limited. Foods that are available at lowest cost and require the least preparation are often high in fat, sugar, and salt.

According to the School Meals Initiative for Healthy Children set up in 1996, school lunch menus backed by federal subsidies must conform to the current guidelines for health. When it comes to fat, this means that meals may contain no more than 30% of total calories from fat and no more than 10% from saturated fat.

National School Lunch Program: School Requirements for Menu Improvement

It also means that schools taking part in the National School Lunch Program have been required to take the following practical steps to improve menus:

  • Adding more fruits, vegetables, and grains to menus
  • Balancing menus by using foods from each of the 5 groups
  • Reducing overall fat content by serving more vegetarian main courses, less beef and pork, and fewer fried foods
  • Varying menus by serving more ethnic dishes, such as pasta and tacos

Team Nutrition

To back up efforts at the lunchroom level, the US Department of Agriculture set up Team Nutrition, a program to improve children’s eating habits and raise their awareness about the links between food and health. Team Nutrition’s goal is to improve children’s lifelong eating and physical activity habits by using the principles of the Dietary Guidelines for Americans. This plan involves schools, parents, and the community in efforts to continuously improve school meals, and to promote the health and education of 50 million schoolchildren in more than 96,000 schools nationwide.

How to Get Involved & Make Your Child’s School Healthier

There’s also a push at the state and local levels to help children eat better. In many communities, children at grade-school level are learning not only how to cook food but also how to grow a variety of produce. Courses combine food production and preparation with valuable lessons about history, economics, social science, and math.

If you’re not satisfied with the choices available in your child’s school cafeteria, get involved in your school’s parent-teacher organization and brainstorm some healthful alternatives, as parents and teachers all over the country are doing.

Even if you haven’t the time or resources to revamp the school cafeteria, you may be able to see that the salad bar offers a good selection of raw vegetables and low-fat dressings. Vending machine choices can also be modified to eliminate high-fat and empty-calorie munchies and provide healthy snacks that include more fresh fruit and low-fat dairy products, as well as water and 100% fruit juice instead of sodas.

Try to get your child’s school to stock healthy choices in the vending machines. Although school administrators fear that they will lose money if they make these changes, schools that have provided healthier options have not lost money or have seen their revenue increase. ​


Source: Bright Futures: Nutrition, 3rd Edition (Copyright © 2011 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


March is National Nutrition Month

March is National Nutrition Month, sponsored by the Academy of Nutrition and Dietetics. Visit their website today for information about Food, Health and Fitness for the whole family! CLICK HERE for fun games, tip sheets and handouts, interesting videos and more!

Then, stay tuned to the Pediatric Plus blog and Facebook page during the month of March as we look at:

  • Preschool: Sample Menu for a Preschooler
  • Gradeschool: Making Healthy Food Choices
  • Teen: A Teenager’s Nutritional Needs
  • Baby: Sample Menu for a 1-Year-Old

Hey, What’s to Eat?

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Unless you’ve been totally out of the loop, it’s likely you’ve heard about the childhood obesity epidemic. Nearly 1 in 3 children in America is overweight or obese. It’s talked about on television, radio, the Internet, and in books, newspapers, and magazines. Yet, with all this focus on kids being overweight and obese, many parents are still confused, especially when it comes to what kids eat. How much does your child need? Is he getting enough calcium? Enough iron? Too much fat?

Whether you have a toddler or a teen, what he eats is important to both his physical and mental development. Here’s what children need — no matter what the age.

Infants
During this stage of life, it’s almost all about the milk — whether it’s breast milk, formula, or a combination of the two. Breast milk or formula will provide practically every nutrient a baby needs for the first year of life, says Jennifer Shu, M.D., FAAP, a pediatrician at Children’s Medical Group in Atlanta and co-author Food Fights: Winning the Nutritional Challenges of Parenthood Armed with Insights, Humor, and a Bottle of Ketchup, published by the American Academy of Pediatrics (AAP).

At about six months most babies are ready to start solid foods like iron-fortified infant cereal and strained fruits, vegetables, and pureed meats, Dr. Shu says. Because breast milk may not provide enough iron and zinc when babies are around six to nine months, fortified cereals and meats can help breastfed babies in particular, she explains.

Once you do start adding foods, don’t go low-fat crazy. Although the AAP recently released updated guidelines stating fat restriction in some babies is appropriate, in general, “you don’t want to restrict fats under age two because a healthy amount of fat is important for babies’ brain and nerve development,” says Dr. Shu.

Toddlers and Preschoolers
“Toddlers and preschoolers grow in spurts and their appetites come and go in spurts, so they may eat a whole lot one day and then hardly anything the next,” says Loraine Stern, M.D., FAAP, a clinical professor of pediatrics at the UCLA School of Medicine. It’s normal, and as long as you offer them a healthful selection, they will get what they need, she says.

One area parents should probably keep under watch is calcium. Calcium, the body’s building block, is needed to develop strong, healthy bones and teeth. Children may not believe or care that milk “does a body good,” but it is the best source of much-needed calcium.

Still, there’s hope for the milk-allergic, lactose-intolerant, or those who are just impartial to milk. Lactose-free milk, soy milk, tofu, sardines, and calcium-fortified orange juices, cereals, waffles, and oatmeal are some calcium-filled options. In some cases the doctor may recommend calcium supplements.

Fiber is another important focus. Toddlers start to say “no” more and preschoolers can be especially opinionated about what they eat. The kids may want to stick to the bland, beige, starchy diet (think chicken nuggets, fries, macaroni), but this is really the time to encourage fruits, vegetables, whole grains, and beans, which all provide fiber, Dr. Shu says. Not only does fiber prevent heart disease and other conditions, but it also helps aid digestion and prevents constipation, something you and your child will be thankful for.

Elementary School
Don’t be surprised if your child quits meat. “It isn’t uncommon for a 6- or 7-year-old to suddenly decide to be a vegetarian once they understand animals and where food comes,” Dr. Stern says. This doesn’t mean she won’t get enough protein. “Animal tissue isn’t the only place we get protein,” Dr. Stern says. Rice, beans, eggs, milk, peanut butter — all have protein. So whether your child goes “no-meat” for a week or for life, she’ll likely still get sufficient amounts of protein.

Areas that might be a little too sufficient are sugars, fats, and sodium. “This time is when kids first go to school and have a little bit more choice in what they eat, especially if they’re getting it in the cafeteria themselves,” Dr. Shu says. Cakes, candy, chips, and other snacks might become lunchtime staples. The body needs carbs (sugars), fats, and sodium, but should be eaten in moderation, as too much can lead to unneeded weight gain and other health problems. Packing your child’s lunch or going over the lunch menu and encouraging her to select healthier choices can help keep things on track, Dr. Shu says.

Preteens and Teens
As puberty kicks in, young people need more calories to support the many changes they will experience. Unfortunately, for some, those extra calories come from fast food or “junk” foods with little nutritional value. Some adolescents go the opposite way and restrict calories, fats, or carbs. Adolescence is the time kids start to become conscious of their weight and body image, which, for some, can lead to eating disorders or other unhealthy behaviors, Dr. Stern says. She recommends parents keep an eye on things by being aware of changes in eating patterns and making family dinners a priority once or twice a week.

Like calories, calcium requirements are higher. Calcium is more important than ever during the tween and teen years because the majority of bone mass is built during this time. However, fewer than 10 percent of girls and just more than 25 percent of boys ages 9 to 13 are at or above their adequate intake of calcium. Encouraging kids to have milk, milk products, or calcium-rich alternatives, even if it means they have to add chocolate syrup to their milk to make it more palatable, should help them get more calcium.

In addition to more calories and calcium, your child’s gender may play a role in whether he or she needs more of a particular nutrient. For instance, teen girls need more iron than their male counterparts to replace what’s lost during menstruation, and males need slightly more protein than girls.

Although getting your child to eat healthy — regardless of his or her age — can be a constant battle, it’s one well worth fighting. A healthy child becomes a healthy adult, and only with your support and guidance will your child be both.

Source Healthy Children Magazine, Fall 2008. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Back-to-School 101: Eating During the School Day

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Studies show that children who eat a nutritious breakfast function better. They do better in school, and have better concentration and more energy.

Most schools regularly send schedules of cafeteria menus home and/or have them posted on the school’s website. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat.

Look into what is offered in school vending machines. Vending machines should stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice. Learn about your child’s school wellness policy and get involved in school groups to put it into effect.

Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Choose healthier options to send in your child’s lunch.

Eating for Good Health

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What was your initial reaction when you realized that your child needed to control his weight? In that situation, many parents find themselves thinking, “I’ve got to put him on a diet.” After all, in a culture in which thinness seems to be the name of the game and Americans just can’t get their fill of diet books, you might instinctively think that the solution rests with the latest weight-loss fad, even though these diets are rarely designed with growing children or good nutrition in mind.

No matter what some diet gurus proclaim, calorie counting and exercising to the point of fatigue are not the answer, particularly for children. In fact, restricting calories in a growing child could pose risks to his health. You shouldn’t do so unless your pediatrician recommends and supervises those efforts.

So what’s the answer? Consistently good nutrition, meal after meal, is a foundation for a healthy childhood. Rather than becoming preoccupied with weightloss goals, you should focus instead on a wholesome lifestyle for everyone in your family, no matter what each member weighs. Establish some structure to your family’s eating — 3 well-thought-out meals and 2 snacks a day. If you take steps to minimize the junk food in your family’s diet, eliminate sugared beverages like soft drinks, pay attention to portion sizes, and add some physical activity to the mix, your heavy child will grow up to have a healthy weight.

In preparing foods high in nutritional value, build the family meals around selections like:

  • Fresh fruits and vegetables
  • Whole-grain cereals and bread
  • Low-fat or nonfat dairy products like milk, yogurt, and cheeses
  • Lean and skinless meats including chicken, turkey, fish, and lean hamburger

The basics of good nutrition really aren’t that complicated. It means choosing low-fat turkey bologna instead of beef, or preparing a grilled chicken sandwich instead of a high-fat cheeseburger. Portion sizes at this age should be less than that of an adult-sized serving. Remember that when you’re in the kitchen, choose cooking methods that involve a minimal amount of fat, relying primarily on broiling, roasting, and steaming.

During the middle years of childhood, there are plenty of obstacles that can trip up your well-intentioned efforts at keeping your family eating right. In the mornings, as you’re rushing to get your child off to school, are there days when he doesn’t have the time to sit down for a nourishing breakfast? At school, does he sometimes make poor choices in the cafeteria or from vending machines?

As a parent, part of your responsibility is to find solutions for any stumbling blocks that arise. If the school cafeteria doesn’t offer many healthy choices or your child cannot be convinced to purchase healthy options (and in many elementary and middle schools, only one lunch entrée is provided), pack a healthy lunch for your child each day. You might prepare a turkey sandwich on multigrain or pita bread. A peanut butter and jelly sandwich is fine, too. There are plenty of good selections, but stay away from pastrami, salami, and other high-fat lunch meats. Add a piece of fruit to your child’s lunch sack and perhaps a bag of pretzels. Pack a small water bottle for him, or give him money to buy low-fat milk in the cafeteria.

Once your child gets home from school, he might head straight for the cupboard or refrigerator and look for something to munch on. Have some healthy snacks for him to choose from — raw vegetables with nonfat dip, fresh fruit, whole-grain crackers, air-popped popcorn, unsalted pretzels, or baked tortillas with salsa. Keep the ice cream, cookies, and cakes out of reach — or better yet, out of the house altogether (reserve them for special occasions). If you don’t limit access to snack foods like these, you’re unfairly setting your child up for a losing battle against weight gain.

Meanwhile, stay alert for other potential stumbling blocks to healthy eating. For example, your school-aged child may sometimes exchange food with friends, giving up the sandwich and fruit that you’ve packed for him and trading them for a bag of potato chips. After school, if he’s spending time at a playmate’s home, he might be snacking there on candy rather than an apple. In short, even if you’ve done a good job of educating your child on making nutritious food choices, he’ll face plenty of temptations, almost on a daily basis.

Also remember that you’re a role model in this process, so make healthy food choices for yourself as well as the rest of the family. Even though school-aged children are busier than ever, make an effort to find time for family meals as often as possible. When all of you sit down at the dining room table together, it’s a perfect opportunity for every family member to describe his or her day and the family to grow closer.


Last Updated 7/9/2014. Source A Parent’s Guide to Childhood Obesity: A Road Map to Health (Copyright © 2006 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Cooking With Your Children

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One of the best ways to familiarize your child with good food choices is to encourage her to cook with you. Let her get involved in the entire process, from planning the menus to shopping for ingredients to the actual food preparation and its serving.

When you are planning meals with her, try to include items from the important food groups. Explain the importance of making low-fat choices whenever possible, choosing chicken and fish rather than red meat in most cases, or choosing low-fat cheeses over higher-fat varieties. Partic­ularly in her first few efforts at helping in the kitchen, let her select recipes that she and other family members have enjoyed in the past, so she can see what’s involved in preparing them.

In assigning tasks to your child, keep in mind that they need to be age-appropriate. For instance, you wouldn’t give a six-year-old a sharp knife to chop vegetables, although she can certainly wash the lettuce. Nor would you let her remove a hot, heavy casserole pot from the oven, although she can carefully open the oven door for you.

Here are some other guidelines to keep in mind:

  • Make certain that you or another adult is in the kitchen at all times when your child is helping out.
  • When your child pares vegetables, show her how to point sharp edges away from her to avoid accidents.
  • Explain how she should weigh and measure ingredients.
  • Use the rear burners when cooking on the stove. Make sure that pot handles are turned inward so children can’t acciden­tally knock them off the stove.
  • Teach your child the importance of using potholders when touching hot saucepans and other items.
  • Shut off the oven and burners when you’re finished cooking.

Last Updated 7/9/2014. Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Are Your Kids Hungry or Just Bored?

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Children (as well as adults) often use food for reasons other than to satisfy hunger. Children often eat in response to their emotions and feelings. If your child seems hungry all the time, use the following tips to get a better idea of what is really going on.

WHAT TRIGGERS HUNGER?
If your child is eating 3 well-balanced meals and 1 snack a day but still claims to be hungry, there may be other reasons beyond hunger that make him or her want to eat.

What You Can Do
Ask yourself the following questions:

  • Does your child sometimes reach for food when experiencing any of the following? boredom, depression, stress, frustration, insecurity, loneliness, fatigue, resentment, anger, happiness.
  • Does your child eat at times other than regular mealtimes and snacks? Is your child munching at every opportunity?
  • Do you reward your child with food (does an A on a test sometimes lead to a trip to the ice cream shop)? This can inadvertently contribute to your child’s obesity.
  • When your child is doing things right, do you tell him or her? Words of approval can boost a child’s self-esteem. They can also help keep a child motivated to continue making the right decisions for health and weight.
  • How are you speaking to your child? Is it mostly negative? Is it often critical? It’s hard for anyone, including children, to make changes in that kind of environment.

HEALTHY ALTERNATIVES
If you suspect your child is eating out of boredom, you may need to steer him or her toward other activities as a distraction.

What You Can Do

  • Make sure your child is eating 3 well-balanced meals and 1 snack a day. This will prevent feelings of hunger between meals.
  • Help your child choose other things to do instead of eating, such as: walking the dog, running through the sprinklers, playing a game of badminton, kicking a soccer ball, painting a picture, going in-line skating, dancing, planting a flower in the garden, flying a kite, joining you for a walk through the mall (without stopping at the ice cream shop).
  • Offer healthy snacks such as raw vegetables, fruit, light microwave popcorn, vegetable soup, sugar-free gelatin, and fruit snacks. Snacks such as chips and candy bars have empty calories that will not make your child feel full.
  • You pick the snack. When children are allowed to pick their own snacks, they often make unhealthy choices. Talk to your child about why healthy snacks are important. Come up with a list of snacks that you can both agree on and have them on hand.

REMEMBER
Your own relationship with food and weight, dating back to your childhood, can influence the way you parent your own child. One of your biggest challenges is to determine whether your child is eating for the right reasons.


Last Updated 7/9/2014. Source Pediatric Obesity: Prevention, Intervention, and Treatment Strategies for Primary Care (Copyright © 2014 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.