Can 10- and 7-year-old picky eaters, accustomed to being served the easy meals they prefer, change their ways?
The first Picky Eater Project for the Motherlode blog, chronicled how we successfully helped a family with one very picky 4-year-old transform mealtimes and help the child — and his twin — open up to new tastes and new rules, especially around dinnertime. To his parents’ relief, they no longer feel compelled to make two dinners, and we called the project a complete success. The truth is, it almost seemed too easy. Would it work for older children?
This time, we’re working with the parents Marlo and Corey and their children: Brooke, 10, and Hunter, 7. Brooke refuses to eat many foods, preferring pasta with butter and cheese or ramen noodles. Her younger brother almost always follows her lead, and to make sure the two active children have enough energy, vitamins and minerals to grow, Marlo and Corey are willing to prepare something different for each child just to be sure that they eat enough. Their primary goal is to make one dinner for the whole family, and to have the children eat more vegetables (carrots are their default) and fish (which they will not eat). Over the next six weeks, we (the authors Sally Sampson, founder and editor of the nonprofit children’s cooking magazine Chop Chop and Natalie Digate Muth, a practicing pediatrician and registered dietitian) will work to help them reach those goals.
The big question, for Marlo and Corey and for many families like theirs: Once picky eating is a set pattern, is it better to avoid a lot of heartache, fighting, wasted food, and the children potentially going to bed hungry by just letting them eat the foods they like?
It isn’t better, and what’s more, it isn’t necessary. Between us, we have worked with hundreds of families who are committed to raising their children to be healthy eaters. Along the way, almost all of them (ourselves included) have had to deal with the very common experience of picky eating. We’ve found that the best way to help children expand their eating preferences — especially school-aged children — is to get them involved in growing, choosing, preparing and experimenting with food. In other words, teaching children to cook.
To help Marlo, Corey, Brooke and Hunter, we sat down with them to better understand their family mealtime routines. Marlo, a nurse in a cardiac cath lab, has a very sporadic schedule, including many overnight and weekend calls. Corey works as a federal agent with erratic but somewhat flexible hours.
There is not a lot of time or desire to throw together gourmet meals. Not that the children would eat them anyway. Marlo and Corey think their children are “picky eaters” because they won’t try entire categories of food, and they refuse almost anything unfamiliar. (For the purposes of this column, a picky eater is a child who won’t try foods, not one who is willing to try but doesn’t like a particular food or foods.)
Marlo and Corey usually start by offering one meal. But when the children refuse it (which they do more often than not), the parent cooking readily jumps up and makes something else. Marlo and Corey would like their children to be more adventurous in their eating choices, but do not feel it is worth fighting about or letting them “starve” by refusing to cook something different. Both agree that Brooke is the pickiest of the two. She is also the most influential. If she tries something, Hunter will too. If she refuses or rejects it, there is little chance Hunter will go for it, unless he is trying to win bonus points.
Interestingly, when Brooke learned about the project, she jumped up and pulled an apron out of the kitchen drawer and exclaimed, “Wait, does this mean I get to learn how to cook?” Hunter’s reaction was to share his disdain for brussels sprouts, but then later offered that if he helped make it and it looked as if it would taste good, he would give almost anything a try.
PhotoHunter, 7, peeling carrots.Credit This first meeting, we set goals.
Marlo’s goal is to get the children to eat more variety of healthy foods, especially fruits and vegetables. She would really like them to eat fish, because she loves it and would like to eat it together as a family.
Corey’s goal is for the whole family to eat the same meal, and ideally to get a list of meals that everyone will eat rather than eating the same one acceptable meal day in and day out.
Brooke’s goal is to learn to flip a pancake without having it smear all over the pan, and to be trusted to use not only the microwave but also the oven, stove and toaster. Her all-time favorite meal is turkey, stuffing and cranberries. She says her favorite vegetable is broccoflower, which she has never tried, and celery.
Hunter’s goal is learn to make artichokes, which he tried at a friend’s house, thanks to positive peer pressure, and to his surprise he really liked. His all-time favorite food is pizza. He says his favorite vegetable is artichokes (his parents would say it’s carrots).
Based on those goals, we gave the family a realistic plan for the week:
Create a mission statement together. What do you hope to achieve together by the end of the six weeks?
Make a few “mealtime rules” for everyone. We offered our 10 Rules for Picky-free Parenting
(available at the link, and below), like “We are one family, and we will eat one meal” and “As parents, we will decide what foods are offered, when, and where. As kids, we will decide what we will eat and how much.”
Cook one meal together this week. Based on this family’s food preferences, we offered the following recipes to try: Roasted Carrots, Pasta Pesto with Peas, and Avocado Green Goddess Dressing.
Plant a small herb garden Put a few plants in the windowsill or backyard to harvest from later.
Try one new food For Brooke and Hunter: Taste something that you’ve never had before and write a quick sentence of what you thought of it to share next week.
Over the next six weeks, we will share this family’s experience; what we suggest, what the children commit to and how it all turns out. If you have a picky eater in the family, know that it can’t change unless you try, and better yet, try together. Join us for your own “picky eater project,” and share your stories here.
10 Rules of Picky-free Parenting:
1. As parents, we will be good role models. We will only ask the kids to eat foods that we are willing to eat ourselves.
2. As parents, we will decide what foods are offered, when, and where. As kids, we will decide of the food that is offered, what we will eat and how much.
3. We will value the process of learning to be more adventurous eaters. We will be willing to try new foods, even if it is just a tiny bite.
4. We do not have to clean our plates. We will listen to our bodies and let hunger be our guide.
5. We will not offer food rewards. In other words, we do not have to ‘eat our vegetables’ in order to get dessert. We will not reward good behavior with sweets and ‘treats’.
6. Mealtimes are a family affair. As often as we can, we will shop, cook, and eat together.
7. We are one family, and we will eat one meal. We will not make separate meals. But we will be sure to include at least one thing each family member likes at each meal.
8. We will learn together about food, nutrition, farming, and cooking.
9. We will have fun, play, and experiment with new foods.
10. We will be consistent in following these rules, but not rigid
Terry Alves-Hunter, Foster Parent Advocate
Not in my womb, always in my heart
Learning & Emotional Assessment Program (LEAP) The Learning and Emotional Assessment Program (LEAP) at Massachusetts General Hospital assesses students and children ages 2 to 22 who have developmental difficulties and consults with their parents, teachers and care providers.
Our clinical professionals have devoted their training, research and clinical practice to acquiring the specialized skills needed to assess children with learning disabilities, psychological and developmental disorders. Our team loves working with children and has a natural ability to put them at ease.
The Department of Psychiatry offers a depth and breadth of resources available at few other hospitals or psychiatric centers, meaning your child receives comprehensive, state-of-the-art care without leaving our campus. Services available at the MassGeneral Hospital for Children include:
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Our clinical assessments are designed to be a comfortable and often fascinating experience, and we find that many children enjoy the warm, one-on-one attention they receive. In addition, our professionals excel at discussing the benefits of assessments with even the most skeptical of adolescents. Our Staff
Our experienced professional staff includes Child psychologists, Licensed clinical psychologists, Neuropsychologists, Certified school psychologists, clinical psychology interns and postgraduate fellows.
Research is an ongoing companion to treatment in the LEAP program, with clinical test data collected daily. This data is used to help participants in LEAP, as well as in other programs and departments. Conditions We Evaluate
LEAP treats a variety of conditions and disorders. With the trained resources of Mass General Hospital's Dept. of Psychiatry, we are able to evaluate and treat a variety of conditions and disorders.
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Boston Medical Center
Dr. Augustyn is the Director of the Division of Developmental and Behavioral Pediatrics at Boston Medical Center (BMC) and is a Professor at Boston University School of Medicine. She went to medical school at Loyola Stritch School of Medicine, completed her pediatric residency at UCLA and her Developmental and Behavioral Pediatric Fellowship at Boston University-Boston City Hospital. Her clinical work at BMC primarily involves the evaluation of children with various developmental delays including autism,speech and language delays, global developmental delay, learning disabilities, ADHD to mention a few.
Her research work has varied across her career and includes work on the effects of both in utero cocaine exposure and violence on early childhood and parenting and recently she has been a leader in developing the Center for Family Navigation at BU, a national leader in promoting and developing the use of navigators to support families of children with developmental disabilities.
Dr. Augustyn is co-editor of The Zuckerman Parker Handbook of Developmental and Behavioral Pediatrics for Primary Care and the section co-editor for Developmental and Behavioral Pediatrics for the online journal UpToDate. She currently sits on the sub board of Developmental and Behavioral Pediatrics at the American Board of Pediatrics and is on the Board of Directors of the Society of Developmental and Behavioral Pediatrics. She is also on the American Academy of Pediatrics planning committee for Practical Pediatrics, their national CME Program.
Deborah Frank, MD
Dr. Frank is the Director of the Grow Clinic for Children and a board-certified Developmental and Behavioral Pediatrician at Boston Medical Center (BMC). She is also a Professor of Pediatrics at Boston University School of Medicine. Dr. Frank attended Harvard Medical School and completed her residency at Children's Hospital Seattle. After her residency, she went on to complete a fellowship in Child Development at Children's Hospital Boston. Dr. Frank specializes in issues of growth and nutrition and the impact of hunger on child development.
Dr. Frank has written numerous scientific articles and papers. Her work has focused on breastfeeding promotion, women and children affected by substance use, nutrition among homeless pregnant women and children, Failure to Thrive, food insecurity, and the “heat or eat” phenomenon, the dilemma that many low-income families face in the winter when they have to make the critical choice between heating their homes and feeding their children. She is especially proud of successfully mentoring many pre-professional and professional colleagues.
Cited as a respected authority in her fields, Dr. Frank has frequently given testimony to state and federal legislative committees on the growing problem of hunger and associated hardships in the United States and its effects on our youngest children. She has recently been nominated by Congresswoman Nancy Pelosi to the newly established National Commission on Hunger. She is also an invited member of the Aspen’s Dialogue on Food Insecurity and Health Care Costs.
L. Kari Hironaka MD, MPH
Dr. Hironaka is a board-certified Developmental and Behavioral Pediatrician at Boston Medical Center. She completed her fellowship at Boston Medical Center. Dr. Hironaka specializes in health services research, health literacy and ADHD, as well as residency training.
John Maypole, MD
Dr. Maypole completed Pediatric Residency in 1999, and Pediatric Chief Residency in 2000 following his training at Yale University School of Medicine. Dr. Maypole has consistently included primary care, medical education, and in participating in and developing innovative clinical programs for complex children and their families. Dr. Maypole served as Associate Director of the Pediatric Integrative Medicine Education Project and performing Holistic Medicine consults and medical education at Children’s Hospital from 2003-2005. In 2005, Dr. Maypole became Director of the Department of Pediatrics at the South End Community Health Center while serving as an attending physician for the Comprehensive Care Program (CCP) in the Department of Pediatrics at Boston Medical Center. CCP is a multi-disciplinary team of providers who provide enhanced and coordinated primary care to the most medically complex patients and higher risk families in the Pediatric Department, including ex-premature infants, children with special health needs and neurodevelopmental disabilities. In February of 2013, Dr. Maypole came to Boston University/Boston Medical Center to work full time to develop approaches and programs to address this fast-growing segment of the pediatric population. In September of 2014, Dr. Maypole received an award from the Center for Medicare Medicaid Innovation, supporting a 3 year effort for the Massachusetts Alliance for Complex Care/4C program--a consultative, multidisciplinary care support model of care for PCPs and families of medically complex children, of which he is co-principal investigator. He is an associate professor of Pediatrics at BUSM. Dr. Maypole writes child health-related articles for a lay audience, for mainstream media and online publications.
Jenny Radesky, MD
Dr. Radesky is a board-eligible Developmental Behavioral Pediatrician and a board-certified general pediatrician who recently joined the faculty at Boston Medical Center after completing her fellowship training here. She attended Harvard Medical School and completed her pediatrics training at Seattle Children’s Hospital. Dr. Radesky is a clinician-investigator whose clinical interests include early childhood adversity, attachment relationships, and child self-regulation, as well as teaching trainees methods of observing parent-child interaction. Her research examines mobile/interactive media use by parents and young children and how this effects parent-child interaction and child social-emotional development. She is an active member of the AAP Council on Communications and Media.
Arathi Reddy, DO
Dr. Reddy is a board-certified Developmental and Behavioral Pediatrician at Boston Medical Center. She attended medical school at Western University of Allied Health Sciences in Pomona, CA and completed her residency at Morristown Memorial Hospital/ University of Medicine and Dentistry of New Jersey in Morristown, NJ. She completed her fellowship at Einstein Montefiore and worked in NYC prior to joining the faculty in March 2011.
Jodi Santosuosso, NP, MSN
Jodi is a certified nurse practitioner in the Developmental and Behavioral Pediatrics Division at Boston Medical Center. She attended University of Massachusetts College of Nursing and Health Sciences and completed her residency at University of Massachusetts, Boston. She joined the Boston Medical Center and Boston University School of Medicine faculty in April 2007. Jodi has had extensive training in developmental and behavioral pediatrics, gastrointestinal (GI) diseases and ear, nose and throat (ENT) disorders.
Laura Sices, MD, MSDr. Sices is a board-certified Developmental and Behavioral Pediatrician at Boston Medical Center (BMC). She attended medical school at University of Pennsylvania in Philadelphia, PA, completed her residency at The Children's Hospital of Philadelphia and completed her fellowship at University of Washington in Seattle, WA. Dr. Sices was on the faculty at Rainbow Babies and Children’s Hospital in Cleveland, OH before joining BMC in 2007. Dr. Sices’ clinical work focuses on assessment and management of children with a variety of different concerns, including developmental delays, speech and language delays and conditions, ADHD, learning disabilities and differences, and autism spectrum conditions. Her academic focus is on developmental screening and the early identification of developmental delays.
Naomi Steiner, MD
Dr. Steiner is the Director of Training at the Division of Developmental and Behavioral Pediatrics. Dr. Steiner studies how computers train the brain, which is an area of great interest in overlapping fields of ADHD, psychology, neuroscience and education, and closely followed by many as a complimentary or alternative approach to the traditional psychopharmacological treatment of ADHD. She is specifically interested in implementing neurofeedback attention training in schools. She is also interested in teaching self-regulation skills and relaxation breathing in schools. Dr. Steiner is multicultural and multilingual. In 2030 more than 50% of children will be raised bilingual in the United States! Dr. Steiner has written a book on how to successfully raise children bilingual (7 Steps to Raising a Bilingual Child), and instructs medical professional, teachers and parents on how children learn two languages, and how English Language Learners can be successful at school.
Mary Ellen Stolecki, NP, MSN
Mary Ellen is a board certified pediatric nurse practitioner in the Developmental and Behavioral Pediatrics Division at Boston Medical Center and an Instructor of Pediatrics at Boston University School of Medicine.
She specializes in primary care of the Child with Special Health Care Needs (CSHCN) in the Comprehensive Care Program. She also practices in the Pediatric Gastroenterology Division providing specialty care for gastrointestinal (GI) conditions.
Her clinical interests are primary care for medically complex children (as well as GI issues) of CSHCN including: care of the premature infant, autism, cerebral palsy, seizures, Down syndrome, Williams syndrome, Turner syndrome,achrondroplasia,and multiple congenital anomalies.
Jodi Wenger, MD
Jodi Wenger, MD is a graduate of Dartmouth Medical School who completed her pediatric residency at Boston Medical Center. She spent several years on the Navajo Reservation in northeastern Arizona before transitioning back to Dartmouth Hitchcock Medical Center in Lebanon, NH. She served as a pediatric hospitalist, outpatient provider and educator at Dartmouth Medical School.
She has always had an interest in children with special health care needs. She worked in the Comprehensive Care Program at BMC as a resident and is thrilled to return. She was the general pediatrician at the multidisciplinary spina bifida clinic at Dartmouth Hitchcock and cared for children with neurologic challenges while on the Navajo Reservation.
Dr. Wenger has also had an interest in resident work hour reform and continues to support the software she and her husband created during her chief resident year. Amion, continues to allow one to make fair physician call schedules that can be easily accessed online.
Barry Zuckerman, MD
Dr. Zuckerman is Professor and Chair Emeritus of Pediatrics at Boston University School of Medicine/Boston Medical Center. He is a national and international leader in child health and development. His research focuses on the interplay among biological, social and psychological factors as they contribute to children's health and development. Dr. Zuckerman and colleagues have developed four programs that transformed health care to better meet the needs of low income and minority children. The success of these efforts is that they are now all national programs; Reach Out and Read, Medical-Legal Partnership, Health Leads and Healthy Steps. In addition to more than 250 scientific publications, he has edited nine books, including three editions of Behavioral and Developmental Pediatrics: Handbook for Primary Care. He has served on prestigious national committees; National Commission on Children, Carnegie Commission on Young Children, Bright Futures, and has received numerous national and international awards including the C. Anderson Aldrich for Child Development and the Joseph St Geme Award for Leadership from AAP, and the Policy and Advocacy award and Health Care Delivery Award from the APA. He has consulted in Turkey, Bangladesh, and Thailand regarding child development.
- See more at: http://www.bmc.org/pediatrics-developmentalbehavioral/team.htm#sthash.UrLgPWRv.dpuf
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