A Mother's Influence on Her Child's Diet

      Part One of this Science Friday series discussed a variety of ways that parents can influence their children's food choices. I know that I saw at least one finding discussed in Part one's post at our home this week- namely, a child's ability to control their own food intake. For Q-ball's birthday, we gave her sweet yogurt the day before her birthday, and she devoured it!  On her actual birthday, we presented her with her first cake and ice cream and expected the same results, but she barely touched anything!  I guess she knew she had had enough the night before!

And, that's about all the cake and ice cream she ate!

    This post is going to specifically explore a mother's role in her child's eating habits. As one of the studies I read explained, "Mothers are often one of the most influential people in a young child’s life."  It makes sense, then, that the mother is often the one to have the most influence on a child's food choices. Obviously, I'm a mama, so I found this a really interesting topic to research especially as I am working to instill healthy eating habits in Q-ball.

     Many of the studies I found dealing with parental influences on children's eating habits focused on preschool-age children.  However, I did find one that looked specifically at a mother's actions while she was just introducing solids to her child- from 6 months to 1 year. Even at this young age, at least two studies show, how a mother feeds her baby is related to a baby's weight.  Mothers are much more likely to pressure their "skinny" babies to eat than they are "chubby" babies. This is especially interesting as it is rather common knowledge that fat babies are happy and healthy babies. (Good news for Q-ball! Just the other day a 8- or 9- year old boy at the park came up to us and called her fat!) Mothers who were deemed to be "controlling" during feeding according to researchers were more likely to have babies with slow weight gain.  I thought this finding was so sad- mothers might be jeopardizing their babies' health because of perceived cultural norms!  What is especially interesting about this finding is that researchers theorize that the mothers then see their babies' slowed weight gain as a success.  As such, they continue to restrict the children's feeding in the coming years, and, as we saw in the last post, this will likely eventually lead to overeating by the child!  What a cycle!

     On the other side of the food control spectrum is pushing children to finish their food. The method of directing children to eat was discussed in Part One, but this week, I am going to look at the issue from a slightly different angle.  Many mothers actively encourage their children to finish their plates or to take a couple more bites. But, studies have shown these reminders last beyond dinner time.  In one study, children were given pudding to eat in a laboratory setting on multiple occasions.  When the children's mothers were present (not encouraging them to eat- just present), overweight children (this specific study was comparing normal weight children to overweight children) were much more likely to eat more pudding. Not only did they eat more, they ate faster and took bigger bites!  The researchers concluded that in these cases, the mothers were likely contributors to their children's weight.

      Finally, it is difficult to look through too much research that discusses women and food without coming across information about eating disorders. Unfortunately, little research has been done on any possible effects that a mother's eating disorder may have on how she feeds her child.  But, at least one study does compare how mothers with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and no eating disorders (No ED) feed their children.  No differences appear in pressuring children to eat across the groups. But, it found that mothers suffering from BN and BED were more likely to restrict their children's food intake.  Additionally, these mothers were much more likely to report that their children had anxiety issues and difficulty eating (although the researchers admit it is difficult to determine the causality of this reporting.)   The study is not a longitudinal study, so it cannot tell us the long-term effects on these children's eating habits. However, it is known that the odds of having an eating disorder are influenced by both genetic and environmental factors, so it can be assumed these children would have an increased risk of eating disorders.
   Another blog I follow, Parenting Science, recently published a post about the effect of a mother's weight gain during pregnancy has on the child's weight as an adult. I won't rehash the post, but it turns out that mothers the under-eat during pregnancy increase their babies odds of being obese later in life.  If you are interested, the whole post is available here.

     It's amazing to see the amount of influence that mother's can have on their children's daily habits! What struck me in these studies is that the mother's actions seem so off-hand or slight that she likely does not give them a second thought.  But, the long-term impacts are pretty profound.  It's certainly made me think about how I feed Q-ball and how I eat in front of her.  I vow to no longer eat peanut directly from the jar.  At least in front of Q-ball...

Sources:
Brown, A. & Lee, M. (2011). Maternal child-feeding style during the weaning period: Association with infant weight and maternal eating style. Eating Behaviors, 12. 108-112.
Munsch, S., Hasenboehler, K., & Meyer, A.H. (2011). Is amount of food intake in overweight and obese children related to their psychopathology and to maternal eating behavior? Journal of Psyhcosomatic Research, 70. 362-367.
Reba-Harrelson, L., Von Holle, A., Hamer, R.M., Torgersen, L., Reichborn-Kjennerud, T. & Bulik, C.M. (2010). Patterns of maternal feeding and child eating associated with eating disorders in the Norwegian Mother and Child Cohort Study (MoBa). Eating Behaviors, 11. 54-61.

Montessori at Mealtime: Better Late Than Never

    While we love following Dr. Montessori's principles at home, we decided not to use her methods at mealtimes.  Instead we used baby-led solids (a.k.a. baby-led weaning).  These approaches do have similarities, but some very fundamental differences.  Melissa from Vibrant Wanderings did an excellent comparison of the two here, so I will not try to re-create. While we have been very happy with our decision to use BLS, we have decided it is time to introduce a few more skills.
   As I explained in a previous post, one of my primary reasons for choosing BLS when introducing Q-ball to solids was that it recognizes babies' developmental capabilities. I believe it is absolutely necessary to give babies and children opportunities to do things themselves.  This is critical for them to demonstrate and further master their capabilities.  Dr. Montessori absolutely agreed.  As she explains in The Montessori Method, "nature has furnished [the child] with the physical means for carrying on these various activities, and with the intellectual means for learning how to do them.  And our duty toward him, in every case, that of helping them to make a conquest of such useful acts as nature intended he should preform for himself."
    And, yet....a few weeks ago I realized that we have not given Q-ball very many opportunities to drink from a cup or to use silverware.  So, how do you implement Montessori feeding methods a little late?  Here's what we are doing:

Using A Spoon
    At least during one meal a day, I give Q-ball a child-sized spoon.  The first few times, I gave her the spoon after she had already eaten some food as that she would not loose complete interest in eating.  But, I realized that this was not as necessary as I expected.  While she was very excited about the spoon, she typically continued eating (except for a few times when I think she was pretty much finished eating anyway.)    
    When presenting her with the spoon, I demonstrate scooping up food from her plate (kept on the table- not her high chair) and then using the spoon to eat the food.  I've had the most luck doing this at breakfast when we are eating sticky oatmeal vs. dinner when we are eating rolly-polly peas. In accordance to BLS, I do not feed her from the spoon.  I simply place the spoon in front of her.When she requests more food, I continue serving her food on her spoon.
    Has it worked? Not quite yet.  At first, she looks at the spoon with a big smile, and then use her fingers to dig the food off of the spoon.  Now she does occasionally get the spoon in her mouth, but sans food.  I believe she has the concept, though.  She does hold the spoon correctly, and it hasn't been thrown to the floor nearly as much as I anticipated (unlike last night's dinner of potatoes and green beans...)

Using a Cup
    As for drinking, we have tried a variety of things, but Q-ball seems to big one of the biggest proponents of breastfeeding around and is confused as to why she should bother with anything else.  She refused a bottle, thought a sippy cup was a really fun teething toy, and did start to use a straw cup, but never really mastered swallowing.  So, now I am just presenting her with a cup filled with a little water at the end of our meals. Before placing the cup in front of her, I demonstrate how to drink from it. She gets very excited. Then she picks up the cup looks curiously at the water inside and rolls the cup around in her hands, moving the water in the cup. And then dumps the cup on her high chair table and tries to use her hands to drink it.
Has it worked?
   Obviously, not yet.  But, I'm certainly not giving up. She'll obviously get it soon enough. 


Sources:
Montessori, M. (1912). The Montessori Method. New York: Fredrick A. Stokes Company. (Trans. Anne E. George).

Baby Approved Recipe!

I enjoyed sharing one of my most successful baby-led solids recipes last week, so I thought I would share one more that would be perfect for a holiday (or any other) party- a baby-led solids version of spinach and artichoke dip. I made it for a recent (and disappointing) football party.  I served it to Q-ball with whole wheat pita, and she loved it! 

Here's what made this meal good for BLS:

1) Spinach is full of vitamin A, a nutrient that is deficient in breast-milk fed babies after 6 months.

2) White beans and artichokes are full of fiber, which many babies need to help with the constipation that is normally associated with introducing solids. 

3) White beans are also a pretty good source of iron, which is very important for babies as breast milk provides very little iron and most babies have exhausted the iron reserves with which they are born after 6 months.

From the WHO Guide to Complementary Feeding

Some notes specific to cooking for babies:

• I try to use organic ingredients (whether fresh, canned, or frozen) whenever possible for BLS recipes.
• We do not have any history of allergies. Of these ingredients, Q-ball had previously eaten cheese and whole wheat pita.

Enjoy!

1/2 cup fresh Romano or Parmesan cheese

1/4 cup yoghurt

1 tsp fresh lemon juice

1/4 tsp black pepper

1/8 tsp red pepper

15 oz. white beans (canned, rinsed and drained or prepared dried)

6-8 cooked artichoke hearts, quartered (or 14 oz can)

9 oz. chopped frozen spinach (thawed, drained, and squeezed dry)

1/2 cup mozzarella cheese

Preheat oven to 350.  Place all ingredients expect mozzarella, artichoke and spinach in food processor and process until smooth.  Spoon into bowl and add artichokes and spinach.  Place in 1-quart cooking dish, sprinkle with mozzarella and bake for 20 minutes or until browned.

Sources:

Department of Nutrition for Health and Development, World Health Organization. (2000). Complementary Feeding: Family 

http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2626/2

http://www.caloriegallery.com/foods/calories-in-cooked-white-beans.htm

http://www.artichokes.org/health.html

Baby Approved Recipe!

   Before starting baby-led solids, I spent quite a bit of time looking for information as I did not know anyone else who was choosing to go down this path or anyone else who had done it. For an explanation of why I chose BLS, see this previous post I especially liked reading about other recipes or foods that families were using as I found this was the best way for me to visualize and later employ BLS in my own house.  So, I am sharing last night's dinner recipe- Mediterranean-Inspired Butternut Squash with a side of hummus- as it was our most successful so far.

Here's what made this a good meal for BLS:

1) Every member of the family loved it (even meat-eating Daddy), especially Q-ball.  I've rarely seen her so excited to eat. 

2) The main ingredient- butternut squash- has super high levels of Vitamin A- which is one of the nutrient gaps in babies as breast milk no longer supplies adequate amounts as in babies beyond 6 months.

3) Hummus (I made a basic homemade hummus)- provides both a low fat (chickpea) and high fat (tahini) source of protein

4) Easy to serve with couscous or whole wheat pita to provide additional energy for baby.

5) Lots of exciting new flavors for baby.

Enjoy! 

Some notes specific to cooking for babies:

• I try to use organic ingredients (whether fresh, canned, or frozen) whenever possible for BLS recipes. But, I, admittedly, do not use organic onions or butternut squash as they have been identified as "clean"er by the EWG. It saves a few dollars on groceries.
• We do not have any history of allergies. I did introduce tahini to Q-ball on its own a few times as nuts are high on the potential allergy list. Whole wheat was also introduced on its own several times before serving with other foods.

1 butternut squash (2 lbs)

2 Tbsp olive oil

1 large yellow onion

2 cloves garlic, minced

1/4 tsp cayenne ( I was a little more heavy handed than this, and I think Q-ball needed the hummus to cool off at times...)

1/8 tsp ground cinnamon

1/8 tsp ground nutmeg

1/2 tsp cumin

1 cup diced tomatoes (fresh)

1/3 cup raisins

1 1/2 cups water or reduced sodium veggie broth (I used the later)

Peel squash and remove seeds. Heat oil in heavy saucepan over medium heat.  Add onion and cook until golden.  Add garlic, cayenne, cinnamon, nutmeg, and cumin.  Cook for one minute.  Add squash, tomatoes, raisins, and water/broth.  Bring to a boil.  Reduce heat, cover and simmer for 10 minutes.  Uncover and simmer until squash is as tender as desired.  

Adapted from a recipe from Real Simple magazine.

Sources:

Department of Nutrition for Health and Development, World Health Organization. (2000). Complementary Feeding: Family foods for breastfed children. Retrieved from http://whqlibdoc.who.int/hq/2000/WHO_NHD_00.1.pdf

Nutrition facts and analysis for squash. http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2648/2

Baby-Led Solids

I just introduced solids to my 6 month-old.  Like most new parents, I had lots questions.  When? How? What? How much?  After a bit of research, I decided to use the baby-led solids (or baby-led weaning) method in which baby feeds herself from the get-go with food that is suitably sized (not too small to choke on, big enough to hold, but not too big to fit in baby mouth, and not pureed). 

 I am a big fan of the logic behind the method.  It recognizes and furthers baby’s developmental abilities (Palmer and pincher grasps, hand-eye coordination, budding decision making).  It also acknowledges that breast milk (or formula) is baby’s primary source of nutrition for the first year of life.  Nearly everything I read was very positive towards BLS and further convinced me to try it (although I was still nervous- I am a new mom, after all!)  But, there was a study that was reviewed in several news sources that made me take a second look.  

The title reads “Baby-Led Weaning Is Feasible but Could Cause Nutritional Problems for Minority of Infants.”  True, it says minority, but no one wants to possibly cause nutritional problems for their infant!  The article focuses on a study that is one of the first looks at BLS from a formal, research-based approach. The article lists some of the findings of the study (see link above), but I didn’t think the findings listed completely supported the researcher’s conclusion, which is: “BLW might be feasible for a majority of infants but could lead to nutritional problems for infants who were relatively developmentally delayed. A more pragmatic partial BLW approach would probably be the wisest option.” (Quoted from the original study.)  So, I decided to track down the original study and analyze all of the findings.

I found some very interesting information that is not listed in the article.  First of all, the data used was not collected with BLS in mind; it is from a survey of parents of over 600 infants from 4 to 12 months in the UK who were asked to keep a finger food journal for their babies.  As such, all methods for introducing solids to infants were included, a fact I believe serves as a possible bias. 

Next, the researchers found a “substantial discrepancy” between infants who were over 6 months in age and actively reaching for food and those that were allowed to grab the food.  Even for infants who had been reaching for food for over 2 months, less than two-thirds were offered finger foods more than once a day; while 25% of parents reported their infants could not feed themselves at mealtimes.  Sadly, these parents held low expectations of their infants’ abilities as they were never given a chance to eat finger food, although they had been reaching for finger food for at least 2 months!  This is even more tragic given that the study also quotes research that says that in some countries, later onsets in social skills and self-feeding have been observed when infants are fed purees, in lieu of self-feeding. 

Another interesting fact is that “15-month-old infants eating a finger-fed meal took 50% longer to eat only just over half the weight of food eaten at a comparison spoonable meal, but the average energy intake at both meals was the same.”  A study found that even when self-feed babies took less bites than babies fed with purees, they gained just as much weight.   So, babies are getting more bang for their buck with finger feeding versus purees.  I imagine quite a few adults wish that they could find a way to take in healthy nutrients with half the Brussels sprouts.     

Finally, in regards to the “minority of infants” for which BLS may not be feasible- this amounted to 6% of the study.  These infants were observed to be developmentally delayed in other physical and mental milestones.  As such, it makes sense that their ability to self-feed may also be delayed.  This is a fact noted by the BLW community, and the BLW forum (www.babyledweaning.com) advises against this approach for such infants.

So, in the end, this study actually made me more interested in BLS!  It highlighted everything that attracted me to BLS in the first place- an emphasis on recognizing my baby’s capabilities, likes & dislikes, and needs.  

Here's what Q-ball's tried so far-- 

sweet potato, apple, pear, peas (this is the only thing she hasn't successfully eaten yet), blueberries, whole wheat toast, Cheerios, Chex cereal, broccoli (this was very easy because the stem was perfect for her to hold!), baby carrots, bananas

Sources:

Aboud, F., Moore, A., & Akhter, S. (2008). Effectiveness of a community-based responsive feeding programme in rural Bangladesh: a cluster randomized field trial. Retrieved from http://www.psych.mcgill.ca/computing/aboud/MCN08.pdf.

Baby-Led Weaning Is Feasible but Could Cause Nutritional Problems for Minority of Infants. (2011, January 14). Science Daily. Retrieved from http://www.sciencedaily.com/releases/2011/01/110112081454.htm

Wright, C., Cameron, K., Tsiaka, M., & Parkinson, K. (2010). Is baby-led weaning feasible? When do babies first reach out for and eat finger foods? Maternal and Child Nutrition, 7(1), 27-33. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1740-8709.2010.00274.x/full#b3.