# Presentation: 035521

## Fit WICChildhood Obesity Prevention Project

- Fit WICChildhood Obesity Prevention Project

- Inter Tribal Council of Arizona, Inc.
- WIC Program
- October 2001

**Notes:**
Discuss how the project plan was developed and is being implemented.

## Project PlanFocus on Feeding Relationship	

- Staff Training on Parenting Aspects of Feeding
- Discussion Groups with WIC Caregivers
- Nutrition Activities for WIC Kids
- New assessment and educational materials
- Local agency project
- Calendar on Feeding Children

##  Thinking About You Activity	

- Think back to an experience you had eating with your family.
- Share your experience.
- Describe what happened, what you thought about it, how you felt, what you did.

## Thinking about WIC families

- What experiences do WIC families have about food?
- How do their personal experiences influence the way they feed their children?

## What are some feeding practices WIC families use?

## Feeding is Parenting

- What does this mean?

## What goals do we portray to our parents?

- Raise a healthy and successful child
- Raise a well-nourished child
- Raise a child who is not fat
- Raise a child who won’t
- get heart disease,
- cancer or diabetes

## Our goals should be to raise a child who...

- Likes eating and feels good about it
- Is interested in food
- Likes being at the table
- Relies on internal hunger cues and fullness to know how much to eat
- Enjoys many different foods
- Can try new foods and learn to like them
- Can turn down foods politely
- Can make do with less than favorite foods

## Children Know How to Eat and Grow

- Relax about Feeding Children

## The Division of Responsibility

- Parents are responsible for what foods are provided, when they are provided and where they are eaten.
- Children are responsible for how much and whether they eat.

## What are caregivers responsible for?

## Caregivers are responsible for:

- Controlling what food comes into the house
- Making and presenting meals
- Insisting that children show up for meals
- Making meals pleasant
- Teaching children to behave at the table
- Regulating timing and content of snacks
- Making other rules (no standing at the refrigerator door, no candy before dinner, etc.)

## What are caregivers not responsible for?

## Parents are not responsible for:

- How much children eat
- Whether the child eats
- How the child’s body turns out

## Children Know How Much to Eat

- Growth of child is in genetic blueprint
- Child needs support and acceptance and to be fed lovingly and reliably with appropriate foods

## Growth Reflects Your Child’s World

- Best to look at child’s growth over time
- Good indicator of how child is doing medically, nutritionally, emotionally and in the feeding relationship
- Examples:  P. 36
- Growth at extremes is OK

## Restricting Intake/Forcing Food	

- Example on P. 46.
- My examples.

## Big and Small Children Regulate

- Big children should be allowed to eat as much as they want
- Small children should be allowed to eat as little as they like
- Trying to control it makes things worse

## How Much Should Children Eat?

## We shouldn’t say how much a child should eat.
We don’t need to know 
how much a child should eat.
Children have finely tuned 
mechanisms that tell them 
how much they should eat

- We shouldn’t say how much a child should eat.
- We don’t need to know
- how much a child should eat.
- Children have finely tuned
- mechanisms that tell them
- how much they should eat

- How much do children eat?

## Eating Varies

- Eating and needs vary from child to child
- Eating and needs vary from day to day in the same child

## How to Feed Toddlers

- The caregiver is in charge of the menu.
- Serve three meals and planned snacks.
- No asking for food or drink between meals
- Time snacks appropriately.
- Child should be included in family meals.
- Let toddler choose what and how much to eat from what is offered.
- Let child eat as much or as little as she wants.
- Don’t press food on child.

## How to Feed Toddlers

- Present foods in a way that child can handle.
- Let child eat in her own way.
- Don’t force or entice child to eat something she doesn’t want.
- Don’t make her clean her plate.
- Make meals pleasant.
- Talk and pay attention to toddler.
- Turn televison off.

## Choose Food that will help toddler eat well...but don’t cater

- Serve soft, moist food that is easy to chew.
- Serve new or disliked food with something your child likes.
- Always put bread on the table.
- Offer another starchy food such as potatoes, tortillas, rice, noodles
- Have favorite foods sometimes
- Don’t force child to eat anything.

## Signs of too much parental control

- Stay at the table to eat something
- Clean her plate
- Eat everything before dessert
- Get by on three meals a day

## Too little structure or limits

- Give snack or food whenever child wants
- Allow child to behave badly at table
- Prepare special food for child
- Short order cook
- Allow milk or juice whenever child wants

## Common skirmishes  P.365-73

- I’m not eating
- I’m not hungry
- Now I’m hungry
- I don’t like that
- I want cereal please
- See what a good eater I am?
- I want to do it myself

## Feeding the Preschooler (3 to 5 yrs old)

- Same as toddler, learning more
- Initiative
- Self-awareness
- Wants to please and imitate you
- Playful

## Why Structured Mealtimes?

- Give child love, food and mastery expectation
- Know they are going to be fed
- Learn to like a variety of nutritious foods
- Sociability of family table
- Learn social skills

## Make Meals Pleasant

- Turn off the television
- Include child in mealtime conversation
- Don’t criticize or judge child
- Don’t allow child to interrupt adult conversation
- Don’t try to entertain child by singing, playing games, etc.

## Other Recommendations

- Teach child to behave at meals
- Tell child to stop the behavior then ignore him
- If it doesn’t stop, excuse him from the table
- Cook with child, grow a garden
- For the joy of it, not to teach or get him to eat
- Makes children more willing to taste it

## Preschooler Problems	P.405-15

- The Child who is cautious about food.
- The child who loves to eat.
- The fat child.
- The vulnerable child.

## How can this feeding relationship approach be used with WIC families?

## Counseling on Feeding Relationships

- Sometimes participants have other priorities in their life
- Its OK to take care of other needs first
- List clues that may let you know a participant isn’t ready for counseling in this area.

## Counseling on Feeding Relationships

- Sometimes participants are ready for counseling, but might not be ready to make the change.
- What clues would let you know if a participant was ready to make a change?

## How to Set Limits with Children

- Make rules about eating
- Be consistent with the rules
- Say No and stick with it
- Don’t give in to whining or crying
- Offer alternatives and solutions
- Set a good example

## Materials and Care Plans