Dr. Heather's First Live TV Appearance

Despite awakening at 4 am with bloodshot eyes from an allergy attack (perfect for HDTV, right?) -- I was psyched to head down to KITV yesterday morning to talk story with the gang about parenting. So mahalo to Jill Kuramoto for inviting me, and a big aloha to Mahealani Richardson, Moanike'ala Nabarro, and Yasmin Dar for making me feel so at home in the studio. Looking forward to seeing you all again next month!

Here's the link: Dr. Heather on KITV -- January 17, 2012


Dr. Heather The BabyShrink

Toddler Behavior: Reasons Your Toddler Doesn't Eat Much

I've just had a rare parenting experience; making a meal that my toddler ate -- and enjoyed.

Pediatricians tell us that toddlers need fewer calories, so not to worry. But there's another more developmental reason that toddlers often don't eat. The "simple" cycle of HUNGER -----> EATING -----> FEELING BETTER isn't really so simple for your toddler. It involves conscious awareness of a physical cue (hunger), understanding that FOOD is the solution to HUNGER, and then expressing that need to us. Not only do toddlers have better things to do than to sit and be restrained in a highchair (things like walking, running, climbing and screaming about bathtime), but they have a hard time "tuning in" to that feeling of hunger to begin with. We can all relate to that, right? Getting so consumed in an absorbing activity that we forget to eat. That's the daily experience of your toddler.

Understanding this dynamic makes it easier to handle. Try this:

Think ahead about when your toddler's likely to get hungry, and offer something she usually likes to entice her to the highchair. (Thin, crunchy breadsticks are the snack of choice at our house these days.) Then offer her a prepared meal -- don't expect her to sit and wait while you make it. If she resists, that's OK. Take her down and send her on her way. Try again at the next regular snack or mealtime.

Drinking milk is your toddler's default -- it's a lot easier to drink milk (think how easy a nice milkshake goes down), and it's reminiscent of the good ol' baby days, when parents took care of everything. In other words, it's regressive -- and comforting. And sometimes, toddlers get so crazy-hungry that they're beyond food -- it just doesn't satisfy the way milk would. As long as your toddler's experimenting with food and getting a little variety during the course of the week, regressing to milk in the service of preventing a hunger meltdown sometimes is OK. (But check out her menu with her pediatrician if you're unsure.)

Don't panic about rejected food. You can't force a toddler eat, poop, or sleep. Putting extra pressure on the situation only makes it worse. Take a deep breath and be glad you're not contributing to a future food neurosis.

Rest assured that as your toddler gets a bit older, this dynamic will naturally improve -- young toddlers have more trouble with food than older, "more experienced" toddlers do. And as she gets to preschool age (3 or so), she'll be more interested in playing social games involving food (think "Tea Party"), AND she'll have a lot more experience with food under her belt. Once again, the miracle of development will help us get through this maddening stage.


Dr. Heather The BabyShrink

Toddler Behavior: Why Does My Baby Behave Better With The Babysitter Than With The Parents?

It's always a shock -- finding out your oppositional little tyke is a perfect darling for the sitter (or grandma). When I found out my usually picky eater ate like a champ at a neighbor's house, I felt embarrassed that I had been complaining about it. It must be me, after all! I worried. Then I realized that our kids have special plans for us -- plans to humiliate, embarrass, and otherwise show us for the idiots we fear we are. And these plans don't stop at toddlerhood, they only get more complex as they get older and wiser. Parents are morons, right? I guess I remember feeling that way about my own parents (sorry, Mom and Dad!)

It helps (a little bit) to know that toddlers act better for others because they love us so much. When they're with the sitter, they "hold it together", waiting for the moment when we return. They put on brave little faces and their best behavior for those temporarily in charge. And then when we return -- look out! All of that stored up stress and worry and upset about our leaving is dumped at the feet of those who caused it. Here's a reader question about the issue from the comments section, posted here in case you missed it:

Hi Dr. Heather,

But he never uses a sippy cup at home!

I could use some advice on getting my baby to drink cow’s milk. He just turned one last week, so I started mixing breastmilk with cow’s milk in equal parts. Our sitter says he drinks it with no problems from a sippy cup, but with us, he doesn’t seem interested in it with either a sippy cup OR bottle. He drinks water from the sippy cup, so I know that he is capable of using it. Same thing with naps…no problem at the sitter, but with us, he puts up a fight. Is it common for babies to behave differently with the sitter vs the parents? Do we just wait him out with the milk until he’s so thirsty that he’ll drink anything? Should I be concerned that he still drinks from a bottle? I’m clueless!


Dear JD,

YES, it’s extremely common -- predictable even -- that your baby will “perform” better for a sitter. The babies save their best — and their worst — for us. They seem to “hold it together” while missing us at the sitter, and then sort of fall apart for us. Refusing things like milk or cups falls into the same category.

But what to do about the milk dilemma? Milk in particular is reminiscent of the early, close bond with mom, and so there is often a special struggle around it. Try VERY SLOWLY introducing the cow’s milk — say one tenth at a time, and wait until you’re SURE he’s used to it, then another tenth. DON’T MAKE AN ISSUE OF IT — don’t mention it, (and try not to show him both milk containers in the kitchen, maybe prepare them in advance) and just try to be matter-of-fact. Slow, steady, but no pressure.

For the cup thing, offer him a sippy of perhaps watered down juice — just a small amount, ALONG WITH whatever he’s used to, at his highchair. It’s a drag to offer both I know, but he’ll start out “playing” with the sippy and eventually get used to actually drinking out of it. And he won’t fear that you’re trying to take away his usual. You can also make a game of it by giving him juice to drink in the tub, or even in the stroller, car etc. Eventually offer the cup more and the bottle less, and offer a lot of praise when he really starts to get the hang of the cup. Also, point out kids he likes when they're using their cups. "Look at Max and his cool Spider Man sippy cup. Max sure looks thirsty!"


Dr. Heather The BabyShrink

Child Development: Food Allergies, Your Child's Behavior, and YOUR Guilt

I've been away on vacation for a bit, and we were able to visit lots of family and friends. I was struck by how many have kids with food allergies and sensitivities -- more and more of us are discovering what a difference our food choices have on how we, and our kids, feel and behave. But it ain't easy, managing special diets. The pressure to "join in" and have "just one cookie" is quite difficult. The pressure even comes from within the family, often in the form of well-meaning relatives who want our kids to "not be different" and "just have fun". Many parents feel guilty that they can't give their child what the other kids can have. But guess what? Parenting is at least as often about saying "no" as it is about saying "yes", and having limits and structure in life is good for our kids' ultimate development. On the other hand, you don't want to go to the other extreme and be rigid when there's no need. So it's a balance between being realistic about food choices, firm in your decisions, and flexible when you CAN be. I appreciate the comments left by Hot Wife, KiwiLog and Margaret after my last post, and I urge you to review them, and their resources, if you're interested. Here are some of my additional thoughts and recommendations as well:

For parents of kids with food sensitivities:

Make a big deal out of exploring new, safe food options. Have fun in the kitchen and enlist your child's natural desire to learn the "rules".

Kids with sensitivities (as opposed to true food allergies) can often have a certain amount of the "offending" food. Determine, with her doctor and/or nutritionist, how often your child can have foods that trigger her sensitivities. Once a week? Once a month? Once a year? Then give her the freedom to pick and choose those foods within her allowed time-frame.

Be flexible in allowing "treats" that fit in with her diet -- don't make yourself crazy trying to follow every single rule about healthy foods. The more unnecessarily rigid you are, the more you risk a backlash against your rules in adolescence.

Stay closely in touch with online or in-person support groups, as information about food sensitivities and allergies changes rapidly, and your doctor may not have the resources to keep you abreast of all the developments, new foods available, etc.

For parents of kids with life-threatening allergies, I also suggest the following:

TALK to your child, even if she's very young, about her food safety issues. Empathize with the fact that she can't have what she wants; you understand that it's hard. Give her examples in daily life of you and others saying "no" to themselves in order to be healthy and successful. Explain that it's hard for ALL kids to say "no" to themselves, and you'll help her to do that until she's able to do it for herself.

Try not to feel guilty about "depriving" your kids of the junk they can't have. All parents have challenges with their kids, and this is yours. It's your job to keep her safe. She'll understand your reasons as she gets older.

Don't hesitate to tell everyone at your child's school, and playdates, about her safety issues. Don't worry about "rocking the boat". Use your child's pediatrician as a backup if the school doesn't take your child's safety seriously.

Use this experience as an example of how the whole family can effectively deal with one of life's challenges. This is only one of many that will be faced by you and your child, and you have the opportunity of making it a learning experience for everyone!


Dr. Heather The BabyShrink

Child Development: Does Your Child Have Food Allergies?

Having a child with food allergies is tough -- first, there are the obvious safety issues involved. You don't want your child to accidentally -- or intentionally -- eat something that may make him sick, or even kill him. Then there are the practical challenges; finding acceptable, palatable food substitutes for the things he can't eat. I know many families who have to spend tons of time (and money) planning and making separate meals for their allergic kids, and strategizing about "dangerous" situations like birthday parties and school lunch rooms. But it doesn't stop there. The doctors and nutritionists who diagnose the allergies, and prescribe the necessary diets, unfortunately don't often have the time to get into the psychological aspects of food allergies -- and leave the parents wondering how to handle this very tricky aspect of the allergy.

The behavioral and emotional effects of the allergy and related diets include the resentment caused in the child by not being able to eat foods his friends CAN eat. The feelings of deprivation and being "different". The parents' worry that these food issues will lead to eating disorders in adolescence. All of these problems are very real challenges of raising a child with a food allergy.

I recently got a phone call from a friend who's daughter has multiple food allergies -- gluten, casein (dairy protein), tree nuts -- the works. They've been able to reasonably control her food intake up until recently; she's now an active, busy second-grader who is starting to get resentful that the other kids can get all kinds of foods that are forbidden to her. My friend was mortified to tell me that they discovered a stack of 30 or more string-cheese wrappers stuffed under the couch recently. And a rash that preceded the cheese-eating was diagnosed by the doctor as "psychological". Poor little thing is itching herself raw, and hoarding and "sneaking" disallowed foods.

I've got some ideas about how to handle these issues, and I've had to do the gluten and casein-free diet in our home for awhile when we were ruling out food allergies with our daughter. But I know there are a LOT of you out there struggling directly with these challenges in your home. I'm hoping some of you will post your comments to my friend here, giving us some tips for what works -- and what doesn't -- in your home. I'll collect your responses and include them with some of my own in my next post.


Dr. Heather The BabyShrink

Toddler Behavior: Dealing With Toddlers and Picky Eating Habits

Hi Dr. Heather: I eat a variety of healthy foods, heavy on the veggies, with a variety of ethnic cuisines, most of which I cook myself. On the other hand, my daughter more or less eats the same things every day.

It's called experimentation, Mom!

Every resource says the same thing: keep offering it to your child. My question is: how do I do that without wasting large amounts of food? Also, how do I offer it to her at all, when she will eat the foods she likes and leave the foods she doesn't?

Please tell me my kid will grow out of this! I feel stumped when other moms chime in with something encouraging like, "Broccoli is my kid's favorite!" or "I can't pry the sushi from her hands!" I should note that 1) she ate it all just fine when we were in the baby food stage, and right at about 13-14 months she started refusing vegetables, and 2) she doesn't seem like a "picky" kid to me- she eats a wide variety of foods, pretty much anything except vegetables.

I'm sure I'm putting too much pressure on myself with this, but my husband is obese and struggling to lose weight, and I so want to avoid the same fate for her!

Patricia in Atlanta

Dear Patricia,

I know they tell us to keep offering a wide variety of foods to our toddlers and young kids. And we start to feel there’s something WRONG if they don’t eat a nicely rounded diet all the time. It’s another source of pressure and guilt for us, as parents. It had better be healthy! Organic! Wholesome! Etc, etc, etc.

But what they DON’T tell us is that our kids are BORN with very strong tendencies, in terms of eating preferences. I have one kid who’ll eat just about anything, and always has. I have another who is extremely choosy, and yet another who is somewhere in the middle.

You can’t make a kid eat something they don’t want to eat. And if you TRY, you risk setting up a power struggle that YOU CAN’T WIN. It’s normal for young babies (6 to 12 months or so) to happily eat whatever we put in front of them. After one year of age, however, their caloric needs DECREASE, and their desire to be independent INCREASES, as does their desire to get moving! Crawling, walking, running, talking; it all holds much more interest than sitting and eating vegetables. So it’s fairly common to see what you describe; a baby who eats everything, who turns into a toddler who is choosy, or who has inconsistent food preferences. (They often can get into “food fads”, too, where they demand certain things all the time.)

All you can do is go with the flow. Yes, offer her healthy options. Don’t push or insist that she eats her “healthy” food. Set it all out in front of her and then GET OUT OF THE WAY. She needs to make her own food selections, within the range of a variety of foods you set out for her. Your toddler needs to resist and be oppositional, as she works on establishing her independence. Don't let her struggle with you over food. Pick your battles; this one, you won't win. Over time, your daughter will learn to love a wide variety of foods. (But she might not show it until she leaves for college!)

Now, does that mean you give in and offer a Happy Meal morning, noon and night? No. Just try to add something healthy to her plate, and leave it alone.

Let her see you enjoying your healthy, interesting variety of foods. And don’t let her associate pressure or stress with that image.

In our house, our 2-year-old is attempting a coup to establish him as Food Dictator. It's a struggle on a daily basis. His preferences change daily, too. Here's what we do: Put the healthy stuff in front of him while we prepare the rest of the meal. That way, while he's really hungry, he's more likely to try the good stuff. Then we offer him a choice or two, and that’s that. I do try to include something I know he’ll eat, whether it’s pasta, or PB and J, or some cheese. He also does like fruit, so I offer lots of that. If he doesn’t want the options, he can eat at he next mealtime. He whines and complains, but I only have the energy to do a certain amount! What’s interesting is that he often craves the food on OTHER PEOPLE’S PLATES; especially Daddy’s, right now. And he will tackle veggies and other things he flatly refuses when put on HIS plate. So we engage in a little trick-the-baby-psychology, and allow him to eat off his Daddy’s plate, after he’s done with his own. We get a little extra nutrition into him that way. We’ll set firmer limits with him on that as he gets closer to 3, because by then we'll want him to see that he's got to stick to HIS plate. But for now, it’s not so bad for Daddy to share some of his dinner with our cute little guy.

Now, I’m not a physician or a nutritionist, so you’d better check with your pediatrician just to make sure things are OK with your daughter's nutrition. You can also read more about the issue in Dr. Brazelton’s books; I love how he deals with the issue.

Good luck, and let us know how it goes!


Dr. Heather The BabyShrink

PS Want to read more about annoying toddler tendencies? Check out my Toddler Page for more.