“My almost 5 year old is a selective eater. She suffers with constipation, and all the doctors we’ve seen say we need to “fix” her diet. She doesn’t drink a lot of water, she prefers juice and milk. I’ve been following the DOR for over a year and notice my daughter is much more relaxed around food. My ex is insisting we follow the advice of the pediatric nutritionist who recommends pressuring our daughter to eat more variety. I feel stuck, because if I don’t go along with the advice to pressure my daughter to eat, I fear my ex will use my unwillingness to follow ‘doctor’s orders’ against me.”
Mom has been following the Division of Responsibility (DOR) for over a year. Mealtimes are predictable and structured with no grazing allowed in between. Mom decides what to serve for dinner, a favourite meal is served 1-2 times a week and there is always a safe food on the table. If Daughter chooses to fill up on milk, bread and/or fruit, Mom lets her daughter eat until she is full. Mom also offers a small treat with dinner.
Daughter likes to help in the kitchen, and will sample some of the food she is preparing, sometimes to the point of not being hungry for the meal. Despite these achievements, Mom is concerned that Daughter continues to drop foods from her diet and since the divorce, her mealtime behaviour is degrading.
A recent visit to a pediatric nutritionist seemed hopeful at first. Claiming to be well versed in the DOR, the nutritionist pulled out a folder full of documents authored by Ellyn Satter. The advice that followed, however, bore little resemblance to the DOR feeding model.
Nutritionist observation #1: Daughter has too much control.
Meals are to be pre-plated, serving small portions of everything from the meal and Daughter is required to taste everything. No seconds of preferred food until non-preferred has been tasted. Limit milk at dinner so she doesn’t just fill up on it. Dessert is to be used as a reward for tasting the foods on her plate instead of being served with dinner.
Nutritionist observation #2: Daughter needs to be pushed to branch out, she needs to “do her part.”
Daughter cannot be allowed to fill up on bread or fruit or milk at dinner and she cannot refuse to touch the other foods on the table. Daughter needs to get involved in planning all meals, choosing a protein, starch, veg/fruit. If she won’t choose, Mom will choose for her. Mom is to keep a food diary and a sticker chart to reward Daughter for tasting new foods and then Daughter will be asked to rate the food. Desserts are to be limited to 2-3 times a week and only offered if Daughter complies with the tasting.
Why This Isn’t the Division of Responsibility
Following the Division of Responsibility, it is Mom’s responsibility is to decide what food is served for meals, and when and where they are eaten. This predictability and structure help children feel secure in knowing there are regular opportunities for eating that include enjoyable food. Daughter’s job is to choose how much to eat from what is offered. Mom should not encourage, reward, bribe or force Daughter to eat certain foods in certain amounts and Daughter should not be planning the menu.
Dessert is not a reward, nor should it be used to encourage eating less preferred foods. With selective eating, a palatable treat often helps a child anxious about food to relax and connects them with their appetite, much like not realizing how hungry you are until you start eating. Stress kills appetite.
Daughter is already doing her part. The first signs of success with the DOR is a child who is more comfortable around food and well behaved at meals. Children need to be confident that every meal will provide enough rewarding food to eat, because the food preferences of children are driven by what tastes good, not by what’s good for them. Once children trust that they will be satisfyingly fed, they will then, and only then, consider branching out around their safe foods and very slowly into novel foods. This isn’t something that happens on any set schedule. Using pressuring tactics to speed the process up only slows it down, or stops it completely.
Finally, shared custody arrangements can sometimes be confusing for a young child. It’s worth considering the impact of any tension Daughter may be perceiving in the relationship between parents. Children communicate with behaviour and often after the fact. The recent undesirable behaviour at mealtimes may have more to do with feeling safe at Mom’s table, and less about what’s on it.
Mom Really Does Know Best
Daughter expressed her concerns to Mom about changing the rules around meals. Dad had pressured Daughter to eat an entire piece of chicken, and when she didn’t, she was denied dessert. Daughter went to bed hungry. The following evening, Mom and Daughter prepared pasta, chicken and salad together. Daughter sampled some cucumber and green peppers and remarked how sweet they taste. Mom offered a taste of pasta sauce, which daughter enjoyed. She then added some to her pasta and ate the entire bowl. She didn’t want to try the chicken and she still had dessert. Daughter hugged Mom after dinner, saying “Please don’t change the rules, Mom, I like dinners the way you do it better.”
Does following the division of responsibility mean you have to starve children to make them eat?
Building Trust With The Food Adverse
Brilliant Bites: Feeding With Freedom
I was sooo hoping for a solution offered at the end. What a tough situation. What about married parents who differ in daily application or extent to which they are willing to apply DOR?
I wish this story had an ending, and an amicable one at that. Hopefully a solution is forthcoming.
As for married parents, it’s tricky when spouses aren’t on the same page – and very confusing for the child. Sounds like a very open and honest discussion about what is best for the child is overdue.
Sometimes they are on the same page, but the devil is in the details. Both parents may say “Okay we’ll try this” but one might ‘get it’ a bit better. So even while they will both agree on the principles, pressure can sneak in in very subtle ways, as you know. Nobody wants to debate those details AT the dinner table and then they get forgotten. If a child doesn’t have feeding issues, it is easy to let things slide. I can only imagine how frustrating it would be if there were feeding problems to begin with.
As a mom who has had to deal with a child’s chronic constipation: that alone can kill appetite! It might be useful to consider treating that in another way instead of by forcing a “diet” that is supposed to help. And, yes, it’s certainly a struggle when parents differ on the approach used (divorce or not) – I hope it becomes more obvious to all involved that the child is learning to become a more competent eater when DOR is used. My heart goes out to this family…
I know… there are cultural differences at play here, but there you are… 😀
What surprises me is that nobody picks on the, for me, obvious flaw… the girl drinks milk (or “juice”) with her meals instead of water. This means that the girl does eat… she eats milk; we mustn’t forget that milk is a food, NOT a drink (the fact that it can be drunk is beside the point). Just look at the nutritional values and you will see that if you drink close to 1l a day of milk there will be very little left for any other kind of food, not to mention the protein excess that you end up ingesting on a daily basis.
Obviously the problem lies most likely with the parents, who don’t drink water themselves, so they don’t set any kind of example. Personally I don’t know anyone in Italy who drinks milk (or juice for that matters) with their food and I would not dream of doing it, but cultural differences aside, why you never seem to hear from people in the US that perhaps this is a habit that should be actively discouraged? Comparing milk to water is demeaning for the milk and the poor cows that live a not very happy life to provide us with plenty of the stuff 😀 Is milk such a taboo that you may not say anything even remotely against it?
Just to be clear, juice is ALMOST as bad.
All that aside, I would look for another nutritionist 😀
I believe the recommendation for milk consumption on this side of the pond is 2 cups a day (500mls). Daughter does eat – just a limited variety of food. Cultural differences that guide food choices are very interesting. Isn’t milk quite expensive in Europe?
Another nutritionist would be the easy answer, but that’s not in Mom’s hands to decide. Divorce does odd things to the balance of power between parents and unfortunately, sometimes the child ends up becoming a pawn on the chessboard.
Well, I live in the UK now and here milk is virtually free (about 1.5$ for 4 pints). In Italy it costs about twice as much if not a bit more.
If I am not mistaken the AAP says that 1l a day is acceptable, while in the EU they limit it to 500 ml a day. That aside, I find that the idea that milk is a drink to be fundamentally wrong, not the milk itself (which I have daily for breakfast) because you forget that you are actually eating something. It would be interesting to work out how many calories (and animal proteins) the girl eats, counting the ones she gets from milk.
I think the nutritionist is going to fail her DOR 101 exam… big time 😀
Well said, as usual! Great read!