Transcription:
Managing Picky Eaters

Scott Webb: We all want our kids to eat healthy, but sometimes we just need them to eat, right? And since almost every family has at least one picky eater, those dinnertime battles can be legendary. And joining me today to help us with our picky eaters and tell us about the WakeMed Children's Pediatric Weight Management Program is Dr. Samerah Hill. She's a pediatric weight management specialist with WakeMed Children's.

This is WakeMed Voices, a podcast from WakeMed Health and Hospitals in Raleigh, North Carolina. I'm Scott Webb. Dr. Hill, it's so great to have you on. As we were discussing before we got rolling here, I have a couple of kids that are older. One was a Picky eater, one wasn't. One today, the 13-year-old, she'll eat sushi, so she's very adventurous that way. So, doctor, what do you consider a picky eater?

Dr. Samerah Hill: Picky eating is actually kind of normal for all kids. You know, all children are kind of skeptical of unfamiliar foods and they take time to learn to enjoy things. But it really becomes more of a problem when the child is really not having enough variety of foods in their diet because they are so picky. They're not having enough fruits and veggies and protein sources to have that, you know, amount of balance in their diet. And there are some, they call these extreme picky eaters. Those are the ones we worry most about and they eat less than like 30 foods. They don't ever want to try new foods. And it's just once they stop eating something, it's really hard to bring it back. And those parents find those kids the most challenging.

Scott Webb: Yeah, I'm sure they do. And of course, as parents, we want our kids to eat. And so sometimes we're fighting the good fight. I'm getting them to sort of expand their horizons a little bit and try some different things, you know, go beyond the 30 foods. But when is it really a problem? You mentioned, you know, the extreme picky eaters. But for us parents, you know, how many days can we go with putting chicken nuggets on the table before it really is a problem?

Dr. Samerah Hill: I'm not sure how long that would take for a kid to just permanently decide this is the way it's going. But I think if we avoid that whole situation, we kind of push kids and families and parents to really think about food as it's not good or bad, it's just food. You know, it's just fuel and it's not really up to the kids to decide if this is healthy or not. That's really the parent's job. It's the parent's job to do, you know, "Is this healthy? Am I going to provide it? How much am I putting on the plate?" Those kinds of things. But the kid's job is really just to say, "Am I going to eat this right now? And how much of it am I going to eat?"

So it goes back to the responsibility of the parents to kind of offer the kids variety, but also have that variety on their own plate. And kids really just look at their parents as models. And if the parents are eating and enjoying them and always kind of having an opportunity to see it on their plate, having those opportunities for the child to have the chance to taste it, then they're more likely to try it. So if it's always a part of your family meal, it's always on the plate, then it gives the child their opportunity to pick and choose from what they have made available at the meal.

So we never try to like pressure the kid to force them to eat it. But also at the same time, if a kid wants something else, we recommend the parents really tell the child, "This is what we have, but you can pick out of what we have, you know, what to eat." But once you start making second meals and they learn real quick that they can get another meal and it's typically, you know, nothing nutritious. It's usually like cereal or, you know, like something you can pop in the microwave, which is usually not as good as a home cooked meal, more balanced. Once you get into that habit, then the kids know that there's that opportunity. So it's easier if we don't even get to that point, I think, you know, from the beginning.

Scott Webb: Yeah, I think you're so right. Easier if we just sort of set the precedent from the start that we're just not going to do that. There's not going to be second meals. And I just remember like we were all kids once, right? So I can remember drawing the line in the sand as a kid and just refusing to eat. "I'm not eating this. And I will sit at this table 'til morning if I have to. You cannot make me eat this," right? So you mentioned, you touched on like not forcing our kids, but in that battle, you know, that battle of wills with our kids, at what point do the parents have to just say, you know, "Okay, then. Fine. Go to bed. Go to bed hungry," or "I will make you a second meal this time, but just this time." But of course, as you pointed out here, we get into that precedent and kids learn and they know how to push our buttons and they know how to play us. So where do we draw the line in the sand with our kids?

Dr. Samerah Hill: You know, it's extremely challenging and I'm a parent of three and those kids, they're constantly pushing your buttons and they're constantly asking and they wait for those weak moments, you know, when you're distracted. So if you get into that pattern of, "This is what the family is eating. You can eat what you want, but this is it. This is all we have," and you stay firm on that, after a while they get, "Okay, mom and dad are the boss," you know? And that's hard. That's hard for parents to do. But I don't know if you remembered what your parents did, but that's probably what they did. They probably said, "Go to bed hungry."

Scott Webb: Yeah. That's exactly what they said. And at some point, my mom, she turned the light off in the kitchen and I'd be sitting there in the dark.

Dr. Samerah Hill: Yeah. And I think those battles are really hard, but if we have the kids involved in some of that meal planning early on, we usually recommend like give them food that you know they'll eat. But if you're trying to get them to eat something new, put like a little bit of it next to the foods they already like. And don't say anything, just like step back and everyone's just eating it. And they could say, "Oh, I don't want this." You can say, you know, "Take a few bites." But don't make it like, "Okay, if you don't eat this, you'll never get dessert," because then it makes dessert the good stuff and the, you know, whatever it is they're picky about the bad stuff.

So this is just food, you know, but if you keep doing it the next day, a little bit on their plate, you know, the next day put something a little different, because kids' taste buds change, especially like around three to five. You'll see that like one week they love something. Next week, they hate it. You know, it's like, "How come you liked eggs yesterday but not today?" Their body's just trying to figure things out, try new things. So, you know, it's on the parent to just keep trying new things, keep bringing it back. Don't make it a big power struggle, but just, you know, have it on the plate. And they'll eventually get curious. You know, "What is mom and dad eating?" You know, but as soon as you pressure them or you bribe them or you say, "You can't get this until you get to dessert," then they know, you know, this must not be good.

Scott Webb: Yeah, absolutely. And I wanted to ask you about that, because I am sure I know the answer, and I can remember doing this that, "Okay, if you eat this, then we can go and get whatever treat that they liked," you know, it was the hot treat at the moment, right? But I'm guessing that that's not a great practice for parents to bribe their kids into eating something that we know is healthy for them, right?

Dr. Samerah Hill: Right. Right. I think it's how we put value on different foods. You know, this is good or this is bad. And then the kids really quickly learn. There is a dietician called Ellyn Satter who says totally take away the value on food. That food is really just fuel. And sometimes she recommends maybe even putting the dessert with the meal, not a lot of it, but a little bit, maybe like three M&Ms along with all the other food, just to be like, "Okay," you know. And they will typically eat a little bit of everything. But once you start putting value on the food, then it gets harder. And the kids, they'll test you, they'll watch your reaction. And as long as you're like, "Okay. This is just food, it's not a big deal. You know, I'm eating my salad. Don't make a big deal about it," They follow your lead. But I think role modeling that is really important too, because a lot of the times the parents don't really want to eat a variety of food either, you know, so...

Scott Webb: Yeah, I think that that falls under maybe that "Do as I say, not as I do," right?

Dr. Samerah Hill: Right.

Scott Webb: It's hard for us to stand tall against our kids when we're the ones eating pizza and cheeseburgers, and like, "No, you need to eat your veggies. You need to eat your salad." "Really, Mom and dad? Really?" I do love the idea though about including the kids in meal planning. We do that with our daughter, she's 13 and she's got some great ideas because she's on TikTok or whatever. And so she's like, "Oh, you know, I saw this great recipe idea the other day on TikTok." And we could have a different conversation whether she should be on TikTok. But for now, let's limit it to she's had some great ideas and we've included her in the meal planning process and it's worked out pretty well.

Dr. Samerah Hill: I love that idea. We have a garden in our backyard, especially in the summer. And the kids have started to like eating like green beans because it's just the nature. You just pull it off the plant. And normally they would never eat green beans. There's something about touching a food, looking at it, smelling it because by the time they see it on the plate, it's changed form for what it looked like originally, you know? So when they see it in the grocery store and you go with them and, you know, you can have them pick out fruits and veggies that they like, different meats they want to try. And when they're older, you know, over 10, they could probably safely help you in the kitchen. If they cook it, they're more likely to try it. So that's another great strategy. You know, if your daughter's picking out something she can help cook, I'm sure she'll be more likely to eat it.

Scott Webb: Definitely. And before we wrap up here, I wanted to ask you about how can WakeMeds Children's Pediatric Weight Management help parents and children?

Dr. Samerah Hill: Our program, we see children who struggle with obesity and they're usually referred from their pediatrician or from self-referrals from parents. And our whole program is really to help the whole family get healthy together to prevent health problems that come from extra weight. And one of the key elements of that is we have a wonderful multidisciplinary team, which includes physicians like myself, but we also have wonderful dieticians and behavior specialists. And most of what they do is exactly what we're talking about is how to help families bring in new foods into the table and how to time meals and how to support parenting, because, you know, the kids used to certain habits for awhile, how to reverse that. You know, if they're used to getting a second meal, how to empower the parent to offer them one healthy meal, you know? And so a lot of it is just relearning those things. Sometimes the parents aren't comfortable cooking and we do offer a free cooking class as well as part of our program because we're trying to just give them the tools they need to succeed. And they really enjoy that cooking class and be much more comfortable with knives and, you know, just eating more fruits and vegetables because they're being exposed to them. So I think, you know, any family who needs that kind of help and who's also struggling with a child with obesity, you know, we're definitely here to help them.

Scott Webb: Yeah, you definitely are. And this has just been a great conversation. What an awesome program you have there, you know, multidisciplinary, comprehensive and fun and, you know, helping them learn how to cook and be a part of the process. I mean, one of my big takeaways today is going to be just thinking of food as fuel. Don't put such a high price on it. Don't make such a big deal out of it. You just kind of make what you make and you put some things on the plate and hopefully the parents are also eating those things and you hope the kids come on board and, you know, the age old battle between parents and children, you know, over dinnertime and what they're going to eat and how long they're willing to sit there. You know, good strategies you offer today about how to overcome that, when to introduce foods, how to introduce them, how to involve them in the process. This is all really great. Dr. Hill, thanks so much for your time.

Dr. Samerah Hill: Absolutely. It's a pleasure.

Scott Webb: That's Dr. Samerah hill. And to learn more about WakeMed Pediatric Weight Management Services, please visit wakemed.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. This is WakeMed Voices, a podcast brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. Thanks for listening.