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Wednesday 31 March 2010

ಹಿಂದಿನ ಕಂತೆಗಳು- ಇಂದು ತೆರೆದಾಗ...೧೦

Eating Habits in Children

The behavior associated with feeding is not simple as it is thought to be. It takes more than “milk and bread” to satisfy the impulses and needs associated with the feeding process. Many so called “Behavior problems” in children are feeding problems. During early childhood, between 21 months and six years, children show varying degrees of food finickiness. This is fewer in the age range of seven to fourteen years. “Finickiness” denotes an active aversion for many or several specific articles of food. It is a problem considerably more often than insufficient appetite for food in general. This tendency sometimes grows with them as they grow and enter adolescence.

Under nourishment is a problem of early years of childhood and middle childhood, whereas Anorexia Nervosa and Bulimia Nervosa are eating disorders usually seen in teenagers; especially in young American women. This eating disorder of adolescent girls is more of psychological problem. Both of these are mainly because of this society’s attitude towards obesity and perceived glorification of “thinness” and “beauty”. This forces the young woman to “starve” and under nourish herself to be thin and look beautiful. But in reality this would lead to ill health and may even to death.

Obesity, on the other hand, is an eating disorder which can cause more severe health problems later in life. Obesity of children in the age group of seven to twelve years has a direct link to the obesity in their adulthood. Though American society equates “thinness” with “beauty”, 39% of American adolescents are in the category of obesity. These obese children, either in middle childhood or in adolescent are likely to suffer physically and psychologically because of the tendency of this society towards obesity. These individuals who are obese are more vulnerable to physical injuries due to the overweight and “gravity-shift”. The psychological damage is when the peer group rejects them or teases them. They become the targets of their own peer group’s bullying. this ‘hits’ very hard on a teenager’s emotional aspects.

A poor eater may manifest him/herself as early as twelve weeks. Some children are constitutionally poor feeders by usual cultural standards. They may also be underweight. But if their muscular tone is good, motor activity, motor coordination and intelligence are superior, there is nothing to worry about. They are often good sleepers too. Some children who are very sensitive to slightest change, may refuse to take milk from a bottle if the nipple is different. Preferences for certain food become fairly well by one year of age. For a toddler (between 12 months and 24 months) feeding himself is of main interest rather than how well he eats. But most of the time “mealtimes” deteriorate into power struggles between parent and child, resulting in tensions and feeding problems. Parents can avoid it by giving the child a feeling of mastery by helping him/her learn to feed him/herself. Some of these steps would help both in the process.

a) Parents have to consider the experience of “self feeding” and eating from the child’s perspective, since it is big-deal for the toddler.

b) Let the child dedicate the pace at which the transition from “parent feeding” to “self feeding” happen. If the child returns to parent in the middle of his self feeding meal, oblige him. If he grabs the spoon when parent is feeding him let him have his way.

c) Allow more time for each meal than expected, plan ahead, and be prepared for the mess. While a child is eating, he is not just eating, he is learning to feed himself. If parents rush through the mealtime, it will take away the enjoyment of feeding in the long run.

d) Parents shouldn’t make “food” and “love” synonymous. They shouldn’t ply an upset child with candy/snacks. Such parents have trouble with finicky eaters and want to use force or bribery to get them to clean their plates.

e) Not getting overly worried about nutrition by offering nutritious choices. Toddlers like to choose their food for themselves. By letting them select from a range of foods all of which are nutritious, both the parties will be satisfied.

f) Parents have to avoid viewing feeding as something very sacred and valuable, not wasting a bit neither played around. Feeding should be joyous experience and child learns the skill of feeding through “trial and error” and “hit and miss” policies.

g) Mealtime shouldn’t mean “hard to pass” time neither to parent nor to child. It should not be covered by any other activity, since feeding herself is challenging enough for the toddler.

h) Most of all. parents being models for their toddlers is what impresses the young minds very much.

Sometimes the food may be refused by the toddler because he may not be hungry at all or she may be too busy exploring the environment or even may simply be tired and needs rest. When the child doesn’t eat, it is important not to punish the child. On the other hand, the behavior of the child can be managed and turns around to positive thinking about eating, through activities. The activities like pretend games of shopping for vegetables, cooking food, serving etc would help in this regard. This way child will learn to readily accept most, if not all, foods. Children imitate adults, in some cases other siblings’ and parents’ eating behavior may have stronger influence on the child’s habits. Placing a “picky eater” at the table next to a child who has learned to enjoy all foods often helps encourage the picky child to try a variety of foods. Presentation of new foods first, when the child is really hungry might encourage the child to become acquainted with the new food.

The children in the age group of two to six are more frequently named as “finicky” or “fussy eater” than any other time. By two years child can name certain foods that she wants. Her affection is shown towards food too. It is best to allow these children to have “food jags” or “fads”- having “typical food” several days without any change. New foods are to be introduced slowly under new and pleasant situations. They don’t need and relish a great variety of foods. Even a good eater may turn to be picky by two years of age, which is typical at this age. They are very emotional. They are also moving towards independence which causes them to be bossy and demanding. They need to assert their will and they use food as a way to be more autonomous. Saying “NO” is a way of asserting their autonomy. And because food is such an important part of life, many children become tyrants at the table making an issue out of what they will and will not eat, how much and when. It is not hard to do, as most parents are vulnerable when it comes to food and very easy to manipulate.

So a preschooler prefers desserts and sweets, meat, fruits and milk on top of the list. They accept vegetables very slowly especially greens. Preschooler likes foods that requires more chewing (like raw vegetables, potato skin, meat on bone, etc). By the age of four or five, they learn more tricks to manipulate parents. Vomiting may be used as threat or as an act to dominate the environment. They enjoy having control over something and may even resolve to go on hunger strike to boss parents. However if the parent stays calm, and in control, refuses to engage in a food struggle with the child, and takes responsibility for what, when, and where the child eats to some extent, the situation turns around easily. Parents provide the menu, regularly scheduled meals and snacks, (structure is very important to children which makes them feel comfortable) children are to take the responsibility for whether they and how much. As long as parents provides healthy food in a pleasant setting on a regular basis their job is done. Dictating how much or which type of food the child actually eat will backfire and doesn’t really yield any result. When parents enforce and maintain this “division of responsibility”- children learn to be responsible for their own eating habits and eventually enjoy food.

Toddlers and preschoolers may be eating less, simply because their growth rate has slowed down and doesn’t require as many calories to sustain them, Toddlers can not be expected to eat three square meals everyday. Healthy children who are developing normally regulate their own eating habits unconsciously, so over a period of about a week or so their diet is fairly balanced. One of the most significant physical changes that toddlers and preschoolers experience is that they grow differently during these years than they did during previous years, They get taller more quickly than they gain weight. That is why most of the preschoolers look lean and thin. They begin to loose their body fat (commonly known as baby fat). A child who is energetic and good muscle tone, bright eyes, glossy hair and an ability to spring back quickly from fatigue is unlikely to be suffering from inadequate nutrition, no matter how traumatic their mealtimes are.

As a child grows older in middle childhood (ages six through twelve) the average body weight doubles and child’s play demands great expenditure of energy for which they need plenty of food. These years children usually eat a greater amount of food and eat it fast. Rarely a child might revise the timing of his large meal of the day. A school goer may take very little breakfast but eat heartily at supper time, this way they maintain the calorie intake per day.

Malnourishment becomes very obvious and takes its toll over the growing body in the middle childhood years more than the previous years. Malnourished children are shorter than well-fed ones. It takes some energy and protein just to stay alive and more energy and protein to grow. When a child doesn’t take enough food to sustain life and promote growth, latter is sacrificed to maintain the body. Good nutrition is also essential for normal mental, physical and social activities. Some studies in African countries showed a direct but complex link between the protein supplements in infancy and social interaction in middle childhood years. Those children who as infants had not received protein supplements tended to be passive or dependent on adults and more anxious in their middle childhood. Those who have received protein supplements were happier, livelier and got along better with other children. This finding supports the conclusion that poor nutrition leads to less activity. One study found that a child’s diet from birth to age two is good predictor of social behavior from age six to eight. The way this happens is very complex but it is a fact.

As children grow to be adolescents, the growth spurt of this developmental stage entails an eating spurt. Boys need more calories than girls do in these years due to the physical growth changes and the kind of activities. Protein is important in sustaining growth and teenagers like anyone else should avoid “junk foods”. Adolescents are prone to mineral deficiencies. Calcium, Zinc, and Iron are very important. Calcium deficiency in girls may cause serious problems later in life such as Osteoporosis in post menopausal age. Anemia due to Iron deficiency is common among American adolescents. Even a mild Zinc deficiency can delay sexual maturity.

Obesity is becoming one of the major problems of the younger generation. According to a recent study children develop a dislike of obesity between the ages of six and nine. This is largely because American society equates thinness with beauty. But it is astonishing that there are more fat children in the U.S. than ever before. Because of social attitudes these children are likely to suffer psychologically as well as physically. Hence most kids develop a typical attitude towards what they eat. Preoccupation with weight is becoming increasingly common among young children. They often refuse a favorite food in a fear of getting fat. More than 15% of adolescents are affected by this eating disorder in the U.S. alone. Obese teenagers tend to become obese adults, subject to a variety of health risks. It is a matter for serious concern, therefore, that obesity has been on the rise among adolescents. Between 1963 and 1980 there was a 39% increase in obesity and a 64% increase in super obesity among adolescents. This is caused by using the food for consoling oneself at the time of depression or indulging in too much of junk foods and sweets which give empty calories, sugars, and fats.

On the other face of the coin, are two eating disorders seen in young adulthood and early adulthood, especially in girls and women. These disorders are characterized by abnormal behavior which apparently arise from a determination not to become obese. They are Anorexia Nervosa and Bulimia Nervosa. This is grossly due to the unrealistic glorification of slenderness in particular. This cultural factor interacts with families and personal factors to make many adolescent girls and young women obsessed with their weight. By the end of high school more than half have dieted seriously, some never stop and some adopt bizarre eating habits.

Anorexia Nervosa is an eating disorder seen mostly in young women characterized by self starvation. This tendency might be seen in people of both sexes from the age of eight to thirties, or even older. But the typical patient is a bright, well behaved, appealing white female between puberty and early twenties. The symptoms include stopping of menstruation, thick-soft hair spreading over the body, patient becomes intensely overactive and may eventually die. This is a psychological problem. Anorexics are pre-occupied with food– cooking it, talking about it and urging others to eat, but they hardly eat themselves. They tend to be good students and model children but are often socially withdrawn, depressed and obsessive perfectionists. The cause is unknown, though it is considered as a reaction to extreme societal pressure to be “slender”. It is also seen as a psychological disturbance related to fear of growing up, fear of sexuality or extreme family malfunction. They are likely to suffer from depression and anxiety.

Bulimia Nervosa is the other eating disorder that is very closely related to Anorexia Nervosa. This also affects mostly adolescent girls and young women. Bulimic regularly (at least twice a week) goes on huge eating binges (consuming up to 5000 K.calories in a single sitting often in secret) and then purges herself by self induced vomiting, strict dieting of fasting, vigorous exercise or use of laxatives. There is some overlap between Anorexia Nervosa and Bulimia Nervosa, but both are separate. This is a depressive disorder and it stems from an electrophysiological disturbance in the brain. Psychoanalytic explanation is that the bulimics use food to satisfy a hunger for love and attention they did not receive from their parents. Bulimics report they felt abused neglected and deprived of nurturing from their parents.

The treatment for Anorexia Nervosa and Bulimia Nervosa includes getting them to eat, to gain weight and to live. Medication is used to inhibit vomiting and in extreme cases hospitalization and intravenous feeding are called for. Psycho-therapies are given to gain insight into feelings underlying their disorders through counseling, cognitive therapy, group therapy. Even family psychotherapy or some combination of all these are used to treat. Sometimes antidepressant drugs are also used in the hospitals during treatment.

Eating habit is a behavioral, physiological, and psychological problem, that might start as early as three months of age and might go on through out the life. In general the feeding problem may be of two natures: (1) Physiological Factor- i.e. specific allergies for certain food groups (like milk and diary products) or digestive weakness or even prolonged sickness. (2) Psychological Factor. The feeding problem may indicate variety of concerns in a child’s life. Food and process of eating have many psychological meanings. Food is a symbol of intimacy and sharing. Sometimes it is used to satisfy cravings that reign deeper than mere physical hunger. Under-eating and over-eating, both are symptoms of anxiety. Feeding difficulties may be an expression of anger (taking revenge on parents or siblings by refusing to eat) or fear (dreads the thought of going to school, so the child has no appetite for breakfast). Refusing the food may also be a means by which a child asserts himself or calls attention to his needs. One study has showed that food finickiness in boys may be linked with their “Dependence – Independence Struggle”.

In the early years of childhood and in middle childhood parents or caregivers are more active participants in the process of establishing a healthy eating habit in the child, than in the adolescent years. In early and middle childhood years, the children show these distinct behaviors to establish their sense of self, independence to reinforce their presence and importance. This attitude is to assert the emotional needs that is very important for their healthy development. Parents with a few tricks and good tactics like- adding undetectable vegetables to kids approved foods; allowing kids to pick vegetables from the garden, if possible; allowing them top participate in cooking; serving raw vegetable with dip as snacks and salads; juicing the vegetables and may be combining with fruit juices etc. These are only a few ideas. Parents can be creative in this area.

Parents by sticking to their responsibility of only providing their children good nutritional meals and not dictating how much the kid is going to eat, can get better results. Children like to have some responsibilities and independence, so let them have it and let them decide how much they want, when and what, as long as their demands are reasonable and nutritional. Occasionally rewarding and not bribing is a good idea. It should not be too obvious that the child loosed the joy of having food and eats his meal only to get the praise or reward. Deserts and sweets when become parts of the meal are more healthy for both parents and child. Encouraging the child to have good eating habit through our actions and having lot of patience is what counts in the long run. Once the children learn the habit of good eating, they rarely encounter other problems like obesity and Anorexia Nervosa, Bulimia Nervosa. Good eating habit, established in the early and middle childhood is the best foundation for building a healthy, happy and fulfilling life in the years to come.

Bibliography

Books

  1. “Child Psychology” by Arthur T Jersild (1968).
  2. “Infant and Child- in the culture of today” by Arnold Gessel (1974).
  3. “Child’s world- Infancy through Adolescence” by Papalia Diane E.
  4. “Food Nutrition and the Young Child” by Jeannette Brakhane Endres (1985).
  5. “Food makes the difference” by Patricia Kane (1985).

Magazines

  1. Parents’ Magazine:

A) Nov. 1992, B) April 1993, C) May 1993, D) Jan 1994

2. The UC Berkley Wellness Letter: Jan 1994.

3. Journal of the American Dietetic Association: June 1990.


(Class assignment, EWRT-1A, De Anza College, Oct 2002)

5 comments:

ಸಾಗರದಾಚೆಯ ಇಂಚರ said...

Collective information\

nice article

ಸಾಗರಿ.. said...

thanks to a good informative article. I am a mother of 1 year old kid. and It helped me a lot to understand some of their eating urges.

ಸುಪ್ತದೀಪ್ತಿ suptadeepti said...

Yes, Dr Gurumurthy; this is an article with collected information presented as an essay. Thanks for your observation.

You are welcome saagari, on both aspects- for your visit to my blog and for your comments here. Take care of yourself and enjoy this time of your parenthood. It is best and beautiful.

Anonymous said...

One little comment. I do apologize that I haven't read it fully, however, the length of the article could be a detrimental factor for the busy readers. In my view, a)target the reader community, b) condense the vast variety of information available either in books or elsewhere, and crystallize them to yield an article whose length is not more than 2 pages (max). This would definitely attract more readers, and enhance the breviety. -D.M.Sagar

ಸುಪ್ತದೀಪ್ತಿ suptadeepti said...

Sagar,
Thanks for expressing your views.

(a) I don't write here with a target reader in mind. Who reads my blog is important to me. And I don't want to limit my writings to please only those. People who don't have time to read a lengthy article just because it is long will be missing something, I'm sure.

(b) This was written in 2002, as a class assignment. I did not edit it before publishing here; no intentions to do so to attract more readers.