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Nutrition Note: How Much Protein for Kids

Nutrition Note: How Much Protein for Kids

by Katja Rowell, MD | Nutrition Notes

Protein seems to be a common nutrition concern in pediatric feeding. Parents commonly worry that their child doesn’t get enough. Most parents greatly overestimate how much protein a child needs. One mother offered a perfect example. After a workshop, she...

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When we lower anxiety and help children to feel sa When we lower anxiety and help children to feel safe, secure, and not under pressure at mealtimes, we often start to notice improvements in what looks solely like sensory processing challenges. When children’s accepted foods are served with the meal, when children are not prompted or pressured to eat any other family foods served, and when children are reassured that they can eat as much or as little as they like, children’s anxiety often reduces, sometimes quickly and dramatically. (This doesn't mean they will suddenly devour everything in sight, but is a necessary first stage towards a better relationship with food.) At this point, parents have shared examples with me such as: “He doesn’t seem so bothered by the smell when I’m cooking meat anymore.” “She couldn’t sit still before – but her need to get up and down from the table seems to be reducing.” “Gagging at mealtimes is almost non-existent now – we haven’t noticed it for a while.” This reduced anxiety and increased comfort at mealtimes paves the way for the child’s confidence (RFT value of competence) and curiosity (RFT value of intrinsic motivation) with eating to grow. More on mealtime anxiety and sensory processing in child feeding in our recent blog post, contributed by Dr. Hazel Wolstenholme --->link in the bio 👆🏽 RFPro 🧡
“When people in positions of responsibility or a “When people in positions of responsibility or authority - for example, parents and teachers - support the autonomy of those with whom they interact, the latter individuals tend to display enhanced autonomy, intrinsic motivation, and self-regard. Overcontrol, conversely, is typically associated with diminished motivation and self-esteem.” How does this principle translate into mealtimes? (Even, and especially if there are feeding challenges present?) Kids who feel independent and autonomous at mealtimes tend to feel better about themselves and are more likely to want to explore and learn. They are able to be open to curiosity without distractions. Kids who feel the pressure from controlling feeding approaches are more likely to take a "passive" stance at mealtimes, rarely taking the initiative to try new foods, and have lower confidence as eaters. Would you like to know how to apply this concept to your work with families? Register for our new series of webinars coming out in a couple of weeks - link in the bio. 👆🏽 We will dive deep into the new research and practical applications of responsive feeding principles in everyday work with families. Research article: Cicchetti, D. (2016) Ed. Developmental Psychopathology: Theory and Method, Wiley, p.811 RFPro 🧡
Don't miss this practical discussion with Virginia Don't miss this practical discussion with Virginia tomorrow about how we can talk about growth and weight and bodies while minimizing harm. Words like "overweight" or "failure to thrive" can shame and prove unhelpful. (And are they clinically meaningful?). What words can feeding professionals use instead? Virginia's Comfort Food Podcast and Burnt Toast newsletter looks at many of the complexities around food and bodies and offer often reassuring wisdom in a world that struggles to relate well with food. Virginia Sole-Smith is a journalist, author and mother. As the parent of two girls, one with a history of medical challenges and feeding struggles, and one a more typical eater, she has become an unwitting expert in child feeding and body image, from dropping NG tubes to packing school lunch. Sole-Smith's 2016 article for the New York Times Magazine, When Your Baby Won't Eat, shares her family's journey with complex eating challenges and explores deep philosophical divides in the feeding therapy world. This experience, along with her personal evolution and curiosity led to the critically acclaimed book, The Eating Instinct: Food Culture, Body Image and Guilt in America. Check them both out! Hope to see you there! Drop any questions in advance that you might have in the comments below. #selectiveeating #pickyeating #intuitiveeating #responsivefeeding #responsivefeedingtherapy #extremepickyeating #haes
In this literature review of parental feeding prac In this literature review of parental feeding practices in relation to food insecurity, Arlinghaus and Laska highlight the importance of context. To work with families living with food insecurity, we need to try to understand what this means for them and their child. ✅Responsive Feeding Therapy is concerned with seeing the whole child, including their cultural milieu and social power structures which may affect them. ✅It is an individualized approach, so interventions are child and family specific. ✅To miss the relevance of food insecurity to feeding work is to risk shaming families and failing to truly understand the dynamics at play. Katja Rowell and Jo Cormack will be addressing these issues (and more) in the final webinar of our six part foundational series (All of Me: considering the whole child in Responsive Feeding Therapy). Link to sign up--->https://responsivefeedingpro.com/series-1/ Arlinghaus, K. R., & Laska, M. N. (2021). Parent Feeding Practices in the Context of Food Insecurity. International journal of environmental research and public health, 18(2), 366.
Are low carb/sugar and keto diets safe for childre Are low carb/sugar and keto diets safe for children? Considering the scarcity of research into their long-term safety, the answer is probably no. Keto diets can be especially dangerous, as they are low in fiber and can: increase constipation; lead to nausea, irritability, and fatigue. Research suggests that keto diets in children can lead to dehydration, kidney stones, impaired growth, high blood lipids, low blood sugar, and vitamin and mineral deficiencies. Despite its popularity, the whole concept of carbohydrates as "empty" calories is deeply flawed. ✅ Children need 45-65% of all their calories to come from carbohydrates ✅ Glucose is the primary preferred fuel for our brains ✅ Restricting carbs and sweets can make children more focused on them ✅ Even "refined" carbohydrates can be perfectly nutritious ✅ We can use accepted/preferred carbs to create felt safety at mealtimes and help children gradually expand to other options. Read full post on our blog - link in the bio 👆🏽 RFPro 🧡
Autonomy pertains to agency and respect for person Autonomy pertains to agency and respect for personal space and bodily integrity, enabling a person to be in control of their own actions* How might this look in session, or coaching parents about how it might look at mealtimes at home? A child may “comply” and lick a cracker in therapy, but not at home. Some children will do what is asked of them, even as their autonomy is undermined. There are ways a child “says no” without using a word. Observe the child: ✅ Are they looking away, squirming more, leaning back, making faces, chatting less, shaking their head, expressing relief when the task is over. ✅ Are they visibly upset and dysregulated? Big body movements, rocking, stimming for regulation, crying, pushing you away, gagging, vomiting? Are they breathing rapidly, flushed or pale, quiet or “zoned out”? Reinforcing a child’s right to bodily autonomy is one of the earliest ways they learn about consent that translates into other areas of their lives. Can they say no safely? Will their "no" be heard and respected? *from the White Paper on RFT, for more on autonomy what we do and believe, link in bio RFPro 🧡
Jennifer Berry OT/L joins Katja for an IG Live dis Jennifer Berry OT/L joins Katja for an IG Live discussing motor learning and skill development and intrinsic motivation. They will briefly explore external vs internal motivation and some applicable research. They will also touch on non-eating activities and how they relate to learning and skills around eating. Jennifer Berry OT is an RFPro team member and will present in our foundational series next month (with Heidi Moreland SLP) on the values of competence and intrinsic motivation. With over 20 years of experience working with the full range of feeding and eating challenges, you won't want to miss Jennifer's insights. Jennifer is a founder of the Thrive with Spectrum Tube Weaning program, a co-author of the white paper on RFT, podcast co-creator at Tube to Table, and is actively collecting data for research and publication. RFPro
It's only 3 weeks away and we couldn't be more exc It's only 3 weeks away and we couldn't be more excited to open our virtual doors to child feeding professionals from all over the world joining us for our brand new webinar series. A few facts about the event: ✅ The series consists of 6 x 90-minute webinars that can be watched live or as recordings (you will have access for a year) ✅ At the moment, we have registrants from 5 continents! ✅ Our series is approved for 9 CEUs for RDs and SLPs and we are waiting for approval for OTs ✅ The contents of the webinars will be a mix of up-to-date research, theory, and practical recommendations to help you integrate the Responsive Feeding approach in your work. ✅ The information and strategies shared will benefit all child feeding professionals, so make sure to send us a request for our group rate if you work in a multidisciplinary or group practice setting. ✅ The registration will be closed 48 hours before the event, so don't wait till the last moment! "RFT has given me a whole new context to the way that I am working; when I reflect back on the changes in my approach I can see how much I have evolved as a practitioner. The support I am able to offer families and the positive changes they achieve around feeding continues to develop and grow. This not only benefits the families themselves but brings me a huge amount of satisfaction in the work that I do." - Lucy Neary RD. Link to register in the bio 👆🏽 RFPro 🧡
Are "counseling" skills necessary when it comes to Are "counseling" skills necessary when it comes to working with families experiencing feeding and eating difficulties? We say YES! Most of us are far more comfortable with the "informational" side and don't always know what to do with the big emotions that come up around feeding and eating challenges (for parents or children). ✅It's essential to address parents' feelings of say, anxiety, frustration, fear, shame... and their response to the child's eating and the general mealtime 'climate.' ✅Parents who do not feel heard, or have their deepest worries addressed, are less likely to be able to make positive and sustainable changes that ultimately help children do their best with eating. ✅Parents who are stuck in big feelings and with dysregulated nervous systems are less able to take in the "informational" piece. This slide comes from one of our upcoming foundational series webinars, where we focus on the relationship between the clinician and the family. Concrete steps focused on co-regulation will be shared. Registration is open for three more weeks with student, group, and equity discounts. We want everyone who wants to be there to be able to attend. Registration closes a few days before the event starts on November 1st. Reserve your spot by clicking the link in the bio! 👆🏽 RFPro 🧡
🧡Let’s chat about competence at mealtimes. 🧡Let’s chat about competence at mealtimes. Children (and parents) need to feel competent in order to be successful at mealtimes. We use the term ‘competence’ in two ways: first, to refer to the individual’s perceived (as opposed to objectively assessed) sense of being capable of managing in a situation. Secondly, competence is also about the skills involved in eating. What we believe: ✅ A positive relationship with food and the skills to eat are attainable goals for most children, even those with severe challenges. ✅ The acquisition and development of skills, including feeding and other motor skills, is a process of discovery optimally experienced through meaningful activities in a natural context. ✅ Children gain skills in a safe and meaningful environment, to the best of their abilities (including those with developmental and/or motor disabilities). ✅ Even children who have never eaten by mouth may not need skill interventions (including non-nutritive chewing or oral-motor exercise). Interventions should consider the child’s capabilities and development and mirror typical development when possible. ✅ Progress is not simply measured in bites taken or number of accepted foods. ✅ Early progress such as comfort, decreased anxiety, and curiosity builds a foundation that leads to increased variety. ✅ Nutritional wellbeing is a long term outcome of responsive feeding relationships and a positive relationship with food. Find out how we help children gain competence, as responsive feeding professionals, in the White Paper -
"My child is addicted to chocolate." "They'll neve "My child is addicted to chocolate." "They'll never stop if I don't limit sweets/candy." "My children are obsessed with sugar." Do you hear these and similar statements from the parents you work with? Caregivers (and feeding specialists) are flooded with headlines about the dangers of sugar, and that children are "addicted." And with Halloween around the corner, the anti-sugar posts will get more frequent and even scarier! How can we approach these sensitive topics? Is food addiction real? Can sugar cravings be caused by nutritional imbalances? And why we are more likely to use the word "cravings" in the western world? Join us for a discussion at 4 pm EST today (Oct 5th) where we will dig into these questions and more. (We hope this time will be more friendly for our followers in AU and NZ.) RFPro 🧡
Skye and Rachel join the RFPro team as lived exper Skye and Rachel join the RFPro team as lived experience advisors. 🎉 🧡 Rachel Dorsey @rdorseyslp is an autistic SLP. During her childhood and adolescence, Rachel experienced undiagnosed Avoidant/Restrictive Food Intake Disorder (ARFID). Rachel shares how her own experiences shaped her person-centered and affirming approach as an SLP working with communication building and speech, and with feeding and eating challenges. 🧡 Skye Van Zetten is the mother of now teenaged twins. She started a blog called Mealtime Hostage several years ago to capture the isolating experience of feeding a child diagnosed with food phobia. She is admin for a private group on Facebook (also called Mealtime Hostage) providing support and hope for thousands of parents worldwide. She also helped with a Parenting Science project that resulted in a published, peer-reviewed article on picky/avoidant eating. Check out Skye's blog on misophonia - link in the bio 👆🏽 We value all our team members' behind-the-scenes support and look forward to future content from Rachel and Skye! RFPro 🧡
" I am so happy my child finally ate French fries! " I am so happy my child finally ate French fries!" - "Wait, aren't French fries bad for her?" 🎯 Individualised care is at the core of RFT. It refers to personalized interventions with a focus on the whole person, in the context of their families, communities and cultures. What does this mean for the notion of ‘healthy’? Well, when we are looking at the whole child, we can’t make blanket judgments about the inherent value of a certain food. 🍕 If a child in a food-insecure household eats the same meal six days in a row because dad bulk-bought frozen pizza to last the week, that child is fed. 💊 If a child can only manage with crackers and apple sauce for now but - helped by supplements - meets their nutritional and caloric needs, are those crackers ‘unhealthy’? Does this mean that we think nutrition and a varied diet aren't important? No. This is a misinterpretation of what RFT is about. The critical point though, is that RFT practitioners believe the path to helping children access a broader and more nutritious diet (in the context of avoidant eating) is to begin by accepting where they are, focusing on their experiences with eating times and with food, rather than on how many bites of vegetables we can get them to swallow. Source: white paper - link in the bio 👆🏽 RFPro
🧡Katja Rowell, one of our co-founders, provides 🧡Katja Rowell, one of our co-founders, provides a sneak peek into her presentation from Responsive Feeding: the foundational series. ⁣ ⁣ Watch the video in the carousel 👆🏽to find out how high levels of anxiety and conflict impact the parent-child relationship beyond mealtimes. ⁣ ⁣ And if you are considering attending the series, make sure to use the code RFTEARLY! to get 10% OFF before 11.59pm on September 30th. ⁣ ⁣ Link in the bio 👆🏽⁣ ⁣ RFPro
If you are considering joining us for our new webi If you are considering joining us for our new webinar series Responsive Feeding Therapy: the foundational series, use the early bird discount with the code RFTEARLY! to get 10% OFF before September 30th. We are expecting 9CEUs for SLPs, OTs and RDs and you get access to recordings if you miss the live lectures. "RFT has given me a whole new context to the way that I am working; when I reflect back on the changes in my approach I can see how much I have evolved as a practitioner. The support I am able to offer families and the positive changes they achieve around feeding continues to develop and grow. This not only benefits the families themselves but brings me a huge amount of satisfaction in the work that I do." - Lucy Neary RD Register using the link in the bio 👆🏽 RFPro 🧡
Join us today at 12 pm EST for an IG live with SLP Join us today at 12 pm EST for an IG live with SLP Christan Hancock @heart_soul_speech as we explore how FASD shows up in feeding work. Christian is “passionate about empowering families to create communication and connection” and has developed a special interest in FASD. September is fetal alcohol spectrum disorders awareness month. Did you know that FASD is more common than autism? Did you know that FASD impacts growth, coordination of suck, interoception, impulsivity and more? If you work with children with feeding and growth challenges, you see children impacted by FASD, though diagnosis is especially difficult. This brief (aiming for 20-30 min) discussion will be an introduction to a complex topic where we begin to consider how RFT, with a focus on felt-safety and connection, can help children with FASD.
It is sadly ironic that the guidance designed to i It is sadly ironic that the guidance designed to improve nutritional outcomes for children, may actually make them worse! Black and Aboud (2011) summed this up in this influential paper in which they made important links between responsivity in parenting and in feeding. They highlight the vital role of context: not only is the feeding environment key, so is the role played by children’s eating behaviors. We know that feeding is bidirectional, so how children eat affects how parents feed, and vice versa. These are the kind of nuances that are missed by nutritional recommendations focusing only on food. Nutrition is important, but feeding children is about so much more than the macro and micro nutrient content of the food on the table. RFPro 🧡 Black, M. M., & Aboud, F. E. (2011). Responsive feeding is embedded in a theoretical framework of responsive parenting. The Journal of nutrition, 141(3), 490-494.
The Early Bird rate for "Responsive Feeding Therap The Early Bird rate for "Responsive Feeding Therapy: the foundational series" expires at 11.59 PM EST on October 18th, 2021 and we are thrilled to see that some of you put it to good use! If you haven't yet, make sure to enter RFTEARLY! at checkout. We hope to see many of you at this online event, every Monday and Wednesday between November 1st and 17th, 2021. A brief outline of the series: 🎵 Monday, November 1st: Peace, Love, and Understanding: Responsive Feeding Therapy the origins, the journey and the future. Presented by Jo Cormack MA (Counselling) MBACP (Reg.), a counselor and PhD candidate. ♩ Wednesday, November 3rd: I Did it My Way: child autonomy in Responsive Feeding Therapy. Presented by Jo Cormack MA MBACP, a counselor and PhD candidate. 🎼 Monday, November 8th: What’s Love Got to Do With It: relatedness in Responsive Feeding Therapy. Presented by Katja RowellMD, a feeding relation specialist. 🎶 Wednesday, November 10th: I Believe I Can Fly: skills and confidence in Responsive Feeding Therapy. Presented by Heidi Moreland MS, CCC-SLP, BCS-S, CLC and Jennifer Berry MS, OT/L. ♬ Monday, November 15th: “I'll tell you what I want, what I really, really want...” : intrinsic motivation in Responsive Feeding Therapy. Presented by Heidi Moreland MS, CCC-SLP, BCS-S, CLC and Jennifer Berry MS, OT/L ♬ Wednesday, November 17th: All of Me : considering the whole child in Responsive Feeding Therapy. Presented by Katja Rowell MD and Jo Cormack MA MBACP. We are applying for 9 CEUs for OTs and SLPs and CRD and expect reciprocity for OT and SLP for UK and AU. Check the details and register by clicking the link in the bio! RFPro 🧡
🤔 Do we really need to "get" kids to interact w 🤔 Do we really need to "get" kids to interact with food? We believe that when children are intrinsically motivated, they are capable of more! 🎉 Intrinsic motivation describes a desire to act that is self-driven rather than brought about by external forces. 🧡 What we believe: ✅ Children do well with eating when they can ✅ Humans eat for many reasons including fuelling their bodies, comfort, pleasure, novelty, and enjoying culture and community ✅ Positive mealtimes, however limited the diet, are central to improving the child’s relationship with food ✅ Almost all children have an innate capacity to regulate energy intake, which continues into adulthood if nurtured (including those with avoidant/restrictive food intake disorder (ARFID), autism spectrum disorders (ASD), medically complex situations, and children fed by a feeding tube) ✅ Eating may not be a pleasurable experience for everyone, but mealtimes can become neutral or positive, nurturing social interactions ✅ A focus on skill development beyond the child’s pace and stage can result in dysregulation and hinder progress ✅ A child’s anxiety is a barrier to intrinsic motivation, internal cues of hunger, a sense of relatedness, and feeling safe ✅ Parental anxiety, misperceptions, and misinformation often contribute to maladaptive feeding, which thwarts the child's ability to recognize and respond to intrinsic drives ✅ Strategies that rely on external motivation, such as rewards, persuasion, or inducing fear of negative health consequences, may ‘work’ in the short term, but can override the child’s ability to listen to their body, limiting long-term, sustainable change ✅ Long-term, sustainable change is underpinned by intrinsic motivation and internal drives including hunger, the seeking of pleasure and new experiences, curiosity, and a striving for competence ➡️ What we do as responsive feeding professionals to support children’s intrinsic motivation - in the white paper - link in the bio What are your thoughts on intrinsic motivation? Do you find it hard to trust children to be self-driven? RFPro 🧡
🧡 It's finally here - and we couldn't be more e 🧡 It's finally here - and we couldn't be more excited. We are opening the registration to a series of webinars - "Responsive Feeding Therapy: the foundational series," delivered globally (via an online conferencing platform) every Monday and Wednesday, between November 1st and November 17th, 2021. This series is a labor of love from a team of multidisciplinary practitioners with a combined 50+ years in the child feeding arena, including an occupational therapist, speech therapist, MD relational feeding specialist, and counselor/PhD candidate. ✅ You will discover how the RFT values of autonomy, relationship, competence, intrinsic motivation, and whole child care can enhance your practice. ✅ The foundational series includes 9 hours of content, all delivered online. ✅ The sessions will feature research (including some yet unpublished) video, and related educational and clinically relevant handouts you can use right away, plus 20-30 minutes of live Q and A per webinar. 💪🏾 We are applying for 9 CEUs for OTs, SLPs, RDs and expect probable reciprocity for OTs and SLPs for UK and AU. The cost of the $315 ($35/hour) for 9 CEUs/certificate of attendance Early Bird discount: 10% off at $285 through 11.59 PM EST on September 30, 2021 Interest-free payment plan (4 x monthly payments) available . We also offer group rates, student rates, and an equity access rate. We truly believe that responsive feeding therapy tools and insights can bring a tremendous amount of value to your practice and we cannot wait to show you how to integrate them. To read more and register - click the link in the bio 👆🏽 RFPro 🧡
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