How much is enough for my child?

Posted 18 September 2017

Ana-Kristina Skrapac, Paediatric Dietitian

Many of the parents that I see in clinic have concerns regarding how much their children are eating, either too much or not enough.

The most common question I get asked by parents is how best to manage their child’s appetite and address concerns of weight gain. Let’s take a look at a real-life scenario: Sally who struggles with feeling hungry all the time.

 

“I have a 6-year-old daughter Sally and she is slightly overweight for her age. She has always enjoyed her food. I find it difficult to distract her from wanting food and snacks, she always says she is hungry, even if she has just eaten. How do I best manage this without putting her on a diet? “

 

Managing children’s appetites can be a real challenge for many parents. Recognising a child’s hunger versus their desire to eat can be difficult and balancing this as a parent in a sensitive way is important to get right from a young age. The following tips may be useful to help guide you in how to respond to your child, and how to coach them towards finding the right balance.

As a first step, it is important to check the growth of your child. This can easily be done with a health visitor, GP or school nurse. Comparing a recent height and weight measure to that of your child’s growth since birth (it’s helpful to refer to your child’s red health book that they have from birth) can highlight if there is a problem, or reassure if they are continuing to grow proportionally. If your child’s weight plots higher on the graph than their previous trend and higher than their height, this may highlight that what they are eating is more than what they need.

Using portion sizes of foods can be a great visual way to check whether your child is eating close to the recommended amount for their age, or if they are exceeding it. With young children, I tend to explain what they need to make their tummy feel comfortably full using approximate portions that fit in their hand. Getting children to place their hand on their tummy to notice if it is grumbling as a sign of hunger is a practical way of helping them to understand the natural cues for hunger and fullness.

If your child is overweight for their age (their weight is plotting on a higher centile than their height), it is important acknowledge this as a parent, and tailor meals and snacks so that they are closer to the recommended portion for their age. Making changes as a family helps to ensure your child is not singled out. As health professionals, we do not advise dieting or weight loss for young children, unless medically directed. Generally, by making adjustments with a family approach, the rate of weight gain may be slowed as your child grows taller.

  • Keep portions to about the size of their hand (portion sizes increase with age)
  • Offer 1 portion of starchy carbohydrates at each meal for sustained energy throughout the day (slice of bread, small bowl of cereal flakes, ½ cup of rice or pasta)
  • Include ½ portion of protein rich foods with lunch and dinner (roughly the size of their hand for meat, chicken, fish or ½ cup of beans, pulses, tofu as vegetarian alternatives)
  • Always include vegetables with lunch and dinner, roughly two handfuls of different coloured veg (carrot & cucumber sticks, baby tomatoes, peas & corn, or 2 -3 broccoli & cauliflower florets)
  • Offer 2 – 3 dairy portions over the day, this could be 150ml milk, a small tub of yoghurt (120-150g), a matchbox size of cheese or 1 cheese string
  • Encouraging fresh or dried or canned fruits from a young age helps to build healthy appetites – fruits make great snacks.

If your child, like Sally, says she feels hungry all the time, then it is best to respond with a behavioural distraction following the meal. You might respond by saying ‘we have just eaten Sally, and if we feel our tummy, it’s quiet and no longer making noises, our tummies are nicely full…let’s go and see if we can find your favourite toy..’

Acknowledging that Sally has just eaten, helps to link her own awareness to her own body cues, and following this with an activity can help shift Sally’s attention away from food Responding in a similar manner each time can help your child learn new cues and gradually normalise their desire to eat.

Feel confident that your child has just eaten and remind them that the next meal or snack is only a couple of hours away.

Avoid getting into ‘battle’ with your child. Children of a younger age respond better to stories or games and are more motivated to eat their greens if they think their favourite cartoon character eats them too. Children are also much more likely to eat certain foods if they see others eat them too, so make sure you eat with your child as much as possible.

Keeping to regular mealtimes really helps children to adjust to normal hunger and fullness patterns. If children graze throughout the day they will be less aware of when they are truly hungry.

Finally, encouraging active play is really important throughout the day. Active play helps children learn coordination, body awareness and confidence.

 

For more info please watch Making Sense of Sugar’s video to give you some ideas on how to make sure you child enjoys a balanced diet throughout the day. Then why not try our quiz and test your knowledge on portion size. BNF’s blog on portion size is also helpful when considering your child’s diet.