1. Healthy Feeding for a Healthy Weight

2. WIC’s job is to help families and children get a healthy start on a healthy weight. Emphasize healthy growth, not healthy weight

3. Levels of Intervention with Feeding Primary Education, early problem-solving Secondary Detailed evaluation and treatment Tertiary Detailed evaluation and treatment of complex problems with other specialists (i.e. MD, therapist, etc.)

4. WIC Primary Intervention: Education and early problem-solving Support a healthy feeding relationship. Teach stage-related feeding. Explain normal growth. Encourage age-appropriate active play. Promote other healthy behaviors.

5. What is healthy growth? ?

6. Children are excellent regulators and tend to grow in accordance with their genetics.

7. Children Tend To Grow Predictably Weight for age 0-24mLength for age 0-24m

8. It’s not a perfect system… it can get off track.

9. Growth divergence may or may not be normal.

10. Slow growth divergence over time is likely to be normal. Weight for age 2–20 years

11. Rapid growth divergence may be normal. Weight for length 0–18 months

12. Rapid growth divergence may not be normal. Weight for age 0-36 months

13. Asking the Right Questions How is feeding going with your child? How do you feel about the meals and snacks that your child usually eats? Is there anything about mealtime that you would like to be different? How do you feel about your child’s size and shape? How do feel about her growth pattern? Do you, or anyone else, have any concerns or questions about how your child is growing?

14. Interfering with feeding may lead to weight gain and/or other feeding problems.

15. What is interfering? ?

16. Division of Responsibility Adults are responsible for what is presented, when and where it is presented. Children are responsible for whether to eat and how much to eat.

17. Division of Responsibility Crossing the division of responsibility can lead to problems. Restricting food scares children and makes them overeat when they can. Pressuring children to eat makes them less interested in those foods.

18. Division of Responsibility Research reveals: Caregivers understand and accept the adult’s role in feeding. Caregivers have more trouble with the child’s role in feeding. Adults need reassurance to trust a child’s ability to self-regulate.

19. Division of Responsibility Research reveals: Children will eat. They know how much to eat. They will grow predictably. They will eat a variety of foods. Their eating skills mature with age.

20. Division of Responsibility Parents who can utilize primary intervention are able to: Self-evaluate. Accept the child’s point of view. Set aside agendas. Incorporate advice.

21. What is a healthy eater?

22. A Healthy Eater Eats from internal cues. Enjoys a variety of foods. Experiments with new food. Maintains a healthy weight.

23. Ages and Stages of Raising a Healthy Eater

24. AgeParent JobChild Abilities Infants Birth–9 months – Attend to cues – Offer appropriate food – Feed child – Child centered routine – Knows hunger/ fullness Toddlers 9–24 months – Routines for eating – Variety and experience – Utensils & physical structure – Opportunities for mastery – Knows hunger/ fullness – Self-feeding begins – Limited verbal communication Early childhood 2–5 years – Routines for eating – Variety and experience – Utensils – Opportunities for mastery – Eating with child – Knows hunger/ fullness – Self-feed – Self-serve – Conversation

25. The Newborn Bonding with baby for a lifetime of healthy eating

27. The Newborn Establish feeding relationship. Feed based on baby’s cues. Accept baby’s growth patterns. Trust different feeding patterns.

28. The Toddler Making the transition to solid foods

30. The Toddler Establish a regular routine. Choose “safe” foods. Offer different foods to enjoy. Let child decide how much or how little to eat.

31. The Preschooler Accept drive to “do it myself”

33. The Preschooler Eat together as a family. Offer a variety of foods. Avoid pressure to eat. Allow child to “experiment” with food and eating.

34. Talking to Parents About Growth and Feeding

35. What Parents Want To have happy, smart kids To be seen as experts on the subject of their own kids To be seen as acting in their kids’ best interest To make parenting as easy as possible

36. It’s Not What You Say…As Much As How You Say It Instead of … You have to quit feeding him so much! Your child has to get more exercise now! Your child is getting severely overweight. Parent is on the defensive – with no choices. What about … What fruits and veggies does your family enjoy? How often do you get to play at the park? How do you feel about how your child is growing? Parent is able to express his/her concerns.

37. Suggest the Right Amount of Change Consider the barriers and the benefits to change. Trust the client to determine how much change they think they can do. Be ready to accept no change since this may open a door for future change.

38. Roles and Responsibilities Your job is to provide information and support positive choices. The client’s job is to decide whether to change and how much change to make.

39. Healthy Children Come In All Sizes