How to Create a Pressure-Free Feeding Environment with Jessica Setnick, MS, RD, CEDRD-S

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Jessica Setnick (1m 28s):

For every bad experience with food, it takes many good experiences to outweigh it. So we may not be able to make a child's eating better, but we can definitely make it worse.

Katie Ferraro (1m 38s):

Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven specializing in baby-led weaning. Here on the baby-led weaning with Katie Ferraro podcast. I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using baby-led weaning. Are you possibly pressuring your baby to eat without even realizing it? If mealtimes feel tense or you find yourself stressing that your baby isn't getting enough from solid foods, your baby can sense that and it can be negatively impacting their interactions and experiences around learning how to eat.

Katie Ferraro (2m 22s):

I know that I, for one, am guilty of one of the biggest mealtime pressures of all excessive cheerleading. I'm always praising babies for eating the food I want them to do or doing something that I want them to do at mealtimes. And all of this mealtime pressure takes its toll, especially on our earliest eaters who are babies. Just tried to figure out what to do with solid foods. My guest today is going to put us on a pressure free pathway. Her name is Jessica Nik and she's one of the most well known Dietitians that I hope you or your children never have to visit because Jessica specializes in eating disorders. Now you might be like, wait a minute, why is an eating disorder Dietitians on a baby led weaning podcast? Well, Jessica has seen quite a number of things during her last three decades of eating disorder practice and she has lots of thoughts on the behaviors that might initially seem harmless, but that can actually lead to pressure and disordered eating.

Katie Ferraro (3m 13s):

So Jessica is going to be teaching us how to make mealtimes calm and un-clustered all without perfection and she'll be sharing what words to say instead of all of that pointless praise without bribing and without saying the word no, which is very hard for me. So I learn a lot when I listen to Jessica. We are gonna learn how to separate food from feelings and stop accidental guilt, which if you've been a parent for a minute or two, who doesn't need that? So we recorded this interview a while back, but Jessica's advice is so sage, so timeless, it holds up and I wanna make sure that you are getting these pressure free messages too so that you don't make the same mistakes at mealtimes that so many new anxious parents end up doing.

Katie Ferraro (3m 53s):

They oftentimes end up making things a lot worse than they had to be by ramping the pressure way up. So Jessica is going to show us how to dial it back because she knows probably more than anyone that your baby's relationship with food matters more than any single bite. Okay. So with no further ado, I am pleased to introduce you to the eating disorder Dietitians extraordinaire and my very good friend Jessica Setnick from Understanding Nutrition.

Jessica Setnick (4m 21s):

I'm here.

Katie Ferraro (4m 22s):

Alright. I've known you in a personal and professional manner for probably about 15 years and I know you as an eating disorder dietitian, you teach eating disorder bootcamp, but I always think of you in the eating disorder space, but I know that you got your start working with children and pediatrics in feeding disorders. Yes. So I was wondering if you could just maybe tell us a little bit about your professional history and how you got to where you are today.

Jessica Setnick (4m 45s):

Absolutely. So my first job out of school was at Children's Hospital here in Dallas. They were just starting an eating disorder program and I was the first dietitian to be hired specifically for that program. And as it grew and developed, we all learned a lot about the different things that can go wrong with kids eating and eventually opened up a feeding disorders program for kids under six years old. So pretty much in every way, I would say the beginning of my career was about everything that can go wrong with kids eating because the other part of my job at the children's hospital was working in the endocrine clinic. So it was really quite an education and I've been able to carry that into my private practice and then into now my speaking career because just aren't a lot of pediatric specialists Dietitians who specialize in eating disorders, it's like two specialties layered on top of each other.

Jessica Setnick (5m 36s):

So we do have about 800 of us around the country, but it's still a pretty small percentage of all the Dietitians out there. And it's really what I love

Katie Ferraro (5m 45s):

And I think that's a fabulous combination of skills, Jessica, because I know so many parents, especially new parents, are worried about all the things that can go wrong. It's helpful to hear about them to some extent, but I know that you'll be able to leave us with some tangible ideas on things we can do to prevent some of these issues and help create a pressure-free feeding environment.

Jessica Setnick (6m 4s):

Oh, absolutely. Yeah. And I feel like knowing the things that can go wrong doesn't mean you can prevent all of them, but it certainly helps to identify where things can go wrong and what the critical points are and what we can do instead.

Katie Ferraro (6m 16s):

Now I know you have a background in eating disorders and feeding disorders and I, we were looking at a lot of your work kind of getting ready for this episode and one thing that jumped out at me was your use of the term universal precautions. And I was curious if you could explain your universal precautions approach and are there any takeaway ideas from this concept for parents who are just starting out on solid foods with their babies?

Jessica Setnick (6m 39s):

Absolutely. Because the basic foundation of the universal precautions is that we don't know who has the potential for an eating disturbance. So we treat all kids as if they have potential for problems because they do, they could develop a problem. And so the universal precaution says let's do everything we can to prevent a problem in advance. Now the universal precautions were originally designed for dietitians, but the two key steps that parents can implement right from day zero are taking morality out of foods and separating eating from feeling.

Katie Ferraro (7m 8s):

So How do we take morality out of foods? Oh my gosh, that's a really interesting phrase.

Jessica Setnick (7m 12s):

Yeah. So the idea behind that is to look at food as fuel, look at food as molecules, however you have to do it so that you are not calling foods or labeling food good and bad for you. And it's really hard to do because the truth is our bodies know what to do with food. It, I mean if you wanna think about it as a miracle I do, or if you wanna think about it as just amazing, the fact that you can put carrots and corn flakes in your mouth and somehow your body knows how to make hair and energy and nostrils or whatever out of it, it's really amazing. And even when I talk to kids about nutrition, we really talk about it on that level. It's, it's that basic and you don't have to get involved into, you know, what are the ingredients of food.

Jessica Setnick (7m 56s):

It's just the idea that food can turn into your body is really amazing or energy and our body knows how to do that the same way our body knows how to turn oxygen into whatever oxygen becomes. And I, showing my ignorance of that aspect, I know a lot about nutrition, but that's all. So like the, like taking morality out of food just means saying that food is fuel for your body and it doesn't make you a good or bad person whether you eat or don't eat or how much you eat or which foods you prefer. Everyone's entitled to the preferences.

Katie Ferraro (8m 26s):

And I love that. It's funny 'cause we're both dietitians, we have a lot of Dietitians in the audience, Dietitians who are also new moms. And then sometimes we sometimes focus, especially the Dietitians too much on the nutrition parents, especially moms and the Dietitians moms are so worried about how many milligrams of iron the baby's getting and how many micrograms of this. Oh

Jessica Setnick (8m 43s):

Yeah. You can't, you can make yourself nuts.

Katie Ferraro (8m 45s):

Yeah and The babies, if you think about it, babies are just learning how to eat during the weaning period. It's completely asinine to expect that they would be able to meet all of their nutrition needs. Right. You know, you don't flip a switch at six months of age. So we try to, especially the ones who are prone to counting the calories and the grams and the micrograms back off of that and give your baby the opportunity. Yeah. To learn how to eat.

Jessica Setnick (9m 6s):

Yes. Well and the beauty of nutrition is that it's not a matter of if your baby doesn't eat, let's say a green vegetable all day today than tomorrow, they're gonna be deficient in something. Right. Our body has nutrient stores and we try to encourage new parents to think of nutrition as a two week cycle. So if your baby eats a green vegetable sometime in a two week period, they're getting the nutrients in that green vegetable. It's not a matter of trying to get one in it every meal or every day even because the body knows how to store nutrients for tomorrow.

Katie Ferraro (9m 37s):

And you'll often hear parents say, well I wanted to, I finished his meal with something I know he likes like a GLO of peanut butter if it's an older baby or a pouch because I just wanted to make sure he got enough. Yeah. We always try to remind parents that breast milk and or formula still providing the majority of your baby's nutrition needs during the weaning process. Yeah. Don't focus on how much your baby's eating. Give them the opportunity to learn how to eat. So in the vein of that, how to eat messaging, Jessica for parents and caregivers who are just starting out on solid foods, can you give us some tangible ways that we can set this stage towards creating this enigmatic peaceful eating environment that you always hear about?

Jessica Setnick (10m 12s):

Sure. And I'm not gonna pretend it's easy Katie, but it's the single most important thing that a new parent can do here it goes. Manage your own distress and concern. I know that's huge, right? But it is literally, I know you've

Katie Ferraro (10m 26s):

Been to my house at mealtime.

Jessica Setnick (10m 29s):

Yes I have.

Katie Ferraro (10m 29s):

And it is absolute chaos and it's like probably the least peaceful place on the planet, but you're like, this is such wonderful chaos. Listen to all the noise. I'm like, oh my god, this is not peaceful.

Jessica Setnick (10m 38s):

Yes, exactly. It's, and so peaceful is maybe not quite the right word, but Ellen Satter uses the word calm and uncluster. Think about us as adults, when is the last time you ate in a calm and unclustered environment?

Katie Ferraro (10m 51s):

Anytime I was away from my kids. Right.

Jessica Setnick (10m 53s):

But we're, we're not eating in the car or you know, whatever the case may be. So whether it is, you know, talking with a pediatric Dietitians to comfort you, go for it. If it's a Facebook group with other new parents, go for it. Or seeing a counselor. I'm not saying you should B word the rest of the time. What I'm saying is that managing your own anxiety and stress about your kids eating is actually good for your kids eating.

Katie Ferraro (11m 16s):

And we teach parents that that you know, babies really can recognize and they respond to stress, especially in the beginning when parents, babies are gagging and Oh yeah, parents, we teach them how to get over their fear of gagging. That's a natural and necessary part of learning how to eat. And if you freak out and you lunge at the baby and the baby hunches back and sucks air in and then causes a harmless gag to become a harmful choke, your reaction has actually made a natural situation harmful. So we do have to work on our own behaviors. Yeah, I love talking to you because I feel like you speak a different language than me. You always have like something that I would say you would say in such more eloquent fashion instead of peaceful eating. You said unclustered and what was the other word?

Jessica Setnick (11m 54s):

That's actually Ellen Satter's words. Calm and unclustered.

Katie Ferraro (11m 57s):

Calm and unclustered. Okay. So talk to us more about language because for specific language that parents can use, like for me I'm big on, I mean I don't wanna be, I'm a big yeller and I'm big on no like without even thinking no is outta my mouth and I always like, oh my gosh, I need to reframe that and speak positively, but it just doesn't come naturally to me. And for other parents who might raise their hand and be like, yeah, me too. How can we use language that's encouraging but without being overbearing or interfering when the babies are learning how to eat.

Jessica Setnick (12m 26s):

So to me it's the exact same language that you use when a baby's learning how to do anything else. But for some reason we seem to get much more stressed out about eating. Like when a child is learning how to crawl or something like that, you don't reach out every second and like wipe the drool off their face. But when a kid is eating, we reach out with a towel and wipe the food off their face every second. And so it's really about just thinking about the way you give your child within a safe space. You know that they're safe, you give them a little bit of room to experiment and experience. So what would you say when a baby's learning to crawl good for you? Good trying. You're so precious, your mama's little sweetie, right? Any of those things are appropriate to say they're cheerful.

Jessica Setnick (13m 8s):

And honestly we all know your child does not know what the words mean. You say yummy, yummy in your tummy and the child just sees smiling and happy tone. But that's the stuff that encourages a kid to keep going. And someday your child will understand the words you say. And so it's a good habit to get in now being positive because there's so much time that you have to say things like, aren't you going to eat more than one macaroni noodle? Or are you sure you're going to eat more macaroni? Like it's so easy to judge what someone else is eating. But we don't do that with crawling. We don't say, are you sure you're finished trying to roll over for the day? I think you should try rolling over one more time.

Jessica Setnick (13m 49s):

Right? We just, we let the kid find their way and that's really the same stuff we should be doing when they're learning to eat.

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Katie Ferraro (16m 10s):

One of my colleagues uses the same analogy as the voice you use when your baby meets a dog. Like for example, if you're scared about gagging instead of freaking out, you need to remain calm. So you said you don't need to be fake, but sometimes you do need to fake it. And she says, use the same voice that you use when your baby meets a dog. It's okay baby, it's just a dog. The dog's not gonna hurt you. And when the baby's gagging you can say, it's okay baby, it's just a gag, work through it. But we don't touch the baby, we don't lean into the baby, we don't interfere because the baby can work that out on their own. And so I think, yeah, like it goes back to your original recommendation, which is parents need to manage their own distress. And again, a lot of our parents that are coming into this situation, you know this working with eating disorders, that a lot of parents don't have an entirely healthful relationship with food and they don't want to see those feelings and behaviors reflected in their children.

Katie Ferraro (16m 57s):

So, but one of my other colleagues describes it kind of as your writing your family's food story, like your baby is basically a blank slate and you know, you don't need to project your issues and relationship with food onto your baby. Your baby will learn how to have a healthful relationship with food if you do create this pressure-free feeding environment. Would you agree?

Jessica Setnick (17m 15s):

I do. I think that we can't always make a baby's eating better, but we can definitely make it worse. And that's where I think we have the most impact is if you have inherited a mixed up relationship with food, then it's really important to meet with an eating disorder Dietitians, even if you don't consider yourself to have an eating disorder. But simply because our default pattern is to either recreate the trauma that we had in childhood with food or to go 180 degrees different, which is not always good either. And I can use an example from when I was raising my step kids and they were both extremely selective eaters. I met them when they were five and six. And the lie that we stepmothers can tell ourselves, maybe stepdads too is that if I was in the picture from the very beginning, these kids would eat everything, which is not true.

Jessica Setnick (18m 3s):

But again, it was a story I could tell myself, and this is not exactly about eating, but when I was a kid, I felt like I did not get to do anything on my own. I felt really micromanaged. So for example, if I were making something in a recipe, my mom would come along and recut it or re season it. She still does to this day, I've just learned to handle it differently. And so when Peyton, my little one was about six years old and we were baking something and she said, well how much of this should I make? Or how should I cut this? Or something like that. I said, however you do it will be fine. Thinking that that's what I wish someone would've told me. Well she said, I'm six, I've never made this before. I need some advice. And it made me realize that just doing things differently from the way they were done for us is not the answer either.

Jessica Setnick (18m 48s):

We really have to be careful that we aren't trying so hard not to be like our parents, that we end up being a different kind of crazy, and forgive me if I just called your parents crazy, but we have to remember that almost everyone alive right now is either the child or grandchild of someone who went through a traumatic food situation, if not you, yourself. So there were refugee situations, there was the Great Depression, there was World War ii, there was Vietnam. I mean there's all these different situations where people did not have enough to eat or didn't have eating on a regular time schedule. And those things influence us to this day. Another example is a patient I had who was very specific that he would only eat at nine o'clock, noon and six o'clock.

Jessica Setnick (19m 33s):

Those were meal times. And he had a serious eating disorder because he didn't actually only eat at those times. He also had a binging problem and he was binge eating it other times. But when we talked about it, he said, no, everything else is wrong except for nine noon and six. And I didn't really understand it and he didn't really have words to explain how that happened. And when I was speaking with his wife at one of our sessions, she said, oh, I know why he does that. It's because his father was disabled and there were a bunch of kids in the house. And the way the mother stayed organized and was able to keep everything shift shape was that she said, the meals are at nine noon and six, and if you're not there, you don't eat the end. And so that's how he was raised and it wasn't a bad way to be raised, it's just that he was so inflexible because it felt like somehow betraying the way he was raised.

Jessica Setnick (20m 21s):

And so that's what we're trying to avoid is we're trying to avoid passing on those same things that may have had a purpose at one time but are no longer needed. And so that's where you get into trouble where a child who for example, has been having trouble growing and the pediatrician saying you need to encourage them to eat more, then at some point we say, oh well they're growing too fast and now they should eat less if we just kind of left them alone to their own devices. A lot of times those kids turn out fine without the pressure that we put on them.

Katie Ferraro (20m 50s):

And you mentioned the Ellen Satter earlier and I think, yeah, one thing that's so helpful to parents is if we can just keep in mind like I love to just, I tell my own kids mind your own business. But if we could all as adults remember what our jobs are, essentially mind our own business and feeding, which is, it's our job to pick what the child eats and where they eat and when they eat, but that ultimately it's up to the child to determine how much or even whether they eat. Yeah. And so sometimes when parents get so stressed about how much they're eating and just say, Hey, you gotta mind your own business, that's not your job. I say it more nicely than that, but you mentioned like the meal times, you know, the other end of the spectrum. 'cause I feel like now I'm setting up traumatic feeding experiences for my kids by making us eat at exactly the same time every day. But if there are no meal times and children are allowed to graze throughout the day, that's the other end of the spectrum.

Katie Ferraro (21m 33s):

Which is not ideal either because then the baby or child never feels hunger. Right,

Jessica Setnick (21m 38s):

Exactly. Exactly. You don't just do 180 from whatever was a problem for you. Exactly. And another thing I feel like it's really important to have compassion for yourself as a parent too, because if you think your main job is to, you know, beach shelter and clothe your child and a third of that seems to be going wrong, there's a lot of ego that gets involved in a kid's eating right. And a lot of comparing this kid's eating more variety than that kid or even siblings. Even twins, oh my gosh, you are the person who would know this the best of any of us that even twins are, in your case quads are not all going to develop at the same pace or eat the same foods, et cetera, et cetera, et cetera. And it's really important to keep our ego as parents out of it and not feel like the way the kids eat reflects on us.

Jessica Setnick (22m 24s):

And I'll tell you, sweet Peyton and Derek as as selective eaters as they were when I realized that they may be going off to college only eating these five certain foods. And I thought, well, okay then they're just gonna learn how to be confident ordering in a restaurant. They're gonna learn how to eat at the table with nice manners. They're gonna learn how to have conversations with adults. I'm gonna help them with the things that I can help because these kids, on top of being selective eaters, are not also going to be ashamed of being selective eaters. And the Ps of the story is that around maybe 10 years old, Derek started suddenly asking for foods that he had not eaten before. Foods that Greg and I ate that were at the table, but he had not eaten before and it was really a huge change over the course of a few weeks.

Jessica Setnick (23m 8s):

And so at a non meal time, I asked him and I said, Derek, it's really fine that you're eating these other foods, but I just, I, I'm so curious, I have to know why now what's changed? And he said, I mean he looked at me so seriously and he was I think 10 years old and he said, Jessica, I'm gonna be dating soon and I am not gonna order off the kids menu. And I remember having this huge sigh of relief internally, silent sigh that, oh my gosh, all this Ellen Satter stuff that I've been teaching people my whole career, it actually works because here he is not having felt pressure to eat things and yet he's choosing on his own schedule. It wasn't our schedule, it was his schedule. And now that child eats everything and you know, wherever the older child goes, and in our case the younger child wasn't far behind, but it's really hard to keep your ego out of it and think, I made this food for you, why aren't you eating it?

Jessica Setnick (23m 57s):

Or I paid for this food. My God, if you haven't heard that, you did not grow up in America for babies.

Katie Ferraro (24m 2s):

It's like you need this food, you have to eat this so you can grow. Oh yeah, yeah. And you know, failing to recognize that it's a continuum,

Jessica Setnick (24m 8s):

It's so easy to focus on. Like if my kid would just eat that one bite of broccoli, then everything would be okay. And it's really easy to to sort of hone in on that. But that's where we have to manage our own anxiety, manage our own ego, keep the good and bad out of food, but also keep the good and bad out of ourself. I'm a bad parent if my kid only eats off the kid's menu or something like that. You're not a bad parent. There's lots of factors that go into what your kid eats. And if your child, like in my case, I felt like if my child knows how to sit at a table and you know, eat with a knife and fork and have nice manners and and say no thank you to something they don't want, then I am a successful parent or stepparent as opposed to what actual foods that they eat.

Jessica Setnick (24m 49s):

But it's hard. It's hard when you have sort of shaming, blaming, ego tripping people in your circle whose kid, you know, eat whatever and you know, sushi with chopsticks when they're six months old and you know, you feel like you're a terrible parent, but you just have to remember that's nothing to do with it.

Katie Ferraro (25m 6s):

And our parents see so much of that. And one of the things that I've really tried to do in creating what's now the largest digital community that's dedicated to baby led weaning is that really trying to flip that conversation and focus on the positive things associated with starting food because there is so much judgment, there's so much comparison, so wrong, and it's just, it's so unnecessary. We don't need that as parents, we don't need that as educators. We're trying to help our kids learn how to eat. So having said that, knowing that you work with families who have eating disorders and feeding disorders, I was wondering if you could share some of the things that you see in those clients, obviously without, you know, violating their privacy, but what's the bad stuff that could happen and you're like, hmm, if they had just done this or that, I know it's not that black and white, but just some walkaway tips for our audience.

Katie Ferraro (25m 48s):

Like what should we avoid? Yeah. In feeding? So there's

Jessica Setnick (25m 51s):

Two things that really come to mind. One is you wanna avoid making your child feel bad. Like they've disappointed you for you know, not eating food like, well I thought you would really like this, but I guess you don't like broccoli anymore or whatever. You know, that kind of like guilt tripping, that's not ideal at all because it mixes up food with feelings. And that's the second thing that we can do that we should really avoid is mixing up food and feelings in terms of if you are sad here, this lollipop will make you feel better. Or if your kid gets good grades, oh yeah, let's go celebrate by having ice cream. In other words, food is fuel and it's appropriate to have food you enjoy.

Jessica Setnick (26m 33s):

Sometimes it's lollipops, sometimes it's ice cream, sometimes it's kale, sometimes it's sardines. But it's not because you were a good kid or you're not withholding food because someone was a disappointment or didn't get good grades or things like that. It just develops that really unhealthy relationship with food. And one of my catch phrases for the past 22 years has been your child's relationship with food is more important than any one food that they do or don't eat. And that's really the main thing I would encourage everyone listening to keep in mind is that you're really building day by day meal by meal, a healthy relationship with food. Because it's probably hard to imagine when you're talking about a three month old or newborn, but you only have a certain number of years under which you are the person controlling your child's intake.

Jessica Setnick (27m 21s):

Because as soon as they start going to school, they're exposed to other foods. As soon as they grow up and have home or go to college, they're gonna be buying their own groceries, right? So there's a limited amount of time that you have to control what they're eating. So you're really not trying to control what they're eating for a lifetime. You're trying to set the stage for a healthy relationship with food for a lifetime. And that's something if you think about we're really setting the stage for a lifetime, it can be overwhelming I'm sure, but also think about it as, okay, we have a whole lifetime to deal with here. We're not trying to get this one food in by tomorrow. You just have to take that time pressure off and remember that for every bad experience kids have with a food, it takes many, many good experiences to outweigh it.

Jessica Setnick (28m 6s):

So the best thing we can do is avoid those bad experiences in the first place so they don't have to overcome them, but

Katie Ferraro (28m 12s):

Also continue to offer those foods. Because as we know, oh yeah, research shows us you may need to show a food to a baby 10 or 15 times before they like or accepted. But

Jessica Setnick (28m 20s):

Offering food isn't a bad experience. Forcing a kid to eat is a bad experience.

Katie Ferraro (28m 24s):

I think some parents confuse the two, oh where I offered it, they didn't eat it. So now I feel like I'm forcing. Well no, we need to mix up how we're offering it, the way that it's prepared what foods it's offered with the time of day. Well it's not that you're forcing, you're just reintroducing it, but you can't offer your baby broccoli once and say, oh no, well they don't like it. I guess we're just gonna have big Macs for the rest of our life.

Jessica Setnick (28m 43s):

No, no, no, to me, well first of all they have to see it and experience it and be in the kitchen while you're cooking it and all of those things that build up to actually putting it in their mouth. And some kids are just naturally more excited about new things and some kids are less excited about new things. I mean, the truth is everything is new for babies, right? I mean, air is new for babies, like being wrapped in a blanket is new for babies. So you know, we think, oh well if they don't try something new then they're gonna eat the same things for the rest of their life. Well no, let's get a little nicer to babies and and give them some credit that they just need to try things a little more at their own pace. But absolutely trying something or putting something on the plate or putting it even on a spoon and offering it to the child's mouth that's not forcing.

Jessica Setnick (29m 27s):

Forcing is when you actually put something in a child's mouth, they give you that p you know, where it's like, no, we're done here. Like there's no more of this going in my mouth. And you keep sticking that spoon in that baby's mouth. That's why I think baby led weaning is so cool because there is no forcing, right? I mean you're allowing the child to make the decision. It's such a cool idea and it really supports what we're already saying. And what Ellen Satter says too is that at some point you can get a child to surrender and to stop fighting you and they will just eat whatever you give them. But that's not a healthy relationship with food because right now maybe it's you telling 'em they have to eat one more bite or 10 more bites or whatever, but someday it's gonna be a diet or a drug dealer.

Jessica Setnick (30m 10s):

I mean, I hate to say that a celebrity but celebrity. But they say that the same kid that says like, no, I'm done. I'm not gonna eat anymore. It's the same kid that says, no, I will not do drugs or I will wanna have sex with you. And those are good things. So we should not be trying to, you know, force kids to violate their own boundaries when really we're trying to encourage kids to listen to their own cues because that's the only thing that's gonna be consistent throughout their life. You won't always be there.

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Katie Ferraro (32m 10s):

One of my favorite presentations that you give is called, is this Normal Childhood Feeding Problems. So could you just give us in summary here at the end of the interview, like a rundown, what are some of the problems that we could be on the lookout and then any preventative advice you have for parents that is like just starting out in solid foods, like I don't wanna make this mistake. Just high level suggestions for us.

Jessica Setnick (32m 31s):

Sure. So number one is just development should guide feeding. Don't compare too much to other kids or siblings. Don't pressure kids beyond their abilities. Development should guide feeding. When a child can hold a spoon, they can have a spoon. When a child can hold a carrot, they can have a carrot. When a child can hold their head up without flopping over, that's when they can sit in a highchair, right? Those are the things that we're looking for as development and not using our own sort of calendar of events or whatever book says at which stage, you know, your child should be doing this, doing that. So number one is development should guide feeding because yes, childhood feeding problems are all kinds of things where you have a kid who is feeling pressured usually to eat and then they shut down and then they're not eating at all.

Jessica Setnick (33m 18s):

And then you're offering the things, but I know you like this, I know you like this. And they are not even eating the things that you know they like because they have just mentally shut down from this whole eating experience. And some other feeding problems I think are trying to get a child to explain to you why they don't want something. And they're, a lot of times kids don't have the words for it. We want an explanation. So you end up getting things, and again, this is not for for infants, but you get a child saying, well it doesn't look right or it's too hot or it's too cold or it's too mushy. And none of those things are really it. They're trying to come up with an explanation that will satisfy you and get you to stop offering it.

Jessica Setnick (33m 60s):

But really there is no explanation beyond their tummy isn't hungry for it right now. And so I feel like one of the feeding problems we can try to avoid is like you said, offering something, but there is a limit to when we start to sort of sense that pressure. And I think you can feel it too. The tension is rising because the number one thing that I have seen with kids is that once they get anxious, they will not come to the table. And then you end up with a problem where you're just trying to fight your kid to get to the table or you're running around with food. Oh my gosh, there's a commercial out there right now with this mother running around and she's saying, what? Just one bite. Just one bite running around the house.

Katie Ferraro (34m 39s):

First of all, where are you watching commercials? Secondly, what is that a commercial for?

Jessica Setnick (34m 43s):

I don't even wanna tell you.

Katie Ferraro (34m 44s):

No, don't tell me. BRAF

Jessica Setnick (34m 45s):

Macaroni and cheese. Yeah, which

Katie Ferraro (34m 47s):

Is fine, it's a sometimes food. We all do it and it's delicious. But running around you get exactly. It's preying on parents' fears of picky eating and marketing that we both have a problem with, right?

Jessica Setnick (34m 55s):

Like I don't have a problem with Kraft macaroni and cheese. Now let me tell you, my kids would not eat Kraft macaroni and cheese. They would only eat velv vita cheesy shells. And let me assure you that my husband had to drain it because if I drained it, they would be too dry. I mean this, I am very familiar with this, but never in my weirdest nightmare would I run around the house chasing a child with a spoonful of food. Like at some point you have crossed a line, right? But I get it, I totally get that. It's that fear of like, is someone gonna think I'm a bad parent? But let's be honest, if you look at it as an outside person, it's easy to see that chasing your kid around the house with a bite of food on a spoon is not gonna help. But when you're in it, I think we've all done things like you said with your no, you know, we've all done things where we're like, wait, did I do that?

Jessica Setnick (35m 38s):

Am I that parent? And that's okay. The good news is you don't have to be perfect all the time. Part of it is that you can model for your child regret and you can say, you know how I was running around the the table with you or I yelled at you because you wouldn't come to the table. You know, I regret that and I'm sorry that I did that and I don't wanna do it again that way. And you can repair things with your kid. Now, your pre-verbal kids, the way you repair is, you know, you don't pressure them in the same way next time and they learn. But again, for every bad experience with food, it's gonna take many, many good ones to outweigh it. So the best thing is to avoid those bad experiences in the first place. And I like to think of it as taking an imaginary Valium before you sit down to a meal with your kids and you are just completely zen about it.

Jessica Setnick (36m 25s):

You are like sitting cross-legged floating three feet above the ground like the Dalai Lama. That's probably not a good example. I don't really know that the Dalai Lama levitates, but you know what I'm saying, you are just completely zen.

Katie Ferraro (36m 37s):

Well yeah, your imaginary Valium is my like real life massive glass of wine before I do dinner. Like just to take the edge off, sorry.

Jessica Setnick (36m 45s):

But however you manage it, right? If it's that you have to do yoga before meals or whatever, but you are so calm, cool and collected because you know you've got a well-nourished kid in general and that doesn't mean you are feeling pressured about any one meal, anything they do and don't eat. So whatever you gave them mashed potatoes and they finger painted with it, instead of eating at some point you just say, okay, I guess that's the end of this meal and you don't worry about it. Now one thing I will say that can get in the way, one thing that can really get in the way is if you put too much on a kid's plate, then you end up not noticing how much they have eaten. You only notice how much they haven't eaten. And so I would really encourage you to go with small portions first for tiny tummies and then know that you can give someone more.

Jessica Setnick (37m 32s):

And we need to get over the idea that eating more than one portion is too much or you know, not finishing is not good. I remember when I was a kid, my parents would give me an apple and I would eat a ring around the center of the apple 'cause that was the best part I thought. And then I'd give it back.

Katie Ferraro (37m 47s):

And because you're a kid and they all do that.

Jessica Setnick (37m 49s):

Yeah. And they would be mad like why did you do that? And I look back on that as a Dietitians now, and I think, okay, look, once it happened twice, like this is a trend, this is not going to change. Now it's on you parents either gimme a smaller apple or cut it up in advance or just no, you're gonna be finishing my apple for me, right? This is how I'm going to operate. And just because it's not your methodology or the way you would do it, that's totally different. But it's really hard when you put a lot of food on a plate for a kid and you really don't like to waste food. And that's how someone like my husband ended up sitting in front of his mashed potatoes overnight, literally sleeping with his head on the table because he didn't wanna finish the mashed potatoes. And I mean these things are real, right?

Jessica Setnick (38m 29s):

A lot of people listening may have been in that situation. To me that sounds nuts. But he didn't have bad parents. They were just doing what they thought was right. You're not supposed to waste food, got it. But the best way to not waste food is to put less in front of the kids and then they can always have more.

Katie Ferraro (38m 45s):

And that's a great reminder to parents too. You mentioned like the finger painting with the mashed potatoes, which we talk all about managing the mess. The goal is not to prevent the mess because you know, it's part of the sensory experience of learning how to eat, is touching it, tasting it, smushing it, et cetera. But if it, like for right now, my example, my aunt is staying with us and she's not as used to my seven kids and the noise and the mess. And I've noticed my anxiety at level at mealtime is higher because of her perception of what's happening at mealtime. Mm. If it's just me, I don't care how loud it is, I don't care how messy it is, it's part and parcel of the whole feeding process. And so if you notice other people in your feeding environment who are stressing you out, when you're the primary caregiver and the one in charge of feeding, you have the right to tell other people that they can't be there.

Katie Ferraro (39m 25s):

Especially when your baby's learning how to eat. If they stress you out, if you find that they're judging, if they're gonna freak out about gagging, like you are the one, you're the boss of your house and you do control the feeding environment. And if you can, it's always good to keep the people out who aren't ready to be there yet.

Jessica Setnick (39m 40s):

That is a really hard Katie, now you're talking about family dynamics. And I'm thinking I was 28 years old the first time I told my mother, no, I mean this is tough stuff. It's really existential. So I just wanna put in my vote for, you know, make sure you have someone that you can talk to about this. And whether it's just vent or you want advice, either way let them know which one you want. But it's just really important that you have someone that sort of validates you and helps you feel normal. Because the more stress that you are at mealtimes, the more stressed your kid's gonna be. And you know, it's very challenging to listen to your hunger cues and what sounds good. And you know, your internal sense of when you've had enough, those are really hard things to listen to when you're stressed out.

Jessica Setnick (40m 22s):

They're hard enough when you're calm, but when you're stressed out, it becomes almost impossible. Some people eat more when they're stressed, some people eat less, but nobody is really able to do a good job nourishing themself under stress. And I agree with you, it's your responsibility as a parent to keep that environment as calm as possible and not calm in the like. It's all quiet and we're all silent during meals. Katie, I mean calm in terms of no one is being pressured or stressed or rushed,

Katie Ferraro (40m 48s):

Even if it's louder or messy, even if it's louder even. And I love your suggestion, your mention listening to learning to respond to and recognize your own hunger cues. But you have to remember that your babies are learning how to do that right now too. This is new and we need your suggestion to just make more appropriate portions, which are small, and then look for your baby's hunger cues. Learn how to recognize them and respond to them, which means maybe giving a little more food. We don't wanna drip the food, meaning you don't just put a piece out, let the baby eat it and then put another piece out. You have to guesstimate around what you think your baby will eat. But if they want more, it's fine to give them more. They're learning how to pace themselves and the rate at which to eat and then what that food makes them feel like. This is all a learning process.

Katie Ferraro (41m 28s):

We as adults don't even have it figured out sometimes. Yeah. But we've certainly engaged in a lot of practices that unteach learning how to listen to and respond to our hunger cues. And we don't wanna do that for our babies.

Jessica Setnick (41m 38s):

And I do think talking to other people is so helpful because the things that you get sort of blindered by because they are emotional for you, I think that they're not necessarily emotional for someone else. And I'm thinking of an example that I saw online where someone posted in a question forum, they showed this picture of this child like screaming at a mealtime and he had a plate of kind of crazy looking wild spaghetti with sauce on it. And some of the suggestions were just, have you tried something like a rotini where he could pick up a piece? Like how does a baby pick up a piece of a long piece of spaghetti and get that in their mouth? Right? So it's just sometimes it's simple things that are really, and maybe your kid loves to pick up spaghetti and put it in their mouth.

Jessica Setnick (42m 21s):

But I guess what I'm saying is sometimes getting an outside person, non-judgmental person, an outside non-judgmental person's ideas can be really helpful because there's just sometimes where we just can't see things because we just never did them that way. I mean, the idea of cutting the crust off a peanut butter sandwich, for example, some people are like, well what are you gonna do with the crust? Waste it. Well guess what? I never thought of this, but if you thought of cutting the crust off before you make the sandwich, you can use your bread crusts to make breadcrumbs for your next pasta recipe that asks for breadcrumbs, but you have to cut 'em off before you make the peanut butter sandwich. So little tiny things like that, that sometimes are someone else's brilliant idea, you just can't see it 'cause you've never done it that way.

Jessica Setnick (43m 3s):

So I really wanna tell everyone, whatever shame or embarrassment you have about the way your kid eats, or the way you feel like you're not a good enough parent or whatever, you've got to move on from that and get over it. And even if you're just whispering it to one person, you've got to tell someone else what you're going through because that's the only way you can get support.

Katie Ferraro (43m 20s):

And that's the whole point of this community is to support parents through what can be a really challenging time. And I appreciate your expertise coming on, like to have you sharing these experiences with all of our moms and dads and caregivers who might be really new to this just knowing, you know, you can do this, you've got this. Does they always say your child will not go to kindergarten in diapers or not knowing how to eat. Like you will get over this as well. But it does always help to have someone who's listening to you. So thank you Jessica, so much for sharing all of this information with us. Where can our audience go to learn more about you and your work?

Jessica Setnick (43m 52s):

Jessica snick.com is the easiest place to find me. Or if it's easier to remember, understanding nutrition.com. They both go to the same place.

Katie Ferraro (43m 60s):

Wonderful. Well thank you so much, Jessica.

Jessica Setnick (44m 2s):

My pleasure. This was really fun, Katie. Thank you for inviting me.

Katie Ferraro (44m 6s):

Well, I hope you guys enjoyed that interview with Jessica Setnick. She is one of my favorite people on the planet. When my quadruplets were born and they were in the nicu, she came to visit them and they're older now, and I hate stuffed animals. They have overtaken my house. Jessica gave us our first round of stuffed animals, I should have known she started it all. The first stuffies that they ever loved were the ones that Jessica brought to the nicu. But she's been a dear friend and she's certainly a leader in the space of nutrition with regards to eating disorders as well. So I'm really grateful that she took her time to kind of tailor this message for new parents to help dial back some of the anxiety that we feel about the pressure that oftentimes a lot of us are just placing on ourselves at mealtime.

Katie Ferraro (44m 46s):

So be sure to check out Jessica's resources@jessicasetnick.com. Again, if you know of anyone in your life world, etc, that needs eating disorder resources, if you're a Dietitians looking to specialize in that, or if you're a family who needs resources, please do check out Jessica's tools and her courses. I mean, she's got so many wonderful resources. She's written a million books. She's like one of the most productive, yet charming and totally generous, gracious people that I've ever met. I love her to death and I think she did a wonderful job sharing that message with us. So I'll put all of her resources on the show notes page for this episode, which you can find@blwpodcast.com/72. And I wanna say a special thank you to our partners at AirWave Media.

Katie Ferraro (45m 27s):

If you like podcasts that feature food and science and using your brain, check out some of the podcasts from AirWave. We're online@blwpodcast.com. Thanks so much for listening, and I'll see you next time.

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