Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
How can parents avoid the dinnertime battle with their children?
Still, there are some gentle ways parents can nudge their kids toward more healthful eating habits. Here are a few thoughts from nationally known nutrition experts on how to get kids to go from
being picky eaters to people with sound, varied diets:
Avoid a mealtime power struggle. One of the surest ways to win the battle but lose the war is to engage in a power struggle with your child over food, says Jody Johnston Pawel, LSW, CFLE, author of The Parent's Toolshop. With power struggles, you're saying, "Do it because I'm the parent" and that's a rationale that won't work for long, she says. But if your child understands the
why behind the rules, those values can lay the groundwork for a lifetime of sound food choices.
Let kids participate. Get a stepstool and ask your kids to lend a hand with easy tasks in the kitchen, says Sal Severe, PhD, author of How to Behave So Your Children Will, Too. "If they participate in helping to make the meal, they are more likely to want to try it," he says. Older children and teens can begin to prepare special meals or dishes by themselves. Get teens started learning to prepare healthy foods before it's time to live on their own.
Don't label. Severe reminds parents that, more often than not, kids under 5 are going to be selective eaters. "Being selective is actually normal," says Elizabeth Ward, MS, RD. She prefers the term "limited eater" to the more negative
term "picky."
Build on the positives. "When I sit down with parents, we'll often find that their child actually does eat two or three things from each food group," says Ward. Just as children can get comfort from reading the same story over and over, they enjoy having a set of "predictable" foods. "Even though they aren't getting a wide variety of foods, they are actually doing OK nutritionally," says Ward. When the child goes through a growth spurt and has a bigger appetite, use that opportunity to introduce new foods, she
recommends.
Expose, expose, expose. Ward says a child needs to be exposed to a new food 10 to 15 times before he or she will accept it. But many parents give up long before that. So, even if your child only plays with the strawberry on her plate, don't give up. One day, she just may surprise you by taking a bite. But don't go overboard, says Severe. Limit exposure to one or two new foods a week.
Don't bribe. Avoid using sweets as a bribe to get kids to eat something else, says Pawel. That can send the message that doing the right thing should involve an external reward as well as reinforces the pattern that eating unhealthy foods is a good way to reward yourself . The real reward of sound nutrition is a healthy body, not a chocolate cupcake.
Beware of oversnacking. Sometimes the problem isn't that the child doesn't like new foods but that they are already full, says Ward. "Kids can consume a lot of their calories as milk and juice." Encourage the kids to drink water rather than juice when they're thirsty. You can also create flavored waters by adding a splash of their favorite juice to sparkling or still water. The same goes for snacks that provide little more than calories, such as chips, sweets, and sodas. "If you are going to offer snacks, make sure they are supplementing meals, not sabotaging them," she says.
Establish limits. Having a set of bottom-line limits can help a parent provide some consistency, says Pawel. For example, parents may require that kids eat nutritious foods before snack food. Or that they must at least try a new food before rejecting it. "Consistency only works if what you are doing in the first place is reasonable," she says. So, avoid overly controlling or overly permissive
eating rules. If bottom-line limits are healthy, effective, and balanced, they'll pay off.
Examine your role model. Make sure you aren't asking kids to "do as I say, not as I do," says Pawel. If your own diet is based mainly on fat, sugar, and salt, you can hardly expect your child to embrace a dinner salad over
French fries.
Defuse mealtimes. Don't make your child's eating habits part of the mealtime discussion, says Ward. Otherwise every meal becomes a stressful event, centered on what the child does and does not eat. Ward suggests
that parents reserve talks about the importance of good eating for later, perhaps at bedtime or story time.
Give it time. "I find that children become much more open to trying new foods after the age of 5," says Ward. "Most of the time, kids will simply grow out of limited eating."
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Croup is a contagious viral infection that affects children's respiratory system. Symptoms include a barking cough, stridor, fever and difficulty breathing.
Colic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.
Alcohol is the most frequently used drug by American teenagers. Teens that drink are more likely to drive under the influence, have unprotected sex, and use other drugs, like marijuana, cocaine, and heroin. Symptoms of alcohol abuse in teens include lying, breaking curfew, becoming verbally or physically abusive toward others, making excuses, smelling like alcohol, having mood swings, and stealing.
Alcohol intake by a pregnant mother may result in fetal alcohol syndrome (FAS) in her child. A child with FAS may be hyperactive and have a low IQ, a small head, a growth lag, short eye openings, flattened cheekbones, a short nose, a smooth, thin upper lip, shortening of the fourth and fifth fingers, and a heart murmur.
Child abuse falls into four categories: neglect, physical abuse, sexual abuse, and emotional abuse. There are certain risk factors that predispose a child to being abused and an adult to abusing a child. Risk factors for children are age, children with learning disabilities, adopted and foster children, children with congenital abnormalities, and a past history of abuse. Parental risk factors include young or single parents, those who suffered abuse themselves, adults with substance-abuse problems or psychiatric disease, and those who didn't graduate from high school.
Drugs commonly abused by teens include tobacco products, marijuana, cold medications, inhalants, depressants, stimulants, narcotics, hallucinogens, PCP, ketamine, Ecstasy, and anabolic steroids. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common treatment methods include therapy and medications.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
About 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Reye's syndrome (RS, or Reye syndrome) is a sudden, sometimes fatal, disease of the brain with degeneration of the liver. Reye syndrome occurs in children and comes after the chickenpox or an influenza-type illness, is also associated with taking medications containing aspirin. Symptoms include vomiting, listlessness, irritability or combativeness, confusion, delirium, delusions, convulsions, and loss of consciousness. Treatment depends on early diagnosis and focuses on protecting the brain against irreversible damage by reducing brain swelling, reversing the metabolic injury, preventing complications in the lungs, and anticipating cardiac arrest.
Stuttering is a speech disorder characterized by speech disruptions such as prolongations of speech sounds, syllables or words, frequent repetitions, or the inability to start a word. Over 3 million Americans stutter, and boys are more likely to stutter than girls. Stuttering may be developmental, neurogenic, psychogenic, or even genetically determined. Treatment for stuttering may incorporate stuttering therapy with a speech-language pathologist and educating the parents about restructuring the child's speaking environment.
Depression in teenagers may be caused by many factors. Symptoms of teen depression include apathy, irresponsible behavior, sadness, sudden drop in grades, withdrawal from friends, and alcohol and drug use. Treatment of depression in adolescents may involve psychotherapy and medications.
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence is also called bedwetting and sleepwetting. The cause of nighttime incontinence in children is unknown. Daytime incontinence in children may be caused by an overactive bladder. Though many children overcome urinary incontinence naturally, it may be necessary to treat incontinence with medications, bladder training and moisture alarms, which wake the child when he or she begins to urinate.
Bedwetting, or nocturnal enuresis, is the accidental passage of urine while asleep. There are two types of bedwetting: primary and secondary. Primary enuresis is bedwetting since infancy, and secondary enuresis is bedwetting after being consistently dry for at least six months.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
The cause of sudden infant death syndrome (SIDS) is unknown. The risk of SIDS peaks in infants 2-4 months of age. SIDS is more common among male infants, particularly African American and Native American infants, during the winter months. Putting the baby to sleep on his/her back, avoiding fluffy, loose bedding, using a firm mattress, and avoiding co-sleeping may help to prevent SIDS.
Fast food consumption and lack of exercise are just a couple of causes of childhood obesity. Health effects of childhood obesity include type 2 diabetes, heart attack, stroke, high cholesterol, asthma, sleep apnea, gallstones, fatty liver disease, GERD, depression, and eating disorders.
1p36 deletion syndrome is a genetic disorder that causes severe intellectual disability. Characteristics of 1p36 deletion sndrome include temper tantrums, biting, and other behavoiral problems. Physical conditions include seizures, hypotonia, swallowing problems, and microbrachycephaly.
Guinea worm disease (GWD or dracunculiasis) is an infection caused by the parasite Dracunculus medinensis. After a person drinks water contaminated by water fleas that harbor Guinea worm larvae, the larvae grow into adult worms (2-3 feet) in the small intestine and then migrate and emerge from the skin. Symptoms and signs include fever, swelling, and pain near the blister on the skin where the worm will emerge. As there is no medication to treat GWD and no vaccine to prevent infection, treatment focuses on minimizing pain and swelling (with the use of ibuprofen or aspirin) as the worms are slowly pulled from the wound over the course of a few days to a few months.
Setting a good example for your children when it comes to diet and exercise will help them to make healthy decisions about nutrition and fitness. Eating calcium-rich foods and performing weight-bearing exercise will help your children prevent osteoporosis and fractures later in life.
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