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Dec. 3, 2022

#94 Normal Growth, Forbidden Foods, Sneaking Snacks and Red Flags when it comes to Feeding with Aren Dodge, RDN, CDCES

#94 Normal Growth, Forbidden Foods, Sneaking Snacks and Red Flags when it comes to Feeding with Aren Dodge, RDN, CDCES

In episode #94, Aren Dodge returns to help guide us through a myriad of topics. We discuss normal growth in our children, forbidden foods and snacks, sneaking foods, and red flags when it comes to feeding. Aren is the owner and founder of Dodge Diabetes, she's a registered dietician, a diabetes educator, and she has been living with type 1 diabetes for nearly 30 years. As a diabetes educator, Aren has advanced training from the Ellyn Satter Intitute and the Ellyn Satter method of division of responsibility which you'll learn more about in today's episode. As a diabetes educator, Aren is trained on all of the FDA approved pump systems that are on the market today! Feel like you might need Aren's help? Good news! She's available! Be sure to check out the links below so you can find Aren on the web and on social media. Enjoy the show!

Aren's Website: Dodge Diabetes
Aren on Instagram,
@dodge_diabetes
Aren's awesome Facebook Group:
Dodge Diabetes Community
Learn more about the
Ellyn Satter Institute and the Division of Responsibility
Episode #92 with Aren:
Raising a Healthy and Competent Eater
Episode #93 with Aren:
Helping and Encouraging our Healthy Eaters

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Transcript

Katie:

Hello and welcome to episode 94 of the Sugar Mama's Podcast. If you think I'm talking a little softly today in the intro, It's because I'm up early and most of my family is still asleep. The other members of my family got up at an ungodly hour to search for the elf on the shelf because it's the beginning of December here. Gotta love that Elf on the shelf. I took last week off from the podcast to celebrate Thanksgiving with my family, and we had such a nice time. I hope you too, had a lovely and relaxing holiday and that your blood sugars behaved, or your kids' blood sugars behaved. Aaron Dodge is back today To help guide us through a myriad of topics, we're going to discuss normal growth in our children forbidden foods and snacks, sneaking foods, and red flags when it comes to feeding. Erin is so great. She is the owner and founder of Dodge Diabetes. She's a registered dietician, a diabetes educator, and she has been living with Type one diabetes for nearly 30 years Erin has advanced training from the Ellen Satter Institute And Ellen Satter's, method of division of Responsibility, which you'll learn more about in today's episode As a diabetes educator, Erin is trained on all of the FDA approved pump systems that are on the market today. Feel like you might need Erin's help. Good news. She's available. Be sure to check out the links in the show notes to be able to find her on the web and on social media. Enjoy the show. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseboro. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks. Hello friend, we are back today. I'm back with Erin Dodge owner of Dodge Diabetes. Just a reminder, Erin is a registered dietician, a diabetes educator, and she's been living with type one for nearly 30 years. So needless to say, she's a wealth of knowledge and information and I'm just feel very fortunate to have her on the show. So welcome.

Aren:

Hello.

Katie:

Hello. All right. Today's topic is going to be on just kind of growth in general with our kids. Kind of like what's normal, where should we kind of start to get a little concerned about patterns in their growth that we're noticing. And then we're gonna kind of segue into talking about, you know forbidden foods maybe kids sneaking food, trying to hide that from their parents. And then we'll try to tie all that in you know, looking at all that through the lens of being a parent with a child that has type one diabetes. So we'll do our best to get all that in today. And I have no doubt that Aaron is, is ready and prepared with all that information. Aaron, let's start with. You know, just every year we take our kids in for these wellness visits and we get these growth charts and, you know, the doctors are explaining what percentage they are on the growth chart. So, for parents out there, could you just kind of give us an idea of like, what's, what's a normal, growth pattern on one of those growth charts? What, what should that look like?

Aren:

For your child that's a little bit older, and even like in the toddler to adolescent age, they'll sort of nestle into a predictable growth pattern. So you'll find that they'll hang out. If they start at the 50th percentile, they'll kind of stay at the 50th percentile, and that's considered normal predictable growth for that child and some kids. Smaller than other kids. Some kids are bigger than other kids, so as long as it's growing predictably on that growth chart, we know that that's normal growth. what's interesting is kids, even as infants know how much to eat, it's only when unfortunately, well meaning as parents, we try to kind of get involved and interfere and we kind of step into those roles that we talked about in the previous episode about divisional responsibility with infants specifically I'll just mention. So any kind of way that you feed your baby is, is great. But what we know about formula feeding versus breastfeeding is that when you're breastfeeding, you have no clue. How much food that baby's getting. You're just kind of, looking for clues and cues from the baby when they're crying. If they're hungry, you feed them and it's kind of like this on demand thing. And if everything's going great, the baby's getting enough food and self-regulating how much to eat. And they did this super interesting study even in the NICU with premature babies. And you know, again, help meaning, well meaning healthcare professionals would try to intervene and get this baby to eat more calories to gain weight. And guess what the baby did would just eat less. For what their body needed. And then if they diluted the food down, they would just eat more to get that same sort of predictable amount of calories that the body needed for that specific baby and how it was made and genetics and all that stuff. So it's super interesting how when we try to interfere that sometimes innately the baby already knows how much to eat. But if you start ignoring the cues from the baby that it's done eating and try to get that last couple ounces in with the bottle, whether it's, you know, pump breast milk or formula food, you can start to see patterns and trends. If it's a consistent thing that's happening where the baby's gonna go off of his normal projected growth for predictable healthy to get the healthy body that that baby's intended to get as a even growing into an.

Katie:

Okay. So like for instance, I just took my son, my son's 12. I just took him. He does not have type one diabetes, just to clarify for anybody that's jumping in. And is new to the podcast. But he has always really consistently been like in the 50th percentile on the growth chart. So kind of right there average. And so that's kind of where I was predicting he would go. And then recently he's kind of jumped up to the 70. Fifth percentile on the growth chart, which when I look at him, I think he looks perfectly fine. I mean, I, I, I think he got my jeans. He's probably gonna be a little shorter than, I mean, his dad is six one, so I don't know that he'll be that tall. I mean, I don't, I'm not really sure, honestly. But, you know, I look at him and I, I think he's happy, he's healthy, he's doing great. You know, and I, I do think he's probably getting ready to go through a big growth spurt because he's 12. So we're getting ready to, you know, probably enter into the hormones of the teenage years and all of that. But like as a parent, is that something that I should be concerned about or at what point in time should I start to be a little bit concerned about you know, the growth chart, whether, whether or not they're going down in the percentile, you know, the percentage or going up.

Aren:

So most kids by age seven, they again kind of find that like little pattern where they're gonna be through like, you know, being 18 through their um, into their adult years. anything that's more than. A jump in those percentiles. So going from like the 50th percentile up to the 75th or the 95th percentile specifically for weight is gonna be a concern that you wanna kind of look at in terms of how you're feeding.

Katie:

Mm-hmm.

Aren:

And we know that kids naturally get chubby and then grow like three inches and it's so interesting that their bodies know what type of foods to eat to support their body if they have that good competent eating skills that, that they've been developing with feeding and parenting and all that. So for example, toddlers know that they need to eat more fat because they're growing this big old no and brain that they need all that extra fat for. So they'll, I mean, honestly, my kids, whenever. They were toddlers would eat like butter, like they would just grab it, scrape it off the toast, and eat the butter. And it was their body knowing that they just needed more fat to grow in that point of their, of their projected growth intake. it's kind of like the French paradox. You hear like, oh, the French people, they eat sweets and they just know when to stop or they know what to eat and when to eat. And if you can kind of listen to your body, you sometimes you'll crave vegetables and sometimes you'll crave more fattening foods. And that just may be like even now they're learning more about women's hormones and kind of the foods that help you through your cycle and build those hormone surges and things. And that's all kind of innately built. when it comes to kids, we take an average of the three days of food. So sometimes the kids will like not eat anything one day, and then the next day they'll eat you like outta house and home, and then they'll be not really hungry for the next meal or snack. So there's a lot of jags with kids eating. But you just have to trust the process. specifically like with your son on the growth chart like you said, he may be getting ready to hit another growth spurt with height and so that his weight, if he did jump up a percentile, as long as you watch it and it's not projecting even higher off the growth chart or dropping down below more than one or two percentiles at a time, then you'll know that that's normal predictable growth where they kind of stay and grow pretty smoothly along that curve as they become teenagers.

Katie:

Yeah, I I mean the doctor obviously saw the growth chart and she said everything looked great and you know, wasn't concerned at all. So therefore I was not concerned at all. And just having read the book, you know, it didn't seem like a stark, you know, this wasn't the first appointment that he had jumped up to the 75th percentile. I think it was like, you know, it's been, maybe there's been a couple dots on that line, so I don't know. It didn't really raise any red flags with me, but I was just curious, I wanted you to kind of explain to parents like, what, what are some red flags that we might see on the growth chart where we might need to rethink, like, okay, well what am I doing as, as a parent? You know, how am I feeding my children? Maybe what can I do differently to you know, not pressure them as much to eat more or eat less things like.

Aren:

Right. And I think as, as a parent too, you want to be supportive and do everything you can to help them be healthy. But sometimes that can backfire. And specifically with a again, you have to kind of look in the mirror and sort of see, like you said, like you're not super tall and, but your husband's a little taller. But if you are, are. Then you can't expect that your child's gonna be in the 95th percentile for height. And same thing for weight. Every kid is gonna be different, and as long as they're kind of somewhere on that growth chart, you can be confident that they're gonna grow up to get the bodies that they're meant to get if they grow predictably. And you're feeding with that division of responsibility and love at the table and not kind of tiptoeing into their jobs with restricting and, and pressuring with food. But the other job as a parent too, is to just give your kids a little bit more confidence about their bodies and feeling comfortable in their own skin whatever size that might be. So give them emotional support and things around food and growth in their own bodies. But A lot of parents specifically get concerned if their child is falling off the growth chart. And if they've always been on the low end of the growth chart and it's growing predictably at the third percentile, then that's still predictable normal growth and wouldn't really require any changes in your feeding, just feed how you'd normally feed, just like those NICU babies that would just eat less if you kind of concentrated the formula. It's just feeding in that most reliable way because we know that that a child's weight is not what you feed them, it's how you feed them.

Katie:

Yeah. I'm just thinking about this kid in our neighborhood, which obviously won't name any names, but, you know, he just, this child has always been very, very small, like, very, very slender. And my kids, they have a good relationship with, with them and they're always like, you know making jokes and it's, it's a funny thing. And the other day, like somebody actually said something like, I'm a little bit concerned about, so andSo, because, you know, they really are so skinny. And I'm like, okay. Like, I don't, first of all, we know that this person belongs to a very wonderful family, that is absolutely providing food for their children. And like we've known this person for seven years now, or five years now, five years now. And they've always been skinny and small. Like I think it's just, I think that's just their stature and how they are. And it was just funny to me that all of a sudden somebody was like actually concerned about it, whereas years and years go by and it's just kind of like a funny thing that people comment on. But

Aren:

No, it's true. And then, you know, as long as it's predictable growth, that's what we wanna see is just that predictable, steady growth that sort of follows that pattern on the growth chart for weight and obviously for stature also as well.

Katie:

Yeah. I know my sister-in-law used to always has told me several times, like, she's super tall and super, super thin and she has been her whole life. And people when she was in high school, like people would constantly be concerned that she had an eating disorder. Cause she was so thin. And she's like, I promise I do not have an eating disorder. Like, I, I eat and I eat a lot and I love food. And, but she, she was really frustrated with that. Like, people were very concerned about her weight and it's just like, I've, I've always been this way. This is, this is just how I am. D know.

Aren:

Right. Yeah. So with the, with the low weight, again, a lot of parents will just try to get any kind of food in that they can. So that usually turns into really lack of structure and like just constant grazing, like a free for all. Cause any time they eat something, it's like a celebration because you have the, the physician let's, if it's a failure to thrive or something like that, like a diagnosis like that, it's so much more pressure to get those, those foods and those calories in. And so just too much pressure or interference in general will make the child again that reverse psychology, not want to eat as much. And not having the reliable meals and snacks will backfire as well because they found that kids who graze eat about 50% less calories than they would if they were given set steady meals and snacks. So and the other thing we know, speaking of the, the division of responsibility is that when you prepare the meals, there's a lot more nutritious options and foods to eat a sit down meal than there is when they're just, you know, nibbling and snacking and grazing. So I would just encourage you if you do have a child that's underweight or that there's been some concern about with their weight and their growth on the, on the growth chart, just work with your provider and your physician. But try not to interfere too much with the how much and the what. Just sticking with the division of responsibility in providing those opportunities for the child to eat that structured meal with nothing between meals and snacks except water. That way they'll have an appetite and they'll be ready to eat when they sit down and eat a meal or their next snack.

Katie:

I have a friend who actually follows the Ellen Saturn method. She said she's been more consistent with it at certain parts in time, you know, at certain times in her kids' lives than others. But she really is intentional about having which is what you're talking about with structured snacks, where she actually has sit down snacks with her kids. Like she, and I mean, this takes a lot of planning and not all of us have this kind of time, but when her kids get home from school, she has like, it's almost like a snack meal ready to like sit down with them and there's, there's options on, you know, it's not just one thing, like it's not just almonds or whatever, you know, she'll have a couple things on the table, but like, this is our snack and you can eat as much of it, or as little of it as you want, but like, we're not eating again until the next meal. And she has told me that like when she's really good about being intentional and doing those structured. snack situations. It makes such a difference in the way that her kids come to the table at dinner and their attitudes because then they're not just getting home from school and grazing and grabbing things out of the pantry whenever they want them. They're, they're, they're having what she provided and then they know that they're not gonna eat again until, until dinnertime, which is really only a couple, a couple hours away,

Aren:

Right. And the trick is, is for them to arrive hungry at the dinner table, but not starved because what we know about kids that have Issues with structure around food whether it's like over restriction with not eating enough calories or if it's like, unfortunately I think even during the pandemic it was like one out of five kids were food had food insecurity, so they weren't getting enough calories or enough food. And so what that turns into is if you can imagine just empathizing and being a child, you depend on this other grownup human for all of your meals and snacks and for your wellbeing, and all of a sudden there's this lack of structure and you're starving and there's nothing to eat and no one to give you food. It makes a lot of panic and anxiety. And then guess what happens when you do get exposed? You're in a situation where you can eat as much as you want. that's what tends to happen with food insecure kids. And I have a big heart for school food lunch programs and things because of how they help in food insecurity and things. And those are the kids that are tend to be more overweight because they lose that ability to self-regulate their hunger and satiety. So when there's an opportunity to eat, They're gonna eat as much as they want until they can get as full as they can, because they're not sure when they're gonna have that next meal or snack, which is really sad and it kind of breaks my heart. But you'd think that a child without enough food is gonna be skinnier or thinner, and that's actually the opposite because of that lack of structure and that lack of trust that they're gonna have the next meal or snack available you know, in a few hours. So when you look at the growth charts for accelerated growth, again, if you see normal, steady, predictable growth, and then all of a sudden there's a big jag where the child gains weight above two percentiles. So it goes from, let's say the 50th percentile up above the 75th or even into the 90th percentile, that's a red flag on that growth chart and how the child's being fed. Not what you're feeding specifically, but how you're feeding. So it could be that food insecurity piece that, is causing that big growth change. And the same thing can happen even without food insecurity with a mom that's not able to feed 'em at a certain time. Or you get busy and then it's really late by the time you sit down to have dinner. That can create some of those same patterns. And if it's consistently happening, then you're gonna see problems with the growth chart. But again if the weight is, is on the high side what they know is that if you if you think even in the back of your mind that your child is overweight, they've shown that you will unintentionally manipulate and pressure. Your child's feeding and eating, whether it's the look or something kind of obscure where you're not really saying anything or when you're portioning out plates or something like that, then they get less or whatever it is. The way that you talk to your child that is having that accelerated growth are heavier. They've shown that even just thinking that they're overweight will make that happen. They will start to increase their weight on that growth chart just by thinking it. So you have to be a real advocate for your child at all sizes and encourage them to, you know, like listen to their stomachs, you know, without being kind of in, in a judgey, like I told you so way, but just. Nonchalant okay. Listen to your stomach. You don't wanna get a belly ache or whatever. And use those, that sort of terminology, but without pressuring or giving the look or, you know, encouraging them to eat less of a certain food or the quantity.

Katie:

Mm-hmm. Mm-hmm. Yeah. I have, I have some kids that tend to overeat more than others, and you know, and they have, there have been some situations where they've actually like made themselves sick because they just had unlimited access to certain food, and I hate so much of it that they like felt ill. So moving forward with that, like there have been times where, You know, I've seen that, that that's pattern, same pattern is kind of starting. And I've said, you know, hey, I just, let's just take a minute to like, take a breath. You know, remember last time when you, you felt so sick after you ate all of this? Like, I want you to listen, listen to your body, I think is what I say. Not, I don't think I've said listen to your stomach, but listen to your body and you know, just remember how you felt last time. Cause I know, like I saw it with my own eyes. You did not feel good. Or there have actually been a few times where there's been like vomit involved. So that's obviously not, that's, that's definitely not good. But so are you talking about like that sort of thing or is that, is that encouraging or is that more of like an I told you to situation and you

Aren:

Well, it's just your tone. So if they're eating like a forbidden food, like a dessert or a snack or whatever, and you're kind of lecturing or giving that kind of, everybody knows that tone that no one really likes to be talked to that way, but just like, That interference. But for, for if you say, Hey, listen to your stomach, don't forget last time you over, you overdid it. And you know, every time mommy over does it, it makes me feel sick. So just make sure that you're listening to your body and just kind of leave it at that. And we've all done it. I mean, Thanksgiving is coming up, Christmas holidays and everybody's overdid it where they ate more than they should have. And then it's like a reminder like, oh man, why did I do that? Why did I have that extra blah blah, blah, and now I'm miserable? So just learning kind of that intuition with food, having food competence and being able to eat what you want, but then just kind of self-regulating how much that you consume without making yourself feel sick.

Katie:

Right. And I have heard them verbalize I think I'm, I, I don't think I'm gonna have, you know, this or another one of these because, you know, I'm, I'm pretty full and I don't wanna feel sick. So I, I've actually heard them say that a few times, so I feel like that's, that's good. Right. They're kind of recognizing like, I don't wanna feel that way

Aren:

And honestly, forbidden foods are really tricky. So forbidden food would be any kind of goody snack treats, sweets, cakes, cookies, candy, and then also, so those are like the sweets and desserty things. And then other forbidden foods like chips and french fries and like more of those high fat high salt food foods. And those foods in general, forbidden foods are typically higher calories because of all that extra sugar and fat, but they're delicious and they're really easy for kids to love. But with that said too, it's sort of just like with everything else, with parenting, it's kind of a tiptoe line where you don't want to let it be a free for all, but you don't wanna over restrict to the point where it creates. These food related, like emotional issues. So you wanna kind of normalize these foods and the way to do that is with that structure and giving them exposure to some of these sweets and treats. And even like with in some scenarios, even unlimited amounts so that they can learn those cues and those satiety signals from their body so that they know to stop. So I think some kids have a better handle on this than others. My daughter has definitely has a sweet tooth, so she gravitates towards sweets a lot more. But the worst thing you can do for a child that has like a sweet tooth is to just completely restrict all of their sweets. And you guys have all seen those children that they, you know, that their parents are super strict about what they're having and the amount of sugar and the serving sizes. Think about the last birthday party you were at. Most kids that have a normal relationship with sweets will grab a cookie and then go run and play and have fun. But then there's always that one kid that hovers around like the cupcakes and the desserts and all the stuff that's laid out, and they almost over obsess about those forbidden foods because they're so restricted, they don't have a relationship A healthy relationship to where they can stop when they're full and eat, you know, a little bit when they're hungry. And so, and you guys know, I guarantee, you know, a grown up like that too. You know, a friend that if there's a bowl of chocolate on someone's desk, They have no self-control. They walk by, grab a piece every single time, and their garbage can's full of, of Hershey kiss wrappers. And that's probably someone who doesn't have that self-regulation and a good eating competence. So when it comes to the forbidden foods, you wanna leave opportunities to where it's just an everyday sort of food, for example, with meals.

Katie:

Okay.

Aren:

best way to include dessert with meals is to have it on the table with the rest of the food. You don't wanna put forbidden food up on a pedestal because then that makes the kids think they're that much special and they're that much more of a, of a want and a need and a have. So if you just put like a chocolate pudding on the table, everybody gets a certain portion. The one thing with, so typically with the division of responsibility, the child can choose how much or whether or not they eat anything on the table except dessert. Because let's face it, your kid would eat all their calories in dessert. It's way easier to like chocolate pudding than it is to eat green beans. So when it comes to those forbidden foods, you set it at the table on the plate with the rest of the food at that meal time as part of that, that dinner option, and then they can eat it first. It doesn't matter. They can eat it in the middle or at the very end of the meal. So you're kind of taking that stigma away from that forbidden food when you give it with the rest of the other meal.

Katie:

and I'm, I'm sorry, I'm not sure if you said this or not, but she does have a rule about desserts where it, it might be out there with all the other foods, but you are, you, you get one serving of dessert, is

Aren:

Correct. Yep. So you just get one serving cuz otherwise if you gave them unlimited access, they would just eat that the meal.

Katie:

right.

Aren:

Now

Katie:

But then, oh, go ahead.

Aren:

I was gonna say there's other opportunities though where you can kind of let them choose how much and whether in instances with forbidden foods as well.

Katie:

Yeah,

Aren:

So that's specifically with desserts. But let me back up a second and say, remember we had the sugary forbidden foods and the high fat forbidden foods. What they found in research is that the high fat foods don't compete. For kind of like the availability with the other foods as much. So, for example, like chips. So if you guys are having or french fries, if you're having burgers, having fries is a side, even though it's kind of a, a higher fat, higher calorie food, having unlimited amounts of those fries as an option for your meal is absolutely fine. So the child can self-regulate and decide if they want more fries the burger and whatever else that you have at the table. But in terms of dessert, you wanna limit that to just one, one portion that's appropriate for the child.

Katie:

Okay. What are, I'm trying to think about how I wanna verbalize this question I think, I wanna ask, like for parents that have been restricting their kids eating, I feel like it's probably a good idea to honestly evaluate whether or not that is working. you know, do a little self-evaluation for, your own family and you know, you doing x number of years of this and restricting foods and you're only allowed to eat a certain amount, or you have to eat what's on your plate. Or try everything that's on the table. Pressuring, I guess pressuring would be a better word, like pressuring around feeding situations. I feel like it's a good idea to take a step back every now and then and, and ask yourself like, is this, has this been working for me? Because I do feel like a lot of parents, myself included that sometimes it turns into, it has nothing to do with the food. It has everything to do with control. we just wanna have control. We all do. Kids do, parents do. We all want control over the situation. And like, and I think we get stubborn sometimes we'll say something like, you need to, you know, have at least one piece of broccoli. Well then the kid doesn't want to eat one piece of broccoli and then, but it's like, but now I've said it and I want you to obey me and I'm gonna make a point and, and all of this. So like, I don't know, is there, are there any, I, I have fallen into that trap, so I will be the first to raise my hand. But is there any words of encouragement for, for those parents that are like, oh yeah, that's me too,

Aren:

There's always hope, like there's always time to make those changes, even if they're already kind of teenagers. And you've missed kind of the window. You can always start anytime. Anytime is better than never. And even for those older kids, having that conversation and be like, listen, I know I've tried these tactics before and what I've seen work really well is with like the older adolescents and stuff. Even kind of showing the divisional responsibility and having them, the parents and the kids keep each other accountable for tiptoeing in their lane, You know, in like a kind way. So it's kind of nice to be able to have that conversation and that feedback from the, from the kid about about their division and responsibility and their jobs with feeding. And like I said on that Ellen Satter Institute website, there's age specific things that can kind of help guide you because. Across the lifespan. There's a lot of different recommendations from what you do with toddlers versus kids that are pretty independent. So that might help show you a little bit more specifics about what that looks like in terms of division or responsibility for specific age groups.

Katie:

Mm-hmm. and probably having, having a conversation too with your older kids. I was listening to a parenting podcast the other day, and the, it had nothing to do with feeding it, it was about a certain it, it was like basically this parent had kids that were, one was a toddler and the other one was in high school. So like a huge range between her four or five kids. And the older ones were voicing their frustration with the fact that the, the younger one gets treated differently. And, you know, the parent was just having to have a conversation with them of like, well, of course I'm treating them, you know, they're three or four or whatever, and you're, you're 17. Like of course I'm gonna have different expectations for this child versus you. I think just explaining that, you know, if you're a parent who's sitting down at the dinner table, and maybe you do have a high schooler and a toddler, like explaining to the high schooler, you know, if they're upset about not expecting, maybe this toddler. Behave a certain way at the table versus the older kid. Like, just have those conversations with them and be honest, like, well, you're, you're different ages, you know?

Aren:

Right. And that's just that whole emotional support and growth that kind of comes along. And, and feeding is the corner. Own for good parenting. So if you do a great job with parenting and feeding, then I think your child in general is gonna be, again, they shown with the competent eaters have are more happy, they have better health outcomes in terms of chronic disease and their weight, having a healthy weight and a healthy relationship with food. And just more emotionally sound because of how they were fed and raised in their parents. It's a lot on our shoulders as parents, and to be honest, we all wanna do what's right for our kids and every. Pressure and every restriction that that we see happen is all outta love and concern. And like, oh my gosh, I don't want my, you know, blah, blah, blah. That you are just really worried about that child and that's why you're interfering. But what the research shows, and even in good emotional health is that the child has to learn on their own limits, on those forbidden foods. So like you were talking about with like, you'll eat till you throw up. It might take a child, especially if you've been restricting food and restricting those sweets for a while it may take that child getting sick at their stomach or even throwing up a couple times until they learn and you reinforce that they could have as much as they want as certain sit down snacks and things, and that they are not putting that, that forbidden food up on that pedestal to where again, it just takes a little time for their brain to sort of rewire to wear, I'm gonna get snacks and sweets and treats and things. And they kind of lose their shiny glow. Like they, they lose that once you get sick on it and once you realize it's just kind of a sweet, then it's an everyday normal food that fits into every other fruit, vegetable, grain, you know, meat sort of breakdown food. And that's the true, that's probably the true test of competent eating is how you handle sweets and, and kind of overdoing it,

Katie:

Okay. I know you wanted to talk a little bit about just like unlimited snacks or unlimited sweets. What did, what was your, what would you like to say about.

Aren:

So remember we were saying that the trick with forbid foods is to not give Unlimited access all the time, but then balancing that with over restriction. So the way that you can teach your child how to eat and manage forbidden foods and sweets is to give them opportunities to learn how to self-regulate. works the best I would say. A few opportunities a week, maybe once or twice a week, where at one snack you give them unlimited access to a plate of cookies. So you bring a plate of cookies out for your kids and say, oh, here's what we're having for snack. There's milk, you gonna milk and cookies. And then you let the child choose how many cookies they're going to eat. Now remember, if you've been restricting sweets in the past or have only served one or two cookies at the snack time, this new found access to sweets is going to backfire in terms of those first few introductions of this unlimited access. Because again, kids love sweets and snacks, but they need to learn how to regulate those just like every other food. So what we know is that kids who are over restricted on sweets and forbidden foods will. Eat more of those foods when they get the opportunity and almost overdo it to where it makes 'em sick. And then even they will start, as they get older, start sneaking those foods that are over restricted. And you guys all know the kid that like comes over to play and then raids your pantry like, Hey, you guys have any snacks? And like, goes and looks for foods that are forbidden at his house, that will kind of satisfy that urging like that sweet tooth that they've been restricted on. you have to find that happy balance and that medium. So the plate of cookies, eat until you don't want any more. And then when snacks over, we're gonna wait and we're gonna have something later for dinner or for whatever, or a bedtime snack. You can kind of build that in as a special treat. But what you'll find is at first it'll be six cookies. I mean, the kid will just. Will splurge because they've never had that access to sweet, but that luxury wears off after you've had a belly AC or two. So you'll notice progress would be four cookies and then a little bit more milk and maybe three cookies, then it'll be a more healthy relationship with those sweet foods to where they'll just eat a couple and then they'll be done. Nothing screams success with forbidden foods than serving a bowl of ice cream to all your kids and then noticing that they don't finish it all. You know, that's kind of like a big win in that terms of, of balancing forbidden food.

Katie:

absolutely. Okay. Let's talk about type one diabetes a little bit. Because serving a plate of cookies to your type one diabetic, I'm sure is making a lot of parents sweat out there,

Aren:

Yes. Cringe a little. Ooh.

Katie:

Yeah. Yep. So how would you, how would we handle that as, you know, if our kid has type one diabetes? I mean, I'm assuming kind of the exact same way that you just mentioned it, except for there's insulin involved.

Aren:

Right. So it's unraveling and undoing some of that food pressure and, and str like the, the restriction that has to be unraveled. So again, it's not gonna be overnight or one sort of conversation for them to feel safe around foods. And I actually, I had this lady, God bless her, she was about my age and she had diabetes back in the eighties and nineties before we had a lot of knowledge about matching food and insulin and all that. And she got caught sneaking up. It was like one of those lame starlike candies. It wasn't even a, in my opinion, a good candy. So she got ahold of this thing and got caught with it, and they beat her with a belt. I mean, not, not great parenting. It was out of love and concern because she had diabetes and they were terrified. but what happened 30 years later when she's in my office with her insulin pump and all that stuff, she has the worst relationship with sweets and with food because of the guilt and the shame that was built around her eating sweets as a kid. So it's a really fine line of balance with over restriction and just unlimited access again. So with type one, it's really treating food the same kind of way and same approach. So if you're giving your kids all a snack, you can't, you have to give everyone the same choices. And that includes meals too. So if you're serving. Steak and baked potatoes and green beans, then everybody at the table gets the same options of things. Now the dessert will be that like kind of same portion based on the child's age. And you only get one serving of that, but everything else is fair game for the whole. So, so what I would encourage you to do, if. Making special arrangements and foods for your child with diabetes, that's gonna backfire and turn into resentment and sneaking food. And if you've already noticed that your child with diabetes is sneaking food, again, you don't wanna look at this as a short-term thing. This is the long game and creating a healthy relationship with sweets and without guilt and shame around these foods that are in the world around us. So you're, you're feeding it home to be able to push your child out of the nest into the world where there's all kinds of food choices and selections. And you're right, the same approach that you would take with a child who's not diabetic or doesn't have diabetes, is gonna be the same approach. Now that sounds terrifying because you're gonna sit there and, and try to calculate for six cookies. If they'd splurge, then you have to dose the insulin to match up with that. And again, it's almost like a therapy session for the kid to reestablish a healthy relationship with these sweet foods because a lot of that negative sort of pressure against not eating them and even just the whole culture of diabetes and sweets has been sort of you know, manipulated a lot to where it's not really that true. So you wanna try to match the insulin with the food, just like a child without diabetes is gonna eat six cookies and their pancreas is gonna dose the insulin properly, naturally cuz they don't have diabetes. So again, you just have to be your best pancreas in that situation and match the insulin up with those six cookies, and then trust that the next time that you offer unlimited cookies, that you'll gradually see your child come around to not be so super obsessed with sweets.

Katie:

Yeah, yeah. I, I, I think I mentioned in the last episode, or maybe the episode before that I was talking about our experience with going to summer camp last, last summer with Sarah and I was a chaperone cuz it wasn't a diabetes camp, it was a church camp and, you know, meal times, every meal time, breakfast, lunch, dinner was a buffet style free for all. Now they did, I mean they had like healthy options. There was a salad bar and there was vegetables and everything, but there was also pizza bar and there was a dessert bar and there was like a pancake bar at breakfast. And I mean, it was just, was unlimited access to food. And so the, that was, that was honestly a little nervewracking for me. especially with camp. Cuz then there's a lot of excitement and activity involved too. So you don't really know how that insulin's gonna respond all the time. But I don't know. The way that I handled it, and maybe this will calm some parents down, is like I knew going into a meal like Sarah's. Probably gonna, I can almost guarantee she's at least gonna eat this number of carbs, you know with, with her meal. So I would just go ahead and dose for that ahead of time. I mean, you know, I know not everybody's comfortable with a pre bowlus, but I would give it to her, you know, 15 or 20 minutes before we would eat. And then I would just kind of keep an eye on her. I wasn't hovering over her, following her around the buffet lines. I'm just kind of like keeping an eye on things outta the corner of my eye while I'm also serving myself. And then I would, you know, just casually walk by and glance at her plate and be like, okay, if she eats all of that, then we're gonna need to give this much more carbs or whatever. And of course, I'm guessing at all of this, cuz who knows, I didn't have a food scale with me. But, but it, I mean, it worked out, it worked out. I mean, not every day was beautifully perfect on the cgm, but it, it, it, we had a great week, you know, it was really fun and, and I think that was really a great experience for Sarah to be able to serve herself and have control over how much of the food. That she eats. And you know, I think that, I don't know. I, I just hope that offers a little bit of encouragement to parents who maybe don't know how to handle these situations and are just really terrified

Aren:

Right. And, and you as a parent in general, you have to give your kids the tools to be able to do it on their own. So like, I bet it was even kind of nice to see, oh, look at that. She put a vegetable on her plate. Like, you know, like kinda a pat on the back for how you've been feeding and. The exposure she's had to all kinds of different types of foods to feel confident and comfortable on this buffet and then still do dessert. But a couple just tips because I know it feels so overwhelming and especially if you have a lot of control over the food with type one, which it feels so controlling. And remember, we know that this control correlates a lot with DIA bulimia, and that's where you can restrict insulin to lose weight or you're, you have a really poor relationship with food, so that's why it's even more important to stick with the division or responsibility so that you can raise competent, healthy eaters that have a good relationship with food. Just so that you can have, again, the long game. It's not just what they're eating right now. So I would encourage you if you are struggling with that balance, start with something like that you know the amount in the grams and set some guidelines with your, with your child that has type one and say, listen, you can have as many cookies as you want, but let me know how many you eat so we can work together to dose the insulin the right way. Cause when you eat a lot of carbs and sugar, it makes it a little trickier to be a pancreas, So, in that scenario, it might make you feel a little more comfortable to have something that's measurable, that has a food label just to kind of ease into

Katie:

Mm-hmm. Mm-hmm. Yeah, definitely. I had just yesterday Sarah came home, she gave herself insulin in the car on the way from school. And she came home and she had like, maybe like two thirds of the carbs that she probably needed to eat. And then she was like, can I have some of this bread? Like we, our church, I don't know, I don't even know what, how they get these things. But like every Sunday they have these bags of bread, literally bags of bread on shelves from Panera for anybody to take. I think Panera just like, apparently Panera's like not even allowed to give that stuff to the homeless community because there's rules around that. Like if they

Aren:

oh my God.

Katie:

I know. Isn't that awful? so they bring it to our church. Anyway, all that to say, usually my children are grabbing bags of bread as we're leaving church every Sunday. So we had this bag of church bread on our counter and Sarah was like, can I have some of that bread? And I was like, Yeah, I, I said, yeah, you can have some, I said that bread is pretty dense, so, you know, I wouldn't take like a huge piece and then I'd like forgot, walked outta the room and forgot about it. And Sarah apparently ate some bread and it, maybe it was more than the carbs that she really needed or whatever. Anyway, long story short, she ended up pretty high. And so later in the day I just looked at her and I was like, Hey, sweetie uh, you're running pretty high. You know, I, I really, it's fine. I'm just asking because I need to know how to manage this insulin situation. I don't wanna give you too much. And you also have this automated system that's probably already been giving you insulin. But like about how much, like, show me with your hands about how big the size piece of bread that you ate was. And she did. And, and I was like, oh, okay. That's probably why. Cause I was like, I, I need to know, is this a pod fail

Aren:

Right.

Katie:

Or is this just, oh, you maybe ate more bread than we, you know, than I realized you ate or whatever. And she showed me with her hands. I'm like, oh, okay. Okay. Yeah. Not a pod fail. It was probably just the bread. I was like, all right, well we probably need some more insulin. So, and she did it and it was fine. And I don't know, there wasn't, I didn't feel like there was any tension around it. She willingly admitted how much bread she thinks she ate. I don't know. I'm, I'm a little bit, I probably need to be a little bit more structured than I am when it comes to snacks

Aren:

but How old is she? She's nine 10. So she's, so if you, that's a really cool transition age for them being able to serve their own snacks and do more things in around feeding and, and snacking. as long as you can keep the communication lines open and like the optimal thing would be like, ugh, Hey mom, I ate a little bit more carbs than, you know, I ate this whole thing, this whole, this whole slice of bread instead of just the piece. And then you guys could work together to dose that way. And maybe just reinforcing that communication to her in a non-judgmental bread kind of way. Like you ate how much bread, you know, kind of thing. And you did perfect with it. But anytime you kind of put judgment or Pressure or any kind of restriction, even in the tone of your voice. It can be perceived by the child in a different way than you're intending in terms of like wanting to help and like being concerned and the, oh my gosh, the blood sugar's high. again, trying not to, just looking at the numbers like data and not saying, oh, that blah, blah, blah, food that you ate. Just I told you so, and now you're 300. You know, trying not to associate the foods specifically, especially forbidden foods with bad blood sugars. And just trying to work as a team to kind of get the best outcomes in terms of more in range blood sugar values. And again, it's fines, it's a lot of adjustments and juggling. And honestly, you're doing the work of a pancreas. It's hard, it's unpredictable and so just give yourself some grace. But I feel like the. Instances of a few high blood sugar readings in this recovery process of unraveling over restriction with feeding, especially with kids with diabetes. It's way more important in the long run for them as an adult and having a good relationship with sweets and forbidden foods. In the long run and they're watching you. Like there's even research that shows that if the mom is dieting, like on and off cycling and dieting and restricting and then overdoing it, binging that the kids also see that pattern and are more likely to over-indulge and then restrict. it's, it's crazy. And so again, the IT backfires is just the bottom line is that any kind of restriction with forbidden foods over restriction will result in your child being heavier than they should be for their body and then them sneaking food behind your back. And I just wanna. Make kind of a blanket statement. I had, where I had a client where it just went really wrong. The mom really was very controlling in a caring way. Like she wanted her blood sugars to be perfect. She was scared to death of any complications or problems, and the daughter was pretty compliant. Like, again, the child's personality will be different based on your restriction too. Some kids will just be like, I ain't, you're, you're not gonna tell me what to eat. And they'll just figure it out on their own. Or, or like you said, the broccoli bite, like they'll just set you out at the table. Wait you out at the table. But some kids are like, oh mom, I'll do what you say, and they'll go along with, But in, still in the back of their head, it's messing up their innate ability to be able to self-regulate. So this this little girl went along, did a lot of the restriction, especially with the Forbidden foods. And then she graduates from high school, her A1C is 5.6, she's doing amazing on her devices. And then she's pushed out of the nest and goes to college and she's exposed to all of the things that's so amazing at college. Starbucks, pizza, you know milkshakes and she has no clue how to manage those items. So if, I would encourage you, if you can work as a team and communicate with your kids and as, especially as they become adults and, and teenagers especially, is what I meant is that you can kind of help. Hand that baton over to them in their diabetes management so that they can be successful. And I feel like in this world, you have to let them be comfortable and confident navigating these sort of sweet foods and, and foods. I mean, when your sugar's 300, it feels, it doesn't feel great. But sometimes it's worth it. I mean, that cupcake might be worth feeling 300, you know, because it was just so good. And you were at a party with your friends and everybody else was eating cupcakes and you just wanted to have what they were having And it, it's so hard to be a kid, even just remembering when I was little and having diabetes. And in holidays my grandma would give me, give everybody else desserts, and then I would get an apple and it

Katie:

Which, which is actually pretty hard to dose for

Aren:

Right, right. So, but anyways, it's just like you have all this resentment. Diabetes is hard enough, and then you're like, oh, look at me. I'm different now. I have to eat, you know, this stupid apple. And then you also are like, oh, apples, I hate apples. You know, and you have this negative thing even about healthy foods. So again, you wanna kind of clear the board and just be really careful about your wording. And then just matching the insulin and the food the best you can to give your kids tools to be able to navigate different foods outside of the house.

Katie:

I think it's important to remember too, like you know, all these low carb foods and, and some people really just do so phenomenally well, like with, with all of that stuff. And I'm truly impressed. I just, but like they, they're really expensive. A lot of them are, not all of them, but a lot of them are. Meat is really expensive. Low carb options are so much more expensive than the other stuff. And yes, I know it's an investment in our health, but like your, think about your kids graduating from college, they're probably not gonna be making enough money to buy all these super expensive foods all the time. I mean, maybe they are cause they won't maybe have a family at that time and kids, and, you know, it all gets more expensive the, the more people you add to your family. But, you know, I think that's something to remember too, that like, not everybody has the financial means to really eat this, like this lower carb option lifestyle. You know, it, it, so I.

Aren:

when, in terms of low carb, when it comes to feeding with the Ellen Satter thing, Again, you get to choose what you have in the house. So if everybody is eating low carb, there's no exceptions and there's no specific like, oh, Johnny has diabetes, so that's why everybody's not allowed to have X, Y, Z anymore. I mean, siblings can be brutal. So you have to make sure there's no like animosity towards the child with diabetes because everybody's eating low carb all of a sudden. But again, everybody should be eating the same thing in the household. And then It's a level playing field without, regardless of diabetes. And so you know your child better than anybody else. You know their personality. If they're gonna rebel and sneak food behind your back, that's a red flag that whatever approach you're using isn't working for their emotional help and probably for their diabetes as well. Because if they're sneaking food, they're likely not taking insulin to, to cover that. So watching out for those red flags, and if you try it and it works great, then by all means keep, doing what works for your family and you can modify kind of off that, that deal the vision, responsibility a little bit with what you're choosing to feed your children, but really focus on the how much and weather, and then if it starts to become a problem or red flag. I would reevaluate, take a step back. That's what the best parents do. If something's not working, they take a step back. Don't feel guilt or anything about what you choose to do, you know, for your family. But honestly, I mean, low carb is a lot easier to manage glucose values and to stay in range. But I feel like with the age of the technology that we have, How close we can get to, to decent glucose values with these automated insulin delivery systems. I feel like the rate and risk of complications goes drastically down when you, you embrace this technology. So what we were afraid of back in the eighties and nineties when we had all this lousy insulin isn't really, if you can be a ninja with insulin, you can choose and eat whatever foods you want to eat. But I just wanna encourage you to not just focus as number one, health criteria is your child's blood sugars. You have to look at the big picture in their emotional health, their relationship with food, and when they're an adult. And if they wanna be do like you said, like do low carb or do something like that. Just make sure they have the tools to be able to do both.

Katie:

Mm-hmm. Yeah. And I'm sure there's a lot of parents listening that have a specific question about their specific circumstances. So, you know, I would encourage you to get in touch with, with Erin. I mean, I will leave links in the show notes to where you can contact her. And, and she's available. She, she's available to work for you so you can, you can get in touch with her and, and she can help you troubleshoot. Specific situation and what you're dealing with, with your family in particular. Cuz you know, there's only, there's only so much we can cover in an hour long podcast, but, you know, I hope we got kind of the wheels turning people thinking about how they're, they're feeding their children and if it's working, if it's not, you know, maybe, maybe a lot of people have realized today that, gosh, we're doing an awesome job, or gosh, we really need to take a step back and, and reevaluate what's going on here. Especially like, like you said, if your kid is sneaking a lot of food or going to a friend's house and raid their pantry, things like that. So but anything else you wanna add before we, we sign off for today?

Aren:

No, I would just, again, that communication with your child and then just giving them the tools that they need to be successful with diabetes as an adult is. So valuable and you know, just focus on love. Like, and, and you know, your child and just doing what you can to, to be supportive for them is just, it's man, diabetes is so hard.

Katie:

It is, it really is. It is being pa let's be honest, just being a parent is really, really hard. So,

Aren:

right? It is. And then throwing that chronic disease when it sort of thing in there and then balancing it with the rest of your family can, can be tricky.

Katie:

Absolutely. Oh, you know what, real quick, celiacs like you, you talked about low carb, like if you're gonna do low carb, then everybody at the table needs to eat low carb. But I, I thought about Celiac in that moment too. Like if you're going, if you're, if somebody in the family has a gluten allergy, then it's probably best that everybody at the table is eating gluten-free options. Would you agree?

Aren:

Not necessarily. So for the way that the dor, the division responsibility works with allergies, it's just a matter of fact. Sorry, you can't have that and having like an alternative. So for example, I have celiac and so I have my own special bread so that if we're having bread at dinner, I'll just thaw out a piece of mind to have along with the family meal. Same thing for, for kids with the allergies. I also have a dairy allergy, so you can kind of modify the way that you prepare things to have their kind of rice without butter on the side. Or you can buy specific items like sugar. Sorry. Gosh, don't ever buy sugar free. I don't know. I'm joking. But I said sugar free, but I meant dairy free. So you can have, if you're having ice cream for a snack after, you know, for a bedtime snack and everybody's eating ice cream, then definitely you can get a substitute that's dairy free for that child. So there's, in, in terms of allergies, there are definite just substitutions that just will go in instead of the allergen.

Katie:

Okay. Okay. All right. Well thank you so much Erin. Thank you for your time as always. It's been such a pleasure to have you on. Um, I've loved chatting with you. Well, have a good day,

Aren:

Yeah, you too.

Katie:

That's it for our episode today, friend. It is always a joy chatting with you each week. I hope this topic was a help and a blessing to you, and I just wanna send a humongous thank you to Erin for taking the time to come on and do this mini series with me on raising a healthy and competent. Eater. Thanks, Erin. Remember, you can hire Erin to help you if you need her. If you're nodding your head yes, like I really need to do that, then check out the links in the show notes so you'll know where to find her on Instagram, Facebook, and the web. All right, have a great week. I will chat with you soon, but until then, stay calm and bolus on.