Feeding Your Child - The Brazelton Way


By T. Berry Brazelton

By Joshua Sparrow

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Nursing newborns, picky toddlers, four-year-olds with bizarre food preferences-at every age, parents are concerned with what their children eat. In this indispensable, straight-to-the-point guide, Brazelton and Sparrow follow the same approach of the earlier three very successful books in this series. First they apply the Touchpoints philosophy to feeding (watch for the setbacks that often come before a leap of progress), then they follow feeding progress age by age, and finally they deal with the most common issues: breast or bottle, weaning, basic nutritional needs, the over-involved parent, food battles, adolescent overeating, and the roots of eating disorders. Mealtimes can be fun, healthy, family times-the Brazelton Way.


Also in the series
Calming Your
Fussy Baby
Toilet Training

also by T. Berry Brazelton, M.D.
On Becoming a Family
The Growth of Attachment Before and After Birth
Infants and Mothers
Differences in Development
Toddlers and Parents
Declaration of Independence
Doctor and Child
To Listen to a Child
Understanding the Normal Problems of Growing Up
Working and Caring
What Every Baby Knows
Families, Crisis, and Caring
Your Child's Emotional and Behavioral Development
Going to the Doctor
with Bertrand G. Cramer, M.D.
The Earliest Relationship
Parents, Infants, and the Drama of Early Attachment
with Stanley I. Greenspan
The Irreducible Needs of Children
also by T. Berry Brazelton, M.D. and Joshua D. Sparrow, M.D.
Touchpoints Three to Six
Your Child's Emotional and Behavioral Development
Calming Your Fussy Baby: The Brazelton Way
Sleep: The Brazelton Way
Discipline: The Brazelton Way
Toilet Training: The Brazelton Way

To the children and parents who have taught us so much through the years

This book is meant to complement, not substitute for, the advice given by your child's pediatrician. It should not be used as an alternative to appropriate medical care. The authors have exerted every effort to ensure that the information presented is accurate up to the time of publication. However, in light of ongoing research and the constant flow of information it is possible that new findings may invalidate some of the data presented here. Before starting any treatment or new program, you should consult your pediatrician about your own child's health, symptoms, diagnosis, and treatment.

Ever since I wrote the first Touchpoints book, published in 1991, I have been asked by parents and professionals all over the country to write some short, easy-to-read books on the common challenges that parents face as they raise their children. Among the most common are crying, discipline, sleep, toilet training, and feeding.
In my 50 years of pediatric practice, families have taught me that problems in these areas often arise predictably as a child develops. In these short books I have tried to address the problems that parents are bound to encounter as their children regress just before they make their next developmental leap. Each book describes these "touchpoints" so that parents can better understand their child's behavior. Each also offers practical suggestions on how parents can help their child master the challenges and get back on track.
In general, these books focus on the concerns of the first six years of life, although occasionally older children's issues are referred to. In the final chapters, special problems are discussed. These short books are not intended to cover such topics exhaustively. Instead, we hope that these books will serve as easy-to-use guides for parents to turn to as they face their child's growing pains, the "touchpoints" that inevitably arise as children and parents navigate these common and predictable childhood issues. For parents who want more information, references are provided for the topics covered.
As with Touchpoints Three to Six, I have invited Joshua Sparrow, M.D., to co-author these books with me, to add his perspective to mine. Although difficulties such as food refusal, weaning problems, and chaotic mealtimes are common and predictable, they make great demands on parents. These kinds of problems are, for the most part, temporary and not serious, yet without support and understanding, they can overwhelm a family and send a child's development seriously off course. We do not want to load parents down with advice that stops them from following their instincts, but instead to offer them the support they may need to understand their child and reaffirm their own expertise. It is our hope that the straightforward information provided in these books will help prevent those unnecessary derailments and provide reassurance for parents in times of uncertainty, so that the excitement and joy of helping a child grow can be rekindled.

A Parent's First Job
Feeding a child is a sacred mission for a parent. From the first stirring of the baby in the womb, a parent-to-be feels: "This will be my new life. It will be up to me to assure that my baby grows and thrives. Feeding her well will be my job—one part of all that responsibility." This new role may begin to feel like a challenge even before the child is born. After birth, although feeding may lead to more worries, it is more likely to be a source of great pleasure—from the very first feeding—for parents and baby.

Touchpoints—A Predictable Path for Development

The steps along the path taken by dedicated, responsible parents and their child are predictable ones. There are times when the child will be difficult to feed. These predictable hurdles, which I call "touchpoints," often precede a new burst of independence in the child.
When a strong-willed child is eager for more participation in feeding—holding the bottle, sippie cup, or spoon or flinging hunks of food from the high chair—parents can feel challenged. These touchpoints occur as a child is ready to take on a larger role in caring for herself. Parents sense the child's pulling away. They may try to regain control, lest they lose the child they have learned to understand. But parents can also learn to let go and feel proud of their child's new resourcefulness. When they do, feeding will again become a source of pleasure and a special time for being together.
I call these times of change touchpoints because I have found that passionate parents can reevaluate their role if I can reach out to them at the right time with the information they need—revealing the child's struggle as an important one for her future development. We hope you can use Chapter Two, "The Touchpoints of Feeding," to help you watch for the conflict between your child's goals for independence and yours for "getting her fed properly." As you learn to prepare yourself for these times, you'll find it easier to plan your child's meals, and encourage her participation in them.
Chapter Three, "Feeding Challenges and Opportunities," addresses common problems that arise as children learn to eat, and parents learn to feed them, in the first years. As you can see, this book is not meant to be an exhaustive guide to pediatric nutrition or gastrointestinal illness. While pointing out some basics, it focuses on the behavior and psychological issues that accompany feeding, from the beginning of life through the early years. Specialized questions, for example, about food additives, allergies, or digestive disorders can be pursued through the books and resources in the bibliography.

"Ghosts from the Nursery"

As a baby grows, a parent's responsibility to nurture can seem even greater. No wonder a parent can find it difficult to turn feeding over to the child as the child fights for independence in making her own choices. My own mother, a sensitive and worthy lady, could not let my younger brother learn to feed himself on his own. My memories of meals when we were little are of her cajoling, singing, and poking bits of food at him for two hours at each meal. He, in turn, was in control. His jaw muscles bulged as they held his mouth shut. His eyes were rather merry as he led my mother through the two-hour battle. "Please, just one bite!" she would plead, over and over, to no avail.
This experience became a "ghost" in my own nursery, an expression that child expert Selma Fraiberg coined to describe the effects of certain childhood memories on adult behavior. It helped set my future. I eventually determined to become a physician who could turn parents' passion toward positive approaches to child rearing, especially in the area of feeding. Many parents discover their own "ghosts," childhood memories about being fed, as they accompany their own child through the touchpoints of feeding.
By the end of the first year, for example, control over choice and quantity of food must become the child's. Many parents find it hard to turn that job over to the child. However, no parent can successfully force a child to eat: a battle over food is one the parent is sure to lose. Parents can only present the child with healthy choices.
Feeding oneself and making one's own choices is a necessary goal for any young child. Parents will have to learn to give up the delicious sensation of the baby nursing in their arms and to enjoy instead the mealtime company of a 1-year-old who is more interested in testing out gravity with her food than she is in putting it in her mouth. Ultimately, though, enjoying the pleasure of being together that goes along with mealtimes will be the most effective way for parents to support the child's development of healthy eating habits.
When parents struggle with a child over food—what to eat and how much—the child's hunger seems to lose its importance. Hunger is a basic instinct, controlled by a fairly primitive part of the brain. However, more complex parts of a child's brain are set in motion and can override hunger. This occurs, for example, when a child begins to wonder, "Do I have to eat this because my mother says I do? Can she make me?" When there's a chance for a struggle, a child's hunger may not be enough to push a child to eat. If there is turmoil over food between parent and child, food loses its primary meaning—as a necessity for health and a source of comfort and pleasure.
Sometimes such struggles arise from a parents' "ghosts," sometimes from limitations in the baby or young child's ability to suck, swallow, coordinate chewing movements, keep food down, and so on. Often these factors work together. Struggles over food are always passionate. Parents everywhere know that food is as necessary to survival as air, and they care deeply about their child's survival and growth. Children, for their part, have strong preferences from an early age. Cultural traditions are also an important part of a parent's passion.

A Parent's Passion

Parents' commitment to feed their children and to protect them from malnutrition is powerful. This became clear to me in a study we did of a malnourished group of Mayan Indians in Guatemala in 1978. Pregnant women were subsisting on 1,200-1,400 calories a day, even though more than 2,000 calories per day (exact amounts vary depending on height, activity level, and other factors) would be necessary for adequate nourishment of the developing fetus's brain.
We tried to increase their diet to an adequate level. We offered these women a daily 1,000-calorie liquid supplement. They came into our local center each day to get the supplement, take it home, and then—use it to feed the rest of the family! Our special liquid supplement for these pregnant women never reached their fetuses. The mothers felt they must first feed their already born children. The sad result was a lower than expected IQ by the time these unborn babies reached school age.
When we finally recognized the obvious, that of course a mother would feed her children before feeding herself, we changed our tactics. We began to urge these well-meaning women to drink the supplement "in order to have smart babies." When they understood that they were not just taking this additional food for their own benefit, but instead for their unborn babies' well-being, they were willing to drink it themselves. How powerful is the maternal instinct to protect her offspring!

Brain Development Begins Before Birth

The Guatemalan study also showed us the strong influences of poor nutrition on children's development. We learned that lower intelligence was all too likely if children were undernourished in the womb or in early infancy. At birth, babies who have been undernourished during pregnancy are already less responsive to nurturing. Mothers may then feed them "when they want it," often only three times a day for a lethargic baby, rather than the 6 to 8 feedings a day that well-fed newborns usually demand.
Even in a land of plenty, parents are just as passionate about their responsibility to ensure that their child is well nourished. In fact, our increased understanding about the effects of nutrition on health and early brain development can lead parents to put pressure on their children. This can interfere with pleasure in eating—the second most important motivator for children after hunger.
There is still much to be learned about nutrition. In the meantime, a child who learns to enjoy eating a wide variety of foods will receive the balance of nutrients that, as far as we know now, will best help her grow up healthy and strong. For a child to develop this kind of curiosity and flexibility about food, mealtimes need to be fun, relaxing, and a time for a family to enjoy being together. In this book we suggest ways to keep them that way.
Pressure from others, along with a parent's sense of duty, can get in the way. So can a child's struggles to eat independently. Parents need to be prepared for the touchpoints in which struggles are likely to arise. The goal must, of course, be for a child to feed herself independently and to enjoy eating enough of the right kinds of foods to help her grow and be healthy. Parents will want to take into account the child's temperament as well as the developmental challenges of each touchpoint, which we will explain in Chapter Two.


Feeding a Quiet Child

A quiet, sensitive child may be on a different track from her peers. She may comply with being fed and continue to be compliant even during the usual times of conflict. For example, unlike other children her age, she may allow herself to be fed into the second year, apparently content to be a passive recipient. Then, all of a sudden, refusal! No longer will she put up with being fed. Passive resistance may be her response.
Her refusal to be fed is a warning to her parents to pull back and let her try feeding herself. Since she has not had experience with finger feeding or with utensils, her first attempts to feed herself may be clumsy. A big mess at every meal—food on her face, her clothes, the table, the floor, everywhere—will be the inescapable price for her earlier compliance.
Parents may even be thankful for the slobbery mess when it comes—a welcome relief from the initial food refusal of this phase of self-assertion! Patience with such a child will be the saving grace. Let her learn how to take over the job of feeding. Offer her only two bits at a time of an attractive finger food for each meal. Then ignore her struggle and leave it to her. Keep her company, but don't cajole during meals. If and when she downs the two bits, offer her two more at a time, until she starts smooshing them or launching them over the edge of her high chair. This means it's time to stop—until the next meal. Don't let her "graze" between meals. And for now, don't worry about a well-rounded diet. Remember that this previously compliant child is quickly learning the skills of self-feeding. It might have taken her several months longer to learn had she been less passive and started in with her attempts to take over her own feeding earlier. Be patient and follow her lead.

Feeding an Active Child

At the other end of the temperament spectrum is the active, constantly moving, curious-about-everything child. She is far more interested in sights, sounds, and rushing around than in food. A parent whose motive is to see that the child is well fed is bound to feel frustrated, even desperate. "Sit down in your seat," a worried parent will beg as the child climbs out of her high chair to hang teetering on the edge. The child looks up coyly, holding out one hand for a "cookie." Anything she can eat will do as long as at the same time she can clamber around the house, up and over furniture and into drawers to pull out clean clothes with grubby fingers.
Many parents of active children have asked me: "Should I feed her on the run? She'll never eat enough sitting down. She barely sits before she's gone. I wait until she's hungry, but she never is. I feel like I need to give her bits of food all through the day so that she'll get enough. What should I do?"
My advice has been:
1. Keep mealtimes a sacred time for the family to be together. Don't let the phone or other interruptions interfere.
2. When your child loses interest in sitting at the table—that's it. Put her down and let her know her meal is over. No grazing between meals. No more food until the next meal.
3. Make meals a fun time to be together—at least as much as is possible with a squirming, food-throwing toddler. Make meals as companionable as possible—you eat when she does. But if she doesn't, eat your own meal and let her know that you can chat and be together if she stays at the table. If she squirms to leave, put her down. But she'll have to wait for your attention until you're done. Eventually she'll learn to model on you.
4. No television at the table or promises of special sweet desserts to get her to sit and eat.
5. Be sure you let her feed herself. Never say, "Just one more bite." If you do, you'll be setting yourself up for testing.
6. Don't go to special trouble to cook her a special or exciting meal—your disappointment is likely to outweigh the benefits. Instead, let your child know that "this is what we're having for dinner tonight." If she doesn't want it, she'll have to see if she likes the next meal any better.
7. Let her help with meals as soon as she is old enough to do even the smallest task, such as setting the table (start with the napkins only!), cleaning it with a sponge, and so on.
8. Have your child's pediatrician check her weight and growth, and ask her for supplements if necessary.
9. Above all, don't set meals up as a struggle or her high chair as a prison to keep her in.

Beyond Nutrition

Right from the first, feeding is an opportunity for intimacy. Parents find such satisfaction in being able to provide a child with what she needs and to enjoy with her the pleasure of eating. Mealtimes are opportunities for parents and child to relax and enjoy each other. If parents can manage their own feelings about their child's independence in this area, the child will look forward to meals, to eating the way the rest of the family do.


On Sale
Jan 8, 2004
Page Count
192 pages

T. Berry Brazelton

About the Author

T. Berry Brazelton, MD was professor emeritus of pediatrics at Harvard Medical School and adjunct professor of psychiatry, human behavior, and pediatrics at Brown University.

Joshua D. Sparrow, M.D., child psychiatrist and supervisor of inpatient psychiatry at Children’s Hospital Boston, is Assistant Professor of Psychiatry at Harvard Medical School, and Associate Director of Training at the Brazelton Touchpoints Center. He is co-author with Dr. Brazelton of Touchpoints Three to Six and several titles in the Brazelton Way series.

Learn more about this author