How to Get Your Kid to Eat…But Not Too Much, by Ellyn Satter, Palo Alto, CA, Bull Publishing Company, 1987, 306 pp., $16.95.
In How to Get Your Kid to Eat…But Not Too Much, Ellyn Satter proposes and clearly demonstrates through research, anecdotes, and common sense that "feeding is a metaphor for the parent-child relationship overall." A healthy parent-child feeding relationship is the key to decreasing the incidence of childhood eating problems. It is also critical in eliminating the later development of poor adult body image and eating problems.
With these ideas as a foundation, the author successfully presents advice on feeding, nutrition, and general parenting. This should be helpful to physicians, childcare providers, parents, and anyone else involved in meal planning, preparation, or the feeding of the children of all ages and needs. Her book is divided into three sections: Basic Principles of Feeding, Feeding As Your Child Grows, and Special Feeding Problems. Because the author reiterates her basic ideas frequently throughout the book, each section could stand alone.
In Section One, Ms. Satter suggests that the way to develop a positive feeding relationship with a child is through division of responsibility. "The parent is responsible for what the child is offered to eat, the child is responsible for how much, and even whether, she eats." If parents can adopt this philosophy they can avoid pressuring children about what to eat and how much. Research has shown that the more babies and children are pressured to eat, the less they eat and the more stressed their parents become-a vicious cycle ensues.
Another central theme is that all children are different with regard to food interest, appetite, caloric needs, and basic body structure. Understanding your child's temperament as it relates to eating and food, and accepting your child's genetic body type are important to preventing feeding problems. Accept your child as s/he is and teach your child love and acceptance of one's self.
In Section Two the feeding relationship and basic nutritional needs of children are highlighted for each age group from newborn through teenager. In each chapter, a separate age is discussed and common themes are repeated. Again, reading only one chapter is possible.
The common issues of poor feeding, obesity, and eating disorders are covered in Section Three. Feeding children with special needs, including prematurity, diabetes, and tube feeding is addressed. Perhaps the most controversial chapter relates to obesity and dieting. Ms. Satter emphatically states that she is opposed to putting any child on a diet. She believes it interferes with a child's autonomy and leads the child to feel angry with his parents and poorly about himself. It also creates dependence on his parent for eating control. She does offer suggestions for the prevention of obesity including scheduled meals and snacks, eating slowly, providing foods with less fat and sugar content, and regular, fun family exercise.
As a whole, I found this book interesting and helpful. I have already used many of her ideas with my pediatric patients and my own child. Much of it is common sense when one steps away from the table and puts the feeding relationship in the context of basic parenting. As she states "The best parenting provides both love and limits," and her feeding techniques teach us how to do this and take the pressure off our children and ourselves.
On the other hand, at times I found her remarks condescending and critical especially of professionals working with families. The repetition of concepts was occasionally monotonous. However, the merits of the book far outweigh these small criticisms and I would highly recommend it to parents and professionals who care for children.
Jeanne E. Ziter, M.D.
Providence, Rhode Island