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Do you sometimes compare your child’s height with that of his classmates and worry about their health?
Just as you shouldn’t judge a book by its cover, you can’t judge a person’s health by their appearance alone, says Jill Castle, a pediatric dietitian in Massachusetts. In her new book, “Kids Thrive at Every Size,” Castle aims to offer a new model for assessing and treating children’s health.
Children with larger or smaller than average bodies are at higher risk for psychological harm because of their size than their average-sized peers, Castle said. And some of the tactics adults use to influence their child’s size can have implications for their health and relationship with food for the rest of their lives, said Jennifer Rollin, founder of the Eating Disorder Center in Rockville, Maryland.
With the new school year upon us, children with larger or smaller bodies may struggle in school, but the adults who care for them have an opportunity to reframe the family’s attitude toward health and size, Castle said.
If you’re looking to introduce your child to new healthy habits as the new school year begins, here’s what Castle has to offer — and what you may want to rethink.
When assessing children’s health, great attention is often paid to their size and shape, Castle said.
“We work on the fixed weight model or the fixed height model. That involves looking at a child who is too short and saying, ‘Hey, we need to adjust the height of this child and make them taller,'” she said. “Or we look at a child with a larger body and say, ‘Hey, that doesn’t fit our norm.'”
There are some problems with this approach. One is that weight and height rarely tell the whole story, says pediatrician Dr. Nimali Fernando, founder of the Dr. Yum Project, a Virginia-based nonprofit that helps communities overcome barriers to healthy eating.
“When we look at a child’s overall health, we have to take into account a lot of social factors. It’s very easy to just focus on the things we can measure rather than really taking the time to understand what’s going on in a child’s life,” she says.
Another problem is that the options for addressing size directly are often not helpful.
“Forcing children to eat more or less, denying them seconds – we know that these feeding methods do not work very well in the long term and can disrupt the development of a relationship with food,” Castle said.
Instead, Castle developed a model called “Whole Child Healthy,” which focuses on the balance between physical health and emotional well-being.
“(The factors) include things like sleep and exercise, screen time and food, but also family culture and self-love as pillars,” she added.
Strict health regulations are not the way to a healthy and fit child – instead, says Castle, “every child needs good, healthy habits to grow up healthy and happy.”
Family culture: The first pillar of health, which Castle emphasizes, is not about a child’s diet or physical activity. It’s about the family culture that surrounds them.
“A family culture is who your family is,” she said. “As a family, it’s what you believe in, your core values, your attitudes, what you spend your time doing. And children growing up with larger or smaller bodies need families with strong, positive family cultures.”
She recommends taking a close look at how your family talks about food, your own body, other people’s bodies and other things that are important to you. Family meetings, family mantras and activities that support these values can help reinforce the environment you want to create for your children, she said.
Eat: “The goal of the nutrition pillar is to allow flexibility in diet and to focus on foods that are high in nutritional value and … also to allow foods that are minimally nutritional in the diet, in a way that is fully enjoyed and flexible,” Castle said.
However, this flexibility does not mean that there are no limits and structures.
Instead, Castle recommends focusing on things like eating meals at roughly the same time every day, having predictable snacks, mindful eating, and eating together as a family as often as possible during the week.
“And you really have to do your responsibilities as a parent, which is buying the food, preparing the meals, getting them on the table and then freeing yourself as a parent from the further task of getting your child to eat,” Castle said.
Finally, we should try to view foods as more or less nutritious and move away from branding them as “good” or “bad,” Castle advises.
“The Clean Club or rewarding with treats – that may work in the moment, but it doesn’t help build confidence and an intuitive, good relationship with food as children grow up,” Castle said.
Sleep: Good sleep is crucial for your child’s physical and emotional well-being, so maintaining good sleep hygiene should be at the top of your priority list, Castle says.
That means developing habits like not having screens in the room, minimizing noise in the bedroom, darkening it and making sure your child has a relaxing bedtime routine, Castle says.
A sleep routine should also include setting a regular bedtime and a regular wake-up time in the morning, she added.
Without school and extracurricular activities over the summer, some important health routines may have fallen by the wayside. Fortunately, your family can view the new school year as a fresh start.
“This is a good time to get back on the habit wheel and restart, refresh or renew habits that may have gotten a little out of whack over the summer,” Castle said.
Sending your child back to school doesn’t have to mean giving up your dietary limits, Castle said.
Your family can plan ahead by looking at the school cafeteria menu or making plans to pack and select a lunch together – and also talk about your expectations for the food, she said.
“Parents should feel encouraged to be able to say to their children, ‘I expect you to have a portion of fruit on your tray every day this week at school lunch. … You can choose what you want, but fruit is really important to your overall eating pattern and it’s important that you get some at school,'” Castle added.
Families may also be concerned about the new school year and the possibility of their children, both big and small, being bullied.
First, it’s important to know you can advocate for your child, whether it’s by taking the pediatrician aside and discussing how to talk to your child about weight during office hours or by speaking out against stigmatizing curricula or policies at school, Rollin says.
Then it’s important to look at the environment you create at home, Castle said. Have you conveyed to your child that everyone is accepted at home? Do you treat your children differently depending on their size? Or do you emphasize your child’s worth that has nothing to do with their appearance?
And one of the biggest influences you have on your child is the behavior you model for them. It can be important to look at how you talk about your own body and your relationship with food, Rollin said.
Working with a weight-neutral dietitian or talking to a therapist can help you overcome your own beliefs about body image so you can reduce your fears and create the best environment for your child, she said.
