Does encouraging a "small" child to eat all day work? Lessons from shopping on an emtpy stomach.

Standard advice parents hear when they worry their child is "too small" or not "eating enough" is to offer and push food all day long. They are told by their child's doctors and specialists to push Pediasure or  high-fat foods, "...any time your child lets you." I had one call with a client a few years ago who was panting on the phone, out of breath from chasing her toddler with a piece of sausage. My friend had a sippy-cup full of high-calorie drinks that she would put in her toddler's mouth in the stroller on the way to the park, at the park and on the way home, only to be frustrated when she didn't touch her lunch.Pushing kids to eat, or  trying to get a little bit in to them whenever you can, most often backfires and results in children who eat and grow less well. Kids end up "grazing," or taking in small amounts throughout the day: a bottle with protein powder, a sippy-cup full of Pediasure or milkshakes, only "healthy" choices, crackers...Often the intake analyses I see with clients worried their child is too small shows a child who is eating a little bit, every 30-60 minutes, often with a lot of nagging and effort. Parents tell me that their children "can't" feel hunger cues, or never show that they are hungry.As Hydee, our consulting pediatric RD said, "These children are never allowed the opportunity to develop an appetite." (I loved how she worded that...)"Appetite," or foods being appealing, is seriously bummed out by a few things: stress, anxiety, pressure, and/or constantly having a little something in your tummy. Maybe this analogy will help explain.Imagine you are shopping for groceries and haven't eaten for several hours. What is that experience like? Do you, like me, find that everything looks good, that you have all kinds of ideas about what to cook, with several items not on your list finding their way into your cart? Maybe you even notice that more of the high-calorie, high-fats food seem appealing, and you find three bags of your favorite chips in your cart, not the usual one.  Maybe you even make a point of visiting all the sample tables. It ALL looks yummy!Now think about when you shopped after a big and satisfying meal. You stuck to your list, weren't as tempted by other things, breezed by the free samples with not interest...It's similar with children and appetite. Ever heard, "hunger is the best cook?" It's true. Structure means that at planned meals and snacks, your child has a little hunger, isn't ravenous, and has the opportunity to develop an appetite. (It also helps to even out blood sugar levels which often helps with behavior.)So, if you are working hard to get more into your child, maybe fill in the intake form (under Appendix Items, feeding and intake journal)  for three days, note when and what your child is eating. If you find your child is eating much more than every 2-3 hours (for younger kids) and 3-4 hours (for older kids), maybe part of why your child is "never hungry" is because well, she's never hungry.Consider structuring meals and snacks (the when from the division of responsibility) and see what happens. It might take a few days to see your child learn to listen to cues of hunger, but working on structure is one of the most important ways to help a child with self-regulation and learning to like new foods.(Check out this free video on how to feed a child you think is too small. How to transition to structure when you feel stuck is discussed in detail in Chapter 4 in Love Me, Feed Me.)

What do you think? Did planning meals and snacks help you or your kids with their eating?