Families

Supporting families to develop healthy eating behaviours

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Many food preferences can be developed during this stage of life, so offering young children a variety of food will help them develop healthy eating habits later in life.

The whole family (parents/carers, siblings and other family members) can play a role in promoting healthy eating in children and being positive role models. Even if parents/carers don’t like a particular food themselves, it is important to show enthusiasm and encourage their child to try/eat the food.

The following tips might help parents/carers to introduce healthy eating at home.

Mealtimes
  • Offer regular meal and snack times throughout the day where possible.
  • Encourage the whole family to sit down and eat together where possible, and to create a positive environment that can help responsive feeding.
  • Try and keep mealtimes free from distractions (e.g., TV, i-pads), as this can lead to unresponsive feeding (i.e., children and parents/carers are less aware of the child’s hunger and fullness cues).
  • Try and make mealtimes calm and relaxed.
Trying new foods
  • Try offering new foods with already accepted or familiar foods.
  • It can take several attempts for a child to accept a food so continue to offer the food at future meals or snacks (even if the child has rejected it on previous occasions).
  • Try not to show frustration when a child won’t eat a certain food, take it away and try again another day.
  • Encourage parents/carers to be aware of what they say around children. Try to avoid labelling children as “not liking” a certain food – if children hear this they will internalise it. Instead keep encouraging them to try, and encourage parents/carers to be positive role models (by showing willingness to try foods rather than expressing their own dislikes).
  • Offer children meals and snacks with lots of colour and texture as this can be more appealing to a child.
Promoting a healthy relationship with food
  • Some children can be put off by large portions so offer them smaller portions and seconds can always be offered if they are still hungry.
  • Offer praise when children have eaten well.
  • Try not to talk about “good” or “bad” foods, and instead promote a healthy, balanced diet.
  • Try not to use high sugar and fat “treat” foods as rewards or bribes (for eating other healthier foods).
  • Avoid bribing a child to eat more - let them decide when they have had enough.
  • Promote enjoyment in cooking, e.g., involve children in the preparation of meals and snacks.
  • Make food fun, e.g., shaping foods as their favourite animals, or making faces out of fruit.
  • Accept that mess can be part of mealtimes and can help children to learn about food and eating.
  • Help children understand why food is important for our bodies (focus on what our bodies do, rather than what they look like).

Parents/carers’ own relationships with food and weight

How parents/carers behave around food and weight can have a large impact on children. Children pick up on what their parents/carers say (e.g., “I feel fat today”) and notice what they do (e.g., skipping meals), which could lead children to internalise certain unhealthy attitudes or behaviours around food.

If as a practitioner you have a concern about a parent/carer’s relationship with food or weight, the charity Beat Eating Disorders provides useful information about where to get support and about starting the conversation with someone you are worried about.

For adults living with obesity, it is worth finding out about your local NHS weight management services and how to refer/signpost adults who might benefit (this is usually via the GP, but your local public health team will be able to provide more information).

Talking to parents/carers about children’s diets

Talking about food can be a sensitive topic. Nowadays, most parents/carers have good knowledge of basic nutrition, and challenging this might lead to feelings of inadequacy or cause defensive responses. By drawing on the communication skills and behaviour change techniques from the earlier modules, it is possible to create a safe space to have open and helpful conversations about children’s and families’ eating behaviours.

Please see the resources section for information sheets to print out and support these conversations.

Try the activity below to reflect on how to talk positively about children’s diets with parent/s carers.

Over to you

In the video below the practitioner (Paula) is talking to the mother of 3-year old Toby (played by an actor) about his diet. Watch the video and try to identify:

  • three positive communication strategies the practitioner uses
  • three areas that could be improved to help the mother feel more supported.

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Click here to read some possible answers:

Positive communication strategies

  • Paula uses open questions to gather an understanding of Toby’s current eating habits. She does this by asking the parent to talk through a typical day and what Toby might eat and drink. This is a useful way to introduce discussions about lifestyle, since it places fewer expectations on the parent than asking closed questions. For example, if Paula were to ask “what does Toby eat for breakfast?” or “how many portions of fruit does Toby eat?” she would be implying that Toby does these things, which may in turn lead to socially desirable responses from his mother (e.g., saying what she thinks the practitioner wants to hear). Instead by simply saying “talk me through a typical day” the parent is able to explain how things happen in her own way.
  • Paula offers affirmations to praise Toby’s positive eating habits. This helps to promote the parent’s feelings of competence.
  • Paula asks permission to make some suggestions for improving Toby’s diet (rather than “jumping in” with advice). By asking permission, it is the parent’s choice to receive advice, therefore promoting autonomy. The combination of affirmations and seeking permission allows Paula to raise a sensitive issue (i.e. Toby’s over-consumption of juice) without placing any blame on his mother.
  • Paula gave the mother a chance to ask questions, allowing her space to raise anything that hadn’t already come up in the consultation.
  • Paula ends the consultation with a summary, which provides another opportunity to remind Toby’s mother what she is doing well whilst also checking both practitioner and parent are clear about the next steps.

Areas that could be improved

  • It might have been useful to start the consultation by asking some more general questions. For example, how are things going with Toby’s eating? What kind of things does he like to eat? Are there any areas you’re concerned about? This would allow Paula to understand more of the mother’s perspective and act as an ice-breaker before moving on to discuss his current diet in more detail.
  • Rather than asking about a typical day, it might have been more helpful to explore a specific element of Toby’s diet at a time. Having to describe a “typical day” might feel quite overwhelming for a mother, as firstly they might feel that every day is different and secondly, they might not know where to start. Instead, it might have been helpful to talk through key aspects of children’s diets we know to be important (e.g., mealtimes, drinks, snacking, trying new foods), then focus in on one specific aspect at a time. To give the mother some autonomy in this, Paula could outline the areas they are going to talk about, then ask which she would like to discuss first.
  • Paula could have helped the mother understand why Toby has developed a preference for fruit juice. As Toby was used to drinking flavoured drinks all the time, it is likely water tasted very plain. Paula could have explained how by watering down his juice and by gradually introducing some water in between meals Toby’s taste-buds will adapt and he might begin to enjoy water more.
  • Paula could have worked collaboratively with the mother to come up with fun ways of introducing water. For example, perhaps the water could be introduced alongside a snack that Toby particularly likes, or in his favourite cup. Paula could go through this process collaboratively with the mother by first asking her what Toby enjoys, and whether she can think of anything that might make drinking water more fun for Toby.
  • Paula could have focused more on what can be done, rather than on her concern over the juice. At times, the conversation sounded a little negative and the mother might have felt like she was being judged or was doing something wrong. It might have been better if Paula talked with the mother about achieving 5 fruit and vegetable portions a day and how fruit juice can form a positive part of this (but this is best limited to 1 of the 5 portions).
Quiz

Below is a short quiz to help you evaluate your learning from this module. You may take the quiz as many times as you like.