pediatric nutrition: babies & toddlers

Teach Them how to Eat, Feed Them for a Lifetime

November 4, 2022

Feeding our kids is something all parents think about - from the decision of bottle or breast to gassiness and spit-up, our children's eating habits - and our feeding habits - play an important role from the earliest days of parenthood.


The Division of Responsibility in Feeding (sDOR), is recommended as the #1 method of feeding children by the American Academy of Pediatrics (AAP), the Academy of Nutrition and Dietetics (ACEND), and other leading organizations. sDOR, created by Ellyn Satter, MS, RD, CICSW, BCD provides an excellent framework for a foundation of lifelong eating habits that promote normal growth and development and a healthy relationship with food and body. Satter states, “It’s a lot less important what we feed our children, than how we feed our children.” She also posits that “We don’t have an obesity epidemic; we have a feeding problem. We are abysmal at feeding ourselves and only marginally better at feeding our kids.” sDOR provides a framework to help parents feed their kids in a consistent way in order to provide them with security in knowing that they will always have enough food to eat, while empowering them to maintain the ability to tune in and honor their hunger and fullness cues as they grow into adolescence and beyond. 

Teaching our children how to eat


sDOR delineates feeding and eating related responsibilities and separates them into 2 categories: the parent’s feeding responsibilities and the child’s eating responsibilities.
The parent’s feeding responsibilities include what, when, and where the child eats, and the child's feeding responsibilities include whether and how much to eat of the food that is served. This framework encourages the child to take ownership of their eating by empowering them to be 'in charge' of tuning in and honoring their hunger and fullness cues. At the same time, it takes a load off of the parent's already heavy burdens; once they provide balanced meals and snacks at consistent times, parents are free to enjoy their children at mealtimes without policing their kid's food intake.

sDOR reaps rewards far past the childhood years, with the child's reinforced ability to eat an amount that feels good in their body and approach all foods with neutrality, as well as the numerous long-term benefits that are derived from family meals (which are a component of sDOR).


sDOR means moving away from many societally accepted means of 'getting' our kids to eat in the moment, towards providing them with food and a positive, pressure-free environment and allowing them to make decisions of whether and how much to eat, on their own. In other words, “The parent provides, and the child decides.”

Some societally normalized feeding tactics parents often use include things like:
"First, finish your chicken and then you can have more rice."
"Take 2 more bites before you leave the table, please."
"When you finish what's on your plate you can get dessert!"


All of these instructions depict a parent crossing over to interfere with the child’s responsibilities.
"First, finish your chicken and then you can have more rice."
This teaches the child that chicken is ‘better’ than rice. The chicken becomes the ‘must do’, while the rice becomes the ‘preferred’ food. Creating this hierarchy of foods moves away from food neutrality–when people relate to all food from a neutral standpoint and can tune in to their body to ask, ‘What does my body want right now?’ without feeling pressure or guilt of ‘This is what I should/shouldn’t eat’. The latter way of relating to food leads to a restricted mindset, the restrict/binge cycle, and many negative health outcomes.

"Take 2 more bites before you leave the table, please."
This teaches children to gauge when they are ‘done’ eating according to an external marker (in this case, the arbitrary amount their parent has instructed them to eat) as opposed to according to their internal fullness cues. Children who are conditioned to eat according to external food rules (‘clean your plate’, serving sizes, etc.) instead of tuning in to their internal hunger and fullness cues, grow up to be adults who do not feel their hunger or fullness and struggle with eating in a way that feels good and energizes them.

"When you finish what's on your plate you can get dessert!"
This combines the teachings of the other two instructions, by giving children a directive to clean their plates, as well as rewarding them for eating, with another food. This places the ‘treat’ food on a pedestal, and breaks down that neutrality to food discussed above. This is the initial cause of many adolescents and adults struggling with feeling out of control around sweets; they restrict them because they feel like they’re not ‘healthy’ (another message often given with good intentions), but they desire them intensely because they associate them with rewards and have put them on a pedestal, and end up binging on them later on. This instruction also teaches kids to eat past their fullness by encouraging them to eat dessert after they’ve eaten their fill of what’s on their plate.



In practice, implementing any new behavior modification requires a lot of focused consistency. Changing old habits is tremendously challenging, and it often feels like implementing DOR takes a LOT of work. Remembering to offer kids food before they ask for it (or get overly hungry), gently and firmly moving away from ‘short-order-cook meals’ where kids are provided with their ‘favorite’ food every night instead of what Mom made for dinner, and breathing deeply through our kids initial crazed excitement of the sweet, dessert-type foods that we are now providing more frequently (to habituate them to these foods), can be overwhelming.
In the long run, though, feeding kids this way is so, so much easier.

Once these things become routine for you and your kids, you can say goodbye to mealtime power struggles, preparing more than one meal for any given feeding period, snack-time battles, worrying about our children’s weight, and more.


sDOR reaps rewards far past the childhood years, with the child's reinforced ability to eat an amount that feels good in their body and approach all foods with neutrality


Put the rice, chicken, vegetable, and dessert food (if you wish to serve it, as well as any other food you wish to include with this meal) on the table, or on the child’s plate (if they will allow it!)
Make yourself a serving of food as well.
Sit, eat your food, talk to your kids about their days and yours and whatever other topic tickles your fancy.
Don’t worry about how much or what they’re eating!
Enjoy this time to bond with your kids without policing them.

You can ask your kids if they’d like to try x dish, in a no-pressure tone. “Would you like to try some of this roasted broccoli? I’m really enjoying it.”
You can gently remind your child that now is dinner time and later is not going to be time to eat (among your responsibilities to determine). “Honey, I just want to remind you to make sure your tummy is full now because now is dinner time and after dinner it’s going to be time for bath and book and bed and there won’t be any more food until tomorrow. So please listen to your tummy and make sure you eat until it’s full.”
You can gently and firmly encourage your child to sit at the table with the family during dinner, even if they’re choosing not to eat. Remember, though, that little kids can’t sit as long as adults! It’s best to start having them sit for as little as 5 minutes and work your way up gradually to a family dinner time that lasts longer. “Sweetie, please come to the table now because it’s dinner time. You don’t have to eat any more if your tummy is full, but I want to sit with you and hear how your day went.”


Don’t worry! Every family has their own unique dynamic and what’s important is that we apply the foundational principles Ellyn Satter discusses in sDOR and make them work for our family. In whatever capacity you are able, make feeding time as pleasant for your children as posible and empower them to trust their bodies to tell them how much to eat, with the knowledge that you trust them to eat the amount that is right for them. Do not pressure them to try certain foods or to eat more or less than they are inclined to. Whenever possible, eat with them, or even engage with them while they eat and you cook or work at your computer. Remember, “perfection is the enemy of progress” and you are the absolute best mom for your kids. Noone can do this better than you!

Working directly with a dietitian to help you implement sDOR with nuance and flexibility is tremendously helpful, since each child, parent, and family have unique dynamics. Mealtime can be enjoyable again!

sDOR means moving away from many societally accepted means of 'getting' our kids to eat in the moment, towards providing them with food and a positive, pressure-free environment and allowing them to make decisions of whether and how much to eat, on their own.

Is there any one method that is ‘the best’?

What is the Division of Responsibility in Feeding (sDOR)?

How does sDOR work in practice?

What are some things I might be doing that I would be changing with sDOR (and why should I?)

OK, but what should I do instead?

What if my schedule doesn’t allow us to eat dinner together?

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meet the author

Meet
Shira

Shira is a Registered Dietitian who works with children and parents and guides and teaches them how to feed their family in the most nutritious and delicious way.

She helps take the stress out of eating and helps each family improve their health, prevent disease and help develop intuitive eaters. She specializes in pediatric and family nutrition.

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