Q: At what age can children start serving themselves and still get balanced nutrition?

A: Remember that an adult should be present to give the children guidance. Reassure the children that there is always more for seconds, why don't they try some other foods as well as what they seem to like so much of. So, children can start serving themselves from the beginning, with guidance from the adults.

Q: What do you think about the rule "You eat what you serve"? The children are only serving what they want seconds on.

A: Be cautious on serving a lot for seconds. They may want only a little bit more. Children are still learning what they need. Trust the children to learn the amount.

Q: How do you deal with children who over-serve themselves and never eat it all?

A: Remember adults eat with children. Watch to see if children are just serving because they enjoy the activity. Perhaps they can have an activity later in the day similar in action, such as scooping sand. Remind the child that they can take a little now and they can always have more later on. They don't have a lot of experience doing this and need guidance from adults.

Q: Can adults choose the time when children eat?

A: Absolutely. Children need frequent feedings. Remember adults set the environment for children.

Q: Two children choose to eat bread and milk all the time. Is it okay that they never choose to eat anything else?

A: Adults decide what is offered. Children choose how much and whether to eat. Eventually they'll decide to eat more. Keep offering a variety of foods. Occasionally offer bread, or offer it later in the meal. Adults model behavior, so help the children become comfortable with new foods. Don't push them, but offer variety. Remember short term vs. long term effects.

Q: A child who eats a lot. How much should I let them eat before it is too much?

A: How much access does the child have to food at home? Have the parents forgotten to feed the child in the haste of the day? Or perhaps, it is a method of delaying going on to the next activity of the day. The adult can ask, "Is your tummy still hungry?" If they are eating simply because they like the way the food tastes, there needs to be a lot assurance that the food will be offered again. After talking more with this particular teacher, we found that this went on for three years, that the child ate a lot of something if he ate it, and very little if he didn't like it, and that his mother did the same thing at home. Also keep in mind that children eat more when they are active and growing. Let the child eat according to their internal cues.

Q: How do you deal with mealtimes when you have different age groups, like you have in home childcare programs?

A: There are real positives to feeding various ages. There will need to be a lot of observation and thought put in to the foods to be prepared. But children listen and observe others. Younger children can learn from the older children, and the older children get an opportunity to be an example to the younger children. Sometimes the younger children want to eat what the older children are eating, so some special preparation may be required. We can't expect the very young child to get all it's nutritional value from the same foods because they can't handle the same foods as the older children, but let them experiment with it. Be very careful about any potential choking hazard, foods could be difficult from a choking standpoint, but let the child experiment with it. Children have different skills. Maybe serve toddlers first because they have a hard time waiting. Then they can serve themselves the seconds. Children can learn a lot from other children, so let them eat together.

Q: How do you deal with the child who doesn't sit down long enough to eat. He just wants to run around. He can sit for activities, but mealtimes are a problem. What do we do?
Also, there is a child who holds food in his mouth for hours. What should we do about that? He is a picky eater, doesn't like meat or vegetables, and that is usually what he holds in his mouth.

A: Remember the importance of routines. It is a major choking hazard if the child is running around while eating. Adults set the eating environment. The children make choices within the limits, and one of the limits is that they sit at the table during mealtime. Talk about what happens at the table; even if they don't feel like eating, they can come for a few minutes and have conversation with the other children there. Mealtime is about more that just eating. It is also important to not get in a power struggle over this with the child. As for the other child who holds the food in his mouth, ask more questions. Does he have problems chewing tough foods, like meats or vegetables? If so, cut the food into smaller pieces. If he doesn't like meats and vegetables, what are they doing in his mouth? Someone is making him eat them, and children can hold food in their mouths for a long time if they don't like them. It is a major choking hazard. Ask them to spit it out, and don't let them run around with it.

Q: Is there an appropriate time limit for different age groups to finish meals? What are they?

A: You'll have to observe the children and see. There is a difference in lingering at the table because you're afraid of going on to the next activity, which is true for some children, and staying because you are still hungry, or staying because there is a really pleasant conversation going on. Some places don't have the choice of lingering at the table because someone else may be coming in to use that space to eat; the system may not allow you to linger. Again, observe the children and see how long it takes them. Remember the organizational factor, but remember the individual child as well. There isn't necessarily a time limit that is age based, but based on the children you have. Determine when things start to deteriorate, then time is probably up. And you'll know that. Routine is another aspect. Best suggestion: time it. How long do they have to wait? How long does it take them to get started? Examine the mealtime. When you feel you are ready to be done, hopefully they will too. Another factor is ratios. If there just aren't enough adults to go around, make sure the children eat a little more quickly. But as much as possible, let the children find their own tempo for eating. There is no magic number based on age.

Q: A four-year-old comes to a center one day a week. He won't eat unless it is prepared exactly like mom makes at home. He has come seven times so far and has eaten 1.5 crackers. What do we do?

A: This child is probably coping with a new setting. Everything is different, eating with other children, eating with these strangers that they call teachers. He needs a lot of support and encouragement. This is his way of coping for now. Food is a comfort. Familiar food makes him more comfortable.

Q: Is there a single definition for "Family Style Service"? Does it mean the children serve all the food themselves, or just some of the time?

A: Bottom line is to help the children get in touch with serving themselves, how much they need, the internal cueing. Let children make decisions on how much is going on their plate. It also involves sharing and passing food.

Q: Has Susan Johnson written any books on childhood obesity or children's growth?

A: She has written numerous articles in professional journals and she has written chapters in books, but hasn't written a book yet.

Q: One of the childcare providers in our group has a child that comes in one or two days a week who eats nothing but candy. The mother brings the candy with the child for her to eat. The provider has tried several different methods to encourage the child to eat with the other children and has absolutely no results. The mother refuses to cooperate with the provider on this matter. The child is between two and three years old. What do we do?

A: This situation is probably about a transition issue. There's no routine at work. Is the candy a consoling thing from mom, or a reward from mom? If so, it would be very important to the child. Need to talk a lot with the parents to find out what is important. What does the child need and how does that comply with the organization's policy. Usually there are many more questions that need to be asked. Consider short term vs. long term consequences. Is the child learning to console with food? There needs to be some way for the child to make the transition, but candy may not be the best method. Also remember to have the girl sit at the table with the other children, whether she eats or not. It is a very important social time for her.

Q: A child serves themselves three green beans, but the USDA requires ¼ cup of green beans. What do you do to keep the requirement?

A: Regulation says there needs to be ¼ cup of vegetable available for each child. It specifies what is required to be offered. One child may eat three green beans, another may eat zero green beans, and another may eat ½ cup green beans. The USDA simply states what is required to be offered the children.

Q: Vegetarian diets: There are employees that are vegetarians, and there are children of vegetarians. Are tofu and texturized soy products recognized by the childcare program?

A: The Director of the program in the state of Idaho states that tofu is not a reimbursed food because there is no standard of identity, there is no guarantee that there are the same levels of protein and other nutrients in different types of tofu. It doesn't mean that you can't serve it, but that you won't be reimbursed for that type of food. Many other soy products do have a standard of identity and can be reimbursed. Using foods such as these would be great for adding variety to the children's menu plan.

Q: What do you do when the children zero in on the "last piece"? They all feel as though they need to be the one to eat it.

A: Reassure the children that they will have it again. Talk about how many people are at the table, encouraging a sense of community. Maybe cut it up into small pieces so that they all get just a little piece.

Q: When you eat with the children, is it okay to be in the same room with them, but not at the same table? Or do I need to be sitting with the children the whole time?

A: It is ideal to be at the same table with them, but not always practical. It is second best to just be paying close attention to what the children are eating, their internal cues, etc. Sit as much as you can, however.

Q: If one child has an allergy, should you stop serving that kind of snack to all the children, or just the one with the allergy?

A: Children understand when another child has to do something different The allergic child will learn to adapt, but will need a lot of support from the adults. It is difficult to learn what our role is in a child's life when a child has health-related issues because the adult needs to be more involved than normal. So, removing the food item from the individual child should be fine. The person doing the food preparation must be very aware of the food labels. Be very careful with severe food allergies because any trace could set the allergy off. With severe allergies, it is best to not serve at all, but with less severe allergies, it is fine to serve it to the rest of the children, just keeping it from the one who is allergic.

Q: What advice should be given to parents of obese children to establish and maintain the division of responsibility?

A: Remember that the adults decide what is to be served. Try to find out why the child is so focused on food. Is it a way to console themselves? Assist the children in recognizing their internal cues and respond when they are full. And remind children that if there is a particular food that the are very fond of, that we will always have it again.

Q: What about staff who are on diets? How do they eat with the children?

A: It doesn't matter what the foods are, it is how much you eat as far as weight loss. You don't have to eat as much as you normally would, but it is important that you eat some of the same foods, so that you are modeling for the children. The children need to see and example of how to eat some foods. It is really important for children to see adults eating the same foods.

Q: What do you do when the staff doesn't like the food the children are being served?

A: What if the children don't like the food? Give feedback to the cook. Make an effort to eat at least some so that the adult is modeling for the children.

Q: We have to find time for the staff to take a break. How does this fit in with the staff eating with the children?

A: Mealtimes are an incredible time in the curriculum. Certainly the staff need a break, but take a good look at the schedule and see if anything else will work. The children need the staff at mealtime, just as much as they need them in other activities.

Q: It makes me sick to watch what some of the children do at the table. What should I do about this?

A: Children need to learn to handle food. So, if it makes you sick, it's time to analyze the behaviors that the children have. Figure out where they can start to work on some of those things. Provide napkins. The very youngest children, if napkins are provided will start to use those napkins. Start where the child is and help them to work on those hygiene things. And remember that you set the environment.

Q: What about water and children?

A: It important for children to get enough water. Children are usually in tune with their thirst and can differentiate between being thirsty and being hungry. Often, however, they are very involved with playing and don't take time to think about whether or not they are thirsty. We worry about athletes becoming dehydrated because we know that thirst always lags behind the need for water, and in the case of athletes who become dehydrated faster, there is a chance that they are going to become very dehydrated by the time they realize that they are thirsty. This question came from Puerto Rico, and it is also true about living in a warmer climate. Children can become dehydrated much faster. The best approach is to keep offering water at regular intervals and encouraging the children to drink some. They're going to do better drinking small amounts more frequently than trying to play catch up later on.

Q: What about choking hazards?

A: Adults can model how to eat foods. Tell the children what you are doing: "I am taking very small bites and I'm going to chew and chew so that I won't choke." Encourage small bites, encourage chewing completely, and insist that they sit to eat, and cut the food into small pieces (¼ - ½ inch) when it is prepared. Here is a list of problem foods: nuts, berries (whole), raw celery and carrots, grapes, raisins, hot dogs, large chunks of meat and cheese, popcorn, hard candy, large blobs of peanut butter. Stay away from foods that are hard and round. They are very slippery and can slide very easily into the windpipe.

Q: What do we do when a parent asks us to restrict a child's intake?

A: Explain to the parent that children can learn to do this for themselves. You can help the child by giving them a lot of cues to help them learn when they are full or still hungry. Give cues and information so they can learn the skill of responding to internal cues. Also observe the child and determine when they are eating because they are still hungry, or when they are eating for a different reason.

Q: The child is supposed to choose how much, but what if they drink most of the milk first, then refuse to most of the meal? The child says they can't eat the meal unless there is milk available to drink. What do we do about that?

A: They go through stages. It's a comfort food for them. Eventually they will eat other foods. Keep offering them a variety and they will start to eat eventually.

Q: What about contamination in family style feeding? How can childcare centers approach this with the Health Care Department?

A: Keep in mind risk vs. benefit. Explain the many benefits and describe how you are going to minimize the risks. Remember that it is very important to have adults eating with the children for this very reason. Also, make sure that you know exactly what the regulations are, so that you aren't swayed by someone's personal opinion. Know that when with the children it is very important to keep your eyes open and have the children wash their hands. Children learn that washing their hands is part of the routine.

Q: A child takes a lot of food at childcare, but not at home. Any thoughts?

A: Keep reassuring the child that there is enough food to go around. Children need a lot of reassurance.

Q: How hot can food be when placed on the table (i.e. soups and sauces)?

A: If it is too hot, serve it yourself. If it is cool enough, the children can still serve it. Make sure it isn't too hot for the children to eat.

Q: What if food jags result in food allergies?

A: Eating a lot of a particular food does not necessarily cause the child to develop a food allergy. With time children will eat a wide variety of foods.

Q: What do you think about a "no thank you" bite? Shouldn't children try a variety of foods?

A: We discourage a "no thank you" bite because the children are very subtly being forced to eat something that they don't like, which reinforces their dislike for the food. Hesitancy to try new foods is a stage that most children go through and it will be outgrown. Remember that adults are modeling for children, and they will be more willing to try new things as they see others doing it as well.

Q: What do you think about using divided plates? What are your thoughts on bowls?

A: Deeper bowls are better for children because they need sides of the bowls to push the food against. We don't particularly like divided plates because it defines where the food goes, and gives an impression of how much food should be taken. They can be good, however, when the children hate the food running together. So, it is up to you, whatever works best for your situation. Weigh the risks and benefits for your own situation.

Q: What age are children able to screen out things that they hear? Using selective hearing, and focusing their attention?

A: From the time that they are born. They are able to focus from the beginning. The difficult part for adults is that children change what they focus on very quickly. When an environment is very busy, we can't know what they are going to focus on. They are not able to categorize what they hear like adults are able to.