1. Look for a normal growth pattern. Healthy children, whether small, medium, or large, tend to stay at about the same place compared to other children their age. So children who are well above average at age two years tend to remain above average by roughly the same amount at age four, six, and eight. Plotted on a growth chart, what you see is a growth line running in between the same two curving percentile lines year after year. If a child's growth line takes a sharp turn either up or down, it's a sign that there may be a problem.



2. Learn your child's body type--and accept it. Bodies come in three main types: drawn-out and thin (ectomorph), round and thick (endomorph), and in between (mesomorph). Body type runs in families, so if you and your partner are endomorphs, chances are that your children will be endomorphs, too. Unfortunately, our society's idea of beauty leans way over toward the tall-thin side. This often gives rise to excessive concern about weight as parents size up their endo- or mesomorphic children against society's ectomorphic ideal.
   
   Parents who try to change their children's body shapes by pushing or limiting food, are bound to fail. Quite often the effect is exactly the opposite of what the parents intended: Round children learn to cram in as much as they can before their plates get snatched away; skinny children become experts at resisting pressures to eat and in the process develop a general habit of resisting food.



3. Instead, help your child learn to pay attention to his own hunger signals. Humans come equipped with a very sophisticated system that tells their brains when they've had enough to eat. This system ensures normal growth, neither too much nor too little. Well before babies learn to talk, they know how to send clear signals for "more food!" or "enough!" Appetite changes from week to week, largely because children grow in spurts, with periods of slow growth in between. That makes it hard to predict from day to day how much food a child will need. But children who are tuned in to their bodies' hunger signals know when to eat and when to stop.
   
   Heeding your child's requests for food doesn't mean offering unlimited cookies and candy, however. It does mean making sure that there is enough nutritious, healthy food available so that your child can fill up when hunger dictates. And it means trusting your child to know when to eat more and when to stop. When parents trust children to control their own food intake, children learn to trust themselves.



4. If you're concerned about weight, consider diet changes--but not dieting per se. Dieting is rarely a good idea for children, whose bodies are growing rapidly. In some cases, unwise diets have led to real health problems. Be sure that you work with a competent physician or nutritionist before starting your child on any sort of special diet.
   
   However, if your child is overweight, there are some powerful diet changes you can make to help bring his weight into line. Ounce for ounce, fats pack about twice the calories of proteins, sugars, or starches. If your child seems to be gaining too quickly, it makes sense to discuss with your child's healthcare professional whether you should try to cut out unnecessary fats (for example, by changing from whole milk or 2 percent to skim or 1 percent).
   
   If your child seems to be gaining too slowly, you can discuss increasing the amount of calories by adding fats whenever possible. For example, use whole milk on cereal instead of skim, and add cheese to vegetables and peanut butter to sandwiches. This recommendation often raises questions with health-conscious parents, who know that high-fat, high-cholesterol diets increase the risk of heart disease later in life. But when a child is truly underweight, restoring adequate growth is a priority, because under-nutrition can have long-term consequences for brain development and learning. Talk over any major dietary changes with a pediatric health professional ahead of time to be sure that they are a good idea.



5. Make healthy food choices yourself. You can't control what goes into your child's mouth, but you can certainly control what foods come into your home. Most experts now agree that diets should be largely based on vegetables, fruits, and grains, with dairy and meat in moderation and only small amounts of sugar and fats.

© Copyright 2004 The Dr. Spock Company. All Rights Reserved.