USDA FNS child feeding policies and recommendations: What is the role for the division of responsibility in feeding?

June 2013
Family Meals Focus #82

by Carol Danaher, MPH RDN


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From Ellyn Satter: As demonstrated by her recent FMF newsletter and webinar, Carol Danaher, experienced and resourceful public health nutritionist, Ellyn Satter Institute board president and faculty member, understands policy and respects its role in collaborative programming. In this guest issue, she analyzes how USDA's recent child feeding related policies integrate and support Satter’s Division of Responsibility (sDOR) in feeding. I strongly concur with her insights and recommendations, and this article has been reviewed and endorsed by ESI. Here is Carol:


I couldn’t have paid my Public Health Nurse colleague to ask a better question:  

“You are telling me that children decide how much and whether to eat. I was taught that children were supposed to eat 5 servings of fruits and vegetables every day. What am I supposed to do?"

As my colleague demonstrated, USDA Food and Nutrition Service (FNS) application of dietary guidelines is enormously influential. In addition to USDA’s role in educating the general public, state and local nutrition educators must use USDA-consistent messages, curricula, and materials in programming for more than 30 million mothers and/or children who are FNS food program participants. These programs include the Supplemental Nutrition Assistance Program Education or SNAP-Ed (formerly Food Stamp nutrition education), Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the Child and Adult Care Food Program (CACFP), and the National School Lunch Program (NSLP).

Recent USDA FNS publications support sDOR

In 3 recent and important publications on feeding young children, FNS has begun emphasizing behavioral issues - the how of feeding:

Maximizing the message: Helping moms and kids make healthier food choices (October, 2008) contains the new focus group-tested Core Nutrition Messages and the recommendation for consistent messaging to facilitate maximum impact on low-income mothers and children participating in Federal nutrition assistance programs. Included in the core nutrition messages is the stipulation that preschool aged children are fed according to the concept of division of feeding responsibilities (DFR), citing Satter,1 where the parents decide what, when, and where foods are offered and the child decides whether and how much to eat.

Child Feeding Tips and Advice(December 2012), expands on the Core Messages with 9 parenting tip sheets on how to teach a child good eating habits and have positive family mealtimes.  The tips and advice are based on FNS DFR concepts and offer strategies for successful feeding, although the DFR is not explicitly mentioned.

Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program (January 2013) is a result of the Healthy, Hunger-Free Kids Act of 2010 which directs USDA to provide technical assistance to CACFP providers. The Act specifies that the handbook recommendations be consistent with current USDA and HHS publications on nutrition, active play, screen time, and wellness. The Handbook gives strategies for purchasing, preparing and serving healthy foods. Feeding practice recommendations are limited to parent role modeling and ways to encourage kids to eat healthy food.

Exciting Possibilities and Challenges

For practitioners who rely on sDOR as the foundation of their nutrition education guidance for parents and other caregivers, the FNS endorsement of sDOR principles of child feeding guidance is significant. Relative to appropriate application of sDOR (see the table below), autonomy messages in Maximizing the Message address almost all of the sDOR tenants, and in Child Feeding Tips autonomy messages are emphasized. For both, leadership messages are in place but still have some gaps.

Here are some recommendations for practitioners using the FNS guidance:

  1. Fill in the missing pieces within FNS DFR-based guidance to utilize the sDOR construct as a whole. As a model, sDOR is effective only when all the elements are in place: the what, when, and where of feeding AND the how much and whether of eating. Together, sDOR’s parent leadership with feeding and child autonomy with eating create a synergy that produces cohesive and authoritative parenting around feeding.
  2. Teach sDOR (or FNS DFR, if you will) to parents. sDOR gives a simple, empowering overview of the feeding dynamics model. Given this overview, parents will be better able to utilize the many excellent focus-group-based feeding suggestions in the FNS publications.
  3. Emphasize leadership by recommending snack and mealtime schedules. Avoid strategies intended to get children to eat certain foods. FNS DFR tends to present meals and snacks as a means to the end that focuses on “healthy eating habits” stressing encouraging/motivating children to eat healthy food, even if it is at the expense of structure, e.g., "Make sure fruits and veggies are in reach.”
  4. Be alert to recommendations that impinge on child autonomy with eating. Exposing children, in a neutral way, to a variety of foods is appropriate. Parents are role models for child learning, but influencing children's food beliefs through elaborate modeling or urging them to eat certain foods typifies pressure, and is inconsistent with sDOR.
  5. Extend sDOR to your guidance for the school-aged child. Tips and Advice is geared to parents of preschool aged children. Maximizing the Message Core Nutrition Messages for the school-aged child are focused exclusively on getting kids to eat healthy foods. For sDOR consistent messages, see the handout  Feeding Your School-age child on the ESI website, or review these guidelines.2
  6. Support the FNS goal to “speak with one voice.” In your nutrition education activities, inform other nutrition educators of the new FNS emphasis on the division of feeding responsibility and family mealtime.

Summary:

USDA FNS’s new feeding practices emphasis is much needed, and commended.Judging from my own experience, incorporating sDOR messaging into FNS-funded parent education will be a rigorous but rewarding journey. I suspect, however, that you, like most of our readers, have been on this journey for some time.  If you would like to share your own successes and challenges as a professional, parent, or both, visit Facebook at http://www.facebook.com/ellynsatterassociates.

I appreciate the comment of Facebook contributor, Megan Briggs: I think parents today desperately want to do best by their children. And in that effort, they feel a need to "get in" as much food and good nutrition as possible. I think it’s [their putting pressure on feeding] in large part due to not understanding what "normal" eating behavior in children looks like. There are so many mixed messages about feeding and nutrition that it's a wonder anyone feels a sense of competence about any of it!

Table: Consistency of two FNS publications with the Satter Division of Responsibility in Feeding

 

     sDOR  Maximizing the Message  Tips and Advice
       Preschooler  School-age  Preschooler

Parent leadership

Parents provide positive context and social environment and choose what food to make available at structured, sit-down meals and

What

Parents are gatekeepers with foods in home

YES

YES

NO

YES

When

Emphasize mealtime schedule

YES

NO

NO

YES

Emphasize snacks at set times

YES

NO

NO

YES

Where

Encourage eating in places free from distraction

YES

NO

NO

YES

Child autonomy

Child determines whether and how much to eat  from what parents provide at structured eating times

How much

Child determines amounts

YES

YES

NO

YES

Whether

Child decides what to eat

YES

YES

NO

YES

 

A note to readers:

The Ellyn Satter Institute is now the primary distributor for Ellyn Satter's resources and materials. The Ellyn Satter Institute is a 501(c)(3) institute that sustains and furthers Ellyn Satter’s Feeding Dynamics and Eating Competence Models through education, training and research. Visit www.EllynSatterInstitute.org today for a comprehensive set of free articles about eating and feeding, information on ESI's programming resources and the full line of Feeding Dynamics and Eating Competence books, videos, and continuing education products.

REFERENCES

  1. Satter EM. The feeding relationship. J Am Diet Assoc. 1986;86:352-356.
  2. Satter EM. Appendix H, Nutrition Education in the Schools. Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook. Madison, WI: Kelcy Press; 2008:255-261.

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