Raising children can be a challenging job. It can also be rewarding. When it comes to eating, the more caregivers know about children's natural eating patterns, the easier and more rewarding the job of feeding children can be.

Like many other behaviors, children's eating patterns are largely learned. Starting from infancy, a child learns what is edible and what is not, what is appropriate within the culture and the family regarding food etiquette, what types of foods are liked and disliked, and what cues are important in controlling food intake. Children's eating patterns move through predictable developmental stages that present challenges and opportunities for learning and mastery. Early feeding interactions influence the set of skills and behaviors children possess as their eating moves from complete dependence on their caregivers to more self-directed control.

Innate Abilities, Preferences, and Transitions

Because a newborn spends about 50% of its waking time eating, the feeding interaction is perhaps an infant's most important experience. Feeding not only supplies nutrients for growth, it also establishes the mother-infant bond, provides a sense of security and pleasure for the infant, and presents repeated opportunities for learning and social exchange.

A child's transition to solid foods is a dynamic period of growth and learning. Dietary patterns change more during this period than during any other time of life. This transition requires rapid learning about flavors, foods, etiquette, and social exchange.

An often unrecognized milestone in young children's eating behavior is food neophobia -- literally translated as the fear of new foods. Infants and young children are predisposed to neophobia, which typically occurs between 18-24 months of age. Children previously judged as "good eaters" often begin to reject new foods and refuse formerly accepted, familiar items. Children's acceptance of new foods is not instantaneous. It requires repeated exposure and experience with new foods to overcome neophobia and enhance acceptance.

The Family Eating Environment

Parents and caregivers profoundly influence the eating environment in which children's preferences and intake patterns develop. Caregivers determine the availability and composition of a child's diet, provide a model of eating behavior, and guide a child's eating through feeding practices. By selecting the foods that come into the home, parents have direct control over the foods to which children are repeatedly exposed. This is particularly important given that familiarity and repeated exposure to foods help determine food preferences.

At any point in development, large differences may exist among parents in the extent to which they allow a child to control eating, including the timing of meals, as well as what and how much is eaten. Overly restrictive feeding practices are not effective, but rather may be counterproductive in promoting healthful eating patterns. Specifically, the use of pressure and restriction in child feeding appears to have the opposite effect on children's preferences. Another unintended consequence of using pressure or restriction in child feeding is that it may cause eating to be influenced by factors other than a child's own hunger and fullness.

The Contemporary Eating Environment

While the family is the most important environment in which children's eating develops, cultural and physical environments also play a role. Environmental constraints on parents' ability to promote healthful eating patterns include increased time demands in family life, loss of the family meal, increased television viewing during meals, increased dining out occasions, and increased use of childcare. Parents also struggle with the broader health and eating concerns of our society. This climate includes poor diet quality and an ever-increasing number of overweight parents and children. At the same time, society places an enormous emphasis on dieting and thinness.

Promoting Healthy Eating Behaviors

A worthy goal for parents and caregivers is to create feeding environments that foster healthful eating behaviors and support healthy weight and growth. There are several important feeding issues for most children.

• Young children eat small amounts of food frequently; three meals and three snacks is a normal eating pattern until well into the school years.
• The appearance of erratic intake patterns is not synonymous with poor eating habits; children's self-regulation of energy intake occurs across a number of meals. Parents should consider the adequacy of intake across the day and beyond, rather than focus on "getting a child to eat" at a particular eating occasion.
• Young children require fewer calories and smaller portion sizes. Because increasing portion sizes may increase energy intakes, exercise caution against routinely offering adult-size servings of beverages and snacks. Keeping these issues and the following ten tips in mind will help parents and caregivers develop healthy eating behaviors in the children they care for.

Ten Tips for Putting Information into Action

1. Children benefit from eating routines and structure in the same way that they benefit from bedtime routines! Be sure to offer three meals and two to three snacks across the course of the day. In between, avoid grazing by adopting a "closed kitchen" policy.
2. What does hunger have to do with it? Everything. Direct children towards internal cues like hunger and fullness. Speak plainly to children about hunger and fullness during mealtime and snacks.
3. Avoid focusing on amounts consumed. Instead, offer healthy choices and learn about appropriate portion sizes for children.
4. Offer healthy snacks and routinely remind children that fruits and vegetables are available for snacking.
5. Don't give up! Children need repeated and varied experiences with new foods before they learn to like them.
6. Be conscious of low nutrient, high-energy beverage and food consumption.
7. Be active! Turn off the television (limit of 2 hours per day) and encourage free play by GOING OUTSIDE!
8. Make family meals a priority whenever possible. Try for at least three family dinners a week. Limit eating out to twice a week and try to choose restaurants with surroundings that permit conversation.
9. Develop children's conversational styles and their sense of importance by eliminating distractions like television and music during family meals.
10. Promote healthy eating -- not dieting -- in word and deed. Adopt a moderate approach that includes all foods in age-appropriate portions.