Mothers and fathers of disabled young children are asking the government to assistance them manage specialised system.
Finn McGrath was wounded whilst getting born back in 2009, which led to a mind injury and cerebral palsy.
“I believe folks do not comprehend that young ones with important disabilities are on these waivers since main insurance plan typically does not address the requirements of these children,” reported his mom, Laura McGrath of Richmond.
A finances modification proposed in both the Property and the Senate would allocate $21 million beginning in fiscal year 2024 to the Virginia Section of Health care Support Expert services to entirely reimburse families for the medical machines wanted for their youngsters this sort of as Finn McGrath.
The spending budget amendments were released by Del. Emily Brewer, a Republican who represents Suffolk and Western Tidewater north to outside Petersburg and Hopewell, and Sen. Siobhan Dunnavant, R-Richmond.
“Families have not been in a position to get protection of goods that are necessary to treatment for their small children in the household,” Dunnavant reported in an emailed assertion. “Virginia has manufactured a commitment that the dwelling is the best, most enriching location for little ones with these remarkable desires and now we need to be confident they can get the resources they need to have for care so they can keep at home.”
Households these kinds of as the McGrath’s are fundamentally trained to operate an intense care device out of their house, according to Michael O’Brien, a respiratory therapist and pediatric household ventilator system coordinator for the College of Virginia Children’s Medical center. He claimed there are many issues mothers and fathers of these medically fragile little ones face, these kinds of as the complexity of treatment which exacerbates the already existing problem of a health-related team lack.
“It’s tougher for families to provide the treatment in the way they were taught since they don’t have the supplies that they need,” he said.
The offer chain tangle prompted by the pandemic has also reverberated into these households, as wanted supplies require to be made use of for longer periods of time then intended, in accordance to O’Brien. This in turn also will make these elements not just additional pricey for households but also for the resilient medial gear businesses are furnishing these goods at a loss mainly because their reimbursements have not improved possibly, he stated.
“Before the pandemic, you might be capable to go online and discover some[airway tubes] through an online merchant for $50, but now, relying on the measurement of the tracheostomy, it’ll be many hundred bucks,” O’Brien explained.
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This presents a dilemma in making sure these medically fragile young children are ready to keep at dwelling and be healthier as people test to stretch their remedies as their budgets tighten the very same way that individuals with highly-priced medication may well not acquire it every day as prescribed so they have to buy the treatment from the pharmacy a lot less, in accordance to O’Brien.
On the other hand, providers prescribe solutions as they do in purchase to continue to keep people balanced and in outpatient care.
For instance, the formulation are specialized for the children with these precise circumstances and are crucial part of keeping them nutritious, according to pediatric health-related specialists at the Children’s Clinic of The King’s Daughters and College of Virginia Clinical Heart.
“When insurance policies doesn’t address these matters to a good sum, the people are left possessing to fork out that change and that’s likely to increase up because these are not disorders that go away with time,” Eileen Coffman, metabolic dietitian with CHKD’s Division of Healthcare Genetics.
The formulas also assist avert complications from surgical procedures, in accordance to Michele Spurlock, Pediatric Dietitian with CHKD’s Pediatric Intense Care Device.
“We should take care of method as a medication for the reason that that’s what it is,” she said.
Ian Munro, ian.munro@virginiamedia.com, 757-447-4097
This story includes discussions of suicide. If you or someone you know is in crisis, you can get help from the Suicide and Crisis lifeline by calling or texting 988.
While most kids his age were wrapping up their junior year of high school, Daniel was in a box.
“It was like I was sitting in a gigantic FedEx box being shipped somewhere,” he said. “But like, add one bed and the door had to be closed at all times.”
Daniel’s years of mental health struggles, stretching back into his early childhood, came to a head in early 2022. His often-uncontrollable emotional outbursts became unmanageable; he was “unraveling,” his parents said.
CBS News is only using the first names of former patients interviewed for this story to protect their privacy.
Fearing Daniel might harm himself, his parents took him to the only place they could: the emergency room. After seven days in the ER, Daniel was discharged; hospital staff felt he was no longer in danger. His parents disagreed.
“We were like no, no, no, he is so not ready,” his mom Kathe said. “We’ve been waiting and waiting, but he is not ready.”
Daniel’s therapist even wrote a letter to the hospital saying he wasn’t ready to be released. But the hospital said he needed to go home.
Ten days later, he was back in the ER — this time at another nearby hospital, where he would stay for 19 days.
“There’s barely any room in the [hospital] room to walk around,” Daniel, now 18, said. “So I was just sitting on my bed all of the time. I had some rough times there, like it was really difficult to, like, stay put, you know, and that’s what they expected [me] to do.”
Read more: Inside America’s youth mental health crisis
Instead of the intensive mental health care he needed, Daniel said he got very little help while in the room.
“Dan, rightfully so, he was like, what am I doing here?” Kathe said. “This is not help. You promised help. Where’s the help?”
“Severe shortage”
Stories similar to Daniel’s are growing more common in the U.S., fueled by a critical shortage of doctors, therapists and resources to address the needs of kids in crisis.
In Massachusetts, the number of kids landing in ERs for mental health treatment soared 200{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}-400{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} during the pandemic. That same trend is reflected across the country: a 2021 study found the number of kids stuck in ERs awaiting treatment tripled between 2019 and 2021.
“I do think it is very bad,” said Dr. Muniya Khanna, research scientist at Children’s Hospital Philadelphia and a former faculty member at the University of Pennsylvania’s Department of Psychiatry. “Suicide is now the number two leading cause of death in children 10 to 24. And this trajectory is only getting worse after the COVID pandemic. And so, we are absolutely in a crisis.”
Experts say it’s a demand and supply issue: demand for mental health services has increased after the pandemic and the supply of trained staff hasn’t increased enough to fulfill the needs.
Forty U.S. states and Puerto Rico all have “severe” shortages of child psychiatrists, according to data from the American Academy of Child and Adolescent Psychiatry (AACAP) analyzed by CBS News. Only the District of Columbia reported having enough child and adolescent psychiatrists to meet AACAP standards.
RELATED: Half of all Texas school districts have no mental health services
Amid this lack of formal mental health treatment options, ERs have become the last and only option for many families, according to numerous mental health experts interviewed by CBS News.
“Kids languish for days, weeks, sometimes even over a year in children’s hospitals around the country,” said Zach Zaslow, vice president of advocacy and community health at Children’s Hospital Colorado. “This is not just a Colorado problem, and it happens because there’s nowhere else that’s safe for them to go.”
In Colorado, Michaela, who grew up in foster homes, told CBS News she tried get a special therapist to address her anger, anxiety and depression nearly a dozen times.
“I would be crying out for help,” Michaela said. “I would say I need support. And it wouldn’t happen until I came to a point where it was too late to really come back and not make a bad decision that in the end would hurt me.”
Michaela said she tried to hurt herself, including several suicide attempts, over those years. She said the system in its current form does not do enough for young people until they reach a crisis point.
“I think it’s really hard to get into a good therapist or just a therapist in general,” Michaela said. “It doesn’t matter if they’re good or bad.”
Michaela said she had a total of eight ER visits for mental health crises, and often left the ER without seeing a therapist. The few times she did meet with a mental health expert, she said her therapy was cut short.
“It did cause me to have to go back [to the ER] again like less than a year later just because I didn’t get the help that I needed,” said Michaela. “And I think it was partly because I left too early.”
Michaela, who is now 20, said she is proud that she’s “beat the odds” and survived. She now sits on a youth advisory board as part of a partnership between the University of Colorado and Children’s Hospital Colorado.
“It definitely made me feel like all of that pain and suffering that I had to go through wasn’t a waste,” said Michaela. “Because now I can be the voice of power for so many other young people who are stuck in the same situation that I was and give them hope that I didn’t have then.”
A revolving door at ERs
Experts told CBS News the use of ERs as stopgap mental health treatment measures simply doesn’t work.
“For anybody who’s been in an emergency department for more than a few hours, it is not an ideal place to be,” said Dr. Kevin Carney, an emergency room physician at Children’s Hospital Colorado.
Massachusetts General Hospital in Boston, where Daniel stayed for 19 days, acknowledged the problem, saying in a statement to CBS News that “shortages [of proper mental health treatment options] have forced youth in crisis — and their families — to turn to their local emergency departments where ongoing capacity challenges may mean waiting for days or weeks for appropriate inpatient care to become available.”
For kids in crisis, ER visits can make matters even worse.
A December 2022 American Academy of Pediatrics study found more than a quarter of children who went to ERs for mental health issues were hospitalized — either in ERs or in mental health facilities — within six months. And about 26.5{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} were back in the ER within a week.
Dr. Sandra DeJong, a psychiatrist and the secretary with the American Psychiatric Association, said if kids don’t get proper care early, their condition can rapidly get worse.
“My fear is that we really have significant risk for the future,” DeJong said. “Because if we don’t address the needs of particularly young people now, then they are going to grow up to be people who are diminished and don’t have the capacity to function in the way that they could have if they had gotten the treatment.
“And frankly, they’re going to be expensive to care for because if they go untreated, there are situations that are likely to get worse and then they will need higher intensity care. It’s just not an effective way to approach the problem.”
Meanwhile, more and more kids find themselves in crisis. Suicide attempts by teen girls jumped more than 51{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} between 2019 and 2021, according to a study by the CDC. And a recent study published in the journal JAMA Pediatrics found the number of suicide attempts by overdose reported to poison control centers more than doubled between 2000 and 2020.
The number of kids with mental health issues coming to the ER “has been unrelenting,” said Zaslow.
“And it’s not acceptable,” he added. “It means ultimately, at the end of the day, that there are kids waiting for those beds every single minute as soon as one frees up.”
Dr. Taylor Louden, medical director at Cook Children’s Medical Center in Fort Worth, Texas, said that in recent years he’s seen more and more young patients come into his ER for mental health problems.
“We are seeing even younger and younger kids, 8-, 9-year-olds — ages of my kids,” said Louden. “Some are expressing that they want to hurt themselves that they want to die and it’s really tough to hear.”
Not only are there more kids showing up in ERs, Louden said, but they’re staying longer, too.
“No one should ever be in an ER longer than a few hours,” he said. “That means that the system is broken, in my mind.”
Inside an ER’s psych room
04:04
“It’s not acceptable”
Numerous experts CBS News interviewed said serious investments are needed to increase the mental health resources available to kids in crisis.
CBS News went to the person in charge of the system in the U.S.: Health and Human Services Secretary Xavier Becerra, who said “we have to do a lot” to fix the problem.
“It wasn’t until recently that you could get an insurer who actually gave you access to mental health services,” Becerra said. “And we still have a system where mental health is what you get at a primary care physician when you go to a family doctor.
“That’s got to change. Mental health, it’s got to be part of primary health, not something where you get a referral to a specialist.”
When asked about children getting stuck in ERs rather than proper mental health treatment facilities, Becerra said it was “not acceptable.”
“It’s not care,” Becerra said. “It’s housing them until we can get somebody who could give them professional help. They’re crying out and shame on us that we haven’t prepared.”
Becerra pointed out that several states and the federal government are investing billions of dollars into mental health care. And last summer, the Biden White House announced $300 million to expand mental health services in schools.
“That’s where the president last year in the State of the Union and again, double down this year has said, Congress, we’ve got to step up, we’ve got to finish the job of making sure that mental health is treated like any other aspect of health,” Becerra said.
But doctors Khanna and DeJong both said much of this federal spending comes in the form of one-time grants that will eventually expire.
“Now it’s really time to start investing time and resources on all levels for making that happen more on a regular basis,” said Khanna.
Attracting more people to work in youth mental health must be part of the equation, DeJong said.
“You can build all the beds and clinics in the world,” DeJong said. “But if you don’t have enough people to staff them, which is a real problem right now, we’re not going to meet the needs that we’re facing.”
Secretary Becerra agreed.
“You just got to put your money where your mouth is. And President Joe Biden is trying to put his money there,” Becerra said. “We need now the partnership with Congress to make it happen.”
HHS Secretary Xavier Becerra speaks about youth mental health crisis
06:53
Some aren’t waiting on the federal government to help, instead trying new approaches in attempts to address this crisis and meet young people where they are.
One of those approaches comes in the form of a youth advisory group at Children’s Hospital Colorado. The advisory group consists of teenagers who regularly meet to give advice to therapists and hospital officials about how to meet the needs of young people.
Another new approach: construction of a new, first-of-its-kind facility at the Cherry Creek School District outside Denver that will combine a mental health medical facility and a school when it’s completed in the fall of 2023.
When kids in crisis leave ERs
Finding help after a hospital stay can be even more challenging.
The Academy of Pediatrics study found just 31.2{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of children had a mental health follow-up visit within seven days of leaving the hospital and only about half had a mental health follow-up with a specialist within 30 days of leaving the hospital.
“I think what is very distressing about this mental health crisis that we’re facing is that while we very much take as part of our responsibility to make sure that we are keeping kids safe and stabilizing them when they’re in crisis or have harmed themselves,” Dr. Carney said. “The very hard thing is knowing that at that point I can’t do anything else for that child.”
Dr. Glenda Wrenn Gordon knows those statistics firsthand: she and her 18-year-old son lived them.
Wrenn Gordon said even though she’s an Atlanta-area psychiatrist herself, she was surprised by the effort she had to put in to find help for her son in crisis after she got him to the ER. She said she thought she knew what to do, but still found the system of finding and getting care post-hospital visit to be daunting.
“We moved very quickly through the ER because I knew exactly what to say and how to say it to get us where we needed to go,” she said. “I was extremely frustrated for how hard it was. I was thinking about these other families. What hope do they have and what it must be like?”
When asked what she fears most if the system is not changed, Wrenn Gordon was blunt.
“We will continue to bury our children,” she said.
Atlanta psychiatrist struggles to find help for her son
02:56
If you or someone you know is in crisis, get help from the Suicide and Crisis Lifeline by calling or texting 988.
In addition, help is available from the National Alliance on Mental Illness, or NAMI. Call the NAMI Helpline at 800-950-6264 or text “HelpLine” to 62640. There are more than 600 local NAMI organizations and affiliates across the country, many of which offer free support and education programs.
This is an installment of Good Fit, a column about exercise.
I took my first CrossFit Kids class when I was 10 years old, the summer between fifth and sixth grade. I remember a circuit that involved situps and running around cones, facilitated in the parking lot outside the CrossFit “box” my mom went to. I was immediately hooked. In part, I’m sure, because it was fun—the instructors were kind and encouraging, the other kids nice. But more fundamentally, because of what I hoped it would do: make me thin.
CrossFit itself is famously controversial, even when it’s just adults in question. Its critics argue that the workouts, which encourage participants to complete complex weightlifting movements as quickly as possible, are injury minefields. Die-hards say that this caricatures CrossFit, and that the mistakes of some coaches aren’t representative of the whole community.
At a more fundamental level, CrossFit founder Greg Glassman has described CrossFit as “a religion run by a biker gang”—and CrossFit the company historically appears to have incorporated the worst elements of both. Glassman stepped down as CEO and then sold CrossFit in 2020, following deeply racist comments about the murder of George Floyd, which themselves intersected with a corporate pandemic response defined by both dismissiveness and ignorance of science. (Glassman also faces allegations of workplace sexual harassment, which he denies but which were thoroughly reported by the New York Times.) Those crises set off a domino of CrossFit gyms’ disaffiliating from the brand—and the company, under new leadership and ownership, now faces the challenge of charting its future.
The controversy surrounding CrossFit’s exercise philosophy and the brand’s serious culture problems are even more pressing when you take into account the CrossFit Kids program, which has been a part of the company since 2006. The aim of the program is to provide “a physically and psychologically fun and safe space for kids to socialize while supporting a healthier lifestyle,” Nick Pappas, a CrossFit Kids seminar trainer (aka a trainer who trains trainers), said in an email. More than 3,500 CrossFit affiliates offered kids programs as of 2018, and that year there were 407 grade schools registered as affiliates, the company told me. Participants range in age from 3 to 18.
When I started CrossFit, the classmates who called me fat behind my back—and the adults who tried to subtly suggest various exercise routines to me—had already convinced me that I needed to lose weight. At CrossFit Kids, that was never explicitly the goal: The instructors talked about healthy lifestyle choices and the mental benefits of movement. But it was impossible to separate the kids’ classes I took from my underlying shame, vulnerability, and deeply rooted fatphobia. The atmosphere of the classes certainly did not dispel the idea that a central goal of exercise was to have a particular body shape: Adults at the gym discussed macros and the calories they were burning on the rowing machine, and swapped anecdotes about fellow gym-goers who had come in overweight but now wore size 4 Lululemons. During yearly CrossFit Open competitions, they showed videos of pro CrossFitters without an ounce of body fat.
For me, this environment was magnetic: I went to every class my parents would take me to, bought a situp mat to use at home, went on long walks around my neighborhood during my free time, and began tracking calories on an app, trying to keep myself under a strict limit. That summer, I lost 30 pounds.
The praise and surprise from teachers, coaches, and random friends of my parents taught me an important lesson: Under no circumstances could I stop what I was doing. For the next seven years, I didn’t. I graduated from a CrossFit Kid to a CrossFit Teen, snatching and push-jerking and kipping my way through adolescence. I earned medals from CrossFit Teens competitions, as well as a tear in the cartilage of my hip socket from overuse. I moved into adult classes.
Because it was my first serious encounter with exercise, CrossFit has shaped the way I approach fitness. In an effort to better understand how, I decided to read the 154-page CrossFit Kids training guide, which is available for free online.
The training guide, a CrossFit Kids bible of sorts, first came out in 2011 (about three years after I started CrossFit) and is now on its fourth edition. It’s paired with the CrossFit Kids Starter Curriculum, a 269-page resource full of sample workouts and games. This is important because, while trainers have some flexibility, CrossFit generally follows a clear, top-down structure—it’s not like, say, your local yoga studio, where instructors design their own routines.
The guide starts by walking through the fundamental logic behind CrossFit: Our ancestors ate varied, unprocessed foods and were constantly moving, whereas we eat Cheetos and sit behind a screen all day. CrossFit, then, “is one component of how to change the behaviors of adults, in an attempt to reverse our maladaptation to our current circumstances.” (Is a 10-minute pullup and clean circuit really a close approximation of a hunter-gatherer lifestyle? Don’t think about it.) CrossFit Kids, the guide continues, is an attempt to “break the cycle” and “reduce Exercise Deficit Disorder and poor lifestyle choices”—before 3-year-olds have a chance to grow up into Cheeto-munching, scrolling adults.
Some of the guide is a useful breakdown of how to teach young children the basics of exercise movements. Preschool participants might learn, for example, how to deadlift (without any weight) through cues to assume an “angry gorilla position,” an instruction that still comes back to me when I prepare to deadlift. Older kids add in real weight and learn more complex movements like front squats, thrusters, and push presses. And teen classes include scaled-down versions of the standard set of adult exercises. The guide acknowledges an “undercurrent of concern that children lifting loads is inherently dangerous” but argues that such concern “has been discredited by modern sports science.” Indeed, there isfairlygoodconsensus that strength training, including just learning about form, can be beneficial for children, so long as actual weights are not introduced until around age 7, and after that, only light weights. At the end of the day, safety is dependent on how well instructors plan their classes and monitor their athletes. I was lucky to have good trainers who prioritized safety, carefully broke down movements, and gave me weightlifting confidence and skill that aren’t easy to access, especially for teen girls.
The food stuff is iffier. Trainers are instructed to incorporate nutrition education into their classes—children can be taught, for example, to associate foods with various kinds of nutrients via “plastic food replicas and teams shouting answers, all in an exciting game format.” Although the CrossFit Kids training guide specifically discourages calorie counting and “panacea” supplements, it recommends that “everyone optimize their own ratios … by weighing and measuring food” and repeats the CrossFit nutrition mantra, still prominently credited to Glassman on CrossFit’s main site: “Eat meat and vegetables, nuts and seeds, some fruit, little starch, and no sugar. Keep intake to levels that will support exercise but not body fat.” The guide also includes 40 pages of paleo recipes for things like “Pumpkin Nut Muffins by Primal Blueprint” and “Crockpot Buffalo Chicken Lettuce Wraps by Skinny Taste.” And while I can see the importance of incorporating general nutrition education into exercise programs (for example, protein is important!), the focus on no sugar, low body fat, and paleo muffins feels like an explicit, and dangerous, replication of diet culture propaganda. Not only can you have high body fat and be good at weightlifting, being heavy, including via a belly, can actually help with lifting.
Nonetheless, this exercise and nutrition regimen has produced an impressive star: After starting CrossFit at age 10, Mallory O’Brien won last year’s CrossFit Open at just 18 years old, becoming the youngest person to do so—and she’s a front-runner to win this year’s CrossFit Games. (You should probably watch this video of 17-year-old O’Brien clean-and-jerking 245 pounds.) O’Brien came to CrossFit as a competitive gymnast and trained with a private coach, so our experiences are very different—but we’re both roughly part of the generation that saw CrossFit Kids grow up, and grew up alongside it. Indeed, CrossFit recently pointed out in a video profile of O’Brien that she is among the first group of professional CrossFit athletes who started the sport as children.
There are also probably thousands of more attainable, real-world success stories of kids finding an outlet for their emotions and developing skills and community. If I don’t squint back at it too hard, I could perhaps even put my experience among them. I fumbled around for years in team sports before finding in CrossFit a place where I felt as if I belonged: It was the first time I had ever felt “good” at anything physical, because my progress was measured individually. Exercise became a habit, an escape, and even something I could find joy in. Two years after starting CrossFit, at age 12, I was fit enough to run a half marathon, my first of many such races.
Though I stopped CrossFit at 17, when I went to college and moved away from my beloved box, I kept running and lifting weights. I have CrossFit to thank for my relative comfort in the weights section of the gym, a place that (unless you, for instance, played college rugby or pledged Sigma Chi) is notoriously intimidating.
But I also walked away with a real, deep belief that my self-worth was tied to exercise—that there was such thing as a “correct” body, and that exercise is what would keep my body that way. I still feel enormous pangs of guilt every time I take a rest day, even though logically, I know that resting is a critical part of any fitness regimen. Sometimes I still can’t tell if I run marathons because I truly enjoy distance running or because I’m so programmed to believe that the best version of a sport is always the most “intense” version. I’m not sure I can blame CrossFit for these attitudes—perhaps I would have learned the same thing in track or ballet or basketball, as plenty of people do.
When I read the CrossFit Kids Training Guide, I felt desperate to find red flags, something I could point at to definitively explain my screwed-up relationship with my body. But mostly, the guide seemed like a replication of the tired narrative of “lifestyle choices” and diet culture that underlies a lot of the ways we talk about exercise. CrossFit might, per the founder, have a bit of a religion-slash-biker-gang aura around it—but what it transmitted to me about food and body fat wasn’t all that different from the standard cultural dogmas.
On my training runs, I occasionally pass a CrossFit gym. When I do, despite myself, I can’t help but notice that I miss it.
As a parent and caregiver, you play an important role in making healthy choices for your children and in teaching them to make healthy choices on their own. With so many mixed messages surrounding nutrition, it’s a task that can feel overwhelming. Venus Kalami, MNSP, RD, CSP, a clinical pediatric dietitian and nutritionist at Stanford Medicine Children’s Health, breaks down some simple things you can do to help your family establish healthy eating habits.
Focus on the joy of food
According to Kalami, our focus should be on having a healthy relationship with food, rather than on restriction. She encourages parents to reframe their mindset around food. Due in part to the influence of marketing and diet culture (in a nutshell, the focus of everyone being on a diet and wanting to lose weight), there is a lot of false information about nutrition that we can unknowingly pass on to our kids. By peeling this away and embracing the enjoyment of a wide variety of foods, you can help your family cultivate healthy habits.
“As a society, our tendency is to focus on the things to restrict, like sweet treats or salty snacks, and it’s not healthy for our minds to be wired so negatively and fearfully around food,” she explained. “But if we focus on balance, variety, and a healthy relationship with food, without giving all of this extra negative attention to the sweet and salty snacks, then we can have a healthy diet and lifestyle, with some flexibility for treats. … By keeping it about balance, positivity, and joy, we help break the cycle and build a generation of healthy and happy eaters.”
Make time for breakfast
A long night of sleep can be restorative, but all those hours of fasting and repairing the body can also mean lower energy stores in the morning, especially for growing children. Breakfast refuels and replenishes their bodies so they have energy to play and learn. Kalami suggests offering a balanced meal that contains protein, carbohydrates, a healthy fat, and a fruit and/or vegetable. It could be as simple as avocado toast with an egg, tofu soup with noodles, or options like Greek yogurt with fruit and oatmeal.
“Having breakfast is particularly important in younger children, who are going through more frequent periods of rapid growth,” Kalami said. “But truthfully, breakfast is still going to be important for all age groups, adults included, as we are all dynamically experiencing different shifts and changes in our body, and starting the day off with a nutritious and fueling breakfast helps set everyone up for success, by giving us fuel, consistent energy levels, and a more stable mood.”
Whenever possible, Kalami suggests, have a family meal at the table. Eating together has been linked to many positive health outcomes. However, hot or cold, or even on the go, there’s no wrong way to have breakfast. “Breakfast doesn’t have to be the very first thing in the morning, and it doesn’t even have to happen at home,” Kalami said. “Sometimes life is so hectic that breakfast happens when the child gets to school, and that’s totally OK—perfect doesn’t need to be the enemy of good.”
Help your child listen to their body
While you may feel tempted to beg your child to eat one more bite of peas, mealtime offers a great opportunity to allow children to listen to their body’s instincts. Kalami said that most children do a good job of self-regulating their hunger and appetite. This means they will naturally eat the right amount of food. So, instead of tracking calories or asking for “just one more bite,” parents can look for other cues to make sure their kids are eating enough.
“Fortunately, there are more holistic indicators to tell us if a child is eating adequately, such as their energy, ability to focus, endurance and stamina, mood stability, going to the bathroom regularly, and growing and gaining consistently, to name a few,” she said. “If one or some of these domains are ‘off,’ then that tips providers off to investigate a little further to make sure a child is eating and drinking enough.”
Keep your child hydrated
Getting kids to drink enough water can be challenging. When kids play hard or participate in sports, they may be too distracted to stop and get a drink to stay hydrated. For kids who just aren’t interested in drinking water, Kalami recommends finding fun ways to promote hydration.
“To get them interested in drinking more water, I like to encourage getting a fun and cute water bottle that they’ll enjoy drinking from,” she said. “A rebranding, like ‘sparkly mint water’ instead of ‘water with added mint leaves,’ can also help pique their curiosity and wonder, which helps motivate them to drink water more consistently.” And if it’s developmentally appropriate, explaining how hydrating well can help them “crush” their sports performance (or whatever other activity they enjoy) is often highly motivating!
Foster your child’s independence
One of the best ways to reinforce healthy eating habits in children is to nurture their independence. According to Kalami, it makes them more likely to engage in and continue healthy eating and lifestyle habits. Even toddlers can help with meal prep by washing produce, tearing up lettuce, or just standing and watching happenings of the kitchen in a safe way. As children get older, they can be more involved with selecting recipes, helping with grocery shopping, and preparing meals.
“It can be a huge help to sit down together once or twice a week to softly brainstorm some ideas, grocery shop together, and assemble meals ahead of time,” Kalami said. “Grocery shopping is a wonderful opportunity and activity of regular life where kids can build curiosity and an interest in food, outside of the kitchen and away from the dinner table, that lends to an overall positive experience.”
She recommends setting loving boundaries by gently guiding children to make good choices, such as picking a fruit, a protein, and one “fun” food, so there is a balance of fun and nutrition—while also helping the child build an understanding of how to structure balanced meals to fuel all of their fun.
Support kids with medical diets
For children with food allergies, intolerances, or special medical diets, healthy eating and a good relationship with food is still possible with some advance planning and communication. The biggest challenges often come when eating outside of the home, such as at school, at parties, and when celebrating holidays.
“Communicate with others, plan ahead, do your research, have a backup plan, and do your best. … As you gain more practice, you become more adept at navigating all of the social settings that involve food,” Kalami said. “The goal is to participate in everyday life as much as possible! Ultimately, the purpose of these medical diets is to keep the child healthy and sound, so that they can live their fullest lives—and not live their lives around their diet.”
Connect with your village
Developing nurturing eating habits in childhood can provide lifelong benefits for our children. While it can feel like a lot of work, you don’t have to do it alone. Kalami encourages families to reach out for support from a professional if they have questions about nutrition. “You don’t ever have to wait until you have a food-related problem to see a dietitian,” she said. “Dietitians can help with not only navigating the logistics of nutrition, diet, medical dietary restrictions, supplements, and more, but they can also help with facilitating behavior change toward healthy and wholesome diet and lifestyle practices.”
For more advice about healthy eating from Venus Kalami, check out Eating Well with Celiac Disease or What You Need to Know About Improving Your Child’s Gut Health.
