Raising a Healthy, Happy Eater with Melanie Potock, CCC-SLP

In this episode, Melanie explains normal feeding milestones, how they are developmental tasks, how some children need more support reaching these milestones, and how to help your child become a great eater!
Melanie Potock, MA, CCC-SLP, is a pediatric feeding therapist, international speaker, and certified speech-language pathologist with over two decades of experience helping children and families establish healthy relationships with food. Known as “Coach Mel” on Instagram (@mymunchbug_melaniepotock), she is the author of six books, including the award-winning Raising a Healthy Happy Eater and Responsive Feeding. A sought-after expert in both typical and complex feeding development, Melanie combines evidence-based strategies with real-life parenting insight. Her guidance has been featured in over 50 media outlets, including CNN and The New York Times. Certified by ASHA and the recipient of ASHA’s 2024 State Clinical Achievement Award, Melanie has also received eight ACE awards for excellence in continuing education and provides training for healthcare professionals 

Cover art by Charlotte Feldman
Please note that while I am a pediatrician, I am not your child's pediatrician. This podcast is for informational purposes only and does not constitute medical advice. For any medical concerns or decisions, please reach out to your child’s health care professional.

Transcript

0:11

Welcome to Kids Matter. I'm Dr. Elisa Minkin. As a pediatrician, mom and grandma, I understand how challenging it can be to help our kids grow into their best selves. We are so much more powerful together. Here I will be sharing the knowledge and wisdom of a wide range of people who understand and care deeply about children. I'm hoping for your input as well because kids really do matter. They are our future.

Alisa Minkin 0:41

Welcome back to the Kids Matter podcast. I'm really, really excited and really honored to have with me today, Melanie Potok, who is both a feeding therapist and a speech therapist, here is a. Pediatric Feeding therapist, international speaker and certified speech and language pathologist. With over two decades of experience helping children and families establish healthy relationships with food, known as Coach Mel on Instagram under My Munch Bug. I love that. She's the author of six books, including The Award-Winning, raising a Healthy, happy Eater for people who Have This on video. There you go. I am gonna link them in the show notes and responsive feeding. A sought after expert in both typical and complex feeding development. Melanie combines evidence-based strategies with real life parenting insight. Her guidance has been featured in over 50 media outlets, including CNN and the New York Times certified by Asha. This is the American Speech and Hearing Association. And the recipient of Ashe's 2024 State Clinical Achievement Award. Wow. Melanie has also received eight. ACE Awards for Excellence in Continuing Education and provides training for healthcare professionals worldwide. So as a pediatrician and a mom of a child who had really very severe feeding problems, I happen to be very passionate about raising kids to be healthy, adventurous eaters, and I'm so, so excited to have you here. You've been so approachable and so amazing. Just to work this out with me. So thank you so much for joining me today, and we're gonna go right into it. I want to divide our talks. We talked about not biting off more than we can chew. I wanna divide our talks into two parts and have you come back for part two. So today will be about typical feeding issues, the typical developmental milestones to expect, and then we'll get to actual problems with feeding. At part two. So I'm gonna ask you to star please with Baby's introduction to Solids. We're gonna skip over the bottle and breast if that's okay with you.

Melanie Potock 2:48

Absolutely. Well also thank you. I'm so excited to be on this podcast with you and I know it's taken a little time to schedule it and you've been so patient and wonderful. So I, I could talk about this topic all day long, so I'm gonna jump right into it. You were asking when a baby should start solids, and I think this is a

Alisa Minkin 3:05

I think this is a great question because it's amazing

Melanie Potock 3:09

get their information off social media. It's part of the reason why I'm on Instagram. But you know, there are so many different opinions about this and let me try to break it

Alisa Minkin 3:19

down.

Melanie Potock 3:19

In the easiest way possible. Typically, we anticipate that the majority of babies will start solids at about six months, right

Alisa Minkin 3:29

Right.

Melanie Potock 3:30

six months. But it does depend on. Signs of readiness, like sitting with a little bit of support, maybe, you know, some really good head and neck control. That's probably more important even than the sitting, 'cause we can certainly help to bolster up their little hips with a rolled up towel or something like that. And I have a lot of information about that on my, on my Instagram. We wanna make sure that that child is already bringing hands and toys to mouth unless they have some. Special needs around motor challenges and they're seeing an occupational

Alisa Minkin 4:02

occupational

Melanie Potock 4:03

a physical therapist or a speech language pathologist, then we'll help the parents adapt so that we can start solids at that six month mark. And then finally, we do like to see kids showing interest at, you know, what you are eating. It's not

Alisa Minkin 4:18

it's not an.

Melanie Potock 4:19

necessity, but it's one of the things we love to see in terms of readiness signs. The main thing that we pay attention to is that head and neck control, because that's what we need for safe swallowing. We can usually adapt around the other things. then I'm gonna probably read your mind here, but you wanna move on too?

Alisa Minkin 4:41

How do.

Melanie Potock 4:43

In terms of what to feed them. a lot of different ways to approach this and I, again, I don't wanna jump ahead too much, but because we were talking about safe swallowing, you wanna make sure that whatever you are going to provide, that it's squishable. Almost

Alisa Minkin 5:02

Almost like you were to

Melanie Potock 5:04

press

Alisa Minkin 5:04

press down,

Melanie Potock 5:05

oh gosh.

Alisa Minkin 5:06

gosh,

Melanie Potock 5:07

little

Alisa Minkin 5:07

a little piece of avocado.

Melanie Potock 5:10

and your forefinger. And if you can press down and you can easily squish it as you pinch it between your two fingers, probably baby can too, because you don't need teeth at six months to eat. You just need gums and a relatively strong jaw,

Alisa Minkin 5:24

strong, which they should have by now

Melanie Potock 5:26

of six months of breast or bottle feeding. You just mostly wanna start with. Small tastes, not full meals, just little tastes of beer, a variety of things, and just follow your baby's cues and really follow

Alisa Minkin 5:41

follow what we

Melanie Potock 5:43

feeding

Alisa Minkin 5:43

feed.

Melanie Potock 5:44

I have a

Alisa Minkin 5:44

I have a book called

Melanie Potock 5:45

Feeding, and that's just

Alisa Minkin 5:47

that's just simply.

Melanie Potock 5:48

paying attention to the baby's cues, making sure that we're following their lead and really letting them explore.

Alisa Minkin 5:57

I love that. I love that. A couple things. I'm glad you brought out that babies can chew without teeth 'cause that's one problem. One question that parents often have is how can they have solids when they don't have teeth?

Melanie Potock 6:08

Correct. You know, it really is just those gums and the tongue squishing that food. You can certainly offer purees as well. I'm a big fan of offering both purees and more squish foods. Roasted vegetables, like a little piece of roasted squash

Alisa Minkin 6:26

Squash

Melanie Potock 6:27

even a strip of res roasted

Alisa Minkin 6:29

roasted

Melanie Potock 6:29

pepper. That

Alisa Minkin 6:30

That avocado I mention that's squishable food.

Melanie Potock 6:33

Those are

Alisa Minkin 6:34

Those are all foods that may make kindler to self feed using a baby

Melanie Potock 6:37

method.

Alisa Minkin 6:38

method. You

Melanie Potock 6:40

to limit

Alisa Minkin 6:40

don't have to limit yourself.

Melanie Potock 6:41

only baby self-feeding. You can certainly learn

Alisa Minkin 6:44

learn how

Melanie Potock 6:45

to

Alisa Minkin 6:45

to

Melanie Potock 6:46

spoon and, and offer a

Alisa Minkin 6:49

a variety of

Melanie Potock 6:50

thicknesses of puree 'cause that

Alisa Minkin 6:53

because that helps.

Melanie Potock 6:54

too.

Alisa Minkin 6:55

I love that. And you're mentioning baby led weaning, and that is a question. As a pediatrician, I get asked all the time, should I do baby led weaning or should I do purees? And so I want you to talk a little bit more about that. Why would someone just choose baby led weaning? Why are purees also important in your mind? Because this is sort of ideological to some degree. I wish it weren't.

Melanie Potock 7:14

You know, my job as a pediatric feeding therapist is to support either model that the family wants to follow. They're both great. nothing wrong with combining it. And in my experience, more parents want more of a hybrid approach, and I think it's

Alisa Minkin 7:30

I think it.

Melanie Potock 7:31

With baby led weaning, as great as it is, it isn't what they grew up with and they wanna do what's familiar

Alisa Minkin 7:41

Er

Melanie Potock 7:42

introducing some of

Alisa Minkin 7:43

or so

Melanie Potock 7:43

weaning concepts. So that hybrid approach

Alisa Minkin 7:46

church to be

Melanie Potock 7:47

of both worlds. And in terms of the benefits of puree, the wonderful Catherine Shaker, who's an expert in our field, is the one who said to me once, she said, you know, Mel. We know for

Alisa Minkin 7:59

suburb.

Melanie Potock 8:00

purees help to build the intrinsic tongue muscles, and those are essential for safe swallowing. They have a purpose, and of

Alisa Minkin 8:10

And of course the dog

Melanie Potock 8:11

all the time. We all eat yogurt and applesauce and,

Alisa Minkin 8:15

and

Melanie Potock 8:15

a variety of yummy sauces that are, you know poured over our

Alisa Minkin 8:18

that are

Melanie Potock 8:19

that sort of thing. I could probably name a hundred different purees. We, we enjoy, we just don't always think of them as a quote. So

Alisa Minkin 8:27

so.

Melanie Potock 8:27

a category of texture that we want the child to be introduced to early. We just don't wanna linger there. We just don't want kids to be a hundred percent on purees. the ninth month because that indicates that they

Alisa Minkin 8:44

That they aren't getting

Melanie Potock 8:46

And the repetition to begin working in their jaw

Alisa Minkin 8:49

their muscles, their muscles, their muscles.

Melanie Potock 8:52

to safely learn to swallow. They're so intimately tied to reflexes at that age as well. So hybrid approach is,

Alisa Minkin 9:00

Approaches.

Melanie Potock 9:00

what I really encourage.

Alisa Minkin 9:02

I love that and I'm, I'm glad that you're explaining that different things are happening when you feed purees versus the baby lid weaning where the baby is doing it on their own, often with more solid type textures. And I think there's a lot of things to pick apart there. Okay. Because I think from a parent's perspective, they may like the purees better because they see and can measure what goes in.

Melanie Potock 9:24

Yeah.

Alisa Minkin 9:25

I want you to talk a little bit about that. I could talk about it forever, but.

Melanie Potock 9:28

That that's so true. And know over 30 years ago when I started my career as a feeding specialist in the NICU with these babies who are just learning to probably bottle feed, work our way up to breastfeeding, even in that situation, so many. Professionals in of my generation, I'm in my sixties, that that

Alisa Minkin 9:53

They

Melanie Potock 9:54

all had this

Alisa Minkin 9:55

had

Melanie Potock 9:55

the baby needs to finish the bottle. And even as baby got a little bit older, I would see parents come in and they

Alisa Minkin 10:04

and they

Melanie Potock 10:05

had

Alisa Minkin 10:05

thought

Melanie Potock 10:05

the bottle because that's the way we were raised. But we know so much

Alisa Minkin 10:09

so much

Melanie Potock 10:09

We know that if we're gonna follow a responsive feeding model, which is the only method of feeding. That the

Alisa Minkin 10:16

only

Melanie Potock 10:17

of Pediatrics, unicef the World Health Organization that they

Alisa Minkin 10:20

that they all.

Melanie Potock 10:21

because it's

Alisa Minkin 10:22

Guess it's an umbrella over.

Melanie Potock 10:24

baby led weaning and traditional purees responsive feeding is the model We want to strive for that when we really take the time to read the baby's cues to stop when the baby indicates they wanna stop. pause when the baby indicates they want to pause and then they're ready to begin again and to

Alisa Minkin 10:48

To offer

Melanie Potock 10:49

they appear like they're ready and hungry. We are providing

Alisa Minkin 10:54

providing that.

Melanie Potock 10:55

that, that beautiful dance, that communication between the two of us. And we know for sure that when we allow kids to do that, they're more likely to grow at a healthy growth rate including their actual body weight and not. Seed that not be over fed. And they also pay attention to their own hunker cues rather than performing and sucking on a bottle or being asked to stay at the breast too long because we're driving them to do that. And that's strictly because a lot of us were raised that way and we just, we just know more now. So that's why, I really stress to the parents. Above all else, this is about communication,

Alisa Minkin 11:44

Communication.

Melanie Potock 11:44

it is the food.

Alisa Minkin 11:47

I love that. And I didn't know until I read your book, responsive Feeding, that pureed feeding could be done in within that responsive methodology. And I think that's really important 'cause I think there's a backlash within the baby lady wean movement that we're not going to force feed, so we're gonna let the baby choose. But as any parent feeding a baby for the first time knows it all seems to, you know, ends up on the floor. And then what are they actually eating? And so I've heard the line food for the food before one is just for fun. What is your take on that?

Melanie Potock 12:18

I really understand the intention behind that phrase, but the truth is food before one is for learning. And so many of our kids begin to as, and you can speak to this as a pediatrician, begin to deplete their iron stores and other important nutrients at about six months of age, that we really do want to encourage some consumption. And certainly as long as we're offering iron rich food and, and foods that are, offer a variety of nutrition. Eventually the kids get it in. But I think one thing we wanna be sure not to forget is the latest research on introducing top nine allergens. So if I can just quickly recap that and why this is so important and why I love Purees is because. We know based on the research around egg and peanuts that babies are introduced safe versions. In other

Alisa Minkin 13:18

You

Melanie Potock 13:19

smooth peanut butter or maybe diluted with a little bit of breast milk, just a couple teaspoons or so that they, when they get that a few times a week, as early as four months. They are much less likely

Alisa Minkin 13:34

likely.

Melanie Potock 13:34

an allergy to peanuts. We have similar data around eggs and we apply that data to the other seven allergens as well. So to recap everything that we've been saying and the excellent points you're bringing up, the another reason to consider possibly introducing a few tastes. foods as early as four months with your doctor's approval would be to

Alisa Minkin 14:02

To introduce.

Melanie Potock 14:03

early. But for sure we gotta do it at six months. And when I see a few tastes, it might just be a little bit of that puree on your pinky finger and they just suck it off while you're holding them a little bit upright. It's not sitting in a highchair having breakfast, it's, you wanna think of it almost like a little bit of. in a way that those top nine allergens are going to help to prevent future allergies

Alisa Minkin 14:33

That's really important.

Melanie Potock 14:33

are gonna be the easiest way to provide that too.

Alisa Minkin 14:36

First of all, I just have to give my disclaimer, we're not here for medical advice. Please consult with your pediatrician or clinician about when to start solids and when you should do it at four months and when you should do the allergens. We're not here for that. So, but that's really, really important and that's one big change that's happened over time. But a baby could do that on their own. That's not really in my mind, related to baby lid weaning versus purees. Right.

Melanie Potock 14:58

and to clarify a little bit, they absolutely could do it on their own. But to piggyback on your earlier comment about not knowing how much they consume. I prefer that the parents provide and those top nine allergens via puree at first, because we want to make sure, according to the research, they get roughly about two teaspoons twice a

Alisa Minkin 15:18

Ah,

Melanie Potock 15:19

So

Alisa Minkin 15:20

see.

Melanie Potock 15:20

if

Alisa Minkin 15:20

Wow.

Melanie Potock 15:21

spoon feeding your child, looking for their cues that they're ready to accept the spoon that, yep, I, I'd love a little taste of that, then it's

Alisa Minkin 15:28

And it's so easy to get.

Melanie Potock 15:30

Early on, however, we still

Alisa Minkin 15:32

We still

Melanie Potock 15:33

a responsive feeding model. And if baby isn't. Into taking a taste of

Alisa Minkin 15:38

taste that at that point.

Melanie Potock 15:39

several more days in the week where you can give it another try. It'll be okay.

Alisa Minkin 15:43

Great. I never heard that before. And that, that's, that's a valuable nugget. So thank you. I wanted to ask you how parents should introduce solids related to the formula of breast milk, because you know, you mentioned not having enough iron roll babies who are in formula, that formula is fortified with iron. It has all the nutrients. It is potentially a full set of nutrients and calories for a baby if they were just to be on a formula till a year, that's not nutritionally a reason. Right. Breastfeeding is different.

Melanie Potock 16:09

Breastfeeding is different. Breastfeeding is different, and some babies really take off with solid food and they begin to take less and less formula. Sooner than the other baby. And that's

Alisa Minkin 16:21

That's why

Melanie Potock 16:22

my

Alisa Minkin 16:22

in my mind,

Melanie Potock 16:23

find those well checks to be

Alisa Minkin 16:24

checks.

Melanie Potock 16:25

so that it can, we can really keep tabs on how much formula they're actually consuming. I still think it's important to introduce those iron rich foods and, and keep a variety of nutrition available for them. But yeah,

Alisa Minkin 16:41

yeah, you know,

Melanie Potock 16:42

do

Alisa Minkin 16:43

do

Melanie Potock 16:43

that

Alisa Minkin 16:44

that formula was,

Melanie Potock 16:45

little bit more of a safeguard. And in terms

Alisa Minkin 16:48

in terms of the timing, who asked about,

Melanie Potock 16:50

we offer just about 10 minutes

Alisa Minkin 16:54

minutes of

Melanie Potock 16:55

in solids, mouthing a few pieces of, of

Alisa Minkin 16:58

of

Melanie Potock 16:59

squishable foods, you know, just

Alisa Minkin 17:01

know starting to drive.

Melanie Potock 17:03

about. One day, one time a

Alisa Minkin 17:06

One time a day,

Melanie Potock 17:07

two if you have time. And we typically do that. After. Sometimes we'll do it after a Happy Milk feed where they're

Alisa Minkin 17:15

they're.

Melanie Potock 17:15

They're like, my belly's full. I'm not like, I've gotta get something in me. We don't want 'em be too hungry, but other times you might have the option to do it right before a milk feed where they're not so hungry that they're willing to explore and put foods up to their mouth, but they don't become so hangry or so frustrated. That they assign those frustrated feelings to the solid foods. 'cause really they just want the Rester bottle. So here we get back to responsive feeding where each child is unique and we're just paying attention to their cues to figure out what works for them.

Alisa Minkin 17:50

I love that and it's gonna change over time and it should change over time. Like right, that pattern of the once a day, almost more of a play is gonna have to move to actually consuming more food and less milk.

Melanie Potock 18:01

Very good. Yep. 100%.

Alisa Minkin 18:04

So, I mean, I know as a pediatrician what I do is at the nine month visit, I go through a, just a brief anticipatory guidance that I want the child at one to have three meals, two snacks, and not more than 24 ounces of milk if they're having milk in a bottle. And I tell them that because what I see one, one pitfall that I see, and we could talk about other pitfall. To transitioning to solids is if you don't tell them that they may not realize and the kid may still be licking food and having 32 or more ounces a day of milk and then they're not hungry. And I really want you to talk a little bit about the window of learning to eat. 'cause that's one problem I see.

Melanie Potock 18:38

Yes, yes. Well, first of all, there's a flavor window between four and six months where kids really four and seven months, where kids are really interested in flavors. How many times have we all watched on YouTube videos where babies are tasting lemons and they're making that sour face, and they're so cute, but do you ever notice they almost always reach for the lemon again? Yeah, so into flavor. Yeah. They, they really do, you know, despite the little shutter and the cute purse lips and you're thinking, oh my gosh, I don't know, that poor baby lemon. And then they're reaching for it again. And that's, that's just so true of that age. We call that the flavor window. We, you might actually see that through that first year of life as well. Where babies are more interested in trying a variety of foods, but early on we really recommend that you offer as much variety as possible, including roasted or, or very well steamed vegetables, because although those tend to have a little bit more of a bitter undertone. They're an important part of being an adventurous eater, and if kids are more willing to try them, and the more you try something, the more you learn to love it. Then we want to offer those while the window's open.

Alisa Minkin 19:57

I love that. And I, I also interviewed Dr. Mali Fernan Fernando, who is your co-writer on this book. And part of the Dr. Yum project, which I'll probably link to your talk as well 'cause it's such a great resource, the Dr. Yum

Melanie Potock 20:07

Yeah.

Alisa Minkin 20:08

And we talked also about vegetables. And I think I said with my talk with her that I thought those green purees, none of my kids ate them for the most part. And if you taste them. Ew, but, but roasting vegetables, okay, you didn't say it, but it makes them yummier and sweeter.

Melanie Potock 20:29

It

Alisa Minkin 20:30

And my grandchildren, I cannot roast enough cauliflower or broccoli for them. All of them adore it. They're coming like, oh my God, I've gotta have five heads of cauliflower.

Melanie Potock 20:37

That's fantastic. It's so true, and one of the reasons I love to roast vegetables is because you can do all of them on a big sheet pan and then they store well for a good week in the refrigerator. You can puree them up if you want to. You can chop 'em up and add 'em to scrambled eggs to get that allergen in. You know, there's so many different things you can do and they're right there so handy, and you don't even have to serve 'em warm. A lot of kids love a roasted red pepper strip straight out of the fridge.

Alisa Minkin 21:04

They can hold them

Melanie Potock 21:06

They can hold them. Exactly.

Alisa Minkin 21:07

the cute little toddler holding their little broccoli stock.

Melanie Potock 21:09

It's so cute

Alisa Minkin 21:11

But make them, it also makes them softer, right? 'cause one promise vegetables, it can be too hard and it could be a choking hazard. And we're gonna put, put the warning out there for choking. It's very important if possible to get a, to take a CPR course. American Red Cross offers them so you know what to do about choking. But I really want you to talk about choking versus gagging. 'cause that's another landmine.

Melanie Potock 21:31

definitely. And a lot of misinformation out there. Here's what I want everybody to know as often as feeding specialists like myself, say things like, well, gagging is actually good because it's a protective mechanism that helps to protect your child from choking. That's not entirely true because. A little bit of gagging, occasional gagging, and you know, people always ask me for a number, but like, you know, three times a meal when you're first starting to explore new food, notice just like babies tasting

Alisa Minkin 22:05

lemons.

Melanie Potock 22:05

that that little kid will have a little gag. They'll learn to manage the food. It might spill out of their mouth. That's okay. And then they just keep going on their own, especially if we don't overreact. but if you do have a child who is gagging frequently during a meal and you can tell, gosh, it kind of makes them shut down. They seem a little scared now. They seem uncomfortable. They just wanna get outta the chair. That happens too often. Then we are worried about developing an aversion to food. So gagging is really good on the. Every once in a while basis. Right. And the reason why it's good is it is the gag reflex is designed to make sure food doesn't fall back in the airway, but it is not foolproof. Choking is when the food does fall into the airway. It doesn't have to go all the way into a lung or down your, d I'm trying to think of the right terms to use for your audience. Bear with me. All the way down what you think of as the air pipe. Think of it that way.

Alisa Minkin 23:08

Yeah.

Melanie Potock 23:08

But, but there is also a little triangle of tissue at the top of that airway. A lot of times round foods like hotdog coins or grapes or even a blueberry will lodge right at the top of that funnel, and that is. Very difficult to dislodge. So choking is truly where we are blocking off the airway in one of those areas that I just mentioned.

Alisa Minkin 23:43

Because of that,

Melanie Potock 23:44

you have to have air to produce voice. So if that baby isn't making any sound, they're choking. If you start to

Alisa Minkin 23:55

you start to.

Melanie Potock 23:56

coming out the sides of their mouth or a little bit of a bluish tint, but they're, they're

Alisa Minkin 24:01

They're

Melanie Potock 24:02

and very little. If no sound is coming

Alisa Minkin 24:05

coming.

Melanie Potock 24:05

they are choking. It might look like a gag, but it's the sound that makes the difference because the airway is blocked. What does that mean for you as parent? If choking has no sound, you will not hear your child choking. Please always keep an eye on them. If you can sit with them when eating, when they're eating, that's amazing. But I also understand when you got a couple kids and you're running around, you're trying to get everybody fed, just be aware. Choking typically has no sound. You will not hear it. You will see it.

Alisa Minkin 24:44

And that's why using the Red Cross, you know, program and knowing how to handle it is really, really important. But also avoiding choking hazards. That's my other concern with baby Lid weaning is if, if you don't understand what's a choking hazard that you're giving to that child and you have to worry about choking for years. Okay. It's not like the first 12 months or 24 months, it's at least 40 years.

Melanie Potock 25:05

is at least four years. It's at least four

Alisa Minkin 25:07

Yeah.

Melanie Potock 25:08

and I probably post more on this topic on my Instagram than any other topic because. And, and yet the number of people who still comment who don't know about this, I would say, tell me what you think. But I would say the one that most parents don't know about when it comes to toddlers, you know, even a 3-year-old is popcorn and those babies are getting fed popcorn in a dark theater. That's the one that scares me the most. Although I could, I could certainly list a lot more, but that's also a surprising one for parents. He can't have popcorn, not until at least age four. It's so chunkable.

Alisa Minkin 25:48

It's, it's really hard. I mean, and even you said blueberries. That actually surprised me 'cause I thought they were pretty small. But blueberries vary in size, actually.

Melanie Potock 25:54

in size and they're round,

Alisa Minkin 25:57

Grapes, oh my god. Grapes. Hot dogs. Oh my god. Hot dogs, grace. All of these things that form this, like, you know, it becomes a bull valve. I mean, it's a, it's a really big problem.

Melanie Potock 26:07

plug. It's a

Alisa Minkin 26:08

Yes. And, and also not, not giving kids food to eat while they're running around. Again, it's really hard. I know. I.

Melanie Potock 26:12

And, and without taking up too much of your time, and also it's a little bit hard to do an an audio broadcast in a podcast, but so all my books describe, okay, what do you do instead? For example, hot dogs, you're gonna cut it into four to six long strips and the kids can hold the strips or you can mince it and I mean, really mince

Alisa Minkin 26:34

Tiny, tiny pieces,

Melanie Potock 26:36

and because you don't wanna make a bunch of blueberry sized pieces, 'cause now we're really in trouble you can do that as well. And finally, for anyone listening who's thinking, I don't know, like, does my kid really need to have a hot dog? not. I certainly realize there are quote unquote healthier versions of hot dogs

Alisa Minkin 26:55

right.

Melanie Potock 26:56

you know, certain brands. But I think also we can't let go of the site that. There are certain foods, especially in the United States that are very much Americana and there are, the kids are going to get exposed to these maybe when you're not around. So at least establish, establishing what the routine will be. That when if you get a hot dog, you bring it to mommy and she'll, she'll cut it up for you. You know, I want the kids to learn these things. Mommy, I've got grapes. Can you cut them for me? And then maybe when they're around three. When they're sitting and paying attention to you. Then we practice eating a hotdog together. That's whole. Then we practice eating, biting off a whole grape, but only face-to-face supervision and practice so that if they do get one on their own before the age of four, hopefully we've done a little bit of parenting proactively to safeguard some of these hazards.

Alisa Minkin 27:58

Absolutely. And also everybody else that feeds the child needs to know this. Like grandparents.

Melanie Potock 28:02

That's right. That's right. And these are wonderful grandparents. You and I are grandparents.

Alisa Minkin 28:06

Yeah.

Melanie Potock 28:07

are wonderful grandparents. Yeah. But, but you know, things change. We learn as the more we know. I hope that anyone listening will feel free to sign up for my newsletter or go to my website of so many free handouts there and share those with

Alisa Minkin 28:23

Exactly.

Melanie Potock 28:24

because they wanna keep that baby safe too.

Alisa Minkin 28:27

Right. And it also makes it more like, less emotional. Like here, this is what my feeding expert says. Not what I'm saying. Not like you did something wrong for me. And, you know I wanna talk a little bit about parental anxiety because before we started we talked a little bit about COVID and how we're seeing more feeding problems. And we're not talking about feeding disorders, but we're trying to be more proactive and saying, what is the role of anxiety? And when I say anxiety, I mean anxiety in the child and anxiety in the parent and feeding.

Melanie Potock 28:52

I love this question. Pediatric anxiety and anxiety in general is a really big special interest of mine and I've, I. Been studying it prior to COVID, but definitely during the

Alisa Minkin 29:06

Person,

Melanie Potock 29:07

Boy did it come to light. not

Alisa Minkin 29:12

not only

Melanie Potock 29:13

is the way I want everyone to think of it. I want you to imagine everybody carrying around a bucket that bucket is labeled anxiety, and in that bucket is a certain amount of anxiety water that's just splashing around. We all have different levels of anxiety in our buckets. Some people are less anxious than others, and it's okay if you tend to be a little bit more of an anxious person. Now, when that bucket is so full that it becomes so burden burdensome to carry, it is heavy. It is quite the load. It's always. You're always aware of it. Then we start to become concerned that perhaps this

Alisa Minkin 29:59

Versus

Melanie Potock 29:59

an anxiety disorder where. Typically a little bit of anxiety. Water is there to keep us safe, you know,

Alisa Minkin 30:07

you know.

Melanie Potock 30:07

there to help us remember to cut up the grapes before they turn Four. A little bit about anxiety around choking is, is a good thing, but being so scared that your child would. Choke that you aren't willing to try some foods that they need to learn to chew or mash and you stick with purees for over a year. that's where the parent anxiety is really beginning to impact the child's feeding development. And then likewise, I always want everybody to remember. That children, especially our own children, are little sponges and I think, especially in my professional opinion with their mom, if the mom's the primary caregiver that that they can pick up on our own anxiety and our anxious feelings. So. Learning to identify the difference between adaptive anxiety, which is what keeps

Alisa Minkin 31:05

Keeps

Melanie Potock 31:06

and

Alisa Minkin 31:07

anxiety.

Melanie Potock 31:07

in the way and it's there. It results in functional impairment. That's what we wanna pay attention to because that's going to have a direct impact on the way our child the world as well. then if I can take that one step further, Lisa, it would just be that. Kids who have trouble eating for a variety of reasons that we won't, probably won't go into today, tend to develop anxiety around food. Because eating is hard. It's challenging, when as a parent, when you see your child struggling to eat, that creates so much anxiety in you as well, because. We want to nourish our children. We want to see them eat, we want to see them thrive. And in my opinion, I think it's one of the number one things parents worry about is their kids' growth and whether they're eating a variety of foods and, and truly becoming an adventurous eater, but also getting the right nutrition. so you

Alisa Minkin 32:09

So you.

Melanie Potock 32:10

where the child's anxiety and the parent's anxiety are intimately connected.

Alisa Minkin 32:17

I love everything you said and it is intimately connected. You really were talking more about the parent than the child's intrinsic anxiety, although you kind of alluded to the fact that when the child has it, the parent feels it worse. 'cause it always hurts us more than it hurts them. It's so true. We are gonna have to have a second ASEP second episode on actual feeding problems. We didn't even mention neurodivergent kids because we are seeing also. Since COVID, before COVID, a rise in Neurodivergence in children. And those kids tend to have more problems eating and that's intrinsic to them. And by the way, we are not blaming parents here. You are not causing any problems at all, right? We're talking about being aware, right? Of your anxiety, it is not your fault, right? Wherever it comes from, whether it comes from dealing with your kids' anxiety, whether it comes from your own anxiety, it's just a piece we need to address, but it's not, it's not blaming. I wanna really make that that clear.

Melanie Potock 33:11

Absolutely. And also I know from getting to know you, Lisa, that when a parent comes to you with concerns about their child's eating, you are very keen and and interested in what they have to say. I also want to give all the wonderful pediatricians out there a break because I know, you know, my brother's a pediatrician, my best friend's, a pediatrician. I go to the a EP every year talk to pediatricians, and I know how busy and stressful their days are, and sometimes they

Alisa Minkin 33:49

they may not

Melanie Potock 33:51

to take parents seriously when a parent expresses that they're

Alisa Minkin 33:55

that they're about

Melanie Potock 33:56

nutritional health. The biggest tip I can give parents is schedule a separate call. And even if you might not even wanna bring this up in front of the child, you could even hand them a note, write it before you get there, and hand them a note as you go and say. Here's one more thing. I'll call you about this one, and I'll schedule it at the front desk before I go, but I wanted to let you know, I, I want to talk about this one more thing when it's just the two of us. Now they are tuned in during that phone call for that one concern, and that's when I want you to stress. you are stressed because tying back to what we were just talking about, your own anxiety comes into play here. It is not your fault. It is valid. Those feelings are very valid. Follow your instincts. If you have any concerns about your child not being an eater, where they find joy in food, where they're interested in food, where they are willing to try a variety or you're just not quite sure of how to go about it. Talk to your pediatrician about getting some support from a pediatric feeding specialist.

Alisa Minkin 35:04

I love that so much louder for the people in the back, number one. Number two, I read this in one of your books and I loved it and I told you this. Not every pediatrician is. Passionate about feeding. So one thing you could also ask for, is there a particular pediatrician, clinician in the practice that specializes or especially interested in that and request a meeting with them? Okay, number one. Number two, not every kid can get into feeding therapy because it's not so accessible outside of, unless you're gonna pay privately or you qualify through early intervention services. Which is very hard to do on, on feeding alone, just. To be completely transparent. So those were things that I really wanted to point out there, but I really appreciate you're giving a shout out to the pediatrician, and this is where I give all pediatricians everywhere a big hug. It's really, really hard to be a pediatrician now, and we are definitely not, not blaming you either.

Melanie Potock 36:00

no.

Alisa Minkin 36:01

But talk about the way things used to be. It used to be that you would say normal, normal, normal, and the kid's growing fine. And I think one stumbling block is you go to your pediatrician and they say, well, your child's growing on the curve, and all kids are different, so it's not a problem.

Melanie Potock 36:15

But, but the problem is that it's stressing you out as a parent. And, and that I think parent, you know, pediatricians care so much about the kids, but they also are in this field 'cause they care so much about the parents. And I, I really, truly believe, I don't think I've ever met a pediatrician. Who brushed off the fact that a parent said, this is really stressful for me. And even if it's just to hand them a book and say, don't you take a look at this? Let's schedule another call. I just wanna really, I want the parents to hear how much

Alisa Minkin 36:52

Pediatrician

Melanie Potock 36:53

cares

Alisa Minkin 36:53

cares about. Really, really true. But they may not, the pediatrician may not understand. And I really wanna talk a little bit about developmental variations in feeding, because I don't remember if it was in this book or one of your other books you talk about Feeding is a complex developmental task. And I, I, pediatricians, are not necessarily trained in that the same way as say a feeding or speech therapist is not many are by the way, many are very, very savvy. I don't, I'm not out there to mock the pediatricians, but there can be a knowledge gap as well. And the parent may not be anxious about it. They may say to their pediatrician, is everything okay? And the pediatrician says Yes, and then they're fine because they weren't worried. 'cause the pediatrician reassured them. Not every parent is worried about this.

Melanie Potock 37:35

That's, that's a good point that sometimes just hearing that, you know, all kids are picky. He's gonna be fine. He'll grow out of. Is reassuring to the parent. and it may be that that particular pediatrician doesn't have the background in feeding development, as you mentioned, frankly, many SLPs and OTs do not either. It's really a specialty. But when I first met Dr. Mali Fernando, who you just interviewed, and we decided to write this book together, when we talked about what's our main goal of this book, she said, I wanna get this in the hands of every pediatrician. And I said, I want every pediatrician to know that feeding is a developmental process, just like learning to crawl, walk, run, you know, just like learning to sit up on your own. It's a developmental skill. It doesn't come to every child naturally. in fact, one out of four. Typically developing children will require pediatric feeding therapy. So we don't want to take a wait and see approach when we know that one out of the four kids that walked into their office that day might truly need some support. And so that's why I appreciate this podcast so much because it is about the more we know. Right? And just talking to you, I've learned so many things, so I

Alisa Minkin 39:06

So

Melanie Potock 39:07

the fact that. Everyone focus on how to support the process with patients and

Alisa Minkin 39:14

and

Melanie Potock 39:14

right strategies, and that we give children the foundation they

Alisa Minkin 39:17

they need.

Melanie Potock 39:18

to become confident, lifelong eaters.

Alisa Minkin 39:22

I love that. And we're gonna have to do part two and I, that's such a great place to end. I'm gonna end here. So thank you so, so much for doing this with me and I can't wait until part two.

Melanie Potock 39:34

I, I, now, I'm excited. I wanna do it right now, so we should get on the schedule.

Alisa Minkin 39:37

Yes, we will. But goodbye to everybody right now. We'll, we good back later.

Melanie Potock 39:41

Bye everybody.

Alisa Minkin 39:43

Thank you.

39:47

Thank you for listening to Kids Matter. Raising Healthy, happy Children Takes a village, and I'm grateful you are part of ours. If today's conversation resonated with you, please share this episode with another parent, grandparent, teacher, or anyone who cares about kids. Together we can build a supportive community our children deserve. I'd love to hear from you. Share your thoughts, questions, or suggestions for future topics at Kids Matter podcast@gmail.com. With no explanation for your voice truly matters. Until next time, keep advocating for the children in your life because kids really do matter. They are our future. I'm Dr. Elisa Minkin and this has been Kids Matter. Please note that while I am a pediatrician, I am not your child's ped. This podcast is for informational purposes only and does not constitute medical. For any medical concerns or decisions. Reach out to your child's healthcare professional.