Helping Children with Diabetes Develop a Healthy Attitude About Eating

As parents, it’s hard not to micromanage everything our children eat. After all, wouldn’t they sit around snacking on cake all day, while never touching a single vegetable, if we didn’t?

Surprisingly, research shows that children who are offered a variety offoodson a routine schedule, in a calm environment, will naturallyeatthe appropriate quantity of food they need to grow and stay healthy. This also applies to children with diabetes.

To assist her clients, Anne Blocker, adiabeteseducatorand registered dietician, has introduced the Division of Responsibility. Created by Ellyn Satter, a feeding dynamics expert, the Division of Responsibility (sDOR) is a feeding model.

What is the Division of Responsibility?

The sDOR was designed teach parents that everychildcan be trusted to learn to like the food eaten by their family, as well aseatthe appropriate quantityto grown and stay healthy. When childrenare raised according to the sDOR, they grow up to be good eaters, though this isn’t something that happens in a single day. It requires conviction, persistence, and a touch of blind faith. Here are the 3 crucial points of sDOR.

Parents and children have different responsibilities

According to the Ellyn Satter Institute website, “When parents do their jobs with feeding, children do their jobs with eating.”

Essentially, parents are responsible for determining what food will be served, as well as where and when. Children are responsible for deciding how much and whether or not they willeatany of the food served.

Blockersays,“Fear about low blood sugarsandlong-term blood vessel and body damage due to thediabetescan scare a parent into controlling their child’s food intake. However, I think it is always important to remember that thechildwithdiabetesis still a normal child. They still want to do things with their friends andeatcake and ice cream when everyone else does. sDOR can help a parent teach theirchildto stilltrusttheir internal

It is crucial that children have a daily schedule for meals and snacks.

Children, as a general rule, are comforted by a schedule. This is why they need to have their meals and snacks served in regular intervals throughout the day (and around the same time everyday). This keeps children relaxed because they know that they have another meal or snackcoming up.

Blockerreports, “The structure of consistent meals and snacks, which is at the core of sDOR is also at the center of excellentdiabetesself-management. These regular feedings can prevent swings in blood sugar and support an internally regulated appetite.”

Blockeralso states that consulting with a doctor anddiabeteseducatorin order to learn how topost-doseis crucial for the success of sDOR.

She explains, “Rapid acting insulins enter the system and work within 15 minutes. Post-dosing allows a child to eat what they are hungry for and then give insulin accordingly. Giving insulin prior to the meal can lead to eating pressure if a child isn’t very hungry or doesn’t eat the anticipated or planned amount of carbohydrates. This situation usually leads to food struggles, fear on the part of the person giving the insulin and potential lows later in the day. If a child’s blood sugar is high before the meal, a pre-determined amount of correction insulin may need to be given.”

Meals should be free of pressure.

The sDOR believes that one of the most importantwaysto offer support duringmealtime is to serve food “family style”. This involves placing everything in the middle of the table in different bowls. This gives children the autonomy to determine what they want to eat, as well as how much.

It is a good idea to serve both familiarfoodsand unfamiliar foods. This lets children know that there will be both something they can count on to fill them up, while also encouraging them to try something new.

Blocker reports, “Of course, with Type 1diabetesthere will be special circumstances, but overall, the trusting approach that sDOR presents will help achildin the long run.Someof thetraditionalwaysof managingdiabetescanunderminea person’strusthungerandfullnesscues,andcontinuallycorrecting ups anddownscanaddto acycleofforcingfoodswhen achildis not hungry.”

Yes, the rules of the sDOR probably go against everything you have learned as a parent, particularly parents of children with Type 1 diabetes. However, when parents learn totrustthat their kids with what they eat, children grow up to be confident, self-sufficient, and comfortable around food.


Leave a Reply

Your email address will not be published. Required fields are marked *