Nutrition and Your Child

Nutrition and Your Child

by | Oct 1, 2020 | Nutrition | 0 comments


At Keānuenue Pediatrics, we focus on all aspects of a child’s life that contribute to their overall health. Check out the image below. It’s just a snapshot of our brand new website coming soon 🙂 Stay tuned! The values of Mind, Body, Spirit, Family, and Community are the different ways in which we think about your child’s health.

In my previous emails, I’ve talked about a few things related to these values: mental health, exercise, sleep hygiene, and sort of touched on nutrition. Today, I want to take it a step further and expand on the nutrition aspect.


I’m going to mimic Dr. Waipa for a bit and share my vulnerability with you. Almost two years ago, someone very close to me was diagnosed with cancer. Yep, the “C” word that everyone hates to hear. We found out over the holidays in 2018 and to make matters worse, I was on my oncology rotation (cancer rotation) at the time. Double whammy. If this has happened to you, you know what it feels like when you hear the “C” word. It’s devastating. Now, I won’t go into the details, but I want you to know that if this has happened to you, you’re not alone. Thankfully, after six cycles of chemotherapy that person is now over 1.5 years in remission. Yay! I feel extremely blessed.

But I must admit that sadly, it took something that drastic to make me really think about how I was taking care of myself. I didn’t want to take my health for granted anymore. After all, I’m a doctor. We preach health, so we should be healthy, right? I mean, I tell patients to fill half their plates with fruits and vegetables and to exercise throughout the week. But what was I doing?

This was my exact lifestyle up until that point of finding out about the “C” word: I worked 80-hour work weeks, skipped meals because I was too busy, ate cookies, donuts, chips, candy, or whatever snacks I found in the workroom, slept horribly because of my work schedule, and then rarely worked out (there was no free time!). Fruits and vegetables were hardly ever on my plate. If there was an excuse, I found it. Yes, it was horrible, and I was definitely NOT a good role model for healthy living.

I really started to look at what I was putting into my body and again realized I needed to make a change. I know I can’t control everything that might happen as far as future diseases, but I can make small changes that will benefit me in the long run.

When thinking about what changes I could make, I knew I couldn’t control my work hours or sleep deprivation that came with residency. However, the one thing I could control was my eating habits. I made a goal for myself to get away from the word diet and turned it into a lifestyle change. I’m writing this to you one year after starting my lifestyle change.


First of all, there are soooooo many aspects of nutrition that I could address, and I want to break it down into short pieces over several emails. For today, we will touch on Division of Responsibility.



Before talking about the nitty gritty, I want to tell you about a patient encounter I had during residency. It was a routine check-up for a four-year-old girl, and the parents and I started to discuss her nutrition. They mentioned that their daughter was a very picky eater (by the way, Dr. Waipa wrote about picky eaters in a previous email. Check it out!). They told me that she ONLY WANTED TO EAT MCDONALDS FRIES. They looked at their daughter as she shamefully smiled and avoided eye contact with me. I told them it’s okay if she has McDonald’s every once in a while, but she shouldn’t eat it every day. The father then turned to the four-year-old and said, “See! You can’t have McDonald’s all the time.”

I tell this story because it brings up a few important points. One, about addressing picky eating. Two, reframing the thought process. THE FOUR-YEAR-OLD CHILD IS NOT DRIVING HERSELF TO MCDONALDS EVERY DAY.


Division of responsibility helps families decide the responsibilities of the parents and the responsibilities of the child when it comes to eating. Once you fulfill your responsibilities as a parent, you can leave your child to fulfill their own responsibilities. It takes a lot of pressure and stress out of family eating, which should be fun anyway.


  1. Decide what to eat
  2. Decide when to eat
  3. Decide where to eat.

Sounds simple right? It’s much easier said than done. Let’s break it down a bit further.

  1. What to eat:
    1. Choose healthy foods and drink options
    2. Offer the same food to everyone in the family. This eliminates feelings of unfairness if another family member doesn’t have to eat fruits and vegetables, but the child does. Remember you’re always modeling!
    3. Already plate their meals with fruits and vegetables.
    4. Reminder: You are NOT a short-order chef. You don’t have to cater to every request. Deciding what everyone eats is your responsibility, not theirs.
  2. When to eat:
    1. Again, create a schedule that lets family members know the timing of their meals.
    2. Being consistent as often as possible here can help
  3. Where to eat:
    1. Together, at a table, and not in front of the screen.
    2. Make it family time. Engage with each other over the meal.


  1. Choose whether to eat or not
    1. Allow them to choose from the food already on their plate
    2. They could eat it all or they could eat nothing, it’s their choice; remember, your work is done once you’ve fulfilled the above responsibilities.
    3. There should be a time limit. Don’t give them forever to finish their food, a good 15-20 minutes is plenty (less for toddlers with short attention spans).
  2. Choose how much to eat
    1. Never force a child to eat. They will come around.
    2. If the child wants more, it’s okay to give them more.
      1. However, think about which food is being offered as the second helping. Do you offer more rice, more meat, or more vegetables?
      2. Prioritizing veggies first before extra meat or rice is ideal.
    3. Offer praise to your child if they prioritize their fruits and veggies the right way.

For some, applying this division of responsibility to your family’s meals may require a lot of changes. Start small and build your way up! You could pick one of the items in each responsibility to work on and go from there. I’m excited to hear about your family’s health journey. If at any time you need help or feel like things aren’t working, let us know! More info on nutrition in the future. Stay tuned!

With care for your keiki,
Keānuenue Pediatrics