Sarah Almond Bushell is an award-winning Registered Dietitian, ex NHS Consultant child nutritionist of 22 years and founder of ‘The Children’s Nutritionist’ who is working to reduce the stress around mealtimes for parents and is passionate about helping to cut the ties of generational eating habits, fuelled by misinformation and desperation tactics.
Katherine Ann Byam 0:00
Changing what we eat is one of the best ways to have a significant impact on climate change. Yet a lot of us are afraid to make those important shifts, I had a chat with a dietitian and a feeding specialist to talk to her about what we can do to make change happen. Here's a clip of that recording now.
Sarah Almond Bushell 0:18
So I think one of the big myths that a lot of parents have, particularly parents of young children is they worry about how much protein their children having. So one of the most sort of frequently asked questions I get is, you know, my child won't eat any meat or fish I'm worried they're not getting enough protein. But actually, in truth, the protein requirements are really quite small. So we eat far more protein than we ever need. So it's absolutely no problem at all if people want to reduce the amount of meat that they do eat. That's, you know, that's absolutely fine. It's not going to have any nutritional problems at all.
Katherine Ann Byam 0:55
This is season five, the great debates of our times, Season Five will be centred around the great debates. And we will be comparing and contrasting different viewpoints on various topics that are consuming the public discourse at present. The reason I've decided to take this approach is because we, or at least many of us, are losing the skill of debate. And I think this is an essential skill for us all to practice once more. I don't see how we get to the point of saving the world and saving our planet. If we don't know how to discuss our differences. I also think that the solution to most of our challenges are somewhere in the spectrum of views, but never a type of extreme. I will be working with guests to curate the content and discuss beforehand, I will understand their positions, their areas of genius, and navigate my questions around that so that the conversation is challenging and stimulating without being combative. I hope you enjoy season five of where ideas launch the Sustainable Innovation podcast.
Sarah Almond Bushell is an award winning registered dietician, ex NHS consultant, child nutritionist of 22 years and founder of the children's nutritionist, who's working to reduce the stress around mealtimes for parents and is passionate about helping to cut the ties of generational eating habits fueled by misinformation and desperation tactics. Sarah, welcome to where ideas launch.
Sarah Almond Bushell 2:23
Thank you so much for having me.
Katherine Ann Byam 2:25
Sarah, I'm excited to have you because I think food is such an important subject. And I want to be able to unpack all the things we never understood about food, nutrition, feeding. And I also want to explore another angle, which is how we can change and adapt our own nutrition even as adults. Given that we need to look at those relationships later on for what is to come. So let's get started. You are a nutritionist who couldn't get your kids to eat. Tell us about your early experiences as a mother and how this impacted your journey.
Sarah Almond Bushell 2:56
Yeah, absolutely. So I qualified as a dietician and had been working 10 years in paediatric in a hospital setting. So in paediatric clinical nutrition when my first baby came along, and at the time, this sort of buzzword was all about responsive feeding. And so letting the baby kind of take charge and be in control of what they wanted to have and how much they wanted to eat. And so I truly embraced that because I felt that was what I was the right thing to do. And what I found was he was a particularly strong willed little boy who was very, very demanding, and essentially, he would demand milk, he would demand snacks as he became a toddler, and he ended up with iron deficiency anaemia, which made me feel like a bit of a failure considering I was a paediatric dietitian working in a children's hospital and my own child had a nutritional deficiency. And then with my second child, she was actually much harder. So she came along two and a half years later, and from day one, she vomited. She was falling off the growth charts. She wasn't growing in the way that she was intended to. She was covered from top to tail in eczema, but she was just a really sicky baby. And the GPS would kind of fob me off has been a bit of a paranoid mother. Health Visitors didn't know what to do. And it transpired that she actually had quite a severe anaphylactic food allergy, which she was getting through my breast milk, but by the point we identified that she was like eight and a half, nine months old, and by that time, she'd just associated anything that went in her mouth with feeling poorly. So she just didn't eat. She refused breastfeeds. I tried her with formula she'd refuse that, she'd refuse food. Sometimes I could get a little bit of food into her and then she would puke the whole lot up. And then that would be you know, that food written off completely. So she just associated food with pain and ended up with a feeding aversion.
Katherine Ann Byam 4:56
What an incredible trauma.
Sarah Almond Bushell 4:58
Yeah and as a dietitian When I felt absolutely rubbish, you know, this was my job. This is what I did. I was supposed to be the person who you would go to when children had feeding problems. And I'd failed with both of my own children.
Katherine Ann Byam 5:14
You speak about the generational sort of challenge with this, was there something that came also from your own past that might have impacted on your children to your knowledge.
Sarah Almond Bushell 5:18
Not at all that came later, actually, what happened next was a lot of my colleagues and the Children's Hospital where I worked essentially couldn't help because they all said, well, we don't know what to do, I can't help you don't know what to do here. And so I ended up basically going to Google and spent hours and days and months typing stuff into Google to try and find out what I could do to help her in particular, and what I found was a lot of the stuff that's on there was really unhelpful, you know, stuff about changing the food, trying new recipes, cutting sandwiches into the shapes of teddy bears, or stamping hearts in cucumber, and all of this kind of stuff. But none of that actually works. And so I ended up stumbling across quite randomly, a team of feeding therapists based in Colorado in the USA, and essentially, I stalked them and learned so much from them and went on to become a an advanced level feeding therapist with them. And that's what led me to learning that with my daughter, she needed quite specific feeding therapy because of all of the early experiences that she'd had. But with my son, what I recognised there is that my role in the feeding relationship had a start and an end. And his role in the feeding relationship also had a complimentary start and an end. And when we crossed streams, so to speak, that's when the problems arose. After, you know, sorting out my own children, I started to apply this to my patients that were coming through the clinics. And what I discovered there was there was so many of these eating habits that were just passed down from one generation to the next to the next through, you know, with families, and they hadn't really ever considered the way they do things. So for example, one of the big ones is withholding pudding until you've had your dinner, you know, you can't have pudding until you've eaten your dinner, or you need to clear everything on your plate before you're allowed to have pudding. And it was these sorts of things that I started to realise that actually if we flip that around and allow the child to have what the pudding just put it on the table so they can see what it is. And if they choose to eat that first. So be it. As long as it says small enough portion size, because there's plenty other food there to fill up on. It actually changed the dynamic of feeding and family relationships. I think that was that was the main thing sort of the family mealtimes became collaborative, they became calm, people would report back that things had changed quite drastically from just minor tweaks in how they fed their children.
Katherine Ann Byam 7:55
That's quite incredible and quite unexpected. I think a lot of people listening to this will be thinking what feed your kids the dessert first. And let's talk a bit about that. So what are some of the myths that we need to bust about the way we do mainstream nutritional education at the moment, starting with our kids?
Sarah Almond Bushell 8:15
Yeah, so it's mainly around the feeding rather than nutrition, I would say so in food and feeding are two completely separate things. And what I've ended up doing is kind of specialising in the feeding part. So a lot of it is cultural, you know, it's the stuff that our grandparents taught our parents and our parents taught us and then we've passed on to our children and none of it is actually backed in science at all. But now we do have some you know, amazing psychology research, which has kind of unpacked these cultural ways of feeding children and found out that there's better ways to do things. So going back to that example about allowing your child to have pudding, you know, early on in the meal at the start of the meal perhaps what that does, is it it takes the sweet food, the pudding food from being this highly desirable thing that's you know, upon a pedestal that children almost have to earn by completing that arduous task of eating their meal before they get their prize. So when we do it the old way like that, what happens is foods that are sweet essentially, because that's what pudding tends to be, is considered much higher value becomes much more desirable. Children will crave it, we use those sorts of foods in celebrations don't we, so like birthdays Christmases, you know, even going to the cinema, you know, you might get an ice cream or popcorn or something like that. We use sweet foods as a way of celebrating happy times. And so they've already got that power of being something highly desirable. And something that's really nice.
Katherine Ann Byam 9:51
I would also say it's used as a bit of behavioural control as well, right. I'll give you a sweet if you just stop screaming.
Sarah Almond Bushell 9:57
And it works. It works. So that was, I actually forgot about this one, but that was actually how we got to potty train my son. Every time he managed to do a week on the potty he got a sweet. And so he picked up potty training and within hours you know, it does work as a reward. And what's interesting about that is sweet foods, babies are born with really mature sweet tastebuds and it's an evolutionary thing to, it's a survival mechanism actually, is to help them seek out the breast at birth for survival, but that, that really mature sweet taste stays with them all through their childhood all through the teenage years. And it only, the sort of bitter and the savoury stuff that has to be learned over those years, only catches up in that early adulthood time. So those sweet foods have already got you know, far more power over children than anything else that that we can offer them.
Katherine Ann Byam 9:59
That's really, really, really interesting. Thank you for sharing that what I wanted to kind of switch to or move to is how has your training actually influenced your family.
Sarah Almond Bushell 10:57
It's had a huge impact actually. So first of all, my daughter who had this, you know, feeding aversion and fear of food, essentially, she's 13 next week, and she wants to be a chef when she grows up. She absolutely loves food. It's really helped her blossom into this fearless foodie for a want of a better word. So her favourite subject at school is food tech. She wants you know, she wants to be cooking all the time, when the lockdowns hit, we were all at home. And so we would all sit around the table and eat together and share, you know, one meal between everyone. And that's had a real, profound effect as well. So one of the things I do recommend to all families is to try and eat together whenever you can. And part of that is because if you've got very young children, you're their role model, and they need to see you doing it first, before they ever decide to you know, pick up a piece of broccoli or a green bean and see you eating it and know it's safe before they'll ever do it themselves. But it's also where you learn a lot of the social skills as well. And if you're wanting to introduce new food, it's a really safe environment to do that, provided there's not pressure to eat the new food, because a lot of the way that children learn is through their sensory systems. So just by placing the food on the table, they're seeing it, they're smelling it from afar, they're looking at, you know, the colours, there's all this sort of sensory characteristics they're picking up on. And so that can really help. So in terms of my family, I would say that both children are much more adventurous with foods they'll try. And we often see that now and they bring their friends home, we serve what I call sort of family style. So it's where you put all the different components of the meal in the centre of the table, and everyone has an empty plate and helps themselves to how much. And their friends are often gobsmacked at that, because their parents have pre plated for them. Again, it's a cultural thing, not based on science, but their parents have decided how much of each part of the meal they should be eating. And so when they're given this autonomy of having an empty plate, and they can decide how many spoons of carrots they want, and how many potatoes they want, it's really, really interesting to watch, they almost don't know what to do.
Katherine Ann Byam 13:06
Now, thats really great I like this, this idea and this concept. And it's bringing me to you know how this links to my sustainability conversation. And one of the things that we're being told now, and I think it's really important for us to understand and figure out how we adapt, is that the amount of meat that we eat, is starting to really have massive impact on our climate, because it takes so much land space to grow the food crop that feeds the animals, as well as it's a little bit inhumane, right? If you really think about it, then we can get some, at least most of the nutrition that we need, we can get it from plant substitutes. So there is a big change that we need to do. And I'm wondering how we face that change? Because at the moment, it's quite difficult. I've cut my own meat consumption to about 50% of what it was, except during holiday weeks. But you know, this isn't easy for people to do. So what are your thoughts on how we could approach that?
Sarah Almond Bushell 14:05
Yeah, absolutely. So I think one of the big myths that a lot of parents have, particularly parents of young children is they worry about how much protein their children are having. So one of the most sort of frequently asked questions I get is, you know, my child won't eat any meat or fish and I'm worried they're not getting enough protein. But actually, in truth, the protein requirements are really quite small. So we eat far more with protein than we ever need. So it's absolutely no problem at all. If people want to reduce the amount of meat that they do eat. That's, you know, that's absolutely fine. It's not going to have any nutritional problem at all. What I would say is one of the things that we can think about doing is reducing our dairy consumption. So using some of the plant based milks, I would say that if you've got a child under two, that's not a great idea because they still need a lot of nutrition from their milk and cow's milk contains that whereas plant milk doesn't. Even when it's been fortified, it doesn't really match up. It's more like a flavoured water. I often say to people, but you know, from two and above, you can absolutely use a plant based milk. Instead, just make sure it's got calcium, make sure it's been fortified with iodine as well, that's one of the limiting nutrients. So that's the other thing they can do. And then the other thing as well is looking for products that have been produced locally. So not buying foods that have been flown halfway across the world just so that we can eat them, you know, all year round. So seasonal, and local are two big things. So there's lots of parts, I think, to more of a sustainable way of eating that we can all do fairly easily.
Katherine Ann Byam 15:45
Yeah, absolutely. What further tips and advice can you give to young families on their nutrition journeys that we haven't covered already?
Sarah Almond Bushell 15:53
Yeah, absolutely. So if you've got a child who is, eats well, so not a fussy eater, where they might need extra help, the main things that families can do is look at something that we call the division of responsibility and feeding. So I alluded to this earlier, where the parents have their role, and the child has their role, and it's a shared relationship. So what that means is that the parents role is to choose what's on the menu to decide what the family are going to eat. And that's really important because children have very poor nutritional knowledge. So when parents say, what do you want for tea, they're always going to pick the thing that they fancy rather than, you know, with their nutritionist hat on. So parents are in charge of the what they're going to eat. Parents are also in charge of where so whether that's going to be at the kitchen table or picnic in the park. And then parents are also in charge of when. So by that I mean sort of the routine or the shedule. And actually, it's really quite important to have a set routine for children when they're eating, which usually looks like meal, snack meal snack meal bed, because that allows a relationship of trust to build because they know it's predictable, they know when the next meal is coming from, and then that's the parents job done. So they don't need to do anything else, the child's role is to be in charge of their own bodies. So be very autonomous about what goes into their bodies. So they decide if they're going to eat, sometimes they don't. And if they do eat, they decide how much they're going to eat, in what order and crucially when to stop. So when I see battles at meal times, for want of a better word, or drama at meal times, it's often because parents have looked at what the child had and thought that's not enough, please eat a bit more, you know, just just take another teaspoon of peas, or you know what, I'm not going to give you a pudding until you've eaten all your chicken. And actually, that's not our role as a parent, you know, we need to let our children be in charge of what and how much.
Katherine Ann Byam 17:51
This is brilliant. Thank you so much for these really great nuggets of advice. Let my listeners know how they can get in touch with you or work with you if they have children who need some support with this, or parents actually who need some support with this.
Sarah Almond Bushell 18:03
Yeah, it's a pleasure. So my website is probably the best place to find me. It's children's nutrition.co.uk. And I've also, I'm on Instagram at the Children's nutritionist. And I have a Facebook group which is called the children's nutritionists community.
Katherine Ann Byam 18:20
Perfect. Thank you so much for joining us today.
Sarah Almond Bushell 18:22
It's a pleasure. Thanks for having me.
Katherine Ann Byam 18:27
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