Behavioral Consult

Family dinners are good medicine


 


Parents can use this time to help promote good habits in their children. Talking about why manners matter while practicing them at the table is powerful for young children. Let them know manners are how we show people that we care about them, whether by taking turns talking or chewing with our mouths closed! Older children and adolescents can learn about how effort is an essential ingredient in every important area in life, from school to meals. Tell them that sometimes the work or effort will be uncomfortable, and pitching in to share the effort lightens everyone’s load. When parents ask for help, they show their children how to do the same and that they have confidence in their child’s ability to be helpful.

Parents should share the joy of the effort, too! They can invite their young children to help with the meal preparation in age-appropriate ways: pulling herbs off of their stems, rinsing vegetables, sprinkling spices, or emptying a box of spaghetti into a pot of water. Older children feel honored to be given bigger responsibilities, such as carrying plates to the table or cutting vegetables (with supervision, when appropriate). And adolescents, exploring their interests and enjoying their independence, may enjoy building their own menus for the family, doing the shopping or leading the preparation of a dish or full meal themselves.

While there is a role for supporting good manners and helpful habits, help parents avoid getting into power struggles with their children over what they will eat or how they conduct themselves at the table. There should be reasonable rules and expectations around mealtime, and predictable, reasonable consequences. If children try a food and don’t like it, they can have a bowl of (nutritious) cereal and stay at the table with the family. Phones should not be allowed at the table, and televisions should be off during the meal (although music may enhance the sense of pleasure or celebration). Mealtime should be time for relaxing, listening, and connecting.

Dr. Michael S. Jellinek, professor emeritus of psychiatry and pediatrics, Harvard Medical School, Boston

Dr. Michael S. Jellinek

Offer some ideas about how to facilitate conversations. Asking about how a child’s day went may spark conversations sometimes, but usually people benefit from specific questions. What made you really laugh today? What did you have for lunch? Whom did you sit next to on the bus? If a parent starts by telling a story about his or her day, even better! This is especially potent if a parent talks about something embarrassing or challenging, or mentions a failure. Young children will have plenty of these stories, and adolescents build resilience by internalizing the idea that setbacks and difficulties are a normal, healthy part of every day. This is a great time to talk about current events, whether in the news, entertainment, or sports. And telling stories about when children were younger, when the parents were children, or even about grandparents or more distant ancestors is a wonderful way to engage children in the greater story of their family narrative, and is always engaging and memorable.

At a deeper level, the family dinner is a time that recognizes each person’s contribution to a discussion, and facilitates a calm discussion of the families’ history and values. There is connection, communication, and building of trust. Families that cannot schedule a minimum number of dinners or that have dinners filled with tension and conflict, are very likely to have children at risk. For those conflicted and often unhappy families, a pediatrician’s early recognition and intervention could make a meaningful difference.

Dr. Swick is physician in chief at Ohana, Center for Child and Adolescent Behavioral Health, Community Hospital of the Monterey (Calif.) Peninsula. Dr. Jellinek is professor emeritus of psychiatry and pediatrics, Harvard Medical School, Boston. Email them at pdnews@mdedge.com.

References

1. J Adolesc Health. 2006;39(3):337-45.

2. J Adolesc. 2010;33(1):187-96.

3. J Adolesc Health. 2009;44(5):431-6.

4. Health Psychol. 2008;27(Suppl 2):s109-17.

5. J Adolesc Health. 2009;45(4):389-95.

6. Pediatrics. 2019 Jul 8. doi: 10.1542/peds.2018-945.

7. Arch Pediatr Adolesc Med. 2004;158(8):792-6.

8. Prev Med. 2018;113:7-12.

Pages

Recommended Reading

Mismatch and repair technique adapted for autism
MDedge Pediatrics
Suicide rates rise in U.S. adolescents and young adults
MDedge Pediatrics
Scoring below the cut but still depressed: What to do?
MDedge Pediatrics
Medical cannabis laws appear no longer tied to drop in opioid overdose mortality
MDedge Pediatrics
About one in four youths prescribed stimulants also use the drugs nonmedically
MDedge Pediatrics
Social media use linked to acceptance of cosmetic surgery
MDedge Pediatrics
Self-harm with bupropion linked to greater risk compared to SSRIs
MDedge Pediatrics
No increased risk of psychiatric problems tied to isotretinoin
MDedge Pediatrics
Perinatal depression screening improves screening, treatment for postpartum depression
MDedge Pediatrics
Book Review: The hope that comes from ‘Growing Pains’
MDedge Pediatrics