For Eva Ingvarson Cerise, the pressure to raise a perfect eater began before she even conceived her. Eva was forty-two and had already had one miscarriage when she and her husband, Kirk, began trying to conceive again. Eva is a planner and a perfectionist. At the time, she created websites for a large financial firm in Los Angeles. She’s also into the West Coast’s alternative-health scene, with its promises of a more holistic, natural lifestyle. She’s not crunchy, exactly; she’s part of a new trend of consumers who see their diet and lifestyle choices as a constant opportunity for self-improvement and empowerment. Healthy living offers a way for Eva to be her best self. And also, she wanted a baby. Badly.
So Eva did what she calls “the typical over-forty thing” of going to a naturopath and an acupuncturist to try to boost her fertility. By “typical,” of course, she means for mostly white women of a certain social class in Los Angeles, which is more or less ground zero for the wellness industry and its obsessive relationship with food. Going on a special “fertility diet” doesn’t seem strange there, because people are going on and off detoxes, cleanses, and other kinds of diets all the time. Eva wasn’t surprised when both of her practitioners recommended overlapping versions of the same fertility diet, which they claimed would regulate her hormones by cleaning her liver with foods like beets, lemons, and artichokes. Eva’s reproductive endocrinologist was “less strict,” but nevertheless advised her to quit caffeine and alcohol and eat as healthfully as possible. Eva followed all their diet advice to the letter. “That was the Halloween where I ate prunes,” she says. “That was fine.”
But eating so meticulously had ripple effects. Even in health-conscious LA, Eva says she saw relationships with friends change because they could no longer share meals. She stopped accepting dinner invitations because restaurant menus were too daunting to navigate. And getting pregnant suddenly seemed less a shared project with Kirk and more a solitary mission. “I had to think about food all day long, every day,” she says. “He was still eating like we always had. I felt very alone.”
It took another miscarriage and three rounds of IVF, but Eva finally sustained a pregnancy when she was forty-four. “I know my age was the biggest factor in my fertility troubles,” she says, “but I do think my diet could have contributed to the quality of my one good fertilized egg, and to my body’s ability to sustain that pregnancy.” And during the nine months that Eva spent growing her daughter, Annika, her obsession with eating perfectly only increased, especially in the first trimester, when all she could stomach was sour candy and crackers. “After my miscarriages, I felt like I had to do everything I could in order to keep this pregnancy going, and here I couldn’t eat any healthy food,” she says. “It was terrifying.” But her morning sickness subsided in the second trimester, which she describes as “blissful.” She walked, swam, went to prenatal yoga, and dutifully followed all of her OB-GYN’s rules about pregnancy nutrition, which meant avoiding soft cheese, frozen yogurt, and salad bars, and eating no more than twelve ounces of fish per week to limit her mercury exposure. The diet was a little complicated, but also satisfying because everything was going so well. Then, at the end of her second trimester, Eva was diagnosed with gestational diabetes as well as a rare bone condition called transient osteoporosis of the hip. The doctors who diagnosed her osteoporosis wanted Eva to eat lots of calcium and protein. But her endocrinologist wanted her to limit dairy because it contains naturally occurring sugars that can interfere with blood glucose levels. Eva found she couldn’t even put milk in her morning coffee without a blood sugar spike. “The two conditions completely worked against each other,” she says.
Eva had gained eighteen pounds by that point in her pregnancy; in the weeks following the diagnosis of gestational diabetes, she lost seven. “They said nobody ever followed the guidelines so fully,” she says. “But I’m a rule follower, especially when you tell me high blood sugar might harm my baby!” Her doctors were pleased, but Eva was unnerved by the sudden weight loss. And in the last few weeks of her pregnancy, the baby stopped gaining weight as well. She began eating every two hours, alternating bland protein shakes with three eggs at a time or several handfuls of almonds, and her maternal-fetal medicine specialist told her to ignore any restrictions on dairy and carbohydrates and eat lots of high-fat foods. But at the endocrinologist’s office, a nurse told Eva that eating that way would risk her baby’s health. “It felt like both specialists thought following the other’s advice would harm my baby, and I was caught in the middle,” says Eva. “Nobody talked to each other or helped me come up with a ‘safe’ diet, so I was left to figure it out on my own.” She decided she could eat yogurt and bread in the afternoons, when her blood sugar was more stable, as long as she tested it frequently, and that seemed to work. But still: “I was so frustrated,” she says. “It felt like I was jeopardizing my pregnancy at every meal.”
Eva’s food anxieties are in large part, the result of her privilege; not every pregnant woman can splurge on acupuncture and fertility teas. But every socioeconomic group today is subjected to an onslaught of messaging around the importance of prenatal nutrition. We’re told that whether we eat enough protein or too much sugar will directly impact our baby’s development in utero, but also whether she grows up to like vegetables or be fat or get heart disease. And women aren’t encountering this pressure in a void—it piles on top of whatever food anxiety they were already incubating. Yet few prenatal-care providers talk about what happens when you start off frustrated by your weight for primarily aesthetic reasons—an already fraught situation, to be sure—and then add on the overwhelming responsibility of building a healthy baby with every bite you take. For women who are unhappy with their weight before they conceive—and that’s two thirds of us, most of the time, according to a 2016 study published in the journal Body Image—it’s difficult to transition to dispassionately assessing their weight gain during pregnancy as a neutral marker of health. Instead, it becomes evidence of whether we’re getting pregnancy “right.” And that’s only the beginning. Our anxieties about weight and diet continue to filter into how we think about feeding our babies from birth on into early childhood, when everything diet culture wants us to do seems to contradict how the little people we’re feeding really need to eat.
* * *
“Food was not fun when I was trying to conceive or when I was pregnant,” Eva says now. “But I had this crystallizing purpose. I just had to have this healthy baby. I would have done anything.” And all the diet tweaks and restrictions still felt temporary. She knew her gestational diabetes would disappear when Annika was born, and the doctors expected her osteoporosis to resolve as well within three to fifteen months after she gave birth. Annika was born on December 4, 2015, weighing seven pounds, seven ounces. But her cry was weak, she spat up every time she tried to nurse, and in her first forty-eight hours, she failed to pass any stool, which can be a sign of intestinal problems. Eva’s hospital transferred the baby to the neonatal intensive care unit, where she spent the next week undergoing various tests and treatments. “It was only a week in the NICU. I know how lucky I am,” Eva says. “But it was also awful, because I just knew, in my gut, it had to be related to how I had nourished her during the pregnancy.”
Eva’s one source of relief was the thought that at least eating could go back to normal. She could breast-feed and nourish Annika properly by eating a wide range of foods, and she could finally indulge in everything she’d been denied for nine months. And at first, it seemed as if she was right. Since she had lost so much weight during pregnancy, she immediately began enjoying bread, chocolate, ice cream, and everything else that had been on the restricted list. “I felt like I was owed,” she says. “I had earned the right to eat whatever I wanted.” Annika finally pooped and the family went home. And then, everything got worse.
When Annika was six weeks old, she developed a rash and started screaming and pulling off the breast every time she nursed. Her stool also changed, becoming “mucusy” in consistency. This was especially alarming to Eva after Annika’s rocky first week. She worried that the two digestive problems were related and that her baby was somehow still suffering ill effects from Eva’s weird prenatal diet. Eva and Kirk called the pediatrician three times, and were told each time that Annika was probably “just fussy.” Finally, after two weeks of this, they were told to bring the baby in. The doctor tested Annika’s stool and found blood. She explained that when Eva ate certain foods, traces of those foods were absorbed into her breast milk, which then would inflame Annika’s intestines and make her bleed. “Basically, she was reacting to the proteins in most of the foods I was eating,” Eva says. Even if her prenatal diet had no lasting impact, every bite Eva took now seemed like playing Russian roulette with her baby. And there was no way to know for sure which foods were causing Annika’s inflammation.
On her pediatrician’s orders, Eva tried to narrow the list of suspects by cutting out the eight most common food allergens: dairy, soy, tree nuts, peanuts, seafood, corn, eggs, and fish. Still, the bloody stool continued, so Eva added wheat to the list. Annika seemed to react to almost anything Eva ate, even kale. “I was terrified to eat, terrified to nurse her, terrified to change a diaper and find more blood,” she says. Her pediatrician seemed stumped, so Eva began her own research, consulting a naturopath and joining Facebook groups where mothers of babies with food intolerances compared notes and strategies. Elimination diets are in constant rotation on these groups; Eva dismissed a popular plan that would have required her to drink straight chicken broth for several days. “That felt way too intense.” But she decided to try one that would cut her down to just seven foods: chicken, quinoa, turkey, zucchini, sweet potatoes, apples, and pears. “I was also allowed to have olive oil, salt, and pepper. I did that one because my naturopath said these were all low-allergy foods that would keep me satiated,” she says. “I mean, these are all crazy, extreme diets, but for women whose babies have this, it’s the only thing that gets them to baseline.”
Support groups like the ones Eva joined are closed and often require mothers to fill out extensive waivers in order to participate, both because sensitive medical information is discussed and because these mothers are used to encountering a fair amount of judgment and shame. Eva understood because she was experiencing the same thing. “My immediate family was supportive, but most other people told me I was being crazy and extreme, and kept suggesting that I just switch to formula,” Eva says.
I also ask Eva why she didn’t consider formula. It’s clear both that she is sick of hearing the question and also that she never really considered formula a viable option. Annika had vomited when she was given some during her NICU stay. “I didn’t want to try it again, especially since most formulas are dairy- or soy-based, which we now knew Annika couldn’t have. So we’d have to import this European allergen-free stuff,” she explains. “Also, talking to those crunchy moms online, they all said breast milk is better than formula even if she’s reacting, because she’s getting that better variety of nutrients from me.”
There is an obvious flaw in this logic: If Eva could have found a formula that didn’t trigger Annika’s internal bleeding, surely one could argue that that would have been more healthful than depending on the breast milk that did? And yet—her thought process makes me remember Violet’s heart surgeon saying, “I prefer breast milk,” and my corresponding despair as my supply dwindled. If “breast is best,” as new mothers are told relentlessly, then doesn’t a sick baby need the very best of all? Even when breast milk is the apparent problem—as it was for Annika, as it was for Violet when the act of breast-feeding became too physically taxing and traumatizing—it is hard to shake the aura of “liquid gold,” or to feel as good about opening up a can of Enfamil. “I was committed to breast-feeding because it is important for a baby’s gut health and I had tremendous guilt over my daughter’s gut issues,” says Eva. “It’s complicated emotional stuff, but she will breast-feed for as long as she wants.”
But even as she pressed on, Eva wondered about the nutritional value of her particular brand of breast-feeding. “I worried all the time because here I was not nourishing myself,” she says. “I know the baby sucks out the best I have, but what was I really giving her?” It’s a valid question. In 2004, the National Academy of Sciences appointed a committee of ten pediatricians, dietitians, and research scientists to study the health benefits of breast milk and formula. They published a 220-page evidence review in which they concluded that “breastfeeding is the standard by which all other infant-feeding methods should be judged.” But they also pointed out: “Human-milk composition varies considerably among and within individuals over time.” This variation can include energy density, which may range from 15 to 24 calories per ounce, as well as the concentration of some essential nutrients. Up to 30 percent of breast-fed infants develop an iron deficiency (double the rate of formula-fed babies) and they may also be more likely to develop vitamin D deficiencies because human milk contains low levels of vitamin D, while formula is fortified. (Accordingly, the American Academy of Pediatrics recommends supplementing all breast-fed infants with vitamin D daily.)
“What a mom eats will absolutely impact her breast milk, and if you don’t have enough calories, your body will shut down production,” says Christie del Castillo-Hegyi, an emergency physician and co-founder of the Fed Is Best Foundation, a nonprofit advocacy organization that studies the relationship between breast-milk production and newborn brain injury, jaundice, dehydration, and hypoglycemia. “That’s why we don’t produce milk on the first day after childbirth. Labor has depleted you and you need to recover.” Castillo-Hegyi says there is no good research on how elimination diets might affect a mother’s milk supply, but she is concerned that “Breast is best” campaigns often under-inform women about the potential risks of exclusive breast-feeding. “Too many pediatricians’ offices have this culture of reassurance, where everything is fine until something really bad happens,” she says. “But any neonatologist will tell you that they admit a handful of babies every week who become dangerously malnourished when their mothers exclusively breast-feed despite insufficient milk supply.”
On Eva’s elimination diet, breakfast was a sweet potato covered in a quarter cup of olive oil; lunch was quinoa or plain turkey flavored only with oil and salt. She was supposed to eat that way for only a week, but she ended up doing so for much longer because being back at work full-time meant that Eva had to pump most of Annika’s milk. On any given weekday, Annika drank from the stash that Eva had been faithfully stockpiling in her freezer. It took a month to replace all Eva’s frozen milk and get to a place where she felt the diet was beginning to work. Slowly, Annika became less fussy, although her poop stayed liquid in consistency until she was nine months old and steadily eating solid foods.
At her nine-month checkup (by which time Eva had reintroduced many, though not all, foods), Annika’s weight had dipped from the 50th to the 30th percentile, but her pediatrician said that kind of shift is common once babies start to crawl. She has otherwise continued to thrive and meet milestones; at age two, the worst of her intolerances are behind them though Eva still avoids feeding her wheat and lentils. Annika herself enjoys eating a range of solid foods, which she took to without much fuss. But for Eva, the experience has transformed how she thinks and feels about food. “I no longer eat for pleasure,” she says. “Eating has become this constant quest to get the ‘right’ nutrients to nourish my daughter.”
* * *
Choosing to breast-feed often means choosing to continue considering your own diet through the prism of how it nourishes your baby. How do you space alcohol consumption with nursing sessions? Is the baby crying because she’s cranky, or because she’s reacting to something in your breast milk? Are you getting enough of the elusive “variety” in your diet to expose your baby to the myriad of tastes she needs to ensure she grows up to like healthy foods? Choosing formula, as I quickly learned, doesn’t absolve you of these pressures; if anything, it requires an even steelier commitment, since the choice is likely to be questioned by everyone you meet. And anxiety around these decisions appears to be universal: 90 percent of American mothers said that breast-feeding was best, even though only about half of them did so for six to twelve months or more, according to a 2015 survey of 13,519 mothers in ten countries performed by researchers for Lansinoh, a manufacturer of breast-feeding accessories such as nipple cream and breast pumps. It’s important to note the probable bias of a survey about breast-feeding performed by a company that promotes and profits from breast-feeding. But it also seems fair to extrapolate from those numbers that at least some of us who stop breast-feeding sooner than we have been taught to consider ideal struggle with that decision.
As a result, prenatal and postnatal nutrition has become a big business: La Leche League International, once a grassroots collective of seven Catholic mothers, now has branches in seventy-seven countries and raised $1.2 million in revenue in 2015. And BabyCenter.com, a website owned by Johnson & Johnson, reports a monthly audience of 45 million parents. Which means even the most laid-back new mom is subject to constant messaging about food from the media as well as from her pediatrician, friends, family, and the Facebook mommy groups she joins in an effort to find comrades.
Weight gain is considered an important indicator of prenatal health because women who don’t gain enough tend to have smaller babies, and babies with low birth weight (defined as less than five pounds, eight ounces) are also more likely to spend time in the neonatal intensive care unit. They’re also more prone to have problems with their hearts, brains, lungs, and intestines, though some researchers, including Allen Wilcox, M.D., Ph.D., an epidemiologist who studies fetal development for the National Institutes of Health, have noted that the relationship between weight and such conditions is likely more correlative than causal. “Birth weight is one of the most accessible and misunderstood variables in epidemiology,” Wilcox wrote in a 2001 evidence review published in the International Journal of Epidemiology. “Methods of analysis that assume causality [between birth weight and health outcomes] are unreliable at best, and biased at worst.”
And most public health messages to pregnant women today focus on warning women against gaining too much weight rather than too little: “Like it or not, eating for two isn’t a license to eat twice as much as usual,” warns a MayoClinic.org article just below the headline “Here’s Why Pregnancy Weight Gain Matters.” A similar piece on BabyCenter.com admonishes the reader that “you probably don’t even need any extra calories in your first trimester.” To be fair, delivering a baby of “high birth weight” (above eight pounds, eight ounces) is associated with an increased risk for birth injuries, as well as future risk for diabetes, autism, and other health problems, but here again, birth weight has not been proven to be a root cause of those conditions.
Eva says she was “comfortable with eating,” but “not so much with my weight” before she began that first fertility diet. “I liked to cook a lot, and try new restaurants,” she says. “I was fairly adventurous.” And cooking together was a pre-baby bonding activity for Eva and Kirk. But “I had the typical American-girl guilt any time I ate french fries or dessert,” she admits. And she then adds, offhandedly: “I did have an eating disorder when I was fourteen, but that was more about control than thinness. Just your typical Type A Connecticut girl stuff. I grew up in a wealthy town, so this was my rebellion.” The eating disorder lasted into Eva’s twenties, but she says it was episodic, not chronic. Once a year or so, she’d get stressed out about life and start skipping meals. She’d drop ten pounds and everyone would tell her how great she looked. But really, she was too scared to eat. “I’d get so anxious that any food made me vomit,” she recalls. “So I ate very little during the school day because I was scared to vomit. And I also became a vegetarian. It was all tied into my good-girl rebellion.” Finally, in her twenties, Eva found a therapist to help her work through her social anxiety, and began to deal with her eating issues as well.
Eva doesn’t connect her past disordered eating patterns with anything she’s been through in the past few years. “I do stick with eating rules strictly, whether those are the rules I set for myself when I had the eating disorder, or rules imposed by a doctor. I don’t cheat,” she says. “But it feels different now because I have different skills to cope with my anxiety. I don’t look at food as bad anymore.” But she acknowledges that, good or bad, food—and planning what to eat, when to eat, and how it’s likely to impact her health and Annika’s—still occupies a tremendous portion of her waking hours. Because it’s not just about Eva anymore. By the time a baby is old enough to begin expressing opinions about what’s for dinner, a mother has often spent the best part of two or three years assuming total responsibility for a baby’s nutrition and therefore, his or her health, growth, and mental and physical milestones. How a baby or young child then takes to eating on his or her own is yet another litmus test of how good a job you’ve done. If your toddler embraces kale smoothies and edamame, you’ve won. If not, you have only yourself to blame.
* * *
It’s almost five p.m. on a January Friday in Brooklyn’s hip DUMBO neighborhood, and Kate, a cantorial soloist and full-time parent, is trying to figure out dinner. Kate (who asks me to use only first names for her family) has actually spent much of the day thinking about dinner because tonight is the Jewish Sabbath, which the family marks each week with a ceremonial meal. A duck that marinated all morning in soy sauce and garlic is now roasting in her stainless steel oven alongside broccoli, cauliflower, and butternut squash. “Cooking duck makes me feel very fancy but it was actually just cheaper than the chicken,” she tells me. Vintage silver candlesticks, plus one covered in glitter by her three-year-old daughter, Malka, stand ready on her marble dining table, a pretty little oasis amid crumbs from earlier meals, a few pieces of kid artwork, a sticky copy of Jamberry, and other detritus of family life. The sun is setting, so all we need now is for Kate’s husband, Simon, to come home from his job running a midtown hedge fund so the family can begin Shabbat. But Simon has just texted that he’s running late, which means Kate needs to fend off Malka and her one-year-old sister, Vivie, who are both starting to melt with hunger and whatever else it is that makes small children everywhere fray so desperately around the edges at five p.m.
“Mama, can I have milk?” Malka asks. She and Vivie are both big for their ages, with their father’s solid build and their mother’s infectious grin. Malka, who longs to be a ballerina, pirouettes around the living room, wearing only pink underpants. The girls are fresh out of the bath and she has not yet agreed to be clothed again.
“First let’s have some cheese and crackers,” says Kate, sliding over a plate of organic Ritz knock-offs and sliced cheddar. Malka takes one bite, then jumps down to show off her toe point. “Look, Mama! Feet!” she demands. “Feet!”
“Yes, feet! Amazing!” says Kate. She scoops Vivie into her high chair and serves her some leftover roast eggplant and lamb, which she’s pulled out as a kind of appetizer for us all.
“I don’t like eggplant,” says Malka, observing Vivie. “Mama, I want my milk!” Kate brings her a previously discussed cream-cheese sandwich. Malka again eats one bite. “I don’t like it.”
I am confused as to why Kate isn’t pouring a glass of milk, but then I realize: That’s not the milk Malka wants. At age three, she’s still nursing—something Kate is conflicted about. She’s fine with it at bedtime, but tries to stave off the requests before dinner in what has become an all too familiar pattern. “We eat like, ten dinners most days,” she tells me as she heads back to poke around in the fridge. In addition to the nursing debate, there is the mealtime chaos that most parents can relate to: Both girls are hungry earlier than she or Simon normally eat, and Malka, in particular, is a kid who never specifically says she’s hungry, but turns into “a miserable little tyrant” when she doesn’t eat enough. “I’m constantly trying to make sure I remember to feed her enough so we can avoid the tantrums,” Kate explains. And that makes it hard to insist that Malka finish what she’s started. “I just want to get something in her.”
Kate offers granola and regular milk in a bowl, which Malka accepts. But then she stubs her pointed ballerina toe hard on the kitchen radiator. Tears ensue. The granola sits forgotten, soaking in its milk. A few minutes later, the cycle repeats. Malka rejects offers of a quesadilla, a hard-boiled egg, and an Amy’s organic pizza pocket before choosing Cheerios, which leads to a negotiation over whether she can have Honey Nut Cheerios or the regular kind.
“These are too sweet, they’re just for grown-ups,” says Kate, tucking the coveted box away in a crowded pantry cupboard. Vivie placidly eats fistfuls of ground lamb and eggplant, watching as Malka melts to the floor in a classic three-year-old tantrum, feet kicking and fists pounding. “But I had it last week! I want it! It is for kids!”
They settle on mac and cheese, which Kate swiftly heats up and deposits on the table. Vivie grabs a fistful. Malka, again, takes one bite and zooms back to the kitchen, where Kate is now starting to carve the duck. “Mama, I want my milk! I didn’t have my milk yet!”
“Why don’t we go ahead and bless the challah and then you can eat that?” Kate says. “We can bless it again when Daddy gets home.”
A few minutes later, Simon arrives. He’s a sweet, smiling father and the girls are ecstatic to see him. They dissolve into giggles when he pops in and then immediately pops back out of sight, playing peekaboo around the corner of the loft. Kate puts dinner on the table, turns off the overhead lights, and lights the candles. Around us, the lights of the city sparkle through the apartment’s enormous windows. Malka and Vivie gaze into the candles as Kate, who has a gorgeous voice and has performed in her childhood synagogue since the age of fifteen, sings the blessings. There is no whining. It is a moment of peace and wonder, the end to another chaotic week.
It is not, alas, the end of Malka’s mealtime indecision. As Simon serves himself duck, he cleverly piques Malka’s interest: “Oh, I don’t think this duck is for you.… It’s just for me!” She immediately demands her own duck, but then ignores it. “I want my milk, Mama! You said I could have it after I ate my mac and cheese!”
Kate has to acknowledge defeat. “You’re right. I did say that. Okay, ten seconds.” Malka hops off her own chair and onto Kate’s lap, and nurses for a moment. “That’s enough, Malka. You can have more at bedtime.” But then Vivie begins to fuss; she also wants a turn. Kate takes a few hurried bites of her own dinner and lifts Vivie out of her seat. Simon clears away the mountain of food—mostly Malka’s discards—that has piled up in front of the baby. When Malka sees Vivie nursing, she is displeased. Within seconds, both girls are crying. Kate calls it. “Okay. Bedtime!” Shabbat dinner is over. The duck that took hours to prepare is abandoned after fifteen minutes.
If you’ve never met her, Kate, age thirty, could be a little bit easy to dislike. She lives in a stunning DUMBO loft with expansive river views. The building was once a cardboard-box factory, but now features gleaming open-concept kitchens, high ceilings, and marble bathroom vanities. Kate’s unit has three oversized bedrooms, but the whole family sleeps together in one king-sized floor bed, under a vintage chandelier. Malka and Vivie were both born in that bed, under the supervision of a doula and a midwife. And because of Simon’s success, Kate doesn’t have to work any more than she wants. Most of her days are spent with her girls, both of whom she has breast-fed for far longer than the American standard of less than twelve months.
Like Eva’s obsession with acupuncturists and inflammation diets in California, this combination of privilege, chic aesthetics, and alternative lifestyle choices is often put together into a stereotype of white urban motherhood most frequently situated in Brooklyn or Los Angeles, though you’ll also encounter it in cities like San Francisco and Seattle, and see it skewered on sitcoms. There’s an expectation that an educated stay-at-home or work-from-home mother in one of these places will also buy only whole, unprocessed, organic food, enroll her children in enriching activities such as pottery for two-year-olds, have definitive views about sleep training, and perhaps be suspicious of vaccines. Mothers like Kate are supposed to do lots of yoga and maybe write a lifestyle blog with recipes for sugar-free birthday cakes. But Kate doesn’t do either, and it’s not clear where this stereotype originated. It may have begun with Gwyneth Paltrow and GOOP, her much-parodied lifestyle newsletter in which she promotes organic, macrobiotic cooking alongside $400 bedroom slippers. Another factor has been the rising popularity of attachment parenting, a philosophy espoused by La Leche League, the well-known pediatrician William Sears, and many celebrities. Attachment parenting encourages mothers to wear their babies, sleep with their babies, and breast-feed exclusively, on demand and for as long as possible. Modern food culture also plays a role: as we become more aware of ethical farming practices, toxic-chemical exposures, and our carbon footprint, upper-middle-class consumers have become more willing to pay a premium for organic, fair trade, and locally sourced food, especially for our kids. And the food industry has been delighted to market to these demands. My goal here isn’t to shame parents who practice extended breast-feeding or want their kids to eat only organic; it’s to understand why these beliefs about kids and food are so powerful—even as they are also often problematic.
Kate, in person, is far more thoughtful, irreverent, and complicated than the prosperous-white-urban-mother cliché. She doesn’t present any of her choices as dogma, just as what’s working for her in that particular moment as she wings her way through what she affectionately refers to as “the shitshow” of raising small children. And she resists being labeled. “Everyone I know gives their kids sugar, and most moms don’t breast-feed for extended periods of time,” she says. “I keep waiting to meet the hippie Brooklynites I read about in articles. Maybe they’re in Park Slope?”
But Kate is also aware that her tendency to make unconventional life choices requires a degree of ambassadorship. “There’s pressure to have had a perfect experience with it because you’re representing this whole group,” she says. “But I’m just not a very nostalgic or romantic person.” When it comes to extended breast-feeding, Kate is glad to have had it work out so well for both of her daughters, but she’s honest about the parts she doesn’t love. With Malka, in particular, things started out rocky. Cracked, bleeding nipples, a painful latch, lots of crying from both mother and baby. In an email she sent me when Malka was a few weeks old, Kate described herself as a “crying, hormonal wreck,” but she was nevertheless determined to keep at it. Her mother is a lactation consultant and a longtime member of La Leche League. “If I do formula, my mother will probably kill me. And then she will take Malka and bring her to a young, fertile wet nurse,” Kate joked.
The pain got better, and Kate stopped needing to be in a certain position, with a certain pillow, to nurse successfully; she became a mother who could nurse lying down, standing up, on the subway, while eating a sandwich. And Kate assumed that weaning would happen naturally when they were both ready; instead, Malka’s feelings about nursing seem to be intensifying as she gets older. “Malka has never, ever turned down an opportunity to nurse, and especially when she feels a little wary, like around new people, she’ll ask to nurse even more than usual,” Kate explains. “Meanwhile, Vivie generally nurses less during the day than Malka, and will often prefer something else, even when I offer. So now I know it’s a personality thing and definitely more about comfort than calories.”
And so, at age three, Malka is still breast-feeding, with no sign of weaning in sight. Yet the rest of her diet consists almost entirely of the high-sugar, refined-carbohydrate-heavy processed foods that the mothers in Kate’s purported tribe are supposed to decry. The romanticization of extended breast-feeding tends to go hand in hand with a certain kind of nutritional ethos that makes very little room for mac and cheese and Honey Nut Cheerios. But the reality, in Malka’s case, seems to be that the one has begotten the other.
“I think I was really very smug about Malka’s diet,” Kate says when she considers how they got here. In that first year, in addition to devoting herself to exclusive breast-feeding, Kate also read up on baby-led weaning, in which babies skip over purées and are instead fed only table foods, in sizes they can manage—another concept pioneered by Kate’s own mother and now embraced by crunchy yoga mothers all over Brooklyn’s elite neighborhoods. Kate was careful to wait until Malka was sitting up and developing her pincer grip before introducing foods, and then made sure to offer a wide range of flavors and textures. “Other people would complain that their toddlers wouldn’t touch vegetables and I would just feel so self-righteous,” she recalls. “Like, I just gave my baby asparagus and she loved it!” Kate attributed her daughter’s sophisticated palate to their breast-feeding success, because she had read that breast-feeding exposes babies to more varied flavors than formula does, and she herself ate a pretty varied and healthy diet. “I thought I was doing everything right.”
There is an extensive body of research to back Kate up on this. Julie Mennella, Ph.D., a biopsychologist at the Monell Chemical Senses Center in Philadelphia, has been studying how babies learn to eat based on the flavors in their mother’s milk and amniotic fluid since the 1980s. This phenomenon of “flavor learning” was first documented in animals. Flavors that dairy cows eat, or even just inhale, show up in their milk. Rabbits who are fed a diet rich in juniper berries have offspring who seem programmed to choose juniper berries when they’re first learning to forage for their own foods. Mennella conducted a series of blind sniff tests and taste tests on human breast milk, which revealed that flavors like garlic, mint, cheese, and alcohol are detectable if the mother has recently consumed them. In a later experiment, she demonstrated that the human babies of mothers who eat carrots during pregnancy or while breast-feeding are more likely to enjoy carrots as one of their first foods. “Prenatal and postnatal flavor learning appears to be a fundamental feature of all mammals,” says Mennella. This makes sense: Babies of all species learn from their mothers how to discern what’s safe and nutritious to eat. And they don’t have language yet (or in the case of the cows and rabbits, ever). So we’ve evolved to learn flavors in order to imprint our young with the information they need to feed themselves.
In my first conversation with Mennella, which took place around the time that Violet was beginning to eat her first full meals, I told her how surprised we were that Violet gravitated toward strong flavors like chicken tikka masala, spicy pasta sauces, and lemons, which she would happily chomp on whole. But then I remembered how Dan had complained that I put too much lemon on all our salads whenever I cooked during pregnancy; lemon was one of the few foods I craved. When I went nine days past my due date, I ate spicy curries and sauces almost daily in the hope they would jump-start labor. “See, that’s it right there!” Mennella said excitedly. “Even without breast-feeding, she learned her early flavor preferences from you; she tasted all of that in your amniotic fluid.”
The health implications of Mennella’s work are far-reaching, because in our modern food culture, babies don’t learn which berries are safe to eat in the wild. They learn the flavors of a modern diet from their mothers, and whether that diet is full of whole grains and vegetables or fast food and soda could, Mennella and others argue, impact the foods they gravitate toward as they grow. “We’ve got to understand the taste world of children in order to get them off to a good start,” says Mennella.
But back to Kate, who, like most of us, doesn’t spend a lot of time reading biopsychology papers and instead makes decisions about what to feed her kids that are informed by her own instincts and life experiences. In her case, those experiences started with a childhood in a rural part of New Jersey, where her mother, whom Kate lovingly describes as a “crazy hard-core health food nut,” fed the family an entirely organic, locally sourced diet back in the 1980s before such things were trendy. Kate’s dad has type 1 diabetes, so healthy eating was of paramount importance to the family. “This organic co-op would deliver all our food on a tractor-trailer once a month,” Kate recalls. The family also had a huge garden. There was no junk food or fast food, not even restaurants of any kind; Kate remembers when her brother won a reading contest at the library and the prize was a Burger King gift certificate. “It was a huge deal because we had never been before,” she says. “And I was probably twelve.”
Kate doesn’t view her mother’s way as gospel. As a teenager, she began cooking for herself because she just didn’t like her mother’s food: “I liked bread and melted cheese,” she says. “It wasn’t meant as a rebellion. I just prefer fattier, richer foods with a lot of flavor and that’s not really how my mom cooked. My favorite thing about being an adult is that I get to eat whatever I want now.” But in a weird twist of fate, Simon is also a type 1 diabetic, which means Malka and Vivie have about a 1 in 17 chance of developing the condition as well, according to the American Diabetes Association. So Kate cooks family dinners that Simon can eat, like the duck and vegetables, and she initially steered clear of refined carbs when choosing foods for Malka. She felt proud when her new eater snacked on seaweed and broccoli.
Then, when Malka was around eighteen months old, she “just shut it down,” as Kate puts it. She stopped trying new foods. And then she stopped liking foods she had previously liked, until all she ate was Kraft macaroni and cheese, Amy’s organic pizza pockets, and eggs. Meals became a battleground, with Kate trying to persuade Malka that she still liked broccoli, and Malka spitting out every bite. Malka also wanted her food to look exactly the same every time. Eggs would be rejected if they carried a single fleck of visible black pepper. Chicken had to be scraped to remove all excess flavor. “She has developed every habit that I always heard about, but had attributed to poor parenting,” Kate says. “You hear these stories and think, ‘Oh my God, don’t cater to all their demands; just say this is what’s for dinner and let them go hungry if they don’t want it.’ But I found I couldn’t really follow through on that.” Malka’s tantrums were formidable. Kate was pregnant again, and Vivie was born when Malka was two. “It all went totally to hell,” Kate says of trying to manage mealtimes with a newborn and a toddler. A year later, Malka still eats pizza pockets or mac and cheese for almost every meal. “I don’t even offer the foods I make for the rest of us anymore. I have just totally given up,” Kate says. “It’s so embarrassing and so frustrating. I feel like I failed, and also like, ‘Come on, kid. What’s going on?’”
Kate’s annoyance stems partly from the fact that Malka will eat just about anything that’s offered at the preschool she attends on weekdays from nine a.m. to two p.m. Her behavior is also much better there. “It’s made me realize that she’s a kid who thrives on routine and structure and I need to be giving her more of that at home,” Kate says. But she also feels a little let down by all the people (including her own mother) who told her that she was doing everything right in terms of breast-feeding and early flavor exposures. At a recent play date, a friend began waxing poetic about her son’s love of sushi. “I was just like, ‘That’s great, but I straight up hate you,’” says Kate. And then the friend began to muse on how her son’s eclectic palate must be the result of the thoughtful approach she took to feeding him, with unlimited breast-feeding and frequent early exposures to a diverse yet healthful diet of table foods. For Kate, it was like talking to her former self. “I mean, come on. I did all of that! My kid should love sushi!” she tells me while peeling hard-boiled eggs for the girls’ after-school snack; within minutes, Vivie will have crushed hers into the rug, while Malka will begin lobbying for something different. “Meanwhile, I get sad watching other kids eat a clementine because I realize she’s never even tried one. And that’s a sweet, delicious fruit. That’s supposed to be easy to like.”
If early childhood nutrition can program your future health, then kids like Malka might be in trouble. But there is an alternative understanding of these children, which is that maybe they aren’t contradicting Mennella’s findings or developing early sugar addictions or otherwise going off the rails with food. Maybe they’re progressing along a totally normal developmental trajectory—and have now hit a stage that is just as well documented in science as early flavor learning, but much less understood or even much discussed by parents in Kate’s circle. Leann Birch, Ph.D., a psychologist who studies childhood obesity at the University of Georgia’s College of Family and Consumer Sciences, was one of the first scholars to investigate how humans learn to eat in the first years of life. In 1982, she published the first in a series of papers describing how the initial period of flavor acceptance is followed by a stage of neophobia, a “fear of the new,” which can last for much of early childhood. The paper cites research done on rats in the 1970s, which identified the presence of neophobia, as well as its gradual reduction; rats became more willing to eat a new food after repeated exposures. Birch herself later documented the same phenomenon in human children, noting that humans take much longer than rats to accept new foods; it took around ten feedings for infants and preschoolers in her studies to embrace a new vegetable—and that number may feel like a conservative estimate to many of us.
So why do almost all young eaters, even the previously adventurous ones, inevitably go through a neophobic stage? “This response may seem maladaptive, because omnivores need variety in the diet and the young child must learn to accept at least some of the new foods offered,” Birch writes. “However, this need for variety must be weighed against the fact that putting something new in the gastrointestinal tract is a risky business.” From that perspective, a toddler’s disdain for clementines or kale can actually be understood as essential to the survival of a species that has only had the luxury of a safe food supply for the last two hundred–odd years (and even then, only in certain parts of the world). Prior to that, discerning eaters were far less likely to pick the wrong berries or eat too much spoiled meat. This understanding of neophobia is also a hopeful one, because, Birch emphasizes, this stage is temporary: “Neophobia does not reflect a fixed dislike for a new food, but a transitory one that may be altered via subsequent food experience,” she writes. “The view that the neophobic response is normal and adaptive also implies that when children reject new foods, they are behaving normally, and should not be labeled as ‘finicky’ or ‘fussy eaters.’”
This last part often gets lost as parents panic at the onset of neophobia and begin to reach for such labels. So if all kids must pass through this developmental stage, how many of them actually wind up as true picky eaters? Estimates vary wildly. Fifty percent of two-year-olds were identified as “picky” in a 2004 survey of 3,022 children published in the Journal of the American Dietetic Association. But the researchers also noted that most of the caregivers with “picky” children offered them a new food no more than three to five times before deciding the child disliked it—not nearly enough, according to Birch. A 2016 study published in the journal Eating Behaviors found that 39 percent of kids aged three to eleven were identified as picky eaters at some point in their childhood. The differences in these numbers are difficult to parse out, because although many scholars agree with Birch that neophobia is a normal stage of development, others use the term interchangeably with “picky,” “fussy,” or “selective” eating, while still others define it as an actual phobia and use the word to describe the most extreme cases rather than a baseline. But the bigger problem may be that the researchers conducting these studies usually ask parents or other caregivers to assess a child’s eating habits. How often do kids present with innate and rigid food preferences—and how often do their parents just misperceive them this way?
* * *
“For me, the big change, the big epiphany moment was when I realized, this wasn’t anything my son was doing,” says Skye Van Zetten, a married mother of two in Ontario, Canada. “It was me. I’m screwing this up. I’m ruining this kid’s relationship with food through my fear.”
Eating started out just fine for Skye’s son, TJ, and his twin sister, Dawne. “In fact, when I first gave them cereal at five months, TJ was all over it and my daughter was more like, ‘Hmm, I don’t know about this,’” Skye recalls. But when the twins were seven months old, TJ choked on a small bite of pear. The ordeal was over in seconds; Skye, who is a trained lifeguard and CPR-certified, knew exactly what to do. “I yanked him out of the high chair, smacked him on the back, and out came the pear,” she says. “And it was just like, ‘Okay, the pear is out, good, let’s eat more pear.’ It was terrifying, but he seemed fine.”
Skye didn’t think about the choking incident again until TJ was two. He choked on some crackers and, again, recovered well. But afterward he wouldn’t touch those crackers. The response of Erik, Skye’s husband, was, “Great, now there’s something else he won’t eat!” And that’s when Skye realized, “You know what? This kid really does not eat a lot of food.” At age four, TJ choked again, this time on a raisin. He dropped more foods and began refusing to come to the table for family dinners. When Skye insisted, he hid under the table or behind the sofa, wide-eyed and terrified. The list of acceptable foods continued to dwindle, until TJ was eating just eleven things: chocolate milk, juice, ice cream, pizza, strawberries, peanut butter, bread, and four types of crackers. “That was enough for him to go on,” says Skye. “But it wasn’t enough for me.”
Everyone told Skye: “Picky kids will eat when they’re hungry enough.” So she and Erik decided to get tough. On the first night, Skye made chicken, mashed potatoes, and corn with diced carrots for dinner. TJ refused to eat a single bite. The next day, she served it again and he refused it again. Skye was alarmed but also convinced she was being a “good parent” by not giving in to TJ’s resistance. She did allow chocolate milk at the table, but TJ, overwhelmed, drank only a few sips. Finally, on the fourth day of TJ’s hunger strike, Skye was done. “Fighting over days-old, possibly spoiled chicken seemed pointless,” she says. “I fed my son.”
Skye reached out to an occupational therapist, who diagnosed TJ as “an enigma.” During the evaluation they played games together, such as pretending to brush their teeth with carrots, but TJ still refused to eat. A pediatric mental health clinic flagged him as a trauma case because of his history of choking, but couldn’t make any progress with his eating either. Then Skye read about a clinic in Seattle that prioritized “food exposure” over actual eating, so she served pasta for dinner but told TJ he didn’t have to eat anything. “He was relieved and confused.” Skye and Eric threw all the normal rules about table manners out the window and encouraged the kids to play with their food. “We all sat there flinging macaroni noodles at each other,” she says. “That was the first time I could remember the whole family enjoying food together.” But still, TJ stuck to his safe foods.
Then in 2012, Skye began blogging about her experience and found her way to Ellyn Satter, the registered dietitian and family therapist who pioneered the Division of Responsibility model of feeding that we found so helpful in teaching Violet to eat. The key tenets of Satter’s philosophy resonated deeply with Skye as well. She already sensed that force-feeding tactics were only reinforcing TJ’s fear around food—but now she saw that so was the “he’ll eat when he’s hungry” approach, if she didn’t combine it with offering the few foods he did feel safe around.
On the first night of their new order, Skye put a bowl of TJ’s favorite crackers on the table alongside the family’s dinner of macaroni with marinara sauce, peas, and carrots. TJ ignored the other food, ate four crackers, and declared himself full. Skye went to the bathroom and cried. But she didn’t ask TJ to eat any more. Every day, she put a mix of foods on the table, including one or two of his staples, and then left the rest up to him. Every day she saw him start to slowly unwind, and start to eat a little bit more. Some days, he ate a little less again, as if checking to see whether she’d really let him. But a week later, he surprised everyone by grabbing a piece of bread. He took one bite, then put it down. This time, Skye thought to ask why. “It’s too hard,” he said. So she got him a softer piece and he ate two of them. “It was me that had to do the changing,” she says.
Skye thinks that TJ’s early choking experiences may have set the stage for his anxiety around food, but she’s sure that her corresponding anxiety and high-pressure tactics played a huge role in exacerbating his fears. “We create the neurosis that creates the need for a diagnosis,” is how she puts it. And Skye went into parenting primed with her own neuroses around food. “My family tends toward leaner body shapes, but my mom would go on a diet whenever she gained five to ten pounds,” she explains. “I remember watching her wrap her midsection in Saran Wrap before going on a walk to ‘melt off the pounds.’” Skye thought her mother viewed any extra weight as a sign of weakness, so she kept an eye on the bathroom scale to make sure she wouldn’t be viewed as a failure. “I had all these ideas about what’s a healthy way to eat, but it was all about weight,” she says. For Skye, that meant losing weight. “When I hit a certain number, even if I felt shaky and faint every time I stood up, that was health, in my mind,” she says. When TJ’s problems began, Skye became just as fixated on his weight, only now it was about whether he could gain enough on his limited diet.
But as she began to trust her son to eat, Skye says her own thinking about how to eat became far less black-and-white as well. “I had this tendency—and I think a lot of us do this—to think low-fat dairy means no dairy, and lean meat means no meat. And while you’re at it, cut out gluten, so there go grains. Now we’re down to fruits and vegetables, and fruits have too much sugar,” she says. “So vegetables are really the only foods that parents feel good about feeding their kids—and kids don’t like them!”
Today, Skye reports, “There are too many foods in TJ’s diet to count.” He’s comfortable around many kinds of fruit and even a few vegetables, and will also eat bite-sized pieces of chicken as long as it’s been breaded and baked till crispy. “I have no worries that he’ll get where he needs to be with eating in his own time,” she says. “And what makes me very happy is that practicing the Division of Responsibility approach seems to also be saving Dawne from the fat-phobic, female-shaming attitudes that I grew up with.” At age eleven, Dawne scoffs at the ads in beauty magazines and often asks her mother, “Don’t these women know they’re already beautiful? Why would anyone believe this garbage?”
Skye has chronicled much of their journey on her blog, Mealtime Hostage, and also runs a Facebook group where she daily encounters mothers who have diagnosed their kids as picky eaters because they only want to eat pasta, chicken nuggets, fruit, and milk. “The truth is, that’s actually enough for the kid to live on, but the mother is panicked that it’s too much sugar and the child will get diabetes,” explains Skye. “I can’t just say, ‘No, that’s wrong.’ Many mothers hold beliefs about food that are nurtured by fear and founded on the red herring that appearance equates to health. You have to wade in gently and delicately pick it all apart.” From where she’s sitting: “The problem really isn’t your kid.”
* * *
But the problem isn’t really parents, either. It’s what happens when diet culture invades how parents think about food—including the food their children eat. Eva, Kate, and the mothers in Skye’s Facebook group are getting their ideas about how they should feed their kids from the wellness-industrial complex I explored in Chapter 2, as well as from the lifestyle blogs, magazine articles, and celebrity cookbooks that provide much of the average parent’s education on early childhood development and nutrition. The so-called lifestyle experts who now champion these causes aren’t rigorously fact-checking their claims against nutritional guidelines designed for infants and children. In fact, there has long been a lack of federal nutrition guidelines for babies under the age of two, which leaves parents flailing around for guidance on how to best feed their new eaters. They wind up drawing on a mix of popular dieting wisdom and the alternative-food movement, both of which espouse a near religious fervor for the superiority of home-cooked whole foods. And so an army of bloggers, food writers, and celebrity moms celebrate a kind of continuum of “clean” eating that starts with breast-feeding and continues on to a diet high in protein and vegetables, but low in sugar, dairy, gluten, and just about everything else.
SuperHealthyKids.com is a wellness brand that has built a substantial following (including more than three million Facebook fans) by offering “clean” recipes that they claim kids will actually eat, such as “Rainbow Buddha Bowls” and “Sweet Spinach Muffins.” They also regularly post advice with headlines like “5 Reasons to Serve Veggies for Breakfast” and “The 5 Biggest Family Feeding Mistakes You Made in 2016”; the latter list of offenses includes not making a detailed meal plan every week to ensure good health at every eating opportunity, and not taking the time to chop vegetables or cook whole grains in the morning, a failure that leaves you vulnerable to falling back on processed-food shortcuts when you cook dinner. More than 113,000 people follow Jenna Rammell on Instagram, where she challenges them to “Sugarless Holidays” and shows off her kids’ lunches, brimming with vegetables and styled into chic stainless steel bento boxes that retail for $40 to $50 each. Catherine McCord, author of two cookbooks and the popular Weelicious blog, offers up recipes for gluten-free black-bean brownies and coconut chia-seed “breakfast pudding,” though her 167,000 Instagram followers presumably also appreciate the occasional shot of sugary baked goods, accompanied by winking captions like “weekend balance: donuts then smoothies.” Meanwhile, beautifully photographed cookbooks with titles like Real Baby Food, Little Foodie, Whole Food Baby, and Smart Bites for Baby promise to help parents train their little eaters to love kale, daikon radish, tofu, and yes, sushi.
Much of this philosophy is rooted in the nutrition ideals of Kate’s childhood, all grown up into a hipper, Brooklyn-fied version of the same sprouted wheat bread and almond butter that her mother served, a whole-grain island floating in the 1980s sea of Wonder Bread and Skippy. The mainstreaming of socially conscious, environmentally friendly health food has had plenty of benefits, of course. Locally and regionally grown food is now a $6.1 billion market, according to the USDA, with 150,000 farmers and ranchers selling directly to consumers. And grocery stores no longer think it’s weird if you bring your own reusable shopping bags.
But these changes in food culture have also made eating an increasingly anxious and thought-provoking activity. And parents are on the front lines. They have to reconcile these new standards and fears with the reality of their kids’ perfectly normal preferences and developmental trajectories, and figure out what to do with a two-year-old who snubs sushi or a preschooler who is disgusted by daikon. The upshot is that we’re more alarmed about picky eating than ever before, while also having raised the bar on how kids are supposed to eat. We end up throwing darts: We fight to keep breast-feeding going as long as possible even when it has stopped being what’s “best” for us (and maybe for our child, too). We insist on three more bites of broccoli or two more sips of kale smoothie. But then we also give in to the demands for Honey Nut Cheerios and mac and cheese. Meals become a hodgepodge of perfectionism and permission, structure and rebellion. And kids who might otherwise have sailed through a few years of toddler neophobia absorb their parents’ anxieties and become anxious themselves. Food becomes a power struggle as kids become increasingly rigid in their own eating preferences. We impart confusing messages to our children about good foods and bad foods because we are so confused ourselves. And our confusion is not just about what they’re supposed to be eating, but also about how best to feed ourselves and about how much guilt to feel over our own indulgent falls from nutritional grace.
“I want Annika to see food as fuel, as healing,” says Eva. “I want her to enjoy food. I want her not to think about it.” I am struck by the disconnectedness of those twin wishes; but for Eva, the combination makes sense. Thinking about food, trying so hard to get it right, has robbed eating of all enjoyment. The only way Eva can imagine Annika feeling good about food is if she can just not care quite so much about it. But Eva’s not sure how to get to such a point, when she’s never been there herself.