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The Satter Feeding Dynamics Model

The Satter approach to feeding

fdSatter, sDOR, and sDOR.2-6yTM

The Satter Feeding Dynamics Model (fdSatter) is a grounded in a practical and theoretically sound understanding of and trust in normal child development, including growth, and  children’s behavioral, nutritional, psychosocial, oral-motor, and physical competence.1-6 Given a supportive feeding context, children evolve Eating Competence-consistent eating attitudes and behaviors: They feel good about eating, push themselves along to eat the food their trusted grownups eat, eat as much as they need to grow predictably, and join in comfortably with family meals and structured snacks. These positive eating attitudes and behaviors, in turn, allow children to evolve dietary variety,7-9 maintain energy balance and growth,10-12 follow predictable patterns with respect to oral-motor 13, 14 and psychosocial15, 16 development, and respond optimally to authoritative parenting.17, 18

The Satter Division of Responsibility in Feeding

fdSatter is implemented by the Satter Division of Responsibility in Feeding (sDOR), which, in turn, is tested by the validated sDOR.2-6yTM.19, 20 sDOR translates authoritative parenting into feeding, encouraging parents to take leadership with respect to feeding and give children autonomy with eating. Parents who score high on sDOR.2-6yTM trust children to eat what and as much as they want from what parents provide and avoid pressure and restriction,19 direct or indirect, positive or negative.

Agencies recognize sDOR as best practice, and sDOR is a core component of the feeding messages developed for preschool-aged children by the Food and Nutrition Service of the US Department of Agriculture,21, 22 and guidelines from the American Academy of Pediatrics,23 24, 25 The Academy of Nutrition and Dietetics26-28 the Special Supplemental Nutrition Program for Women, Infants, and Children;29 and Head Start.30

sDOR.2-6yTM achievably tests nutrition risk

The Satter Feeding Dynamics Inventory, sDOR.2-6yTM directly assesses sDOR adherence in parents of 24- to 72-month-old children19, 20 by addressing both and only the degree to which parents take leadership with feeding and give their child autonomy with eating. As demonstrated by coded video observation, parents do in practice what their test answers say they do.20 Correlation with other validated questionnaires indicates that children of parents who follow the Satter Division of Responsibility in Feeding—who score high on sDOR.2-6yTM—have lower nutritional risk. That gives parents and professionals an achievable way to address their biggest feeding worry: that children are doing well nutritionally.19 Parents who test high on sDOR.2-6yTM have higher Eating Competence, sleep quality, and psychosocial functioning and lower stress and lower levels of uncontrolled or emotional eating.19  Go to Using sDOR.2-6yTM for permission to use the inventory at no cost in research, education, and clinical practice.

References

  1. Satter EM. The feeding relationship. J Am Diet Assoc. 1986;86:352-356.
  2. Satter EM. Feeding dynamics: Helping children to eat well. J Pediatr Health Car. 1995;9:178-184. Computer.
  3. Satter EM. The feeding relationship: problems and interventions. The Journal of pediatrics. 1990;117:S181-S189. Computer.
  4. Satter EM. Internal regulation and the evolution of normal growth as the basis for prevention of obesity in childhood. J Am Diet Assoc. 1996;96:860-864.
  5. Satter E. The Satter Feeding Dynamics Model of child overweight definition, prevention and intervention. In: O’Donahue W, Moore BA, Scott B, eds. Pediatric and Adolescent Obesity Treatment: A Comprehensive Handbook. Taylor and Francis; 2007:287-314.
  6. Davies WH, Satter E, Berlin KS, et al. Reconceptualizing feeding and feeding disorders in interpersonal context: The case for a relational disorder. J Fam Psychol. 2006;20:409-417. Computer.
  7. Birch LL, Deysher M. Caloric compensation and sensory specific satiety: Evidence for self regulation of food intake by young children. Appetite. 1986;7:323-331.
  8. Birch LL, Fisher JO. Appetite and eating behavior in children. Pediatr Clin North Am. 1995;42:931-953.
  9. Addessi E, Galloway AT, Visalberghi E, Birch LL. Specific social influences on the acceptance of novel foods in 2-5-year-old children. Research Support, Non-U.S. Gov’t. Appetite. Dec 2005;45:264-71. doi:10.1016/j.appet.2005.07.007
  10. Fomon SJ, Filer LJ, Jr., Thomas LN, Anderson TA, Nelson SE. Influence of formula concentration on caloric intake and growth of normal infants. Acta Paediatr Scand. Mar 1975;64:172-81.
  11. Pietilainen KH, Kaprio J, Rasanen M, Winter T, Rissanen A, Rose RJ. Tracking of body size from birth to late adolescence: contributions of birth length, birth weight, duration of gestation, parents’ body size, and twinship. Am J Epidemiol. Jul 1 2001;154:21-9.
  12. O’Connor EA, Evans CV, Burda BU, Walsh ES, Eder M, Lozano P. Screening for obesity and intervention for weight management in children and adolescents: Evidence report and systematic review for the US Preventive Services Task Force. JAMA. Jun 20 2017;317:2427-2444. doi:10.1001/jama.2017.0332
  13. Kleinman RE. American Academy of Pediatrics recommendations for complementary feeding. Pediatrics. Nov 2000;106:1274.
  14. Morris SE, Klein MD. Pre-feeding skills: A comprehensive resource for mealtime development. The Psychological Corporation/Therapy Skill Builders; 2000.
  15. Greenspan S, Lourie RS. Developmental structuralist approach to the classification of adaptive and pathological personality organizations: Infancy and early childhood. Am J Psychiatry. 1981;138:725-735. to pull.
  16. Erikson EH. Eight ages of man. Childhood and Society, 2nd Edition. W.W.Norton; 1993:242-274.
  17. Rhee KE, Lumeng JC, et.al. Parenting styles and overweight status in first grade. Pediatrics. Jun 2006;117:2047-2054. doi:10.1542/peds.2005-2259
  18. Kakinami L, Barnett TA, et.al. Parenting style and obesity risk in children. Prev Med. Jun 2015;75:18-22.
  19. Lohse B, Mitchell DC. Valid and Reliable Measure of Adherence to Satter Divisionof Responsibility in Feeding. JNEB. 2020;
  20. Lohse B, Satter E. Use of an Observational Comparative Strategy Demonstrated Construct Validity of a Measure to Assess Adherence to the Satter Division of Responsibility in Feeding. JAND. 2020/12/18/2020;
  21. USDA, FNS. Maximizing the message: Helping moms and kids make healthier food choices. FNS-409. Accessed February 18, 2021. https://www.fns.usda.gov/tn/maximizing-message-helping-moms-and-kids-make-healthier-food-choices
  22. US Dept of Agriculture, Food and Nutrition Service. Child feeding messages. Accessed February 17, 2021. https://www.fns.usda.gov/core-nutrition/child-feeding
  23. Krebs NF, Jacobson MS, American Academy of Pediatrics Committee on Nutrition. Prevention of pediatric overweight and obesity. Pediatrics. Aug 2003/2007;112(2):424-30.
  24. Barlow SE, Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics. 2007;120(Supplement_4):S164-192.
  25. Kleinman RE, Greer FR. Pediatric Nutrition, 8th Edition. American Academy of Pediatrics 2019.
  26. Nicklas TA, Hayes D. Position of the American Dietetic Association: Nutrition guidance for healthy children ages 2 to 11 years. J Am Diet Assoc. 2008;108(6):1038-1047.
  27. Ogata BN, Hayes D. Position of the Academy of Nutrition and Dietetics: nutrition guidance for healthy children ages 2 to 11 years. Journal of the Academy of Nutrition and Dietetics. Aug 2014;114(8):1257-76. doi:10.1016/j.jand.2014.06.001
  28. Hoelscher DM, Kirk S, Ritchie L, Cunningham-Sabo L, Academy Positions C. Position of the Academy of Nutrition and Dietetics: interventions for the prevention and treatment of pediatric overweight and obesity. Journal of the Academy of Nutrition and Dietetics. Oct 2013;113(10):1375-1394. doi:10.1016/j.jand.2013.08.004
  29. Institute of Medicine, Dietary Risk Assessment in the WIC Program. 2002.
  30. Health and Human Services Office of Head Start. Introducing the new Head Start program perfomance standards. Accessed February 17, 2021, http://www.acf.hhs.gov/ohs/policy
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Measuring sDOR

To understand how to be faithful about doing your jobs with feeding and scrupulous about letting your child do her jobs with eating. read Ellyn Satter’s Child of Mine: Feeding with Love and Good Sense. 

Family Meals Focus ~ No. 08

 

The Satter Division of Responsibility in Feeding

The Satter Division of Responsibility in Feeding (sDOR) encourages parents to take leadership with the what, when, and where of feeding and give children autonomy with the how much and whether of eating. sDOR applies at every stage in the child’s development, from infancy through the early years through adolescence.

The parent is responsible for what children are offered to eat. The child is responsible for how much and whether to eat of the foods offered by the parent. sDOR says to feed infants on demand, letting them determine the timing and tempo of feeding. As the child develops and becomes more regular in his eating patterns, the parent gradually takes on responsibility for when and where the child is fed. Later still, during the later school-age years and adolescence, children gradually take responsibility for when, where, and what they will eat. However, until children leave home, parents can expect children to arrive at family meals hungry and on time.

Most children are ready to join in with the meals-plus-snacks routine of family meals by the end of the first year or the beginning of the second year. After that, parents need to maintain the structure of family meals and sit-down snacks throughout the growing-up years.

When parents do their jobs with feeding, children do their jobs with eating.  

sDOR encourages parents to take responsibility for feeding . . .
  • Choose and prepare food.
  • Provide regular meals and snacks.
  • Make eating times pleasant.
  • Step-by-step, show children by example how to behave at family mealtime.
  • Be considerate of children’s lack of food experience without catering to likes and dislikes.
  • Not let children have food or beverages (except for water) between meal and snack times.
  • Let children grow into the bodies that are right for them.
An essential part of sDOR is for parents to trust their child to be capable with eating.
  • Eat the amount they need.
  • Learn to eat the food their parents eat.
  • Grow predictably in the way that is right for them.
  • Learn to behave well at mealtime.

For a PDF of Ellyn Satter’s division of responsibility in feeding, click here. For a PDF of  Ellyn Satter’s división de la responsabilidad al alimentar (sDOR in Spanish), click here.

 

The book that launched a movement

secrets-of-feeding-a-heatlhy-family-book

This book by Ellyn Satter breaks the spell of negativity and fear that permeates our eating.

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