Well might we say that a fat baby is a healthy baby, but Mashblox research is that self-feeding is the best way to reduce obesity risk as well as fussy eating. Just Google "spoon feeding and obesity" to see supporting evidence and academic speculation emerging around the world; Mashblox is special because it contributes the reasons why, and practical safe alternatives that benefit nutritional programming also with their benefits to fussy eating.
<iframe width="560" height="315" src="https://www.youtube.com/embed/FZ8CfIwGrOs" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
(1 minute overview prepared for The Speakers Institute TENx Global Conference, on the TEDx stage, 29th November)
The TEDx link is expected mid-January 2021; in the meanwhile, here is the transcript of my story.
Infant fussy eating, and infant obesity. Two modern day dilemmas without explanation, or are they?
Alix O'Hara is an internationally winning inventor, CEO, for-purpose startup founder, and recent PhD candidate breaking new ground academically, commercially and for parents of fussy eaters. Her she explains her research, her philosophy and how her experience with teenage obesity inspired it all.
She introduces her story with trigger warnings for those sensitive about body image, self harm, and domestic abuse.
My topic is the impact of How much children learn, or are taught to eat, to their lifetime relationship with food and their bodies.
This distinction is important: learning implies mindfulness and listening to the intrinsic satiety cues we’re all born with, teaching implies extrinsic influence and perhaps subtle force.
We can offer infants the healthiest foundations just by letting them feed themselves.
I anticipate that this may be a controversial talk, but please bear with me because it’s coming from a good place, and this is where it started.
When I was fifteen, I gained 30 kg in the space of about 3 months. Something had gone badly wrong in my personal life, my family were not supportive, and the only comfort I’d been taught to seek was food.
The conditioning in my household was that the most I could aspire to was to be visually appealing, so this hit particularly hard.
My academic performance, my athletic performance, my art, my music, my writing: none of these things mattered unless I was also utterly subservient and “traditionally beautiful” – but when I started to blossom, I was treated as a threat.
My self-esteem and health was how I was punished. It was the middle of summer, I’d just been sexually assaulted, and the whole family – a single mother and two boys - told me that my body looked disgusting and that I should go and put some clothes on.
I went above and beyond, as I always had, and started dragging a blanket around to cover myself. I stopped showering so that I wouldn’t have to see my own disgusting body, and the blanket helped to cover the smell.
I dropped out of school, and I spent 8 months self-harming in my bedroom, while I starved myself from a size 10 to a size 14 or 16. My family kept telling me to kill myself, and I really believed that my life was over.
It wasn’t, of course, and friends finally pulled me out of there to find other distractions, mostly boys that treated me with about as much respect as I was used to, and then various other addictions to bandage that pain. An addiction to food was both the hardest to diagnose and manage.
I wish I could tell you that I escaped that environment immediately, but this is what I was conditioned to, and the conditioning lingered, as it does.
My personal mission eventually became to help others to avoid my pain.
This experience ultimately gave rise to my research, to my invention, my company, my health policy contributions, the ideas and insights that I’m sharing today, and the driving passion behind all of it.
Hands up anyone that can relate in some way?
(I was expecting ~20%. Upwards of 50% audience members surprised me by raising their hands.)
Well that is my Why, and it is my intention to present you with a new perspective on our relationship with food, and how it starts.
The status quo of diet science has been reigning for so long that I’ve found resistance to new ideas, despite all evidence that conventional wisdom isn’t working. These insights are needed now.
Who’s noticed that when you lose weight, it’s usually less about what you eat, than about eating less.
And yet if you deliberately restrict intake, the diet often ends up blowing out?
Why do you think that is?
In my experience there are two component wounds that need addressing first.
There’s the psychological aspect:
Food is a proxy for love. It’s the first expression of love, nurturing, connection and attention that we receive, or seek, dating back to the breast crawl moments after birth. It shows us that we matter, and that we’re cared for.
If we’re deprived, we feel like we’re starving, then we find ways to rebalance.
Then there’s the physiological.
We can visualize the stomach as a balloon. It’s elastic, but if consistently overfilled then it doesn’t easily return to its original shape or elasticity.
Let’s now picture that it’s lined with sensors that need a degree of pressure for us to feel sated, and we can start to see how if it’s stretched beyond capacity, and we’re used to feeling overfull for both psychological and physiological reasons, how overnutrition habits established when we’re learning to eat really start to add up.
What we are taught to eat, our nutrition, is secondary to both aspects, but in my observation pays little attention to either.
One of the cruelest elements to my story was that while I was being conditioned to believe that fat was the worst thing I could be,
I was also being force-fed and conditioned to overeat at home.
I was exercising like an athlete for years just to keep on top of it.
“If you don’t eat your dinner, you won’t get dessert”
- Who remembers hearing that one?
What’s your relationship like with food now, can I ask? Do you eat when you’re not hungry? Do you even recognize when you’re hungry? Or full?
For me that was the standard response when I said that I was full, as far back as I can remember. I was well within my rights to insist on respect for my bodily autonomy, for my intrinsic satiety cues, and ultimately for the foundations of my health, to say No.
But I didn’t. Because I wanted to please my Mum. Eating was about obedience, comfort, occasionally competition with my brothers, almost anything besides actual hunger. I became conditioned to accept any food I was offered.
This childhood experience isn't uncommon, so my first research question became How far back does this pressure to eat start?
I think it’s with spoon feeding, because how do you know that they’re not just eating to please you?
Does anyone actually remember being spoon fed?
You can quickly try it with the person next to you if you like.
I don’t care what age you are, it’s a weird sensation, isn’t it?
The aeroplane spoon is designed to make food fun, but often it’s more about surprising and delighting the child to open wide, and then they receive a mouthful of food that they didn’t necessarily want or need… and then we wonder why they spit it out.
My research suggests that the tongue extrusion reflex is more of a response to the spoon than the food. And why are we spoon feeding them anyway, when the first thing they can do for themselves is to put things in their mouth?
There are so many conditioned beliefs and behaviours around food that start young and have impact.
“One more spoonful” teaches our children to ignore their bodies, just as much as “finish your plate”.
“Everything in moderation” is meaningless if children are effectively taught to binge. "Finish your plate" ends up applying as much to a McDonald's meal as it does to a salad.
It seems that for as long as parents ancestral conditioning is to feed children as much as possible, children are being conditioned to overeat.
They’ll tell you when they’re hungry, but they won’t necessarily tell you when they’re full:
So the fussy eating that affects 50% of kids worldwide and has their parents tearing their hair out for years and hoping that they grow out of it – some don’t – in some cases might even be their only defense mechanism against infant obesity.
But what if we were just taught to eat for the right reasons?
Every species on the planet does this naturally, and none have a problem with obesity, unless we feed them.
Nobody who knows better than an infant how much they need to eat, so we should be supporting them to feed themselves.
Whenever I’ve raised the previous points without my story of my mother’s favored control and abuse tactics of overfeeding,
- Not that I'm saying that everyone who pushes for "one more spoonful" is abusing their kids -
But whenever I've raised the research, I’ve been shouted down on from all sides:
How could I be so callous, what are my credentials, where’s the evidence? And why do I care about infant obesity anyway?
( This is in fact the first opportunity that I’ve had to communicate my message in full and for such a broad audience, so thankyou for being a part of it. )
They say “a fat baby is a healthy baby”.
But the evidence is that 20% of adult obesity is created in infancy (American Journal of Clinical Nutrition, 2010), and both the world health organization and the International Journal of Obesity have flagged this maxim as doing as much harm as good.
Conventional wisdom places the blame on “Diet and exercise” in adulthood, and that’s part of the reason that this is such a triggering topic, isn’t it, because just those two verbs imply sloth and gluttony. Obesity becomes a sin, and “Diet and exercise” blames you.
But willpower was never a complete answer if either of those wounds are in play.
Common sense is that it doesn’t matter how well you eat or how consistently you exercise if you were trained to eat two to three times as much as your body needs, from your first experiences with food.
“Diet and exercise” is even more unfair when applied to the 1 in 5 Australian children who are overweight or obese before they enter primary school at 5 years old.
This already costs the our economy $17 million per annum (Wiley, 2017). As well as affecting their immediate health, quality of life and educational outcomes, they’re also two to three times more likely to be hospitalized, or to develop an array of lifelong conditions. By the time 20% of them reach adulthood, the direct adjusted costs of not intervening in infancy are 2.9 billion per annum (Bupa, 2019), or $19.2 billion in total economic impact (Access Economics, via Diabetes Australia, 2018), and Dietitian's Association of Australia flags as the biggest threat to public health and the economy (2018).
The evidence is that infant self-feeding is the only successful obesity intervention measure (BMJ Open, 2012), in 195 countries in over 30 years (The Lancet, 2013), because they’re learning to eat as only much as they need, and this is where and how interventions need to start.
[I offer my speculative review and opinion why no research initiative since has been able to replicate benefits to BMI trajectory in my blog here: Mashblox self-feeding research case]
We do actually have hard data on the effect of extrinsic control on the volume infants eat, it’s just not read that way.
There are mountains of papers correlating lifelong obesity risk with bottle feeding. [Refer Mashblox' Submission to the Senate Inquiry, 2018]
But I’ve seen two that even acknowledge that it might be more about the child’s autonomy to decide the flow, whether they’re suckling and can just stop or turn their head, or they have a nozzle and a recommended volume pushed into their … throat.
The rest take the diet angle to pursue the nutritional or possibly immunological differences between bottle- and breast-milk as causal.
[I couldn't even find a reputable source on the volume of an infant's stomach to support the balloon slide (and I hope we can all agree that a 6 month old baby doesn't need as much food as a child, or their 18 month old sibling), but in the process I did find several blogs assuring parents that it's practically impossible to feed an infant, owing to their self-regulation mechanisms. This Simply Isn't True unless they're self-feeding, and actually supported to self-regulate]
Common sense is that it’s so much simpler. The evidence is that -unless we’re very sensitive about it- we’re often overfeeding them.
Conventional wisdom is that obesity is genetic, and it’s certainly hereditary. But commonsense, and epigenetic evidence, is that obesity is at least as much a taught habit.
Spoon feeding, and our ancestral conditioning to overfeed, is just the other half of the equation, and it's the confluence of these factors, the pressure parents are under these days, the ready abundance of any food, not just junk - is why every developed country and regional cuisine now has an obesity problem in infants as well as every other age group.
Even the Italians with their Mediterranean diets are facing the fastest growing rate of child obesity despite the lowest rates of adult obesity in the OECD (OECD.org, 2019). Could it be their culture to “Eat, eat”?
It’s not like babies aren’t getting the exercise they need.
So What Can We Do About It?
You’ve probably seen headlines on the scope of the problem worldwide. Interventions start so simply!
My award winning invention, squishy hollow silicone self-feeding blox, simply takes kids instincts to play with their food, and put everything in their mouths, to support them to feed themselves. Mashblox is helping kids enjoy foods their parents thought they hated, including banana, avocado, porridge or spinach, just by mashing them and putting them inside.
This opens profound insights on the drivers of fussy behaviour:
Sometimes it’s the colour, texture, the way it looks or glistens on the plate, OR the way it feels in their hands; and sometimes it’s overfeeding, or being spoon fed. [But there's been no methodological way to determine what the problem is, until Mashblox innovation]
My research has discovered that both infant fussy eating and weight problems start as different responses to the same stimuli: acceptance or resistance to extrinsic pressures to overeat.
20% are overweight or obese, 50% are fussy eaters for some reason,
And the research enabled by this is differentiating the causes and providing real solutions For The First Time.
This has profound implications for their nutritional programming, RDIs, even allergy management, not just their satiety programming, and we’re now able to apply AI to tailor coaching for parents on how they can overcome various feeding challenges. We’ve already started on the App. Like “diet and exercise”, neither is a complete solution, but These Insights Provide The Missing Piece to address this unseen pandemic, and all of its corollaries.
There are a handful of other pioneering experts around the world starting to recognize the wisdom in infant self-feeding also. Ellyn De Satter, Jill Castle did another Ted talk, and Melanie Potock wrote at least one book about how to make the practice safe for all kids.
Both Canada and UK governments already recommend it anyway, 14% of UK mothers practice it, and by making age-appropriate textures -including iron fortified cereals- practical and less messy and fun to self-feed, this overcomes the choking and iron deficiency risks associated with current baby led weaning methods.
I was in year 8 before I overheard the most profound statement about food, “I only eat when I’m hungry” – doesn’t that sound like such healthy conditioning? But this was never an option for me at home, and I barely even have those sensors there anymore.
Let’s help the next generation grow up with those intact, by just letting them feed themselves.
The world health organization states that a multisectoral approach is essential for sustained progress on the infant obesity epidemic, and I absolutely agree. But an enterprise solution has much greater opportunity to for scalable impact than top-down government or peak body recommendations alone – if they were even aware of and addressing the drivers of the problem.
They also call for leadership. But while every initiative has hung its hat on “evidence based”, rather than innovative thought and solutions;
Or on conventional opinion, like our recent National Obesity Strategy, I don’t see anyone stepping up to the plate. Their risk appetite keeps them, and the global headlines, going round in circles.
My philosophy with Mashblox that has gotten me this far has always been that if a business is just a scalable solution to a common challenge, then it follows that our most significant global challenges are also our greatest commercial opportunities.
I’d like to leave you with one other thought:
Wouldn’t it be amazing if rather than enabling or feeding off problems, with food or with anything, newly emerging industries could be built on empowering solutions?
The next generations are actually counting on it.
My BMI at time of recording, for the record, was 26.2 (According to the Heart Foundation).
Height 168 cm, weight 73.6 kg. My choice of dress was to show it, though I recognise the viewer won't see the dysmorphia.
I've always been an athletic / muscular build (and in my mother's household a girl of any size was completely unacceptable, so I've had to train myself out of looking in the mirror with the hate and disgust she ensured I would feel, from both self-image and ), but I was over 80kg at 16.
My research has never been about judgement, and everyone deserves to grow up feeling happy in their skin, but the next generation deserve better than to bandage their self-esteem, reduced quality of life and life expectancy with body positivity alone. Notwithstanding genuine health complications, every child has a right to a healthy BMI.
This talk is the product of four years' research, and my personal psychological and trauma therapy process incorporating both nutrition and microbiome. My BMI is currently 24.8 (two weeks on).