Does food affect children’s sleep? With Lucy Upton – Food For Kids Podcast episode 81

Joanne Roach (00:13)

Hello and welcome to the Food for Kids podcast. I'm Joanne from the Foodies. If there was an Olympics of things that parents worry about, there would be a few contenders, but I reckon there would definitely be food and sleep up there on the medals podium. And when those two things combine, there's a lot of room for self-doubt. So on today's episode, I'm interviewing Lucy Upton about children's food and sleep.

Lucy goes by the name the Children's Dietitian and is a leading UK paediatric dietitian and author with over 15 years of experience. She's dedicated to helping babies, children and their families find joy and health through food and nutrition, as well as dispelling the overwhelming misinformation surrounding children's food. Lucy's approach is very empathetic and she blends real life mum experience with evidence-based advice. So her posts on social media are always a very helpful mix of science and normal family life, including a recent one about whether dinner times affect sleep. So I thought she'd be a perfect person to answer some questions about children's food and sleep. So let's get into it.

Joanne Roach (01:18)

So Lucy, we obviously all really want our children to sleep and we also really hate the idea of our children going to bed hungry. That's one of those things that makes us feel like a terrible parent. So do we need to be making sure that they eat quite a lot at the evening meal?

Lucy Upton (01:33)

So the first thing I would say is as a mum who has a little one who definitely was not high up in the line when they were handing out sleep, I really empathise with wanting take the reins of variables that will help children sleep. And we do have this fear of what if they wake up and they're hungry?

So the thing that I talk to lots of parents about is that actually society puts a big onus on the evening meal for us all. You know, we probably sit and that's our biggest meal of the day. Whereas actually children don't really abide by social norms. They don't care if it's the biggest meal of the day. And what lots of children do really is just self-regulate their appetite. And that isn't just a 24 hour o'clock where they in the morning. That happens over essentially days and weeks, which is why we see children's appetites seeming a little bit erratic, which is very normal.

So, you know, you might have a bit of a front loader. I have one of those in our house who… breakfast is the best thing ever. We'll go to preschool, we'll have a second breakfast. And actually when I ask parents to imagine an empty cup and you think about they're filling up through the day, they're sort of front loading, actually what's left to play with by the time you're at that before bed meal might not be very much at all. So we're thinking you need to eat this full meal, you'll wake up hungry and the reality is is their body's going I've kind of already done most of the work like I might have a few mouthfuls and then I'm done. So what I ask parents to do is really trust that actually what's on board is not just what's before bed but is what the last 24, 48 hours and probably even beyond has looked like for your child.

Often our equivalent of feeding them before bed is like us having our dinner at something like nine, nine-thirty. You know, it's quite often quite close to that bedtime routine. And often by that point in the day, I'm pretty knackered. I’m just ready to go and rest. I might be a bit more irritable. And actually, those aren't great conditions for eating.

Joanne Roach (03:28)

Certainly not at the table with a bunch of other people.

Lucy Upton (03:31)

So, you know, what I'll often say to parents is sit and think about how your child's eaten across the rest of the day. Give them a bit of empathy for how hard this evening meal is. It's often the most complex meal as well, isn't it? You know, it's the mixed dishes, it's all the vegetables, it's the foods that are less predictable than the foods that fall earlier in the day, the good old reliable cereal and the sandwiches and stuff like that. And try not to put any additional pressure on it because I think again, if the worry about them waking and hunger is something that drives additional persuasion at the meal time, that's another reason children sort of tap out. And I actually do this exercise with lots of my parents when they're worried about this. And I'm like, let them eat to appetite in the evening, trust that they've had enough and test for me one night to start off with. I get lots of messages saying, I feel so much better now, they're fine. There will be some of you who have children who wake overnight and that's quite a normal pattern for them anyway. My daughter wakes overnight actually once a night. I would say that's four nights out of seven for us anyway. So I'm not necessarily going to attribute that to hunger because I know that's what her temperament with sleep is like. So always step back and look at the bigger picture.

Joanne Roach (04:41)

So if a child doesn't manage much at the evening meal, we don't have to be trying to give them something for supper or just before they go to bed.

Lucy Upton (04:48)

You don't have to. If it's something that is really very activating for you and you're going to lie tossing and turning, that's also not healthy. So I say, if you feel like you need to give something before bed, keep it small, keep it boring, don't be their favourites, just keep it very plain. Offer a small portion and a good distance after the evening meal. Because again, children often do take the easier route because that's very typical development. If they know that they're going to get their favourite whatever it might be, lots of children will just wait.

Joanne Roach (05:19)

Yeah.

Lucy Upton (05:20)

So we just want to make sure it's quite a distinct separate thing. But just ask yourself, is this definitely something that I think that they need? Have I got good evidence for that? Or actually, am I okay trusting their appetite? And there is something quite empowering about that with kids when we start to lean into they're in control of their own body.

Joanne Roach (05:38)

Am I giving them this extra piece of food because it's helping me rather than I think it's actually helping them.

Lucy Upton (05:43)

Yeah, absolutely.

Joanne Roach (05:45)

Okay, so in the event that a child does start waking in the night, they've been sleeping and then they suddenly start waking up, maybe they're having a grow, something like that, and they start saying they're hungry, what should we do in those circumstances?

Lucy Upton (05:56)

So in those circumstances, I asked parents to go back and look at the day as a whole, have we got regular opportunities to eat that are sort of age appropriate for this child? You know, young children have got quite small stomachs versus quite high energy requirements, which is why that sort of regular pattern every two to three hours of offering an opportunity to eat, is really important.

I would also start to think about what is going on at that evening meal. If that is really very challenging, stepping back and going, right, how can I make this more enjoyable and an environment where they're more likely to engage with some foods? Do I need to drop the portion size on their plate? Do I need to give them some degree of choice? So we serve food in the middle of the table and they can decide what and how much comes to their plate. Do we need to focus back on connection and kids look forward to coming to them because it's not just, it's not like getting them to eat, it's about how's your day been? Like everyone touching base after a busy day.

You know, I'm broken record especially around food refusal that actually stress and a child's nervous system will always override hunger. If you do have a child who seems to hate their dinner and then all of a sudden they really do seem hungry and they're constantly asking for food, do just make sure that there's nothing about that meal time that is creating stress, discomfort, nervous system dysregulation for them. Because what we do then is just block hunger. We’re just switching their body off from eating.  And then when things calm down, then they tune back in with that hunger and they're like, excuse me, I am hungry. I will have something now. So look at your meal time dynamics. Is it communal? Is it calm? Is there foods there that you're quite confident that children will eat? if you've got a child, you know, my daughter's been through this recently who really, know, mixed dishes have been a big like flat out. “I don't know what that is so no, I see that it's wet and it's mixed. I'm not interested” which is developmentally very typical. Can you deconstruct that meal? So if you're putting your bolognese on the pasta, and that means you've lost the whole meal, because it's all covered in sauce, could you offer those things separately so that they could eat plain pasta and cheese, which by the way, has way more nutrition in it than many people will give it credit for?

You know, could you make sure that actually there's one or two foods at the table, even if it's a bit of a random side, if it's a jar with some breadsticks in that actually is something you know that they will reliably eat. And it’s to give them the best opportunity of having something before bed.

Joanne Roach (08:17)

Okay, so if you've got a child that's starting to show signs of hunger at bedtime or during the night, work backwards and think what was happening in those days that meant that they didn't feel like they could fill that metaphorical cup up.

Lucy Upton (08:31)

Yeah, you will you know, you might find that you can get some extra things in throughout the day, you know, are they having very high carbohydrate snacks, but actually, we could introduce some protein and fat in there, they could have some cream cheese with their breadsticks, they could have some peanut butter with their oat cakes, So actually, we're helping with that satiety, but we're also sort of topping up with nutrients throughout the day. But yeah, if you do just check in on that evening meal. We can't control our children, we can't get them to eat, but our job as adults is to arrange the environment so that we get the best opportunity that they will.

Joanne Roach (09:00)

So that's looking at the evening meal and sleeping in terms of whether they're full or not. Is there anything else to do with food that can have a negative effect on sleep?

Lucy Upton (09:08)

Yeah, really interesting question. So obviously there'll be certain things that do disrupt sleep. One of those is going to be caffeine. The half life of caffeine is quite long, which means it stays in our system for quite a long time. And children can be a little bit more sensitive to caffeine. So if, you know, for example, they were drinking Coke at a party, you've got an older child perhaps on the diet Coke or, you know, lots and lots of chocolate or lots of dark chocolate all of a sudden, and obviously, you know, if you've got teenagers, energy drinks, anything like that.

Joanne Roach (09:36)

Yeah.

Lucy Upton (09:37)

Please just be aware that obviously those are going to normal cues around sleep.

Something else that I get asked about a lot is children who wake overnight with tummy pain. And this can sometimes it can be quite prolific when babies start weaning and their gut is suddenly like, whoa, look at all these things I've got to manage. And it can be common for children to have a little bit of discomfort associated with, eating windy foods you know, and they're trumping away all night, some children might be impacted by that. Many, aren't, many aren't at all.

The other thing that at points would align with sort of tummy troubles would be actually children who are quite constipated, who do get a lot of pain, who can get quite windy, who seem, this is very sort of anecdotal from clinic, but more sensitive to that overnight when there's lower sensory stimuli, they're not necessarily moving. Those children might have disrupted sleep because their gut is pinging and telling them and giving them messages. So, you know, if you've got a child who's constipated and actually their sleep isn't very good, I'd be really proactive about how we manage that constipation and speaking to your GP and getting them moving because it can be quite a vicious cycle.

And I suppose one of the other things that we do know that does affect sleep is when children are very low in certain vitamins. So I want to cover this carefully because I think increasingly there is a let's over pathologize your child can't possibly be getting enough magnesium X Y and Z give them all these supplements and magically their sleep will improve. And actually I know you spoke to Sara about the fact that magnesium is something very hyped that we don't have the evidence children are falling short of and that they probably don't need these huge expensive supplements.

But there are things, you know, I will see children, for example, because I see a lot of selective eaters and children with feeding difficulties, I see a lot of iron deficiency and iron deficiency anaemia. And particularly as we border the anaemia, what we will often see is children can be quite restless overnight and can have quite disturbed sleep with some of those symptoms improving once we restore their iron levels. You know, that's not me saying if you've got a restless, wakeful child, they must be iron deficient. But if you've had a child who is showing signs of iron deficiency or anaemia, you know, who was pale, who was quite lethargic, but then restless when they were sleeping, you know, who was disengaging in active play, who was breathless, those dark circles under their eyes that they'll often get associated with the pallor. And they don't eat a lot of iron rich foods, you might find that sleep becomes something that also is disrupted.

So is there any signs here that my little one could be low in iron? If they are, by the way, that's a conversation with a health professional. wouldn't necessarily go out and start just pinging things in willy-nilly. You need to know what you're giving and what dose and why.

And then just make sure that I would also say broadly, you're doing lots of the things we would recommend anyway. So vitamin D is another one. because that does have a role in sleep, you know, we're giving the recommended 10 micrograms of vitamin D to our kids, unless they're having 500 mils of formula a day.

Worth mentioning is also kind of sugar, because I get a lot of it's the they have too much sugar at the party, Lucy, that will be the reason that they don't sleep. And, you know, perhaps quite controversially, I would say, our bodies are pretty good at managing carbohydrate load into the body, children included, of course, unless they had something like diabetes where we have to manage that. And actually there was a really interesting study about this several years ago now, sometimes if you're struggling to get them to wind down for sleep, particularly, and you think, my God, it will be the Colin the Caterpillar. Often it's the party. Often it's the fun.

It's a nervous system that is needing some time to just wind down. And I will see lots of children who will just take a little bit longer to settle. I call it a fun hangover, actually.

Joanne Roach (13:20)

That's nice.

Lucy Upton (13:22)

Yeah. So don't worry about blaming everything necessarily on sugar, you know? I think let's be pragmatic about the fact biology has very well designed them to manage, you know, when they consume more of something on a one-off occasion.

Joanne Roach (13:35)

Okay, so if a parent listening has a child who isn't generally a great sleeper, and they're worrying about whether the food they're providing is part of the reason, what would you like them to know?

Lucy Upton (13:45)

It's really, really hard when your kids don't sleep. know, when your baby or your child does that one really random night when they sleep and you try and replicate every single condition, you know, and I have had parents in clinic before who it's been such a cause of concern, you know, they repeatedly offer the same meal because they've associated that with the kind of sleep through, which of course isn't necessarily sustainable. So I think it's important to remember that our small humans' sleep is affected by lots of things and whilst food and nutrition is important it is not the only thing that will affect their sleep. Children have different sleep temperaments. Actually sleep can be disrupted by a whole host of things.

But if you really want to kind of almost audit, am I okay from a diet perspective here? The things I would ask you to look at are, is your child growing okay? Because if they are and they're steadily following their sort of centile trajectory, that's usually a good sign they're consuming enough energy. Is your child having a good balance of nutrients across time? I am very pragmatic. I don't think kids eat balanced meals every single time we offer them to them. So stepping back and looking at balance over time, Have I got a good routine for them? So if you have a grazer and they're constantly in and out of the snack cupboard, actually coming back to creating ring-fenced opportunities to eat where they can eat a little bit more and really hit that, I'm full, like sort of satiety can be really helpful. Look at those broader nutrients. But try not to over focus on specific things because sometimes I think when we do that, we lose the bigger picture. And you know, if you're really finding it's affecting your mental health and you want some peace of mind about those things, go and speak to a professional who can give that to you. Because otherwise if it becomes all consuming, and you're tying that to nutrition, it's really easy to slip into habits where we try and fix or micromanage how our children eat.  And I think that can be a bit of a slippery slope. So reach out for some help if that feels like it might be you.

Joanne Roach (15:46)

I hope you found that as helpful as I did. Because food is such a wonderful way to help your child to thrive, it's incredibly easy to get it twisted in our heads so that it feels like food is the only way, or at least the most important way, to tackle every single developmental issue our child has. And we have to remember that there are lots of reasons that our children do all sorts of things. Sometimes food is only a small contributor to the wonderfully complex circus that is growing up.

I think Lucy's message to just tick off a couple of basic checklists and then try to zoom out and keep focus on the bigger picture is a really helpful one. If you like Lucy's approach, then please do go and find her everywhere as The Children's Dietitian and I'll link to everything of hers in the show notes, including her one-to-one services and her six week picky eaters course. She's got some lovely family recipes on her website too. This conversation ran a little long because it was such a helpful overview, so I won't keep you any longer on this outro. I'll just say that I look forward to seeing you on the next episode and in the meantime, happy eating!

00:00 Introduction

01:18 Do kids need a big meal at night to sleep properly?

04:41 Should we offer top up supper if they don't eat much at dinner?

05:45 What to do if your child starts waking up hungry in the night

09:00 Caffeine and children's sleep

09:44 Tummy issues and sleep

10:48 Deficiencies and sleep

12:35 Sugar and sleep

13:35 How to audit if food is contributing to sleep issues

15:46 Summary and outro