Dept of Professional Dissent

One of the minor irritations of being a physician is seeing commercials wherein something is touted as the product “most doctors recommend.”  As far as I can tell, among professions only doctors (and dentists) are used as collective, anonymous endorsers of products.  (Members of other professions are free to correct my ignorance in the comments.)  These endorsements are almost always meaningless.  “More doctors” may recommend Tylenol than any other brand of painkiller, for example, but we’re really recommending acetaminophen and “Tylenol” is a recognizable shorthand.  This holds true for just about any over-the-counter medication for which there is a generic version available — we don’t care what brand you use.

One product is a particular thorn in my side.  Pity the Better Half when the commercial for “pediatrician-recommended” Pediasure comes on the TV.  (Doubtless many of you may pity the Better Half for a whole host of reasons.)  There he was, dozing peacefully while I watched “Project Runway,” when his rest was interrupted by my yowling at the television set.

The commercial features a mother frustrated by the picky eating habits of her young school-aged child.  As his pickiness persists and her desperation mounts, it causes a distance in their relationship (illustrated in the ad by the dinner table literally growing longer between them).  Thankfully, her wise pediatrician recommends yummy, vitamin-packed Pediasure as a supplement.  The commercial ends with mother and child happily reading a bedtime story, and playfully noting that his feet are sticking out from beneath his blanket.  Yay!  He’s growing!  Thanks, Pediasure!


No.  No, no, no, no, no.  No.

I understand how immensely frustrating it is to try to feed a small, recalcitrant child.  I have a two-year-old, and most of my less-glorious moments as a parent have come when (against my own best professional judgment and advice) I have implored and cajoled and demanded and wheedled while standing over him with foods I know he likes but that he is refusing to eat.  I can handle just about all the other exigencies of parenthood with sangfroid, but trying to feed my toddler sends me right around the bend.  It sucks.  I get it.

You know what I don’t ever, ever recommend, ever?  Giving Pediasure to a perfectly healthy child.  For children who have medical problems (anatomical, physiological or otherwise) that make it difficult or impossible to meet their caloric needs by eating, Pediasure works very well.  (That’s what it was formulated for.)  But giving a kid who refuses to eat a healthy diet a yummy chocolate shake will ensure that the undesired behaviors persist.  (See what I did there?)  If refusing to eat broccoli results in a tasty liquid reward, why on earth would the child ever consider eating the broccoli?

There are ways of dealing appropriately with food refusal, which is a very common problem.  It takes a lot of time and patience, as well as faith that your child won’t allow himself to starve.  Yes, one solution is to cave to your child’s demands and feed her nothing but french fries from McDonald’s.  I would hope nobody would endorse this as an acceptable approach.  Neither is substituting a milkshake for food, no matter how many vitamins may be added.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. This reminds me of Louis CK, as a lot of commentary re: the hard parts of being a parent tend to do. But in a recent episode he was doing a riff on how they make medecine—miraculous, amazing, wonderful medecine!—taste like bubble-gum and other kinds of sweets so the kids will take it. And he ranted on that for a while. It was fun.

    Anyway, my point is to say that it seems like your logic has long-since been rejected when it comes to medecine, at least. There definitely is the subtle but constant reinforcement of the child’s expectation that everything should be pleasurable and sweet. Once I get north of 60 I will have worked out a great diatribe about how this relates to various enduring societal ills, be sure.

    • I don’t mind medicine being flavored so kids are better able to choke it down. Medicine is worthless if the kids won’t take it, after all. Illnesses requiring medication are relative rarity, one hopes.

      But people need to eat food! To live! Real food! Forever! Resorting to giving Pediasure will only exacerbate the underlying problem.

  2. My kid’s former pediatrician recommended pediasure because my kid was in the third percentile for weight and height. I don’t think she believed me when I said he actually eats a decent amount. My kid tried it and hated it. And remains short and skinny.

    • … I have a scale at home. I’d have given him a documented list of what hte kid ate. (okay, this doesn’t work if kiddo is throwing food)

  3. No, you are right. No one cares that most lawyers recommend something but I keep hoping that will change someday.

    • Lawyer 1: “It only took the jury three minutes to deliberate before they convicted my client!”

      Lawyer 2: “It wasn’t your fault, Burt.”

      Lawyer 1: “My own expert said my client did it on the stand!”

      Laywer 2: “What you need is a good stiff shot of Glenfiddich!” [Cut to slo-mo shot of product being poured into a highball glass.] “It’s smoky, but sweet. Glenfiddich. Single malt. Slow-aged twelve years in sherried oak barrels, the old Scottish way.” [Cut back to lawyers, with ties undone, holding three-quarters empty glasses of product.] “Nothing relaxes me like a few fingers of Glenfiddich, on the rocks or straight up.”

      [Cut to] Lawyer 1: [Places glass on table, shakes head back and forth vigorously]. “Mmm! That Glenfiddich is smooth.”

      Laywer 2: “…Not like your expert!” [Both laugh. Cut to still shot of product, narrator says “Enjoy responsibly.”

  4. You make me thankful to have a toddler that loves broccoli.

    The only profession that holds anywhere near the esteem of the general public that doctors hold is probably members of the military (in the U.S., probably less so elsewhere). I’m sure if marketeers find a way to sell the public that some household products are endorsed by our fighting men and women, they will.

    • You should, when considering the beneficence of the universe or the blessings of your deity (your choice), add this to your list of thing to be deeply, deeply grateful for.

      My toddler likes a great many foods. Whether he will deign to eat any of them on any given day is a different question altogether.

  5. But giving a kid who refuses to eat a healthy diet a yummy chocolate shake will ensure that the undesired behaviors persist. (See what I did there?) If refusing to eat broccoli results in a tasty liquid reward, why on earth would the child ever consider eating the broccoli?

    I have mixed feelings about this, I think veering against the attitude of making them eat things they do not like because you don’t want to reward them not liking it. I wrote a post on it here.

    That being said, my wife is a proponent of continually trying and I think I am on board with that. She didn’t like veggies when she was younger but came around to them. She always had to eat at least a bite, but not necessarily a full helping. Generally, the only vegetables I like are the ones that Mom got me to eat by making them taste good (and less healthy). It took hollandaise sauce to get me to eat asperagus, but it put me in a place where I can eat asparagus without them (or with a less unhealthy sauce). Had she taken the attitude of “if not liking it means I have to put something fatty on it, I’m not going to reward that” I probably would have sworn off the stuff forevermore once I left home.

    • What your wife was raised with sounds roughly similar to the approach I recommend. I’m not going to launch into a lengthy discussion of how I address this problem, but suffice it to say there are a great many choices at hand between “force your kid to eat something” (an approach I do not recommend) and “throw up your hands and give your kid a milkshake.”

    • age group.
      Kids under around 5 have different tastebuds, and are kinda wired to dislike things more than adults (probably to keep them from eating poisonous things because they don’t know better).

      Once the kid reaches age 7, I’d give them one/two things that they will not eat, and the rest is fair game. (also, they’d be expected to make food themselves, if they weren’t eating what everyone else was)

  6. This didn’t bother me so much with Offspring Number One.

    Offspring Number Two triggers all sorts of crazy buttons. My wife hypothesizes that this is because Jack is more like her, and Hannah is more like me, and we both love each other and drive ourselves crazy.

    Anyway, Hannah will occasionally just flat out refuse to eat. Just last night, she decided she wasn’t going to eat cheese pizza, which is a food she rejects about as often as ice cream. She’s not even bribe-able.

    Jack, he’d look at something and say, “I don’t want that.” After a couple of minutes of, “Okay, well, if you don’t at least try everything, you don’t get a treat”, he’d try it. And usually he tries it with an open mind, and will eat it if he likes it.

    Hannah just won’t eat. And she’s teeny: people mistake her for a 3-year old just based on size. It drives me bonkers, but she’s healthy and energetic and she just doesn’t need to eat much, so I just remind myself I have to stop channeling my parents and move on.

    • I guess the issue is not “does she not eat”, but rather “does she refuse to eat at mealtimes because she snacks all afternoon beforehand and then gets more snacks between dinner and bed?”

      And it’s also worth asking if this is a behavior that needs to change, or whether you should provide things to snack on that will get the job done–carrots and peanut-butter celery and dried berries and nuts, instead of potato chips and sugar drinks.

      • little bit presumptuous, it sounds liek to me.
        People should do well to remember that kids can actually think. The kid who runs outside barefoot, will be back inside if/when they’re feet get cold.
        Figure “how/when to eat” works similar.

      • We do healthy snacking in the afternoon, but nothing after dinner: it’s baths, stories, and bed. This might be an issue when she’s 9 and stays up later. Occasionally, this is the source; the kids are just not hungry. I’m fine with that.

        There’s also a valid point that some kids are grazers and it’s better for their metabolism to eat small amounts constantly than it is to have three larger meals. I get that too. Probably better for you anyway, although it’s inconvenient at times.

        Usually with her, though, it’s just a power thing. And this is very common for kids this young: they can’t control much about their lives, but they can fishing control what they eat, and between 4.5 and 7 is stretching the bounds of control, and this is where it comes from. “I ain’t gonna eat what you give me, because I reject your parental authority!” I get *that*, too. Okay, don’t eat. Don’t come and tell me you’re hungry at 9:30pm, if you’re done with dinner go get your pjs on.

        We’re big on letting kids make choices, as long as they accept the consequence of those choices. It seems to be working well as a baseline parenting methodology.

        I fully realize most of this is self-imposed crazy, hence the last sentence in the comment. Small isn’t bad, it’s just the way she is, and I have to remind myself of that occasionally.

        • That certainly sounds OK.

          I think the biggest challenge for parents is not so much knowing what to do, but rather consistency–doing the same thing every time, and sticking to it.

          I’ve often thought that the hardest thing will be to not laugh when the kid does something totally ludicrous. Because, y’know, it’s hilarious that the kid stuck a bean in his ear, but if you laugh then you can never have beans again unless you want to spend the whole meal pulling them out of his ear.

  7. One thing the medical and scientific professions really need to communicate to patients over and over and over and over again is that FOOD CANNOT BE REDUCED TO THE SUM OF ITS PARTS!!!

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