Feeding Your Family at Every Stage: A Pediatric Dietitian's Guide to Pregnancy, Postpartum, Picky Eaters, and Everything in Between.
By Kristen Criscitelli, MS, RD — Registered Dietitian specializing in Pediatric and Prenatal Nutrition, as interviewed on the Fed by Science podcast by Claire Goldwitz, founder of Square Fare
Feeding a family well is one of the best things you can do for your long-term health — and also one of the most underserved areas of clinical nutrition. Pediatricians have to cover a lot of ground in a short visit. Often, social media fills the gaps with conflicting information. And parents are left trying to figure it out in real time.
My practice is built around that gap. I work with families across the full arc: expecting, postpartum, infant feeding, solid food introduction, picky eaters, and kids with food allergies, ADHD, and selective eating. Many of my clients find me during pregnancy and stay through their child's early years. My main goal is less stress, more structure, and a relationship with food that actually serves the whole family.
In this piece, I walk through the nutritional realities of each stage — what changes, what matters most, and what I find myself saying over and over to the families I work with. I also share five practical tips that tend to make the biggest difference, not just for clinical outcomes, but for how sustainable and enjoyable the whole process becomes.
Nutrition across pregnancy: trimester by trimester
Pregnancy is not a single nutritional state — it shifts meaningfully across trimesters, and the advice that applies at eight weeks looks very different from what matters at thirty-two.
In the first trimester, caloric needs don't actually increase much. What I see instead is a disconnect between what a patient expects and what her body is doing: she may be ravenously hungry despite needing only modest additional calories, or so nauseated that eating anything at all feels like a challenge. Macronutrients matter most here — getting adequate protein, fat, and carbohydrates — and restriction, whether intentional or circumstantial, is something I work to address early.
By the second trimester, most people feel noticeably better. Energy returns, appetite stabilizes, and there's often genuine motivation to engage with nutrition. This is typically when I see the most traction: clients who are ready to think about food quality, food variety, and what it actually means to eat well during pregnancy.
The third trimester brings its own challenges. Caloric needs are at their highest, but heartburn, swelling, fatigue, and the anxiety of impending delivery make eating well so hard. I spend a lot of time in this phase helping people meet their nutritional needs through smaller, more frequent meals — without adding complexity to an already overwhelming period. The goal is to take some of the mental load of food planning off their plate entirely.
Gestational diabetes: the diagnosis that comes with a lot of unnecessary guilt
Around 24 to 28 weeks, patients are screened for gestational diabetes. When the diagnosis comes back positive, I consistently see the same pattern: patients who haven't received much clinical guidance, who have turned to the internet, and who are now terrified of carbohydrates — convinced they did something wrong.
The first thing I address is guilt. Gestational diabetes has a significant genetic component, and the hormonal environment of pregnancy — particularly the role of placental hormones in driving insulin resistance — means some people develop it regardless of how carefully they've been eating or exercising. It is not a personal failure. The moment I can communicate that clearly, many clients feel relieved.
What gestational diabetes actually requires is structure, not elimination. Carbohydrates are not the enemy — unmanaged blood sugar is. The goal is understanding how different foods affect blood sugar response, how to build balanced meals and snacks, and how to create a plan that accounts for individual variation. Some people can eat certain carbohydrate-containing foods without a significant spike; others can't. Some of that is trial and error. But the approach is always about balance, not deprivation.
One of the most counterproductive things a patient with gestational diabetes can do is skip meals in an effort to control their numbers — and it's also one of the most common things I see. I spend a lot of time helping people understand that eating consistently and strategically is the actual intervention.
Postpartum: the hardest stage to plans for…
After delivery, the focus shifts — but the nutritional demands don't disappear. They change.
For patients who are breastfeeding, I make one thing clear upfront: this is not the time to pursue weight loss. Milk production requires calories and protein, and cutting back will likely compromise supply. There's enormous cultural pressure on new mothers to lose weight immediately after delivery, and I work to reset that expectation early. The mental and physical demands of nursing are significant enough without adding a caloric deficit on top of them.
What I see most consistently in new mothers is unintentional undereating — not dieting, just not eating. Hours pass. Meals get skipped. They realize at five in the afternoon that they haven't eaten since eight in the morning. When you layer breastfeeding demands on top of that, the gap between nutritional need and actual intake becomes a real clinical concern.
My most practical recommendation for the postpartum period isn't a supplement or a specific food — it's planning. Knowing in advance what you're going to eat each day, having it ready or ordered, not negotiating with yourself when you're already exhausted and hungry. That structure doesn't need to be elaborate. It just needs to exist. When it doesn't, the default tends to be whatever is easiest in the moment, which rarely supports recovery.
Starting solids: building a healthy relationship with food from the beginning
When I work with parents before solid food introduction, my focus is less on specific foods and more on setting up the conditions for a healthy relationship with eating — one that will last.
A few things I cover consistently: the top nine allergens — why early introduction matters, how the guidance has shifted significantly over the past decade, and what to watch for. Iron stores, which tend to be lower in breastfed infants, and why prioritizing iron-rich foods early makes a difference. And the principle that a baby's food doesn't need to be categorically different from what the rest of the family is eating.
The patterns established in infancy and toddlerhood matter. Children who see adults eating a variety of foods, who are exposed to different textures and flavors early, and who experience mealtimes as relaxed rather than fraught are measurably more likely to be adventurous eaters later on. That doesn't mean every family can pull off a calm, varied dinner every night — life doesn't always allow it. But the foundation matters, and it's worth building deliberately when you can.
Picky eating: what's actually happening and what helps
Selective eating is one of the most common reasons families come to me, and one of the most mismanaged. The instinct is usually to restrict further — remove the preferred foods, force exposure to the foods the child isn't eating. That approach tends to make things worse.
What I find consistently is that children become more open to food when they feel more in control of it. Getting them involved in selecting groceries, helping in the kitchen in whatever age-appropriate way is possible, choosing their own seasoning, these activities and habits lower the stakes around trying something new. The decision to taste becomes less fraught when the child has had some role in the process.
Preparation also matters more than parents usually expect. I worked with a family recently where the mother was frustrated that her daughter refused to eat broccoli. She was serving it steamed. I asked whether she herself enjoyed steamed broccoli. She said not really. The goal isn't lowering the standard; it's meeting the child where they are. If butter makes the broccoli worth eating, use butter. If ketchup is what makes a new protein acceptable, that's a reasonable trade.
Forcing a child to finish a food they don't want in order to earn something else is one of the most counterproductive patterns I see. It assigns a punitive quality to the food you're trying to normalize, and a reward quality to the food you're implicitly telling them is more desirable. The opposite of the intended effect.
ADHD, sensory difficulties, and feeding
Children with ADHD often struggle around eating not because of willpower or preference, but because of how their attention and hunger regulation work. They may miss meals entirely — not because they aren't hungry, but because they aren't aware of it. They may graze without ever feeling genuinely full, or become so absorbed in an activity that eating simply doesn't register.
Structure helps significantly. A consistent, predictable meal and snack schedule gives the body and brain cues that it might not generate on its own. When children eat consistently, they develop the hunger and fullness signals that inform self-regulation later on. Without that structure, those signals don't get the practice they need to become reliable.
For children with sensory sensitivities, the visual and tactile properties of food can matter as much as taste. The look of something, the texture, the way it moves on the plate — these can all trigger real aversion that has nothing to do with flavor. Repeated exposure, without pressure, is what tends to help. The goal isn't getting a child to like a food by the third try. It's making the tenth encounter feel less alarming than the first.
When the family is the unit: getting everyone on the same page
Most of the time, I'm working with a mother. But what happens at the dinner table is a family project, and the nutrition environment at home reflects the habits, preferences, and food beliefs of everyone in it.
Partners with very different relationships with food — one who cares deeply about meal quality, one who defaults to takeout and doesn't think about it — create a mixed-signal environment for children. Kids are watching. They learn what food means, which foods carry emotional weight, which ones get labeled good or bad, which ones get eaten in secret.
My recommendation is almost always the same: get aligned on the goals before trying to implement them. Not a confrontational conversation — a collaborative one. What do we want food to look like in this house? What matters to each of us? That alignment makes every subsequent decision easier, from what to buy and cook to how to talk about food in front of the kids.
Family meals, even three times a week, are associated with better outcomes: higher self-esteem, healthier food attitudes, more willingness to try new things. The goal isn't a formal sit-down with no devices every night. It's consistent enough exposure to eating together that it becomes part of how the family functions.
GLP-1s postpartum: a tool, not a shortcut
GLP-1 medications come up more often in my postpartum conversations than they used to. My position is that they can be a useful tool — with the right support in place.
What I see without that support is concerning. GLP-1s significantly suppress appetite, which sounds straightforward until you realize that people who aren't hungry still have nutritional needs. Protein intake becomes critical during weight loss; muscle loss accelerates when protein is insufficient. Hydration gets neglected. Fiber becomes harder to hit. And for some patients, the appetite suppression that feels like a solution early on becomes a vehicle for undereating with real downstream consequences.
The psychological side matters too. I work with patients who set a goal of losing fifteen pounds, reach it, and shift the goalpost to twenty. The relationship with the number can become its own problem, and recognizing that pattern early is part of what I do. GLP-1s are a tool in the toolbox. Used well, with a dietitian, a physician monitoring side effects, and ideally some mental health support for food-related anxiety and body image, they can be genuinely helpful. Used in isolation, they're often less effective and sometimes actively harmful.
The neurobiology of why healthy eating is actually hard
One of the most relieving things I tell parents — and patients — is that the difficulty of choosing nutrient-dense food over highly processed food is not a character flaw. It's neurobiology.
The packaged snacks that children (and adults) reliably prefer are engineered that way. A precise ratio of sugar and fat produces a dopamine response that an apple simply doesn't generate. Bright packaging, brand familiarity, and ubiquitous marketing compound it. The brain responds differently to an Oreo than to steamed broccoli, and pretending otherwise doesn't help anyone.
Hunger makes it worse, too. When someone gets to dinner on an empty stomach having skipped lunch and running on coffee all day, they're going to reach for whatever sounds good right now. That's not a character flaw. That's just how it works. Planning ahead is the actual fix. Not willpower. Not motivation. Just not showing up to the decision already starving.
And none of this means processed food is off the table. It means understanding why it happens, dropping the shame around it, and having enough of a routine that you're not making food decisions at your worst.
A clinical example: from weight loss to a seat at the dinner table
One of my recent patients was an eight-year-old with significant selective eating. He ate from a very specific list: one brand of chicken nuggets, one type of bread, very little else. His mother supplemented his intake with four or five pediatric nutrition shakes daily. She kept the kitchen open around the clock, making him something whenever he decided he wanted food — which sometimes wasn't until nine-thirty at night.
The pattern had become exhausting for her and, I think, for him. He was never quite hungry and never quite full. He had no reliable signals to work from. And the constant availability of food, combined with the constant pressure of ‘are you hungry, can I get you something?’ meant the mealtime experience had become anxiety-producing for both of them.
We started by establishing a structure: mealtimes on a schedule, reduction in the shakes, and the language of hunger and fullness — a simple scale that gave him words for what he was feeling and gave his mother something other than guesswork to respond to. We made a list of what I call his "brag foods" — things he was proud to eat — and used them as a foundation rather than a target to overcome.
His mother started taking him to the grocery store and asking what interested him. Not what he'd commit to eating, just what he was curious about. She stopped conditioning dessert on finishing vegetables. She started adding flavor and fat to things rather than serving them plain and hoping he'd accept them. Three months in, on Easter, he sat at the dinner table and ate two of the foods that were served. After the meal, he told his mother it felt like he was normal. That's the kind of outcome that makes this work meaningful.
Five practical tips for feeding your family well
1. Stop trying to fix everything at once. Nutrition information online is overwhelming, and most of it contradicts itself. Trying to tackle all of it at the same time just leads to burnout. Pick one thing, work on it until it feels stable, then move to the next. Sustainable progress beats perfect intentions that last a week.
2. Have a plan before you're hungry. When there's no plan and it's six o'clock and everyone's starving, you're going to grab whatever's fastest. Planning doesn't have to be complicated — it just means knowing ahead of time what the week looks like. When meals are handled in advance, the easy option and the nutritious option become the same thing.
3. Make the food worth eating. Palatability isn't a moral failing — it's just how food works. If you want more vegetables in the rotation, make them taste good: fat, seasoning, the right cooking method. Expecting anyone, child or adult, to eat something they find unpleasant through sheer willpower doesn't work and isn't necessary.
4. Watch the language around food. Words like "bad," "junk," and "you can't have that" teach kids to attach shame and secrecy to eating. The goal is a home where food is just food — where nutritious options are the norm, less nutritious ones aren't forbidden, and nobody's making a big deal out of either. That's the environment where good habits actually form.
5. Get everyone involved. Kids who help pick groceries or have some say in how a meal comes together are more likely to eat it without a fight. And partners matter too — when both people are aligned on food goals, it's actually doable. When only one person is pushing, it's exhausting.
How I work with Square Fare to support my clients
Turning Guidance Into Action
Understanding what to eat and actually doing it are two different things. Planning takes time. Cooking takes energy. And when you're feeding a household where everyone has different needs, even the best intentions fall apart by Thursday night.
That's where I find Square Fare genuinely useful. For families managing food allergies, having meals prepared to a specific restriction list — no hidden ingredients, no cross-contamination worry — is a real relief. For postpartum clients who know they need to eat but can't find time to cook, meals that are ready in two minutes remove the barrier that leads to skipping altogether. And for families working on expanding a selective eater's diet, having reliable, varied options on hand means there's always something safe and appealing available — even on the nights when everyone's exhausted and the easiest option would otherwise win.
When the logistics are handled, everything else gets easier. Families aren't spending energy figuring out what's for dinner. They're free to focus on the things that actually stick.
Kristen Criscitelli is a Registered Dietitian with nearly 16 years of clinical experience, specializing in pregnancy, postpartum, and pediatric nutrition. She sees clients virtually and works with families from the prenatal period through early childhood.
This post is based on a conversation from the Fed by Science podcast, hosted by Claire Goldwitz, founder of Square Fare, a New York City meal delivery service that prepares fresh, personalized meals built around each client’s exact macros, dietary restrictions, and health goals. Every meal is made from scratch, portioned individually, and ready in two minutes.getsquarefare.com — use code CHERRY for 20% off your first order.
