As your baby becomes a toddler, he or she may begin to display some very strong opinions about which foods to eat! Toddlerhood is both magical and frustrating for parents and children alike. Your toddler wants to be grown up enough to make their own decisions, but also to know that the adults in their life have everything under control. They may begin refusing flavors they once loved or throwing tantrums if they do not get the foods that they demand. Take a deep breath, and know that this is common toddler behavior and a wonderful opportunity to set your child up for lifelong healthful eating habits. End the mealtime struggles and help your toddler make the best food choices with these healthy eating habits tips.

Set the Table for Success

Ensure that your toddler is hungry at mealtime by sticking to a regular eating schedule. Three meals plus two or three snacks per day is appropriate. It may be reassuring to your child to know that food is offered on a regular schedule, allowing them to decide if they are hungry or not each time. If your child does not want to eat at a given time, calmly offer that they can sit with the family while the family eats and wait to eat until the next mealtime. They should be hungry by then. Avoid giving your toddler extra treats or sugary beverages (including milk and juice) outside of meal and snack times.

Provide secure seating and age-appropriate dishes. Use sturdy plates that cannot be easily flipped or thrown, and that have sides they can push food against. Provide toddler-sized forks and spoons; encourage their use but allow them to use their hands as well. Be patient and expect messes as your toddler gains new eating skills.

Make eating a family event. That may mean a full house of extended family seated around the table or one caregiver and one toddler sharing a snack. Focus on the food and company at hand, and avoid distractions such as TV, toys, or mobile devices. Keep mealtimes as pleasant and relaxed as possible.

Do not offer alternatives to the family meal. Your toddler should not be eating French fries while the rest of the family is eating burritos. Remember that a healthy toddler will not be harmed by skipping the occasional meal if they refuse to eat. Likewise, do not let them snack on the couch or play on the floor while the rest of the family eats. Serve health-promoting foods that the family enjoys, and they will learn to (mostly!) enjoy them too.

What to Serve, and How Much?

What’s for a toddler’s dinner? Whatever the family is having! Make toddler-friendly accommodations as needed, such as cooking the carrots softer, or cutting the apples into small pieces your toddler can pick up with a fork or fingers. Ensure that the family is modeling healthy eating habits, and your toddler is likely to join in. See the resources at the bottom of this blog to get the whole family on a healthful eating plan.

Call it bento, tapas, or a sampler; offering 3 or 4 separate options is better than one inclusive dish for your toddler. A small compartmentalized meal tray or muffin tray will hold small servings of each component of the family’s dinner for your toddler. For example, if the family is having a lentil shepherd’s pie, your toddler may have separate compartments for lentils, mushroom gravy, peas and carrots, and mashed potatoes. Let them decide how much of each item to eat and in what order to eat them.

If your toddler is leaving a lot of food on their plate, their servings may be too big. A good rule of thumb is to offer about a tablespoon per year of age for each food.

If your toddler rejects a food, try and try again! It can take several times of trying a new food for them to like it. Serve a once-rejected food alongside an old favorite, or with a well-liked sauce or seasoning. Try different preparation methods as well, such as steamed and mashed, raw and minced, or roasted chunks of cauliflower for example. Encourage them to try each food on their plate, but do not force them to eat it. Do not bribe them with dessert or a toy. Do not make them sit at the table until it is eaten. When family dinner time is over, remove the rejected food from their plate, and wait a few days before offering that food again.

Beyond Meal Time

Allow your toddler to help prepare the family meal plan. Instead of asking open-ended questions, such as “What would you like to have for dinner this week?”, offer several meal options for your toddler to choose from.

For example, you could phrase the question; “Do you think the family would like to have vegetable stir fry or pasta primavera tonight?” or “Would you like raspberries, bananas, or peaches for your oatmeal?” When there is a plan in place, your child can assist with age-appropriate food preparation tasks.

Bring your child along to the grocery store, farmer’s market, or spice shop with you, so they can see and understand where the food they eat comes from. Allowing time for your child to touch and smell products when appropriate, will help increase their interest in a variety of foods.

Provide your child with opportunities to gain hands-on experience with the preparation of food. If possible, visit a farm or an orchard where they can pick their own seasonal fruits and berries. Another great approach would be growing your own food at home, such as peppers, basil, or other vegetables and herbs. This can be as simple as maintaining one potted plant in a sunny windowsill! 

Additional Resources

Please discuss any concerns you have about your child’s eating habits with me and your primary healthcare provider. Picky eating is a common feature of toddlerhood, but can, on occasion, indicate a health or behavioral issue. If you are concerned about the amount of foods or types of foods your child is eating (or refusing!), we can help you determine if there are any gaps in his or her diet, and if any further assessment or supplementation would be beneficial.

Our nutritionist, Rachel Williams MS, provides individual, family, and small group nutrition education and counseling services at both the Belington Medical Clinic and Myers Clinic. Nutrition counseling is a free service to all Barbour Community Health Association patients. Please feel free to contact Rachel with any questions you have at rwilliams@barbourhealth.org .

In the realm of education, the focus on student well-being has become increasingly integral. Barbour Community Health Association (BCHA) recognizes the significance of mental health and is proud to offer behavioral health services to the students within Barbour County schools. 

In this blog, we sat down with Casey Jo Cottrill, Psy. D.​​​​ on BCHA’s Brandon School-Based Health Services team, to delve into the advantages of offering behavioral health services in schools, their impact on academic performance, their contribution to community support, and the measures taken to ensure privacy and confidentiality for the students accessing these services.

What are some key advantages of offering behavioral health services within Barbour County schools?

Our behavioral health providers offer the same quality behavioral health treatment as a community clinic, but with the convenience of sessions occurring while the student is at school. We provide care to students efficiently so they miss very little classroom time and can be seen without parents having to leave home, take time off from work, or find a ride. As a part of the school community, we are also uniquely suited to help students navigate academic struggles and advocate for themselves within the classroom.

How do school-based behavioral health services contribute to improving overall academic performance and student well-being?

Treating a student’s behavioral health and improving their emotional well-being allows them to approach academics from a place of stability where their brain is ready to absorb and process new information. Therapy sessions can also focus on improving a student’s time management skills, self confidence in their ability to complete school work, and motivation.

In what ways do school-based behavioral health services support families and communities beyond just the students?

As a school-based health center, we strive to be involved in outreach and prevention opportunities that target the overall health of our students and their families. An example of this is our participation in the Bright Futures of Barbour County substance use prevention coalition. As a health center, we can help our community and school system understand risk factors and protective factors of various student struggles to create an action plan that sets our students up for success. 

What measures are taken to ensure privacy and confidentiality for students accessing behavioral health services within the school?

All school-based centers are held to the same privacy and confidentiality practices as community clinics. This includes private spaces for therapy sessions, obtaining informed consent (express permission) before consulting with a school staff member, and documenting sessions within an electronic health record that the school does not have access to. 

By seamlessly integrating mental health support within the school setting, this innovative approach not only enhances academic performance but also fosters a supportive community environment. Barbour Community Health Association proudly offer behavioral health services to students in all seven Barbour County schools, along with treatment of sore throats, flu/common colds, rashes/acne, vaccinations, sprains and strains, sports physicals, well child checks, primary care services, and more!

To learn more about our school-based services, or to get in touch with a BCHA school-based clinic near you, click here.

When you need quick medical attention at a time that is convenient for you, Barbour Quick Care has walk-in care available to keep you moving forward. Walk into one of our two Quick Care locations in Philippi and Belington to receive healthcare you can trust for you and your family. Services available at both Quick Care locations include immunizations, coughs/colds, flus, sore throats, cuts/lacerations, splinters, pink eye, poison ivy, lab services, imaging services, sports physicals, and more. We sat down with Carol Everson, MS, PA-C, to get the answers to frequently asked questions about the service.

As I am finally retiring, I want to express my appreciation to the Belington Clinic’s patients for their support and our staff for their dedication over the years. When I made the decision to retire at the end of the year, I had completely forgotten that 2023 marked our 50th anniversary. It is certainly worth noting that the clinic is home grown.

When the last doctor retired, Belington found itself without in-town medical care. Seven Belington residents made it their business to find a solution. Because of their efforts, if our organization has any owners, they are the citizens of Barbour County.

The seven included a CPA, a jeweler, a building, supply clerk, a columnist for the Barbour Democrat, a lumber mill owner, a WV state Human Resources employee, and the manager of a hardware supply business. They worked out an agreement with Memorial General Hospital in Elkins to open a clinic in
Belington. The group created a corporation; obtained our 1903 schoolhouse building at auction with the local police chief doing the bidding. Memorial General provided some renovation funding and those seven became the first volunteer board of directors. When Memorial General closed in 1986, this same board made the decision to become an independent clinic and assume full financial responsibility. Their work certainly represented caring about community.

Yet another example of community initiative was in 1992, after the WV Board of Education endorsed the concept of school-based health centers, a committee was formed to develop a plan for submission to the county school board. This group consisted of PBHS educators, a counselor, parents, a pastor, the Barbour County Health Department director, and the clinic. After a lot of work over a year, the proposal was submitted to the school board which approved it after a public hearing. I remember driving into the PBHS parking lot for the hearing and seeing a huge number of cars. I was sure the proposal was dead, but the cars were for a basketball game. With grants from the state, the Benedum Foundation, a $10,000 gift from Davis Memorial Hospital, the project was on its way. Arthur Brandon, a lifetime educator who began his teaching career at the Lillian rural school, donated his home to be sold. The project then had the necessary funding. PBHS soon had West Virginia’s first free standing school-based health center which Ken Auvil had built at cost. Jimmy Harris made all the furniture at less than cost. More people coming together, more community.

It has now been many years since I doubled as the clinic administrator. As it should, Barbour Community Health has moved into the future. We are now joined with the Myers Clinic which has a rich history of its own and strengthened our organization. We are proud of the recent addition of mental health services. However, Barbour Community Health would not exist if it were not for those seven individuals and the work of the Belington Clinic over the years. I do want to leave our patients with this: We are local, not a major health care giant. It is our job to offer quality and service from the time someone calls, walks into reception, is evaluated by a nurse, is examined by a physician or other provider; and then receives appropriate follow-up. If your expectations are met or not met, let the administrator and the Board of Directors know. It is the only way we can objectively improve our services. This organization is yours; the Board consists of your neighbors, and they are your representatives.

Finally, to the patients who have followed with me over the last 45 years, it was a joy. I have had the pleasure of walking into those two exam rooms well over 100,000 times. I was never bored; often felt challenged; and almost always felt like I was with a friend. I will miss our conversations. I will miss the interaction with our staff, particularly those providers who cared so much about their patients. I will most certainly miss working with Judy who kept me on task and did so much for our patients. The best thing is, I will be able to spend more time with the most important person in my life, Kate, as well as these 25 beautiful grandchildren.

– Tom

In the world of healthcare, Nurse Practitioners play a vital role in delivering quality patient care, especially in community settings in rural West Virginia. During National Nurse Practitioner Week, we had the privilege of speaking with Heather Ritchie, FNP, a dedicated Nurse Practitioner at Barbour Community Health Association (BCHA), to better understand the impact and responsibilities NPs have in the community. Heather also shares her inspiration for becoming a Nurse Practitioner and more in this Q&A.

Can you briefly describe your role and responsibilities as a Nurse Practitioner at BCHA?

Yes, my role and responsibilities at BCHA are primarily focused on patient care. I work at the Belington and Myers Quick Care clinics, where I see and treat sick or injured patients. We encounter a wide range of conditions, from colds, flu, strep, and COVID to sprains and lacerations. My responsibilities include assessing patients, interpreting lab results and X-rays, and providing appropriate treatment within my scope of practice.

What inspired you to become a Nurse Practitioner, and what led you to work at BCHA?

I’ve been a nurse since 2009 and loved working at the bedside in the ED, ICU and tele floors. However, I wanted to be more involved in the community while taking a more active role in the health promotion and prevention of my patients, more than bedside nursing could offer. This drove me to pursue a Master’s in Science and become a Nurse Practitioner. I was led to BCHA because they were opening a new walk-in clinic, and my previous clinic was closing around the same time. It just felt like it was meant to be.

How do Nurse Practitioners contribute to the well-being of the community, and what unique aspects do they bring to patient care?

Nurse Practitioners are a great asset to any community because of our unique skill set. Many of us have worked at the bedside in hospitals, and we understand what it means to treat the whole person, not just the disease or diagnosis. I believe that experience is one of the most unique aspects of being an NP. We know how important it is to treat the body, mind and spirit. This sometimes means carving the extra time needed to incorporate their religious and cultural perspectives within their care and this also helps to improve patient compliance.

Can you share a memorable patient success story that highlights the impact of Nurse Practitioners in our community?

When it comes to success in healthcare, it does not always mean reversal or complete healing of a disease or condition. Sometimes it simply means understanding and caring. This involves listening and involving the patient in the care they receive. I have multiple stories, but one in  particular was with a patient who was terminal. We stumbled upon his diagnosis of stage 4 lung cancer with mets – that is a death sentence, and he knew it! But, this was someone who never went to the doctor and was just a tough country boy, until now. He was scared and didn’t know what to do. So, I listened, and I counseled him and I prayed with him, and he decided to take an active part in his treatment. He went to specialists, chemo, and radiation to the point that he did not think he could go anymore, and he would just come into the office to talk and tell me about his day. He made it 11 months after his diagnosis, but a couple of his visits before he passed, he looked so happy and ready. He spent time with his family, turned to God, and felt better than he had in years…despite his diagnosis. He thanked me for listening and caring enough to counsel, pray, and just talk with him. This resonated with his family and friends, many of which decided to establish care within the clinic. What we do matters whether we know it or not, and as Nurse Practitioners, we bring a listening ear, a compassionate heart, and a desire to treat the whole patient to the practice of medicine for our communities.

Nurse Practitioners often work collaboratively with other healthcare professionals. How do you coordinate care with doctors, nurses, and other team members to provide comprehensive patient care?

Working in a quick care environment, we often need to send patients to the emergency room for further evaluation. I always make sure to call the receiving hospital and give a report to the ED provider or to a nurse. Another example is when we need psych evaluations when a patient is in an acute crisis. Thankfully BCHA has a wonderful behavioral health department that is willing to talk to patients the same day if needed. I have had to utilize the therapist in our office to help patients through their tough times and to help get them scheduled quickly for follow up appointments with behavioral health. What helps us here at BCHA is that everyone has a desire to provide efficient care for our patients and that makes collaboration even more effective.

Nurse Practitioners are known for their patient-centered approach. How do you build strong relationships with your patients, and what sets Nurse Practitioners apart in this regard?

When a nurse is taking care of a patient in the hospital, they spend a lot of time with each patient. They are with them for 12 hours a day or night, sometimes for multiple days in a row. Nurses take time to talk and get to know each patient and it helps them learn more about how to care for them. When nurses become NPs, we carry that care over into our practice. We take the time needed to figure out what the patient needs and how we can help them. Sometimes it’s just about sitting and listening without judging or interrupting.

In what ways have you seen Nurse Practitioners evolve and expand their scope of practice in recent years, and how has this benefited our community?

The biggest change I have seen in the evolution of NP practice is the ability for NPs to work independently. In the state of West Virginia, we need a collaborating physician for 3 years, and then we can apply for independent practice, meaning we don’t have to have a collaborating physician anymore. This has benefited communities by bringing healthcare to even the most rural and remote areas. There are not enough physicians to treat the whole county and allowing nurses to further their education to become independent Nurse Practitioners has really helped make healthcare more accessible for everyone.

What message would you like to convey to the community, patients, and colleagues during Nurse Practitioner Week about the essential role of Nurse Practitioners in healthcare?

That we are here to help and to make healthcare more accessible to more people. We care about our patients as a whole and focus on their needs as a part of our care, and we want their input and ideas to overcome barriers to healing and compliance.

Can you offer advice or encouragement to aspiring Nurse Practitioners who may be considering a career in healthcare, especially in a community setting like ours?

Just go for it, it’s worth it. School is hard, but the reward of caring for your community is worth it. As Nurse Practitioners, we bring our nursing experience to the field of practicing medicine and that makes all the difference in the care we provide.

What are some ongoing initiatives or goals for the future that you and your team have to further improve patient care and community health?

I am not quite sure what the team has in mind, but I believe that through community outreach programs and accessible care, we will continue to provide and improve care throughout our communities. Having access to family practice, behavioral health, lab, radiology, and quick care services provided by BCHA, our communities are able to obtain all of their healthcare needs within one organization. This provides continuity of care that was not possible many years ago.

This week, we are feeling extra grateful for our four Nurse Practitioners within BCHA – Heather Ritchie, FNP; Joyce Wilson, MSN, APRN, FNP-C; Amy Rollins, APRN-FNP, and Rhonda Parker, DNP. Thank you for all you do to provide the compassionate and quality care that our communities deserve.

Call BCHA today to make an appointment with one of our caring Nurse Practitioners!