Cara Natterson, M.D.: Keeping a Healthy Conversation Going

This L.A.-based pediatrician and mom updated a seminal book about tween girls and their bodies, and wrote a sequel for older girls.

by Elena Epstein

Cara Natterson

Cara Natterson, M.D., second from left, with son Ry, husband Paul and daughter Talia.

Cara Natterson is an L.A.-based pediatrician and author and mom to Talia, 10, and Ry, 8. A graduate of Harvard University and the Johns Hopkins School of Medicine, Natterson recently teamed up with American Girl to revise the popular tween book, “The Care and Keeping of You,” and write “The Care and Keeping of You 2.” I recently chatted with Natterson about the importance of talking to children about their changing bodies and how to best approach this topic.

The original “Care and Keeping of You” was published 15 years ago and has become a go-to source of information for tween girls. Tell us about how the book has been updated.

We introduced concepts such as obesity prevention that really didn’t exist when the book was first published. We also worked on creating content and illustrations that are appropriate for girls who are a little younger, because girls are entering pre-puberty and puberty at a much younger age. “The Care and Keeping of You 1” is designed for girls ages 7-10 and the second edition is for older girls between 10-13. For the older girls, we also cover the emotional and social issues that are so prevalent at this age.

When is the best time to start conversations with your kids about these topics?

It’s never too soon to start talking about these topics. With your preschooler, you can talk about good nutrition and why putting healthy food in your body is so important. You can discuss why your body needs enough sleep and exercise, why it’s important to shower and use soap and shampoo. These are important topics that even a 3-year-old can understand, and you can start building a foundation from these conversations.

It’s also important for parents to remember that if they have delayed the conversation, don’t panic. It’s never too late to start. And remember this is not a one-time conversation. It’s ongoing and it changes as your kids grow.

What are some strategies parents can use to lessen the uneasiness that some kids might feel when discussing their changing bodies?

A good strategy I found is to have the conversation somewhere the kids don’t have to look you in the eye. Body changes can be an embarrassing topic. Maybe talk in the car, during a hike or at night when you’re saying goodnight and the lights are off. This is the time many kids typically start sharing their feelings more freely.

Sometimes, kids will say or ask something that catches you off guard, like if your daughter comes home and says: “Mom, am I fat?” In those situations, I usually say: “What makes you think that?” You want to do your best not to react, but at the same time you want to understand what’s causing these feelings. Try to ask open-ended questions. A good way to end the conversation is by saying: “I’m so glad we talked about this and I hope you know you can come to me with any questions.”

Why is it so critical to have an ongoing dialogue with our kids?

This generation has something we didn’t have – the Internet. And they feel they can find the answers on their own. The problem is that they don’t always find the right answers online and they can end up seeing images that can leave a huge negative impression on them. We have to take advantage of every opportunity that comes up to talk about health and wellness with our kids.

As kids get older, especially girls, their self-esteem is deeply connected to their changing bodies. We need to give them the tools and information so they feel empowered to make these important decisions.


Elena Epstein is Director of Content at L.A. Parent.

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