This week Buster's therapist decided to try a simple rewards system. Up until now I wasn't sure he was old enough. Turns out, he is. This is so simple and we've used it only to get him to either try something new or get through those final brutal 15 minutes of eating a whole meal.
Tangent for a moment: We actually hit our goal 1300 calories yesterday! Thank you Duocal! Not inexpensive but worth it!
Back to my original story....I've been trying pancakes and red kidney beans this week. Not together, of course, but pancakes at lunch and the beans at dinner. The pancakes have a decent calorie count, especially with butter melted into them. Buster can't see the butter so he doesn't argue about it! And the beans also have a decent calorie count and add protein and fiber.
He hasn't been thrilled about either one of them but takes 2 or 3 bites with some coaxing. Well, his therapist suggested we give him something visual to get to a goal of say, 5 bites. She drew 5 circles on a piece of paper and I pulled a sheet of little stickers out of the art bin. Buster LOVES stickers. He got a sticker for every bite of pancake (and later bean). He took bites himself, with no argument. Once he reached the goal of filling all 5 circles, he got a veggie straw. He loves those potato chip-esque veggie straws. He was happy, we were happy!
So, for the last two nights, I've used this system to get the last of his dinner into him. It's taking about an hour to get him to eat everything he needs to eat. By the last 15 or 20 minutes, he's sick of eating and we're sick of him doing everything he can do to avoid eating: play/be funny/park his "car" (fork) in the "garage" between his plate and cup/shake his head/play with his cup/play with his napkin....you get my point. He's done and we're done but the food isn't in him. Last night I drew one line of 5 circles, the number of bites of chicken nugget he had left on his plate. And, 10 circles for the number of bites of grilled cheese "super man bread and cheese sandwich" I thought he needed to finish. After every bite he popped into his mouth (with no argument, mind you) he got to pick a sticker and place it inside a circle. Within about 5 minutes, he was "all done!" and it was "cookie time!". He got his after dinner thin mint girl scout cookie. He ate about 1/3 of it but I don't really care. He ate his dinner, he got his calories, I got the rest of the cookie.
I'm so glad those sticker packets come with 1,000 stickers. We're going to go through a lot of stickers. Eventually the system and rewards themselves will change but this is a GREAT start!
Friday, May 24, 2013
Monday, May 20, 2013
Self-Feeding Control
I've mentioned Buster's tendency to choke and gag. Though is happened a lot more when he was younger, it still happens now. He will not remove food from his own mouth if he doesn't want it there. He will just sit with it in his mouth for ages. I'm still trying to teach him that it's okay to spit food out...into his hand, into my hand, anywhere really. I don't know if it grosses him out or what but he won't do it.
Here's something I've noticed recently about the gagging. He tends to do it less when he's feeding himself. I don't know if it's because he's concentrating on it harder since it takes much more work for him to get it into his mouth or maybe he's just more prepared for it to get into his mouth. But, for the first part of the meal, when he's feeding himself he gags less. Eventually he gets bored of the process of eating and I have to feed him the rest of his meal just to be sure he's getting enough food. This is when he tends to gag. No actual choking recently, so little happy dance for that!
Bananas seem to be a trigger at the moment. They are kind of thick and mushy and though he likes them, sometimes when it first gets in his mouth he'll gag. We are constantly reminding him to "Chew! Chew! Chew and you won't gag, Buster!" Last night it was bites of sliced turkey. I think he just wasn't into eating it. He had mac & cheese, strawberries, green beans and turkey on his plate. Any sort of meat is always his least favorite thing. He was a strawberry eating maniac but the few bites of turkey I gave to him on his fork immediately made him gag. He would then chew and swallow but not without me telling him to chew.
So how to help him stop gagging? I still do not know. I suppose it's something he'll eventually grow out of and as long as he isn't chocking or throwing up, it's just something I should learn to live with.
This week I want to work on him eating grilled cheese again. He's only eating a bite or two when I make one. He will eat cheese and bread separately but once I put them together and toast them, he's less interested unless we are at a restaurant. His therapist suggested getting some fun shaped cookie cutters and cutting a sandwich (be it grilled or not) into fun shapes. I'm going cookie cutter hunting this week!
Here's something I've noticed recently about the gagging. He tends to do it less when he's feeding himself. I don't know if it's because he's concentrating on it harder since it takes much more work for him to get it into his mouth or maybe he's just more prepared for it to get into his mouth. But, for the first part of the meal, when he's feeding himself he gags less. Eventually he gets bored of the process of eating and I have to feed him the rest of his meal just to be sure he's getting enough food. This is when he tends to gag. No actual choking recently, so little happy dance for that!
Bananas seem to be a trigger at the moment. They are kind of thick and mushy and though he likes them, sometimes when it first gets in his mouth he'll gag. We are constantly reminding him to "Chew! Chew! Chew and you won't gag, Buster!" Last night it was bites of sliced turkey. I think he just wasn't into eating it. He had mac & cheese, strawberries, green beans and turkey on his plate. Any sort of meat is always his least favorite thing. He was a strawberry eating maniac but the few bites of turkey I gave to him on his fork immediately made him gag. He would then chew and swallow but not without me telling him to chew.
So how to help him stop gagging? I still do not know. I suppose it's something he'll eventually grow out of and as long as he isn't chocking or throwing up, it's just something I should learn to live with.
This week I want to work on him eating grilled cheese again. He's only eating a bite or two when I make one. He will eat cheese and bread separately but once I put them together and toast them, he's less interested unless we are at a restaurant. His therapist suggested getting some fun shaped cookie cutters and cutting a sandwich (be it grilled or not) into fun shapes. I'm going cookie cutter hunting this week!
Monday, May 13, 2013
A Visit To The Dietitian
Because we had some serious concerns about Buster not getting enough/the right nutrition since he's started eating solid foods and no purees, we went for an appointment with a Registered Dietitian. We found a great one with the help of Buster's GI doctor and she specializes in pediatric patients. I fully expected to be read the riot act. As it turns out, we're doing a decent job of getting food into the kid! Let's hear it for obsessive parenting!!!! YEAH, I'M A HELICOPTER...I ADMIT IT.
We had to keep a food diary for three days prior to our appointment. On paper, it REALLY felt like it wasn't enough food. I've read a number of articles on the subject and knew that for his size, Buster should probably be eating around 1,100 calories a day. I do try to keep track and we're usually in the ball park but never really exceeding expectations.
I was very curious to see his weight. I do weigh him at home but I'm always suspicious of my bathroom scale. Why I think it weighs me too heavy and him to light, I can't explain, I just do. But I digress...he weighed in at a whopping 26.7 pounds. He's been sitting in that neighborhood for awhile but I was happy to know he isn't losing. He's between the 5th & 10th percentile for weight and around the 25th for height. If he were calculated at his "adjusted age" he's a little higher on the charts. Long story short, he's on the chart and he's not "failing to thrive". WOOOHOOO!
So, my questions were basically this:
Am I a horrible parent and is my child lacking important nutrients? Am I causing him harm?
Answer: No, no and no.
WOOOOHOOOO AGAIN!
What do I need to do differently?
Answer: Nothing but I have some tips to help him gain weight.
REALLY?!
Am I a total neurotic freak?
Answer: Yes.
Okay, I didn't really ask this last one but let's be honest...I am.
She was very kind and full of good information. It was ABSOLUTELY worth the trip and she had some wonderful information. I wanted some sort of guideline for this sweet faced, curly blonde haired little boy. What do I need to make sure he's eating? How can I get him to gain some weight?
Buster is on a high calorie, high protein diet. Which means, basically what we were already doing. Full fat everything. Butter and oils? Bring 'em on! Cream? Throw it in there! The first thing to pay attention to on any food label is calories. Yes, without a doubt making sure he's getting enough essential vitamins and minerals out of his foods is IMPORTANT but if he's not getting enough calories into his body he's never going to gain weight. So, if he wants a cookie, he gets a cookie. (Oh how I wish this were my diet too.) We're keeping his morning Pediasure bottle though someday when he's more willing to eat real food first thing the morning, a big stack of pancakes would be great for him. He drinks whole milk after his nap. We're now adding about 90 calories worth of cream or dry powdered milk into that cup of milk to bump up the calories. He likes eating vegetables but they are low in calories and fat. So, I'm putting butter on everything.
The goal is to get 1300 calories into him a day. We weren't terribly far from that so we just need to add a few things to what he's already eating as opposed to adding more volume. He's not ready for more volume. So, butter on the vegetables and anything else we can possibly get it in. Cream cheese in the mac & cheese. Duocal in anything we can dissolve it in...yogurt, applesauce, whatever. This is a new product for us but I've been using the samples we were given and it's really easy to order either online or through your pharmacy. No prescription. I just called up our Walgreens and I should have a case of it in the next week.
Three meals a day plus two snacks. We are not good at getting a snack in between breakfast and lunch. He has NO interest. So, we will work on it. In the meantime, I just have to make sure we get the calories in the other meals/snack.
In order to continue our never ending pursuit of moving up the growth chart, he should be gaining about 1/2 a pound a month. That's a little more than is recommended for a child his age of normal size.
Below are some of the information sheets we were given. I think they have some great information.
Wednesday, May 8, 2013
Why I Love Superman
My husband's favorite comic book/movie superhero is Superman. Therefore, my son knows Superman. He's never actually watched a movie or cartoon with him. But he has t-shirts, pajamas, capes, Mr Potato Heads, etc... that are all Superman themed. He's knows Superman is cool.
One day we called bread "Superman Bread" and he ate it. He'll eat most of a Hawaiian dinner roll if I tear it into small chunks and put it in front of him. He shouts "Superman bread!!!!" He also loves cheese.
So, the other day we were out at lunch and we thought we'd try something new. We ordered him a grilled cheese and broccoli. I asked the waiter to have them smash the sandwich down as flat as possible when they grilled it so it wouldn't be overwhelmingly thick. The kid will eat at least some of any green vegetable I put in front of him. He was totally excited to eat broccoli. He's played with it plenty of times when he's helping me prepare meals. So, I wasn't shocked when he ate it. The sandwich, I really questioned. To my surprise, after I cut it into tiny bites and told him it was "Superman bread with cheese"...he ate an entire 1/2 a sandwich.
WHAT?! Who are you and what have you done with my child? And, please stay.
Since then, we've tried it two more times at home. We're trying to repeat exposure as much as possible until something is officially "accepted". He doesn't eat it as well at home. Why? I HAVE NO IDEA. Maybe he is just more adventurous at restaurants? Maybe I'm ruining it because I'm sneaking a slice of VERY THIN roasted turkey in there too. I want him to eat more protein. I'm not even sure if he's noticed. He hasn't commented. He just won't eat it without us telling him he has to take bites and even then, he makes it known he isn't happy about it.
Last night was the worst night we've had since this eating real meals thing began. It normally takes us around 45 minutes to get dinner into him. We've been rewarding him with a Girl Scout Thin Mint Cookie at the end. We discovered he liked those last week. They've been a great incentive to get him to finish what we want him to finish. I'm so not above bribery. Anyway, last night he had: 1/2 a Superman bread with cheese (grilled cheese w/ a slice of turkey sandwich), peas, broccoli and apple sticks. He ate about half the veggies and the fruit before he got full enough and bored enough that he didn't want to eat any more. He ate no bites of the sandwich on his own. He let me put a few bites in his mouth after some pouting. Then, things just deteriorated. But he truly had not eaten enough so we had to press him. He turned his head, threw little fits, played with his napkin and flatware...anything he could do. This resulted in 2 time-outs and eventually I had to to get up from the table and walk away for a few minutes. My husband bravely stepped back in a got him to finish his veggies and three more bites of sandwich. All together this process took an hour and a half. I know that's too long for him to be at the table but we did it. And, punishing bad behavior surrounding a feeding aversion isn't encouraged. But, when he's old enough (and he is now) to understand that his behavior isn't acceptable, something has to be done. There was no yelling from us...just the time outs. I think we did the right thing. At some point he's going to able to understand that he as to eat all of A, B and C and a few bites of D before he can get up. He's not really there yet so we're trying it one x or y at a time and reminding him every bite or two that he has to eat until it's "all gone".
This morning, I think I'm still exhausted from last night. It's kind of soul crushing to have a really bad meal again. But, it will happen. We've just got to figure out how to motivate him better on those nights.
One day we called bread "Superman Bread" and he ate it. He'll eat most of a Hawaiian dinner roll if I tear it into small chunks and put it in front of him. He shouts "Superman bread!!!!" He also loves cheese.
So, the other day we were out at lunch and we thought we'd try something new. We ordered him a grilled cheese and broccoli. I asked the waiter to have them smash the sandwich down as flat as possible when they grilled it so it wouldn't be overwhelmingly thick. The kid will eat at least some of any green vegetable I put in front of him. He was totally excited to eat broccoli. He's played with it plenty of times when he's helping me prepare meals. So, I wasn't shocked when he ate it. The sandwich, I really questioned. To my surprise, after I cut it into tiny bites and told him it was "Superman bread with cheese"...he ate an entire 1/2 a sandwich.
WHAT?! Who are you and what have you done with my child? And, please stay.
Since then, we've tried it two more times at home. We're trying to repeat exposure as much as possible until something is officially "accepted". He doesn't eat it as well at home. Why? I HAVE NO IDEA. Maybe he is just more adventurous at restaurants? Maybe I'm ruining it because I'm sneaking a slice of VERY THIN roasted turkey in there too. I want him to eat more protein. I'm not even sure if he's noticed. He hasn't commented. He just won't eat it without us telling him he has to take bites and even then, he makes it known he isn't happy about it.
Last night was the worst night we've had since this eating real meals thing began. It normally takes us around 45 minutes to get dinner into him. We've been rewarding him with a Girl Scout Thin Mint Cookie at the end. We discovered he liked those last week. They've been a great incentive to get him to finish what we want him to finish. I'm so not above bribery. Anyway, last night he had: 1/2 a Superman bread with cheese (grilled cheese w/ a slice of turkey sandwich), peas, broccoli and apple sticks. He ate about half the veggies and the fruit before he got full enough and bored enough that he didn't want to eat any more. He ate no bites of the sandwich on his own. He let me put a few bites in his mouth after some pouting. Then, things just deteriorated. But he truly had not eaten enough so we had to press him. He turned his head, threw little fits, played with his napkin and flatware...anything he could do. This resulted in 2 time-outs and eventually I had to to get up from the table and walk away for a few minutes. My husband bravely stepped back in a got him to finish his veggies and three more bites of sandwich. All together this process took an hour and a half. I know that's too long for him to be at the table but we did it. And, punishing bad behavior surrounding a feeding aversion isn't encouraged. But, when he's old enough (and he is now) to understand that his behavior isn't acceptable, something has to be done. There was no yelling from us...just the time outs. I think we did the right thing. At some point he's going to able to understand that he as to eat all of A, B and C and a few bites of D before he can get up. He's not really there yet so we're trying it one x or y at a time and reminding him every bite or two that he has to eat until it's "all gone".
This morning, I think I'm still exhausted from last night. It's kind of soul crushing to have a really bad meal again. But, it will happen. We've just got to figure out how to motivate him better on those nights.
Wednesday, May 1, 2013
Empowering Him With Choices
The Fit: "NO! No chair! No sit!"
He didn't want to get in his chair and eat. Dad wasn't home for dinner yet. He wanted to watch a cartoon. He just wasn't in the mood. TOO BAD KIDDO! It's dinner time and we're stickin' to our schedule!!!
The Fix: A choice. I gave him some control over what was about to happen.
"Buster, look at me. Stop flailing and look at mama for a minute. Do you want milk or water with dinner?"
"Milk."
"Okay, get in your chair and I'll get you a cup of milk. Do you want a blue cup or a green cup?"
"Bwue."
"Okay. Thank you. I'll get your blue cup of milk."
He had a choice. He had some control. He settled down, got in his chair and two minutes later he was eating green beans, mac & cheese, carrots (first night of success with carrots!!) and not eating, but did touch, some hot dog.
Toddlers can control very few things the happen in their lives. What they put in their mouth, they can control that. Sometimes, it's not yet about the food...just about getting them to the table. It's hard for them to give up that control. So, offering choices will very often give them the control they need to feel they have. Peas or carrots? Cheese or apples? Simple, healthy choices and he's FAAAR more likely to eat something if he feels like it's there because he decided it's there.
As Janet Jackson said "Control....to get what I want." (I just showed my age a little there, didn't I?)
Tuesday, April 30, 2013
Peer Pressure & Rain Forest Cafe
We had a wonderful weekend with my mom, two sister and three nieces visiting for my birthday. I was interested to see if eating with his four year old cousin would influence him to try something new. He did reasonably well through all of his meals.
Saturday evening he ate some bites of vanilla ice cream!! Those were the first ice cream bites he has been willing to accept since his first birthday party. He didn't eat a huge amount but he requested multiple bites!! Then, Sunday morning he ate quite a few bites of waffle! He has, in the past, eaten a bite or two of frozen waffle after I've toasted it and cut it into sticks. But this was a freshly made waffle torn into pieces. I think maybe we'll try some pancakes at home in the next few days as the texture would be a bit closer to what he ate since I don't have a waffle iron. I guess maybe I need to buy one soon. Waffles or pancakes would be great for calories!
Sunday's lunch was an experiment in both feeding and sensory tolerance. We went to a Rain Forest Cafe!! Brave? Yes!!! For a child with sensory issues (or any child that fears thunderstorms) this place can be overload. Sounds, lights, loud in general, scary animatronic jungle creatures lurking in every corner. A thunderstorm was in progress when we walked up to the hostess stand/massive store you must to walk through to get into the restaurant. Buster wanted to "go out!" "go out!" before we got a few feet in. I asked the hostess if we could walk around in the restaurant a little bit to see if we would be able to stay. She very kindly obliged. The "storm" lasts only a minute or so and they told me it happened every 30 minutes. He didn't quite know what to think of the animals. They are pretty realistic and they move...freaky. Then, we walked over to the giant aquarium and the world was a happy place again. A wall of brightly colored fish was enough to convince him that this place would be okay. He agreed that we could sit down at a table and have lunch. I gave him the option of either mac & cheese or chicken nuggets and he enthusiastically chose mac & cheese. Eating went fine...he even had some of his cousin's applesauce and at more ice cream when my mom forced one of those giant sparkler covered birthday deserts on the table that was delivered by a singing, clapping wait staff who all look like they hate their job. (I do recommend the brownie cake at Rain Forest Cafe...it was pretty delicious.) The only moments of panic came in the several thunderstorms that happened through the course of our meal. He whined and cried but we talked him through it and we never did have to get him out of his chair...though arms were outstretched, we just hugged it out. I was VERY proud of him. He was asleep before we made it out of the parking lot.
The one big fail of the weekend came in the form of sweet potatoes. From the time he began eating purees, sweet potatoes have always been one of his favorite foods. They are packed with nutrition so that's always made me really happy. I want to try to get them back in his diet. I thought maybe if I roasted small cubes, he'd eat them. We've tried it only once but it didn't go well. He put two in his mouth. The first one he chewed a bit, then swallowed and gagged a little. The second one, he didn't even chew. When he gets a food in his mouth that he doesn't want, he just sits there. I haven't yet successfully taught him to swipe food out of his mouth when he doesn't want to chew it. His first inclination is to swallow it whole but he now knows he chokes so now he just kind of freezes...he'll sit there FOREVER with food in his mouth. No chewing, no nothing. Eventually I have to pry his mouth open and swipe out whatever he has in there. He's gone over 45 minutes of this before. Now, I won't wait that long. I wish he'd start to take it out himself but he doesn't want to touch it. This is a thing we really need to work on and I'm going to talk with his therapist about methods this week. I will try the sweet potato cubes a few more times this week, then give it a break for a few days. My other plan is to puree some again and mix it into his mac & cheese...a sneaky way to get him to eat a 1/4 cup. I'm all for sneaking food into him if that's what it takes.
Saturday evening he ate some bites of vanilla ice cream!! Those were the first ice cream bites he has been willing to accept since his first birthday party. He didn't eat a huge amount but he requested multiple bites!! Then, Sunday morning he ate quite a few bites of waffle! He has, in the past, eaten a bite or two of frozen waffle after I've toasted it and cut it into sticks. But this was a freshly made waffle torn into pieces. I think maybe we'll try some pancakes at home in the next few days as the texture would be a bit closer to what he ate since I don't have a waffle iron. I guess maybe I need to buy one soon. Waffles or pancakes would be great for calories!
Sunday's lunch was an experiment in both feeding and sensory tolerance. We went to a Rain Forest Cafe!! Brave? Yes!!! For a child with sensory issues (or any child that fears thunderstorms) this place can be overload. Sounds, lights, loud in general, scary animatronic jungle creatures lurking in every corner. A thunderstorm was in progress when we walked up to the hostess stand/massive store you must to walk through to get into the restaurant. Buster wanted to "go out!" "go out!" before we got a few feet in. I asked the hostess if we could walk around in the restaurant a little bit to see if we would be able to stay. She very kindly obliged. The "storm" lasts only a minute or so and they told me it happened every 30 minutes. He didn't quite know what to think of the animals. They are pretty realistic and they move...freaky. Then, we walked over to the giant aquarium and the world was a happy place again. A wall of brightly colored fish was enough to convince him that this place would be okay. He agreed that we could sit down at a table and have lunch. I gave him the option of either mac & cheese or chicken nuggets and he enthusiastically chose mac & cheese. Eating went fine...he even had some of his cousin's applesauce and at more ice cream when my mom forced one of those giant sparkler covered birthday deserts on the table that was delivered by a singing, clapping wait staff who all look like they hate their job. (I do recommend the brownie cake at Rain Forest Cafe...it was pretty delicious.) The only moments of panic came in the several thunderstorms that happened through the course of our meal. He whined and cried but we talked him through it and we never did have to get him out of his chair...though arms were outstretched, we just hugged it out. I was VERY proud of him. He was asleep before we made it out of the parking lot.
The one big fail of the weekend came in the form of sweet potatoes. From the time he began eating purees, sweet potatoes have always been one of his favorite foods. They are packed with nutrition so that's always made me really happy. I want to try to get them back in his diet. I thought maybe if I roasted small cubes, he'd eat them. We've tried it only once but it didn't go well. He put two in his mouth. The first one he chewed a bit, then swallowed and gagged a little. The second one, he didn't even chew. When he gets a food in his mouth that he doesn't want, he just sits there. I haven't yet successfully taught him to swipe food out of his mouth when he doesn't want to chew it. His first inclination is to swallow it whole but he now knows he chokes so now he just kind of freezes...he'll sit there FOREVER with food in his mouth. No chewing, no nothing. Eventually I have to pry his mouth open and swipe out whatever he has in there. He's gone over 45 minutes of this before. Now, I won't wait that long. I wish he'd start to take it out himself but he doesn't want to touch it. This is a thing we really need to work on and I'm going to talk with his therapist about methods this week. I will try the sweet potato cubes a few more times this week, then give it a break for a few days. My other plan is to puree some again and mix it into his mac & cheese...a sneaky way to get him to eat a 1/4 cup. I'm all for sneaking food into him if that's what it takes.
Friday, April 26, 2013
"Help cook, Mama!"
Buster is now old enough to "help" cook. Does it take me twice as long to prepare a meal with him helping? Of course it does. Is it totally cute and worth it? Yes (most of the time).
This helping started within the last two months. I finally trusted him enough to stand on a kitchen chair pulled up to the counter and not cause himself bodily harm. Every Friday night is Pizza Friday in our house. Buster won't eat pizza yet but the kid LOVES to help make "Peep-a Dough!!" That's how this whole thing started. I didn't want him to be freaked out by the noise from the Kitchenaid when I use it. So, I thought if I showed it to him in action, he'd be okay with it. He is. But he also really wanted to participate in pouring ingredients into the bowl. And, I thought if he would stick his fingers in wet, sticky pizza dough it would be great. He doesn't love touching the dough when it's covered in olive oil at the end but he'll do it for a second just to make me happy. Then we have to "wash hand! wash hand!" It's still a win in my book.
Within a few days he started showing an interest in whatever I was doing in the kitchen. I let him participate in any kitchen work or food prep that he wants in on. He puts groceries away. He gets things out of the fridge. (He also puts things in the fridge when I'm not paying attention. I found a Fisher Price bowling pin in there last week.) He loves to help unload the dishwasher, he does the bottom rack and I do the top. Shockingly, no dishes have been broken and if it happens, it's not a huge deal. Washing dishes in the sink is his favorite activity in the world. Not holding my breath that that one will last too many years but a mom can dream. And, when I start chopping veggies or fruit he's right there. I have him pick them up and put them in a bowl or on a plate (whether I really need them there or not) just so he will interact with them. He touched wet diced tomatoes this week. That was a huge victory. He even touched some chopped broccoli to his lips recently. He didn't eat it but SOS therapy in action!!! Yippy!
He's much more interested in foods now. Even at the grocery store, I give him the produce to hold and then he puts it in the basket in front of him. The grocery store we go to has awesome carts shaped like cars that he gets to "drive" and he's a very active participant in the shopping trip. He names foods, he tells me their colors or counts the number of whatever it is we are getting. I give him choices "purple cauliflower or white cauliflower?" He may not be eating cauliflower but he is engaged and that's progress.
He starts to get excited in the late afternoon because he knows it's going to be time to cook soon. "Help cook, Mama!" One of these days he's going to be excited enough about something we are cooking together that he's going to eat it. He'll be proud of his effort. He'll be excited about whatever choices he's been allowed to make in the process of preparing the meal. And, he will want to put some in his mouth. It might be next month. It might be next year or the year after that. But, it is going to happen.
This helping started within the last two months. I finally trusted him enough to stand on a kitchen chair pulled up to the counter and not cause himself bodily harm. Every Friday night is Pizza Friday in our house. Buster won't eat pizza yet but the kid LOVES to help make "Peep-a Dough!!" That's how this whole thing started. I didn't want him to be freaked out by the noise from the Kitchenaid when I use it. So, I thought if I showed it to him in action, he'd be okay with it. He is. But he also really wanted to participate in pouring ingredients into the bowl. And, I thought if he would stick his fingers in wet, sticky pizza dough it would be great. He doesn't love touching the dough when it's covered in olive oil at the end but he'll do it for a second just to make me happy. Then we have to "wash hand! wash hand!" It's still a win in my book.
Within a few days he started showing an interest in whatever I was doing in the kitchen. I let him participate in any kitchen work or food prep that he wants in on. He puts groceries away. He gets things out of the fridge. (He also puts things in the fridge when I'm not paying attention. I found a Fisher Price bowling pin in there last week.) He loves to help unload the dishwasher, he does the bottom rack and I do the top. Shockingly, no dishes have been broken and if it happens, it's not a huge deal. Washing dishes in the sink is his favorite activity in the world. Not holding my breath that that one will last too many years but a mom can dream. And, when I start chopping veggies or fruit he's right there. I have him pick them up and put them in a bowl or on a plate (whether I really need them there or not) just so he will interact with them. He touched wet diced tomatoes this week. That was a huge victory. He even touched some chopped broccoli to his lips recently. He didn't eat it but SOS therapy in action!!! Yippy!
He's much more interested in foods now. Even at the grocery store, I give him the produce to hold and then he puts it in the basket in front of him. The grocery store we go to has awesome carts shaped like cars that he gets to "drive" and he's a very active participant in the shopping trip. He names foods, he tells me their colors or counts the number of whatever it is we are getting. I give him choices "purple cauliflower or white cauliflower?" He may not be eating cauliflower but he is engaged and that's progress.
He starts to get excited in the late afternoon because he knows it's going to be time to cook soon. "Help cook, Mama!" One of these days he's going to be excited enough about something we are cooking together that he's going to eat it. He'll be proud of his effort. He'll be excited about whatever choices he's been allowed to make in the process of preparing the meal. And, he will want to put some in his mouth. It might be next month. It might be next year or the year after that. But, it is going to happen.
Thursday, April 25, 2013
What Clicked?
I wish I had an answer to that question. But the truth is, I have no idea. Maybe he's just gotten a bit older and braver? Maybe he's more confident about his chewing so he's less scared of choking? Maybe the cheers and praise are really enough to motivate him. Maybe he's getting enough sensory input that his sensory system is calmer and he can handle eating. His therapist pointed out that his leaps in progress began about the same time that we started swim lessons. Whatever has happened, I am the eternally grateful to the feeding aversion gods.
Yesterday during therapy he ate a chicken nugget. It was cut up into about 9 small pieces so they would be easy for him to handle and chew. Big bites are too much for him as his chewing skills are still developing. We haven't tried chicken nuggets for months. The only times he's eaten a bite or two, he's allowed us to put them in his mouth but he's never been happy about it. Today, he picked them up, ate them and then went back for more with no hesitation. No "icky" faces, no gagging, no choking. Chewing and eating and smiling because he knew how happy and proud we were. "Mama so happy!!" and "Proud of me!" Brand new sentences for him. I held back tears because I didn't want to freak him out.
THEN...get this...as if the therapy session could get any better...IT DID! He ate bites of a banana. He didn't eat a whole banana or anything but he ate bites and he liked them. He touched wet, squishy, gross banana that two months ago would have led to a massive meltdown.
Then at dinner he ate another whole chicken nugget. With no prompting, bite after bite, tossed in his mouth before he touched any of this other food. My husband and I discussed the question of whether or not, since we've stopped purees, Buster is getting enough calories. The truth is, I'm not sure. I plan to weigh him this weekend and make sure he isn't losing. So, though some feeding clinics would argue with me, I'm letting him "graze" during the day. He will eat fruity Cheerios or Annie's Cheddar Bunnies throughout the day, if I leave them out for him. That's what I've been doing and he's willingly eating his meals. He isn't too full when I put him at the table so I'm going to continue to do this.
Sometimes these little people amaze us for reasons we'll never understand.
Yesterday during therapy he ate a chicken nugget. It was cut up into about 9 small pieces so they would be easy for him to handle and chew. Big bites are too much for him as his chewing skills are still developing. We haven't tried chicken nuggets for months. The only times he's eaten a bite or two, he's allowed us to put them in his mouth but he's never been happy about it. Today, he picked them up, ate them and then went back for more with no hesitation. No "icky" faces, no gagging, no choking. Chewing and eating and smiling because he knew how happy and proud we were. "Mama so happy!!" and "Proud of me!" Brand new sentences for him. I held back tears because I didn't want to freak him out.
THEN...get this...as if the therapy session could get any better...IT DID! He ate bites of a banana. He didn't eat a whole banana or anything but he ate bites and he liked them. He touched wet, squishy, gross banana that two months ago would have led to a massive meltdown.
Then at dinner he ate another whole chicken nugget. With no prompting, bite after bite, tossed in his mouth before he touched any of this other food. My husband and I discussed the question of whether or not, since we've stopped purees, Buster is getting enough calories. The truth is, I'm not sure. I plan to weigh him this weekend and make sure he isn't losing. So, though some feeding clinics would argue with me, I'm letting him "graze" during the day. He will eat fruity Cheerios or Annie's Cheddar Bunnies throughout the day, if I leave them out for him. That's what I've been doing and he's willingly eating his meals. He isn't too full when I put him at the table so I'm going to continue to do this.
Sometimes these little people amaze us for reasons we'll never understand.
Wednesday, April 24, 2013
Adding Extra Calories
I've become an extra calorie adding ninja. Adding more calories and fat into Buster's purees was easy. A tablespoon of heavy cream here, a pat of butter there, an egg stirred in as I heated up a puree was great for calories and protein. Now that we seem to be past the puree dependency (today is day 5 of "big boy meals") it's going to be more of a challenge. I'm going to have to get creative because he doesn't like condiments on his foods. He needs whatever he is eating to have a consistent texture all the way through. In the last few days we have become very dependent on mac & cheese. So, I'm adding some cream cheese to make it a little extra fattening. I also think I will be able to get away with a dusting of parmesan cheese on veggies because he likes the flavor and for the most part, it will melt into whatever I grate it over.
Today we have therapy. I'm going to ask our therapist to try tiny bites of chicken nugget with him. He tends to try things for the first time better with her than with me. I think just the change up of person is good for him plus, I'm his mom and he feels more comfortable refusing me. Also, she's just more fun.
The following information is from Lurie Children's Hospital's Feeding Clinic site:
Do not offer peanut butter, raisins or nuts to a toddler or a child with swallowing or chewing problems.
Learn more in the Division of Gastroenterology, Hepatology & Nutrition about picky eaters – which can progress to extreme food selectivity or food aversion.
Today we have therapy. I'm going to ask our therapist to try tiny bites of chicken nugget with him. He tends to try things for the first time better with her than with me. I think just the change up of person is good for him plus, I'm his mom and he feels more comfortable refusing me. Also, she's just more fun.
The following information is from Lurie Children's Hospital's Feeding Clinic site:
Adding Calories
Each day include an extra 200 to 400 calories in your child's diet. Add calories to everything your child eats and drinks. Each of the following is about 40 to 50 calories per serving.
| 1 teaspoon vegetable oil | 1 teaspoon butter/margarine |
| 1 teaspoon mayonnaise | 1 teaspoon peanut butter |
| 2 teaspoons honey | 2 teaspoons sweet condensed milk |
| 2 teaspoons salad dressing | 1 Tablespoon tartar sauce |
| 1 Tablespoon Miracle Whip® | 1 Tablespoon cream cheese |
| 1 Tablespoon whipping cream | 1 Tablespoon cheese spread |
| 1 Tablespoon chocolate syrup | 1 Tablespoon chopped nuts |
| 1 Tablespoon jelly | 1 Tablespoon sugar |
| 1 Tablespoon syrup | 1 Tablespoon caramel sauce |
| 1 ½ Tablespoons raisins | 1 ½ Tablespoons granola |
| 2 Tablespoons hummus | 2 Tablespoons sweet and sour sauce |
| 2 Tablespoons BBQ sauce | 2 Tablespoons parmesan cheese |
| 3 Tablespoons catsup | 3 Tablespoons dry milk powder |
| 1 egg (never raw) | 1/3 envelope Instant Breakfast powder |
- One half teaspoon oil stirred into mashed potatoes, yogurt, applesauce, pudding and milkshakes
- Salad dressing, mayonnaise, sour cream and cheese spread as a dip for chips and vegetables
- Crackers or bread with peanut butter, jelly, honey or cream cheese
- Dry milk powder or Instant Breakfast added to milk, pudding and yogurt
- One cup milk powder to each quart of whole milk
- Caramel sauce, yogurt and honey as a fruit dip
- Granola, raisins, honey and nuts added to cereals or yogurt
- Tuna salad with mayonnaise and chopped hard boiled eggs
Make sure your child’s teeth are brushed after meals and snacks, especially if adding extra sweets.
Do not offer peanut butter, raisins or nuts to a toddler or a child with swallowing or chewing problems.
Learn more in the Division of Gastroenterology, Hepatology & Nutrition about picky eaters – which can progress to extreme food selectivity or food aversion.
Tuesday, April 23, 2013
If He Graduates From Harvard, This Weekend Will Still Be A Bigger Deal
We've had some huge moments of progress in the past. Eating crackers was big. Eating apple sticks was huge. Eating peas was like a miracle. But this weekend, we achieved a whole new level of breakthrough.
He started eating meals. Real meals with no pureed foods being spoon fed to him. He's eating an entire meal worth of table food and he's pleased with himself. Yes, his menu is limited but this is day #4 with no pureed food. He's two months shy of his 3rd birthday and this is the first time in his life this has happened.
His menus have consisted of various combinations of mac & cheese, applesauce, green beans, peas, apples cut into sticks and carrots. He's even requesting mac & cheese. He's never requested anything other than chips or crackers. EVER.
And the big bonus is, he's self-feeding most of it. Normally after feeding himself 3 or 4 bites he gets bored and stops. His fork skills leave a little something to be desired but he'll get it. He's actually working on it now!
It all started at lunch on Saturday. We went out to Applebee's. (Chain restaurants were something I loathed before moving to the 'burbs but now with a child who requires an environment where he can be somewhat loud, a need for relatively fast service and no one judging us for pulling out a smart phone and playing an episode of Sesame Street, I'm learning to embrace them....kinda.) We usually don't order a child's meal for him. We count on the fact that he'll pick at a few things like fries and then we'll have to feed him more when we get home. But, we ordered a kids meal this time. AND HE ATE! Mac & cheese and applesauce. He also ate pieces of fried mozzarella sticks. He actually ate so much that we didn't have to feed him more later. Amazing.
We've been praising him and telling him how very proud we are all the way through each meal. He's not a fast eater. That's fine. The point is, we're FINALLY sitting down to family meals, a dream we've had since he was born. My birthday is this week and this is without a doubt the best birthday present I've ever received.
He's really doing well with the idea that even if he doesn't want to eat something, he has to have a bite or two before he can be "all done". It's working. So, I plan to repeat exposure to certain things one meal at a time, one bite at a time until hopefully, it's an accepted food. Carrots are first one the list. Then, I'd love to find a protein other than bacon that he will accept. We've had limited success with chicken nuggets in the past so I think it's time we revisit them.
Not to be a Debbie Downer after all the joy I'm trying to spread with this post but one thing about this does worry me. With the purees, I was able to get a wide variety of foods into him...all kinds of veggies, beans, tofu, lentils...he was getting variety. Now, by quitting the purees, his nutrition will be more limited. I'm going to look at like this, it's just more motivation to keep working on new foods. With the Pediasure he gets every day and as long as he doesn't start losing weight, this is the progress we've been hoping for.
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