Hi, I would like to get your opinion on my peds plan for getting my son to eat new foods.

Sebastian has had many food reactions and was only able to eat 5 foods from 6-12 months. We have now been able to add a few new foods without reactions, but he still has food allergies that we have to work around.

He is also a very picky eater. It is really hard to get him to try new things and if I do get a bite into him he will spit it out. The new foods he has like he ends up reacting to and can not have. He loved corn and yogurt, but he can not have those. He used to only eat pureed foods and would chew and spit and finger foods. He stared finally eating finger foods at about 13 months and now he refuses to eat anything off the spoon.

We currently know that he is allergic to milk, soy and corn. The only foods that he will eat are: whole wheat pasta, whole wheat toast (plane), rice noodles, frozen carrot chips (sometimes) Clifford Crunch cereal, and Sesame Street Letter of the day cookies.

The dr wants me to get him eating eggs and meat and taking in less formula. I know he can have chicken, because I used to be able to blend a tiny amount into his baby food, but if he tasted it at all he would not eat the food. I have not tried any other meats with him. I have been trying to try eggs, but he will not have anything to do with them. I put a bite in his mouth and he spit it right out and threw the rest on the floor. If I try to leave them on the tray he will throw them all off.

My peds plan was to cut him down to 16 oz of formula a day and to only offer the foods that I want him to try. His theory is that if he gets hungry enough he will be willing to eat the new foods. He said if this did not work, he could give him some medicine to increase his appetite.

I am doing good with cutting back the bottles, though he is not happy about it, but the food is a lot harder. He gets so worked up and will throw all the food on the floor. He can also get the tray off his high chair and throws that on the floor too.

I tired getting him down and then trying again the next time he asked for a bottle, but he just freaked as soon as I put him in the high chair and threw a major fit. I put a small bite of egg in his mouth and then tried to reward him by giving him his cereal and toast (what he normally eats for breakfast) and he would not have anything to do with it. He threw all the food on the floor and pushed off the tray again.

He then stood under his bottle rack and screamed for a bottle. I finally put him in is little booster seat with a tray and gave him the toast and cereal while he watched Sesame Street. He was happy with that and ate his normal amount (1/4 piece of bread and a handful of cereal) but he never did eat the eggs.

I understand the peds thinking, but I am just not sure it is going to work with Sebastian. He is a very stubborn kid and I am worried that this will only end up making him eating worse, by turning it into a power struggle.

Do you think this is the right approach to take or do you have a method you think would work better?

Thank you for any feedback you can give me.

Hi Katey:

Sebastian is obviously telling you that the pedi's plan is not high on his list :hissyfit: . I think what you may want to look into is some behavioral techniques in conjunction with what already works with Sebastian.

I see a "crunchy" trend in the favorite foods he eats (cereal, cookies, toast, frozen carrot chips). I also see the pastas he likes. Factor in that age of autonomy where the little ones realize they can feed themselves. That autonomy and sometimes food aversion makes a child panic and flail when a spoon comes towards their mouth. I also would put any food on the tray table because that's an invitation for a "dumping."

Let's talk about possible foods to present first. Get off of the egg thing and come back to it later. They are very mushy for kids who have "texture" issues. We can find protein elsewhere. Also, get the heck away from baby foods. They are bland and offer very little caloric value. How about crunchy chicken nuggets? Of course you will have to check the ingredients for milk/soy products, but specialty grocers sell many gluten free products and I suggest you go spend a couple of hours browsing there. You will find a whole new world of food products for people who have food allergies. I know, my child is on a medically restricted diet. I have to order many foods from out of state vendors (most people do not have to go to that extreme). He is on a low protein diet. Cereal bars (again check your gluten free grocer) are a big hit for the self-feeders. Bologna shapes are also a big hit.

I want you to place Sebastian in his toddler seat in view of the t.v. without his bottle in sight. Give him a bite of something you know he likes (toast for ex.). When he eats the bite of toast, turn on the bells and whistles with praise, but also turn on the Sesame Street video for 6 seconds only. Quickly turn it off. Give him 2 more bites of toast this same way. Now offer a bite of something new. The second it goes into his mouth, praise him immediately just as you did above. You are conditioning him. You are not allowing him to throw the food on the floor either. Sebastian will learn that if he eats food, he will get positive reinforcement. He should soon enjoy eating without power struggles and you will be able to fade out the tv/reinforcement.

Regarding the PeriActin (appetite stimulant)...I highly recommend trying it. You are telling me your son has all these allergies. They may be getting in the way of his appetite. You can also discontinue the drug if it isn't working. I see many patients who do very well on it though :)

Robynne

Thank you very much. I will give it a try and see how he does! How do you order food? I know there are products out there that don't have milk, soy or corn, but none of our local grocery stores carry them (rice cheese without casein, chicken nuggets and waffles for example).

I have one more question for you, sorry for being a pest. I noticed that Sebastian still does not chew his food. They commented on it at his swallow study, but said it was normal for his age (9 months at the time). Is that still normal at 14 months, or should he be chewing things by now?

He takes bites really well, and actually prefers his food in big pieces and not cut up, but he will swallow the bite whole or suck on it until it gets soft and then swallows it. I thought he was chewing his crackers and cookies and toast, but when I stated watching him I realized the he is just sucking on them.

It is amazing what he can get down without chewing, he poops out huge pieces of carrot (sorry, I know that is gross) and will swallow a whole rigatoni noodle if I don’t break it up first. He coughs and chokes a lot while he is eating, big surprise.

There have been times when I really thought he was chewing, so I don’t know if it is a matter of him not being able to chew, or just not doing it. But when I really watch him it seems the food is usually at the front of his mouth and he is sucking not chewing.

Hi Katey:

To answer your first question, there are several food companies that cater to people with medically restricted diets. We order from Cambrooke Foods. There is also Dietary Specialties, EnerG Foods, and many others. Taste Connections in CA is another good one. My Drew cannot have milk or soy either. We have to make his bread, pancakes, and tortillas. Birthday parties prove to be a bigger challenge. Cambrooke has excellent baking mixes and pastas. Drew eats basically fruits, veggies, and very limited carbs in addition to his special foods. He has the ULTIMATE diet challenge and remains to be my pickiest feeder of course...lol. I have a freezer just with his foods in it and cook for him on the weekends.

Yes, Mr. Sebastian should be chewing now. I don't know if he has any restrictions from the swallow study as far as liquids are concerned, but a mesh food bag (typically sold at Babies R Us) is a great way to teach him to chew. I have parents put juicy fruits (apples and oranges) in the bags and let the patients chews on them. Another treatment strategy I use is Twizzlers. I place these back to the molars to get the kids to bite down (not bite off a piece). This way they get some of the flavor on their teeth. When I present crackers to patients, I place my thumb over most of the cracker and present the piece to the molars again to initiate chewing. I hope this helps.

Robynne