Catherine's transition to table food diary

[sixdogssixcats]

I love this idea!

Catherine is 2 years old (or will be in 5 days). She's been treated for reflux since she was 10 days old and is still being treated. She also has many sensory issues and didn't eat solids at all in any measurable quantity until about 12mo. And by this I mean purees, not table food. She still consumed primarily purees until 18mo with the addition of dry, crunchy things like Cheerios and crackers. She was still on Alimentum formula until 20mo and then off and on as needed as this was her primary protein source. Now at 2, her GI feels she's big enough and old enough to try a little tough love and force her to regular meal times (she was an all-day grazer) and eat the same food we all eat. Weighing in at the whopping 5th percentile, he thinks she has enough meat on her bones to try this experiment. He says most kids come around in 2-3 days if the parents can just stick to their guns. By the way, the 5th percentile in weight is huge for her. She's been 3-4th for as long as I can remember.

So, tough love starts today, January 13. Catherine weighs in at 22.75 pounds. Up until now, her diet consists primarily of yogurt, oatmeal, applesauce (note the mushy common denominator here?), dry cereal and crackers. She takes Poly-Vi-Sol with iron and 4 Tums for calcium daily. She does not drink liquid milk as dairy products cause her to poo rocks.

Breakfast: She ate one small biscuit and asked for a second but fed it to the patiently waiting dog. She drank a small cup of root & fruit juice with her morning dose of Axid in it.

Lunch: She was offered Spaghetti-o's and pears, just like big brother, and a slice of muenster cheese (which she usually eats). She ate nothing. She had a small glass of pineapple juice (good for constipation!) and was happy to get out of her high chair.

Don't think she's filling up on juice ... each cup she gets is only 1-1 1/2oz and diluted 50/50 with water unless I need it to cover up a dose of something.

Can't wait to see what kind of a miserable failure dinner will be! I'm going to bake a turkey breast and have mashed sweet potatoes with it. Plus a green veggie of some kind.

[Becky in NM]

Are you going to have her weight checked after doing this awhile?

Here's some not-so-tough love from me and D for you guys -- our partners in food experiments:

[sixdogssixcats]

Her 2yo check-up is on the 19th, next Friday, so we'll hold off on any weighing until then. I'll drive myself crazy weighing her. Actually, I'm going to have to restrict myself because I usually do weigh her every day. I'm probably setting her up for an eating disorder with the constant weighing.

[sixdogssixcats]

January 13

Afternoon snack: I decided this should be something I know she will eat. I gave her about 1/4 cup of vanilla yogurt mixed with whole grain/flaxseed/blueberry oatmeal, and she inhaled it and wanted more. I held firm, though, and cut her off.

Dinner: We were out antique-ing, in search of a sofa table and mirror for our front entryway, and decided to try a little pizza place near home. Pizza is a fave of the girl, surprisingly. She ate about half a slice of plain cheese pizza!!!! I'd like to think there is something to this plan we're on, but she would have eaten pizza anyway. I know had I prepared a meal at home, she wouldn't have eaten a single bite.

So, I guess we won the battle but the war is far from over.

[Katey]

It is good to do some things that you know she will eat to keep your spirts up. I hope the plan will work.

[Becky in NM]

It's good to start off with a success, even if it means cheating a little with pizza.

[pedi-ot]

Lesley:

I think you are off to a great start! She is definitely a sensory girl as noted by her texture preferences (either mushy or crunchy). I was impressed with the pizza though. I have found that many of my patients do well in restaurants because of all of the distractions IF they do not have significant auditory sensory issues that make them "shut down."

At that fun age of 2, Catherine is in the "picky toddler" stage of eating. I typically recommend 5 small meals or 3 meals and 2 snacks. Meal times must be with family for socialization and modeling purposes. In my feeding clinic, I offer 3-4 foods at most during a meal. If there is gagging, it is ignored. If there is vomiting, I throw a towel over it and we continue to eat. I do not blink an eye and that is what I teach my parents to do. My patients have their parents so conditioned to freak out, that they typically get their way. All they have to do is gag or vomit when a new food is introduced. I stand behind your GI! Keep up the great work Lesley!!!!!!

Robynne

[sixdogssixcats]

Thanks for your insight, Robynne!

January 14:

Breakfast
1/2 cup oatmeal mixed with vanilla yogurt - ate nothing (and this is normally a fave)
4oz pineapple juice with vitamins and Axid - drank all
Dose of Cefaclor

Lunch
4oz cup of unsweetened strawberry applesauce - ate all
1/4 grilled cheese sandwich - wouldn't touch
slice of muenster cheese - took a couple of bites and crumbled the rest

NO NAP!!!

Snack
approx 1/3 cup of dry Cheerios - ate all and wanted more, which were not given
2 Tums

Late afternoon b-day party - offered vanilla ice cream cake and refused to even taste

Dinner
1 slice cheese pizza (think personal pan pizza from Pizza Hut size - very small)
Refused 2 Tums

Drank ice water all day long with exception of breakfast juice

Bedtime
Dose of Cefaclor and took sippy of water to bed

[sixdogssixcats]

January 15:

Breakfast
1 whole wheat/flaxseed waffle - ate 1/4-1/3 of it. Dog got the rest.

Lunch and afternoon snack
Unknown ...forgot to ask babysitter

Dinner
Catherine is getting sicker again after one good, mostly snot-free day yesterday. And this on a dose of antibiotic that's more than 3x what a child her size should be taking. She cried and clung to me like a leech from the moment we got home. I know she's not recovering and is whiny and miserable. Moreso than usual. I caved in and gave her a waffle for dinner instead of forcing her to eat the turkey, sweet potatoes and green beans we were having. She actually ate most of the waffle and had a few sips of milk. I then offered her tiny portions of what we were having and she nearly knocked her plate off the table. She spent the rest of the meal trying to get me not to eat all the while trying to climb up me.

Bedtime resulted in 45 minutes of shrieking even though I went in about the halfway point and just sat on the floor in the dark and held her until she calmed down. That was shortlived as she started up again shortly after I put her back in bed.

[pedi-ot]

Lesley:

I think I read yesterday something about water all day. Does this mean she drinks it all day or just at meals?
Has Catherine had any MBS studies? How long has she been on prolonged antibiotic use? Which one is she on and how much?
Does the GI want you to give her exactly what the rest of the family is having? What about using a "favorite Catherine food" as a motivator to eat 5 bites of 1 or 2 new foods. I know the doc said use the tough love approach, but 2 year-olds do not often understand that Lesley. Consider using a form of primary reinforcement. Make it obtainable and something she looks forward to. If she takes 5 total bites of the sweet potatoes, green beans, and turkey, she can have her waffle and a sticker( or play with a toy for 5 minutes, read her favorite book, watch her favorite video, etc.) Think about this from Catherine's viewpoint. She is only 2. I know this is hard and you are doing a great job

Robynne