15 January 2014

The Pickiest Eater

To say that Abigail is a picky eater is to make a gigantic understatement.

Most moms of picky eaters bemoan, "He only eats chicken nuggets, macaroni and cheese, and spaghetti!" All I hear is: "my child only eats protein, calcium, whole grains, antioxidants, and, if I use the veggie-based pasta, fiber!" And usually, the list isn't actually that short. Usually the picky little eater will consume almost every kind of pasta, fruit, most breakfast foods (bagels, pancakes, etc), cereal, pizza, quesadillas, mashed potatoes, and every kind of dessert.

If Abigail's list was that long, I'd be in heaven. I'd never be complaining if Abigail got iron and protein from meat; I'd squeeze some spinach into anything with pasta; There'd be chopped-super-tiny peppers sneaking onto that quesadilla; The pizza would be homemade with whole-wheat dough, light on the cheese, and I'd compromise the pepperonis with some mild-tasting veggies hidden under the cheese.

Abigail eats eight foods. Not joking. I can even list them for you.

- Cheerios
- grilled cheese (only with sharp cheddar on store-bought bread without the crusts)
- pancakes/french toast (general speaking, it must have a generous amount of syrup)
- graham-style crackers (straight grahams, graham goldfish, animal crackers)
- granola bars (as long as they are the Quaker Oatmeal style - nothing sugar-free)
- most fruit, most days
- most desserts, most days
- fast-food french fries

Abigail will occasionally eat instant oatmeal, yogurt, and eggs, but she has to be very hungry and it has to have been awhile since she last ate them. And not that I'm complaining about the Cheerios, since of all cereals, that is a good one to favor, but just to demonstrate her pickiness, she doesn't eat sugar-covered kid cereals. Lucky Charms? Nope. Blueberry graham cracker cereal? One bite that was promptly spit out onto the floor.

She doesn't eat chicken nuggets. Dipping them in ketchup or ranch makes them even worse. She's eaten macaroni about three times in her life, each time downing a generous five noodles before signing, "all done." She doesn't eat mashed potatoes, even with butter and cheese and served on a goldfish cracker. I once got her to eat a bite of quesadilla at 2pm when she hadn't eaten since breakfast. The second bite was thrown directly on the floor.

I can add blueberries into the pancakes, but since she eats fruit anyway, I'm not very concerned about the extra fruit. I can sneak tiny bits of spinach onto the grilled cheese. It adds up to about one leaf per day.

I have tried everything. It doesn't matter if she "picks it out" at the grocery store, helps me prepare it, plays in it, feeds herself, or is spoon fed. It doesn't matter who feeds her, if there are kids around her eating without complaint, or if she hasn't snacked between meals. She couldn't care less if her mashed potatoes are smiling up at her from her plate or if the pasta is shaped like Hello Kitty. And she doesn't care how hungry she is. I've tried the "eat this or go hungry" technique. She didn't eat anything for an entire day. And then she didn't eat dinner for four consecutive days. One bowl of Cheerios for breakfast and a grilled cheese for lunch, no snacks and only water. For four days. She refused dinner. By the morning of the last day, she was so lethargic, she could barely get up off the floor. I truly believe she would starve herself rather than eat sweet potatoes topped with marshmallows. She's two-and-a-half and weighs 21 lbs - it's not like she was living off fat stores.

I've researched my brains out. I've read the "picky eaters" section of every parenting book I own and a few from the library. I've spoken with all of her therapists, her pediatrician, and several nutritionists. I've tried everything. No matter what we do, we take one step forward and two steps backward. Every few months, I review her diet and it's worse than it was before.

About two weeks ago, I sat down at the computer during nap time and prepared myself for another round of research. She's been trying to phase out the Cheerios and grilled cheese and I was feeling desperate. When we come across a behavioral problem, I usually give the benefit of the doubt to, "she's a two-year-old, which means she's a pain in the ass" before I blame Down syndrome. But still, I thought I'd researched Ds and picky eating before. I would have put money on it.

I decided to do one quick "Ds and picky eating" Google search before I started looking through the typically developing websites and chat boards. Just one real quick, I told myself, annoyed even as I typed the words.

Mega Freakin' Millions Jackpot

I read about kids who make picky eaters look like hosts on those travel shows who eat fried locusts. Just. Like. Abigail. In fact, it turns out that in the world of Ds, Abigail is an advanced eater. I read about plenty of kids her age who are still on pureed food. At least half of the kids I read about had moms who would be just as jealous of that picture of Abigail eating a grilled cheese while holding it herself as I am of the moms whose kids "only" eat a laundry list of foods. Massive relief washed over me - I instantly called Matt to share the good news: we're normal! In our own little subset world of "not normal," we're normal.

The bad news: Ds and picky eating takes years and years of work; it is a one step forward, two steps back process for a really long time; we will have to fight very hard to take that one step forward - each. and. every. time.

But, hey, at least I can console myself with the fact that we're normal! And be thankful that we're not still on pureed foods.

I checked out a book from the library that came up a few times in my research. From a brief skim, I'm pretty sure we've already tried most of the techniques, but I'll give it a read anyway. And I also bought a tray to make my own popsicles - Abigail isn't the biggest popsicle eater, but I'm going to try to make my own veggie-based ones. Of all the nutrients Abigail is lacking, fiber is one of the biggest (as are good fats, but luckily I can get away with dipping crackers in peanut butter a few times a week and she drinks full-fat milk).

My basic understanding of why Abigail's a picky eater is that it's a very complex issue made up of lots of different complications.

- Abigail's life-long reflux probably turned her off to a lot of foods. Re-visiting your food when you vomit it up 12+ times a day will do that.
- She has really complicated sensory issues that I don't fully understand. To a large extent, she doesn't get enough feedback from the food in her mouth. (Generally speaking), she needs crunchier or spicier or sugary foods so that her mouth can accurately gauge how much food is in it and where it is.
- She's got texture issues. I'm not exactly sure what this is or how this works, but I figure it's related to her sensory issues. I do know both the sensory and texture issues are because of the Ds.
- She is a creature of extreme habit, be it because of her personality or the Ds. She does best when we are at home, eating the same foods at the same time in the same place. She does not eat much when we are not at home and she rarely eats when other people feed her.
- All of the above make her an extremely cautions eater. She must be very, very certain that all her foods look exactly like they should. She doesn't eat Cheerios that are broken or too thin. She doesn't eat graham cracker goldfish heads. Back when she used to eat regular goldfish crackers, she wouldn't eat the "fillets," by which I mean, if it broken in half, it went straight to the floor. She is very hesitant to try new foods, even if the closely resemble well-loved foods (I seriously thought the blueberry graham crackers would be a smash hit).
- Lastly, she is a toddler and a fair number of typically-developing toddlers are picky eaters.

I'm not exactly sure where to go from here. Because she is continue to develop physically and cognitively, most of her "medical personnel" are not concerned about her lack of slow weight gain. My main concern is that she is getting all of her nutrients and that we not revert her to a formula-based diet. I'll read this new book, we'll keep trying new techniques as we learn about them. I need to get myself involved in the Ds community up here so that I can learn from other people's experiences. And I'll keep charting out her diet every few months. Figure out what's lacking and do the best I can to fix it. The only thing I do know is that I'm not giving up. I'm never going to give up. We'll keep plugging away until we find success. Even if it takes years.

1 comment:

Amelia@One Catholic Mama said...

You've probably already tried this, but since she drinks milk and eats fruit, would she drink a fruit-smoothie? You can "hide" a lot of nutrients in a fruit smoothie...coconut oil, peanut butter, spinach, flax seeds..even protein powders.

I make my smoothies by blending frozen fruit with yogurt (but you can use whole milk...it's just thinner), and then add in things like honey (if I'm using milk or unsweetened yogurt...I skip this with sweetened yogurt), flax seed, peanut butter, coconut oil, maybe some spinach leaves etc. If you have a REALLY GOOD blender or food processor it will blend everything up really well so it's all one smooth consistency,