Questions

[TTCH785]

Hello,

  Goodbye

Edited by TTCH785 - 5/16/11 at 4:23am

[sapphire_chan]

Well there is an adoptive parents sub-forum to this one. http://www.mothering.com/discussions...play.php?f=165

The folks over there may have experience related to your concerns and be able to give you ideas.

But feel free to give more information here. Like what does she eat, what are you worried about giving her? Are you concerned about allergies? Concerned because she doesn't have eating skills for her age?

If it's the latter, you might need to work with the early intervention people in your area. They can do evaluations and work with you and the pediatrician on getting your daughter occupational therapy to give her feeding skills.

[annettemarie]

Moving to the Adoption forum.

[Polliwog]

We'd love to help if we have more information. We've helped lots of foster and adoptive children through feeding challenges.

[TTCH785]

Please Help!!!

   Hello,

Edited by TTCH785 - 5/16/11 at 4:24am

[Altair]

I saw this in new posts, I'm not an adoptive mom.

Your daughter is 14 months now, no?

And eating 15 oz of formula, 1 jar of baby fruit, some yogurt, some cereal and a few small carbs or veggies.

No, I don't think that's enough. I don't there there's enough nutrient rich foods (not cereals), protein, fats, basically the things that would satisfy her. My 12 month old east much, much more than that. We nurse, but he gets 8 oz pumped milk a day, plus at least 4 nursings, so I'm estimating 18-20oz of my milk, plus 3 full meals and snacks. His meals are much larger and fat/protein heavier than the ones you mention. Could you add in bone broths, avocados, some healthy oils, more full fat dairy, etc? I don't know that she is able to feel full on 3TBS of cereal and a half jar of food.

So coupled with a child who is used to overeating, I think this does seem like a small amount of food. I do know there is a real biological change that happens to children who are fed severely incorrectly as an infant, which is of course what you're grappling with. I was involved in the life of a child professionally who was neglectfully underfed and now as a 4-5 year old is eating all kinds of toxic non-edible foods as a compulsion. Your case is the opposite, but I'm sure it still hardwired her brain to have a different relationship with food.

I feel like overall you would want to gradually wean her down to less foods, but this seems drastic, no? Does it feel drastic to you?

[Hey Mama!]

I also saw this in new posts. I agree with the previous poster, her age combined with her feeding schedule is not adequate for her. She may have feeding issues from her orphanage, but at 14 months most children are eating 3 regular meals plus snack(s), as well as drinking milk, juice, water, etc. (in my exprience with my own kids and countless others through job experiences, friends and relatives kids, etc) I'm fully aware that not every child eats this way at this age, but I also feel that the amount of formula she is drinking is not enough to make up for what she is not eating in other food. What does her doctor say about her nutritional intake? Have you brought up the problem to them for advice?

It looks like she doesn't eat any protein or healthy fats. Are you veg? Proteins and healthy fats will satisfy her hunger and make her feel fuller longer.

[queenjane]

I havent read all the posts...but wanted to say at 14 months, formula made up the bulk of my son's calories. He certainly wasnt eating "three meals plus snacks" at that age. All kids are different. I wasnt that worried because he was drinking alot of formula (and at 26 months he still has two (sometimes three ) bottles of formula each day...he doesnt like regular milk.

[BeckC]

That doesn't seem like enough to me. Have you considered replacing the jarred food with table food and let her feed herself? A sample menu could be:

Breakfast 9am: Dry adult cereal or piece of bread, scrambled egg, piece of cut up fruit, 6 oz bottle
Snack 10:30am: yogurt or little pieces of fruit/veggies/beans
Lunch 12pm: Sandwich with sprouted/whole grain bread and meat/cheese/veggies and some finger veggies and cup of water or cup/bottle of formula
Snack 3:30 after nap: cheese and crackers or finger fruits/veggies/beans or yogurt with 4 oz bottle
Dinner 5:30: Bite sized pieces of whatever you're eating for dinner - meat/beans, veggies, fruit, grain
Bedtime 7pm: 6 oz bottle

If you wanted to stick to more bottles and less table food, I would increase each bottle by 1-2 oz and substitute more nutrient rich foods for the baby cereal and cheerios, like fruit, veggies (esp avocado and other high fat fruits/veggies), beans, cheese, eggs, etc.

[Hey Mama!]

Originally Posted by queenjane

I havent read all the posts...but wanted to say at 14 months, formula made up the bulk of my son's calories. He certainly wasnt eating "three meals plus snacks" at that age. All kids are different. I wasnt that worried because he was drinking alot of formula (and at 26 months he still has two (sometimes three ) bottles of formula each day...he doesnt like regular milk.

That is why i put a disclaimer, I know that not every child eats the same, just offering anecdotal evidence of what I have observed with many, many children. I'll go back and edit to make it more clear. But, I feel that the amount of formula isn't making up for lack of calories from food.

[lauren]

This may be completely off base, but is there any chance she could have any kind of internal parasite? I'm not sure what conditions she has been in since birth. Eating more and losing weight is the description that made me think that.

[Tjej]

I too am not an adoptive parent, but that volume of food does seem quite limited for her age. My DD was a miniature thing and she ate similarly but nursed (and I am quite sure took in more ounces than the amount of formula you are saying), but my DS is more "normal" sized and ate a lot more than that.

LOTS of kids do level off/not gain much weight from around the age your DD came home until a year or a year and a half - they start being active and don't gain as fast. That in and of itself (even a slight weight loss) doesn't sound like a big deal to me personally. BUT the way your DD seems to be behaving and feeling about food (coupled with the idea that it really does seem like a small amount of food in my experience with that age) does make it seem like something to address.

Is there a nutritionist that your pedi could put you in touch with? Or perhaps even someone through early intervention? Someone who would be well-versed in how much a child of your DD's size would normally consume in calories (and who might have ideas about handling her stress over eating)?

Tjej

ETA: Is it possible some of this behavior is from teething? Just thinking of her age/the behavior outside of the eating context.

I have an oldschool book "Your Baby and Child from Birth to age 5" by Penelope Leach. In it she describes that a child drinks about 3 ounces of formula per pound per day. That is before solids, but solids are on-top of that amount. The trick of it is that the weight you feed for is the "proper" weight for the child, but she seems to suggest that taking the child's birthweight and seeing where they would be now on healthcharts as far as size goes and estimating from that might be helpful. (So if she was born in the 50% and she stayed on that curve it'd be feeding for the weight of a 50% child her age - or I'd think you could use her height and where that falls in the %iles and see the corresponding weight and if the amount she is eating sounds like a good amount for that weight). But of course this is just conjecture on my part.

[mamadebug]

That doesn't sound like nearly enough food to me. My child would have needed a lot more food at that age. He was a huge baby/toddler, but we never limited his food intake in terms of quantity. I did make sure it was all (or almost all) really healthy options.

I would check with a nutritionist. Or consult a few different parenting books and see what they recommend. It's not my favorite book, but What to Expect the First Year I seem to remember offering sample daily menus for toddlers/early eaters (and what I remember from that would include a lot more food).

I would be inclined to give any child as much food as they want as long as the choices are all healthy. Food insecurity can be a really big deal. Maybe you need to talk to someone with more experience with adoption than most pediatricians have. At the orphanage, she was drinking tons of bottles, eating lots of simple carbs and had limited physical activity. I think if you limited her bottles (3 or 4 8oz bottles sounds about right to me for that age), offering her lots of fruits, veggies, whole grains and getting plenty of physical exercise, I think you should let her eat as much food as she needs to be content and shouldn't worry too much about her weight.

[mamadebug]

I just reread your last post, and there is no real lunch for her in there. Not sure if you left it off accidently. But a 3oz bottle in place of lunch (or a larger bottle) doesn't sound like enough to me.

[Polliwog]

I agree with the others. That doesn't sound like nearly enough food (whether it's through formula or solids.) I'd consult a pediatric nutritionist. Nutrition isn't really what pediatricians are trained in. And I'd definitely start giving her more whole grains and protein (bits of meat, tofu, egg, cheese, etc.)

[SpringRain]

My son came home from Ethiopia at about 6 months old and he had feeding issues too. He was terrified that there wasn't going to be enough food and would cry and demand a bottle every time he woke up even if he had just had one 10 minutes before. He always finished his bottle and food even if it made him throw up because he seemed to be afraid he wouldn't get more and needed to stock up. He was a big baby, 95% for height and weight. After talking about it, DH and I decided to meet his needs just as we did with our bio children, by letting him eat on demand. We knew that he was scared that he wouldn't get enough to eat and we felt that by allowing him to eat anytime he wanted, he would eventually learn that there would always be enough food.

It took a while, but over time he became more patient with waiting to eat and became comfortable with leaving food on his plate when he was no longer hungry. Now, at three, he doesn't seem to have any lingering food issues at all. He does eat way more food then either of my bio girls did at the same age, which can be surprising sometimes, but I have to remember that every kid is different. He is now in the 50% for height and 75% for weight and is a healthy, happy kiddo. Our ped says he's perfect!

[sbrinton]

I didn't have time to read everyone's responses, but as a mom who is soon to be adopting a little girl from ethiopia, my heart goes out to you. I am also a family nutrition coach, so I hope I can be helpful.

First of all, I don't think loosing weight is a good goal for a baby. Babies come in all shapes and sizes and a better goal might be for her weight to be stable while she grows taller so that she is leaner. Second, I wouldn't worry too much about her weight at this age. I would encourage her to develop healthy eating habits, introduce her to a wide variety of foods, model good eating as a family, live an active lifestlye...and give it time.

I would take an entirely different approach from your pediatrician. I would invite her instead to be a part of the family, participating at family meal times. Second - and I feel very strongly about this - I believe it is the parents' responsibility to offer healthy, yummy food at appropriate times (3 meals and 2-3 snacks a day) and the child's responsibility to decide how much to eat.

Next, I would look closely at what your whole family is eating. If you want to restore your daughter's natural sense of hunger and fullness - or her ability to be an intuitive eater - you need as a family to eat real, whole foods the majority of the time. This means lots of fruits and vegetables and moderate portions of whole grains, lean meats, fish, tofu low-fat dairy products, and healthy fats. You need to begin to avoid highly processed foods, especially foods containing high fructose corn syrup and hydrogenated oils.

As your daughter is over a year, I would begin weaning her off the bottle entirely. It's also time to be done with baby food. There is no reason your daughter cannot be eating what everyone else in your family eats most of the time.

It seems like the bottle is a comfort object, so it might be a slow process, but I would try to look for alternatives. Maybe you can add a special stuffed animal or blanket that you always give her with the bottle and than slowly take away the bottle while still giving her the comfort object? Another strategy would be to transition to sippy cups.

I would offer milk in a sippy cup with at least 2 meals a day instead of at bedtimes. She doesn't need juice, but if you do offer juice occasionally, add 1 part water to 1 part juice.

One idea would be to create a nibble tray for her. Take a plate with several sections or even an ice cube tray and fill it with lots of little finger foods. Fill at least half the plate with toddler friendly fruits and vegetables. Fill the rest of the tray with a little whole grain (cheerios, whole grain toast squares, whole-wheat noodles) and a little protein (cheese, sliced chicken, edamame, tofu, beans).

And then let her decide how much to eat! Eating with her fingers will slow her down and maybe allow her to experience when she is full. I would also offer her plenty of water in a sippy cup so that she does not mistake her thirst for hunger.

Find ways to help her increase her activity level. Have her crawl up the stairs instead of you carrying her, encourage her to walk (with your help) to meals and diaper changes, go outside and play, take a baby gym class. If she is more active, it may help her lean out but it will also help her in so many other ways - among other things encouraging motor development and strengthening her immune system.

I would suggest several books: The Family Nutrition Book by Dr. William Sears and How to Get Your Child to Eat, but not too much by Ellyn Sater. Both are excellent!

[Polliwog]

Originally Posted by sbrinton

I didn't have time to read everyone's responses, but as a mom who is soon to be adopting a little girl from ethiopia, my heart goes out to you. I am also a family nutrition coach, so I hope I can be helpful.

First of all, I don't think loosing weight is a good goal for a baby. Babies come in all shapes and sizes and a better goal might be for her weight to be stable while she grows taller so that she is leaner. Second, I wouldn't worry too much about her weight at this age. I would encourage her to develop healthy eating habits, introduce her to a wide variety of foods, model good eating as a family, live an active lifestlye...and give it time.

I would take an entirely different approach from your pediatrician. I would invite her instead to be a part of the family, participating at family meal times. Second - and I feel very strongly about this - I believe it is the parents' responsibility to offer healthy, yummy food at appropriate times (3 meals and 2-3 snacks a day) and the child's responsibility to decide how much to eat.

Next, I would look closely at what your whole family is eating. If you want to restore your daughter's natural sense of hunger and fullness - or her ability to be an intuitive eater - you need as a family to eat real, whole foods the majority of the time. This means lots of fruits and vegetables and moderate portions of whole grains, lean meats, fish, tofu low-fat dairy products, and healthy fats. You need to begin to avoid highly processed foods, especially foods containing high fructose corn syrup and hydrogenated oils.

As your daughter is over a year, I would begin weaning her off the bottle entirely. It's also time to be done with baby food. There is no reason your daughter cannot be eating what everyone else in your family eats most of the time.

It seems like the bottle is a comfort object, so it might be a slow process, but I would try to look for alternatives. Maybe you can add a special stuffed animal or blanket that you always give her with the bottle and than slowly take away the bottle while still giving her the comfort object? Another strategy would be to transition to sippy cups.

I would offer milk in a sippy cup with at least 2 meals a day instead of at bedtimes. She doesn't need juice, but if you do offer juice occasionally, add 1 part water to 1 part juice.

One idea would be to create a nibble tray for her. Take a plate with several sections or even an ice cube tray and fill it with lots of little finger foods. Fill at least half the plate with toddler friendly fruits and vegetables. Fill the rest of the tray with a little whole grain (cheerios, whole grain toast squares, whole-wheat noodles) and a little protein (cheese, sliced chicken, edamame, tofu, beans).

And then let her decide how much to eat! Eating with her fingers will slow her down and maybe allow her to experience when she is full. I would also offer her plenty of water in a sippy cup so that she does not mistake her thirst for hunger.

Find ways to help her increase her activity level. Have her crawl up the stairs instead of you carrying her, encourage her to walk (with your help) to meals and diaper changes, go outside and play, take a baby gym class. If she is more active, it may help her lean out but it will also help her in so many other ways - among other things encouraging motor development and strengthening her immune system.

I would suggest several books: The Family Nutrition Book by Dr. William Sears and How to Get Your Child to Eat, but not too much by Ellyn Sater. Both are excellent!

I disagree, in this instance. I wouldn't take away her bottles or her formula (if she's not eating enough in food to get at least 1,000 a day.)

[LaffNowCryLater]

I think she may need more food. The amount of food you give her is what I give my children around 8 months old, maybe even 7 months.

[queenjane]

Can i ask why her bottles are so small? I see you give her 4 and 5 oz at a time...any reason why not 8 or 9 oz? at some point (six months maybe? cant remember) my son moved up from the 4 oz bottles to the 8 oz ones. As an infant he was eating every 2.5-3 hours, on demand (the dr at the time thought he was too fat and i should offer him water instead ), and i know by the time he was 10-11 months he was having 4, sometimes 5 bottles (8 oz) a day. A different doctor said that was too much "he's almost a year old" (no actually he was ten months old)...and that i should offer him more solids. But he didnt want more solids. And i felt that at least by drinking lots of formula he was getting nutrients and calories.

I think that she should be getting at least 24 oz of formula, milk or a milk substitute a day. At least if you increase her formula you dont have to worry so much about a toddler diet that may not be adequate (i know there are days my son hardly eats anything, then days where he eats more food.)

As your daughter is over a year, I would begin weaning her off the bottle entirely.

Why? Why is a "lovey" lke a stuffed animal or a blanket a better comfort object than a breast-substitute like a bottle?

No one would think to tell a nursing mom to stop offering the breast at a year. My son *bottlenursed* until 15 months old (that is, he would not hold his own bottle, i had to give it to him, usually in the cradle position, i had to lay down with him at night and give him the bottle til he fell asleep, etc) and only weaned from it (the bottle nursing, not the bottle) when he saw our new foster child could hold HER bottle. He still very much associates formula and bottles...will not drink formula from a cup but has no problem drinking other things (juice, water) from a cup, and in fact refuses anything else in a bottle but formula. I think the current recommendation is to keep babies on formula until age 2 instead of switching to cow's milk at a year, if you can afford it.

I guess it bothers me when people are so quick to "get rid of the bottle" ESP if they are doing it to wean them from it as a comfort object.