Adoption related-Still food obsessed - Page 8

[Hykue]

I'm not a parent at all yet, not to mention an adoptive parent, but I read through this whole thread, and I wanted to mention that the distended belly thing didn't strike me as worrisome at all. Maybe if I saw pictures it would, but I doubt it. Up until I gained a bit of weight 4 years or so ago, this happened to me every time I ate a big meal. I was always fairly thin (5'8" and 117 lbs from age 17 to age 26), and when I ate, it made my belly enormous. My friends and I used to joke about it, my "food baby" and say that we should show the picture to my hubby and tell him I was pregnant. I really did look pregnant sometimes - not nine months, but six or seven. That was normal for me. Now I'm a normal weight (according to my BMI) and that doesn't happen so much. I just wanted to give you some reassurance that it's possible this is just what her belly does, nothing to do with umbilical hernia (I'm pretty sure I didn't have one), nothing to do with weak abs (okay, my abs might have been a bit weak), nothing to do with food obsession (although I could always impress the teenaged boys by being able to eat more than them at every meal).

Other than that, keep up the good work, it really shines through in this thread how much you care and want to do the right thing. That desire is the most important component of good care, it sounds like to me. I hope you all have fun in Disney!

[lauren]

I want to post some information even though it might not be part of the problem or the solution. I was at a conference today with an infant mental health specialist and she was talking about cultural differences in parent's responses. She happened to mention that she knew of an intern from Ethiopia who educated her about how in Ethiopia as a rule parents have a cultural pattern of overfeeding babies because it is a culture in which famine can be literally not far off at any time. So the culture has adapted around a pattern of feeding babies way more than it would appear that they need--even deliberately ignoring the baby's cues of satiety and continuing to force feed baby when s/he is spitting out, etc. I just thought this cultural perspective might be worth looking into in greater depth--perhaps seeking an adoption specialist who is very familiar with Ethiopian culture and other Ethiopian adoptions. Just tossing this into the pile for consideration.

[Monie]

Hi Anna
I don't often come around MDC anymore, but I saw this topic and wanted to respond. I want you to know that adoption-related food issues can get better.

I am mama to three kids, two were adopted from China. My younger daughter has been home for almost 4 years. She was malnourished when she came to us and is still very small and skinny for her age. We had severe food issues with her when she first came home.

I had to throw away all the ideas that I had about food and children, and discover how to help her heal from her issues. She is almost 6 now, and we haven't had a food-related meltdown in well over a year. What helped the most was availability of food. ALL THE TIME. I fed her healthy, good food for meals and snacks, and bought cheerios by the truckload. She always had a baggie of cheerios available to her. I stashed them in the car, the diaper bag, the stroller, at Grandma's house, in my older dd's backpack, etc. She needed to have the security of being in control of this. If she ate until she got sick, I cleaned her up and refilled her baggies of cheerios.

Now she can play at the playground and not be obsessed with what everyone else is eating. She doesn't ask perfect strangers for their food anymore. We can leave a restaurant now without having to wrap up ALL the leftovers from all of our plates and taking them with us. One of us doesn't have to pay while the other drags a screaming child out because of all the food on the other people's plates. She doesn't need her bags of cheerios anymore. She understands that there will always be food available to her, and that she doesn't need to eat it all at once. She has come to trust that we, as her parents, will provide for her. I won't lie to you, it took a long time and a lot of tears and second-guessing ourselves, but it did work.

Have you asked your adoption social worker for a recommendation to a specialist who is well versed in adoption as well as food issues? He or she should be able to help you, or find out who can.

Lastly, physical issues - has your daughter been tested for parisites such as Giardia? Is it possible that she was suffering from "wet malnutrition" when you brought her home and your doctor did not recognize this?

good luck, I hope you will be able to find something that will work for her and you both.

[pumpkinhead]

Hi Anna. I have been following this thread but haven't posted as yet. I wanted to tell you that I think that you have been amazing on this thread :.

I also wanted to say (if it hasn't been said already) that there are several intestinal disorders that can cause extreme bloating after a meal and can also cause what seems to be insatiable hunger due to vitamin malabsorption. Things like IBS, Crohns/Colitis as well as Celiac can cause this.

I hope things continue to improve for your dd.

[butterflyblue]

Anna - I don't have a lot of advice, I just wanted to put my experience out there for you to consider.

We adopted from foster care, kids that had been neglected. They had been in foster care already for over a year, and still ate until it hurt. We never let them eat enough to throw up. My DS was 20 months when they came, and DD was 3 and a half years. DS would get very upset if you touched his food, even to cut things up or otherwise help him. Both of them would follow you around the kitchen, big eyed, whenever you were preparing food.

At the first caseworker visit she seemed concerned that they had gained weight, so I began to watch more closely what they were eating and what I gave them. The caseworker, who you would think had experience with kids with eating issues, seemed to be at a loss with how to deal with it.

I started reading up on how much toddlers should eat (and talking to other moms) and keeping track of exactly what I gave them. I didn't really cut back on their food, much, but did make healthier substitutions. If, say, they had eaten a lot of lasagna, I might put the lasagna back in the fridge so they wouldn't ask for it (out of sight, out of mind seemed to apply) but I would give them unlimited seconds on green beans or carrots, and a handful of cheerios after dinner.

I fed one snack in the morning, and one in the afternoon. At first we gave them a lot of juice, but then I realized they weren't getting the recommended amount of milk, and made juice a once-a-day thing. Usually a snack had peanut butter or yogurt, some kind of protien, as well as some whole wheat bread or other carbs, and a fruit or veggie. I treated it almost as a mini-meal. I didn't focus on calories much, but instead on the food pyramid number of servings for different categories. There is a website that gives you a personalized food pyramid for your child's age (and maybe weight?). If they wanted to eat a little more than the recommended # of servings, I didn't sweat it too much. Everything I read on child nutrition and obesity didn't seem concerned with toddlers. I thought it was more important to deal with the problems we had (not feeling secure about food) rather than the ones that might crop up later (obesity due to unhealthy habits).

I did realize that some of my own food hangups were coming into play, and I didn't even know until then that I had hangups.

Now a year later, and things really have changed. Sometimes DS is actually a little picky. I take that as a good sign. They just vacuumed up everything in sight, before. He doesn't mind if we touch his food, and while they are always a little concerned before mealtimes about what I'm doing in the kitchen and whether I'm fixing food, I think it is more normal, they just check up in between playing, it's not the only thing they're doing.

So I think with time, you'll find solutions that work for you, even if the end isn't in sight yet.

Oh yeah, if they got upset when we started putting away the food after a meal, we told them we were "saving it for later". That way they knew there was food to be had later, and it seemed to help them not stress about it as much. We also worked with them at recognizing their body signals for fullness - it's hard to tell how much good that did with DS, since he still doesn't say he's "full" unless his plate is empty, but it did seem to help DD.

[carol7906]

Another idea

Anna,

I know you've received a lot of replies and hopefully your situation is better but in case it's not I wanted to offer another idea. Since your little girl was examined by a doctor and found not to have any medical problems, it may be trauma related. A lot of kids who have early loss have experienced trauma. Have you been to a therapist who specializes in adopted children? I would look up a technique called EMDR-Eye Movement Desensitization and Reprocessing; this is a therapy tool specifically for people who been through a trauma. You can find a counselor at emdr.com or emdria.org. There are also websites that will help you find a therapist who has training in adopted children. Those websites are attach.org and at.radkid.org. I hope this is helpful.

[redvlagrl]

Hi
I am totally crashing, and I hope it's ok. I am adopted (as a baby, international) so I like to lurk on this forum.

Frankly, it does seem to me that your DD could have some issues stemming from being institutionalized. Could it be that the only time she received physical contact what when she was fed? Sorry if I am stating the obvious.

I do agree with the others that you might try more caloric and protein rich foods, but perhaps you could ask her if she is hungry or if she would actually like a cuddle? Maybe she is just seeking closeness, hence the fact that she won't stray far from you if there is food?

For myself, my (adoptive) parents were overly concerned with my weight throughout my childhood and I was put on diets and not allowed to eat many foods. Looking back now I can see that my eating was disordered by the time I was 8 (I stole money and would binge on chocolate). Not surprisingly I have had a life long battle with food. I was definitely a chubby baby which did concern my parents.

Respectfully, I would also suggest that you might have some food issues yourself. Why do you care if other parents see you allowing your child unlimited access to food? It doesn't sound like your DD was ever truely obese (like the stories on trash TV) - just chubby. This is no indication of adult size. I am overweight, DD has a very varied diet with a lot of fruit and veg and protein and there are times when she eats a lot. The comments are always positive becuase she has such a healthy appetite and will eat healthy foods. So please don't worry about what others think, unless you're feeing her unlimited candy (which I know you're not).

But clearly you are not dealing with a typical toddler. To me it seems like there is something that's not adding up. I agree with the PPs that you might like to seek some expert advice from someone who is experienced in adoptees.

I hope you can find some answers.

Examples of high protein snacks:

hard boiled or devilled eggs
chicken chunks
pate (homemade)
homemade hummus (that way you can make sure it's not diluted)
frozen soy beans (still frozen)
mini meatballs
cheese in all forms. DD especially loves string cheese
peanut butter on ww tortillas, rolled up and slced into rounds

I know things like cheerios etc are easy to grab as you run out the door, but perhaps you could prepare the night before and bagt them up or have them in tupperware?

[ariahsmum]

Greetings,

I've seen so much activity on this thread, but never read it. Tonight I had some time on my hands and wanted to check in with all the action here...

I'm fairly floored to see so many replies about diet specifics. Especially from those not in this forum typically, and not necessarily sensitive to the adoption issues that are very real post adopt.

Anna, I can only imagine the struggle you have been facing with your new daughter... life has clearly changed so much for you since the beginning of all of this, for your whole family, really. It must be/or have been so completely overwhelming and distressing. I'm hearing so much worry and love in your posts as well. Thank you for being so open and honest here, it takes a lot of willingness to sit open and receptive to such a vast amount of replies and "advices".

You keep talking about her extended belly... I have a son recently adopted from Rwanda (we went thru Addis for immigration... fun, fun!). So, due to our experience with him and what we now know about the water they had access to in the orphanage (common in Ethiopia as well) my first response is:

Has this child been tested very thoroughly for parasites?

When I say thoroughly- from a good reputable lab, and multiple stool samples over a few weeks?

I would never be stupid enough to suggest that *all* that is going on is...parasites....or muscle laxness... or lack of fatty food... because I know from the adoption community how very real food attachments and fears/safety around ample food supply are. I'm guessing you may be dealing with a combination of things.

But I never saw one person respond to your descriptions of the extended belly with a concern over parasites or other buggers. And why would they if they had no clue about international adoptions? But having just gone thru ghiardia it was fresh on my mind.

FWIW, Paci has a umbilical hernia, or a diastasis. Apparently a very common thing with babies from orphanages. It was explained to me that the workers commonly pull babies up by their arms to sitting... babies that lack any muscle tone, resulting in a separation of the abdominal muscles. In fact, we have photos sent to us of other babies adopted from the same orphanage with this problem.

I hope Disney went okay. I love the place myself (a big fan) but have seen many a stressed out parent there. I was surprised to see you go from "we can't go anywhere in public where there might be food" to "we are off to WDW!" Do tell us how it went, and please let me know what GI testing you have done, if any.

All my best,

[Sierra]

Jaya,

I went down a different road with this post, but I agree with you that testing for parasites is important. Thanks for informing the rest of us how important it is to find *good,* adequate testing.

[ariahsmum]

Sierra, I don't believe that the road you went down was without cause. Everything you say makes sense... I just think *for me* as a parent, testing WELL for parasites would be *part* of the picture. It could tend to make any baby, with psychological issues or not, adequate caloric intake or not, hungry *all* the time, no?

My son was not like that (although he likes to know he has food around at all times and exhibits certain tendencies like stealing everyone's food at a park/beach that are imo clearly related to deprivation at the orphanage) but still just *coming* from that region, independent of food issues, warrants extensive parasite testing.

And then add the hungry all the time and the distended abdomen. I'll be curious to see if OP has already been down this road.

[TTCH785]

Ok, so here is an update on our DD.  We went to Disney, and it was SOOOO easy.  I guess it was all the distractions, but she was the baby that I always had hoped for.  She was happy, active, and still slept well.  We ate in restaurants, with absolutely no issues at all.  She waited for the food to get there, and ate and left the table with no problem. Surprised the hell out of me. 

  But, I paid for that when we got home.  She regressed to being clingy, whiny, and totally obsessed with eating and food.  If she wasn't eating, she wasn't happy.  End of story. 

  I took her to the pediatrician and asked to get her tested for parasites again.  They did the tests, and told me they were all negative.  However, when I pushed to see a copy of the lab report, it turns out that he hadn't tested for anything but salmonella and another parasite that is not an issue in Ethiopia.  He specifically didn't test for the one I asked him to.  This is what my life is like lately.  Any possible help/hope gets squashed.  I'm starting to get tired of this crap.

   So after having a miserable Thanksgiving dinner where she screamed for food even with food in her mouth, food in her hand, and food on her plate, I gave in and poured a pile of Rice puff cereal on the chair, took her out of the high chair, and let her stand there and eat.  She ate for a half an hour straight (after her very large Thanksgiving meal), then eventually went and played with others.  She would continue to go back and have a few puffs, but at the end of the night there were still some left on the chair.

   Next morning:  She had her usual  breakfast, then ate for TWO HOURS straight.  Right up until lunch time.  Then she had lunch and took a nap.  Then she ate for an hour, right up until dinner time.  Then she had her usual dinner, and ate more, pretty much until bedtime. 

   She is bloated, uncomfortable, and cannot bend over without spitting up because she is so full.  She had not thrown up, however.  I have split up the rice puffs with cucumber sticks, and she doesn't eat as many but still continuously eats them throughout the day, while the whole time asking for "Cheerios", which is the rice puff cereal.    

  She has pretty much not stopped eating for 4 days.  I am having a hard time and don't know where else to turn.

   If she wasn' already gaining weight quickly, and looking SO HUGE, I would be happy to let her eat all day until she wants to stop.  But how can I let this continue?  

   About a month ago, my doctor suggested her bloated distended abdomen might be because of milk and dairy.  So I have not given her dairy for a month.  She gets NO milk, NO juice, very little in the way of carbs, except for rice cakes and rice at dinner (trying gluten free too), but yet she is still gaining weight (before the all day eating trial) at a very rapid pace.  She gained 2 pounds in 3 weeks, and is now in the 40th percentile for weight and 15th for height.    Something is wrong here. 

  Please be assured that this has nothing to do with me just not wanting her to be "chubby".  This is way more than that.  And if I let her eat all day for a month, she will soon weigh 40 pounds.   Why is it that in addition to her eating problem, she also has this other problem which causes her to gain weight at a ridiculous rate?  Others that have dealt with this issue have been able to let their kids eat Cheerios all day long for months, without any visible signs of a problem .   It wouldn't be a problem for me, either, but to see her not fit into a shirt that I bought her last week because of her stomach, and I have had to keep changing diaper sizes every week, and I really don't know what kind of shirts I am going to put on her next week because NOTHING fits her anymore.  I'm just sick over this.  The cure for her eating obsession is leading to a whole host of other issues. 

   I am going to take some pictures of her later and post them so that you all can see what I'm talking about.  I even went to look at old baby pictures of my other kids to see if I was missing something.  My other daughters were both chubby until they started walking, then thinned down considerably.  My son was never really chubby, but weighed a lot because he was so tall.  My daughters gained only 5 pounds or so from the age of 2 to 3.  At this rate, she is going to weigh what my small 4 year old weighs soon.

    Again, being chubby is NOT the problem.  If she is this way now, how is she going to keep gaining on the endless eating plan for the next few months?   I feel like I'm setting her up to be obese at this rate, and it will happen quickly.  

   I also wanted to mention that she is NOT active at all, especially when she is not spending her entire day glued to wherever her food is.  She pretty much stands around the whole day.   She will come and get me when the food runs out, though. 

    I have no idea where else to turn.  I would gladly see another doctor/nutritionist/etc., if I knew where to go.  No one seems to be able to help me. 

    Anna

[texmati]

oh mama... I don't have any ideas just yet , but I couldn't read and not reply. i wonder why thing were so well over the vacation?

And shame shame on your doctor for not running the right tests. I would call and complain, and as for a refund.

[mamadebug]

I'm sorry.  That's so hard.  I have read this thread from the beginning, but don't remember off the top of my head - do you live near a major children's hospital?  Is it possible to go to one?   The pediatricians there will have subspecialties - maybe pediatricians who specialize in weight control, behavioral issues, tropical/international medicine, endocrinology, etc.  They will often put together a team to come up with the best solution.  Your baby's need to eat like this could be behavioral, could be physical, could be a combination - I think you need help determining even that at this point.  Or, there are hospitals that have clinics for children you have been adopted internationally.  Obviously, they would be more aware of issues/parasites/etc specific to the country your child is adopted form than a regular pediatrician.  Here is a link to a list of some of those clinics -

http://www.adoptvietnam.org/adoption/health-clinics.htm

[Polliwog]

Have you contacted doctors who've worked with adopted children, yet?  If not, I'd recommend doing so ASAP.  Something just isn't right.  And I'm having trouble picturing a child who is in the 40th percentile for weight being huge. 

[karne]

I don't recall if your pedi or you ever thought tha here might be a sensory or OCD component to this behavior?  The image of standing for an hour straight eating puffed rice feels a little sensory, in addition to whatever else is going on, esp. because puffed rice is essentially air, not really nutrition.  Is there something about the feel of food in her mouth that is stimulating to her?

Re: being worried about the clothing, I wonder if it would help to just find loose, elastic waist type bottoms and tops big enough to grow into so that you don't have to stress about it?  

So sorry for you all-what a difficult situation.

[Super~Single~Mama]

This may be a long shot - but do you have a medical school near you?  I've had great experiences getting good treatment at the University of Washington Medical center - it is usually residents that see patients, but they are closely supervised.  The supervising physicians are usually great diagnosticians, and the students work pretty hard to get to the bottom of things.  I know of people who have had great success at Johns Hopkins, and UT Knoxville (just to name a few that my family members have personally had good luck at) - you might want to check into that as an option if your insurance would cover being seen by a dr. at a med school clinic, or by a specialist at a med school hospital.  I don't know your location, but it can't hurt to look.  I'm so sorry this hasn't resolved yet!!!

[VisionaryMom]

I would start with identifying what was different about vacation both in terms of food and environment. DS had an un-diagnosable medical condition for about 18 months until we went on vacation. The food was different, and we were able to pinpoint the problem by sharing what we ate on vacation with the gastroenterologist we saw.

[TTCH785]

Thanks for all the continued suggestions!  I didn't realize the CHOP which is about an hour away from me has an adoption specialized department, so thanks to the poster that sent that list to me.  I also want to clarify, that she is NOT huge, but her belly is.  Some days she realistically looks like a baby that is 9 months pregnant.  But other days she doesn't.  From behind, she doesn't look chubby at all.  I really don't think any other part of her but her belly is chubby.  Not skinny, esp. her thighs, but the rest of her is small.  But after she ate for 2 hours straight, and sometimes even after just a regular sized meal, she will have a very distended belly.  

  I don't think any of this fits symptoms of parasites, but I am definitely going to have that aspect checked out, as well as food allergies and anything else they can think of.  

  As far as vacation goes, the only thing I can think of is that it was REALLY hot, and it affected all of our appetites.  Maybe she just wasn't hungry, and between that and all the distractions, I guess she just wasn't thinking about food as much.  

  Breakfast was exactly the same, as we had a room with a kitchen  and I made her regular oatmeal and peanut butter breakfast.  For dinner, she pretty much had chicken fingers every night, and seemed really satisfied after dinner.  AT home, though, she won't touch chicken, so maybe I should buy some pre-made ones since she won't eat my homemade ones.  

  Thanks again everyone,

  Anna

[Polliwog]

CHOP in Philly?  If so, it's an excellent children's hospital and I think you'll be happy with their adoption-experienced team of doctors.  Good luck.

[ariahsmum]

Hi Anna,

I couldn't read and not respond.  I feel so much empathy for you. This situation must be so intense (is that the most ridiculous understatement?) for you and your family and for your daughter as well.  I can imagine desperation and helplessness as well as enormous frustration and fatigue.

Hang in there, I'm hoping you can turn this over to a crew of docs at the hospital you mentioned.  

Out of curiosity, was the distended abdomen or stools different on vacation as well?  If so, how?

Also, do any of her habits shift if you do not give her attention around the food (you do not react)?  Ie: does she stop eating quicker or consume less if you do not act upset, agitated, disgusted, worried by what she is doing?