Adoption related-Still food obsessed - Page 2

[Marsupialmom]

One things about the bottle. I nursed my neediest child for four years, because she need it. Non-nutritional nursing on a breast is not bad as a bottle. Maybe their is a need to respect non-nutritional sucking -- maybe weaning to water.

Also, Ethiopians are more likely to be lactose intolerant. Yogurt typically isn't an issue, but it should be a consideration.

http://www.ncbi.nlm.nih.gov/pubmed/2787744
http://onlinelibrary.wiley.com/doi/1...080.x/abstract

[Sierra]

Okay, I am back. A lot of what I want to say echos what has been said.

1.

Originally Posted by Tigerchild

Are your pediatrician and nutritionist specialized or experienced in working with kids from institutionalized settings? The advice you were given sounds more "standard" than anything I was ever told to do when caring for neglected kids or kids who hoard food as a foster parent...I wholeheartedly agree with Pumpkin's advice to seek out a *specialized* pediatrician and nutitionist if you've not already. I think an adoption specialist would be ideal.

2.

Originally Posted by Tigerchild

What about those mesh-on-a-stick things that you can put an apple slice or two in for a kiddo to gnaw on ( they're more for babies though, not sure how they'd hold up to toddler teeth! Also, well, they are kind of gross and messy sometimes).

I didn't mean to offend by suggesting celery sticks. My kids were able to handle that kind of thing at that age, which is why I suggested it but put in the caveat about only if it doesn't cause choking (and a lot of times, I do realize, kids who gorge will take in too much and tend to choke more easily).

If she is a kid who is likely to choke, the mesh-bag-on-a-stick thing for babies is a great idea. It can also be filled with ice chips to increase her water intake, as water helps the body sense when it is full. My kids sometimes used it for teething ice as toddlers, and they did not have an issue with biting it.

The other food suggestions have been good. And I really agree that the key may be in part on keeping her filled with proteins. Cheerios for me is really the non-stop edible food.

3.

Originally Posted by Tigerchild

I think it's unrealistic to expect most toddlers to carry something with them and just graze from it unless that is how they are. Most of the toddlers I have known (including mine) will eat everything out of their snacky cup or baggie when they're given it unless they don't like it--they don't have self-regulation at all.

That may be true, but if you are at your wits end, I actually think it would be worth trying it in the "boot camp" style that pumpkingirl suggested. I don't mean fill a little snacky cup. I mean get the kid the biggest lunch box or mess-proof backpack she can handle and prepare a huge amount of food ahead of time to keep refilling her box/backpack with. Stuff it to the brim.

I just threw out the idea earlier thinking of things you might have tried, but now having thought about it, I think it could be an interesting experiment. You may have to be the one ultimately in charge of handling it, and you may put a requirement on it like that it stays in the kitchen or that she has to eat at a small table she can get in and out of by herself (to avoid messes), but the point is that it is readily available.

(For what it is worth, this is actually what we did with our own kids from a very young age. We follow the Montessori philosophy, so essentially we chose a low shelf and made that into the kids snack shelf. Every night we prepared snacks and put them in these sturdy little jars from IKEA that had easy on-off lids, and put those on their snack shelf. Then the next day, whenever the kids felt hungry, they could take a jar and bring it over to their little table and help themselves. My developmentally delayed son started doing this sometime between 13-18 months of age, so it is possible. The hardest part was teaching him that he had to remain seated at the table or that it meant he was done and needed to clear his place...it took patience on our parts, but once he learned that, it worked pretty well. Granted, between the two of them, only my daughter came to us with a history of being overfed, and she never had major issues as a result, but my point is to refute the claim that toddlers can't handle having access to food.)

I would do this for a couple reasons...first, it would help you assess where she is at better. I think there is a chance that the more you stress about this, the more her behaviors will exhibit. So if you give yourself a weekend where you are prepared and ready to just let her eat and eat and eat, and see what happens...then you can get a better idea of what is going on. Essentially, I am recommending that you isolate the behavior from factors like a limited food supply and your own frustrations. Second, I think you also find out whether some kind of system giving her unlimited access to healthy, low-caloric foods would work. She might surprise you! I hear you throwing the idea away because it sounds crazy, and I know it does, but sometimes things like this work in counter-intuitive ways.

4.

Originally Posted by pumpkingirl71

I just wanted to say I know how you feel and it is so hard. For my daughter it was not food, it is 100% undivided attention. If we give our other two children any attention, the negative behavior started. Watching other toddlers play used to make me cry. The good news is that things have gotten SO much better. My six year old has come so far. She is watching her brother play right now and letting me answer this question But it was very slow going. Even at six, in some ways she is still two or three.

Yes! Yes! And this is why I think that working with an adoption specialist as well as perhaps a behavioral therapist, if you are not already, might be tremendously helpful. As many folks here know, we did PCIT-A with our daughter, and it was really helpful with a lot of her behavior.

5.

Originally Posted by pumpkingirl71

Just curious, does she make herself sick?

This is a hugely important question.

6.

Originally Posted by WifeMomChiro

My suggestion would be to have her evaluated for SPD. It seems to me that she is really oral sensory seeking. If you learn some tools to increase her sensory input in other ways it could really help.

Originally Posted by pumpkingirl71

THis could be true, or it could also be true that oral input could help fer avoid food for a longer stretch. Maybe soemthing like a z-vibe or a vibrating teether?

Trying a vibrating teether or z-vibe is a great idea!

7.

Originally Posted by texmati

It sounds like your daughter had gotten used to a steady stream of food, and also uses it for comfort.

What I would look for in a behavioral therapist is someone who has experience helping a child slowly transfer one comfort-seeking behavior to another.

I know you said she doesn't have any attachment issues, and you and the professionals you worked with will know best. But sometimes attachment stuff can be really subtle. When my dd came to me, her comforts were all things *outside* of our relationship. Over time, we've been able to transfer some of her comfort-seeking behaviors to some things that are relationship-based.

What we did is really seek to respect the comforting effect she already had going. For example, when dd came to us she was feeding herself from the bottle. She would sometimes cry for the bottle when she wanted to be comforted, not necessarily because she was hungry (which was also age appropriate). But she didn't want us to hold her. So we respected that she *needed* the bottle for comfort. But slowly we began to help her associate the bottle with *us.* So we weren't taking away what was comforting, but were bringing that thing to us. That puts you in a position where you can eventually can begin to phase out the original comfort item (which wasn't what we did with dd...the bottle was age-appropriate, we just wanted her to begin to associate the bottle with attachment) because you have begun to put the feeling of comfort into a replacement context.

8.

Originally Posted by texmati

I can only imagine being moved from that kind of environment to one where food was restricted. It can be very stressful. I agree with pp's to start out small, and also maybe adjust your thinking about food. Why is it that she can't eat every 20 minutes?

You sound frustrated because your life with your child totally revolves around food, but the above is still a valid question. Is there some way that you can set her up to get her needs met while you also get your needs met?

can she carry around a watered down juice bottle?

Or milk in a sippy cup (to avoid spills throughout your house, since she'll be carrying it around) and then maybe start replacing the milk with increasing amounts of water-milk mix until it is just water (you don't want her to get baby bottle rot in her mouth)?

9.

Originally Posted by tsfairy

One other thought after re-reading some of the posts is that it does sound a bit like an attention/comfort issue. Does she still obsess over food when she's being held and cuddled? Does she maybe associate food with comfort?

It would indeed be helpful to know this.

10.

Originally Posted by Marsupialmom

Also, what do you expect a child's response to be when they see someone in their own home eating? At that age they like to share and being told no hurts their feeling. If you don't want her to snack don't eat snacks in front of her -- that is mean in any situation. I think if you polled you will find many people's toddlers expect sharing.

True enough.

11.

Originally Posted by melon

I started steaming carrot sticks and green beans, and I just leave them in my fridge for when he asks for fruit and he's already had some. (He eats them cold) Also, defrosted frozen peas are a good snack.

I've also been making these "cookies" in the food processor, I'm not sure about quantities, I just fudge it.....Put in some cashews or peanuts, chop em up, move to a bowl....Put in some dates, and maybe some raisins, chop that up, and put in another bowl. Gradually add the nuts to the fruits, mush it up with your hands, and make it into flattened balls. (Wrap in cellophane for an on the go snack, or put on wax paper.) Stick em in the fridge. They're really good.

Those are all good suggestions but anything with dried fruit can cause blood sugar spikes, so may increase her hunger later even though it has protein too.

[TTCH785]

Hello,

Thank you to all of you that responded to my post looking for help/advice. I first want to say that nothing offended me because anything that was said trying to help me is fine with me. If I didn't agree with something, then I don't agree. But I have to say I agreed with almost everything. I am going to try to respond to some of the questions that came up, though.

My daughter has never thrown up after eating because I have never let her eat nonstop. I'm not sure if she would throw up or not.

Yes, it seems like she is a bottomless pit, although occasionally she will say "all done", but never when there is still food on her plate.

I have 3 other children, so I understand that all toddlers will want to share and watching someone eat might not sit well. But my other children, once they were full, would rather go and play than hang around the kitchen. I have usually had the experience that when we are out at a playground or someone's house, actually, that my other children will barely eat because they'd rather be playing. With K, she will DO NOTHING except eat.

K drinks about 10 oz. of milk a day and no juice. I water down her bottles because she still wants 4 or 5 of them.

I am thinking about the bootcamp, but I think I'll need some valium first. Watching her eat endlessly is difficult for me because I am so afraid I am teaching her unhealthy eating habits.

Someone suggested unlimited bottles. I would LOVE to do that. However, if I give her a bottle, she always completely finishes it, to the last drop (and then sucks on the air for a few minutes). So if I refilled it, she would sit and do it again. and again... Should I try it and see if she stops after 4 or 5?

Someone suggested SPD. What is that?

Thank you all again,

Anna

[mariaz]

With SPD (Sensory Processing Disorder) she would be seeking oral input from things other than food as well. My son needs constant oral input and he seeks that from chewing the collars of his shirts ad licking everything he finds.

And generally with SPD (although I am no expert) kids who sensory seek in one area (oral) will have other sensory behaviors as well (seeking or avoiding). So you would notice that she maybe avoids loud sounds or seeks out intense play.

[Diane B]

I know this is difficult for you, but I think you might just try the one suggestion that has been offered over and over but which you haven't implemented yet (I don't think): offering unlimited access to food. You have gotten some great suggestions about how to put boundaries around it and make it work - really, what have you got to lose? I know it causes you anxiety, but it might just be the ticket to help your daughter.

This board has very few international adoptive parents on it, but the problem you describe is not uncommon. I would suggest seeking out support from others who have adopted internationally, particularly from countries where children were institutionalized before placement - China, and Eastern Europe come to mind. I'm sure you can find more "been there, done that" folks who could ease your mind.

I would also google "International Adoption Clinic" and find the one closest to you and get some expert advice from someone who will really understand the situation and can offer advice you can trust.

I do sincerely wish you and your daughter the best.

[queenjane]

When you say she drinks 10 oz of milk a day...do you mean each bottle is 10 oz and she drinks 4-5 of them? or she drinks 10 oz of milk TOTAL each day?

What would happen if you gave her something she could have to "eat" but is difficult to consume quickly? Im at a loss for many ideas, but i'm thinking along the lines of a frozen banana...something she can chew/suck on but she cant gobble up and ask for more?

I think at this point you really can't say "she'll eat til she throws up" or "she'll keep eating and never stop" until you actually try it and see. Which i know is hard but its possible she DOES have a limit you just havent reached it yet. Or maybe she doesnt have a limit then you'll know.

And you said she's been checked for Prader-Willi Syndrome? That would have involved a genetic test.

[pumpkingirl71]

Originally Posted by ram3113

I am thinking about the bootcamp, but I think I'll need some valium first. Watching her eat endlessly is difficult for me because I am so afraid I am teaching her unhealthy eating habits.

I often think that sometimes with adopted kids, going against your gut is the hardest part For me, it is showing affection to my daughter after she has done something very bad. Intellectually, I know I need to teach her I will love her no matter what, but my gut tells me I am rewarding her behavior.

Could you maybe change the way you think about it? Obviously, healthy eating is very important to you. But if you are feeding her three square meals a day, then there are foods she can eat non stop. Would you feel that it is teacher bad habbits if the thing she was eating non stop was steamed carrot sticks or broccoli floretts?

Someone suggested unlimited bottles. I would LOVE to do that. However, if I give her a bottle, she always completely finishes it, to the last drop (and then sucks on the air for a few minutes). So if I refilled it, she would sit and do it again. and again... Should I try it and see if she stops after 4 or 5?

I would keep going until she is just done. BUT there are always complicating factors. My daughter would not sleep unless she still had some milk in her bottle. She also had medical problems that gave her dangerous diaper rash. So we were contantly weighing our need for sleep (so we could be good parents) against the medical issues that too much milk created. Unless there is a reason you can't give her unlimited fluids, I would try and see what happens. I would also say that in my experience of a child deeking comfort from a bottle, 10 oz of milk isn't that much. It may seem that way compared to a typical child, but lots of 19 months old still nurse a lot at that age. My bio daughter was close to done then, but lots of kids are not.

[TTCH785]

Okay, so here is my question: Allowing free access to food (which I guess I am coming to believe is the only thing that is the right thing to do since nothing else I've tried has helped) is difficult for me, but I am going to have to do it.

1. She came home VERY CHUBBY, so clearly she allowed herself to be overfed even then.

2. She is STILL chubby, and I feel like she would eat 10 times more than she is now. So I can pretty much assume that she will gain ALOT of weight if allowed unlimited access to food, even if it is vegetables/fruit.

3. How do I do this logistically. She is 19 mo. old and needs finger foods, and we have an active life. Do I really just hand her a mountain of food in the car/stroller/family room/wherever we are and allow her to eat until she says she wants to stop?

4. What if she doesn't stop? What if she eats until she throws up?

I'm frightened of this scenario, and it is what has been keeping me from doing it. I wish I could hire someone to feed her for me......


Thanks!

Anna

[pumpkingirl71]

Originally Posted by ram3113

2. She is STILL chubby, and I feel like she would eat 10 times more than she is now. So I can pretty much assume that she will gain ALOT of weight if allowed unlimited access to food, even if it is vegetables/fruit.

I hear that you are very worried about her long term health. I don't think she will necessarily gain weight. I personally would not give her unlimited fruit, but I would give her unlimited veggies.

3. How do I do this logistically. She is 19 mo. old and needs finger foods, and we have an active life. Do I really just hand her a mountain of food in the car/stroller/family room/wherever we are and allow her to eat until she says she wants to stop?

I steam a bunch of carrot sticks, broccoli and what every other veggies I am feeding my kids once a week and keep a huge container in the fridge. They are not allowed unlimited food, but they are allowed unlimited veggies. It sounds like you would be doing this once a day, not once a week. I carry them around in gladware type containers. Ironically, I do for the opposite reason you will My kids don't eat, so when they express hunger and try to get me to buy them an unhealthy snack, I have the veggies ready, at least so they can have something healthy first.

[Super~Single~Mama]

Originally Posted by ram3113

Okay, so here is my question: Allowing free access to food (which I guess I am coming to believe is the only thing that is the right thing to do since nothing else I've tried has helped) is difficult for me, but I am going to have to do it.

1. She came home VERY CHUBBY, so clearly she allowed herself to be overfed even then.

2. She is STILL chubby, and I feel like she would eat 10 times more than she is now. So I can pretty much assume that she will gain ALOT of weight if allowed unlimited access to food, even if it is vegetables/fruit.

3. How do I do this logistically. She is 19 mo. old and needs finger foods, and we have an active life. Do I really just hand her a mountain of food in the car/stroller/family room/wherever we are and allow her to eat until she says she wants to stop?

4. What if she doesn't stop? What if she eats until she throws up?

I'm frightened of this scenario, and it is what has been keeping me from doing it. I wish I could hire someone to feed her for me......


Thanks!

Anna

I'm FAR from an expert, but my 2 brothers were adopted from Korea, and my older (by 6mos) brother was CHUBBY. OMG he was CHUBBY - not even chubby, he was FAT as a child. Seriously, as a baby he would eat until he started burping up food. He still eats like crazy (but he is NOT fat - not even close he is 5'10" and maybe 140 or 150?), and just LOVES food. He was a chubby kid until he started school, and then he just shot up in height, and never got chubby again.

Seriously, he was the chubbiest baby anyone has ever ever seen, he had rolls EVERYWHERE!

I really don't have any advice, I just wanted to share that with you. He also hated bottles - he literally just wanted to dump the milk down his throat no sucking involved.

[VisionaryMom]

Originally Posted by ram3113

1. She came home VERY CHUBBY, so clearly she allowed herself to be overfed even then.

She was only 9 months old, right? I don't get this idea that she "allowed herself to be overfed." IME, 9MOs will pretty much do what they're permitted, and I wonder if you've hit a frustration point and are assigning too much ownership of her actions to her. She's still really small.

As for your comment about your children not eating when there's food around, that may be your experience, but I don't think it's typical. Both of my children will want food if we go somewhere with a spread even if we've just eaten. That is especially true of my super-thin 5YO. If one of my kids is having a snack, the other wants one - even if s/he has just eaten. I think all of those behaviors are perfectly normal, and they shouldn't be part of your thinking about food issues with her in general.

I don't know that anyone is suggesting that you feed her unlimited forever, but you need to know what will happen if she is allowed to eat as much as she wants for a couple of days. Right now, you don't have complete information to give any specialists because you're still controlling her food intake pretty strictly. If you let her go for 2-3 days, you will know whether she gets satiated or not and whether she will eat until she's sick or not. Right now, you just don't know, and it could be a clue in helping determine what is going on with her.

Can you give a typical day's food? I know others have mentioned, but I will say, too, that the breakfast you listed wasn't something I would see as filling. It was a good quantity of food, but it had no protein and little fat. She really may need a different nutrition makeup than what you're giving her. Even with the snacking on veggies only, that's fine if the issue is a need to chew or feel she's eating. If the issue really is a need for extra calories, then she's not going to be satisfied with chowing on carrots & broccoli all day.

I understood your post to mean that you give her 4-5 bottles but only 10 ounces of milk, so they are *really* watered down - 2 oz of milk, the rest water. I mention this because my son got really sick around 18 months and stayed that way. We finally found that he has a metabolic disorder that requires lots of extra fat - far more than is typical. Once we added in healthy fats to his diet, he got healthy within a couple of weeks. Because of what you listed for food, I wonder if something like that is happening with her. We did lots of nuts and nut butters, extra olive oil on his foods, avocados to add in fat and satiate him.

[janinemh]

Originally Posted by karlin

It sounds like she gets a lot of sweet things but not a whole lot of protein. Could you try giving her something more filling for breakfast, like sausage? What about cheese for snacks? I know you are trying to watch calories, but they aren't everything. Our bodies store and process sugar differently than protein. I can eat fruit all day and not feel full. Give me some meat and/or full fat dairy and I can go until tomorrow without eating. Same for my son. Maybe you can get some whey protein powder and add it to milk or a smoothie or whatever.

This.

And I would emphasis fat as well as it would keep here satiated longer than low calorie, high carb snacks. Eggs, meat/fish, butter, whole milk yogurt, coconut oil in smoothies or straight, nut butters, avocado, full fat cheese are all good, high fat foods. I think an emphasis on nutrient dense foods such as these rather than calorie control might help.

Also, as someone mentioned, exploring food sensitivities could help as well especially the big two: gluten and cows milk.

[Marsupialmom]

1. She came home VERY CHUBBY, so clearly she allowed herself to be overfed even then.

Very cubby babies are not necessarily over fed.

4. What if she doesn't stop? What if she eats until she throws up?

Then you have a valid issue to take up with the doctor. My middle child has reflux. She would eat and eat. The signals pain/need to eat signals were being misinterpreted. For her reflux medicine cured her.

Her fer more proteins and complex carbs. Boil up kidney beans, cheese sticks, precooked chicken breast.

[Sierra]

Originally Posted by ram3113

Someone suggested unlimited bottles. I would LOVE to do that. However, if I give her a bottle, she always completely finishes it, to the last drop (and then sucks on the air for a few minutes). So if I refilled it, she would sit and do it again. and again... Should I try it and see if she stops after 4 or 5?

I wouldn't do bottles personally (with my kids we did bottlenursing so the bottle was associated with us, and I think that is helpful in adoptions). I would do large sippy cups.

I would not set myself up for frustration by filling one cup at a time. I would instead get a whole bunch of cups -- maybe even ten or fifteen (only because you don't know where her natural limit is right now) -- fill them up and put them in the fridge each morning. I'd let her see me doing this so she'd know they were there. I'd even show her how many. Then whenever she wants a new one, you can help her get it, but you keep yourself out of it as much as possible so your own feelings and fears don't interfere. That's gonna be the key here.

And I wouldn't try it one day and give up. With the "boot camp" a weekend is a good start, especially if your own fears and feelings are problematic, but with this I would want her to normalize to the system before I decided what kind of impact it was making on her behavior...I'd give it at least a few weeks if not a month or two.

Only THEN will you know how much she would drink naturally.

Originally Posted by ram3113

2. She is STILL chubby, and I feel like she would eat 10 times more than she is now. So I can pretty much assume that she will gain ALOT of weight if allowed unlimited access to food, even if it is vegetables/fruit.

There is something critical that has gone unsaid here. I guess I didn't connect what you were saying at first with her size.

When a person is larger, their metabolism is different than a smaller person, and they actually *need* more food. When you feed them an amount you would feed a smaller person, it doesn't meet their caloric needs, so their body starts eating away at fat. That's how people lose weight. This causes ketosis.

As a type I diabetic (that's the "juvenile kind"...not the kind associated with obesity, btw), I am intimately familiar with ketosis because my body does it when it doesn't have enough insulin to process the food I eat.

When ketosis is occurring, your body is in starvation mode. The way people lose weight is that they kick in this mechanism, which is really the body's protection against starvation. So in ketosis, you feel like you are starving. That's the body's primative warning that if you don't increase your calories, you could die. You can have consumed food, and you still feel hungry because your body is telling you that it still needs to eat away at itself to fulfill your caloric needs for your size.

I think I have read that the average toddler needs about 1300 calories a day (about 40 calories per inch of height?). Bigger toddlers need MORE if they are not going to enter ketosis. So the 900 calories recommended to you is probably a weight-loss amount. Significantly so. Which means you are keeping your child in ketosis (which by the way, can damage the body if sustained over a long period).

No wonder your child is hungry. No matter how chubby she is, her body is telling her she is starving .

If I were you, I'd stop worrying about her weight. Give her a chance to come into a more natural relationship with food, to heal from all this, to become more active as she stops focusing on food, and then after being in that state for a year or so, if she is still overweight, *then* work with the nutritionists on a slow plan of weight loss.

Chubby isn't dangerous. It would only be if she was grossly overweight that you should start feeling more urgency. The kid hasn't even had a chance to eat normally.

4. What if she doesn't stop? What if she eats until she throws up?

Then you know she will eat until she throws up, at least while in "healing" mode. You will have more information than you do now. That's a GOOD thing.

Originally Posted by VisionaryMom

If the issue really is a need for extra calories, then she's not going to be satisfied with chowing on carrots & broccoli all day.

Yes. Having thought about this some more, I would offer her mutiple types of food. Would I keep the emphasis on veggies? Yes, but I would still have *plenty* of proteins available, and some carbs such as fruit. Actually, offering her unlimited access to a variety would also give you information about what she is craving, which could be helpful.

And no, she will not gain weight by being offerred unlimited veggies. It isn't possible to eat enough veggies to do that. That's when she'd be throwing up.

[texmati]

Originally Posted by ram3113

Okay, so here is my question: Allowing free access to food (which I guess I am coming to believe is the only thing that is the right thing to do since nothing else I've tried has helped) is difficult for me, but I am going to have to do it.

1. She came home VERY CHUBBY, so clearly she allowed herself to be overfed even then.

2. She is STILL chubby, and I feel like she would eat 10 times more than she is now. So I can pretty much assume that she will gain ALOT of weight if allowed unlimited access to food, even if it is vegetables/fruit.

3. How do I do this logistically. She is 19 mo. old and needs finger foods, and we have an active life. Do I really just hand her a mountain of food in the car/stroller/family room/wherever we are and allow her to eat until she says she wants to stop?

4. What if she doesn't stop? What if she eats until she throws up?

I'm frightened of this scenario, and it is what has been keeping me from doing it. I wish I could hire someone to feed her for me......


Thanks!

Anna

I would explore a little bit why giving her free access to food is so difficult for you-- do you mean emotionally or logistically?

1. I don't think a baby can 'allow' herself to be over fed; perhaps she wasn't being fed healthy food ect, but I don't think any of this is her *fault*.
2. I woudn't assume this. It sounds from your pp that you've essentially put her on a diet, over rode her own feeding cues, and made a battle out of this. Unless her health is in immediate danger, it sound like both you and your daughter are suffering emotionally from this. Let her eat as much non-junk as she wants.
3. Have portion out snacks available in your bag. I know they make little snack sized Ziploc, but that's not a green option. We actually do this with our 11 months old-- I carry a cute cooler tote filled with cut fruit or milk. When she asks; give her a baggie. If you feel that it's attention seeking and it's feasible, perhaps sit and talk with her while she eats. If she asks again in a few minutes give her another one.
4. I'd worry about this when it happens. If she seems to be understainding; I'd talk about how tummies get full, what it feels like, other things we can do besides eating. But I think removing the struggle around food would do a world of good for both of you first.

[Ms. B. Sprout]

Originally Posted by karlin

It sounds like she gets a lot of sweet things but not a whole lot of protein. Could you try giving her something more filling for breakfast, like sausage? What about cheese for snacks? I know you are trying to watch calories, but they aren't everything. Our bodies store and process sugar differently than protein. I can eat fruit all day and not feel full. Give me some meat and/or full fat dairy and I can go until tomorrow without eating. Same for my son. Maybe you can get some whey protein powder and add it to milk or a smoothie or whatever.

Originally Posted by janinemh

This.

And I would emphasis fat as well as it would keep here satiated longer than low calorie, high carb snacks. Eggs, meat/fish, butter, whole milk yogurt, coconut oil in smoothies or straight, nut butters, avocado, full fat cheese are all good, high fat foods. I think an emphasis on nutrient dense foods such as these rather than calorie control might help.

[Sierra]

One other thing about ketosis. The body in ketosis needs more water. This would be a good explanation why she drinks every drop and asks for more.

[VisionaryMom]

Originally Posted by Sierra

One other thing about ketosis. The body in ketosis needs more water. This would be a good explanation why she drinks every drop and asks for more.

You know, I hadn't thought of this, but I should have. My husband also is T1 diabetic, and I know that one way I can tell that he's not in great control of his blood sugar is that he starts to drink enormous amounts of liquids.

I think, OP, that I'm having trouble understanding why your pediatricians aren't looking at other options. I'm not so sure that her problem is psychological in nature, and I wonder if the fact that she's adopted is overriding anything else, i.e. what would they do if a non-adopted child were having these issues with food? I'm afraid you/they are missing a health component because you're looking for a psychological one and focusing on her relationship with food before adoption.

[journeymom]

Most overfed Americans eat too much sugar and fat. Most of us eat more protein than we need. We all know this, we're all conscious and careful and worry about feeding our kids the right kind of foods.

Your daughter is exceptional. You should throw out the above considerations for her. Like the others have been saying, she will really benefit from more protein and more fats than she's currently getting. Reduce the amount of fruit for now. Yes, fruit is healthy but it's also sugar that she burns through. Then she crashes and feels desperately hungry again. Give her more meat, cheese, beans, butter and avocado. She'll feel less hungry. She can have unlimited access to veggies, but first be sure she's getting enough fat and protein. I know, it's upside down thinking.

Have you seen those whole-milk, full-fat yogurts for babies? I think YoBaby is one of them. The reason babies (and toddlers) get to have more fat than we do is because their brains need it. Growing brains need healthy fats.

if I give her a bottle, she always completely finishes it, to the last drop (and then sucks on the air for a few minutes). So if I refilled it, she would sit and do it again. and again...

Others have mentioned it, but I'll repeat it for emphasis, this is her way of communicating her desperate need for oral comfort. She wasn't nursed, she was in an orphanage, she's got exceptional needs for comfort. That, and some kids simply enjoy it.

In this case it's OK if she eats till she throws up a time or two. It's not a bad thing.

Is there such thing as support groups for parents of international adoption orphans??

And a good therapist with experience with foster children or refugee children.

[Sierra]

Originally Posted by VisionaryMom

I think, OP, that I'm having trouble understanding why your pediatricians aren't looking at other options. I'm not so sure that her problem is psychological in nature, and I wonder if the fact that she's adopted is overriding anything else, i.e. what would they do if a non-adopted child were having these issues with food? I'm afraid you/they are missing a health component because you're looking for a psychological one and focusing on her relationship with food before adoption.

But now I am not so sure there is a problem at all, physical or otherwise.

Imagine this scenario, for example:

Child came home at 9 months a large baby. She thus needed bunch of exta calories to avoid ketosis (which causes the feeling of starvation). Her intake was surprising to mom, as mom's other kids were not so large and thus she'd never seen a kid who needed to consume so much. She was also worried about baby's weight. Eventually, the surprise and concern led her to a doctor, where the exploration of the baby's pre-adoption history came to be a big part of the narrative for mom.

The doctor, however, doesn't really think that way. The doctor thinks in a "calories in, calories out" formula. The concern was about the child's weight, so the doctor recommends a reduction in calories. This sends baby into ketosis. Ketosis causes baby to feel the need to eat not just in large quantities, but all the time. And drink too. Since mom has been instructed not to give baby more than 900 calories, mom does not allow baby to eat when she feels the need.

This causes some weight loss, which seems like a good sign on some level to everyone, but at the same time, baby is now extremely focused on food because her body is telling her she is starving. Baby can't stop thinking about food. It becomes her total focus and obsession, as a survival mechanism. This increases the mom's alarm, as baby now seems to be a "bottomless pit" and completely unaware of anything but food. Knowing something is really wrong, mom takes baby to the nutritionist. Mom describes to the nutritionist that baby is completely food obsessed. The "symptom" has changed from when mom went to the doctor originally, as now the baby is in ketosis. So this time, the conversation is different. The conversation is about a child's obsession. The child being overweight, in the nutritionist's mind, is attributed to the consumption level, not the other way around.

But there has been success in weight loss with the 900 calorie diet, and since the nutritionist is dealing with a child who is apparently overweight from overconsumption, the nutritionist thinks of the weight loss as a sign of things being on a healthier track. Once the child learns to eat less, it is supposed, weight will stabalize and the child will eat less in general. So the nutritionist continues to recommend a 900 calorie diet.

And sure enough, baby's weight becomes stabalized, or maybe even weight loss continues, but baby's body is telling her that she is still starving, so the "problem" of overfocusing on food just gets worse and worse. To the point in which mom, who has faithfully tried everything that has been recommended to her by the professionals, cries and leaves the park because her child isn't able to play due to starvation. But mom doesn't know it is starvation because her child is still chubby, and at least two professionals have FAILED to correctly identify the issue so all she has is a dead-end road.

Misdiagnosis can spin into misdiagnosis. Wouldn't be the first time, nor the last time, that it happens. That's why I am recommending baby be given a year to heal and for things to normalize before another wild goose chase ensues. I am crossing my fingers that I am right.

"Bootcamp" is bootcamp for mom, not babe. Mom has to normalize to something new, something that goes against what has been advised to her to date. That's just the begining, not the end of a long process.