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My Child Needs More Nutrition - Page 2

post #21 of 85
I think the hiding foods in other foods is a good idea to a point, but you really need to work on helping her eat a variety of foods. I wouldn't count on the "hiding foods" method to be enought to get her enough nutrition. I mean, how many vegetables is she really going to get in the oh, 2-3 tablespoons of tomato sauce she eats on pizzas or pasta. Not much, and not anywhere near even ONE serving of zuccini or spinach or whatever. And, there IS a limit to how much spinach or zuccini or whatever you can hide. I mean, no way are you going to hide even 1 whole zucchini in a cup of tomato sauce (trust me, I've tried LOL) and really to get a serving of veggies, it needs to be AT LEAST 1/2 cup of something thing like cooked spinach or zucchini. When it comes to eating veggies and getting proper nutrition...VOLUMNE is key. Since she is so mal-nourished, you can't really count her getting those nutrients from veggies unless she eats large quanities of the veggies. There's not enough zucchini in zucchini muffins, not going to be enough blackstrap molasses in gingerbread cookies, etc., etc. . Obviously, every little bit helps..but it sounds as though she just really needs to be getting QUANITIES of nutrient dense foods, not just little bits hidden here and there.

I definitely suggest getting her involved in cooking, finding recipies, shopping, preparing foods, etc. Really, though..she is 11 right. That is old enough to learn that sometimes we eat things don't really like because they are good for us. I cook and eat different veggies almost every night..and trust me I don't LOVE vegeatables. Some I like more than others..but generally I am not eating them because I really like them..I am eating them because I KNOW they are good for me and an imporant part of my diet and I find them tolerable. I think you need to really talk to her about this, and WORK with her on finding ways to make the foods tolerable and yummy. Help her look for recipies. Maybe plant a garden together (late for this year, but maybe next spring). What she grows, she is likely to eat. Go to a farmer's market together, etc. Just really involve her the process and also let her know that sometimes we do eat foods, that may not be super, yumny declicious because our body needs the fuel we provide. I am not saying your should force her or anyting, or start punishing or rewarding when it comes to food, obviously gentle discipline is NEEDED here...but 11 isn't too young to learn that sometimes we eat things we may not LOVE because they are good for us.

The other thing, is does she like nuts. Nuts are really yummy, especially things like cashews and brazil nuts..,most people do like them..and they are really nutrient dense. Dried fruits are good too..and a great way to get the nutrients in a denser form, without having to eat the same quanity as you would of the fresh fruit.
post #22 of 85
Your doctor is an idiot. Anyone who thinks you can force another person to eat something they don't want to is an idiot. It's just really not possible.

How hard is it to just make her what she likes? Why not make Ethiopian food that is familiar to her and healthy available all the time? Make large batches and freeze if it makes it simpler. I can't imagine trying to force a child with health issues to eat food she doesn't like when there is a perfectly reasonable option.

Oh... don't microwave her food either... but you probably knew that.
post #23 of 85
Thread Starter 
Quote:
Originally Posted by kama'aina mama View Post
Your doctor is an idiot.
Actually he's not an idiot. He knows she needs more nutrition.

Quote:
How hard is it to just make her what she likes?
Well, as I mentioned in this thread, the foods that she will eat don't provide her with enough variety to get all the nutrition that she needs. That's why I posted this thread asking for suggestions.

I'm much more along the lines of ameliabedelia in that she needs to learn more about proper nutrition and expand her palate a bit. Another problem is that, when she lived in the orphanage, she had no choice in what was perpared or served. If she was hungry, she had to eat what she was given or go hungry. So things that she would eat in Ethiopia because she had to are things that she won't eat here because she sees that we have lots of other options. Which is fine, I want her to have choices, but it ends up with her eating peanut butter, spaghetti, and carrots almost to the exclusion of other foods. It's not a matter of me making food that she likes. I do that a lot. It's a matter of her not getting a balanced diet because she refuses so many foods that have nutrients she needs.

Namaste!
post #24 of 85
If he's not an idiot then he's an unsympathetic and unrealistic @$$. I also don't find it at all surprising that your dd has food issues. What else has she been able to control in this life. Even if absorbtion is an issue wouldn't a high quality suppliment that absorbs better than other vitamins be better than the other options.
post #25 of 85
I'm sorry, maybe I misunderstood, but when you said
Quote:
Believe me, I have done everything I possibly can short of preparing traditional Ethiopian food every single night of the week (we usually eat it three times a week) to accomodate her likes and dislikes, but the simple fact is, she claims that she doesn't like so many foods that she is not getting enough variety to meet her nutritional needs.
I took that to mean that you believe that if you cooked her the food she is accustomed to and she ate it she would be fine.

Black strap molasses is a great suggestion. Do you have a cast iron pan? Cooking anything in cast iron dramatically increases iron intake. Where is the calcium on a traditional Ethiopian diet? I assume leafy greens... does she eat them when prepared how she grew up with them? Calcium is trickier than iron.

And... okay... explain to me how to force a person to eat.
post #26 of 85
I have no advice to give being the mom of a super picky eater myself, but just wanted to chime in with kudos to you. I've off and on e-stalked you and your path to adopting your daughter and just think you and your family is awesome!

Oh and I'm taking notes because there are some great suggestions in here...maybe I can get Mr. Picky Pants to eat using some of these ideas.
post #27 of 85
It sounds like the doctor and the attachment therapist both have important things to say, but different concerns. The problem is that you share both their (valid) concerns, and you're faced with trying to follow two conflicting pieces of advice!

Perhaps in the short-term you can focus on 'hiding' high-density nutritional foods in the things that she will eat, and using good quality supplements. Long term, if you continue to avoid food battles as per the attachment therapist's recommendation, you may well have more success getting her to branch out and try a variety of foods than if food again becomes a source of conflict and control.

While no doubt the HIV doctor is correct that it is important for her to eat better, he is not a parenting expert, and may not have thought through the fact that trying to 'make' her eat the recommended diet could lead her to stubbornly restrict her diet more. Conversely, hiding the good stuff in things she likes and giving her supplements could take the pressure off and allow an easier path to better eating as you spend more time together, garden, cook, relax, shop for stuff, etc.
post #28 of 85
Thread Starter 
Sorry, I was editing for clarification and we cross-posted.

Quote:
Originally Posted by kama'aina mama View Post
I'm sorry, maybe I misunderstood, but when you said I took that to mean that you believe that if you cooked her the food she is accustomed to and she ate it she would be fine.
No, I meant that, I do what I can to make sure that she has the opportunity to eat meals that she likes, but she needs a wider variety than that.

Quote:
Do you have a cast iron pan? Cooking anything in cast iron dramatically increases iron intake.
Yes, I do almost all my cooking in cast-iron.

Quote:
Where is the calcium on a traditional Ethiopian diet? I assume leafy greens... does she eat them when prepared how she grew up with them? Calcium is trickier than iron.
Mostly it is in milk (which she won't eat) and injera made with teff. Teff has a lot of calcium in it. We are working on making injera (Ethiopian flatbread) with teff, but so far every recipe we have tried has failed. We continue to work on it. They also eat a lot of collards, but she won't eat them here.

Quote:
And... okay... explain to me how to force a person to eat.
Well, you're right, you can't force a person to eat. But telling us that our daughter needs to eat the things that give her the nutrition she needs does not make him an idiot.

Namaste!
post #29 of 85
Making big batches of the foods she prefers and freezing/refrigerating them in meal-size portions sounds great. I often freeze things in sandwich-bag size freezer bags, thaw and serve.
What about meats and eggs for iron? Red meats served with tomatoes?
Almond butter and jelly sandwiches? On fortified bread? Orange juice with calcium? Ice cream, or frozen yogurt, or pudding?
What foods is the doctor recommending?
post #30 of 85
I had another idea, spinning off of both all of the people who thought involving her in food prep might help, and her tolerance for food prepared in a traditional Ethiopian way.

It would be sooo cool for you to write a kids' Ethiopian cookbook with her. It could have information in it about what nutrients people get from traditional Ethiopian foods, how to buy ingredients in a US supermarket for the dishes, and then recipes. it would be a great homeschooling project for your family, it could help her understand how eating more foods is good for her, it would make her proud of a big accomplishment--

and I would totally buy the book when it's done! so would a lot of us! We would love to learn from your family about Ethiopian culture. Plus a lot of us would be happy to get a kid-friendly explanation of nutrition written by another kid.

(Of course she might also want to include recipes for pizza or peanut-butter sandwiches, with nutrition information for those--and that's fine, too.)
post #31 of 85
Quote:
I'm much more along the lines of ameliabedelia in that she needs to learn more about proper nutrition and expand her palate a bit.
She does, I agree, but maybe she doesn't need to do this so much short term as long term. She's had a huge, huge change in her life. Her whole world has been turned upside down. For the better, to be sure, but for a child it's a lot to deal with.

Personally, I'd go along with the hiding whatever good stuff you can in the foods she will eat for now. Pasta 5 times a week with different stuff in the sauce won't hurt her.

You say she eats chicken and beef but you are veggie. Are you willing to cook those things for her? I know it's a pain to have to cook two different meals and in normal circumstances I'm not in favor of it. But I think that right now Desta has enough going on emotionally and developmentally that it might be worth doing.
post #32 of 85
Thread Starter 
Here is an example of how things are going right now:

For lunch today I asked the kids what they wanted. Efram suggested eggs, and Ramona and Desta said that was fine. Efram and Desta chose hardboiled eggs and Ramona chose scrambled. When we sat down to eat, Desta peeled the whites off the eggs and left the yolks (with all the calcium and iron) sitting on the plate.

Another example:

I served burritos for dinner last night. I had rice, corn, beans, lettuce, tomatoes, avocados, spinach, and cheese available as fillings. Desta got a jar of peanut butter and ate a pb burrito.

I don't mean to sound like I am griping. I really don't. I just feel so completely responsible for this kid, ESPECIALLY because her life has changed so dramatically, and trying to balance everything I am trying to deal with in parenting her well and meeting her medical needs sometimes feels like a Sisyphean task.

Namaste!
post #33 of 85
I would just go with it. She ate egg whites and a peanut butter burrito. What's wrong with that? I think if you try to turn it into a control issue, by making her serve what you prepare with a few exceptions, things will get worse.

Can you make more Ethiopian foods? What Ethiopian dishes does she like? Are you making them properly? Is her eating picky there too, or is she more willing to eat those things because they are more familiar?
post #34 of 85
How much of this have you discussed with her?
post #35 of 85
Thread Starter 
Quote:
Originally Posted by EFmom View Post
You say she eats chicken and beef but you are veggie. Are you willing to cook those things for her?
At the risk of being crucified for not being flexible enough, the honest answer is that no, I have not cooked these things for her. Vegetarianism is (among other things) a religious value for us, so we have not as yet prepared and served meat for her in our home.

HOWEVER! Between regular visits to other people's houses, food that Ethiopian friends bring for her, visits to restaurants, and relatives visiting our house and bringing food for her, Desta has the oppurtunity to eat meat 3-5 times any given week, which is about as often as she ate it in Ethiopia.

We have spoken with both the nutritionist and the HIV doc about this (as well as our pediatrician) and all three have mentioned that we don't want to overload on animal fats anyway because HIV meds can raise blood lipid levels. We checked with the HIV doc before we ever adopted her about whether an veg diet would be nutritionally adequate for her and we were told that many HIV docs actually recommend a veg diet. We chose not to "make" Desta be a vegetarian.

We are exploring the idea of buying deli meats for her (not the nitrate-laden packaged kind) that she could put on sandwiches and that we would not have to prepare, but she has told us that she really only wants meat wat (wat is stew in Ethiopia) for meat. She's not even a fan of hamburgers.

Namaste!
post #36 of 85
Thread Starter 
Quote:
Originally Posted by thismama View Post
What's wrong with that?
Well, I meant is as an example of how she tends to avoid the foods that have the nutrients she is deficient in, even down to avoiding the specific parts of those foods that are highest in the nutrients she needs.

Quote:
Can you make more Ethiopian foods? What Ethiopian dishes does she like? Are you making them properly? Is her eating picky there too, or is she more willing to eat those things because they are more familiar?
She claims that I make the Ethio food well, and she eats it with gusto, as long as it's not collards. I have tried that three times and she has eaten very, very small portions of it and then gotten peanut butter to put on the rest fo her injera. I think part of it is that she's just not familiar with a lot of what we eat, so we need to help her expand her familiarity with American food.

Namaste!
post #37 of 85
You know what, I would make the meat wat. You have a child who is HIV+ and probably has low appetite related to her health condition, who came only a few months ago from Ethiopia to America, your family, and all the huge shock and change with that. Can you even imagine? I can't.

And then to have so much of the food be different too. I know it probably seems like a lot to cook Ethiopian food 3x/week, but that means 18 of the meals you are serving her every week are unfamiliar. And how authentically are you able to cook Ethiopian dishes?

Your religious objection to meat, a food she likes, must be hard. Eating it seperates her from your family, at a time when she is new to your family and must feel seperate still already. I think it would be really helpful to show your support and acceptance of her by cooking meat in the manner she enjoys it, or by asking someone else to cook substantial quantities regularly, and have them available in your fridge for her.

ETA - I was veg for 15 years so I can really relate to how odd it feels to cook meat. I think it's worth it, tho.
post #38 of 85
Quote:
Originally Posted by dharmamama

She claims that I make the Ethio food well, and she eats it with gusto, as long as it's not collards.
Well, I think that is great. I would cook it every day. I don't think she needs to eat collards, there are lots of other Ethiopian sources of the nutrients she needs, I'm sure.
post #39 of 85
Hugs. Food issues with any child adopted can be a struggle. Having her be older only means she gets tovoice her displeasure instead of crying. BTDT.

For now I think it wouldn't hurt to grate veggies and sneak it into other foods. Baby steps. Maybe over time you could grate them less finely as she gets comfortable and use to eating it.

Cheese pizza. Can you hide other food under the cheese layer?

What about trying to eat at friends houses more often. Maybe if she is a guest and thinks she has less say or options over eating something else she will eat whats in front of her not to be rude. May not work but could be worth a try.

A goal system. Teach her about food choices and have a reward system if she eats so much dairy or veggies that day she can get a treat or reward. May seem a little childish but if she is working towards something she may eat it.

Other than that good luck. I hope over time it becomes less of a struggle. Others had some great ideas but only you know what will work and what wont. Keep us posted, I so miss the updates in your blog about how she is doing.
post #40 of 85
If it were my child I would give them supplements while working on food issues. I totally agree whole heartedly that nutrition should come from food but you can't let a child, especaily one with health issues, suffer malnutrition until she decides to eat better. I would supplement while working to getting more nutrients into her. You have already gotten some good ideas of how to do that.

Juicing and smooties are both excellent options. you can slip all kinds of stuff into smooties on the sly. freezing them as popcicles are also a good way to add soem more. Calcium fortified orange juice if she will drink it is a good option too (nothing from concentrate tastes good. i would go with the minute maid in the carton . . . ) but litle more than a glorified suppliment. however I am guessing you may have trouble getting suppliments into her . . . . Pudding. lots of milk in pudding. yes lots of crap in the instant pudding but I will risk it for chocolate. . . I mean calcium . . .

good luck. Youhave so many issues working against you. it must be so frustrating. one guy saying youahve to do this because this is best and another saying the oposite is best and both of them being right to an extent.
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