Is docs advice OK re: food and poop related

[robynlyn80]

I have a 24 month old with an extremely limited diet. He likes carbs. Waffles, bread, pasta. Since coming off purees (maybe thats the problem, but for a different thread) he has refused to eat fruit. He has had probably one apple TOTAL (when given peanut butter to dip in, but even now he won't do that) and maybe two bananas total. He does not eat any meat, unless it is mixed into some sort of casserole-ish type dish (like its all mushy and mixed together) and also no vegetable. Literally. I've let it go, continue to offer, but at the same time, we're in a rut because I refuse to make meals anymore that I KNOW he won't eat.

Anyway. He's severely constipated. It's been going on for over a month and we're resorting to glycerin suppositories every other day. I took him to the doc this week (very pro-AP, gentle doc- his family is definitely AP, his wife used to be very invovled in our local AP community) and he basically told me to stop offering carbs. If he chooses not to eat, that is his choice. He's not going to starve and eventually he'll eat.

Is this OK? I mean, if he refuses dinner, but then asks for cereal or waffles, I just say no, you can eat this or nothing?

For the record, I am trying to work with him. Like I made beans and rice for lunch today, because he likes both of those things, but he wouldn't eat it. I do 'sneak' fruits/veggies into things, but really, doesn't he need to learn to eat these things? The poor baby can't poop! He's in extreme pain and just cries and screams "mama bum mama bum!" and he runs to get a diaper.

I have gotten extremely creative with what I do offer him- like I mix wheat germ into his oatmeal etc. So while I know that if you offer suggestions on what foods to give him its with a helpful heart, I've probably already tried it. What I really want to know is: Is it OK for me to say "this is what your choices are...if you choose not to have one of these choices, then I'm sorry." at the wee age of 24 months.

[LynnS6]

IMO, that's lousy advice!

It sounds like your son has issues with texture. There are ways around that, but I don't think the "eat it or starve" method is the best way to go there. I would suggest the book "Just Take a Bite" (The same authors have a book called "Finicky Eaters" and I don't know what the difference is.)

If going it alone isn't helping, I would recommend that you ask for a referral to an OT who does feeding therapy.

And until you get this sorted out, have you considered going back to purees? And a little prune juice? (OK, I don't actually know any children who will DRINK prune juice - how about pear juice, which is supposed to be nearly as de-constipating.)

[SundayCrepes]

I hate baby food. I think it causes problems like this. Although it's probably too late for you with this child, here is a great article on baby led solid introduction:
http://www.borstvoeding.com/voedseli...uidelines.html
We did this with our son and he has absolutely no texture issues. He will eat everything from curry to satay to ...

We also used these:
http://www.amazon.com/Munchkin-Fresh...7003853&sr=8-1
This way we didn't have to worry about choking. His first food was the potato and peas out of a samosa.

We never gave our son baby food EXCEPT, when he was first having solid poops, he was really uncomfortable with the feeling. I found a baby food that was pears and prunes. It is BeechNut stage 2. Not all stores sell it, but he loved it. I still keep some on hand and he will sometimes ask for it just to eat it. Keep in mind we have to hide the prunes at my mom's house since he'd eat a whole bag of them, but I've tasted the pear and prune baby food and it's not too bad. You could always mix it with more pears to sweeten it up a bit.

Regarding your doctor's advise. I would also get an OT consult for textures. However, despite my tirade about baby foods, it could also be that your son just doesn't like the taste of many foods. There are several threads here about introducing veggies. Many toddlers won't eat them. Same with meat. Since I'm a vegetarian, I consider the lack of meat to be a healthy thing.

Because my son will eat so many different foods, if he doesn't like what we're making, I make him something else. When my (step)daughter was little, she was incredibly picky. If she didn't like dinner, she was allowed to make a bean and cheese burrito. I tried to cook what she liked, but if I knew she didn't like our dinner that night, I'd recommend she have a snack. "Dinner won't be ready for about half an hour. Would you like a bagel with cream cheese?" That way she wasn't refusing dinner because she didn't like it, she was just taking small amounts of the things she liked because she was already almost full. That seemed a good psychological way to keep her from setting up the cycle of refusing food. So, I don't know if any of this info helps, but maybe it's fuel for thought.

[madskye]

Shouldn't the issue be limiting the refined carbs though? For example, oatmeal should make him poop, where pancakes won't.

They're both carbs, but one's got lots of good fiber. I like to make what we call muesli--mix uncooked oatmeal with yogurt and let it sit in the fridge over night. (Not baby oatmeal, not quick cook, real oatmeal) In the morning the texture will be soft, but you still get the good oatmeal fiber.)

I'm sorry you're going through this--I think I'd check in with another doctor. To your question, I think it actually is okay to offer him an array of nutritious food that will make him poop, and take the carbs away for a period. You're not saying-eat your brussel sprouts or you'll get nothing else-you're still giving him some choices.

[littlemizflava]

some ideas think for now i think you have to do the sneeky ways. you will have to add little by little dont put alot of new in at once the taste will be different then he might not want that again.
if he will eat walfels or pancakes then i say whole wheat can you add fruits even apple sauce
oatmeal if you can add things to it then add away (mine like creamed coconut and shredded coconut added)
breads and pasta's with the high fibers know mine will not touch ones with "stuff in it" so we have to stick to whole wheat
what can you put on the bread and pasta?

other idead
smoothies can add any fruits and veggies can also be frozen as a frozen pop
soups or stews
cookies or muffins with added fruits

[*Robin*]

Originally Posted by madskye

Shouldn't the issue be limiting the refined carbs though? For example, oatmeal should make him poop, where pancakes won't.

They're both carbs, but one's got lots of good fiber. I like to make what we call muesli--mix uncooked oatmeal with yogurt and let it sit in the fridge over night. (Not baby oatmeal, not quick cook, real oatmeal) In the morning the texture will be soft, but you still get the good oatmeal fiber.)

I'm sorry you're going through this--I think I'd check in with another doctor. To your question, I think it actually is okay to offer him an array of nutritious food that will make him poop, and take the carbs away for a period. You're not saying-eat your brussel sprouts or you'll get nothing else-you're still giving him some choices.

I agree. I mean you want to introduce new foods, etc., but for the short term, can't you just switch to all whole grain carbs? Then also reassess the foods you keep in the house and I would limit his intake of the white flour carbs.

It does sound like your son might have a texture issue. You can ask your doctor to write you a script for a pediatric occupational therapist. My SIL is a ped OT and she specialized in picky eaters. It might be something that would help your LO out.

[annekevdbroek]

Well, there is a very long pooping woes thread in childhood years you may want to look at.

Having dealt with many years of constipation with my oldest DS let me say your Ped's advice stinks.
1. Glycerin suppositories hurt. Stop using them. Try fruit juice, cutting out dairy (it is constipating), prunes. Or some sort of laxitive: magnesium citrate worked well for us. Some others use milk of magnesia, Miralax, or Benefiber (also worked well for us - mixes invistaibly with almost anything).
2. You need to fix the constipation before fixing his diet. He has to poo and not have it hurt before you can focus on trying to get him to eat more things. No one wants to eat well when they are all blocked up.

Not all carbs are bad - look for the highest fiber foods you can find that he'll eat (e.g. Ryecrisp crackers, Cracklin Oatbran cereal, Mini Wheat cereal).

Personally we don't do food battles around here - the kids eat what they will eat, which is currently a fairly low number of veggies. My DS's constipation was related to a slow gut and poor digestion of dairy, not to too many carbs.

Anyhow, I hope your kiddo feels better soon.

[abomgardner417]

I would agree to just get him pooping right now and worry about him getting the veggies later. Carrot juice mixed with a little apple juice and water works wonders when my boys get blocked up. I keep offering them veggies but I sneak veggie and fruit purees into just about everything I make them so at least they're getting something.

That being said, I think it's ok to offer a variety at meals and whatever you eat fine, what you don't fine, but that's what you get until the next meal/snack. I'm to the point where I'm tired of my boys being hungry 30 min after eating because they refused to eat what was on their plates. I make one meal and that's what everybody gets. It may sound cruel, but I do not run a restaurant!

[pbjmama]

Originally Posted by LynnS6

I would recommend that you ask for a referral to an OT who does feeding therapy.

I agree.

[mom2tatum]

texture problem...most likely due to the purees, but ok...it CAN be fixed. Don't worry. I like the OT suggestion, as well. But also, my best advice for constipation is adding ground flaxseed to whatever you can get it into...

We put it in scrambled eggs mostly everyday, but also sometimes:

hot cereals
yogurt
thick soups
chili

It is FULL of all kinds of healthy stuff (no taste) and the fiber in it does the trick like NONE OTHER for regulating BM's. Trust me. Read about it.

[mom2tatum]

Originally Posted by abomgardner417

That being said, I think it's ok to offer a variety at meals and whatever you eat fine, what you don't fine, but that's what you get until the next meal/snack. I'm to the point where I'm tired of my boys being hungry 30 min after eating because they refused to eat what was on their plates. I make one meal and that's what everybody gets. It may sound cruel, but I do not run a restaurant!

also, :

[Keeping up]

I somewhat disagree with some of the other advice - I don't think of texture issues when the kiddo does eat apples/bananas (with peanut butter ... tastes better that way). Your babe is also eating a lot of carbs - which all have a ton of texture, just not particularily healthy texture. It seems he just doesn't like meat in pieces or veggies.

My kiddos (OK - save my 2 year old) don't eat veggies willingly - my daughter eats carrots and cherry tomatoes, my 4 year old realistically nothing unless absolutely hidden - my 2 year old will scale the table to steal your salad plate. We also don't eat much meat other than highly processed - hot dogs and nuggets. My husband and I are good eaters (need more fibre and everyone needs more veggies) so they have good examples but just are there yet.

I have no experience with suppositories (thank goodness) - but I would be probably inclined to keep them up for a very short while to clear out the track - and then you could start a new with more laxative type foods.

- Will he drink more fluids, water spiked with prune or pear juice?
- I love the idea of the flax seed - I am going to follow up on that one (everyone needs more fibre!)
- Any veggies and dips - my 2 year old loves dipping veggies in things (hummus or sour cream/onion dip)
- If he eats meat in 'mushy' casseroles, just put in more veggies in very small pieces.
- When my little ones were constipated, I always thought about adding puree prunes to stuff (like apple sauce to a cake kind of idea) - it might be worth some research.

I guess I wouldn't worry too much about the veggie thing right now. I would worry about the constipation - that hurts. I think the docs advice of don't offer him his carbs isn't a great idea IF your child is very stubborn - my 4 year old would just not eat then. I am not that worried about his 'starving' but am worried about his blood sugar crashing and making life very miserable for him and the rest of the family. I won't ever withhold ALL food - always give him a bit of what he likes to keep the blood sugar up.

Is he potty training right now (you mentioned he says bum hurts and asks for a diaper)? FTR, my eldest pair (the only two trained) both got constipated while potty training (at 2.5 yrs- 2.75 years) because they were scared of the toilet. I reverted to pooping in diaps (and encouraging it) and the consitpation was relieved.

Good luck.

[Keeping up]

I can never edit my posts ... my kids eat highly processed meats (me - I like the expensive 'real' stuff). Just for the record.

[nighten]

A couple of things. First off, you are NOT alone! My toddler refuses to eat so many things -- she won't even try them. The key is to keep offering. Don't think of it as food going to waste, because the act of exposure is serving a purpose. Eventually they will taste it. Eventually they will eat it, at least some of it. Keep offering. Keep fixing those foods for yourself and modeling in front of your toddler.

Also, try freeze-dried fruits and vegetables. Winnie has serious issues with texture and prefers crunchy foods. The Just Tomatoes brand has an organic line that has been great for us.

They get all the nutrition from the dried fruits and veggies, but you do need to ensure he's drinking enough water since they don't have water in them in freeze-dried form.

I don't think it's the carbs alone that are the problem. I think it's the lack of other things that can help soften up his stool along the way, maybe? So definitely lots of water, some apple/prune juice if he'll drink it (we hide apple juice in orange juice).

We are raising our child vegetarian, so we focus on protein from other sources than meat. Can't help you there. :/

Also, if he'll eat pancakes, try using prune juice instead of water, and molasses instead of syrup.

Peanut butter is good for constipation too. As are any fruits beginning with P (prune, pear, peach, plum, etc.). Same with those juices. Apples are good, as is apple juice but apple sauce is binding. Ditto with bananas.

Make sure he's getting plenty of water. It's fine to keep with healthy carbs/fiber but if that's mainly what he's eating then he needs to get extra water else the fiber will bulk things up too much.

Cut the suppository length-wise. It works the same but is easier on baby. Also use a lubricant with it.

Flax seed oil is great but do NOT cook with it. Heat makes it rancid. Hemp seeds (shelled) are good too, and can be cooked up to around 325 degrees, I think? We add those to our toddler's pancakes, and use prune juice instead of water. You can add flax seeds/oil to a smoothie though if he'll drink it.

Pumpkin is also supposed to help.

We've started on some serious (and costly) probiotics, but I'm hoping they will help. It's the Ohhira brand, from Japan.

The problem for us was she had several large and compact stools that were very painful to pass. So she started holding it in (this is both a voluntary AND involuntary thing, so we try to be as understanding as possible with it, knowing most of the time she can't help it). The suppositories helped short term, and we ended up giving her some Miralax (I know -- it's nasty chemicals. We were desperate). There's a healthier solution (Baby Calm) you can try that is magnesium based I believe. The reason we went with Miralax was we needed something that would work very quickly, because the longer she held things in, the harder to pass, the more it hurt and it was becoming a very bad and painful cycle. Miralax is both a stool softener and laxative. We definitely needed something that would soften things up for her. We'd already bought the Miralax before I knew about the Baby Calm.

Anyway once the Miralax kicked in (after about 3 days), we stopped using it. And are relying now on prevention -- ensuring she's getting plenty of water to balance out her fiber-rich diet. And encouraging her to poop the second she feels the urge. (We stopped focusing on potty learning during this time because I didn't want her to have negative associations with the potty.) And NO bananas or cheese. Once she's back on a regular cycle then we'll let her have small amounts of these, but it had gotten to a point where she was eating a whole banana and a bunch of cheese everyday. That made things very bad for her system.

Please feel free to PM me. We've been going through a really hard time dealing with this, and having a picky eater makes it all the more harder on everyone.

Good luck, Mama. I hope your little one finds some relief soon!

[Nolamom]

Don't have much advice on feeding issues - we're going through something similar with our 15 month old son, too! He loves carbs and also fruits (sweet). He refuses most meats/veggies unless they're "hidden" in a casserole, or, under a pile of cheese! I'm just continuing to offer all foods and hoping that his palate will widen.

However, my 4 yr. old daughter (a great eater - still loves all veggies) has suffered from constipation on a couple of occasions. Every time it was related to dehydration (we live in a hot climate and spend alot of time outside). Now, I make sure she gets enough fluids - water, juice, milk, etc. and her problems have disappeared. Push fluids!

[robynlyn80]

WOW everyone, thanks!

ok my shift key is broken, so no more caps.

i'm not sure if i think its a texture issue or not. i go back and forth. his little preschool teacher (he goes twice per week) reports that he will eat most things she offers- including grapes, strawberries- things i have never seen him eat. he does pick blueberries out of pancakes and waffles at school.

at home he does get pretty much whole grain everything. and i make real oatmeal (not instant) and always stir applesauce into waffles/pancakes/oatmeal. so i feel like i make the stuff he will eat as healthy as possible (been putting wheat germ in the oatmeal) but the flax seed is a good idea, too. he gets home made waffles.

i have definitely ramped up the fluids. he was drinking only out of a regular cup, which i think was limiting his fluids. he drinks more when sucking. so i have been giving him the sippy/straw more instead of the regular cup around the house.

he won't drink prune juice or eat prunes. i can't find pear juice. i've been giving some white grape. sometimes he'll eat raisins.

i may consider an ot/speech eval, because his speech is a little behind, i think. but since he'll eat the fruit at school, i think he just knows that if he turns his nose at veggies or fruit, i'll give him something else. he won't drink a smoothie. he doesn't like things frozen- too cold i guess??? i've tried smoothies in all forms- with milk, yogurt, slushier, less slushy...less ice/cold etc. added honey for sweetness...nope. he takes one sip and gives it right back.

anyway the poop is a little better. the fluids have helped. dh and i actually eat pretty well...i cook almost everything from scratch. we don't care for whole wheat pasta but we eat whole wheat everything else. i've never even kept juice in the house before this, and we don't have chips/cookies etc in the house (because i would eat the whole thing in one sitting). so he sees us model good eating. we definitely have veggies with every meal and i eat a lot of fruit. i do lots of baking with veggies and other healthy things...but again, i feel like i just continue to do carbs carbs and more carbs.

anyway i agree that the pooping needs to be conquered first. he isn't really potty training- he'll sit on it sometimes but that's it. he doesn't get much dairy b/c he doesn't like cheese. he does get some cows milk and yogurt, but not very much. maybe i'll cut that out entirely b/c i'm a little lactose intolerant.

the purees could certainly be the problem. he ate them for probably three-ish months. i made them all myself, and really, most things he ate were mushy things anyway like applesauce, squash, and sweet potatoes. i never really got him to eat green beans or peas or the like. he used to eat those things more when he was an infant (like not purees, but actual peas) but not anymore.

anyway, if his speech hasn't improved by his well baby check on the 18th we may go for a speech/ot eval just for peace of mind.

[eepster]

Originally Posted by robynlyn80

and always stir applesauce into waffles/pancakes/oatmeal.

Could you switch from applesauce to pearsauce or stewed then pureed prunes or apricot sauce. Pears, prunes and apricots have more umph than apples.

[nighten]

Definitely ditch the applesauce. It makes constipation worse. Using pureed prunes or pears in the mix instead will help get things moving.

Our local Target and Wal-Marts sell Gerber organic pear juice. Also check your local health food store.

White grape juice is worse than water honestly. It has very few nutrients and breaks down to mostly sugar. As far as I know it does nothing to help with constipation. Apple juice, however, definitely helps.

And you can try teaching him sign language. Our almost two year old still isn't terribly verbal, but she can use signs for a lot of words. That has helped enormously.

Good luck, Mama!

[veganf]

Originally Posted by robynlyn80

he basically told me to stop offering carbs. If he chooses not to eat, that is his choice. He's not going to starve and eventually he'll eat.

I think this advice would have been fine as his experiences with food were developing, but going cold turkey is a bit extreme.
I do believe that--barring an actual diagnosible feeding problem, ie. allergy, physical swallowing issue, texture issue due to some special needs like autism--kids will eat what they're offered if you stop offering only their favourite "junk", if you will. I know some people here disagree, but IME it works.

However, why not first start with the foods he likes, but limit their quantity and improve their quality? For example, buy high fiber waffles or hemp/flax waffles, buy whole grain pasta or pasta with ground flax meal in it, buy only whole grain bread.
You can also bake muffins with a variety of fruits, veggies & nuts in them (mashed, ground, etc so he can't pick them out). Or make some spinach pancakes, etc.
And make sure you are modeling excellent eating habits, even if it means eating most of your high-carb foods out of his sight for a while. Often kids are more likely to try something new if they can have a little taste of what someone else is eating, and most of their eating habits come from what the rest of the family does.
As for purees, if he'll still accept them, I don't think replacing servings of carbs once a day with pureed fruit or veggies is a bad idea. I like some pureed foods, they aren't always "baby" foods.
Smoothies are great. Salting veggies a little might help (I mean, my kids will eat a plateful of spinach if it has a little soy sauce on it, but not care for it plain...I'd rather they have a little saltiness and learn to enjoy their veggies!).

I hope you find some solutions for your son soon!

[yarngoddess]

I don't have any food advice, but wanted to add that once your kiddo is constipated the cycle will continue due to them NOT wanting to poop due to pain. I have a 4 yr old that at 2 had a prolapsed bowel (where the intestines' come out of her anus- had to be physically re-inserted, very painful and tramatic) and she would get constipated, and stay that way despite her diet because she would be holding it unconsciously- even though she was wanting to poop.

We started using mineral oil (1 tsp every day- she suprisingly LOVES the taste, said it was sweet) and that takes a few days to work, but it's like a lube for their intestines, and that really helped her. I have since started using the benefiber and my kids call it medicine sugar and will ask every day if they can have it.

One of the worst things you can do is get upset about this issue. If you are stressed and worried and anxious about food, your DS will pick up on it. If you just back off and take a nonchelante attitude about it you may be suprised to find that he is eating. Also start a food journal, write EVERYTHING he eates, even if it's a bite, and look at it on the whole for a week. And remember that their stomach is the size of their fist.

I agree that OT may help, but also please consider allergy testing. Some kids don't eat because of allergy's. Digestive issues also come into my mind, and may be something to consider.

Hugs, because I know how stressfull this can be. There is nothing like a kid that can't poop, and being a parent feeling SO helpless one of thoes things that is HORRIBLE.