My Child Needs More Nutrition - Mothering Forums

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#1 of 85 Old 09-27-2006, 05:13 PM - Thread Starter
 
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After speaking with an attachment therapist about the issues we were having with our recently-adopted child refusing to eat almost everything we served, we adopted a "here's the food, eat it or don't" approach. This worked very well. We didn't comment on what or how much she ate and the food battles almost completely disappeared.

Well, no good deed goes unpunished, right? When we were at the HIV doctor last week, he told us that, based on our daughter's most recent labs, she is deficient in several nutrients, two of them being calcium and iron. She refuses dairy products and green vegetables, in particular.

Now, I like to believe that children deserve freedom and autonomy in their eating, but I am not willing to let one of my children become malnourished for it. We spoke with the doc about giving her supplements and he said she needs the nutrition from FOOD, not supplements. He talked with her about this, we talked with her about this, but we are having huge food issues again. Her list of what she won't eat is a mile long, and she consistently refuses the vegetables that we serve her. 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.

We were driving today and I was trying to make a list of vegetables that she will eat. I came up with carrots (sometimes, other times she says she doesn't like them), cabbage, and eggplant, but only if it's fried. She won't eat broccoli, asparagus, artichokes, brussels sprouts, zucchini, squash, corn, peas, tomatoes (I know, they are a fruit), okra, spinach, collards (or any other type of greens), green beans, etc. The only veggies that I can remember her eating are carrots (sometimes), cabbage, and fried eggplant.

I am considering telling her that she can choose three or four foods that she absolutely will not eat and that, for the sake of her health, she has to eat whatever I serve if it's not one of those three or four foods.

Any suggestions?
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#2 of 85 Old 09-27-2006, 05:19 PM
 
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Why is the doctor opposed to supplementation? That seems really unfair! So much pressure on you and your children. Is it just because the supplements are poorly absorbed?

Okay, if I were in your shoes (which I am not, so this is just top of my head here) I would get a children's cookbook and do food purchasing and cooking together. I see that you homeschool, and it seems like a great opportunity to do some math and science. You can also do some nutrition curriculum with her. She might learn to like more things if she's involved in preparing them.

I am sorry you are coping with such a tough thing.

Divorced mom of one awesome boy born 2-3-2003.
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#3 of 85 Old 09-27-2006, 05:30 PM
 
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This site mentions other foods that are rich in calcium and iron.
http://www.vegsource.com/davis/nutritents.htm

Mom to unschooling 4everboy since 8/01
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#4 of 85 Old 09-27-2006, 05:41 PM
 
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I know you've worked so hard to get her healthy.

Here are some thoughts in no particular order:

will she eat salad? Spinach can be used for greens.
Will she eat sandwiches? Again- spinach instead of lettuce.
will she eat pizza? or other dishes with tomato sauce? A lot can be added to tomato sauce.

Muffins? zucchini muffins are yummy and sweet.
Ice cream? A good last resort for dairy.
Smoothies?
Yogurt?

For iron, I would increase her vitamin c- to increase absorbtion (actually you need c to absorb both iron and calcium, this could be part of the problem) I would use sodium ascorbate- it's easily disolved in water or juice and better absorbed than other types (like ascorbic acid or calcium ascorbate)

Also for iron, I'd use floradix- yeah it's a supplement, but more natural than most.

I would bet that once her body becomes more balanced, she will become less resistant to so many foods.

good luck!

-Angela
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#5 of 85 Old 09-27-2006, 05:56 PM - Thread Starter
 
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Why is the doctor opposed to supplementation? That seems really unfair! So much pressure on you and your children. Is it just because the supplements are poorly absorbed?
Yes, it's that combined with the fact that HIV can cause malabsorption.

Quote:
will she eat salad?
No.
Quote:
Will she eat sandwiches?
Only PB&J. We went to a picnic and they served turkey sandwiches (we are veg but Desta is not) and she took everything off the sandwich and just ate the bread.
Quote:
will she eat pizza?
Yes, and that baffles me. She says her favorite food is pizza (plain cheese) but she won't eat cheese any other way.
Quote:
or other dishes with tomato sauce? A lot can be added to tomato sauce.
Yes, she will eat pasta with tomato sauce. We make our own, and it does have lots of other veggies in it. That's a good source.

Quote:
Muffins? zucchini muffins are yummy and sweet.
Yes, she does like those.
Quote:
Ice cream?
Nope.
Quote:
Smoothies?
Nope.
Quote:
Yogurt?
Nope.

The vit. C and Floradix suggestions are good ones. Thanks!

Namaste!
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#6 of 85 Old 09-27-2006, 06:07 PM
 
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Okay- the pizza and tomato sauce are a GREAT start. Do you have a food processor? I can hide ANYTHING in tomato sauce

zucchini, spinach, other greens, green peppers, carrots, you name it, it goes in tomato sauce.

Heck, serve pizza or pasta once a day, you can get several good servings in that way.

zucchini muffins can have other stuff added too.

I think the key here is going to be some GOOD quality supplements and being best friends with a food processor for a little while.

oooo, another thought- spinach dip - think it would have any chance of working? Will she eat raw veggies with a dip? Does she like dips? (dips are another good place to hide nutrition)

Go back and pretend she's a 4 yr old who won't eat anything. Try those tricks. (ants on a log? is she more likely to eat it if she made it?)

Ah- one more thought- homemade breads. I often substitute cottage cheese or yogurt for the liquid in bread recipies. you can't tell the difference.

good luck!

-Angela
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#7 of 85 Old 09-27-2006, 06:19 PM
 
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I think you may be reading too much into that... (I think you are great by the way!) and that it is unfair to go there... just my opinion though.

The suggestions here are great... as well as chips with blended bean dip and raw veggies thrown in. Blended soups can be a great way to get things in. Some kids prefer to eat everything raw. Does she like veggie juices?
I would definitely try to make some sort of fun homeschooling thing out of it... maybe explore sprouting things to eat herself, or look at trendy ways of eating like raw food, or vegan.Her helping and having power in making the choices might help. I hate making food an issue as well... but we slowly phased out anything that was not really good nutritionally, and the whole family eats really really well because of this.

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#8 of 85 Old 09-27-2006, 06:24 PM
 
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Oh, no! I didn't read it that way at all!

I read that she went through a lot to bring her here, because she loves her and want the best for her--wants her to thrive and be healthy. So it doesn't make sense to let her become malnourished here where food is so readily available!

If she eats pizza, I would serve that *a lot*. Lots can be hidden in the sauce (pureed veggies, for instance).
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#9 of 85 Old 09-27-2006, 06:27 PM
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I second the whizz everything up into a tomato sauce and let her eat whole grain pasta to her hearts content.

I would be leary of the spinach dip though. She'll see the green bits and go "OMG GROSS!!!!!!"

Will she eat seafood???

ETA: If she likes salty things, and seafood, how about trying to get her to eat some Dulse??

http://www.rolandsdulse.com/ He does mail order...If you tell him Ivy's daughter sent you you'll get the good dulse and possibly a discount.. ETA: AGAIN lol

Even if she wont eat it whole, you can wizz it up into the tomato sauce like you would any other veggie
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#10 of 85 Old 09-27-2006, 06:30 PM - Thread Starter
 
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Will she eat seafood???
Nope. She eats beef and chicken.

Namaste!
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#11 of 85 Old 09-27-2006, 06:31 PM
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Originally Posted by dharmamama View Post
Nope. She eats beef and chicken.

Namaste!
Well your best bet is to get some Dulse and wizz it up into the tomato sauce...if you browse the page I posted it'll show the nutritional content of the plant and you'll be amazed

http://www.rolandsdulse.com/chart.html
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#12 of 85 Old 09-27-2006, 06:50 PM
 
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Will she eat a smoothie? Put enough fruit/other sweeteners in a smoothie and you can add just about anything else without affecting the taste.

yogurt, fruit and frozen spinach (due to the concerns with fresh spinach but also because it helps the smoothie stay cold!) is a good one, and you could add nutritional yeast for B vitamins, protein powder, maybe Floradix (don't know if it would completely hide the taste though) or crush a flavored children's vite w/ calcium and dump it in there too.

make it w/ whatever fruits she likes. heck whatever foods, period, she likes. the blender is magic for making food attractive.

(there is also the old standby of throwing an egg in, too, for added iron and protein, but raw eggs...salmonella...your comfort level may not be high w/ that depending on the source of the eggs.)
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#13 of 85 Old 09-27-2006, 06:51 PM
 
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lots of great suggestions here-I really hope things improve for you all very soon-that must be so hard on you. I have one more tiny contribution. I put a lot of nutrient-dense things in pancakes (silver dollar size go over best here)-flax seed oil, yogurt, pumpkin, spinach, etc. You mentioned you're seeing an attachment therapist, and I'm sure you've explored all possibilities to help her-do you feel there's possibly an emotional component behind her refusing these foods? I hope I don't offend and it's not my intention to pretend to be an expert, but it sounds like she's trying to control her environment. I can't help but wonder if these issues will improve as she feels safer in her new home. I hope she's soon accepting more foods that give her the nutrients she needs, and you're able to put this stress behind you.
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#14 of 85 Old 09-27-2006, 07:01 PM
 
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Originally Posted by dharmamama View Post

Honestly, I am a bit offended that you would even think I think my daughter is a product I bought. You clearly know nothing about me. Perhaps I worded things poorly but really ... give me the benefit of the doubt here. I'm frustrated and worried about my daughter.
I'm sorry your feelings are hurt. I know you are worried about your daughter. I just was really shocked at the phrasing... that after all you went thru, the money you spent, she didn't have the right to malnourish herself. I thought it was important to point it out.

Good luck finding ways to nourish your daughter. I think there have been some helpful suggestions on this thread. I might also prepare more of the foods she is used to, ask her what she would like to eat, that she is familiar with, and prepare that.
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#15 of 85 Old 09-27-2006, 07:01 PM - Thread Starter
 
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I hope I don't offend and it's not my intention to pretend to be an expert, but it sounds like she's trying to control her environment.
Yes, I think you're exactly right. That's why the attachment therapist's advice worked so well. We completely removed the power struggle by saying nothing about what and how much she ate. She was completely in control. It worked well. (Previous to that, she would do things like request something specific for dinner and then, when I served it, tell me she didn't like that food [before even tasting it].) The problem we run into now is that the AT's and the doctor's advice seem to conflict (the doctor was pretty clear that we need to *make* her eat what she needs), and I feel like I'm stuck either way: Make her eat things she says she doesn't want to eat and screw up our attachment but have a healthy kid or let her eat whatever she wants and have a malnourished kid. I'm looking for ways to integrate the two so they aren't opposing ideas. I really appreciate the advice and suggestions I'm getting.

I guess part of it too is that, as a vegetarian, I am constantly inundated with the "eat a variety to get your nutrients" idea, so the idea of serving spaghetti (for example) every day makes me uncomfortable. But it's true that, if I can get a variety of NUTRIENTS into the meal, it doesn't really matter if the MEAL is repetitious.

Thanks again everyone!

Namaste!
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#16 of 85 Old 09-27-2006, 07:01 PM
 
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Back again, post nap.

Peanut butter is a great source of iron. Almonds have both iron and calcium. I grind them in my coffee grinder and put them in baked goods. How about raisins and figs?

Dairy is not an easily absorbed source of calcium, so I wouldn't even look there. The ratio of calcium and phosphorus should be one to one for human absorption, like breastmilk. Cows milk has a one to two ratio. That extra phosphorus REALLY wants to bond with some calcium so it will do so with what is already in your body and cause you to excrete the calcium you had.

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#17 of 85 Old 09-27-2006, 07:08 PM
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oooh I know! Does she like...

COOKIES???

Come on, hehehe Cookies.

You can make, Gingerbread cookies, and subsitute the regular molasses for Blackstrap..voila! IRON SUPPLIMENT!
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#18 of 85 Old 09-27-2006, 07:08 PM
 
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. But it's true that, if I can get a variety of NUTRIENTS into the meal, it doesn't really matter if the MEAL is repetitious.

I think this is probably key at this point. If she wants pizza every day- give her pizza every day. Every week make new sauce and add different goodies She could have muffins every morning- make a bunch of different kinds, pop them in the freezer, defrost a different one every day.

So if you can get two - know she'll eat them and know they're nutritious- meals in her every day, that gives you lattitude to have a family dinner that's different every night that she can eat or not.

Something else to think on- what she's doing is developmentally appropriate. MANY kids go through a finicky stage. Her's is just more dangerous because of her medical issues.

let us know how it goes! I think of your family often

-Angela
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#19 of 85 Old 09-27-2006, 07:41 PM
 
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Originally Posted by dharmamama View Post
Yes, I think you're exactly right. That's why the attachment therapist's advice worked so well. We completely removed the power struggle by saying nothing about what and how much she ate. She was completely in control. It worked well. (Previous to that, she would do things like request something specific for dinner and then, when I served it, tell me she didn't like that food [before even tasting it].) The problem we run into now is that the AT's and the doctor's advice seem to conflict (the doctor was pretty clear that we need to *make* her eat what she needs), and I feel like I'm stuck either way: Make her eat things she says she doesn't want to eat and screw up our attachment but have a healthy kid or let her eat whatever she wants and have a malnourished kid. I'm looking for ways to integrate the two so they aren't opposing ideas. I really appreciate the advice and suggestions I'm getting.

I guess part of it too is that, as a vegetarian, I am constantly inundated with the "eat a variety to get your nutrients" idea, so the idea of serving spaghetti (for example) every day makes me uncomfortable. But it's true that, if I can get a variety of NUTRIENTS into the meal, it doesn't really matter if the MEAL is repetitious.

Thanks again everyone!

Namaste!

yes, that's definitely a difficult balancing act. just trying to think of ways for her to feel empowered and in control here-do you involve her in her meal preparation? I know my daughters are more willing to eat things if they're involved in the preparation, and if the preparation is fun. Using fun shaped cookie cutters (letting them pick out the ones they want to use, etc. etc.) on sandwiches and cheeses, making dips for carrots, having their own little pans for making muffins, breads, mini lentil or meatloafs, etc.
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#20 of 85 Old 09-27-2006, 08:56 PM
 
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Avacado, spinich, collards, broccli, carrot, etc.... these things can get blended/processed and added into so many other things - the pizza sause, sause for noodles, in the dough or noodles if you make them from scratch, in baking (muffins, bread, etc)... Avacado is so easy to hide that you can mash it into pudding cups or blend it into ketsup!

I would also go for suppliments, too. Why not?

Flax oil in cold food...

Strawberries and bananas (kiwi, pear, etc) mashed together into a gram cracker crumb crust - and go ahead an hide avacado mashed up, tofu, and some spinich cut TINY. you can stir in a touch of the flax oil... and even a spoon full of yogurt if you blend it well and add enough banana so she does not know the difference!
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#21 of 85 Old 09-27-2006, 09:18 PM
 
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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.

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#22 of 85 Old 09-28-2006, 12:15 PM
 
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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.
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#23 of 85 Old 09-28-2006, 12:41 PM - Thread Starter
 
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Your doctor is an idiot.
Actually he's not an idiot. He knows she needs more nutrition.

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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!
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#24 of 85 Old 09-28-2006, 12:50 PM
 
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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.
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#25 of 85 Old 09-28-2006, 12:50 PM
 
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I'm sorry, maybe I misunderstood, but when you said
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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.
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#26 of 85 Old 09-28-2006, 12:52 PM
 
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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.

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#27 of 85 Old 09-28-2006, 12:54 PM
 
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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.
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#28 of 85 Old 09-28-2006, 12:57 PM - Thread Starter
 
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Sorry, I was editing for clarification and we cross-posted.

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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.

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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.

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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!
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#29 of 85 Old 09-28-2006, 12:59 PM
 
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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?
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#30 of 85 Old 09-28-2006, 01:00 PM
 
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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.)

Divorced mom of one awesome boy born 2-3-2003.
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