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Rachels
08-26-2003, 02:39 PM
So we saw the nutritionist yesterday. Abigail has lost another half pound, and I'm feeling very freaked out about the fact that she won't eat. Then today, she fell down and cut her gums, which just isn't going to help matters. Sigh. Fortunately, the nutritionist was really great and had lots of ideas for maximizing her caloric intake. This will be LONG, but I thought I'd share in case others are interested in free nutritional advice. The short lesson is that you cannot overdo fats for a baby. Reverse everything you do for yourself regarding fats, and you'll be on the right track. Anyway, this is all high-calorie stuff, so you don't need to fortify milks and puddings and shakes so much if your baby isn't low-weight. Here were some of her suggestions:

Snack ideas:

English muffin with melted cheese or cream cheese
Cheese, meat, poultry, or tuna sandwich with mayo or butter
Cereal with milk AND cream
Whole milk yogurt with granola or toasted wheat germ
Bananas or apple with yogurt dip
Milkshake / frappe (see below) - 1/2 - 3/4 cup for each snack
4 oz yogurt with 1 T heavy cream or nonfat milk powder
Pizza
Full fat ice cream
Crackers with hummus, butter, or cream cheese
Fortified pudding (see below) - 1/4 - 1/2 cup per snack

Shakes and Frappes:
* Vanilla shake (400 calories): 1.5 cups vanilla ice cream, 1/2 c. whole milk, 3 T nonfat milk powder.
* Strawberry Shake (530 calories): 2 c whole milk, 2/3 cup nonfat dry milk or 1pkg Carnation Instant Breakfast, 2.5 cups strawberry ice cream, 2 T heavy cream
* Creamsicle shake (560 calories): 1/2 cup whole milk, 2 T nonfat dry milk powder, 1/2 cup orange juice, 1 c. orange sherbet, 1 pkg Vanilla Instant Breakfast
* Banana Shake (670-790 calories): 1/2 cup whole milk, 1/2 cup orange juice, 1 cup vanilla ice cream, 2 bananas

Fortified Milk (180 - 210 calories): Add 2-4 T of powdered nonfat dry milk or 1 T of heavy cream to 8 oz whole milk

Fortified Pudding (326 calories): 1 cup fortified milk, 1 cup heavy cream, 1 pkg instant pudding mix

Super Grilled Cheese: Dip cheese sandwich into egg and fortified milk mixture, then grill with lots of butter. You can also put mayo or butter inside the bread.

Other calorie info:
* Butter, margarine, oil - 45 cal / tsp - add to everything, spread on crackers, sandwiches, breads
* Instant Breakfast Powder - 130 cal / packet
* Cheese - 100 cal / oz
* Cooked meats: 50-75 cal / oz
* Cream cheese: 50 cal / tsp - add to toast, crackers, breads, fruits, mashed potatoes, mac & cheese
* Heavy cream: 50 cal / Tablespoon - add to milk, cereal, mashed potatoes, eggs, cream soups, milkshakes
* Mayo: 100 cal / Tablespoon
* Sour cream: 30 cal / Tablespoon - use w/ potatoes, beans, squash, carrots. Add to gravies and casseroles and use for dip.

Sample meal plan: (ambitious-- there's no WAY a toddler is going to eat this much, but it's what to work toward in the first six years)

BREAKFAST:
1/2 cup juice
1/2 - 1 egg
or 1/4 - 1/2 cup cottage cheese
or 1-2 tsp of nut butter
or 1 - 1.5 oz cheese or meat
1/2 slice of bread with butter
or 1/4 cup cereal
4-6 oz whole milk or fortified milk

AM SNACK (see snack ideas)

LUNCH:
1 - 1.5 oz of meat, poultry, fish, or tofu
1/4 - 1/2 cup vegetable with butter or margarine
1/4 - 1/2 cup potato, rice, or pasta with butter or margarine
1/4 - 1/2 cup fruit
4-6 oz fortified milk

AFTERNOON SNACK (see snack ideas)

DINNER:
1 - 1.5 oz meat, poultry, fish, tofu
1/4 - 1/2 cup deep green or yellow veggie, sprinkled with cheese
1/4 - 1/2 cup whole grain bread, potato, rice, or other starch with 1-3 tsp gravy / butter /margarine / oil
4-6 oz fortified milk

EVENING SNACK (see snack ideas)

I hope this is helpful!

-Rachel
Mom to Abigail Rose
5/18/02

alkagift
08-26-2003, 02:56 PM
Rachel,
It sounds like you've gotten some good advice there. I thought Abigail was off dairy so I didn't have any good ideas. But from your list it looks like she might be able to eat dairy, so perhaps my lone thought will be helpful: pimiento cheese. It's is a great thing and heavy--grated cheese, mayo and pimiento--you can put pepper in it or not. I ate it on celery sticks as a kid, but crackers or bread are good too. Kids like it because it's a tad bit sweet with the pimiento. If you'd like the recipe, just PM me or reply and I'll post it. You can always buy it too, but it's cheaper and better if you make it yourself.


Allison\r\nMom to Matthew Clayton, 5/19/03

Karenn
08-26-2003, 03:13 PM
This is great, I've printed it! Thank you for typing it all in to share!

Rachels
08-26-2003, 03:24 PM
Oh, you're right, she was. She seems to have outgrown her milk sensitivity. I'm nervous-- really nervous-- about giving her milk to drink, but the last two rounds of food tests have shown milk to be fine, so I guess we're trying it.

-Rachel
Mom to Abigail Rose
5/18/02

COElizabeth
08-26-2003, 03:51 PM
Rachel,

Thanks for posting this info. I was wondering what if anything the nutritionist said about the timing of nursing sessions. I know BM is pretty high in calories and fat, so I have not been worrying too much about whether James nurses before or after a solids meal, but I am wondering if I should change that either now or in the next few months.

Elizabeth, Mom to James, 9-20-02

etwahl
08-26-2003, 04:17 PM
I definitely want to see how she does on milk. lauren's poops are still like watery diarrhea, but at least they're not green.

i hope it all works out better.

Tammy,\r\nMom to Lauren Genevieve\r\n03/12/2003\r\nwww.evantammy.com

newbelly2002
08-26-2003, 04:47 PM
Sorry to hear that Abby's dropping weight, but it sounds like you've been given lots of good advice and support. Thanks for taking the time to type all that out. It's got some great ideas!

Paula, Mama to Dante\r\nhttp://www.shutterfly.com/osi.jsp?i=67b0de21b32384e84594 -6/25 update

Andrea S
08-26-2003, 04:59 PM
Thanks for sharing all that info. I am always looking for different stuff to feed Andrew. I am also curious about when you nurse. Right now we nurse first thing in the morning then 1-2 hours later he has breakfast then nurse before am nap lunch around noon adn nurse before pm nap then dinner 5-6 and nurse before bed. I guess that we nurse instead of snacks.


Andrea
mom to Andrew 8/14/02

Rachels
08-26-2003, 05:24 PM
We sort of do that, too. We nurse in the morning when she wakes up, then before and after naps and whenever she bumps her head. Then we cluster nurse in the evening after dinner-- snuggle, nurse, play, check back in and nurse, play, nurse. Evening breastmilk has the highest fat content of the day, so I let her nurse as often as she likes in the evening.

They didn't say anything much about the timing of nursing. The nutritionist was clear that breastmilk is the perfect food, so that was helpful. The GI doctor would have me quit nursing now in favor of formula, which I'm not about to do. Personally, I don't want to monkey around with her nursing schedule, either. I figure she knows when she needs to nurse, and I respect her clock. She doesn't seem to nurse for hunger in quite the same way that she used to, so I'm not too concerned about trying to figure out a ratio of milk to solids. Also, breastmilk is one thing she will ALWAYS tolerate, even when she's refusing food. It scares me to think what would have happened these couple of weeks if she wasn't getting that.

FWIW, I asked about sugar in some of those recipes-- ice cream, yogurt, pudding. The nutritionist told me that she's not nearly as concerned about that as she is about fat and calories. I made one of the fortified shakes and Abby downed about a third of a cup of it, which is the most she's eaten at one stretch in several days.

-Rachel
Mom to Abigail Rose
5/18/02

nigele
08-27-2003, 10:55 AM
Rachel,

Thanks for posting the info. and I'm glad you got some helpful suggestions from the nutritionist.

I was wondering if she mentioned PediaSure? Our ped. wants Tom to drink one can a day but I'm lucky if he drinks a quarter of it. I was thinking about trying Carnation Instant Breakfast and I was so excited to see the nutr. recommended it for Abby. I'm going to give it a try and see if he likes it.

Edited to add one more thing: Tom nurses a lot during the day when he has to wear his eye patch. I let him since he is so upset about the patch and anything I can do to make up for it is fine with me. I have had a lot of comments from people that he WOULD eat real food if I would stop nursing him so much, which worries me. At the same time, there is no way I am going to refuse him a comfort measure when he needs it. I feel like I'm stuck between a rock and a hard place!

Rachels
08-27-2003, 03:15 PM
Lisa and I talked by phone, but I thought I'd post the answer to this in case others were interested. As for PediaSure, the nutritionist said it was better to use fortified milk (see recipe above). It has more fat and calories, costs less by a mile, and has fewer preservatives and less sodium.

As for nursing...I don't know. She did not recommend that I cut down on nursing, and I wouldn't have even if she had. Breastmilk continues to carry multiple advantages into toddlerhood and early childhood. Here are some links that have a lot of useful info and research about extended breastfeeding:

http://www.kellymom.com/bf/bfextended/index.html
http://www.promom.org/bf_info/toddler.htm

Also, the W.H.O. and UNICEF recommend nursing until AT LEAST two years of age, and they don't qualify that at all. They don't say, "Nurse until two at minimum unless your baby isn't gaining well, in which case you should nurse less and feed more solids."

It's worth noting that the W.H.O. is developing growth charts purely for breastfed babies, because the growth rates of formula-fed babies are different. Current growth charts at your ped's office are for formula-fed babies as well. Remember that formula is usually cow's milk-- which is designed to help little cows double in size within their first month. Unless it's organic, it also will include bovine growth hormone, to make the process even faster. Breastmilk doesn't have any of that, and it's designed to help little people grow at the rate little people are supposed to. That's why it makes sense to separate the growth charts. What looks like low weight gain might just be normal for breastfed infants. You can see preliminary breastfed baby charts online-- I think ProMom has them.



-Rachel
Mom to Abigail Rose
5/18/02

wendmatt
08-28-2003, 03:01 PM
Thankyou so much for all your info Rachel, you're amaziing to take the time to type out all that. Thanks also for the info about nursing. Emily loves to nurse and I don't want to force formula on her. She was 2 weeks late so she was big at birth and has dropped from the 95th to 10th percentile. She looks healthy to me (not skinny)and eats quite well and has grown in height, but seems to be stretching out rather than getting rounder. Ped says to worry, but after reading your info I'm less worried, so Thankyou a million.

Rachels
08-28-2003, 03:16 PM
Oh, my pleasure. I'm glad it was helpful. (And I agree-- don't worry! If your baby is nursing well and is healthy, no need to supplement.)

-Rachel
Mom to Abigail Rose
5/18/02

ginalc
08-30-2003, 09:41 PM
Hi Rachel,

Something else that can help is to offer "dipping sauces" in little cups at meal times as well. I have used salad dressings of different colors (blue cheese, wrangler, etc.) to add some calories to veggies. My oldest DD LOVED veggies and I too needed to add some fat to her diet. The cups worked wonders for us.

Good luck with the new diet. I hope Abigail finds some of these foods yummy enough to fill her little tummy and put on some weight! :)

gina, mom to 3

barbarhow
09-01-2003, 04:43 PM
Another thank you! My ds is also "little". 75th %ile for height and 10th for weight. He looks very healthy to me. Is developmentally on target, happy and alert. That doesn't mean that at times I don't question whether I am doing the right thing bfing. My friends baby was born the day before ds and weighs 22 lbs. DS is only 14. I try not to compare but it is hard. It really helps to know that there is a difference in weight gains for bf babies. Thanks!
Barbara-mom to Jack 3/27/03

Rachels
09-01-2003, 06:56 PM
You're welcome! You're doing a wonderful thing for your baby by nursing him. You're giving him the food your body prepared especially for his needs. Babies grow at different rates, especially if one is formula fed and one is breastfed. The growth charts also represent a normal curve, the very nature of which makes it impossible for every baby to be right at the average mark. Being in the tenth percentile is not any "worse" than being in the fiftieth, or the ninetieth. It's just a way of keeping track, and it's also flawed. If your baby is happy and healthy and meeting milestones, you're not doing either of you any favors by comparing him to others! It makes me a little sad to hear that you question whether breastfeeding is the best thing for your baby. Just remember: your body knew exactly how to grow this phenomenal little creature, and you didn't need help to figure out exactly where his ears should go or exactly when he should get fingernails. It's a miraculous, perfect system. Your body, which knew so well how to grow and deliver your baby, is the very same body which started producing food for him immediately upon his arrival. It knows exactly what he needs, and you're doing him a favor by giving it to him. If you need a psychological boost, though, check out this link. It's VERY interesting, and reassuring.

http://www.promom.org/101/index.html

Keep up the good work!

-Rachel
Mom to Abigail Rose
5/18/02

barbarhow
09-01-2003, 07:59 PM
It's not so much that I question doing it-I love doing it-but when the doctor and family and friends comment on how "tiny" my little peanut is-I start feeling a tad inadequate. I do-in my logical brain, know that the bfing is the best thing for him. I will definately check out the link. Thanks!
Barbara-mom to Jack 3/27/03

houseof3boys
09-01-2003, 09:19 PM
Rachel - I liked that promom site. I went to the part about the 3 minute activist and was impressed at what they had done to try to promote more public awareness with breastfeeding.

Thanks for the link, it was interesting!

peanut4us
09-02-2003, 01:56 PM
Here, here to this whole post! DD is only 2 weeks older than your son and she's just shy of 15 pounds. She seems good and chunky to me and has been entirely healthy for better than a month now (what a relief, whew!).

I'm very interested to see the growth curve from W.H.O. Rachel, do you know when that is going to be done?

barbarhow
09-02-2003, 04:33 PM
I love the promom web-I would love to print the 101 reasons to breastfeed and hand it to anyone who raises a brow....
And thanks Joey for your input, too. He actually appears to be chunking up a bit lately.
Barbara-mom to Jack 3/27/03

peterkin
09-19-2003, 09:00 AM
Just wanted to thank you all for these posts. I know they are old but they have helped me. My DD is in the 10th percentile for weight (95th for height). She has never LOST weight but has been gaining more slowly since about 6 months (she just turned 12 months). She weighed 7 lb at birth and weighs 18 now at 12 months. She seems happy, healthy, on track developmentally, etc. but I do worry a bit that she doesn't take in enough calories. She looooooooooooooooooves veggies so I think that is some of it. So far she is not that interested in most table foods -- she still loves pureed foods, especially veggies but also meats. Not very interested in fruits. She will eat table foods like crackers, bread, cereal, etc, and occasionally other things like grilled cheese or beans or something. We are trying to switch her from bottle to cup (going OK but she is hardly drinking anything now!) and from pureed foods to finger foods (I'm not pushing it too much as we are also doing the milk transition). She eats about 18-30 oz of pureed foods a day and about 20 oz of milk/formula (before we started cup instead of bottle), so the ped didn't think that sounded bad ... Also, my husband's family is all very tall and skinny. (Lucky them!) I have read Ellyn Satter's nutrition book over and over but may try these tips. I guess the main thing is, you can't force your baby to eat, you can just offer the food. So maybe I will try more fattening foods in addition to her beloved veggies. Anyway, thank you for the extensive list and the tips.

Ruth/Kay 09/14/02

spu
09-19-2003, 11:00 PM
Hi rachel,

thanks for sharing all this great information. I hope Abigail is feeling better soon. All these snacks and meals sound too good to resist!


susan

twin girls 7.20.02
charlotte + else

http://home.earthlink.net/~sunger1/bash/nonflash/year.html

doubleL
09-30-2003, 03:12 PM
Rachel,

I am new to these boards and just found this info which is fantastic... one of the many things I wish I'd known a year ago.

Two questions... what is in non-fat dry milk that is not in whole milk, anything other than additional calories? Just curious about this. Also, did the nutrionist say until what age to keep up all the fat?

Thanks tons.

Lou
~DS 5.01
~DD 6.03

Rachels
09-30-2003, 08:15 PM
You should keep upp the fat in a baby's diet for the first two years. I'm not sure if that varies for kids who have weight concerns past that point. I'm also not sure about the nonfat milk. It was suggested to me as a way to boost calories.

Welcome to the boards!

-Rachel
Mom to Abigail Rose
5/18/02

22tango
01-16-2004, 11:36 AM
Rachel!!

I am SOO Thankful for this post of yours from a few months back!! Karenna is a string bean. Although not actually losing weight, she has slipped down over time from about the 25th percentile to the 7th while her height has gone up from the 80th to the 90th!! Her pediatrician doesn't seem concerned yet -- although she did mention the weight going down as a factor of being more active. Still, I'd like to do what I can to help her maintain or even gain back a little weight.

I'm wondering if you have any new ideas for foods/snacks that Abigail loves after following the nutritionist's plan?? THANKS!!

barbarhow
04-01-2004, 10:28 PM
This post was so helpful to me months ago. I am so glad I could find it again. I have printed out your list. Jack has been clinging to his5th percentile curve but has been so sick this week he has lost almost a pound. Alot for a babe who only weighs 18 to begin with. Thanks again Rachel for the list. I hope he'll be up to solids soon so I can start trying these out.
Barbara-mom to Jack 3/27/03

turtledove
10-10-2006, 03:08 PM
Bump for the several people looking for this thread. Can we get this moved out of this forum and into the feeding forum so it is easier to find?

missym
02-07-2007, 11:18 AM
Bumping - this is some of the most useful info I've found on feeding issues.

Missy, mom to Gwen 03/03 and Rebecca 09/05

** Want to discuss issues with other Conservative parents? Join us at
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daisymommy
05-29-2010, 11:35 AM
We need to pin this post.

Rachels
05-29-2010, 08:22 PM
A friend alerted me to the fact that this post has been bumped after all these years. I thought I'd post an update. Abby is now a beautiful, healthy eight year old. She's absolutely thriving. This child who was attached to my hip for the first couple of years is free-spirited and independent and confident. For anyone who is struggling now with a baby who isn't sleeping, who doesn't want to separate, who clings, who wants to nurse all the time, who struggles with eating, I offer this as hope. I followed her cues and respected our relationship with each other, respected what her body and mine said we should do, and accepted her for the child she was. It worked. Like any human being, she's got challenges and things she struggles with, but I would never have imagined that she would get where she is from the place she was when I wrote this post. Trust your baby, trust your instincts. Development happens on its own clock, and it's beautiful to watch. She has been an amazing teacher for me, and she's a fun, spirited, confident kid. What a ride.

mommylamb
05-29-2010, 08:58 PM
I'm so glad it all worked out for you.

I was so confused when I first read this post because I looked at her birth date in your signature and thought you were having problems with an 8 year old not eating... and then people started talking about breastfeeding, and I thought, well, that's strange...

LMPC
05-29-2010, 09:01 PM
I'm so glad it all worked out for you.

I was so confused when I first read this post because I looked at her birth date in your signature and thought you were having problems with an 8 year old not eating... and then people started talking about breastfeeding, and I thought, well, that's strange...

:yeahthat: I was reading...and trying not to judge, but thinking "there must be better ways of increasing calories in an 8 year old besides BM."

SO glad to hear that things have gone well. And thanks also to daisymommy for the bump!

missym
05-29-2010, 09:49 PM
We need to pin this post.

This thread is already included in the pinned topic at the top of the forum: Feeding Your Child Resources: allergies, weight issues, etc. (http://windsorpeak.com/vbulletin/showthread.php?t=286588) .