Saturday, July 17, 2010

Wise Up! = Questions & Comments - to Boost or not to bother?

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Okay, I'll start with the first question.

Background info - Re: Annual checkup(well baby/kid check) time for 5 year old son occurs around his birthday.
nurse practitioner - who had never met him in the last 5 years of his existence - recommends that we give our son lactose free Boost to boost his weight.  His Growth Measurement chart indicates his Body Mass Index is not balanced because his weight has averaged  the same for the past 2 years.  He is 4 feet tall, and has been quite slim since he was 1 years old.   Despite a developmental disability, our son is rarely ill.

We explained to the nurse practitioner that our son has good metabolism, is quite active, runs a lot, gymnastics, trampolines every day, and enjoys 2k nature walks about 3 times a week.

Anyway, 95% of his maternal male relatives (grandpa, uncles, boy cousins) were just as slim as him at the age of 5 and now are as tall as the average American front door. His dad says that he and all of his siblings(of average height) were quite slim as toddlers through high school, and they still are as adults. And, I was quite the model type before I got married (you know the old contentment issue, love handles syndrome,baby fat hanging on...oh!that's right were not talking about marriage bliss and pregnancy weight right now).

Let's stick to the point, bloggers!

As we were saying,...
Furthermore, we informed our new pediatric nurse that he eats well, and has a good appetite, although he is extremely picky.  Over the years, his birth pediatrician has said to not make eating an issue, as longer as he's eating something every day.  Our son enjoyed lactation and the breast milk kept him quite healthy.

Up to the age of 2, our son ate a large variety of foods. Because he has lactose intolerance, citrus allergies, and digestion problems, our son's food selections are affected by his sensory issues. Because his sensory issues affect his food selections, he no longer eats a large variety of foods.  He no longer tolerates 90% of any kind of  soft,stringy, mushy, or cold foods.  That's right - the onset of Autism Spectrum Disorder has taken away his joy of string beans, spaghetti, red beans, hamburgers, pears,peaches, natural apple sauce,real fruit pop-sickles, strawberry vanilla ice cream,cookies and cream ice cream.  He breaks out in itchy hives if given pure citrus-based foods.  Our little boy gags and chokes when attempting to eat oatmeal cereal and mashed potatoes, but will eat skin-on french fries and whole grains bread and cookies.[It's all about texture-smell sensations trumps taste-appeal and visually-appetizing.] 

Yes, our lovely son may take an hour to eat dinner...
First, we deal with the right selection - "I Want...." which he usually knows exactly what he wants to eat and when he wants to eat, and what foods to eat when. This means raisin bread only for dessert and not for breakfast,please and thank you.
Second, he addresses presentation: the right temperature-room temperature,slightly warmed, nothing hot or cold; And the right portion - preferably one food item per dish or a 3-segment dish; And the right size - if cutting no bigger than 1/2 inch on each side with 1 inch total circumference with 1 inch diameter; And the right color- nothing orange, blue,  green, black, dark brown, purple and red. But at least he eats?
Third,since a baby, he has to poke it, look at it, smell it, hold it in his mouth, and hopefully, chew and swallow the food.  At least he no longer holds the food in reserve in his mouth.  Overtime, his eating ritual is less obvious and intense.  But, at least he eats.

Also, our happy son only eats 2 brands of pepperoni pizza(picking off the pepperoni- but he won't eat it unless the round pepperoni is on there,at first).  &. [The pepperoni's got to go but the mild tomatoe sauce is masked by the white cheese, which he likes.]  He likes pb&j, but not on white bread. He likes cheese sandwiches with hamburger buns with seeds, but not grilled. [It must have an angus beef patty in between(which he used to eat and not the bread) so he can seperate and eat only the cheesy, seedy bread.]  But at least he eats!

Additionally, our cheerful son tolerates h2o-based white grape and apple juice &  nuts, oats, kosher chicken/turkey hot dogs. Our wonderful son prefers skin-on french fries, crispy chicken nuggets, fish, and shrimp. For breakfast, he likes blueberry pancakes,crispy hashbrowns,golden waffles, and biscuits with strawberry preserves. For snacks, he eats peanut butter, crunchy nuts and fruit bars, raisins, baked tortilla chips and cinnamon raisin bread.  He enjoys walnut raisin real oatmeal cookies-especially the freshly made ones at school. For dessert, he likes slightly steamed cinnamon apples; gingerbread cookies, and pecan cinnamon sweet potatoes  casserole. His fav treat is apple pie.  Our wonderful son will explore what's on our plates.  About every 6 months, he usually builds his menu choices and eats something different like shrimp. Being selected for his weekly menu is no guarantee that this food choice is permanent.  For instance, after 3 years of eating pork and beans,he suddenly just stopped.  He still eats raisin bread, but not the crust on this new brand- since the area no longer sells his favorite brand. He has refused to eat beef meats for over 3 years!  But, at least he eats.

So,we are creative in food preparation. We know we got to get the vitamins into our 'picky-eater', and keep him nutritionally balanced-while respecting his preferences and remembering his allergies.  For the past 3 years, this means trying to outsmart a toddler by hiding the nutritious foods he does not like in the foods he enjoys eating. I call it "bleguising" = blending + disguising of foods.  And it usually tastes just like it sounds, awful! This means extreme limits on fast-food!  Absolutely No salt additives! Absolutely No soda pop! Portion controls of candy only on holidays!  Extreme limits on sugary foods. 'Bleguising' (blending + disguising) vegetables into foods he does enjoy eating. And ...  flavor-free liquid vitamin supplements and baked chicken every day! Buy organic, gluten-free,casein-free, salt-free, and calcium-rich, when ever possible.

We are proud that our son has learned to enjoy the cafeteria routine; and eats at school - with no 'bleguising'. He enjoys whole grain bread with seeds on the crust-including his schools fresh baked breads and mini oatmeal cookies. He likes the school's breakfast pizza, cinnamon rolls and chicken nuggets.  Maybe, he'll try their salad,too.  He eats in the car, at the park and some relatives homes.  When dining out, he also prefers the single-line buffet style restaurant, but, will tolerate fine-dining waiters, if the ambiance is right -dim lights, low acoustics, and respect my comfort zones - please and thank you.


We think our son will make an excellent food inspector, if he chooses so!

Now for the question:
"Do you think we should follow this pediatric expert's particular weight boosting recommendation or should we just let nature run its course?"
[The Nurse Practitioner was nice, thorough, seemed sincere; and did give us a sample and coupons.]

FYI- Picky Eaters Eating Disorder:  A July 6, 2010 Wall Street Journal article indicating that if  our lovely son does not grow out of the picky eater stage, the 2013 Diagnostic and Statistical Manual of Mental Disorders(DSM) will classify him as having a 'selective eating' disorder 'not otherwise specified' (American Psychiatric Association).  This psychiatric reference speculates that he has 'obsessive-compulsive' tendencies.  Furthermore, long-term, these eating habits  could lead to 'nutritional deficient'  linked to heart and bone problems. 'eating disorder'! Not fair!  Our loving son is already labeled with one disorder-AUTISM SPECTRUM DISORDER! Well, that's another battle with the medical/MENTAL health insurance industry![Reference article "No Age Limit onPicky Eating"]

{Well, after learning that, I think we'll just start 'bleguising' the Boost into our precious son's h20juice!}


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{Well, after reading all of that, I think we'll try 'bleguising' the Boost!}
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