Sunday, March 13, 2011

Food Frustration

I am a crappy blogger, and realized that I haven't had anything to say about the star of this blog since her birthday. Bad Mommy.
Anyway - Natalie is 14 1/2 months old now, and turning into an incredible little lady. She is chattering up a storm, with actual words interspersed in her baby babble. Everything is "ELMO!!!" or "woof woof," or "puffs!" She says Mama and Dada also, and a few other things here and there. I know that, any day now, she's going to start talking conversationally! She's also working on walking - she's taken a few steps on her own, though she doesn't quite trust herself to do it consistently. But if we hold her hands, she'll practically run around the house, giggling as she goes! She still only has her two front teeth in the bottom, though when she smiles I can definitely see a few more that are just below the surface, waiting to push through. It's like everything is going to happen at once, and this is all the calm before the storm!
One area in which she is not excelling, unfortunately, is her eating. We began transitioning her from pureed baby food to table food around November - very slowly at first. Giving her a few bites of age appropriate foods before offering her the purees. At first she did OK - seemed to enjoy being able to self-feed and explore new tastes and textures. But as we increased the amount of table food we were giving her, the more she rejected it. Even things that I knew she liked in pureed form, like sweet potatoes, green beans, and bananas, she was rejecting in their solid form. But I wanted to be patient - let her explore the solids at her own pace, and that eventually it would pick up and she'd transition effortlessly. But it didn't happen as quickly as we would have liked.
We had a little bit of a scare back in January... I took her for her 12 month checkup, and she'd barely gained a pound since her last appointment in October. I freaked. The pediatrician told me it was nothing to really worry about - that she had become mobile since October (crawling) and that burned a lot of extra calories. But from everything I'd read, they should be eating enough calories to make up for the calories they are burning. I know that babies gradually slow down from the very rapid weight gain many of them experience in their newborn months, but this seemed overly disconcerting to me, especially since Natalie's weight had been a concern of ours since day one of her tiny little life. I disclosed to the doc that Natalie had not been eating well - in some cases, even rejecting her beloved purees. She was not very open to trying new things, even when I was CERTAIN she would like them. And this is not for lack of trying on our part. Reintroducing things day after day, and still having no luck. And of course it wasn't helping that the Facebook and social peanut gallery was offering me suggestions and asking things like, "have you tried this? have you done that? you really need to do x, y, and z..." - as if I wasn't trying EVERYTHING in the world to try to get this kid to eat. It was painfully reminiscent of our exhausting breastfeeding struggles which ended in an epic fail... but failure wasn't an option here. We had no choice, we had to get Natalie eating properly.
Once again, the doctor said we really shouldn't be concerned... that as long as she wasn't losing weight, everything was OK. But I was not fully convinced.
So, I called in reinforcements... Montgomery County Early Intervention Services.
While Natalie was in the NICU, our case worker had informed us of this program, and how we'd be eligible for services essentially until she was 2, due to her prematurity and low birth weight. And every few months since she was born, I'd been filling out questionnaires to submit to them to help them "track" her progress. If ever anything came up suspicious on the forms, they would contact me for elaboration.
In any case, emailed our case worker and let her know that I had some concerns about Natalie's eating and weight gain. They dispatched their evaluation team, consisting of the case worker herself, an occupational therapist, a speech therapist, and a behavioral therapist. They conducted their eval of Natalie and determined that, though she was measuring ahead of her adjusted age in every other area, that yes, there likely were some issues with her feeding and they were going to refer us to a team of a dietician and an OT to help work on solving the problem.
Upon meeting with the dietician the first time, and explaining to her what Natalie WOULD eat, and the things that I'd tried to offer her that she had rejected, it was decided that yes, we were on the right track, and no, there was nothing major we could be doing differently, save from a few tips and suggestions. The following week, the Occupational Therapist came, and we began exploring the problem. We determined that a lot of Natalie's issues were texture-related, which is not at all uncommon in premature children. And that some of her resistance was simply her learning that she has an opinion and is able to exert her independence by sharing it. And it was a way for her to be able to control part of her life... something she had previously not been able to do.
The truth of the matter is, she wasn't going to starve. Even if one or two meals a day were less than sufficient, she was still getting the nutrition and calories to help sustain her from her 3 times daily bottles of formula or milk (we were in the process of transitioning her at this time, too). But, I feel strongly about successfully weaning her from a bottle before she's 18 months... so I didn't want to rely too heavily on the bottle, when I knew we just had to keep plugging away with the solids. She LOVES her breakfasts... will often times eat two full Eggo waffles, the better part of a banana, sliced strawberries, or a (200 calorie!) bowl of grown-up oatmeal. So, we know she's getting more than enough food at breakfast. It's the subsequent meals that are a struggle. Especially proteins. Yogurt is always a go-to food for us - she will pretty much eat it, in any flavor, at any time. But beyond that... we have trouble. And don't get me wrong - there are a few things that Natalie will eat, and eat a decent quantity of, at that. But I never know what those things are going to be. I really wanted to avoid the much-criticized "American-kid-mac-and-cheese-chicken-nugget" diet, but I completely and totally understand why it's so popular - as these are two foods that kids will actually eat!  And even those things, as delicious as they are, she rejects sometimes. There are days that she blows my mind, and will eat everything I offer her. And other days when she would rather fire her grapes on the floor and make a mess of her tray than put anything in her mouth.
It's terribly exhausting and frustrating... and I wish there was just a magic solution that would fix it. I know it's not uncommon for kids to be picky, but Natalie's issues are beyond those of a picky eater. And I also know eventually she will work it out. But it's just another thing to check off on my list of "term baby envies" that I have running in my mind. I'm so happy for my friends and their children when I hear of the amazing milestones that they achieve and how easy things are for them... but I can't help but get a little down and feel slightly jealous sometimes too!
All of that said, Natalie is happy and healthy, and according to the dietician's scale, she had gained nearly 2 pounds in the 6 weeks since her January pediatrician appointment, so obviously something is working. But, it's still tough and mealtimes, admittedly, are my least favorite times of the day. Here's to hoping things improve soon!

1 comment:

  1. On my phone right now, remind me to comment more or email you later - we are struggling a LOT with food. I really empathize with you.

    ReplyDelete