My doctor FINALLY found a dietitian willing to see Peanut. I am not sure what exactly I was expecting from the visit, but whatever it was I sure didn’t get it.
Peanut has been exclusively gluten and casein (dairy) free since February. The changes we observed following the elimination of those foods were extreme. He suddenly became MUCH happier. He began making eye contact. His vocabulary began to build. The strange twitches and movements stopped. There was absolutely no denying the positive impact this new diet had.
But we were still left with some dietary ‘issues’
- He’s heavily addicted to breast milk. He’s on and off the breast all day long and breast milk remains the primary source of his nutritional intake.
- He’s a very picky eater. He primarily only eats meat, fruits, muffins and rice.
- He does not chew his food. Everything is swallowed whole and more often than not that which goes in is discovered undigested in his diaper once it comes out. Yuck!
- He refuses soft, squishy or mashed foods. He especially despises soups or foods that are not uniform in texture, but are touching each other. .
- He doesn’t eat consistently. It’s not unusual for him to go an entire day without eating. On occasion, he’ll go longer. But some days he’ll eat non-stop.
I have been on the fence as to what to do in regards to Peanut’s addiction to breast milk. On one hand, I can’t help but think that it has had a beneficial/protective effect. When the neurological symptoms reared their way into our lives during Peanut’s first 18 months it seemed quite apparent that something was terribly wrong and I worried of the extremity of the situation. There was obvious neurological/physiological damage occurring before our very eyes. It could have been much worse. While I do think gluten and dairy were large if not primary contributors to the problems, I continue to feel strongly that the breast milk helped on both a physiological and psychological level. Now Peanut is older (31 months to be exact) and breastfeeding is a HUGE comfort to him. It’s his happy place, unfortunately, it’s draining me physically and psychologically. Some days I just want to yell ‘PLEASE, JUST LEAVE MY BOOBS ALONE!’ I shouldn’t feel that way, yet at the same time, I’m not ready to completely wean either. He’s still very much my baby. There must be a middle ground.
But where? And how?
Truth is, I know exactly where that middle ground is. Nursing only before and after bedtime and naps. But I’m still lost in terms of getting there. Peanut screams when he is denied his mommy milk. And he’ll scream for hours. Literally. You know how some kids are easily distracted — Sorry hun, you can’t have mommy milk right now, but you can have a cookie — and then everything is fine and dandy and the child happily trots away with cookie in hand, well that doesn’t happen in my house. Not with Peanut. When he wants something nothing else soothes him. Nothing distracts him. Nothing!. How on earth can I get him to cut back?
Visit to the Dietitian
The dietitian was of absolute no help in offering ideas to reduce the breastfeeding. In fact, she seemed to favour cutting him off completely cold turkey as if breast milk was no longer of value to a child of his age. He may lose weight she said, he may be miserable, she said, but she could guarantee me that he was not getting the nutrition he required by relying so heavily on breast milk and therefore he must stop.
Ouch! I must say I totally was not expecting that. Have I really been depriving my son of the essentials he needs to develop and grow? To confound the situation further, she expressed worry that Peanut was not even absorbing the nutrients in the food he was eating as he does not chew it, but merely swallows it whole negatively affecting the entire digestion process. So in other words, I’m to completely eliminate the one source of food that is most easily digested and replace it with foods that his body won’t fully utilize.
So what should we do? These are the recommendations given to us by the dietitian.
#1. Give him rice fortified baby cereal.
#2. Puree his food to maximize digestibility and nutrient absorption. All of his food.
#3. Refrain from giving him any foods or drinks 2 hours prior to lunch and supper.
#4. Eliminate all breast milk during the day.
#5. If he refuses water, replace breast milk with fruit juice and or sweetened almond/rice/coconut milk
#6. Request blood work to evaluate for nutritional deficiencies.
I must say, for her being a pediatric dietitian whom specializes in special needs children, I felt a little weary of her approach. Peanut has been diagnosed on the spectrum and has issues with `soft foods` and here I am to offer him rice cereal and purees? I can see that going well… Not! Certainly some nutrient absorption through food chunks would be preferable over not eating at all?
And to replace breast milk with fruit juices and sweetened milk alternatives. Seriously?! I’m not opposed to such things in moderation, but to become his primarily source of fluid intake seems rather ridiculous. Is that really better than breast milk in her eyes? Is she aware of the sugar content of such things? Is she aware of the harmful effects of sugar?
Eliminating all food and drink for two hours before meals will undoubtedly lead to two hours of incessant fussing and screaming.
And is blood evaluation really necessary at this point? That’s a rather invasive test for a two year old. Since we are already in the process of rectifying his diet, wouldn’t it be preferable to wait to see how these diet changes play out before poking holes in the boy? Is he even showing symptoms of pathological anemia? Meat is the primary solid he will eat. Sure, he doesn’t chew, but surely he’s getting some iron form it.
I must admit the whole experience left me feeling a little defeated. Here I have been spending so much time planning meals and ensuring he’s been offered all of the vitamins and minerals his little growing body requires. But what am I to do when the boy doesn’t eat what I put in front of him. And how can I make him chew? We’re already seeing the occupational therapist in regards to this. I’m doing the best that I can. Sigh. I felt as though I was filling the void by breastfeeding, but apparently that is only making things worse. Sigh again! I just can’t bring myself to believe that.
[ Of note: There are zero concerns regarding peanuts growth. He is 33lbs and hovering over the 90th percentile for height. Growth has always been consistent ]