Ask Moxie

Q&A: baby not eating during the day

Fran writes:

"This is kind of an odd question, but is it possible for a six-month-old baby to refuse food even if she's hungry? Lately I've been having a horrible time with my daughter Lulu. She refuses a bottle constantly, or else eats just a couple of ounces (she's bottlefed) and rejects the rest in favor of playtime on the floor. That would all be fine with me, she's in the 100th percentile for height and weight, so no health worries, and I don't want to force her to eat, even if that were possible. What drives me nuts is that 1) she's grumpy a lot of the time because she's hungry and won't eat (and yes, she's definitely hungry, because if I can somehow get her to eat, she cheers up immediately), and 2) she's started waking up at 2 and 5 am demanding food again, I think because she's not eating enough during the day. This is maddening because she was one of those kids who slept through the night early on, and we're having a hard time adjusting. I've tried giving her solids, tried watering down her formula for those middle of the night feedings, tried giving her just a pacifier or water, but nothing seems to work. She's just on the cusp of crawling, but I'm not sure that's the reason for her not eating; she seems bored by the bottle, and will only take it if I put her in weird places, like her exersaucer, or lying flat on her back in the middle of the living room. I'd like to think this is just a phase, but if it is, it's a very, very long one.

The pediatrician recommended not giving her a bottle when she cries in the middle of the night, lest she get used to it, but what can I do? The girl's obviously hungry. At the same time I definitely don't want her to get the idea that this is going to be a regular feature of nighttime. We are so tired that I'm not even sure what I'm asking here--but if you and the Moxites have any suggestions for any of this, we would be so, so grateful!"

And here I thought this was a problem that mostly affects breastfed babies. It just goes to show that one of my primary theories may be correct: Everyone's got the same problems, they just manifest themselves differently depending on your circumstances.

At any rate, this does seem to be a problem of this age and stage of development of babies. They get to this age and are just so excited by everything that's happening during the day that they don't want to stop and take the time to eat. It mean, who wants to waste time on milk when you could be looking at cool stuff? Or trying to crawl or scoot or roll? Only suckers waste time eating.

I also think that sometimes at this age babies are teething (either pre-teething or active teething) and that make them not feel like eating. So combine those two factors, and the kids may not eat much at all during the day.

Of course then they need the calories, so they eat at night while nothing exciting's happening, and while they're relaxed enough that the teething might not hurt so much.

So I would NOT try to cut out food at night, since I think the mechanism works the other way around, and that won't entice them to eat more during the day but will make both of you miserable without fixing the problem. Instead, I'd try to help them want to eat more during the day. The classic trick that most breastfeeding moms have tried (notice how I word that--it may or may not work) is to go into a dark, quiet, super-boring room when it's time to eat. Minimize distractions as much as possible, and hope that that lets the baby focus on eating.

You can also try to feed the baby right as soon as she's coming out of a nap, since kids seem to be more likely to eat while drowsy, before they remember that there's all that exciting stuff going on. As many calories as you can sneak in during the day will help with nighttime.

You can also try to alleviate some of the teething symptoms by giving the homeopathic teething tablets (either Hyland's Teething Tablet--they contain lactose--or Humphrey's #3 formula--they contain sugar but not lactose). The pills  are small and will dissolve easily in a baby's mouth and have such teeny tiny concentrations of active ingredient that there's debate over whether they can do anything at all. I've been happy enough with them (even if it is a placebo affect) to use them for both my kids and give a bottle as a shower gift to my friends. A pill a few times a day should take the edge off just enough to help a teething baby more likely to eat.

The good news is that this is a time-specific problem. At a certain point the baby will become more interested in food again and less agog about the environment, and the days and nights will flip back in your favor.

Anyone remember this phase?

Special needs of all sorts and the school year

I had a great time at the Phila area meetup yesterday. What an interesting, thoughtful, funny, snarky bunch of people.

One theme that came up a lot was that parents seem to be dealing with all kinds of issues with their kids and a variety of special needs, and things seem to be extra amped up now that school's in session.

Food allergies. ADHD. IEPs. Therapy. Learning disabilities. Movement issues. Autism/Asperger's. All kinds of stuff. I just think about these parents standing at the bottom of the cliff, looking up, knowing they're going to have to do such an incredible haul to get up to the top to make sure their kids are OK. It's exhausting just thinking about it.

And if you're thinking, "This doesn't affect me," well, it might, and you just aren't aware of it. I found out last week that the "nut-free and dairy-free classroom" notice for my son's class didn't just mean that one of the kids, A., wasn't allowed to ingest dairy. It means that if A. touches dairy or touches a kid who's touched dairy and hasn't washed hands in between, he puffs up like a big red itchy wheezing balloon. It would have been nice to know how serious it was, so that I'd avoid all dairy things in my son's lunch. I'd been putting cheese inside his sandwich on the logic that my son knew not to give bites to other kids in the lunchroom (bonus of my short-lived gluten intolerance--my son accepts food issues). But once I told my son about the other kid's allergy *he* said, "Oh, so I shouldn't bring cheese in my sandwich anymore in case I accidentally touch A. after I eat it!" Woulda been nice to know--for us *and* for A. and his mom--three weeks ago...

So, anyway, until I get the message boards up and running, could those of you who've been there (enu, hedra, etc.) provide some emotional support for the parents who are in the middle of a long process of advocating for their kids? Also, is there anywhere online a printable list of commercial snacks that comply to food allergy specifications? (Like a list of snacks that are GF, one that's dairy-free, one that's soy-free, etc.)

Product Review: Batter Blaster

If you're like me, you get a Million Dollar Idea every couple of hours or so. Anything from a Monkey Ranch to train monkeys to replace dropped pacifiers in the middle of the night, to very elaborate public toilets in NYC, to a full-body parent suit that would keep us dry and comfortable when pushing a stoller no matter what the weather, to any number of baby gadgets which I'd tell you about except I still harbor plans to manufacture them and sell the in the One Step Ahead catalog (aka SkyMall for Parents).

So I admire people who come up with a Million Dollar Idea and then actually act on that idea. Like the guy who thought, "I could make pancake batter out of organic ingredients, then put it in a Cheez Whiz can, so people could make one pancake or waffle at a time."

And if you're doing something that brilliantly goofy, you might as well call it Batter Blaster.

It's a completely bulletproof idea. Kids like pancakes, but adults don't always have time to mix up a batch. (Apparently it's also marketed to empty nesters or single people who only want a few pancakes at a time.) The mixes cut out some steps, but aren't that delicious, plus they contain a bunch of added preservatives and crap. Batter Blaster is made of organic ingredients and very few preservatives, so technically it's probably healthier than anything you could whip up yourself (unless you buy all organic cooking flours and sugars, etc.).

Confession: I don't like pancakes or waffles. (Although I love French toast. Go figure.) So this is perfect for me. My kids can have pancakes whenever they want, but I don't have to mix up a batch and then feel guilty for not wanting to eat any myself. I tried it out on the kids, and they both gave thumbs up on the flavor. I'm not sure it's better than my mom's recipe, but since I rarely make my mom's pancake recipe because I don't like pancakes, the kids are coming out ahead with the Batter Blaster any way you look at it.

The kids had fun spraying it into the pan themselves. And all I had to clean was the pan. No mixing bowl and measuring cups.

As far as I can tell, there are only two negative things about Batter Blaster. One is that it's on the pricey side: Around $4.80 for one can that makes 24 pancakes. (Although still way cheaper than going out for pancakes.) The other is that it's made of actual food and not chemicals, so it only lasts so long in your fridge before it goes bad. That means you can't stockpile cans of it in your emergency kit. So no pancakes In Case of Emergency.

But if you're willing to pay the money to have good, easy pancakes in the next few days, Batter Blaster is one of those iedas that makes you annoyed you didn't think of it yourself.

The thing I think would make Batter Blaster truly amazing is if they'd make a gluten-free version. Think about the awesomeness of being able to make gluten-free pancakes or waffles by the piece. One GF person in a house of gluten-eaters could still have pancakes! But maybe I shouldn't have given away that particular Million Dollar Idea...

(The Batter Blaster people sent me a can to test out, but I got no compensation except the actual batter.)

Superfoods checklist

One of the support groups on the T-Tapp web forums is challenging ourselves to eat more "superfoods" for the next six weeks. We took a couple of the superfoods lists and mashed them together and reorganized them, then I turned them into a PDF. The challenge is to eat two servings from each of the categories every week. If you want to play along, download the list and jump in.

Download superfoods_chart.pdf

(If you want to mess around with the chart and add your own columns, here's the Excel version.)

Download superfoods_chart.xls

Q&A: hiding early pregnancy on family vacation

I realized I've been dodging writing about negotiating things with your parents for awhile, but it's time to bite the bullet and write about it. And that it's really more like 3 days' worth. So the whole adult kids/adult parents thing is going to start Tuesday, after I've had the holiday weekend (here in the US) to work on it.

For today, though, a time-sensitive question from Rachel:

"I am going to [American region famous for wineries] for an extended Memorial Day weekend family vacation with my in-laws! And, I will be almost 7 weeks pregnant at that time, and don't want to tell them!

Help!

My husband and I don't drink, so we are already out of the wine tasting events, but we have reservations for almost every meal (Sunday through Wed morning) at amazing restaurants. Under normal circumstances I would be *very* excited about these restaurants, however for the past week I have been having major food/smell aversions and my diet has consisted of things like plain chicken breast, white rice and mini stoned wheat thin crackers. Don't think I'll be finding these items on the menus of the foodie restaurants in [American region famous for wineries]. I am assuming my morning sickness/aversions will be getting worse before they get better...Another problem is that my in-laws are late eaters, so all of our dinner reservations are at 8pm and I know I'm going to need to eat before then, especially the first day when I will be on east coast time and 8 will be 11pm for me.

We are also all staying in a "family lodge" which has separate bedrooms, but a common living area, so it may be hard to sneak off for naps, go eat on my own,  to go throw up, etc.

We may end up having to tell them, but really don't want to tell people quite so early as I haven't even had a prenatal appointment or ultrasound yet (just a confirming blood test).

I thought about faking sick, but my MIL is a nurse, and so any mention of illness will actually bring more attention from her, not less. we don't want the pregnancy to be the focus of the vacation, as the intended purpose of the family vacation is to celebrate my inlaws anniversary and birthdays.

If your readers have any advice I would appreciate it! Would also recommend easily portable snacks that can go through airport security for the plane -- my old standby of a turkey sandwich is out due to the pregnancy ban on deli meats..."

Rats. My old standby, faking sick, is out.

Unless... Can your husband fake sick? And you can stay with him to "take care" of him?

My other suggestion is to choose one or two people you would be OK with knowing if you do miscarry, and have them run interference for you.

But you guys are sneaky, too. What do you have for Rachel?

Wow

Do you know what is NOT a good idea?

To have had about 30 g of fiber by lunchtime, and then to absentmindedly eat all the dried figs that are sitting on your desk during the afternoon. (They're just so nice and chewy and sweet.) Approximate dried fig count: 15. Approximate grams of fiber that was: 30.

You can do the math there. Not pleasant. I think I'm having flashbacks to Lord of the Flies.

Cheryl, do you know why too much fiber makes a person stink? Because I definitely noticed that a few hours after Figgate I started to smell like I was two weeks postpartum (sweaty, unshowered, a little sour milk-y) and it lasted for a few hours.

Fascinating. And unpleasant. Fortunately my only plans for the evening were watching my DVR'd episode of The Biggest Loser. (Does anyone else watch? I've been rooting for Kelly the whole time, and love how she's blossomed and gotten so much self-confidence during the course of the show.)

About this fiber thing

It's really interesting that so many of the commenters yesterday mentioned that the solution to their children's potty problems (especially peeing problems) was giving their kids more fiber.

Since I've been getting 5 servings of vegetables every day, I decided to take the next step and start looking at my fiber intake. Apparently adequate fiber intake is the lynchpin of good health. Its helps with elimination, moisture maintenance, glucose and insulin level regulation, healthy skin, and weight maintenance. It helps prevent cancers of the bowel, colon, and stomach. (And, according to this book, eating enough fiber is all you need to do to lose weight. Right.)

In short, fiber is good. Adults are supposed to be getting 30 grams or more a day. (I didn't see a figure for kids in the stuff I was reading, so if anyone knows a good benchmark for fiber intake for kids, please post it.)

I gave in and joined FitDay.com (which I don't love, but it's free and seems to work OK) to track what I was eating to see how I was doing on fiber. You'd think raw kale and spinach would add a lot of fiber to your morning smoothie, but you'd be wrong, because the smoothie ingredient that actually contains the most fiber is the frozen raspberries I've been tossing in just because I like the taste. But I've been getting around 20-25 g of fiber a day without trying very hard (except for the vegetable thing, which was hard at the beginning but isn't anymore).

I'm starting the T-Tapp 60-Day Challenge on Friday, and have decided that my game plan is consistency with the workouts (three a week) and 40 g of fiber a day (I picked 40 sort of randomly). So over this week I've been slowly trying to bump up my fiber intake so I don't cause any sudden stomach issues. The next step is going to be to try to switch around some of the things the boys eat so they're getting more fiber without noticing the difference. I think in the long run, being in the habit of getting plenty of fiber is one of the best things that can happen to them healthwise.

Anyone else interested in investigating the whole fiber thing? Thoughts? Secret recipes? Have you upped your own fiber? Have you upped your kids' fiber?

(My favorite breakfast so far is cooked quinoa, reheated in the microwave at work, with raw almonds, pumpkin seeds, and dried cranberries and a little raw honey. 15g of fiber, and sticks with you for hours and hours and hours.)

Q&A: Baby food sensitivities

Sarah has a question that's beyond me, so I hope there's someone out there who can unravel it for her:

"I just wanted to ask you about my son's sleep problems. He's now nearly 11 months old, and he's suffered from gas pains since he was born. I hoped when he was first born that he would start to grow out of it at 6 weeks, as everyone told me he would, but he didn't. If anything, it intensified. He exhibited the classic signs of colic - drawing his knees up and crying. This would happen exactly two hours after he ate (he is formula fed - I tried breastfeeding but after three bouts of mastitis, flat nipples and chronic thrush I gave it up for a bad job), then he would sleep until his next feed. He would then be happy for two hours, then the colicky symptoms then sleep etc etc. As he grew older, at around 6-8 months, he started crying in his sleep at night then waking up screaming and impossible to console. I did think that perhaps he was having nightmares, but my mother in law assured me that he was too young for nightmares, and on the nights he stayed with her he would do this and then burp or pass wind then go back to sleep, so she assumed it was a gas pain problem. Over time, I see now that she is correct in this - when he does it now, I pick him up and generally he burps and then is calm for a couple of hours.

We discovered over the course of time that elevating his legs seems to alleviate the pain. As a result of his frequent wakings and the need to elevate his legs, we've ended up co-sleeping rather than pogoing out of bed every couple of hours to sort him out. I did think that he would grow out of this at 8 months when his digestive system matured, but it still persists. Even eating solids hasn't solved the problem. I suspect the problem may be yeast related - he had problems with this from the breastfeeding days, and he had the last white patches in his mouth at about 7 months. He also has a persistent diaper rash that doesn't clear up with zinc oxide. I haven't tried thrush creams on it yet, but that will be my next port of call. He's eating half a pot of probiotic yogurt a day to try to combat this, but it doesn't seem to be having any effect. As yet, the health professionals seem unconcerned (however, we do live in the UK where extensive testing for digestive abnormalities doesn't happen due to the constraints on the national health system), but since it seems to have not abated at all, I'm starting to get quite concerned about him. He also has a slight wheeze which intensifies when he eats a new food. In case you were thinking it may be milk related, I've tried him on hydrolised protein formulas and lactase drops and these had no effect either. I recently switched him to iron fortified follow on milk and the wind seemed to get a bit worse.

Do you have any ideas on this? I'm at my wits end, having not slept for more than three hours at a stretch for nearly a year...

My gut reaction is that it's definitely dairy related and that she needs to take him off dairy completely, make sure there's no wheat in his diet, and be aggressive about treating the yeast. But I don't really know where to start on that if he's taking probiotics already.

Is there anyone with more experience with food sensitivities, dairy intolerance, celiac, or yeast issues who could offer some thoughts?

Q&A: "baby led weaning" for a formula-fed baby

Suzie writes:

"At our 4 month doctor visit the other day, the pediatrician brought up the idea of already starting to feed the little Pumpkin solids (rice cereal, purees, etc.), and my internal thinking was, "OK, whatever, I'm waiting for the girl to want to eat before offering her anything to much on." But the ped did leave me wondering: when you start your baby on "real" foods, do you offer only one thing at a time (a la "wait 2 weeks before adding anything new") or just go whole hog and offer a little bit of everything? How do you handle the potential for allergies?

Also, I know the whole premise of BLW is breastfeeding; but that doesn't mean I shouldn't give it a go with my formula-fed baby once she shows interest in what hubby and I are eating, right?"

First of all, BLW (baby led weaning) is explained by researcher Gil Rapley on this page, which now has a photo of a woman nursing about halfway down, with exposed nipple. (I'm not sure why that's necessary. And if anyone knows who makes that sexy nursing bra, please post in the comments.) If you don't want to or can't look at that page, just read the quick and dirty on Wikipedia (taking it the same way you take everything you read on Wikipedia). If you don't want to do that, the basics of BLW are:

Kids will eat solids when they're ready to, and if they aren't ready yet they won't swallow. They tested a bunch of babies and found that in general they were interested in tasting food at around 4 months but wouldn't really swallow until 6 months. Kids have more control over big chunks of food they can hold onto and shove in themselves instead of purees that are shoved to the backs of their mouths that they can't control. So in general they develop the smal muscle coordination to pick up small pieces about the time they can safely eat them. Keep giving them breastmilk or formula until at least a year, and they'll just transition to solid foods gradually and naturally. The End.

Anyway, the trend in the US is to offer only one thing (and people usually start with the totally disgusting rice cereal, which by now everyone knows I hate and think people should skip and go straight to bananas or avocado or something orange instead) for a few days because then you'll know if the baby is allergic to it before you move on to something else.

The problem is that I don't think that there's been any research about whether that has any effect on allergy rates or discovery of allergies, or if it's just something people came up with because it's logical. I don't think there's any harm in doing one thing every few days, but I also don't know if it's necessary. I'd like to see if there are any differences in allergy rates or allergic reaction rates in groups that separate and groups that don't.

I also think that parents know a whole lot about what our kids may be or probably aren't allergic to before we get to the solids phase. You know if they have problems with dairy or soy if you're using formula, and perhaps if you're nursing (anyone who's had to eliminate that sweet, sweet ice cream because of a baby's dairy intolerance is cringing right now). If your baby is your biological child you also know some family history of allergies, and you may have this info if your kid is adopted. Lots of food allergies seem to be connected to skin rashes and other external things you alreayd know about. So definitely take all of this into account, and if your child tends to have allergies to one thing, be cautious about introducing too many new things that tend to be allergens.

And, yeah, of course you can do BLW if you're formula-feeding. She's a human baby, after all, so all the stuff about food size and choking and her learning process (which BLW is about, as much or more than it's about actual nutrition) is the same for her and you as it is for the kid on that site whose mom is wearing that black lace nursing bra. Formula should be her primary source of nutrition for at least the first year, and she'll tell you when she's ready to eat other stuff.

Just beware of veggie burgers, because garlic poop is indescribable.

Sugar substitutes and metabolic syndrome

I'm assuming you guys have seen this article about the study that found that even a can of diet soda a day increases your risk for metabolic syndrome by 34%.

Or this piece on Good Morning America about the article. (You have to sit through an ad first before the story starts.)

I wonder if this is going to make companies stop putting sugar substitutes in otherwise healthy things, like yogurt and food for kids.

I think this also puts the nail in the coffin of soda consumption for many of us. Too dangerous to drink sugar substitutes, and way too dangerous to drink high fructose corn syrup. Plus the caramel color is bad for us, and so is the carbonation.

I guess it's back to water. (Until Passover, when some of the stores in NYC stock kosher-for-Passover Coke sweetened with regular sugar, which I'll indulge in.)

I also wonder if this is going to give stevia (a no-calorie sweetener made from the leaves of the stevia plant) any traction, since it's just a refined leaf, not a chemically-altered substance.