Counting Calories

According to our medical friends, a toddler Gavin’s size needs about 1,000 calories a day. He also needs more than a litre of fluid a day to keep him hydrated and protect his stressed-out kidneys. For the last many weeks, Gavin has refused to eat a single thing, and has been maintained solely on his formula feeds. He has kept his weight up and still been full of energy, but has shown absolutely no interest in putting anything in his mouth.

Last week, I decided that enough was enough. He’d been off the steroids for about 10 days, and it was time to start creating some hunger. After a bit of discussion, Craig and I decided to hold his formula feeds for at least the morning, so that he actually begins to understand what it is to feel hungry. The experiment has been going well, all things considered. We are offering him food pretty much constantly, in an effort to just get those calories in, and then are topping him up with formula later in the day/evening.

My understanding of calories is, I admit, pretty limited. I have never really thought about the number of calories in any given food, so my estimates in this area are pretty laughable. I don’t always eat well, but I am at least very aware of the choices I make. I eat fast food only a couple of times a year, and I never drink carbonated drinks. I eat very little meat and I try to avoid bleached flour, and processed and sugary foods. We eat organic dairy. BUT I like cookies, coffee and chocolate. On my way back to the point. Which is that if you had to tot up all the calories you ate in a day, you’d be surprised. Surprised by how incredibly caloric some foods are and how calorie-light others are.

So. I need Gavin to eat 1,000 calories. Big calorie breakfasts can be french toast or pancakes with maple syrup. (The real stuff, no corn please.) Gavin loves making these things, but tends to lose interest in the eating fairly quickly. He’s just not that used to eating anymore, and his swallow reflex is still impacted. After a couple of bites, he just wants to run off and play. So I follow him around the house, popping bites of whatever meal we’re on into his mouth. Between times, I keep a plate of snacks nearby and offer him something every few minutes throughout the whole day. Yes, as you can imagine, this process is exhausting. I have spent more than an hour and a half on one meal, getting ever more creative in my ploys to get food into his mouth. (There’s a party in Gavin’s tummy and the sweet potato bits are looking for the door, etc.)

At times he is happy to let me do this, and at others gets annoyed and yells No! Don’t feed me!! I’ll do it myself. If he eats ANYTHING on his own, I am thrilled. Back to the calories. Today Gavin ate a bunch of raspberries. I looked these up on a website I found called Calorie King. Raspberries have one calorie each. ONE. So the grand total was… 13 calories. On the other hand, he ate about 2/3 of a cupcake the other day, the total there being about 120. Clearly, we would all rather our kids are eating raspberries than cupcakes, but I am still afraid enough for his health that I’m adopting the motto “any calorie is a good one.”

Although this is such a difficult and time-consuming exercise, I am so happy to see him choosing to eat things now. Hearing him say, I’m going to have some grapes or My stomach is making noises! is absolute blissful music to my ears. We are doing a lot of experimenting. It can be tiring cheffing up meals that you know won’t be eaten. (I’m sure a lot of mothers can relate to that one.) Tonight for dinner I offered him pasta with a home-made tomato vegetable sauce, steamed carrots, and a scrambled egg. He chose to eat the carrots and flatly refused the others. (We made the pasta the other day and he is very against left-overs.) I’m not sure why he wouldn’t eat the egg. He then asked for a bowl of yoghurt, and ate half an applesauce for dessert. So his dinner was carrots and yoghurt. I haven’t even attempted green vegetables yet! Yikes! I had some kale chips here today and tried to get him to try them. He just laughed and said Noooooooo.

The main thing is that he is eating. We are getting closer to NG tube removal, hurrah! The only other concern now with losing the tube is that he will not be drinking enough fluids. It is very hard to get him to drink enough, as he still needs thickened liquids. He drinks about 250 ml a day. As I said earlier, he needs to drink more than a litre! I see myself following Bean around with a cup for the rest of my life trying to give him sips of water.

For a little audience participation, I’d like to ask anyone reading this post to make some suggestions for:

1. Healthy snacks you give your kids or that you think Gavin would like

2. Quick and easy meals that are healthy AND calorie-heavy.

Many thanks readers!

17 responses to “Counting Calories”

  1. Olga

    Good stuff Erica! What about mashed sweet potatoes or similar?

  2. Ivana

    Erica, if he likes yogurt, you can try mixing some cereal into it- that would add calories to it, but wouldn’t alter the taste much. I make this with ‘My Organic Baby’ varieties (found in Shoppers Drug Mart baby section). You can even add some raspberries to it 🙂

  3. Anonymous

    Wow, I can’t believe you got him to eat carrot, we are nowhere near that successful!
    Dipping is a great way to get extra calories for us. We buy Japanese Kewpie in the fun babyshaped bottle and Leif loves dipping stuff in it. Full fat yogurt, esp with jam or maple syrup in it, is a great dipping sauce for fruit or carbs. Organic butter on everything suitable, no matter what anyone tells you if it’s organic butter is good for growing little bodies.
    Leif also loves our juicer, if he gets to have a hand in the making of weird juices he’ll drink them, even if it’s only a few sips you feel like you’ve won the lottery when they have an ounce of beet/apple/wheatgrass/lemon juice for example!
    and pancakes are miracles here (stuff grated zucchini in they’ll never know!) plus butter and syrup for extra calories. whole wheat flour and wheat germ go unnoticed.
    Leif loves salmon sashimi like you can’t believe, you may be able to try that with gavin if he’s allowed raw fish from a reputable source. Asian markets make wicked crunch seaweed snacks that make toddlers really excited. We don’t get a lot of veggies down but survive on seaweed, pickled saurkraut, sweet potato and squash, and avocado, plus easily hidden zucchini.
    Hope that helps and think of you and your amazing family often!

  4. Aunt Karen

    OK part of this is regular kid (unfortunately). Actually i have found that kids LIKE little bites of stuff…which do add up to a regular diet (sort of). Although it doesn’t really help you, it might be sort of comforting to know that kids in general eat LIKE BIRDS!! OMG!! However I know that you want Gavin to up his caloric intake…what about high caloric smoothies ? Go with what he likes and add stuff to it that he is blissfully ignorant about. Sam’s kids eat very little right now except fruit, and pasta. (my observation). i don’t offer them anything that might spoil their appetite. Anything sweet (sugary) means no appetite. How about consulting a nutritionist? Maybe you have. Good luck with this. i’m just so pleased that he’s doing well. Looking forward to seeing you on Sunday (I hear via the grapevine that Gavin is a pretty smart kid!!)

  5. Karen

    Have you tried guacamole? Jack won’t always eat plain avocado but guacamole is always a hit. Chick peas make a good snack too.

    If you want to take Gavin out to a restaurant for a treat, The Beet organic cafe in the junction has a nibbler platter for kids. I’d be happy to meet you there for lunch anytime!

  6. lisa

    I agree that this is normal kid behaviour and EXTREMEMLY frustrating!! We got Lua out of the highchair and into a booster chair that still has her strapped in. She likes to do the “clicks” and doesn’t realize it’s so she doesn’t escape. Then we usually let her pick her favorite video and, yes, she watches TV while she eats. Or rather, while we feed her. We try to get food into her fast and furious while talking to her about the show, so her focus is else where. As soon as she’s bored of the show, she’s also bored of eating so there’s a lot of timing going on. I don’t know if you’re interested but it’s worth a shot. My friend was just telling me about her four year old who eats nothing and won’t sit at the table for longer than a few minutes. We’ll get rid of the video in time, but for now it works.
    Good luck!!

  7. Aunty Kerry

    I agree wiht the above comments, this all sounds pretty normal to me. After having one daughter who would eat anything, then the second one who lived on vegimite sandwiches, banana and cheese for 2 years, I can reassure you it will get better. Kids also seem to go through a period of “snacking” all day rather than having 3 big meals. One of our Grandsons did that for quite some time. Offering food too often may have the opposite effect, he will just get annoyed with you. Its best not to make a big deal about it. In time he will let you know when he is hungry. You could try just sticking to offering food at 3 meals and morning and afternoon tea that way it gives him time to feel hungry in between. I know they are sweet but have you tried creamed rice, custard with fruit or milk shakes/smoothies. You might get away with pureed vegies in you pasta sauce. Good luck – you are doing a fantastic job.

  8. Steph

    Our daughter was going further and further off the growth chart despite eating well. She just refused pediasure and seemed to burn through everything we put in her. I decided I’d try adding calories through fat not sugar since you can remove a lot of the fatty things with low calorie alternatives later down the road.

    If Gavin likes yoghurt try Greek style yogurt like Liberte (french canadian company, go figure!). It has 8% milk fat. Our daughter loves fried plantain when it’s ripened and a little sweet. (Buy some plantain, wait till black spots appear and it feels tender and fry up some slices in hot oil. We reuse the oil). Many people think I’m nuts but I feed our daughter potato chips. You can find them with higher quantity of good fats and with the peel for better nutrion. And for getting meat in, flavoured ground meat works well for us (like for tacos). She doesn’t have to chew so much.

    I second the feeding in front of the TV. It was one of the only ways to get her to stay still. We had to tell her you can’t watch if your not eating.

    Good luck!

  9. Auntie Bev

    Sometimes kids like to help with meal prep. Perhaps Gavin could find something in the cupboard for you, a box of crackers, yogurt/fruit in the fridge, anything that you think will help. He could help you arrange food on a big platter, you and Gavin would munch together while watching his favorite TV show. After reading what he likes, maybe the colour orange (carrots) and red (raspberries) are very appealing to him. Could you try (orange)cantelope, (red) watermelon. You could see how many seeds you could scoop out of the watermelon, and the winner gets a prize!

    Looking forward to seeing you Sunday!

  10. Mette

    Nut butters (almond, peanut, hazelnut, cashewnut) are pretty calorie rich, and high in protein and fat, too. We are still making homemade formula for Zoe (she’s still on tube feeds) and nut butters pack high impact in small volume. Keep at it – eating problems are totally par for the course after ATRT – but many families have had good luck getting rid of the feeding tube! Sounds like you are well on your way.

  11. Steph

    forgot to mention, for my daughter the tv show itself can spark interest in food. From ni-hao Kailan my daughter started asking for dumplings and banana crakers, from wonderpets she started eating even the leaves of the celery.

    of the shows my daughter watches ni-hao kailan is the one that shows characters eating the most.

    hope this helps.

  12. Amy Zammit

    Just a few other options, I make potato & kumera chips at home into little rectangles that look like chips, oven bake them in a super hot oven with a lot of olive oil. They end up a little crispy on the outside but soft in the middle- sprinkle a tiny bit of iodised salt on top to get the taste buds going. Generally, as Phoebe is a really light eater I try to have very high fats in her diet- butter & peanut butter on w/meal toast, extra creamy organic milk, generous olive oil in pasta sauce, fried noodles with veges & sweetened soy sauce etc. I also give Phoebe a dessert of ice cream, cookie or cadbury chocolate sometimes if she eats really well. As you can tell we have had lots of challenges too! At one stage and I belive this is not uncommon… we had her eat in front of the TV and had the remote pointed at it saying ‘if you eat one more bite you can watch!’ I dont recommend that one! Oh one last thing, Phoebe never used to like meat at Gav’s age- I think it was too hard for her to chew & swallow. She does like baked salmon though… and Tom loves flathead fish nuggets (I crumb them & fry at home). Its a lot of work though if you don’t get the desired result! Good luck it sounds like you are getting slow but steady progress.

  13. Jennifer

    There is always the easy way of adding (organic) cream cheese to everything you can. If he likes the taste of it, it can go a long way to making veggies/pasta/ground up fish or meat more appealing (and more calorie dense). I have one friend who buys mini ice cream cones and stuffs them full of cream cheese in hopes of bulking up her daughter. She loves it.

  14. Lisa Conroy

    HI Erica, this is one of Jassies favourite snacks, loaded with cheese and milk this should get a few calories in, plus they are like Muffins!! Good Luck – it warms my heart to see him doing so well…lots of love

    1 cup cooked vegetables (mashed broccoli, grated carrot, chopped shallots, grated zucchini, peas etc)
    1 cup corn kernels
    ½ cup self raising flour
    ½ cup grated cheese
    2 eggs, lightly beaten
    ½ onion grated (optional)
    ½ cup milk
    Sprinkle of dried herbs

    Combine all ingredients together and mix thoroughly

    Spoon into lightly greased mini muffin pan

    Bake for 15 mins at 180 or until golden and cooked through

    Allow to cool. Makes 24

  15. Nicole

    Our Gavin loooves smoothies (great for hiding good foods and uping calories) I know you are working on his textures and swallowing but perhaps this could be a treat for now.

    For snacks our son loves frozen peas and carrots. I assume the cold is nice on his gums and fun to eat.
    Also fruits bites or fruit leather are another HUGE hit!

    I also find that if I only put a few bites on his plate at a time he eats way way more then if I give him the full portion at once.

    I should add that our son is 19 mths old not sure if that helps.

    I wish you luck and hope things continue to improve.

  16. Nicole

    I forgot to add that avacodo’s are huge in calories, easy to eat or blend into things like yohgurt.

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