I tend to look at life in general as a journey. As I cross more and more names of experts off my list, I feel more and more like this family is adrift on a very large ocean in a hurricane. And on a very small raft.
I’ve gotten used to feeling one of two emotions in my search for help along this journey. The most common is dismissed. Most of the specialists I’ve contacted either feel this is a temporary problem that will remedy itself in time, or don’t have the specific experience or resources required to properly address the problem.
I often feel like if I turn enough circles, I’ll eventually catch my tail. Rewarding as that may be on a purely recreational level, it does nothing to solve a problem that continues to create its own unique set of issues.
Today, we met with the Dietician. After a few specific questions and adding the contact information required for her files, she started the appointment with measuring both kids, my son for her records, my daughter to make her feel included.
The World Health Organization has added Body Mass Index to their growth charts to more accurately track the progress of a growing child. Our family doctor uses only height and weight measurements. Today, I learned an unsettling truth about the difference in accuracy between these two methods.
Remember, the kids’ most recent check-up put my son in the 75 percentile for both height and weight.
Using the WHO growth charts, my daughter’s weight and height calculates her BMI at 15. This puts her overall growth in the 41 percentile. Weighing in at 45lbs, she fits into the healthy weight range of 40 – 52lbs for her height.
My son’s height and weight individually are indeed in the 75 percentile, but the two don’t go together. His BMI is 13.1, or the 3 percentile, meaning he is not heavy enough for his length. According to the WHO growth charts, he is currently 2 – 13lbs under the weight range for his height. While that may not sound like a lot of weight to add to him, the bigger picture includes last year’s measurements when he had a BMI of 13.3.
Woulda-shoulda-coulda isn’t going to fix what was overlooked or change the past. Still, I can’t help wondering if our family doctor had been using the WHO growth charts, we would not have been placated and dismissed for so long with terms like normal growth and healthy weight. Regardless, it’s high time to turn this raft around.
After observing my son chewing different textures, something crunchy (crackers) and something soft (bread), the dietitan determined that his eating challenges were likely not sensory in nature. He appears to chew food appropriately, using his molars to manipulate food into a bolus that is swallowed without difficulty. An OT would be able to provide a fairly definitive assessment, but this is still encouraging news.
The appointment continued with a categorization of foods that my son will tolerate. Our protein options are not as limited as we perceive them to be. It’s a short but varied list that includes tofu (added to smoothies), peanut butter, beans (mutated into brownies), milk and yogurt. Vegetables are obviously lacking (read absent), however we have a good, albeit limited variety of fruit to choose from. Dairy is where we have a welcome problem; we have to watch and possibly limit how much is consumed. Grains are often of the whole wheat with germ variety, so there is little concern about adequate dietary fiber.
His diet is lacking in sources of iron, which we are able to fix with the daily supplement. She also suggested finding a multivitamin that contains zinc. Living in a daycare, when I think of zinc, I immediately picture diaper rash creams like Pentaten and Sudocreme. For nutritional purposes, zinc is an important mineral. It stimulates the appetite, improves the sense of smell, as well as cognitive and motor function in children. Zinc is found in beef, pork and the dark meat of chicken. It’s also found in nuts, whole grains and legumes. And chocolate – hurray! 50g of unsweetened baking chocolate contains 64% DV (daily value = 5mg for a child 4-8 yrs old).
Most of the meeting involved discussing the steps-to-eating ladder and the process of slowly introducing food to the table, into his hands, and eventually into his mouth. Again, an OT would be able to assist us getting from developing a healthy comfort level with food to actually eating it. In the meantime, our efforts to encourage playing with the very scary meat and veggies are all great steps to breaking down his fear of them.
As my husband and I chatted with the dietitian, we gained an entirely new perspective and experienced a completely unfamiliar sense of validation and relief. For the first time on this journey, we finally feel like someone outside of our inner circle really understands the problem, and, even better, has sensible suggestions to fix it.
As the appointment comes to an end, my husband says what I can’t. “On behalf of our entire family, thank you for taking our concerns seriously. I can’t tell you what it means to finally find someone who recognizes that this is not just a bad case of picky eating, that this will not go away without help.”
I’m glad my husband can read my mind sometimes. I want to say the same words, but I know I won’t get past “thank you” without a small ocean of grateful tears.
Today was a beacon of light, guiding us through a dense fog of frustration and fear toward the hope of some form of recovery. I can’t say yet that I see land in the distance, but we are at least learning how to stay the course that keeps us in calmer seas.