Sunday is food shopping day (er, night) in my house. My husband took this on years ago – it’s his job. He is better at it than me – faster, more organized, more clinical (he’s an engineer). I get distracted. I’m too interested in new stuff on the store shelves, I meander, I like to read labels on items I don’t even buy just because it’s interesting – even the junk, because I’m amazed by what passes for food, what fills the aisles, what people are buying. I take too long and spend too much. He fired me.
He also sits us both down before the shop, to pin down exactly what our meals will be for the coming week. That can be the hardest part – we blank out. So we keep a list of dinners made over the years and add to it often, when we find a new idea we all like. This has really helped my family eat well. We are spendy on good organic food, and don’t eat out often – something not all families can swing – but just the act of choosing what’s for dinner a week in advance is a worthy time, money, and health saver. Here’s some ideas to get you started – in my house, these meals have to be free of gluten, soy, corn, dairy, and most nuts.
Salmon with saffron sauce and chick peas
…Salmon with saffron sauce and chick peas (Recipe from Hummus and 65 Other Delicious Recipes) with brown rice
…Minestrone Soup from scratch (Recipe from Special Needs Kids Eat Right) with GF Chebe rolls (store bought mix)
…Meatloaf (Recipe from Special Needs Kids Eat Right) with quinoa cooked in chicken broth, green salad, green beans. Sounds pedestrian but try this recipe. It’s good.
…Vegetable Frittata over GF Penne (use any veggies but we like asparagus, onion, spinach, mushroom, and pepper)
…Lentil Shepherds Pie with green salad (here’s the basic idea of this recipe; we use So Delicious or Silk coconut milk instead of cow’s milk, ghee, and green beans instead of corn)
…Pork or Chicken Adobo with brown rice and baked sweet potato
…Spaghetti and meatballs (from Special Diets for Special Kids), green salad, summer squash with oregano, Chebe rolls
…Curried chick pea skillet dinner (from Special Needs Kids Eat Right) over spiral GF pasta
…Coconut chicken curry with sweet potato over rice
…Thai red curry sauce over mahi or haddock (if available) from Blanchard’s A Trip To The Beach with GF risotto and ginger carrots (slice fresh carrots into skillet with olive oil and fresh ginger slices. Add a dusting of curry powder, dash honey, and enough chicken broth to keep from sticking. Cook to desired softness over medium heat).
Adding lemon slices while cooking chicken picatta makes it even better
…Portuguese kale soup (recipes abound, our own version is in Special Needs Kids Eat Right), Chebe rolls.
…Kale calzones with brown rice green pea salad
…Roast chicken, potato, onion, carrot – baked in one big Pyrex. We buy a half chicken with skin; the organs that come with it go to the cats.
…GF penne pasta with pesto – we make ours with pine nuts, which are safe in our house (not walnuts), and skip the parmesan in the recipe.
…Stuffed bell peppers (blanch the peppers, then stuff with whatever mixture you like: raisins, bread crumbs, leftover minced pork or ham, pine nuts, cashews, onions, mushrooms, brown rice, your favorite seasonings – then bake), chicken sausage
…More: Lemon chicken picatta, home made chili, pork loin, stuffed pork chops or chicken (we use mushrooms, minced ham, onion, bread crumbs – whatever is on hand); pot roast or beef stew, lentil soup and hot dogs
…A side of fresh vegetable, stir fried greens, and/or fresh garden salad with homemade dressing is almost always on the table, when vegetables are not featured as a main course.
No doubt I am blanking out again as I type, which is why I keep cookbooks on hand that I like to thumb through again and again – like The Victory Garden Cookbook (1982), Yankee Magazine’s Favorite New England Recipes (1972), Whole Life Nutrition Cookbook (2006), Top One Hundred Pasta Sauces (1987), Gluten Free Italian Cookbook (2008), Hummus and 65 Other Delicious Recipes (2006), a now dog eared Joy of Cooking that was given to me in 1979, and many others. Whether you can manage just one or two home cooked meals a month, or several a week, make them special occasions where your family knows they are being cherished with good healthy food.
So your child is underweight, not eating well, not growing well. You’ve been told to give him calorie dense drinks like Ensure, Pediasure, or Boost; lots of butter, pudding, whole milk, and cream; and of course, lots of ice cream. Is this healthy?
Seeing these common recommendations is one of my least favorite findings as a dietitian in private practice working with kids. There are four problems here that can interfere with restoring your child’s robust health:
One, these drinks and foods are made with conventionally raised dairy products, which can contain bovine growth hormone, pesticides, traces of genetically modified feed corn proteins, and antibiotics, not to mention possible heavy metals from agricultural chemicals. All of these agricultural interventions have been linked to problems ranging from higher incidence of ADHD to earlier onset menses, other hormone disruptions in boys and girls, allergies, and neurological disorders.
Two, the child’s underweight status may be at least partly due to an undiagnosed milk protein intolerance or allergy – which irritates and inflames the gut, making nutrients and energy even harder to absorb. Be sure to get this sorted out before relying on any milk protein sources in your child’s diet.
Three, milk protein (casein) is often a constipating protein source, especially in children with some digestive insufficiency issues, like reflux or imbalanced gut microflora. Healthy gut microflora (bacteria) add enzymes to help us digest and absorb food, and keep bowel habits on track. If your child is unable to comfortably pass a soft formed stool most every day, then appetite can weaken – exacerbating the problem of packing in calories.
Last but not least – drinks like Ensure, Boost, and Pediasure rely on refined sugars and corn syrup (in various forms) to up their calories. I don’t like this because corn syrup is noted for containing a bit of mercury in every teaspoon, thanks to agricultural processing. Corn is also a genetically modified crop. Emerging research suggests that proteins in foods from genetically modified crops can trigger allergy. More allergy = more gut inflammation = more difficulty absorbing nutrients and energy = poor growth and gain. And, there is no sound argument for relying on refined sugars as a major strategy for growth and gain in children.
You can do way better.
First, make sure you are not battling undetected food sensitivities or food allergies. Get tested! You may need to avoid milk protein sources entirely, in order for your child to feel hungrier and digest more comfortably. Many labs and providers can assist with this, and this is a specialty in my practice too. Make sure you look deeper than just IgE allergy responses with a conventional MD allergist. For more information on this, see either of my books.
If eggs and nuts are allowable, get a powerful blender or food processor – the sky’s the limit, with those two ingredients adding creaminess without milk or ice cream. Everything on my list below is organic, no added sweeteners in the milk substitutes, and raw where possible. When using nuts, blend those first to smooth consistency with ice and a small amount of the recipe’s liquid. Then add remaining ingredients til smooth.
Banana Cream: ¼ cup raw cashews, 1/2 ripe banana, 1 cup almond milk, dash vanilla flavoring, 1/2 c crushed ice, 2 TBSP sesame tahini, 1/8 teaspoon stevia powder, hefty dash cinnamon. Add cacao nibs or if you don’t have those, organic mini dark chocolate chips (1 teaspoon) for additional zip. Blend ice, cashews, tahini, and 2-3 ounces of almond milk together first, until smooth and creamy. Add vanilla and remaining almond milk, and blend again til smooth. Add cacao nibs and blend to desired consistency.
Raw cashews, tahini, and banana with ice, almond milk, vanilla, and stevia make this smooth and creamy.
GI Soother: 2 peeled apples, 3 stalks celery with leaves, 5 mint leaves, 1/3 seeded peeled cucumber, 2 teaspoons ground flax seed or ½ teaspoon flax seed oil, ½ – ¾ cup white grape juice, 2 TBSP whole coconut milk, crushed ice
Not Latte: 1 cup organic brewed iced (decaf) coffee, 1 raw egg, 1/2 teaspoon maple syrup, 1 TBSP sesame tahini, 3 TBSP cashews, 3 ounces almond milk, 3 ounces whole unsweetened canned coconut milk, crushed ice
Power Peanut: ½ soft ripe avocado, 1 TBSP cacao nibs, 1 TBSP hemp protein (such as Nutiva brand), 1 TBSP peanut butter, 3 ounces whole unsweetened canned coconut milk, 3 ounces almond or hemp milk, 1 teaspoon honey, crushed ice
Pineapple Smoothie: Fresh pineapple chunks ¼ cup, 1 ripe banana, 3 ounces whole coconut milk, 3 ounces unsweetened almond milk, dash vanilla, 2 teaspoons flax seed meal, 1 whole egg + 1 TBSP egg protein powder (option: try soaked hemp nuts in this one too)
These two are modified from a favorite book of mine called Raw Food Cleanse, which has several great recipes for smoothies, soups, and dips.
Soup Option, serve warm: ¼ cup raw cashews, 1 cup vegetable broth (such as Imagine brand organic), 6 stalks fresh young asparagus, 2 stalks celery with leaves, ¼ teaspoon fresh thyme leaves – blend all til smooth.
Pumpkin Navel: ¼ cup raw pecans, 1 navel orange, ¼ teaspoon orange zest, ¼ cup pitted dates (soak these ahead of time to soften), dash vanilla, crushed ice, ½ cup almond milk, 2 TBSP cup cooked canned pumpkin puree, 1/2 teaspoon honey or dash stevia
Honeydew Lime Creamsicle: Click here for this really good smoothie – doubles as frozen pops in hot weather.
– For any smoothie with fruits like kiwi, berries, papaya, peaches, pear, or mango, adding a raw egg or ground flax seed will create a creamy texture while adding healthy fats, protein, and minerals. Using egg protein powder is an option too. This will make your smoothies fluffy and creamy at the same time, but won’t add the fats you might like.
– Raw nuts blend to a nice creamy consistency with the right tool – a powerful blender, Vitamix, or Bullet mixer. Soak raw nuts (and seeds) ahead of time if you like a more smooth, less grainy texture.
– Hemp seeds, flax seeds, chia seeds, and cacao nibs are up and coming as alternative sources of protein, healthy fats and oils, and minerals. Add these to any smoothie to boost nutritional value along with calories.
– Wean sugar-holics off their favorite processed calorie booster drinks by making your own without any added sugars: Instead of honey, maple syrup, or molasses, switch to an organic stevia powder, which is potently sweet at a tiny dose. One eighth teaspoon is enough to sweeten an 8 ounce blended drink. Add cinnamon in larger amounts – 1/4 to 1/2 teaspoon – to kick up the sweet and benefit from cinnamon’s blood sugar modulating effects.
– Unconventional but healthy options for sweeteners in smoothies can create the creamy texture kids like, plus add extra fiber, vitamins, and minerals to smoothies. Try left over baked sweet potato (skins removed), cooked canned pumpkin, or leftover roasted mashed parsnips, which have a surprisingly pleasant and gentle sweetness when prepared this way (easy, fast, and good; use ghee, not butter, for extra sweetness and to avoid dairy protein).
– Cook brown rice in whole coconut milk with honey, nutmeg, and cinnamon for an alternative to all the pudding your child may have been told to eat. Use a slow, low heat method and add almond or coconut milk to the liquid if needed during cooking. An hour or more of slow cooking may be needed.
– Use coconut milk to make mild (but calorie laden) curry sauces that can go over favorite chicken or fish dishes.
– A good blender or VitaMix will turn raw nut pieces into a creamy smoothie, but organic nut butters are an option if using whole raw nuts is too gritty a texture for your child.
– Get the benefit of butter without the allergy or GMO hassle by using organic ghee (clarified butter). Pricey, but when you need it, you need it. Ghee has a sweeter taste than butter that isn’t clarified.
– Skip the soy. Even if it isn’t genetically modified, it’s a frequent allergy offender, just like dairy protein. And there are endocrine effects from soy that are concerning enough for me to suggest that parents don’t use it as a major daily protein for a child. Translation: A serving here or there is fine, but don’t use it as your child’s protein source at every snack and meal daily. Soy protein is a common addition to bottled smoothies, energy bars, and protein powders.
– If multiple allergies are in the picture – and nuts, eggs, and seeds are out – then work with a knowledgeable nutritionist who can assist with using essential amino acids, medium chain triglycerides, and safe oils to build smoothies around tolerated carbohydrate sources like ripe peaches, pears, avocado, plums, or winter squashes and pumpkin.
These options will give your child several nutrients, healthy fats, more protein, and calories to burn that are head and shoulders above some corn syrup, vitamins, and milk from a cow raised on chemicals. Remember that poor appetite and weak growth pattern can be signs of deeper problems with the GI tract, digestion, absorption, or inflammation. For strategies to sort these out, see either of my books, or get in touch. Troubleshooting growth pattern is one of my specialties in practice.
Kids needing feeding clinic intervention are the pickiest of the picky. Their super picky appetites have frustrated their parents to no end. They tend to have more dental problems, get sick more often, and can have more developmental delays or behavior problems. They don’t eat well, have a very short list of acceptable foods, and don’t grow well as a result.
Why are they doing this? The feeding clinic approach doesn’t ask why, but operates from a cognitive approach – that is, it’s assumed kids are doing this by some choice on their part. Feeding clinics are part behavioral intervention, part social group (peer pressure is leveraged to help kids try more foods), and part occupational therapy. They try strategies to get little ones eating more, by pressuring them to push through texture aversions, gagging, squirreling food in their cheeks, spitting food out, or rigid beliefs about foods.
I’ve met a lot of feeding clinic flunkies – kids who stumped teams of psychologists, speech and language pathologists, GI doctors, and occupational therapists. What went wrong?
In some cases a swallowing issue is found, and an occupational therapist as well as a speech and language pathologist can help this. Otherwise, it’s often assumed that there is no physical rationale for the child’s eating pattern, that it is purely psychological.
But that’s rarely the whole story, in all the kids I’ve met with feeding problems this deep. I often end up finding a physiological backstory. And when that is defined, it can be fixed; when that is fixed, appetites can improve. Eating becomes a non-issue, stress for the entire household drops several notches, and the child can begin eating and growing normally again.
What physiological gaffes can create a picky eater monster? Here are the usual suspects:
1 – Reflux medication. These lower appetite over time, and make everything harder to absorb from the gut. My opinion? These medications are rightfully earning a bad reputation. They are over-prescribed for infants and children. They are associated with lesser bone density (and fractures in older adults), and lower digestive capacity in general. They make it harder for many nutrients to be absorbed, notably, minerals like calcium and iron, and vitamin B12. Reflux medicines also let fungal infections (Candida or yeast) flourish at the expense of healthy gut microflora. I have seen at least one case of stunting due to long term use of reflux medicine. Leaving a baby on this medication during crucial developmental years means optimal levels of nutrients will not reach brain, bones, and body tissues.
Reflux medications leave food sitting longer in the stomach, because they reduce digestion. Food will remain poorly digested. The result can be constipation or loose stools, bloating, gas, more reflux, and – never feeling very hungry. Strategies to wean off reflux medicines – and how to avoid them in the first place – are discussed in detail in Special Needs Kids Go Pharm-Free. Be sure to tell your doctor if you would like to wean this out of your child’s regimen.
2 – Intestinal candidiasis. This is a Candida (yeast) infection in the intestine or GI tract. While Candida microbes are a usual resident of a human gut, they can take over and grow too much. This makes kids more picky for sugary, starchy, smooth foods. A yeast-heavy GI tract also tends to have a pH that weakens digestion. The result is a little like too much reflux medication: Bloating, gas, constipation or loose stool, and picky appetite. Treating the yeast infection with the right medication, diet, herbal tools, or probiotics can move your child to eating healthfully and heartily. In my practice, I use stool and urine tests to detect how much yeast is growing in the gut, and to see what might herbs or medicines might best clear it out.
3 – Food sensitivities. Food allergy is not so hard to see: Usually there are hives, rashes, eczema, stomach pain, tingling at lips, tongue or throat, or vomiting. But food sensitivities can have few obvious symptoms, other than weak picky appetite. I test for these in my practice with a blood test called ELISA IgG to specific foods. We find problem foods, and figure out how to rotate them. This can help your child feel less discomfort when eating, and can help reduce the texture aversion part of the story.
4 – Mineral deficiencies. Picky eaters usually have poor mineral status in their blood and tissues. Iron, zinc, and other minerals all influence appetite. These can be checked with blood tests, but there are also easy to check clinical signs for mineral deficiency states too. See Special Needs Kids Eat Right for a table on detecting mineral imbalances without drawing blood. Restoring good minerals can lift a picky appetite.
If you have an epically picky eater, take heart – there are many nutrition strategies that may crack this nut for you. See either of my books for details.