New stepmom needs help with Eating Decisions

[dkdone]

I am writing to find out if anyone has any advice or knows of any schools of thought about requiring children with CF to eat. In particular any information regarding requiring children to try new things, eat food that is good for them, and dealing with a CF child who may have an eating disorder.
I am about to become a stepmom of a great 7 year old who has CF. His father and mother have very different parenting techniques, and his father and I think that his mother is putting his health in jeopardy.
His mother insists that he should never be required to eat anything other than a chicken nugget or two or maybe some macaroni and cheese (a tablespoon is a meal) and that he is the one to decide whether or not he shall eat and when. His father and I do not support this mentality, and we think that just like all little kids, he should be required to try new things and eat things that are good for him. We are conscious of the fact that he has CF, but we don't think that should give him a pass to not eat or to live on chicken nuggets alone. When he is with us, we require him to eat the same things everyone else is eating, but we do give him smaller portions. We also require him to eat his entire meal which he drags out for hours at a time. (litterally, over 2 hours to eat 1 apple slice and a half of a pancake)
I am very new to this, and I am trying to learn as much as possible. His mother alleges that his nutritionists do not think that he should be required to eat anything he doesn't want to and that he will eventually start eating when he is ready and that he will try new things on his own. (I have never seen a child voluntarily pick up broccoli) I am also worried, because I suffered from an eating disorder when I was younger, and I see alot of the same symptoms in him. He always says that he doesn't want to eat, because he is worried that he is going to become fat.
I would greatly appreciate any comments or information anyone has on this subject and any other information you think a new stepmom should have.

 

[miesl]

Is he underweight?

Has he had his vitamin levels checked? Is he getting what he needs nutritionally?

Are his doctors (nutritionist included) affiliated with an accredited CF center?

 

[CFHockeyMom]

We try not to make food a big issue but facts are that CFers need more calories. That said, I do try to make something I know Sean will enjoy but you can only have chicken nuggets, pizza, and mac 'n cheese so often.

Our dietician told us that it takes 7 times of trying a new food before you can "officially" say, you don't care for it. It has something to do with kids taste bud development. Anyway, we always put a little of everything on Sean's plate. We call them "no thank you" bites. He has to try new things.

We've had to set a timer for him because he's so darn slow at eating. He really values playing hockey and playing PS2 so if he can't eat his meal in 20 minutes, he loses time from one of those activities.

And, he too would gravitate toward salad and broccoli. In fact, just the other night, we denied him a second helping of broccoli and told him to have more or the main course.

Sean doesn't like chocolate, cake, cookies, chips, or a lot of other things he should be feasting on. It's frustrating. Thank goodness he likes ice cream and milk shakes!

One thing we do that helps is try and explain to him why he needs to eat a lot of calories. We had the dietician explain to him the number of calories he should be taking in per day. This gave him a number to work toward. She also explained why it's important to eat quickly. Sean really likes to be in control so we've had a lot of success letting him chose what he's going to eat as long as he gets the right number of calories.

Also, make sure you explain to your stepson that he doesn't want to have to get a G-tube!

 

[anonymous]

We also have a very picky eater. The rule at our house is "one bite". He must try one bite of each thing on his plate. We try to offer plenty of healthy choices but in the end, if he truelly does not like something, we don't force the issue (after the one bite that is.) If he's tried one bite of everything and does not like any of it, we offer an alternative such as a peanut butter and jelly sandwich and high fat block cheese. When he was younger, ds did eat lots of peanut butter and jelly sandwiches and block cheese, etc. We've found as he's aged (7 now), he's started trying more things and it's become less of a battle. In all instances though, with all of my children, if there is a food I know they truelly do not like, I do not make them eat it. (Ie brussel sprouts, etc.) As an adult, I avoid the foods I do not like and out of respect for my child, within certain limits, I allow him to do the same.

I do not have cf but as a child I was forced to sit at the table until I either ate everything on my plate, or until everyone else had finished, had dessert, cleaned the kitchen, and had play time (approx 1-2 hrs. I almost never finished everything on my plate.) As an adult, I am a VERY dysfunctional eater and have to force myself to try new things. In my opinion, from my experience, I think making dinner time a huge battle will seriously back fire in the long run. There are certain foods that as an adult, I still retch when I eat (from having eaten them cold as a child - baked beans, peas, and lima beans are 3 such things.) My dh was also forced to eat everything on his plate, which he did, but ultimately pays the price for now. It's only been in very recent years that my dh has been able to NOT finish everything on his plate. (He's 40 now and overweight.)

As far as time limits, unless the child is truelly enjoying eating and WANTS to sit at the table for 1-2 hours, I honestly think that is WAY too long. If he's not enjoying eating and it's a huge battle, I'd set a time limit of 30-45 minutes.

Just my thoughts based on my experiences<img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[cfmomma]

My son with CF is five and I feel your pain. First of all, I seriously doubt the nutritionist said that to his mother. I would strongly recommend calling the CF clinic, with your husband, and setting up an appointment for the two of you to talk with the entire CF team. You will learn a ton, you can express your concerns, and you will be getting your son's treatment plan firsthand. My son doesn't like to try new things, but as tempting as it may be to give him only chicken nuggets and fries, it is not the best for him. It really does take several tries for a kid to like or dislike a food. Our son has a good appetite, but we give him lots of ensure especially when he doesn't feel like eating much. It really concerns me that your future stepson is worried about getting fat and uses that as as excuse to not eat. The fact that you had an eating disorder makes you much more aware of the "little signs". You and your husband sound like great parents and I know you will help take great care of him!!! Good Luck and Congrats!

 

[IG]

I really have to agree with anonymous ...
In an effort to get me to gain calories I had food literally shoved in front of my face night and day. I am a very picky eater and will not try new foods very often, but I also lived with some very strict people and the plate had to be cleaned before I was excused. It finally became more lenient when they realized [after throwing up] that sometimes I just cannot tolerate certain foods and sometimes I just didn't feel hungry. (for example certain smells are revolting to me and makes me not hungry at all. Meatloaf is a big example of that and fish, especially tuna). After that they let up by a huge margin, I didn't have to clean my plate I had to try to. If I didn't like something after trying it I didn't have to finish it, etc. Kids stomachs are small after all, if your CFer isn't cleaning his plate (and you think he's just playing) why not try after 30 minutes of sitting there not eating have him do his homework for an hour or a certain educational activity and then get the plate back out and warmed up. It might just be the quantity of food as well. I personally don't think a kid should eat all one thing but having a different type of food shoved at him, especially one he doesn't like, isn't going to help things in the long run, but that doesn't mean that he shouldn't try it.

 

[dkdone]

Thank you everyone for your thoughts. I am encouraged to know that others have dealt and are dealing with picky eaters. I agree that children should not be forced to eat things that are generally regarded as foul or even things that they do not enjoy. However, my stepson's first reaction to everything is that he doesn't like it. When I first met him, he had a mantre that he would not eat fruits and vegetables or anything more than 1/2 of a chicken nugget at a meal. Until the last 4 months, he had never been required to try anything other than chicken nuggets, cheese pizza, and grilled cheese. We are not asking him to eat anything bizarre, just food that hasn't been processed and formed into some sort of alien shape. Unfortunately, he has convinced himself that he is never hungry. He has learned at 7 how to fill up on water during the day. He has a G-tube, and he is on vitamin supplements, so he is technically getting enough nutrition, but he is still underweight.

I guess my main question is how to balance the normal eating habits a child has to learn with the needs of a child with CF in a child who is extremely worried that he is going to somehow become fat. If he is not forced to eat, he will not eat anything during the day. When he is told that he will get sick and will have to go back into the hospital, he says that he likes to get sick and go to the hospital because he gets toys and candy and he gets to play video games. He doesn't say that in a smug way, he really thinks the hospital is a fun place to go. I do not want to create an aversion to food, but I want my stepson to learn how to eat in a healthy way.

Again, I really appreciate the feedback. If anyone has any additional thoughts or information, please let me know.

Trying to not be the evil stepmother

 

[anonymous]

I think alot of cfers are picky eaters. I know I am not to much of a picky eater but when i am in a funk or not feeling well i am really picky. I do try to force myself to eat something but sometimes it just makes me feel sick, even if its my favorite thing to eat.
I do like the idea of having several choices for him to eat and to at least make him try one bite of something. Not only is he eating it and getting something in him that way but he is still trying something. I know his age is known for the picky stage. Or so it seems. The other thing is you said he is on a feeding tube. I have heard alot of complaints from cfers and parents alike that the cfer with a feeding tube never seems to be hungry. Because they get all their food with the tube feedings so they never feel hungry. Can you talk with his doctor and ask about making the feedings not so much...like just an example he gets 10 somethings at night reduce it to 9 or 8 for a few days to see if that makes him hungry? It is possible for a cfer to become dependant on the g tube and never want to eat. It is a real problem. Just something to think about. I do suggest you try to go to his doctor and talk to him about your concerns so you dont get everything second hand.

 

[IG]

Well my question is, and the only reason I ask this is because you've brought it up twice, is where did he get the idea if he eats alot he's going to become fat? I mean that sounds like a negative observation coming from a 7 year old of all things. Did his mother say perhaps that chicken is healthy food? Maybe he got that stuck in his head and only eats what his mother approves of? I think maybe it'd be a good idea to sit down with the nutritionist, all of you including him, and discuss diet, nutrition, vitamins, etc. Coming from a parent, when he's already heard that those foods are good for you probably from his mother?, probably won't mean much, but coming from a professional 'that works with food and weight' issues might.
Also I agree with the gtube thing. When I was on it my appetite actually dropped quite a bit and I never really felt 'hungry' which could be a problem here. Maybe just reduce it just a little bit and see what happens.

 

[Seana30]

<FONT color=#008000 size=3><STRONG>We feed Courtney the same foods that the rest of the family eats.  She gets fruits and veggies with every meal, and we try to make them as balanced as possible.  The difference is this........we get brocolli.......Courtney gets brocolli with butter and cheese.........we get mash potatoes...........Courtney gets mashed potatoes with gravy and butter.  We get strawberries.......Courtney gets strawberries with chocolate and powdered sugar.  We try to add as many calories as possible to her regular meal.  She also is required to drink one shake a day.I understand about the different parenting.  I am divorced and my ex and his wife parent TOTALLY different than my husband and I.  The only thing you can do is make sure that your step son knows that there are different rules at your house, and he has to abide by them.  I also don't believe for one minute that a nutritionist would say that he should not have to eat.  I would not believe that!  You stick to your guns, and it wont take long for him to realize that you are not going to bend the rules for him.  He will thank you later.Seanamom to Lauren, 14- no CF  Courtney, 13- with CF  Cameron, 10- no CF</STRONG></FONT>

 

[kybert]

his mum is definately jeopardising his health! no one can survive on bits of chicken nuggets and water. no wonder he needs a g tube <img src="i/expressions/face-icon-small-disgusted.gif" border="0"> he wouldnt need that if his mum hadnt got him into these weird eating habits. as the others have said i can guarantee you that nutritionists and dieticians would not have given this advice out and both you and your husband/partner need to go see a cf dietician. you might also need to take him to a psych about how he likes to get sick and they can also give you advice on how to 'retrain' his eating habits. i can tell you now once he hits puberty he will go downhill if he continues like this. there will be no energy left for anything. im assuming he has lots of bowel troubles from this bizarre diet? as for him being scared of getting fat, why does he eat chicken nuggests and macaroni cheese then? surely his mum didnt tell him that they are healthy foods??? oh boy.

 

[anonymous]

We have different ways of trying to encourage DS to eat, but what really really upset me was when DS's stepmonster thought it'd be a good idea to send him to a CF camp. I was horrified. Thank goodness my ex supported me on this. Hello, there's a reason there aren't many CF camps anymore -- cross contamination!!! Germs!!!

 

[wuffles]

Just one question - do you know what his bowel movements are generally like? The reason I ask this is that I have heard stories of many young children with CF who try to avoid eating some things because they expect it to give them tummy aches because of problems with digestion. It can be an embarrassing subject for them to talk about so they might make excuses and it doesn't get picked up that they may be on the wrong dosage of enzymes. Just one thing to consider!