Tuesday, February 4, 2014

Great Deal on gDiapers Hybrid Cloth Diapers with Flushable Liners (LIMITED TIME)

One of my favorite ways to be a thrifty foster parent is to cloth diaper! For our family it's been a fantastic way to protect our foster babies' tender tushies while also saving a ton of money. I know a bunch of my readers are avid cloth diapering fans or haven't yet dipped their toes into the world of cloth diapering but are curious. gDiapers are a great way to start, especially if you have a child in daycare. Many daycares that won't deal with cloth diapers are happy to do gDiapers because you have the option to use a disposable, flushable liner so there's no scraping poop off cloth. Less laundry, too. Also, they're super cute. We have used the newborn ones for one of our foster babies, although we used homemade cloth liners instead of disposable ones, and they fit very slimly rather than giving her a bulky butt, which I liked a lot. I have friends who use the larger sizes as training pants for 4 and 5 year old foster and adopted children who wet the bed, as an eco-friendly and cost-effective alternative to pull-ups.

gDiapers come in all kinds of sizes and some adorable designs. For a limited time they are for sale on Zulily.com at an extremely low prices - Check it out! Give cloth diapering a try. You can order here (aff). Membership is free.

Sunday, January 20, 2013

Eating from the Trash, Pediatric Nutrition Drinks & More - Q&A w/Dr. Rowell on Adoption/Feeding Issues - Part II

Dr. Katja Rowell, MD
Part I of our Q&A with Dr. Katja Rowell, MD, can be found here. If you haven't read it, it's not to be missed! It deals with food hoarding and integrating older foster/adopted childrens' food preferences into your family.

Dr. Rowell, author of the new book Love Me, Feed Me: The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles and More (aff) was kind enough to give two copies of her book away to my readers (see this post - giveaway now closed!) and has answered another two reader questions for the second part of our Q&A on adoptive and foster care feeding issues. You can find much more on both of the topics addressed here in the book.

Reader Question #3: I have an adopted son (2 years old) who receives food therapy services due to some sensory issues he will not chew food and we still cannot get him to eat. His doctor and nutritionist has prescribed him Bright Begginings Pediatric Drink to make sure that he is getting proper nutrtiion. My question is this I hate giving him three of these a day because he does not eat, what types of food would be good to introduce to him that do not over stimulate him so that he will start eating "normal" foods?

Whether it was something the child was born with (like a cleft palate, or a painful condition such as reflux), or neglectful or traumatic feeding, foster and adopted children are more likely to present with feeding challenges. How we address and meet those challenges is critical. I find that the most selective children also tend to be smaller, and that worry about size fuels the counterproductive feeding practice of only serving supplements or a few favored foods. Oftentimes I also see children who are very bright, independent, or sensitive to pressure or encouragement. If your child tries to draw, for example, and you try to help him, does he let you, or does he get upset and want to do it himself? (These are general observations of traits I often see with selective eaters.)

Too often, when parents ask for help from their doctors (most of whom receive NO training in feeding and weight issues) the solution is a supplement. The solution is in “what” you are feeding your son, and the “how” question is often ignored. As the World Health Organization wrote, “Inappropriate feeding practices are often a greater determinant of inadequate intakes than the availability of foods in the households.” So, before I get to your “what foods to introduce” question, allow me to talk briefly about the “how” of feeding.

Research tells us that the more we push children to eat, usually the worse the child eats and grows. The pressure is met with resistance, and our efforts often backfire.
  • Feed based on what your child can do. If you have a three year-old who eats more like an older infant, feed him based on what he can do. Slowly increase texture and tastes as you can.
  • Ask your speech therapist for suggestions for safe foods, and ideas to progress with texture.
  • Institute structure. Too often parents are told to push the child to eat all day, which deprives the child of the opportunity to develop an appetite. Serve him balanced meals and snacks every 2-3 hours, with only water in between.
  • Initially try serving the supplement only with snacks. Talk to a pediatric RD (registered dietitian) familiar with Ellyn Satter's Division of Responsibility if he truly is compromised with nutrition and growth. (My book has a list of questions to ask RDs and therapists.)
  • How are you trying to “get” him to eat? Games, stickers, TV, begging? Often, pressure backfires.
  • Work on the Division of Responsibility in feeding. You present the foods, he decides how much and if to eat from what you present. (See my answer to Reader Question #2 in Part I of my Q&A on this blog for ideas on planning meals for a selective eater. Something he eats, even if it’s yogurt or applesauce needs to be included at every meal and snack. This is not “starve him out.”)
  • If meals have been unpleasant, or a battle with lots of tears and stress, you need to rehab the mealtime atmosphere and attitudes. Stress kills appetite.
  • If your therapy tasks result in push-back, they are probably not helping your son learn to eat. Trust your gut. As one mother said, “Bad therapy is worse than no therapy.” Some children find even the encouragement recommended in therapy is a turn-off.
  • Try to eat with your child as often as possible. Ignore how much of what he is eating as much as possible.
  • Offer, don’t push.
  • Realize that he may eat less initially as you transition to the Trust Model of feeding.
In terms of what to offer, children generally want to grow up and learn to eat the foods the family eats. If you can modify the foods you enjoy, that would be ideal. Does he like soft, salty, sweet? Are there sauces he particularly likes? Sit with him and eat your meal. If you are making squash for dinner, can you add a little butter and some brown sugar and fork mash it for him? Hang in there. Know that this is a marathon and not a sprint, and that I’ve seen ten-year-old “feeding clinic failures” branch out and do just fine with their eating.

Look for the sensory symbol throughout my book for tips for feeding children with sensory issues.

Reader Question #4: How do you help a child heal and stop eating out of the trash?

It sounds like your child has had some trauma around food, likely some major food insecurity, or restriction, or real hunger. Perhaps to survive he had to literally obtain food from the trash. Perhaps he has been shamed for his hunger, or his size. I like how you phrase your question about helping him heal. Healing a history of food insecurity takes time. Let’s look at how you can help your child begin to heal.

First, has your child had a full physical exam to rule out any nutritional concerns, like anemia or iron deficiency, or lead levels? (Some nutritional deficiencies can lead to PICA, or the eating of non-food items.) How old is he? Are there events that trigger the episodes, like visits with siblings, or stress at school? Here are a few general thoughts that might help heal his anxiety.
  • Try not to shame him about eating from the trash. Remain calm, neutral and supportive. If he survived by eating from the trash or taking care of himself, let him know how brave that was, and what a survivor he is. If he fed younger siblings, compliment him on what a good job he did, but that he doesn’t have to do that anymore.
  • Reassure him verbally, but mostly with your actions, that you are now taking care of and thinking about his needs so he doesn’t have to so much. (See my answer to Reader Question #1 in Part I of my Q&A on this blog for more on food anxiety and hoarding in kids with trauma).
  • Have you tried to ask him what is happening around these episodes? Was he hungry, are there foods he might like you to serve, did he have some feelings he was working on? If you are working with a therapist, this is something you can talk about together to help gain insight, or consider specific therapies. (Avoidance, dieting, shame or restriction would not be considered therapies, in my opinion.)
  • Is there a certain type of food he is eating from the trash? If he is eating “forbidden” foods, like half-used frosting containers, or candy, the goal would be to include those foods, and turn them into “formerly” forbidden foods. That means ask him for his favorites, and plan to serve them with meals and snacks. He can have a portion as his dessert, and once or twice a week, he gets to have those FFFs as his “treat” snack, where he can eat as much as he wants. Serve with milk (dairy, or your alternative), sit with him and enjoy it. He may eat a lot at first, and it will scare you, but as the shame, secrecy and access improves, over time, he should be able to learn to manage and enjoy those foods.
  • Examine how you talk about food, or fatness. If a child hears about “junk” food or “bad” foods, or even “red-light” foods, they often think, “that food is ‘bad’ and if I eat it, ‘I’m bad.’” This elicits shame, which often fuels the secrecy and bingeing. Poverty, food insecurity and higher BMI (body mass index) are related. I’ve had questions from foster parents worried about a fat child, who are advised to put the child on a diet to try to get the child to lose weight. This will not help him heal, and is more likely to lead to higher weight and increased food anxietyand obsession over time.
  • Perhaps a food stash may help your child feel secure. A granola bar, a packet of trail mix… Ask him to try to save it for meals and snack times with you, but it is there if he needs it. See my first Q&A post for more on my thoughts about food stashes.
The critical step to healing his relationship to food is being absolutely reliable about feeding your child, every two to three hours for younger children, and every 3-4 hours for older children. As one mom told me, “I find the more we let the anxiety and control around food go, the more he lets go of the obsession surrounding food (what a concept).” Hang in there and keep asking those questions!

Thursday, December 13, 2012

Free Webinar Today! Developing a Healthy Feeding Relationship (for Adoptive Families)

Part I of Dr. Katja Rowell's wonderful adoption and feeding Q&A here on my blog got a wonderful response, so I know you'll be happy to hear about a free webinar she's conducting today, Thursday, December 13th from 1-2pm EST. The webinar is sponsored by Adoptive Families Magazine. Join in by registering here.

Some more information about the webinar:
Since bringing your child home, have you encountered behaviors like hoarding, food obsession, picky eating, overeating, or everyday power struggles around the dinner table? Join Katja Rowell, M.D., aka "The Feeding Doctor," to ask questions about the challenges you've faced at meal or snack times.

Please note that the information offered in the webinar is for educational purposes only. It is not meant to replace careful evaluation and treatment by medical, nutritional, or mental health professionals.
Check out my review of Dr. Rowell's book. The book can be purchased here (aff).

Part II of Dr. Rowell's adoption and feeding Q&A is coming soon to Fostering Thrifty Families!

Wednesday, December 12, 2012

Product Review: Xlear SparX Xylitol-Sweetened Candy & Tooth Gel

Xlear and Moms Meet recently sent me a generous package of Xlear SparX xylitol-sweetened candies and kids' toothpastes. I was especially excited to have my kids try the toothpaste, as research has linked xylitol to lower rates of tooth decay. Xlear is best known for their sinus sprays for treating and preventing allergies and congestion, but I learned they actually carry a variety of products from candy to toothpaste.

The toothpaste, Kid's Spry Toothgel with Xylitol, was perfect for our toddler who loved the flavor. It's fluoride-free, which some parents prefer, especially if their child is already getting fluoridated water, fluoride treatments, or supplements that may contain fluoride. Because it's fluoride-free it is safe for use with younger children who may still be swallowing more than they're spitting.

Xlear describes its SparX candies as part of "a growing line of healthy, xylitol-based candies. Xlear SparX is sweetened naturally with xylitol, a plant-based, dentist recommended sweetener that’s been proven to improve dental health and strengthen tooth enamel." The kids I shared the candy with described it as "yummy," "crunchy", "weird tasting," "very sweet" and "cool." The best thing about these tiny, crunchable little candies is the plastic canister they come in. The kids enjoyed shaking the candies in their container and dispensing just a few candies at a time. Grown-ups who tried the candies said some of the flavors tasted "off" (including some flavors that tasted downright off-putting) but others were very tasty. Some people found the shape and texture off-putting. One person complained the candies were too small and they preferred candies to be either chewy or to be hard sucking candies rather than something in-between like this. Another parent felt that the candies being so small was an advantage, as she could dispense just two or three as an incentive or reward to the child. The kids had no complaints over the crunch of the candies. The tasters almost unanimously preferred the Citrus flavored candy pack, with the Berry pack coming in second and the Fruit flavors coming in last.

SparX are a great option for parents seeking candies for their children that are free of natural colors and flavors and are sweetened with a sugar that won't promote tooth decay. Check out Xlear's website for a full range of products.

Monday, November 5, 2012

Food Hoarding & Integrating Kids' Diet Preferences - Q&A w/ Dr. Rowell on Adoption/Foster Feeding Issues- Part I

I am so grateful to Dr. Katja Rowell, MD, for not only giving two copies of her new book Love Me, Feed Me: The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles and More (aff) away to my readers (see this post - giveaway now closed!) but also for volunteering her time to answer my readers' questions. During the giveaway readers were given the opportunity to ask questions about adoption- and fostering-centered feeding issues and in this post Dr. Rowell (aka The Feeding Doctor) answers two of them. In a second installment, Dr. Rowell will answer a few more. You can find much more on both of the topics addressed here in the book.

This information is educational. It is not meant to replace careful evaluation and treatment by medical, nutritional or mental health professionals.

Reader Question #1 (from Gabby): Do you recommend foster parents leave food accessible, such as bowls of fruit on the counters/basket of snacks on the shelf at kids' level; or just provide healthy meals and snacks on a set schedule? In training we've heard conflicting strategies up to, and including, giving the child their own container to keep wherever they please and allowing them to "hoard sensibly" while helping them clean out the container weekly... What is your best suggestion for dealing with foster children with food issues?

The best way to lessen hoarding behaviors is to lessen anxiety about food.

Too often, the food stash is presented as the solution to hoarding and food anxiety. It seems to have been presented to you as an either/or scenario: food stash, or healthy food on a schedule? I think the answer is both, or no stash, and that it may change with time. One of my main goals is to empower you, to help you know there is no perfect solution or anything that says you have to get it “right” from day one. That’s not how parenting works. We figure it out with each of our kids…

What I am firm about is that if you offer a food stash, it is not an “out” for providing regular meals and snacks. (Note I did not say “healthy” as I believe that to learn to handle and enjoy all foods, meals and snacks need to include “healthy” and not-so-“healthy” options.) My main concern with the stash, or allowing the child to help himself to the pantry, is that it misses the opportunity to complete bonding cycles and deepen the attachment with your child. For the older child who had to be self-reliant with feeding, showing that you will take care of him is important, and feeding is a concrete way of doing so. Feeding is about trust and nurturing, whether your child is 15 months or 15 years old.

Allowing the child to help himself to food at will can also undermine self-regulation, or knowing how much to eat, which is a skill your child may need to relearn.

Here are two scenarios from my book Love Me, Feed Me: The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles and More:

“Consider Marcus, who did not want to let go of his biscuit. He certainly can be allowed to hang on to the biscuit for a while, and maybe even have one in a baggie in his pocket. Follow his lead. If he throws a tantrum about having it taken away, allow him to carry it with him. But the parent also has to be absolutely reliable about regularly providing food. You may need to offer food more frequently at first, perhaps every hour or so.

In a different case, three-year-old Arielle, adopted at 11 months, was on calorie restriction and was experiencing intense food anxiety and preoccupation. Mom tried to let her carry food in an attempt to address her anxiety, but Arielle gobbled it up and begged for more. In this scenario, Arielle’s actions were not the “hoarding” behaviors seen when a child first arrives from a place of food insecurity, but were actually symptoms of a feeding relationship disruption due to her food restriction (see Chapter 5). Letting her have her own stash of food to carry around didn’t work for this family in this situation.
Feeding your child directly shows your child that you will take care of her and builds trust. Completing that cycle of need and meeting her needs, over and over again, is the basis for attachment.”

A few other thoughts:
  • Offer frequent reassurances such as, “There will always be enough food.”
  • Show him the pantry during the day, perhaps even as you end a meal, “See, there is always enough food here.”
  • Plan on pleasant family meals—if you’re battling over broccoli or a therapy task, that’s not helping him feel more secure.
  • Structure is critical. If you go to the park, don’t forget to bring a balanced and filling snack.
  • Offer food every 2-4 hours depending on your child’s age. Include fat, protein and carbs.
  • Institute the Division of Responsibility. At meals and snacks, he gets to eat as much or as little as he wants from what you provide. Even if he eats a lot initially, this will reassure him.

What it boils down to is this: with reliable, pleasant, and satisfying meals and snacks, hewill learn over time that he doesn’t have to worry about when or how much he will get to eat. You get to worry or think about the food, so he doesn’t have to.

Reader Question #2 (from Ben): How do you respectfully integrate your own family's eating habits and preferences with a child's? For instance we eat a lot of vegetarian only meals, and not a lot of processed foods. How would we honor a child's past experiences while also, hopefully, demonstrating our own?

This question is so thoughtful. Rather than ask, “How can I get her to eat my way?” I think you are asking how can I help her feel honored, safe and nurtured while helping her learn to eat a variety of foods as part of our family. By using the word integrate, you sense that it will take time and is a process. How we frame these questions matters.

I recommend handling this how you might handle an entrenched selective eater. Familiar foods feel safe. Early on especially, it is best to focus on “heart needs” as one client put it, rather than worrying too much about nutrition. All too often, adoptive and foster parents find themselves so caught up in nutrition and weight worries that they push and pressure children to eat only “healthy” foods. Alas, this can lead to conflict and power struggles, and doesn’t help the child learn to eat a greater variety of foods. Often, in fact, it makes matters worse. (Particularly with older or traumatized children, or children with sensory issues.)

  • If you are fostering an older child, consider asking her what her favorite foods are. Also ask if there are foods she likes in general or if there are foods she doesn’t like “right now.” (You never know, she may have been forced to eat foods she has gagged or vomited, or held down and forced to eat.) Hopefully her list of favorite and accepted foods will include a few foods that you are comfortable serving: bread, tortillas, rice, pasta, crackers, corn, canned mandarin oranges, baked beans…
  • Provide her favorite sauce or condiment. Keep a Ketchup bottle at the table, or mustard, or hot sauce that she can use as she sees fit. She may put ketchup on everything for a while, and that’s okay. (Research shows that condiments help children branch out.)
  • If she likes crunchy foods, consider offering new foods that are also crunchy. If she tends to like more smooth textures, consider offering puddings or applesauce.
  • Offer meals and snacks every 2-3 hours for younger children, and 3-4 for older children, maybe more frequently when a child first arrives if they are food insecure.
  • Sit and eat together, whenever possible, without TV or other distractions.
  • Reassure her that there will always be enough food, and that she doesn’t have to eat anything she doesn’t want to.
  • You can consider asking her to try a new food, and see how she reacts. Some children will try it, others will rage or protest if required to take a “no thank-you bite.” Take her lead.
  • Always have at least one thing from her accepted list on the table. She needs to feel that she can come to the table and feel that her hunger will be fed.
  • Consider leaving herbs on the side for now. If you make a Curry, put the cilantro in a little bowl on the side and serve it with rice. If your child isn’t fond of spicy food, prepare foods more mild than usual, and add hot-sauce to your own at the table.
  • Perhaps serve corn bread or one of her favorite sides with your lentil dish.
  • Invite her to help you meal-plan if she is old enough. Perhaps you can say, “We’re having lentils for dinner. Would you like cornbread or rice with that?” Resist the urge to argue, pressure or fight, even if she refuses the food she chose.

When children feel anxious (adults too for that matter) or there are battles at the table, it makes it close to impossible to learn to eat. Stress can kill the appetite or make some children (food insecure or restricted) eat more, so a pleasant table is important. Try to focus not on who is eating how much of what, but on each other. Ask about whom she sat next to at lunch, or how her favorite are class is going. Talk to other family-members too.

Other ways to help children feel safe and “in control” at the table:

  • Set out paper napkins and let her know that she may politely spit out any food she doesn’t want to swallow. Children are much more likely to try a new food if they can spit it out.
  • Don’t worry about enforcing manners right away. Lead by example.
  • Serve foods family-style (so she can serve herself)

Try not to worry if all she eats is bread and milk for a little while. Make up for balance where you can. Fruit leathers or dried fruit, 100% fruit juices or nectars, smoothies at breakfast, popcorn for fiber, maybe a good chewable multivitamin. And hang in there. As sixteen year-old Yiseth said, “Think of it from the kid’s point of view. What is the kid thinking? It shouldn’t be ‘how can I get her to try this,’ but ‘how can I help my child do this at her own pace.’

Over time, and it may take a lot of time if your child has been neglected or abused around foods or if she has sensory issues, she will feel safer with these tips and will be more likely to enjoy your family’s foods.

A lovely resource that helped me “see it from the kid’s point of view” is the book Three Little Words: A Memoir by Ashley Rhodes-Courter, who describes her ten years in foster care. She explores her neglect and even abuse around food, and how at thirteen, she bristled at the nutrition lectures and pressure from her loving and concerned adoptive parents.

Thursday, November 1, 2012

Congrats to the Winners of the "Love Me, Feed Me" Giveaway

Congrats to COLEN B. and GABBY C. for winning the Love Me, Feed Me giveaway! Please e-mail your mailing addresses.

 Sorry it's taken me a little while to draw the winners - We're dealing with the fallout from Hurricane Sandy (thankfully we are all well, just still out of power).

Colen and Gabby will each receive a signed copy of the book Love Me, Feed Me: The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles and More (aff) by Katja Rowell, M.D., aka The Feeding Doctor. You can buy yours at Amazon.com or order it from your local independent bookstore.

Stay tuned for an upcoming Q&A with Dr. Rowell on this blog.

Wednesday, October 24, 2012

Adoption Book Giveaway: "Love Me, Feed Me: The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles and More" by Katja Rowell, MD

I was eager to receive the copy I ordered of Love Me, Feed Me: The Adoptive Parent's Guide to Ending the Worry About Weight, Picky Eating, Power Struggles and More (aff) by Katja Rowell, M.D., when it was finally released last month. I've been following feeding specialist Dr. Rowell's blog and tweets for a while, and have found her approach to the parent-child feeding relationship so sane that it almost seems insane. I knew I'd like the book but I didn't know I would literally read it cover-to-cover (all 354 pages!) in 24 hours. And I certainly didn't know it would seriously challenge me to think about what my actions and words are teaching my children about food and eating and weight.

Parents I know who have children adopted from foster care and orphanages deal are parenting kids with food/feeding issues such as:
  • Slow growth / failure to thrive, sometimes leading to feeding tube placement
  • Difficulty transitioning from formula to solid food
  • Picky/selective eating
  • Sensory issues including texture aversions
  • Malnutrition
  • Underweight and overweight
  • Vitamin deficiencies
  • Anemia
  • Food hoarding
  • Meltdowns at meal time and other difficult behaviors
  • Bingeing
  • Control issues regarding food
  • Oral motor and other physical feeding challenges
This book deals with all of these issues, and more. It focuses on trusting children's ability to learn to self-regulate around food and rejecting the common approaches of coercion, game-playing, force-feeding, guilt trips, pressure and bribery that many of us use to get our children to eat more of what we consider healthy foods. Dr. Rowell's book really turns everything you think you know about feeding picky, overweight, underweight, vegetable-hating, malnourished or even totally average children on its head. It forces you to rethink your own relationship to food and all your beliefs about whether or not children can be trusted to choose what foods they wish to eat and still get their nutritional needs met. It may even go against advice given to you by your dietitian, doctor or speech therapist. But, as many adoptive and non-adoptive parents can attest, it is a proven method that works for so many families. Dr. Rowell has seen this non-coercive, low-pressure, shame-free approach to eating help even children with severe feeding issues thrive and learn to be "competent eaters."

Love Me, Feed Me reflects the authors' familiarity with the issues of foster and adopted childrens from backgrounds of abuse, neglect or institutionalization. She goes over adoption-specific issues such as the cultural differences in feeding practices that may challenge your internationally adopted child when they arrive in your home, the transition diet to help a child get accustomed to a very different diet in your home than what they experienced in a foster home or orphanage, dealing with malnutrition, food hoarding, and more.

You will learn from this book how dysfunctional and emotionally fraught many adults' relationship with food is, and how we pass this on to our children unintentionally... especially if they are "picky eaters" or are "overweight". However, the book spends a lot of time showing us how to break this cycle and get out of thinking of foods as "good" or "bad" in favor of a balanced and healthy relationship with our bodies (at any size) and with foods. It's a book about the feeding relationship between parent and child, a relationship which is an important part of attachment for an adopted child.

What's that you say? You want me to cut the chase and get to the giveaway? Fine, then. Here you are: Dr. Rowell has generously offered two autographed copies of the book to give to my readers! There are a number of ways to enter below.

Whether or not you're entering the giveaway, please be sure to leave a comment with your adoption- and foster-related feeding and food related questions for Dr. Rowell to answer in the upcoming Q&A she's generously offered to do here at Fostering Thrifty Families.

a Rafflecopter giveaway

NOTE: This giveaway is only open to residents of the U.S. and Canada.