dr says he needs to eat more so how do I modify the EASY?

[debandbrian]

Not sure if this fits in this forum, but here goes...

DS has always been small but today at the 9 month checkup the doc has now crossed over into "concerned" since he hasn't gained much in the last month. He's gotten taller and is happy and developmentally on track so I wasn't too worried, but she says if he doesn't gain at least a pound in the next month she's doing bloodwork. My instinct tells me it's hereditary (I'm just under 5 feet, and MIL dug out dh's health records to reveral that he was 20 lbs at 15 mos!!!!)

Nonetheless....she is saying I should offer him 3 (large) meals, 2 snacks, and continue the BF 4+ times a day...I don't think he'll ever eat this much...but does anyone have suggestions on how to do this much eating in one day, so as to basically stay on an EASY plan???

Also (and perhaps this should be another topic), when do most people move from purees to finger foods and/or chunkier items? If I offer anything with any kind of texture - cottage cheese for example - he'll eat it but it slows him down a bunch and ultimately he eats a lot less. Should I push this stuff or focus on feeding him what he'll eat the most of?

I'm so worried!!!
Deborah

[tylersmommy]

That must be pretty frustrating, but on the other hand, that's great that your DS's dr is so attentive! Can you post a sample of his daily routine so we can get a better idea of what his day looks like? That Is a lot of food to fit in, but where there's a will, there's a way!

As far as finger foods go, many babies DEMAND to be fed this way around 9-12 mo by refusing the spoon. If your DS is interested, go for it, but if not, you might just want to focus on what he eats the most of. If you do offer finger foods, it will seem like he's eating less, but he isn't. Keep in mind that purees are mostly water, whereas finger foods are just concentrated food. So a spoonful of puree is actually LESS food than the same amount of finger food. Does that make sense?

You might also try serving some healthy foods that are high in fat, if you aren't already. Avocado can be easily mashed or cut up as a finger food. Cooked egg yolks (safe for babies over 7 mo, wait until 1 yr for egg whites) can be mashed up into purees or given as finger food. And whole milk dairy products like yogurt and cheese are good too. HTH!

[debandbrian]

Thanks for the info!!!
I try to do my own purees when possible and he loves oatmeal so this is what his diet mostly consists of. We did avocado a while back but I should try it again - any advice on how to use up the whole avocado quickly? (except for eating it myself, which I would love but don't need!!!)He was doing yogurt but I wanted to try something else so I got the cottage cheese but he isn't such a fan of that yet. So back to the yogurt it is.

Anyway - our day looks like this:
5 am - breastfeed then back to sleep- we are trying to push this one back little by little so that it is his wakeup feed - but it's so hard to deny a scrawny guy food!!
7 am - a smaller bf - the dr. said if I am going to keep the 5 am then switch this with his solids so he'll eat more breakfast
8 am - solids
9:30ish - nap
11:00 - bf
12:00 - solids
2:00ish - nap
3:30 - bf - I've been trying to add a snack here too, but his appetite doesn't seem to be big enough for both - the bf would be more nutritious, right?
5:30 dinner
7:30 bf
8:00 bed

Any more advice you can offer would be great.  I gave him 8 tbsp of cereal at lunch and about 3 of mixed veggies - he didn't come even close to finishing it. Then for a snack I tried some grated cheese, applesauce, and bread (this is a new one) - he only ate a couple bites of each and wouldn't hear of any more.
One last thing I should share is that he is a spirited little guy - no surprise - so he must be working off all of his calories with all the activity. Too bad I'm not working off those last 5 lbs of pregnancy weight chasing after him, lol!!!!
Deborah

[Nicola_G]

Hi Deborah,

You mention that you are feeding oatmeal as the main ingredient in his diet. A couple of questions from me:

- How much oatmeal/fruit/veg is he eating for each meal?
- Have you considered introducing protein-rich foods like cheese, kidney beans, lentils, egg yolk?

The key here, as Wendy mentions, is bang for your buck. You want to feed him foods which are high in calories as these will put on weight faster, gram for gram, than lower calorie foods. So whilst fruit and veg purees are great, they are relatively empty calories compared with protein and fatty foods. Great as introductions to solids, but I think (IMHO) you need to introduce more variety. In this vein, cottage cheese would be great but if you are really struggling with him with the texture, try pureeing that too. You can always work on texture for one meal per day and the others keep puree on the menu so as to ensure he eats more.

As for volume, my little guy is on the small side too (although within the healthy range, he's just below the average) and I was AMAZED at the volume of solids he can put away in one sitting. Even before I introduced the second meal, he was putting away 8oz (250ml) of puree at dinner time. I actually didn't think his little tummy could be that big.

I started solids early because my lo was not putting on weight, and am happy to say that he's gaining an average of 150g (5oz) per week. Still not huge, but OK. So given the huge volume he's eating (and still on the breast for the same number/length of feeds as before) he's still not gaining a whole lot of weight.

HTH, look forward to hearing your progress.

[tylersmommy]

I hate to say it, but I just can't see any other times you could add in a snack! Hopefully someone else can!

To answer your question re the 3:30 bf...given the choice between bf and solids here, I'd stick with bf. Like you said, it's more nutritious, and if you get a full feeding in (ie, he gets plenty of hind milk), it will likely also be higher in fat than most solids you could offer. For the avocado, you can always mash or puree the whole thing, then freeze the rest in ice cube trays. You can even keep it in the fridge for a couple of days if you'd rather. It may turn a bit brown, but that's just a reaction with the air, and it has no effect on taste or nutrients. Good lucki!

[debandbrian]

Thanks so much everyone for the advice. I offered 8 tbsp of oatmeal last night and for breakfast this morning - with about 2 tbsp of vegs/fruit.  I'd say he ate about 3/4 of the whole thing so that was pretty good. I am going to puree the cottage cheese - great idea - and also try egg yolks today. He has had lentils, chick peas and kidney beans - he'd eat some if they weren't too thick but they were clearly not his favorite. He has this funny way of talking and procrastinating when he's offered something he doesn't especially like. I didn't grow up with good eating habits myself, so I was really trying to expose him to a lot of different tastes, rather than try to disguise the good stuff in the things he likes (oatmeal and applesauce, basically) - but I guess for the next month I am going to have to try that just to see if he gains. I'll be happier knowing that that's all it is, rather than some medical problem.
Wish us luck. I'll keep you posted on how things go. Thanks again,
Deborah

[dkjokisch]

My dd is going to be 1yr on Friday, and we have been dealing with this exact same issue since her 9mos check-up.  Despite introducing solids, she did not gain any weight between 6 and 9mos.  She has actually fallen off the bottom of the weight charts.  At 12mos, she is only 16lb, 6oz.

I looked at your schedule, and do not see anywhere to add another snack.  I would also keep the 3:30pm bf instead of a solids snack.

At 9mos our ped ok'd protein and dairy, so here are some of the things we added to her diet...

Pureed lentils (She really likes them mixed with carrots.)

Dark meat chicken pureed in pan juices (including the fat)

Cheese, cheese, and more cheese! (She loves the prewrapped American cheese slices, but has eaten just about every variety we have offered.)

Yogurt (I don't give her baby yogurt, but rather the highest fat whole milk yogurts I can find the store - she loves Dannon La Creme.  I also give her Stonyfield Farms whole milk vanilla yogurt mixed with pureed fruit.  Yoplait also makes a custard style yogurt that I am going to check the calorie count on.)

Cream cheese (I started lacing her veg purees and oatmeal with cream cheese for a while, but she also likes it on bagels and banana bread.)

Pumpkin custard made with cream instead of evaporated milk (I used my pumpkin pie filling recipe.)

Cheesecake (She tried it and liked it, so I am going to make a cheesecake for her birthday.)

Hummus (I make it myself so there are no preservatives.)

Mashed potatoes laced with butter, sour cream, formula, and sometimes cheese

Any pureed veggie with shredded cheese mixed in

For now, I wouldn't worry about puree vs. finger food.  We offer both at every meal unless we're having a meal where I think she'll eat a good chunk of whatever we're having.  Dd is still eating puree at 12mos, and as long as I am getting food in her and she still has interest in finger food, I am not going to worry about it.  And there's nothing wrong with hiding things they won't eat in things they will.  Dd won't eat pureed beans or meat separately, so I mix them in her favorite veggies.  I assume you're already making his cereal with ebf or formula, but if not, that's something else you could do.

This has been odd for us as dh and I are relatively healthy eaters, and I have had to change my shopping mentality completely.  I know how stressful this can be.  Feel free to pm me if you want to discuss this further.