285715 Thu Jun 08 14:45:54 -0700 2006 35 31 Home Cooking 0 1530690 Any advice for nutrient dense foods for a 20-month old who is losing weight, due to JRA (she is unable to chew anything too hard/crisp and has trouble opening her mouth wide). We have offered smoothies, avocado (mashed with cream cheese as a dip for wheat pita or vegetables), and have added milk puddings and custards with egg. Any ideas are most appreciated, keeping in mind her taste for seasonings is limited. But she really loved the crab bisque, so go figure! Thu Jun 08 14:45:54 -0700 2006 0 Diane 1 1530699 I would keep, keep, keep going with the avocado. It's really a super nutrient rich food. Also, have you thought of bean soups, lentils (dal) and grain salads (quinoa, groats, wheatberries) flavored with anything she likes? Lastly, you can make ice cream! Thu Jun 08 15:25:51 -0700 2006 1530690 0 anu 1 1530700 I don't mean to be rude, I've got thin, VERY picky twins and I would suggest asking the pediatrician for advice and possibly a referral to a really sharp nutritionist. GOOD LUCK!!! Thu Jun 08 15:28:01 -0700 2006 1530690 0 sel 2 1530704 A Registered Dietician is whose help you need. Thu Jun 08 15:30:27 -0700 2006 1530700 0 Candy 3 1530706 OK. Hopefully a sharp pediatrician will give a good referral. Thu Jun 08 15:35:38 -0700 2006 1530704 0 sel 2 4426376 Have them checked for food allergies and celiac. Consider www.NAET.com . Plant based digestive enzymes may be helpful. If they primarily eat carbs and dairy products, gluten and casein sensitivity may be the issue. Sometimes it's a texture, temperature, or smell issue. Tue Feb 17 15:40:41 -0800 2009 1530700 169792 lgss 1 1530717 My 2 1/2 year old DS is also on the skinny side and always has been. Our problem is that he loves fruits, vegetables and water! None of which are heavy on the calories, so we have to sneak extra calories in. A suggestion I got from the pediatrician were to add powdered milk to his regular whole milk and to mix in his smoothies. It adds extra calories and DS doesn't notice any taste difference. I also add butter and/or ghee to a lot of his food. When I make him a scrambled egg, I use like a teaspoon of ghee to cook it in. I also add it to rice, dals (lentils), and his vegetables. Thu Jun 08 16:26:00 -0700 2006 1530690 0 boogiebaby 2 2760525 My wife is an M.S.R.D. (that is a Master of Science in Nutrition combined with an RD license).... she specializes in Intuitive Eating. There is very, very, very strong research that suggests trying to dictate When, What, How your children eats will only develop lasting food issues that will be very hard to break. Some studies claim that 80% of cases of obesitiy, bulimia, anorexia etc., can be attributable to the psychological damage done by well intentioned parents. You can find some good books on the subject on Amazon.com. Wed Jul 18 08:13:10 -0700 2007 1530717 42572 Eat_Nopal 3 2760564 Thank you for pointing this out. Ellyn Satter is the authority to read on this subject. Her book How To Get Your Kid to Eat....But Not Too Much is where I would start - an old book but a classic with an excellent chapter on Feeding the Child with Special Needs. (another M.S., R.D. here. My specialty is pediatric nutrition) Wed Jul 18 08:22:30 -0700 2007 2760525 12823 Junie D 4 4418310 I agree with this advice with regards to picky eaters... But the OP has a young child with a chronic disease (juvenile rheumatoid arthritis) who is actually LOSING weight from the inflammation of the disease, at a time when they should be gaining. This is quite different from a skinny, picky, but otherwise healthy child. Sat Feb 14 20:08:37 -0800 2009 2760564 150115 Mellicita 2 2761558 nwow my daughter and i enjoy these high fat things together. Wed Jul 18 12:18:02 -0700 2007 1530717 17714 alex8alot 1 1530767 You're definitely on the right track... Think about how you can add calories in everything she eats. Add butter/margarine to rice, pastas and even soups and stews. Anything you make w/water (eg soup) make with milk. Use the whole milk versions (rather than low fat) of all dairy foods or even mix half-and-half with milk. This age loves finger foods. Some high calorie finger foods I can think of off hand include ritz crackers, pieces of croissants, mozzerella cheese sticks. Also, she may drink her calories better than eat. Try carnation instant breakfast and milk and even mix in ice cream. Commercial supplements (eg Pediasure) are fine but somewhat costly and the nutrition in carnation instant breakfast is the same. I am a pediatric registered dietitian. Feel free to email me off site. But I bet her rheumatologist can also refer you to one that they work with.. Thu Jun 08 19:37:20 -0700 2006 1530690 0 suebe 2 1530769 Question for the dietician: do some foods exacerbate arthitis pain? Thu Jun 08 19:45:34 -0700 2006 1530767 0 butterfly 3 1530773 I don't know the answer to your question as I work only w/children and not much w/rheumatology. Besides, we should keep this topic to homecooking. There used to be a website www.askthedietitian.com (or.org) that could canser these things. Thu Jun 08 20:17:01 -0700 2006 1530769 0 suebe 3 4417108 my MIL has RA and has always claimed that too much sugar exacerbates the pain. Sat Feb 14 09:42:01 -0800 2009 1530769 75012 jencounter 1 1530782 One thing to check with your doctor: my (older) kid has Crohn's, a digestive disorder, and was losing weight at a time when he should have been rapidly gaining. In his case, once he was finally diagnosed (these problems tend to stick too firmly to the field of whatever specialist you see first) a 15-pound box of bacon turned him around. I asked the gastroenterologist "what about balanced meals"? He said "if he's getting the calories, he's getting the nutrition." A daily vitamin took care of any lingering concerns. Of course, the situation may be different at 20 months - but my point is, in this case, I had to be shaken loose from my desire for perfect balance in favor of "anything he can keep down, and whatever Dad needs to avoid to lose weight, the kid needs to eat lots of to gain weight." Thu Jun 08 20:57:32 -0700 2006 1530690 0 Wayne Keyser 1 1530797 Dianne,you are getting so many good amswers here. Please keep in mind that any one with any sort of crack-pot theory can set themselves up as a nutritionist, There is no degree conferrd for this. There is at this at this time no degree, accrediation or certficate other than something home grown. If you want true healthy recommendations find a registered dietican Fri Jun 09 00:17:27 -0700 2006 1530690 0 Candy 2 1530829 Actually, that's not entirely true. It depends on the state. Some states you must be a registered dietitian (RD) if you call yourself a nutritionist. In California however (my state) any crackpot can practice nutrition although I have met some great, non-RD dietitians. You just don't know... Anyway, this has nothing to do w/homecooking Fri Jun 09 12:06:56 -0700 2006 1530797 0 suebe 1 1530842 my 14 month old is low weight & I make pancakes & french toast & load with butter & syrup. I shortcut by buying french toast sticks in the freezer section. they tend to be soft. Also, oatmeal & grits are easy to load with fattening stuff too. quiches too! Fri Jun 09 13:11:27 -0700 2006 1530690 0 pamd 1 2760761 I going to guess Diane, that since you posted that your 20 month has JRA you have been to a doctor that has diagnosed your daughter. Sorry to hear about all this, but keep doing what your doing, and there are tons of good suggestions as well as advice given here. I'm just going to try to help with answering your request for things to eat that will be easy on her jaws, and perhaps help with the weight gain. But make sure your get your pediatric-ortho specialist or whomever you are working with to approve first. Mashed potatoes, made with cream/butter flan, chocolate tapicoca pudding mac and cheese, small pasta version - pastina I use this all the time for my 18 month he also like cream of mushroom soup - the thick version, and to dunk very soft bread with butter into it and then takes bites chicken and dumplings - child version, make it with biscuits and creamy chicken veggie sauce any pasta dish. We don't have your situation, but I am paranoid about children choking, so I cut everything up small, or use the pastinas. They have some that are alphabet letters. Cheesey sauces made with whole milk or cream for getting some meat, I would grind it up and add it to a light cream marinara sauce that has very little seasonings. And creamy scrambled eggs, (mine likes ketchup) I wish you and your daughter well with this whole thing, and good luck to you! Wed Jul 18 09:14:54 -0700 2007 1530690 50431 chef chicklet 1 2760892 Two words: ice cream. Loaded w/calories, easy to chew/swallow, kid-friendly, and a great way to sneak extra caloric load into the diet without a whimper of protest. Comes in zillions of kid-friendly flavors. Wed Jul 18 09:45:11 -0700 2007 1530690 12023 Hungry Celeste 2 2761597 I make my little ones mac and cheese with heavy cream to add some weight. Wed Jul 18 12:25:46 -0700 2007 2760892 11854 LaLa 1 2761743 All that I can think of that hasn't been suggested yet are soups made with cream. You can easily add pureed vegetables (some people use baby food vegetables), beef or chicken broth, pasta, barley...anything, really. Not only does she get the fat of the cream, but nutrients from whatever else you sneak into it. Try investing in some protein powder and put it in whatever you can, though I would research and see if that's alright for a toddler. Wed Jul 18 12:59:17 -0700 2007 1530690 112034 spellweaver16 1 2761765 Hello, Diane A very good friend of mine has a 16 month old who has/had real problems with texture--everything had to be pureed or he would gag. She also needed to put some weight him. From what I have gathered from her, everything savory gets chicken fat or olive oil added to it, and everything sweet gets coconut milk or oil added to it. She has made all her own baby food and he's started to show improvement. She gives him pate and cream or will, say, puree up some pot roast-n-fixins. He gets squash and avocado every day, also. For a while, she would mix everything he ate with full fat, cream top yogurt, which helped to smooth out any texture issues--he's able to tolerate more textures now. I think one of his favorite desserts is coconut milk pureed with softened dates and macadamia nuts. She gives him lots of things made with bone broth, as well. Much of this is on the recommendation of her nutritionist. Wed Jul 18 13:03:49 -0700 2007 1530690 10206 Laurella 1 2761850 chicken simmered in coconut milk and pulsed in food processor, can add some peanut butter to it..similar to a thai curry whole milk yogurt added to smoothies...i make a yogurt, banana and whole milk smoothie every day for my husband.. I even make my own yogurt savory french toast..soak the bread in cream, eggs and parmesan... cook and sprinkle more hard cheese on it. Wed Jul 18 13:20:51 -0700 2007 1530690 94347 Ela0427 1 2763907 All good suggestions. A great way to add veggies is to dice them and then saute until reasonably soft and then puree them in the food processor and add a couple of spoonfuls in anything savory that she eats. If you stick to a combination of sweet and bland such as carrots and zucchini, they rarely notice. And add my voice to all those saying to consult a nutritionist. Ask your pediatrician or, even better, your specialist for a recommendation rather than trying to find one on your own. You might also ask for recommendations if you have a JRA support group. Chances are, someone in that group has experienced the same issue and will have a resource. Thu Jul 19 07:09:01 -0700 2007 1530690 71196 dalaimama 1 4416096 try a product called scandishake...its very calorie dense Fri Feb 13 19:19:25 -0800 2009 1530690 266672 bettykp 1 4416223 Nut butters or anything you can blend into such? In just a couple more months (or sooner) the earliest spring fruits will be coming on and those will be a good addition to her diet in whatever form. Fri Feb 13 20:21:07 -0800 2009 1530690 14341 OCEllen 1 4418443 Make her dishes with lots of rich stocks. Sat Feb 14 22:00:30 -0800 2009 1530690 25251 hankstramm 1 4418796 Add flaxseed meal, hemp oil and (non-hydrogenated) nut butters (healthy fats) to other foods. Sun Feb 15 06:57:59 -0800 2009 1530690 169792 lgss 1 4418800 Quinoa, hummus...There is also a kind of frozen dessert made with coconut mylk or you can add coconut mylk or hemp mylk to various recipes. http://www.godairyfree.org/Product-Reviews/Frozen-Desserts/Purely-Decadent-made-with-Coconut-Milk-Frozen-Dessert-Vegan-Gluten-Free-Soy-Free.html Sun Feb 15 07:01:32 -0800 2009 1530690 169792 lgss 1 4419087 Weight Watchers has a recipe my 18 month old loves. Of course, you would want to make everything full fat, but it essentially layers whole wheat couscous with banana pudding, into a parfait. you could also add a layer of pureed avocado in as well. top with whipped cream (don't add sugar). It's relatively bland, and she would get whole grains, fruit and dairy. Sun Feb 15 09:12:32 -0800 2009 1530690 265047 puddin head 1 4419513 Our regional trauma hospital serves "Katie drink" to patients who can ingest food orally but have trouble chewing or swallowing, but need nutrition. My brother, who was in the hospital for three months liked it. There are various recipes on line for a "Katie drink". I haven't tried any of them but here's one from the Rocky Mtn chapter of the ALS Associaton (Lou Gehrig's disease). As you can see, you can vary the flavors by changing the ice cream or the jelllo: “Katie Drink” 1/3 cup vanilla ice cream ¼ cup cottage cheese ¼ cup flavored jello Blenderize in blender until smooth, refrigerate until firm. Sun Feb 15 12:13:37 -0800 2009 1530690 19003 PAO 1 4420346 Salad dressing? My 2-year-old loves to lick Caesar dressing off tortillas cut into strips. Sometimes I think I should be giving it to her in a shot glass. (Yours might prefer a blander-tasting variety.) She likes Reuben sandwiches with Russian dressing too. It sounds like the whole sandwich would be too much for your child, but maybe she'd like a grilled cheese sandwich on soft bread with dressing and lots of butter? (notices date of original post) Oh. Your little girl is 4 1/2 now! Sun Feb 15 18:40:07 -0800 2009 1530690 13516 maryv 1 4423520 There has been much recent research into diet as a cause of inflammation, I hope you are consulting a dietician or rheumatologist about your child's diet. Mon Feb 16 19:46:42 -0800 2009 1530690 11234 toodie jane 1 4423660 I hope everyone realizes that the original post is from June 2006, so the OP may not even be reading CH anymore. Mon Feb 16 20:52:50 -0800 2009 1530690 19542 Karen_Schaffer