Friday, 14 February 2014

Adding Calories or Making Every Mouthful Matter

I am told every parent worries at some point whether their child is eating enough.

We did.  Our eldest daughter was born a very healthy 8.5lbs, but after being left blind with severe cerebral palsy within hours of birth by Group B Strep, she would scream minutes into feeds with reflux.  Her weight dropped from 75th in the Red Book at birth to 2nd around 18 weeks, and then round about 2 years old it went off the bottom of the scale.

We were advised by a Dietician at the Children's Hospital to wean her at 3 months, and get to protein as quick as we could as quite frankly fruit and vegetable purees would not give her the calories she needed. At 2 1/2 years, her consultant matter of factly said that she'd hadn't been unduly worried by her weight until now as it had at least been following it's albeit low line, but now we had to consider a gastrostomy or feeding tube - a tiny plug fitted into her stomach for us to to drip high calorie milk feeds into her overnight.

We stalled the feeding tube and redoubled our feeding efforts.  Thankfully, I enjoy cooking (although it is soul destroying to have a child reject a meal you've made 5 helpings of) and together with a photocopied sheet 'Tips for Adding Calories for Poor Feeders' I racked my brains and the supermarket shelves for high calorie ingredients for child friendly meals.

It's been slow process.  At 3 1/2 she appear back on the bottom of the chart in the pink zone, and two weeks away from the date for fitting the gastrostomy that consultant had finally insisted we make, we learnt she had put on enough weight not to need the tube.  At 5, by another cruel twist of fate she was diagnosed with Type 1 insulin dependent diabetes, so the need to keep her food intake up even when she is sick is doubly important.  But at 10 she is now 25th weight and average height for her age, and I would even dare to say my best eater.

So, three kids later, here is how I think you can add calories to even the fussiest of feeders:-

1.  Kids need Calories
If you remember one thing, remember this.  Children under 5 need calories.  Whilst 5-a-Day is a lifesaving habit to get into them as young as you can, children need fatty/high calorie food NOT 'diet' or 'low fat' meals.  But beware false friends - needing calories is not a license to let your darlings gorge themselves on sugary cakes, puddings & sweets.

2. Kids have small tummies, small appetites
Somewhere in all the reading I did on fussy eaters I remember reading that a portion size is the size of your (both child and adult) fisted hand.  Clench your fist and look at it.  It's not big is it?  Now look at your child's hand.  So, realistically a toddler only needs a heaped tablespoon of say macaroni cheese.  Not a bowl full.   I would cook a batch and freeze kiddy sized portions in shallow cream cheese tubs, yoghurt pots.

Aim to give three meals a day with small snacks (biscuits, cheese, raisins, yoghurt, crackers & butter) in between.  Spread the meals and snacks throughout the day, and don't let them fill up on juice or water 1/2-1 hour before a meal if you expect them to eat everything up.  And by all means give a snack in the evening such as a bowl or cereal or slice of toast, but if they aren't eating well in the day you will probably want to make this a really dull but filling option (Later post planned - Don't Feed the Fussiness!)

3. Make Every Mouthful Matter
So if kids need calories but can't eat that much we need to make every mouthful matter and load every spoonful with calories.

Here are some ideas to add calories:-
  • Learn to read nutritional labels on food!  Looking at the per 100g column, supermarket greek style yoghurt has 9.2g of fat per 100g meaning each spoonful is 9.2% fat.  Petit Filous is only 2.3% fat!
  • Starchy foods/Carbohydrate - For a balanced diet you should give at least one starchy food eg chapatti, pitta bread, potatoes, chips, cereals, rice or pasta at each meal.  Try also to give some starchy foods as in between meal snacks; sandwiches, crackers and breakfast cereals are useful snack foods.
  • Dairy - Try to give at least 1 pint of full fat milk, or even better Jersey or Gold Top, every day (give breast or formula milk until your child is at least 1 year old).  This can be given as a drink, on cereals, or in puddings and sauces.  Make cheese sauces or add grated cheese to savoury dishes eg omelettes, scrambled eggs, mashed potato, jacket potatoes, vegetables, beef burgers, baked beans, spaghetti etc.  Add cream or cheese to sauces, soups, cottage pie, fish pie, puddings.  And you can just add it it their portion, not yours!
  • Think fat! All fatty foods are high in calories.  Do not remove fat from meat.  Fry or roast meat, fish, fish fingers, chicken nuggets in oil to add extra fat.  Buy tinned fish eg sardines or tuna in oil rather than brine.  Avoid low fat spread.  Add butter or margarine to vegetables, potatoes or pasta.  Spread thickly on bread, toast, crackers
  • Add nuts and pulses, which are high in fats & protein, such as baked beans, lentils or tinned red kidney beans to soups and casseroles.  Puree them if needs be to hide them.  I used to add a teaspoon of ground almond to almost anything my daughter was eating - porridge, bolognaise, yoghurt, curry, fromage frais, puddings
  • Fruit & Vegetables - these are not high in calories, but are an important source of minerals and vitamins.  Give at least two portions a day.  Fruit can be served with custard, yoghurt, double cream, ice cream etc to add calories
  • Sugar - biscuits and cakes etc are high calorie because of the flour and fats used but they are also high in sugar. These are best saved as a reward or snack.  And don't forget you should be brushing your child's teeth twice a day.  The dentist reminded me last week that children shouldn't be doing it themselves until around 7 or 8 years old!
I began this blog to record what my children eat, and record 'good' food for kids.  Here is a list of meal/recipe ideas.  Some are on my blog, some aren't.  And you might want to take a look at the following labels; baby/toddler, beans & pulses, cheese, family, fussy eaters, pasta, stews & casseroles.  I post recipes my blog every week, and have a 'Fussy Eater' series of posts to do!

High Calorie Recipe Ideas

- Porridge
- Mashed Banana or peanut butter on Toast
- Egg & Toast Soldiers
- Banana Smoothie.  Use this recipe as a base and play around with their favourite fruits
- Homemade Pain au Chocolat
- Pancakes

- Cheese, sardines or beans on toast
- Sandwiches; egg mayonnaise, cheese & mayonnaise 
- Baked Camembert
- Homemade Sausage Rolls
- Homemade Focaccia
- Baby & Toddler Minestrone Soup

- Savoury Pies; Cottage Pie, Shepherd's Pie, Fish Pie, Turkey & Leek
- Cheesy Risotto
- Homemade chips with extra cheese
- Creamy Curries; Toddler Curry
- Sausages with Onion Gravy.  Serve with buttery, creamy mash
- Toad in the Hole
- Beans & Meat Stews. Try Cassoulet, Boston Baked Beans, Chilli con Carne with extra cheese (doesn't have to have chilli in)
- Cheesy creamy pasta dishes; Tortellini/Capeletti in Brodo, Creamy Tomato Sauce,  Carbonara Sauce (bacon or smoked salmon), Macaroni Cheese, Bolognaise Sauce with extra cheese, Pesto, Tuna Pasta, Smoked Salmon & Cream Cheese Pasta Sauce (or spread it on toast).  Try it with smoked mackerel, kippers, or sardines instead of smoked salmon. Or just plain pasta with grated cheese.
- Pizza with creme fraiche and extra cheese
- Jacket Potatoes with butter, baked beans, cheese, mayonnaise, tuna,
- Noodles & Sweetcorn

- Rice Pudding
- Bread & Butter Pudding
- Banana with Custard
- Apple & Almond Pudding Cake 
- Sticky Toffee Pudding
- Hot Cross Buns
- Nutella Muffins
- Soft Muesli Bars

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