Child Development: Does Your Child Have Food Allergies?

Having a child with food allergies is tough -- first, there are the obvious safety issues involved. You don't want your child to accidentally -- or intentionally -- eat something that may make him sick, or even kill him. Then there are the practical challenges; finding acceptable, palatable food substitutes for the things he can't eat. I know many families who have to spend tons of time (and money) planning and making separate meals for their allergic kids, and strategizing about "dangerous" situations like birthday parties and school lunch rooms. But it doesn't stop there. The doctors and nutritionists who diagnose the allergies, and prescribe the necessary diets, unfortunately don't often have the time to get into the psychological aspects of food allergies -- and leave the parents wondering how to handle this very tricky aspect of the allergy.

The behavioral and emotional effects of the allergy and related diets include the resentment caused in the child by not being able to eat foods his friends CAN eat. The feelings of deprivation and being "different". The parents' worry that these food issues will lead to eating disorders in adolescence. All of these problems are very real challenges of raising a child with a food allergy.

I recently got a phone call from a friend who's daughter has multiple food allergies -- gluten, casein (dairy protein), tree nuts -- the works. They've been able to reasonably control her food intake up until recently; she's now an active, busy second-grader who is starting to get resentful that the other kids can get all kinds of foods that are forbidden to her. My friend was mortified to tell me that they discovered a stack of 30 or more string-cheese wrappers stuffed under the couch recently. And a rash that preceded the cheese-eating was diagnosed by the doctor as "psychological". Poor little thing is itching herself raw, and hoarding and "sneaking" disallowed foods.

I've got some ideas about how to handle these issues, and I've had to do the gluten and casein-free diet in our home for awhile when we were ruling out food allergies with our daughter. But I know there are a LOT of you out there struggling directly with these challenges in your home. I'm hoping some of you will post your comments to my friend here, giving us some tips for what works -- and what doesn't -- in your home. I'll collect your responses and include them with some of my own in my next post.

Aloha,

Dr. Heather The BabyShrink

Parenting Tips: Lessons Learned From A Baby's Surgery

Thanks to all of you who wrote your comments and emails of support over the past couple of weeks while I anxiously awaited our 2-year-old's hernia surgery. He's fine today; a little tender, walking around like an old man who put his back out. He's covered in the dirty, gummy remnants of surgical tape, and has two (yes, TWO) inch-long diagonal scars in his groin. But he is fine. So while the memories are still fresh, here are some important things I learned yesterday: Be Ready for Changes in the Surgery Schedule Not easy for a control freak like me, but important to know. The schedule can be changed for any number of reasons, so plan accordingly. For us, T was found to need more extensive surgery, requiring more time (2 hours, as opposed to the 30 minutes we had expected). That meant the doctor had to shuffle his schedule, which affected our arrangements. Stay light on your feet, and keep your options open on the day of surgery. If at all possible, arrange to have both parents present AND a support person (like a grandma -- Thanks Mom!) so you can juggle communication with the staff, care for your child, and other basics like parking, travel arrangements, and food.

Don't Be a Hero I'm a health-care professional, right? I grew up in a medical household; my Dad was a physician. The sight of blood doesn't bother me, I have more than a passing familiarity with medical practices, and I've been roaming around hospitals since I was 3.

But yesterday, I was just "Mommy". A shaky, scared Mom who was an idiot and asked to help carry her baby to the Operating Room, and assist with the baby until he was asleep. I thought that helping out as much as possible would be best for the baby. Big mistake! The sight of my baby struggling and screaming while he was being held down (by me) while the nitrous was administered -- that's an image I'll never forget. And it certainly didn't help T. Take my advice and don't be a hero. Treat yourself with some TLC as much as you can. And let the professionals do their job. I don't care if you're in the profession yourself; on Surgery Day, we're all Just Mom, or Just Dad.

Don't Be an Idiot -- EAT Something! I assumed my stomach would be too upset with worry to eat anything, so by the time 11 am rolled around, I was shaky, dehydrated, and bitchy. Not too helpful (nor very appreciated by Mr. Dr. BabyShrink). If you're used to caffeine in the morning, make sure you get some. And at least bring a banana and some trail mix to the hospital; I picked at it, and once T woke up, he devoured it (and the outpatient surgi-center usually doesn't provide food afterward to the kids; you need to bring something for them, since they may very well get hungry afterwards). And since the surgery took so long, I actually did go to the cafeteria for 20 minutes. I forced myself to read the paper, have a snack, and NOT picture my baby being strapped down to the operating table. Even though part of me didn't want to be farther away from the operating room, walking away from the surgi-center for a short break gave me some perspective and allowed me to decompress for a bit.

Thank You To The Doctors and Nurses We are all incredibly indebted to the doctors, nurses, and other health-care professionals who take care of our kids; those like Dr. Sid Johnson and post-op nurses Jessica and Mike who were among those who took care of TT yesterday at Kapiolani Women's and Children's Hospital. These people have the stamina, dedication, courage and expertise to take care of difficult, challenging, and often very sad cases every day. But mostly they love kids, and it shows in the work that they do.

A Hernia Is Just a Hernia; Nothing More. When TT was resting in the "wake-up room", Jessica shared stories with us about some of the very sick children who come in and out of Kapiolani every day. It gave me some healthy perspective: To them, TT is a healthy, strong child who just needs a little patch-up work. The child on one side of T was a 9-year-old who has had leukemia for 3 1/2 years. On the other side was an 18-month-old who has had multiple surgeries from birth defects, and had reconstructive work done on her pelvis. She was put into a full-body cast. And although our little guy will be sore for awhile, in comparison, this was small potatoes. So while the day was grueling, and we hit some tricky spots, we're home, and everyone is on the road to recovery. We're extremely grateful for the health of our family; even more so, after our experience yesterday.

BabyShrink's Baby Needs Minor Surgery, and Dr. Heather Needs a Little Reassurance

First of all, I want to thank you all for hanging in there with me while I get the feed worked out for BabyShrink. Before I started this site, I thought "feed" was simply the activity in which I engaged, oh, 17 or 18 times a day. (My boys, especially, eat....a LOT.) But thanks to the Other Heather at OhMyStinkinHeck.com, it's all good now! Heather, I really appreciate your responsiveness and expertise. Second, some of you have noticed that my posting has been a little less frequent. After our trip, I intended to jump back in with lots of new stuff. But here's what happened: A few nights ago, Baby TT was jumping around naked after his bath, as he is wont to do. He got into some kind of toddler freak-out about something, and Mr. Dr. BabyShrink noticed a strange little bulge in TT's groin area. It only popped out when TT was screaming, then went back in.TT at the zoo

We both knew it had to be a hernia. The pediatrician confirmed our suspicions, and he's scheduled for surgery August 19 at Kapiolani, which is a children's hospital in Honolulu.

Everyone is very reassuring about the procedure. "It's the bread and butter of the pediatric surgeon. They do it all day, every day.", "It's not considered deeply invasive, and he'll jump right back immediately.", "It will be over before you know it.", "You're lucky it's not something serious."

Of course all of this makes sense to my logical mind. It truly is not a big deal, and we are so grateful for the good health of our three kids.

But my Mother's Fears are going crazy. How can I surrender my BABY up to the the doctors and nurses who will strap him down, drug him, and cut him open? How can I hand him over to total strangers to fix something that doesn't even bother him? What if...What if....What if....

To complicate matters, we have a family history of malignant hyperthermia, which apparently makes the anesthesia more complicated. It should be safe, since they know in advance about what drugs to avoid giving TT. But it still makes me damn nervous.

Lately I've gotten questions from many of you who have children with chronic health conditions. I've thought a lot about the impact of health issues on our relationships with our families, and on our parenting. And of course it's easier to answer questions that OTHERS have. I'll be posting some of those letters soon.

But first, I want to hear back from YOU: those of you who have gone through procedures like this with their children.

What was it like? What can I expect? How did you cope with the anxiety and fears? Were there any lasting impacts on your parenting? How did you explain to your little one what was about to happen? What about siblings; what did you say to them?

Thanks in advance for your ideas and support. You'll be helping me -- and a lot of other families out there who are going through the same process.

Toddler Behavior: Dealing With Toddlers and Picky Eating Habits

Hi Dr. Heather: I eat a variety of healthy foods, heavy on the veggies, with a variety of ethnic cuisines, most of which I cook myself. On the other hand, my daughter more or less eats the same things every day.

It's called experimentation, Mom!

Every resource says the same thing: keep offering it to your child. My question is: how do I do that without wasting large amounts of food? Also, how do I offer it to her at all, when she will eat the foods she likes and leave the foods she doesn't?

Please tell me my kid will grow out of this! I feel stumped when other moms chime in with something encouraging like, "Broccoli is my kid's favorite!" or "I can't pry the sushi from her hands!" I should note that 1) she ate it all just fine when we were in the baby food stage, and right at about 13-14 months she started refusing vegetables, and 2) she doesn't seem like a "picky" kid to me- she eats a wide variety of foods, pretty much anything except vegetables.

I'm sure I'm putting too much pressure on myself with this, but my husband is obese and struggling to lose weight, and I so want to avoid the same fate for her!

Patricia in Atlanta

Dear Patricia,

I know they tell us to keep offering a wide variety of foods to our toddlers and young kids. And we start to feel there’s something WRONG if they don’t eat a nicely rounded diet all the time. It’s another source of pressure and guilt for us, as parents. It had better be healthy! Organic! Wholesome! Etc, etc, etc.

But what they DON’T tell us is that our kids are BORN with very strong tendencies, in terms of eating preferences. I have one kid who’ll eat just about anything, and always has. I have another who is extremely choosy, and yet another who is somewhere in the middle.

You can’t make a kid eat something they don’t want to eat. And if you TRY, you risk setting up a power struggle that YOU CAN’T WIN. It’s normal for young babies (6 to 12 months or so) to happily eat whatever we put in front of them. After one year of age, however, their caloric needs DECREASE, and their desire to be independent INCREASES, as does their desire to get moving! Crawling, walking, running, talking; it all holds much more interest than sitting and eating vegetables. So it’s fairly common to see what you describe; a baby who eats everything, who turns into a toddler who is choosy, or who has inconsistent food preferences. (They often can get into “food fads”, too, where they demand certain things all the time.)

All you can do is go with the flow. Yes, offer her healthy options. Don’t push or insist that she eats her “healthy” food. Set it all out in front of her and then GET OUT OF THE WAY. She needs to make her own food selections, within the range of a variety of foods you set out for her. Your toddler needs to resist and be oppositional, as she works on establishing her independence. Don't let her struggle with you over food. Pick your battles; this one, you won't win. Over time, your daughter will learn to love a wide variety of foods. (But she might not show it until she leaves for college!)

Now, does that mean you give in and offer a Happy Meal morning, noon and night? No. Just try to add something healthy to her plate, and leave it alone.

Let her see you enjoying your healthy, interesting variety of foods. And don’t let her associate pressure or stress with that image.

In our house, our 2-year-old is attempting a coup to establish him as Food Dictator. It's a struggle on a daily basis. His preferences change daily, too. Here's what we do: Put the healthy stuff in front of him while we prepare the rest of the meal. That way, while he's really hungry, he's more likely to try the good stuff. Then we offer him a choice or two, and that’s that. I do try to include something I know he’ll eat, whether it’s pasta, or PB and J, or some cheese. He also does like fruit, so I offer lots of that. If he doesn’t want the options, he can eat at he next mealtime. He whines and complains, but I only have the energy to do a certain amount! What’s interesting is that he often craves the food on OTHER PEOPLE’S PLATES; especially Daddy’s, right now. And he will tackle veggies and other things he flatly refuses when put on HIS plate. So we engage in a little trick-the-baby-psychology, and allow him to eat off his Daddy’s plate, after he’s done with his own. We get a little extra nutrition into him that way. We’ll set firmer limits with him on that as he gets closer to 3, because by then we'll want him to see that he's got to stick to HIS plate. But for now, it’s not so bad for Daddy to share some of his dinner with our cute little guy.

Now, I’m not a physician or a nutritionist, so you’d better check with your pediatrician just to make sure things are OK with your daughter's nutrition. You can also read more about the issue in Dr. Brazelton’s books; I love how he deals with the issue.

Good luck, and let us know how it goes!

Aloha,

Dr. Heather The BabyShrink

PS Want to read more about annoying toddler tendencies? Check out my Toddler Page for more.

Breastfeeding & Bottle Feeding: The “Good-Enough Mother”: Are Breasts Required?

Dear BabyShrink,

I fully intended on breastfeeding my first baby. But after trying hard for six weeks, we had to give up. We had 3 lactation specialists, moms, friends, and my doctor helping. But my baby was not gaining weight and crying all the time. I just never made more than a half-ounce of milk at a time, despite pumping and nursing all day (and night). But the specialists all told me to keep trying. That eventually, I would make more milk. I never did, and I could not stand to know that she was hungry. I had to feed her!

Feeding my baby formula felt like a failure as a mom. But she is developing into a wonderful and healthy little girl. Now that I am expecting my second baby, I still think back to that time and I worry about it. It makes me so depressed that I still get teary-eyed every time I think of trying to nurse again. All my friends and my sister were able to nurse. Why not me? People are urging me to try it, but I just can’t go through that again. I was so stressed out at a time I wanted to be enjoying my new baby. Now I will have a toddler to care for as well.

How do I handle this? Any thoughts are appreciated.

Sign me,

Anonymous in Atlanta

Dear, Dear Anonymous Mom,

I asked you if I could post this letter because so many moms out there are experiencing this same thing right now. Terrible guilt and angst because of being unable (or unwilling, for what can be excellent reasons) to breastfeed their babies. Let me say this immediately: as a psychologist, I want you to be as happy and stress-free as possible during the early months with your baby. Your baby’s development and happiness depends very much on YOUR emotional state at that crucial time. If breastfeeding is causing you too much strain and guilt…it’s just not worth it.

OK, I said it! Let the breastfeeding police come and take me away. But it has to be said.

Some of you are about to get angry at me. So before that happens, let me state a few things as fact:

Breastmilk has absolute advantages, nutritionally, over formula

Nursing has been shown to be beneficial in many ways, to both mother and baby

I support the ability of Moms to nurse their kids anywhere at any time

I nursed our four kids

But the pressure to breastfeed can be harmful to many Moms. It’s hurting some of you (and by extension, your babies). While I accept the fact that some Moms simply may not understand the benefits and simplicity of breastfeeding, and I do wish more Moms would at least try it out, I don’t accept the patronizing (matronizing?) attitude that often goes along with judging Moms for their choice not to nurse…or their physical inability to do so.

As a licensed psychologist, I also see many Moms who feel inadequate, uncertain, and self-critical because of society’s pressure to breastfeed. They in turn transmit those feelings to their babies.

Although we are told that virtually all mothers can (and should) nurse their babies, consider the following real-life examples of Moms who simply can’t breastfeed: The Moms who, like Anonymous above, went through several lactation specialists, medications, and weeks of stress, only to find her breasts simply won’t produce milk (and her baby wasn’t gaining weight)

The Moms who need to take medicine for postpartum depression (or other life-threatening illness) and want to protect their babies from the medication

The Moms who have no breasts, or inadequate breast tissue, either because of an accident, illness, surgery or congenital condition

These are cases where Moms CANNOT breastfeed. Yet in each case, these Moms are criticized and judged by others who have the nerve to ask them, “Why aren’t you breastfeeding?”

But I must maintain that there are also situations where Moms CHOOSE NOT to breastfeed, and that choice must be respected. Who are we to judge the choices other parents make about feeding their babies? Who are we to impose our decisions on them?

I would rather see a happy mom and baby with a bottle of formula than a stressed out mom (and baby) struggling through nursing. To me, the most important thing is that Mom feels comfortable in her decisions as a parent. If Mom is happy, everyone’s happy. I actually stole the term "Good Enough Mother" from one of my shrink heroes, Dr. Donald Winnicott. He was the first to say, "back in the day", that you should not strive to be a perfect parent....just a good enough parent. If you want to get the scoop on him, read more here. (It's a little technical, but if you're into psychology, Winnicott is a classic.)

And it extends to the “I’m a better parent than you” kind of competitiveness that continues beyond the baby stage. Who’s toddler is smarter/cuter/faster/going to the “better” preschool? Who is watching the least TV? Who has the better diet?

Our expectations of being “Good Enough” mothers have gotten completely out of whack. And the very strong pressure to breastfeed our babies does not help.

Again, this is all about expectations. It’s important for parents to have realistic expectations of their parenting. Parenting decisions have to be made with the best interests of both parent and child in mind. Breast or bottle? Your choice is best.

If you're struggling with this issue and want to talk personally with me about it, I'd love to help you. Hit the "Parent Coaching" button, or email me at BabyShrink@gmail.com to arrange a Skype, phone, or in-person appointment.

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert