Sunday Slivers, 9/5/10

The big lacuna in these weekly posts--the one thing I do my best to avoid mentioning every single week--is the eating habits of my kids. To everyone who is intimately familiar with our household, it is no secret that feeding Sava has been difficult from the start; even though he is four years old, "feeding Sava" rather than "Sava eating" is still the correct way around here to refer to mealtimes. While feeding therapy when he was sixteen months old helped turn things around in a big way, at four Sava still rarely gets excited about food. Food is something he puts up with, rather than something he anticipates with pleasure. Even people who know us relatively well never fail to surprise us by offering casual advice, as in "have you tried giving him X, or using Y?", as if it is possible that with a child who has never eaten well, and parents who worry about it 24/7, there is something as simple as a food we have somehow forgotten to offer, or a way to offer it that we have not imagined. To everyone out there asking such questions, our simple answer is: if there is a food or a way to offer a food, chances are roughly 99.99% we have tried it. And nope, it hasn't worked. I've scoured the aisles of all major grocery stores, and I can spot a new product that is safe for him almost as soon as it comes out. We've tried everything, and very few things make a difference. Sava eats everything and nothing: everything because feeding therapy taught him that if he sits at the table and we present him with a meal, he is expected to eat it; nothing because, if it were up to him, he probably wouldn't pick one food over another, except for a few items to which he has shown preference lately: salmon, bread, olives, etc. He genuinely dislikes sweets, and it has taken three years of making the only good recipe I have of dairy-soy-egg free cupcakes (quite good, by all accounts) for him to finally start taking more than a single bite of them. He loves to help make the cupcakes, which excites him far more than the actual eating of them.

Enter Raya. Because the steroids stunted her growth for a few months, she is still at the bottom of the growth chart for height, which masks the fact that she is at the bottom of the chart for weight also. People look at her, and they think she looks perfectly proportionate, which indeed she is. We suspect that she is meant to be taller, and will eventually catch up, at which point her body type is sure to resemble Sava's: on online charts of BMI (ratio of height to weight), he does not even appear at the bottom. Literally, the little dot that should show where on the chart he is does not show up on the chart at all. Nada. Zero.
What's really stunning is how the two of them differ in their similarly difficult relationship to food: he nursed poorly after six months of age, but took to expressed breastmilk in bottles like a champ; in fact, he lived mostly on breastmilk from bottles until feeding therapy at sixteen months; she took bottles for the first two months, but stopped taking them cold-turkey after we offered a single bottle of stinky hypoallergenic formula, at which point she flatly began to refuse bottles, regardless of what we put in them; she knows how to drink from both a sippy and a straw cup, and will drink water from those, but nothing else; she nurses exclusively, some days far better than others.
Sava refused--absolutely refused--eating from a spoon from the very start; no cereal, no jar food, no homemade baby food; people found it hard to believe, and they still do, but he would look at the spoon and begin screaming; no amount of gentle cajoling, distractions, or forceful encouragement worked--until therapist Ben took over, that is. Raya started eating from the spoon, happily, at five months. She is not 100% consistent, and eats better on some days than others, but on days when she is "off"--because of reflux, presumed allergies, what have you--the first thing that goes down is nursing and not spoon-eating.
Though he didn't eat from a spoon, Sava was eager to pick up anything with his hand and put it in his mouth; at least once; he never persisted, and never ate enough of any single thing, but he had no problem picking up food and transfering it to his mouth. Raya will open her mouth for anything--even if we were feeding her a paper clip--but she is squeamish about touching food, and almost never volunteers to put things in her mouth herself. If we put food on the table in front of her--for instance, pasta--she opens her mouth and bends down to get it like a little dog, but rarely reaches out with her fingers to touch it. It's a pretty bizarre thing to witness. We suspect there might be sensory issues going on, but it is a bit hard to tell.

Sava has allergies whose cause and extent we still do not fully understand. No blood or skin test can detect them, and our only medical diagnosis came from a biopsy of his gut done during an endoscopy when he was around fourteen months of age. The diagnosis was nonspecific, telling us only that the biopsy showed inflammation of the intestine symptomatic of food allergies. We were told that it was up to us to figure out what foods triggered his reactions. After years of detective work, we know that he can't tolerate dairy, soy, and eggs; we suspect green peas, green beans, and corn. He eats an extremely healthy but very limited diet: grains, vegetables, and all kinds of meat, with the occasional fruit when he feels like it; he drinks orange juice and rice milk every day.
We don't know if Raya has allergies yet, but we have reason to suspect she does. Our trial of yogurt around nine months ended with greatly increased reflux, constipation, hiccupping (repeated, painful, long-lasting), and, most disturbingly, increased food refusal. We'll probably try again in a month or two. She also eats a limited diet because so many things worsen her reflux, for no reason that we understand: at almost eleven months, she eats oatmeal with breastmilk, winter squash, sweet potatoes, pear, prune, and, just recently, homemade puree made up of regular potatoes, chicken, and spinach. The latter has aggravated her reflux significantly in the last few days, which has led to the dreaded feeding refusal, but we are still unsure what to do.

 Why are children so cute when they are pouting?

With both children, the one thing that seems consistent is anxiety about mealtimes when they don't feel well. And, sadly, the thing that makes them feel unwell most often is precisely the food they eat--because of reflux as infants, and because of whatever else the food does to Sava now that he is older. So, over time, Sava has gone from outright aversion to resigned defensiveness about mealtimes, whereas Raya has developed a solid aversion to drinking that is not nursing, but is still wavering between pleasure on good days and defensiveness on bad days about her solid food.
Most days, my philosophical stance on all this is that all children have issues, and ours just happen to be with food. We don't deal with many other things--behavioral or physical--that worry many other parents, and we are thankful to have vibrant and happy children. On difficult days, we whine about not having time to do anything other than feed, cook, nurse, or pump, and it takes effort to look at the kids and not think only about what they have or have not eaten. On these days, it helps to remember a friend's wise words that many things in life are not problems, but mere inconveniences, and in the big picture of things, children who don't like to eat is definitely just an inconvenience. So, we are beyond thankful for the rest.

*****
And the rest is a good deal.

Raya is working very hard on standing, cruising, and crawling. By the looks of it, she'll be walking before she gives up the army crawl for a real crawl. She especially loves rock climbing the side of Sava's bed--

She also loves tumbling about in her crib, and doing head stands while pontificating; her verbosity has exploded in the last two weeks, just as it happened with Sava at some point; she is always mumbling to herself, or lecturing someone, or demanding something in a loud voice; it's the stage of development where we can hear the intonation of our own voices echoed in hers, and we can see that she believes she is truly saying something, but the frustration of not being understood regularly makes her mad--

She wants to be in on everything, perched on the table even while big bro' is fully absorbed in his favorite new activity of "tracing"--

But the thing that makes us laugh the most lately is her insane obsession with Sava's straw cup; he drinks his juice from a blue cup, and she has a matching pink one, but whenever he is in proximity, she starts hyperventilating to get to his. Here is a series of pictures illustrating one of many similar episodes.

1. Her bottle discarded, she is going for his.

 2. He distracts her by giving her two cars and gently holding down her arm.

She continues to look with longing.

S

3. She attacks again, playfully. 

4

4. Playfulness changes to desperation.

"Give me the stinkin' bottle!"

5. Sava has somehow managed to get her to bite on her own (not suck), and she is temporarily resigned. Temporarily. Repeat again two minutes later.

Because he is so generous, Sava finds all of this funny instead of vexing. Surely some day he'll get fed up with it, but for now it works as play. He is such a fantastic big brother, our boy.

*****

And finally, a rare glimpse of the face behind the camera. Raya now rocks at driving the push cars--