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The utter exhaustion of feeding the small person. And other small things. May 31, 2011

Filed under: Breastfeeding,Parenting — titchandboofer @ 7:21 am
Tags: , , , , ,

Way back a hundred years ago, in February, I wrote this lengthy post about the trials and tribulations of trying to make the small person bigger via the magic of formula. In the first few weeks following the commencement of the Forced Formula Regime things were looking pretty positive. Small was drinking about half his required amount of milky toddler delight, gaining motor skills at a great rate, sleeping like a champion and generally being a happy camper. As third world baby disappeared and cheekily fiendish toddler emerged I was having a brief reprieve from feeling like the worst mother ever (and yes, I shall exaggerate as I wish).

Four weeks into the FF Regime we checked back in with Dr Tactless. Despite my previous experience of his uncharming way with words, I was feeling confident. Small was drinking! He felt like he weighed a goddamn ton! He could take off his own jumper! Win! Win! Win! Or not. Dr Tactless was underwhelmed by small’s progress and even more underwhelmed by his measly weight gain of a microgram (or something equally inadequate). The only thing he was satisfied with was the raft of blood test results, showing no malabsorption problems, no vitamin D deficiency (Ha! Suck on that Tactless. Call my baby pale indeed.), no infections and only apparently borderline low iron stores. His assessment was that the iron would come up with the increased intake of magic toddler milk (stay tuned for more on this later). His advice at this point was that we should really be trying harder to increase his intake and that we should resume trying to get him to have solids. But don’t get into a battle. Make it fun! Obviously, being pretty defective parents, we had Never Thought Of This and Just Weren’t Trying Hard Enough. Equally obviously, Tactless had forgotten having the identical conversation just four weeks before. Anyhoo, home we go to continue the FF Regime and add in a little Eat Your Goddamn Weetbix Funly. On the formula front there were no dramas, but to say that progress on the EYGWF front was slow would be an understatement. Like a dead snail trying to navigate coffee grounds. A good day would see the small one actually swallow about six teaspoons of mashed/pureed something. More would go in and then have to be fished out by the beloved or I later so that he could open his mouth again. Similarly slow was the small one’s acquisition of actual words. We had brought this up with Tactless. His response was ‘He can make sounds, he’ll speak when he’s ready. I’m not concerned.’ (Remember this folks).

So, to the utter exhaustion part. I do sense that some of you may be thinking ‘Meh. Frustrating yes, but exhausting? Really? Other people have Much Bigger Problems.’ Which is undoubtedly true, but trying to constantly rank yourself on a scale of Other People’s Problems is an endless and fruitless task. Yes, other parents have to provide full time nursing care to children with severe cerebral palsy, others need to learn how to resuscitate a baby with persistent apnoea (look it up), others just get to faff around and feed their kids chips and get their nails done. Whatever. For me, the small one’s eating is exhausting. Remember the 100mls over 4 hours bit? Extrapolate that to 800mls of formula, three attempted meals and two attempted snacks per day. My world narrowed to Feeding Small. From 5:30/6:00 o’clock in the morning to 7:30 at night, I mostly tried to feed Small. This was not fun for either of us. I could sit with him for an hour over breakfast and see him swallow two teaspoons of weetbix. And that was on a good day, if the weetbix was absolutely the perfect texture. Too thick and he’d just get all gummed up like it was brown glue. Too runny and it would be everywhere but in his belly. I would try and manage his routine so he had time each day when he wasn’t being asked to eat, when he would get to do normal toddler things like play and climb and dig in dirt. And I would bitterly watch other mothers get irritated by toddlers who constantly harass them for food. That is the day I looked forward to, when small acknowledged hunger and sought food from me. So there was no blogging, no reading of lovely trashy novels, no baking of sugary delights. If I wasn’t feeding small or trying to brighten up his day with sand and buckets, or working, or sleeping, I was slumped on the couch watching reruns of 7th Heaven, wallowing in being worst mother ever and fighting off the gnawing anxiety of destroying small’s relationship with food for life. The weight of being told – and believing – that I had caused all of this by breastfeeding too long and too much was too heavy to shrug off.

Another four weeks pass in much the same way, April begins. We return to Dr Tactless, knowing already that we’re on the brink of firing him, that we shouldn’t be seeking help from and paying someone who consistently contrives to make us feel worse about our parenting. We know better now than to go into his office feeling confident about any progress small may have made. Again his weight gain is impossibly small, although he has grown in height amazingly. Still no words. Still we are Not Trying Hard Enough. Three exchanges during this visit confirm that we are done with this man:

1. It is a warm day and we are carrying a sippy cup of water for small.

Tactless – This is what I mean. You should be taking EVERY opportunity to get calories into him. I don’t recommend offering him water at all.

Me – But he gets very constipated with only formula.

Tactless – Water is what we give people who are trying to lose weight, not gain it.

*     *     *     *     *

2. On the topic of Small’s lack of talking

Tactless – I’m very concerned that he is not talking. At this age (nineteen months) he should have at least ten words. By two he should have fifty words! And I don’t think he’s going to swallow the dictionary overnight.

Me – Four weeks ago you weren’t concerned at all about his speech, what has changed?

Tactless – Now you do know that you should talk to him?

Me – ………………

*     *     *     *     *

3. Later, also on the topic of talking

Me – Should we take him to a speech pathologist?

Tactless – Well there’s no scientific evidence to back up that sort of thing.

Me – Surely his speech and eating are connected?

Tactless – I think it’s really his personality. He’s obviously very stubborn

Hmmmmmm. Done with this man. So. Very. Done.

Despite the supposed witchcraftery of speech pathology, our next step is to find whichever coven a good one hangs out in and take the small one there. Fortuitously, The Nanna and Coach know someone who knows someone and thither we go. And she is lovely, no cat or broomstick in sight, very cheerful, very positive (oh the blessed relief!). Within ten minutes of talking through the small one’s history, watching him interact with us, watching him sign and listening to what sounds he can make, she has a preliminary diagnosis. And it is not that I have breastfed too long or too much. It is….drumroll please…… Verbal and Oral Dyspraxia. The ultra brief, layperson description is that small knows stuff (like that he has to swallow what’s in his mouth) and he can do stuff (like swallow) but the pathway between knowing and doing is disrupted and not under great voluntary control. So he’s not just the world’s most stubborn baby. And it’s not that we’re Just Not Trying Hard Enough. And whilst no parent wants there to be something wrong with their child, I am indescribably relieved. I am floating with relief. I am overjoyed to have an answer that is not simply a way of blaming me or my child for not getting it all right. Want more good news? According to the speech pathologist, even if we did nothing, small will be fine eventually, just frustrated and delayed. And the something we can do? Speech training. And as his control over speech improves, so will his control over eating and swallowing. Just like that.

Interestingly, statistics suggest 10% of children will have a form of dyspraxia. 70% of these will be boys. Even more interestingly, Dr Tactless and the speech pathologist have shared many patients with this problem. Yet he never mentioned this.

Just last week we took small off to a new paediatrician. We shall call him Dr Lovely. I have worked with Dr Lovely on many occasions and have only ever seen him treat mothers and babies with respect. Why it didn’t occur to us to go to him before, I don’t know. Anyhow, Dr Lovely’s take on small?

– Number one issue: low iron. Supplement iron and he’ll sleep, feed, concentrate and generally feel better.

– Reduce formula.

– Increase food, even if it’s the few foods he can handle, like perfectly textured weetbix, rice and all it’s derivatives, nutella and peanut butter.

– Carry on breastfeeding if we fancy.

– Unconcerned re small’s size. Actually noticed my own smallness and – shock! horror! – related that to small’s genetic potential.

Lo and behold, within one week our lives have changed again. Small is eating! Meals! With minimal peanut butter related bribery! And small is speaking! Just a few words… for example: I say “you’re a cheeky boy” and he replies “I cheechee!”. And so I continue to float with relief, unburdened of a layer of mothering guilt, delighting in the further fiendish unfolding of small’s toddlerishness. Time once enslaved to Feeding Small can instead be devoted to Keeping Small Away From The Stove and buying bigger toddler shoes and, well, blogging.

*     *     *     *     *

Stay tuned for chapter two of “A goodly four months of procrastination” – The creation of a Whole New Person.

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No no, not abandoned

In brief, the top five reasons for my neglectful treatment of this blog:

1. The utter exhaustion of Feeding The Small Person

2. The creation of a Whole New Person

3. An unexpected Career Addition

4. An impulsive decision to Move House

5. I just wasn’t Feeling It

*      *     *     *     *

And so “A goodly four months of procrastination: A work of non-fiction in five chapters” is born…

 

Fun parent has left the building February 9, 2011

Grab your cup of tea and a large snack. This will not be brief.

Here I was almost six months ago, mother of a one year old who had zero interest in expanding his diet, and wrestling with the questions of follow versus lead, surrender versus control. My enthusiasm to embrace small’s transition to toddlerhood and our family’s transition out of the hazy circus of babyhood meant that the pendulum tipped to lead and control. And for a time all was well. Somewhat smugly, I felt I had achieved quite a coup: the small one ate a small amount of food and continued to breastfeed a large amount of the time. Huzzah  for extended breastfeeding thought I. Time whooshed by. My work hours stretched into two days a week, the beloved’s compressed to three or four. At some point, small let go of his hatred of bottles and cups. Freedom! The beloved could give him expressed milk and no longer had to plan their day strategically around small being brought in to work for a breastfeed. We could even (gasp!) go out without him, just the two of us.  Just look at us go! Embracing change left and right! Ah, the maturity.

Summer arrived, rainy, humid. Ate a lot of ice cream, lurched onto the mad pre-Christmas treadmill of catching up with friends, worked a bit, got chiropracted a lot (yes, well, if other people can make up words, I don’t see why I can’t join in), got sucked into the shopping frenzy, and expended a lot of energy secretively hiding and wrapping presents. And some time in there the small one just kind of stopped eating again. One day I realised I was still carrying around food for him every day, still offering him three meals plus snacks, but that it was all going uneaten. He was toying with his cereal, having the odd rice bubble or bran flake, crumbling his previously beloved fruit bars and mooshing them into the furniture, turning his nose up at toast, hiding his dinner under an upturned bowl, not really ever eating. He was breastfeeding as much as ever, maybe more, with night feeds escalating wildly to the point where once he grabbed on he wouldn’t let go until dawn. Bloody hell it was exhausting. What to do? I stopped expressing at work, reasoning that a drop in supply might increase his appetite for the alternative. I tried to reinject a little stability in his day, making sure we were at home for mealtimes and sleeps, not varying the food too much.  In the new year I made just one resolution: to night wean.

 

Oy, the trepidation. I had toyed with the idea of night weaning for a while, longing for sleep like a strung out addict. I talked at all and sundry about it. Predictions were dire and unanimous…night weaning and bed-sharing would not be compatible, small would not be off the boob until he was out of our bed and he wouldn’t get out of our bed until he was out of our room and presumably wouldn’t be out of our room until he bought his own house some time in 2039. What the hell, I thought. Can only give it a go. I struck a deal with the small one – you can have all the cuddles you want, all night, but it’s last drinks at 10pm then the bar will reopen when it is light outside. Miraculously, with just one night of outraged shrieking, we succeeded. Yes, he may sleep on my head, or at least on 70% of my pillow, and do a bit of break dancing and occasional squawking through the night, but it’s surprisingly easy to sleep with a toddler on your head and not on your breast. He even stopped the hopeful groping after a few nights. Smug parenting moment. Sleep. Bliss. But mysteriously no increase in appetite. Still no eating. And still attached to the breast at any opportunity through the day. It dawned on me one day that whenever I was stationary, he’d come for me like a homing missile. My latest theory is that the breastfeeding weight loss starts when you start running away from your toddler.

And then it was January. Lazy, sandy, lolling January. Still no eating. No talking. And not really growing much either. And then he got a virus, not a bad virus, just persistent enough for us to go to the GP. Unsurprisingly the GP said ‘small is too small, take him to a paediatrician…really, it won’t be that bad, he won’t bite you’. Coming not long after the new and disliked maternal child health nurse snippily said ‘well, I have to tell you to see a paediatrician, even if you won’t go’ and right on the back of a close friend having the courage to tell us that she didn’t think all was well with small and his food strike, it was the straw that broke this mama’s resolve. I’d grown hardened to the insensitive, offhand and sometimes plain ridiculous comments coming from any old schmo in the street. It’s hard to hear but even harder to ignore it when it comes from someone who loves you and your baby dearly.

So to the paediatrician we went. Grimly prepared, list of questions in hand, contents of Blue Book virtually memorised, I felt like I was going to sit a test for which I couldn’t possibly study well enough. Yes, this could be taking a healthy wariness a little too far, but the clawing anxiety was hard to suppress. What was my worst fear? Being told ‘you must wean and give your baby formula’. And what happened? I was told ‘you must wean and give your baby formula’. It played out like so:

Me – So, I have x, y and z concerns. I’m not really concerned about his size. Genetically, he’s going to be small.

Dr Notsochatty –  (after about twenty minutes of silently examining, weighing, measuring, charting and noting developmental milestones) None of x, y or z are concerning to me at all. These things will be fine. He is too small. It’s a very simple issue – not enough calories.

Me – Why doesn’t he seem hungry? Why doesn’t he take the abundant food or drink offered to him? I assumed he would instinctively take what he needs.

Dr Tactless – He is like a baby in the 3rd world. He’s just used to not getting enough so he doesn’t ask for more.

Me – Wow. That makes me feel great. So, I have been effectively starving him for months. But he seemed so happy.

Dr Slightlyobtuse – Lethargy can look a lot like contentment. The solution is to wean and put him on toddler formula. He needs to be having (tappity tappity of calculator) one litre a day.

Me – I’m quite devastated. (trying not to embarassingly cry) I don’t want to wean him completely. I still feel there is value in breastmilk for him.

Dr Sceptical – What’s your problem with formula?

Me – Urhh. That’s not really what I have the problem with. I have a problem with weaning completely.

Dr I’mdonenow – Well don’t then. Just make sure you give the formula first. We’ll see you in 3-4 weeks. If he’s not improving we’ll look at admission to a hospital or a mother-baby unit.

Me – ……………

That was that.

I thought ‘I could fight this, I could ignore this advice and carry on waiting for small. But why did I come here? Wasn’t I ready for something to change? Yes. We have tried it small’s way and that hasn’t worked. So we’ll try this other way’. And before I could get distracted by the competing voices in my head, I stamped over to the supermarket and bought a tin of toddler formula. On the up side, it is organic.

Then we went home and I was introduced to a new side of the small person – the you-thought-I-was-stubborn-before-ha-you-aint-seen-nothing-yet side. Again I say – goddamn genetics. Since before I was pregnant I was repelled by the advice given to always dominate your child, to show them who’s in control, to wield all the power, to not give the inch for fear of losing the mile. I so dearly wanted to respect my child’s individuality, to recognise the limited ways he has to voice his own wants, to honour his right to exercise his own willpower. I didn’t want to get into power struggles with him. I wanted to negotiate peacefully…….. It’s fine. You can get up off the floor now. Wipe away the tears of laughter. Oh ho ho ho. And yes, I have met toddlers before, but obviously mine was going to be special and different. Be careful what you wish for indeed. Small obviously feels that his right to exercise his own willpower is indeed honoured.

 

 

So, the formula. The first day I managed to cram 100mls into him. It took four hours. Mainly he did angry backbends over my lap, his face contorting in his efforts to escape what was effectively waterboarding with powdered milk. God it was dreadful. Not only was I the worst mother ever, with my third world toddler, but now I was torturing him. But as the week has unfolded, things have improved. Cooperation up, bodily restraint down. And despite my scepticism, and being completely aware of my ability to rationalise any decision I’ve made, the regime is working. This week has been like watching the small one come out of hibernation. He’s more vibrant, social, curious, vocal. His concentration span has soared. His sleeping has improved out of sight. He’s incredibly affectionate. It’s amazing to watch.

Yet painful. While I’m grateful that there’s nothing wrong with him that food cannot fix, it kills me that he’s been doing without for months. It challenges my faith in extended breastfeeding. It really challenges my faith in baby-led weaning/solids. It scares me that this could have gone on for longer. It makes me feel foolish for being so, so sure of my convictions.

 

Laughing in the face of dubious advice September 15, 2010

About a week after my encounter with the GP I heeded part of his advice and took the small person to see the homeopath. By this time I was feeling pretty blase about the whole breastfeeding/eating issue and was mainly keeping the appointment out of curiosity – could there really be a homeopathic treatment for ‘disinclined to eat mashed food from a spoon’? Anyhoo, off we went, small, the beloved and I. Things did not get off to a cracking start. It took us about ten minutes and several variations on introductions before the homeopath understood that the beloved is small’s other mother, not my sister, his sister, my friend, my cousin, my mother, my hairdresser, the local lollipop lady or any other random person I might have decided should come and contribute to healthcare decisions pertaining to my son. While she did have some semi-useful suggestions re menu-planning while introducing solid foods, she really lost me for good when she said that all babies should be weaned at nine months or they become too dominant in the parent-child relationship…for ever. After that I was really only hearing elevator music. Except for the bit where she said that babies shouldn’t have peanuts. Nothing to do with allergies mind you, but because they’re basically like eating chocolate and will ruin their kidneys. Good thing we kept the Nutella story to ourselves.

Bad Bad Peanut Butter Biscuits

– makes about 40, if you like peanut butter you will luuurrrve these biscuits

adapted from The Hummingbird Bakery Cookbook, an excellent collection of baked delights

230 grams of unsalted butter, at room temperature

200 grams of caster sugar

200 grams of brown sugar

2 eggs

1 teaspoon of vanilla extract

300 grams of crunchy peanut butter

350 grams of plain flour

2 1/2 teaspoons of bicarbonate of soda

90 grams of dark chocolate, chopped

Preheat your oven to 170 degrees celsius (160 fan forced)

Line 2 baking trays with baking paper

You can use a freestanding mixer or a handheld electric beater

In a large bowl cream the butter and sugars until light and fluffy

Add the eggs one at a time, beating well after each addition and scraping down the sides of the bowl as needed

Mixing on low speed, add the vanilla extract and peanut butter

Sift in the flour and bicarbonate of soda

Mix on low speed to combine well

Stir in the chocolate until evenly spread through the mixture

Spoon generous tablespoonfuls of mixture onto your prepared trays, leaving a good 5 cms between each ball of dough to allow for the mixture spreading (6-8 biscuits per tray will work)

Bake for 8-10 minutes, until just golden

Leave to cool for a few minutes on the tray, then transfer carefully onto wire racks to cool

Repeat until all the mixture is used up

Scoff them down with the visitors whose very presence excused this off-schedule baking activity (am saving my one baking pass this week for a sour cherry custard tart) and wash down generously with tea. Then give one to the baby. Then line up a few family members for future kidney transplants.