Childhood Diseases

Posted by: Peta | 2010-01-11


Diet - 15 month old. Is he getting enough food, esp protein?

Hi Dr
Firstly, thanks for all your advise in the past, it has been most helpful.

My little boy is 15 months old, suffers from dairy allergy with anaphylactic shock, intolerance for soy, has issues with tactile dysfunction and suffers from food aversion. He had a Nissan anti reflux procedure done in June.

He suffers from Crycopharyngeal Inco-ordication sydrome with pharyngeal incompetence. He is only allowed to drink pure water and solids, no sloppy foods at all - we are due to have Barium done in Feb to see if he is still aspirating.

He has also had a mickey inserted by paed surgeon Prof Rob Brown and I have been feeding him his formula through that for the past 8 months since it has been inserted. He drinks Similac Alimentum.

He is growing well now (just under 10kg) and is hungry but most days refuses to eat much at all. He used to have bottles every 3-4 hours of 180ml per bottle. This is after trying to get him to eat, in desperation i would give him the bottle as he has learnt that eating makes him sick (24 hosp admissions from Feb-Dec last year, many of them aspiration pneumonia and therefore that and failure to thrive led to mickey).

The 2-3 weeks I have tried to get him to eat more. At last it seems to be working and this is the pattern that will happen 2-3 times a week with the other days being mostly bottles during the day as he wont eat:

6am 180ml similac alimentum Bottle
Morning sleep
11am Food offered such as soft boiled egg, cereal (10-15 teaspoons eaten) or pumpkin/butternut/sweet potato (10-15t). Water offered in mug, usually takes 5-10ml
1pm - 180ml bottle
2pm - snack such as a marie biscuit / fling / purity fruit/ fish finger / chicken. Usually wont touch it.
Afternoon Sleep
4pm - Food - A cereal (mixed with water) which he will eat well. Water offered in mug again.
6pm - Another 180ml bottle Similac, this time with 3t purity fruit added in.
6-7pm - snack offered, such as biltong to chew, piece of fresh fruit etc. Not interested.
7.30 Bed
10pm - 180ml Similac with 2t dry cereal added in.

My question are these:
1. Protein - how do i get him to eat protein as he wont touch meat to chew it. Is there a supplement he can have?
2. Is there a general supplement that he can have to encourage good health / boost his immune system etc.
3. he wont touch anything with lumps in it and we have tried everything to get him to eat - taken him to speech therapists etc but i dont seem to be making much progress. How do i go out introducting these lumpy foods?

Lastly, he is due to have his tonsils out on Wed and my paed said to be sure to tell the ENT that he has food aversion and therefore the membranes wont fall away or something like that? What does that mean? I am told that the tonsils are a day op but with his history do you think i should rather keep him in hospital overnight to be monitored?

Thanks so much for your assistance.


Expert's Reply



Your son has had a very difficult first year,but you have done an excellent job in coping with his multiple problems. Your son's weight is good and that is the measure of his progress. the rest will come right with time and with lots of patience and attention to detail. Many children prefer soft mushy food still at this age so do not be concerned about this. He will be getting good amounts of protein in his milk. Boost his immunity with daily Probiflora Children's and consider giving him an Omega 3 supplement as well. It seems essential that you work with a dietician to advise you about your son's diet.

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