Category Archives: Health

My ten-year-old has been watching Maury – and it turned out OK

sex-for-can-of-sodaOy. We were at the dinner table, discussing puberty (as you do).  The six-year-old strongly expressed her desire never to “born a baby,” and said she never will, because there are pills that can keep you from getting pregnant. (We’ve discussed this particular issue before.) Then the older kid started listing other birth control methods. Like, really specifically, and with authority. I don’t have a problem with her knowing about these things, but I haven’t gotten to that level of detail with her, and I don’t think it’s in any of her books. So I asked where she learned all that. I think it helped that I had more of an admiring tone than a worried or judgmental one.

So she told me about encountering a link to the “Murry” show after watching a Minecraft video, and being so shocked and disturbed by the title she felt compelled to watch it. And that led to watching a lot more. Once she described stories of tweens having group sex, 14-year-old prostitutes, and nine-year-olds smoking and drinking, I figured out which show she was talking about.

And actually, it led to a great discussion. As I told her, this is one of the reasons why we’ve told her not to go exploring on YouTube. Because I would rather that she learn about normal, healthy behavior before being exposed to what is really just a modern-day freak show. Maury is designed to shock and titillate, and provide fodder for that impulse we have to judge others. It’s pretty much the worst sex-ed material you could find outside of porn. But, I was pretty impressed at her ability to digest the information and process it into useful caveats about sex and drugs. Of course, she is also naturally cautious, thoughtful, and eager to please authority figures, so that probably helped. But her overall reaction was shock, and a passionate determination never to do things like that.

I think this important conversation was only possible due to two major factors:

  • We mostly avoid punitive discipline. Not completely, but I do try to adhere to “connection before correction,” in an effort to keep my kids comfortable coming to me in situations that they worry might get them in trouble – whether that’s spilling something on the furniture, watching inappropriate videos, or (eventually) something bad or dangerous happening involving cars, alcohol, sex, or whatever.
  • Before encountering these videos, my kid knew quite a bit about sex, from a loving, factual, normalized perspective. I strongly feel that the best way to approach sex education is to treat it like all other education – answer questions as they come up, in an honest and developmentally appropriate way. I found It’s So Amazing to be a wonderful resource, which I could use for visual reference as I shared information with my pre-literate children, and then as an age-appropriate resource to be used by reading age children on their own.

I believe that pretty much everyone’s kids are going to run across some puzzling, worrisome, or disturbing content before we would consider them ready to handle it. Having so much information at our fingertips makes it nigh inevitable. It’s worth thinking about how your parenting might not just limit the chances of such an occurrence, but also give your child space to ask for your help if it does happen. I feel like if I’d been a bit less connection-focused (I’ve been working on minimizing punishment lately), or if my kids didn’t already have a firm track record of me talking about squirm-inducing subjects in a matter-of-fact and open way, or if my daughter had had no context whatsoever in which to place the extreme spectacle she saw, she probably would have simply clammed up, hidden it from me, and worried about it on her own.

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Confessions of a Fever-Phobic

jonaylorUntil this week, I was shockingly misinformed about fever. Despite being generally well educated and pretty savvy about medical stuff, I had some serious misconceptions. Misconceptions that may have led to unneeded treatment of my child, and definitely led to a lot of unnecessary anxiety for me!

My poor kid has had some UTIs lately, and one involved a fever up to 104° (40° C) for several days. My husband and I had to threaten, coerce, and manipulate her to get her to take some ibuprofen to get the fever down. I was terrified she’d get brain damage, start hallucinating, or seizing, or . . . I dunno, other unspecified awful stuff. I slept next to her, my clothes arranged like a firefighter’s, so I could jump up and run her to the emergency room if the fever went over the magic number (101° while on ibuprofen) one of the doctors specified.

During our next visit with a different doctor, he mentioned that fever is not a problem, and doesn’t need to be treated. But it was a brief comment amongst a lot of other critical information about kidney involvement, ID and sensitivities, and the right antibiotic. I felt like I’d gotten some mixed messages, but I didn’t think about it much at the time.

Two weeks later, my lucky kiddo came down with Fifth Disease. And her temperature went up. When it rose to 103.7°, and her skin felt as hot as a baked potato fresh from the oven, I woke her up and tried to get her to take some medicine. Despite (or because of?) her evident misery and restless sleep, she refused, so I pushed fluids, kept the covers off her, and stroked her with a wet cloth.

Now, we had called the advice nurse that evening, and she told me, “A fever between 100 and 104 is therapeutic.” In Worried Mom mode, I didn’t reflect on it much. My baby was frighteningly hot! Everything in my guts said, “Fix it! Cool her off! NOW!”

But later, with a little distance and a lot more sleep, I decided to investigate just what the deal is with fever. Turns out, fevers in response to illnesses are relatively harmless. (Heat stroke is a separate issue.) They might even help get you better faster. They don’t cause brain damage or any other lasting harm, and are self-limiting to 107° or less. Pediatricians do not recommend taking a child’s temperature frequently, or waking them up to take “antipyretics” (that’s acetaminophen or ibuprofen) to bring fevers down. Many parents dose antipyretics wrong, which is a much greater risk to a child’s health than a fever is. Even febrile seizures are not likely to cause harm, and using antipyretics doesn’t seem to prevent them. Oh, and if it’s lower than 100°, it’s not a fever, it’s a normal fluctuation in body temperature that happens every day for all of us.

TL:DR version – even high fevers in children are harmless. (NB: Fever in young babies is more complex.) You can give your kid medicine if they are suffering, but the fever itself isn’t anything to worry about.

This still feels wrong to me. But I checked. And checked. And checked. And checked. And checked. I think part of the reason fever phobia is so stubborn in our culture is that pediatricians focus on fevers. Every office visit starts with taking the child’s temperature. Any fever is focused on and investigated – how high? How long has the child had the fever? Presumably they’re trying to find out what is causing the fever, and to eliminate possible serious underlying conditions. Which is sensible, but gives us parents the impression that fever is scary. Plus clearly different doctors have different attitudes and give conflicting advice about fever management. Add in the historical use of “fever” in the names of many scary childhood illnesses, and it’s a great recipe for continued fear in parents!

Fever itself isn’t dangerous, and in the future I’m going to attempt to stow my anxiety and deal with it more rationally. Of course, my child tends to feel quite miserable, has trouble sleeping, and won’t eat or drink much when her fever goes over 101°, so I might still give her medicine, but at least I know now that the risk I’m battling is her discomfort, and I don’t have to worry that she’s cooking her own brain.

For reference by worried parents, here is a nice rundown of the common worries and the facts about fever.

Give Peas a Chance – Book review

peasFull disclosure: the publisher contacted me and offered a free review copy. So I may be biased by swag.

This is a great book for parents who worry that their toddlers don’t eat enough. I would say that the focus of the book is definitely on anxiety about getting enough calories in to your kid, with getting more variety a second goal, and more aspirational nutrition running third. So if your child eats plenty of food, is gaining weight well, and you mostly want to teach him to love whole grains and broccoli, this might not be your go-to manual. If, however, your doctor is concerned that your child has fallen off her growth curve and you find yourself chasing your toddler around trying to get extra food into her, this is going to be very helpful.

Samela does a good job of walking parents through both normal toddler behavior that can complicate healthy eating (can’t sit at the table for long periods, will graze all day on snack food if allowed, etc.), and the standard dietetic requirements. She discusses macro- and micro-nutrients, and cautions against common pitfalls such as depending on commercial “toddler foods,” letting a child drink vast quantities of milk, or expecting a toddler to eat far more food than they actually need.

The advice about what to feed your toddler seems pretty good, but a bit unambitious at times. Perhaps I hang with too crunchy a crowd, but I know a lot of mothers who would stroke out at reading the recommendations to feed your toddler a Nutella and Fluff sandwich, frozen yogurt sprinkled with Fruity Pebbles, or a pudding cup with vanilla wafers. However, if a parent is worried about getting enough calories in, these Whole Food heresies are probably defensible, and they are counterbalanced with many more healthy suggestions. As a mom whose children eat plenty of food, but gravitate to white starches too much, I would have loved more advice on nudging them in the direction of vegetables, but again, that doesn’t seem to be the main purpose of this book.

The one thing I found truly irksome about this book was its disregard of breastfeeding. This book is explicitly aimed at children 12-36 months old, and it has not one breath about continued nursing. I understand that nursing past one is very rare, but it is recommended by health professionals and organizations, and it deserves at least one sentence when there’s an entire section devoted to “Milk.” Even chocolate milk gets a positive side-bar, and  rice milk, almond milk, soy milk, hemp milk, and coconut milk are all discussed, but giving a toddler the biologically normal and most healthful milk is not even mentioned. Maybe sustained nursing is unusual, but is it really less prevalent than parents giving their kids hemp milk?

All in all, if I knew a pretty mainstream family with an underweight toddler, a parent who was anxious about getting enough calories in, or a mom who was “addicted” to processed foods from Gerber and Beech-Nut, I would heartily recommend Give Peas a Chance. For the average family dealing with a health-but-picky kid, I’d say it’s useful enough. For crunchy folk, or parents who are looking to make their child love kale and quinoa, I’d say another book would probably be a better fit.

Dr. Amy and Conspiracy Theories

tinfoil hatA friend pointed out this 2012 article by Amy Tuteur about skepticism versus denialism. It’s a worthy topic, and I’m right with her (or perhaps more accurately with her cited material from Andrew Dart) regarding vaccine and evolution “skepticism.” But I take issue with her broad brush getting paint on me when she states, “Though it isn’t as obvious, natural childbirth and homebirth advocates are denialists, too.”

I’m a natural childbirth and homebirth advocate in part because I’m a skeptic! (The other major impetus for me is gender equality and bodily autonomy.) Look, I realize there are loonies in the natural/home birth camps. There are people so out there that Koi-Assisted Birth was greeted not simply with “Great satire!” but with many readers taking it as real. But there are plenty of advocates interested in evidence-based medicine and freedom of choice. Take someone who questions the benefit of routine continuous electronic fetal monitoring. That’s a reasonable question to ask when the intervention was introduced on the guess that it would be helpful, then later research showed it may result in worse outcomes. When you equate a skeptic about that issue with a crank who believes against all evidence that the earth is 6,000 years old, you’re being both inaccurate and insulting.

Here’s a rundown of the most glaring logical problems in Dr. Tuteur’s article.

Universal statements – Note the lack of “some” or “many,” or “the most extreme,” preceding the terms natural childbirth advocate and homebirth advocate. The existence of a single skeptical, reasonable advocate of natural childbirth upsets her argument.

False Dilemma – she gives the impression that a person either supports typical hospital birth, or is a loony conspiracy theorist who ignores all evidence that homebirth is imperfect. There’s no intimation that some people might occupy a middle ground.

Equivocation - Tuteur quotes Dart’s discussion of conspiracy theories, then uses an unexplained, idiosyncratic definition of “conspiracy theory” to assert that natural childbirth advocates are conspiracy theorists. Under her implicit redefinition of “conspiracy theory,” anyone who acknowledges unconscious bias (such as the possibility that a doctor might intervene quicker if he wants to get to a golf game) is evoking a conspiracy theory.  She also redefines conspiracy theory to include the realization that medical schools often teach by tradition, rather than strictly keeping to the latest evidence-based practice. The normal definition of “conspiracy theory” hinges on deliberate plotting. Dr. Amy’s special definition includes totally unconscious, unplanned behavior. I guess if she used the real definition, she couldn’t include natural childbirth advocates under Dart’s definition of denialists.

Guilt by association: “And natural childbirth and homebirth advocates share key attitudes with vaccine rejectionists, creationists and other denialists.” First she lumps natural childbirth and homebirth advocates together, then further assumes that homebirth advocates universally support poorly trained CPMs, and don’t care about any evidence that they might be less safe. Through this chain of association, suddenly a mother who gave birth in a freestanding birth center because she was worried about unnecessary interventions is equated with believers in a global conspiracy to give kids autism with vaccines.

Personally I get the impression that “The Skeptical O.B.” is herself a bit of a denialist, that she believes typical hospital birth with lots of interventions is the best, safest practice, and that no evidence will ever be good enough to dissuade her. So rather than searching out the best evidence about these practices and questioning her own biases, she targets people who do question, and paints us all as crazed fringe ideologues who don’t care about dead babies.

I admit I am biased toward natural childbirth and questioning medical interventions. But, I at least try to remember that I have that bias and attempt to embrace the foundation of skepticism – watching out for my own perceptual foibles. If there is solid, evidence-based consensus that the benefits outweigh the risks for routine continuous electronic fetal monitoring, routine episiotomy, or nil by mouth during labor, I would be interested in seeing it, and if it’s convincing I would change my mind about the desirability of these procedures. Being willing to change your mind is what skepticism is all about, while protecting your current beliefs at all costs is denialism – even if your beliefs are culturally mainstream.

(For the record, I’m a natural childbirth advocate and homebirth advocate in that I believe in making these options available to women, I am skeptical of some of the typical hospital practices, and I was personally more comfortable birthing outside a hospital, where I felt my providers’ approach to birth dovetailed with mine. I’m 100% in favor of making CNM-attended homebirth a common option. I am not personally as comfortable with CPMs, and unattended childbirth scares the hell out of me. But I still think women have the right to do either, though they should have access to the risks and benefits information as best we have right now.)

Do you have Forer’s Disease?

via Flickr, by SuperFantasticA hidden disorder may be making you ill. It’s quite common, but many people don’t know they have it and conventional doctors tend to ignore it. Medical tests fail often enough, turning up negative while patients continue to suffer a plethora of symptoms. Few people will have all of these symptoms, and most symptoms will be intermittent, and at least partially resolve when the patient is more active, so there will be great variability between patients. An estimated 80% of people experience Forer’s Disease at some point in their lives, yet it is frequently overlooked and misunderstood by the medical community. Forer’s Disease is becoming a popular topic in the medical community; as a result, it is important to recognize the symptoms of this particular condition. Sufferers typically experience a wide assortment of symptoms, and it’s important to learn how to recognize them.

Most sufferers of Forer’s Disease experience some or all of the following symptoms:

  • Fatigue
  • Backache
  • Mood swings
  • Digestive upset, such as nausea, indigestion, and gas pains
  • Headaches and migraines
  • Insomnia
  • Low energy/malaise
  • Joint pain
  • Decreased libido
  • Constipation
  • Skin irritation
  • Memory problems
  • Cravings, especially for sugar, salt, and fat

Sound familiar?  Of course it does, because the actual condition that leads to these symptoms is “being human.”  Pretty much every person (in an affluent nation at least) will experience many of these symptoms at some point in their lives.  And people are more likely to experience many of them during periods of high stress or, let’s face it, when we’re getting older.

I borrowed the name Forer from the Forer Effect, in which subjects assign a high level of accuracy to a list of vague and generally applicable descriptions, when the list is presented as a personalized profile of the subject.  It is most often used to discuss horoscopes and personality tests (“You are a caring person, but sometimes you fail to live up to your own ethical standards.  You enjoy being with other people, but sometimes feel shy and reticent”), but I think a similar effect occurs when someone suffering from obnoxious symptoms reads a list like the one above, paired with a proffered cure.  The list of symptoms seems to be so accurate, even tailored to the reader.  It’s easy to believe that the web site or book you’re reading is accurately diagnosing what’s wrong with you.

Deliberate quacks and misguided natural health gurus alike have a tendency to cobble together a similar list of “if you’re human you have them” symptoms and assign a disease to them.  If you have many of the above symptoms you qualify for Systemic Yeast, Multiple Chemical Sensitivity, Gluten Sensitivity (with negative Celiac test), Subluxations, Adrenal Fatigue, Electromagnetic Sensitivity, and Wilson’s Temperature Syndrome, and probably a dozen more fad diagnoses that have come and gone over the years. The problem is that aggregating a bunch of common symptoms and deducing a particular disease isn’t reliable.  As you can see, it casts far too wide a net.

It is true that there are established, scientifically supported disorders that create symptoms on the Forer’s list, and which don’t have a definitive test for diagnosis. But in such cases, emphasis is placed on ruling out other possible causes before diagnosing something like Chronic Fatigue Syndrome or Depression. On the other hand, quackish sources will actually recommend the opposite:

First, list every single symptom that nags you, whether sporadic or chronic. Don’t make assumptions, like my back problems are from sitting too much. Just list them without trying to explain them away.

(From the Gluten Sensitivity link, above.)

It can be particularly confusing because many of these suspect symptom-list descriptions promote disorders that play on the edges of well-established diseases, such as hypothyroidism or celiac disease.  And it is true that medical science doesn’t always get things right (to say the least!). So what do you do to try to feel better? Personally, I think there are two vital steps to take before you put yourself on a highly restricted diet or other regimen that may cost money or interfere with quality of life.

First, see a medical doctor who is trained in ferreting out actual, verified disorders.  And of course, if a doctor doesn’t take your symptoms seriously when you say they are causing you distress, find someone else.  A bad doctor may say, “Systemic Yeast isn’t real – it’s all in your head!”  A good doctor will say, “Systemic Yeast isn’t a recognized diagnosis, but we do need to get to the bottom of the recurrent vaginal infections, fatigue, and stomach pain that have been bothering you.” It’s also important to remember that more than one thing could be wrong.  Recurrent vaginal yeast infections might turn out to be a misdiagnosed bacterial infection, fatigue may be from low Vitamin D levels, and stomach pain could be from lactose intolerance.  If you assume at the outset that an entire list of disparate symptoms must spring from a single underlying disease, you could be missing some obvious answers.

Second, go ahead and follow the universal recommendations among healthcare professionals of every stripe: eat a plant-heavy diet full of fruits and vegetables and low in processed foods.  Get moderate exercise on a regular basis.  Drink water when you’re thirsty. Practice good sleep habits and give yourself enough rest time. Pretty much everyone agrees that these practices are the foundation of good health, and introduce little to no risk. Adopting these habits is likely to ameliorate most of the symptoms above, and it’s no coincidence that a lot of cures proposed for Forer’s-like diseases happen to introduce some or all of them. Unfortunately they also tend to be so restrictive that they detract from quality of life, and go hand in hand with alt-med supplements or treatments that likely do no good and at least cause the harm of extracting money from you needlessly.

(N.B.: I also borrowed all the scare-language in the first paragraph from the various malady web sites I linked to.)

My new vegan diet cure!

A few weeks ago I had a couple anxiety attacks.  We had discovered a pretty extensive infestation of carpet beetle larvae around the house, including in the pantry, and literally the next day we found the kids had lice.  I had a lot of trouble coping with all this.  Twice it got so bad I was hyperventilating, my heart was pounding, I was dizzy and feeling dissociated.  Luckily my husband is made of awesome, and he took over the cleanup, with help from his amazing mother.  And my epically wonderful friend Ginger came over and nit-combed my hair, then carefully vacuumed each individual molecule in the kids’ playroom.

Meanwhile, I went to the doctor for some freaking Xanax.  Or something.  My blood pressure was 155/90, noticeably higher than my usual less-than-120/80 zone, so I knew I was really having a serious physical reaction, not just overdramatizing.  I wanted a medicine to force my fight-or-flight reaction to calm down, as I felt like I was in a feedback loop of worry–>adrenaline–>panicked feeling validating worry–>more adrenaline.

My regular HCP wasn’t in, so I saw someone else.  She didn’t want to give me a benzo drug, because of all the potential problems with them, and I can understand that line of reasoning to an extent.

But then she told me what I really need to do for my anxiety and panic attacks is switch to a vegan diet.

And she didn’t just mention it in passing.  She got pretty damn vegangelical on me.  She seemed to think that being fat is a key part of my mental illness, and getting fit would make me better. And veganism is the way to get fit. Even though my response to the first attempt was to scowl disbelievingly and say, “No,” she didn’t let my unmistakeable body language and monosyllabic retorts stop her – she pushed it several more times, trying to cajole me into trying it. She was very sure that during this stressful period when I was having trouble coping with life, what I really needed was a complete diet overhaul to a new, highly restricted way of eating.

So you know what, I guess I’m convinced.  Here is my new vegan diet plan, which will make me thin and solve all my health problems!

Breakfast:

Cocoa Puffs with full-fat coconut milk
Apple Cinnamon Pop Tarts
Ghirardelli Hot Chocolate

Snack:
Little Debbie cake donut
Starbucks Venti Toffee Nut Soy Latte

Lunch:
“Chicken” nuggets
Biscuits (made with Crisco)
Corn chips with guacamole
Kool-Aid

Snack:
Barbecue Fritos
Hansen’s Cola

Dinner:
Veggie burger on potato roll
French fries with mayo dip
Canned creamed corn
Bulleit bourbon and water
Marie Callender cherry pie

I can NOT wait for the health returns to start rolling in with this!  Soon I’ll be slim and fit, as well as mentally healthy.  I bet I won’t even need to go to the gym or therapy anymore!  Who knew perfect health could be this easy and appealing?

Seriously, my normal PA prescribed a beta blocker to tamp down the adrenaline, and that allowed me to use my cognitive behavioral therapy techniques to much better advantage.  I feel normal again.  And I’m making braised beef shanks for dinner.
Oh, and more thanks to Ginger for being so funny about this whole topic and alerting me that Pop Tarts are vegan, thus giving me the idea for this post.

Time’s poor science reporting on AP sleep habits

Would you be surprised to learn that Time Magazine published an article criticizing bed sharing and staying with a baby or toddler until he’s asleep?  Me neither.  Would you be surprised that the “science reporting” involved was pathetic?  Me neither.  How about the fact that the story is framed in an inflammatory, accusing manner?  Not a shock, huh?

This was back in 2008.  Time put out an online article with the headline How not to Get Baby to Sleep.  The article reports on two different areas of study, but discusses them in tandem to make its point: If you’re present when your baby falls asleep, or bring them into your bed, you will cause significant sleep problems.  This in turn is “associated with an increased risk of being overweight and having emotional and behavioral difficulties in adolescence and adulthood.”

The referenced study discusses parents being present when the child falls asleep, taking the child into the parental bed, and giving food and drink upon night waking, and describes these actions as “maladaptive parental behaviors” . (I don’t know if the study authors are just presumptuous, judgmental jerks about cosleeping, or if “maladaptive parental behavior” is an actual, defined term of art in this field.  Regardless, I felt like I needed a barf bag nearby for use every time I read it.)  Of course, the first two “maladaptive” behaviors are common practices of attachment parenting.  According to Time, these behaviors “led to disrupted sleep — bad dreams, short sleep time and delays in falling asleep — in children of preschool age.”

The clear message of the Time article is, “If you cosleep, you’re causing your child’s sleep problems and probably dooming them to a fat, stupid, anti-social adulthood.”

The problem is, the cited study actually comes to almost the opposite conclusion:

Findings support the hypothesis that maladaptive parental behaviors develop in reaction to preexisting sleep difficulties. Further, early sleep difficulties are more predictive than parental behaviors in explaining [bad dreams] and foreshortened [total sleep time] beginning at age 50 months. Results are interpreted in light of early emotive/physiological self-regulation problems. . . .

When controlling for early sleep factors, most parental behaviors no longer predict future sleep disturbances ([bad dreams], [total sleep time]) or remain predictors only in interaction with prior [sleep onset] difficulties.

The study found that it first appeared that cosleeping and staying while a child falls asleep might be causing sleep disturbances, but when they controlled for early sleep difficulties, it showed that parent behaviors had almost no effect on sleep problems.  The one effect that remained was that taking a child into the parental bed upon night waking was associated with a sleep onset time of more than 15 minutes.  So if you’re really concerned that it might take your toddler 16 minutes to fall asleep instead of 14 minutes, you might want to worry about that.

(And actually, given that the study relied on questionnaires filled out by parents, how reliable is this?  How do parents who aren’t present at sleep onset determining the time until sleep onset?  I think the results would be better summarized as “When parents are absent at sleep onset, they assume their kid fell asleep faster.”  Who would have thought that it seems shorter when you’re downstairs watching Game of Thrones than when you’re in the dark, singing “Toora Loora Looral” for the twelfth time in a row!)

But it’s not good marketing to write an article that says some kids are born worse sleepers, and that parents wind up lulling them to sleep or cosleeping more often, but that there’s nothing you can really do about it.  People want to have directions on how to fix infant and toddler sleep problems, and the ammunition to judge those smug, freaky AP parents who don’t let their babies cry themselves to sleep.  Subtle, equivocal results just aren’t sexy.

And this speaks to the larger issue of the diminishing quality of science reporting.  In a recent episode of The Skeptic’s Guide to the Universe, Steven Novella pointed out that every major news article got the “Did dinosaur flatulence warm the Earth?” study totally backwards, no doubt because it’s a more charming, clickable headline if dinosaurs farted themselves to death, regardless of what the science actually says.  He also mentions being interviewed and having reporters feed him quotes.  They didn’t care what their expert source actually thought or what the evidence showed – they just wanted a ventriloquist’s dummy with some letters after his name to mouth their preconceived angle on the story.

Luckily, Emily at Double X Science has a good checklist to run down when you see a showy “science” headline: The Double X Double-Take Checklist for Reading Science News is a great list of suggestions that will help you avoid being taken in when science journalism goes to the dark side.

I suggest you keep that checklist (and possibly that barf bag) handy whenever Time addresses attachment parenting.

Extreme rice!!!

That’s an MST3K reference there, in case you wondered.  And I use it because my kid has taken picky eating to the level of an extreme sport.  Chloe is naturally a fairly high-anxiety, control-enthusiast type personality (wonder where she gets that?), and when she was 2, she got a dreadful stomach virus that caused continual vomiting for days.  It was bad enough that I actually stopped nursing her for 24 hours, because her stomach seemed unable to digest anything.  We wound up giving her 10mL of water a few times an hour to keep her hydrated, and had to give her Phenergan suppositories to even let her keep that down.  It was horrible and traumatic.  And ever since then she’s had almost a phobia of any new food, and tends to stick with bland, uniformly-textured, familiar foods.  She would quite happily eat nothing but refined baked goods and dairy products if I let her.

Let me tell you, I’ve grown to hate advice about picky eaters.  Making food into fun shapes, smiley faces, or forests of broccoli standing up in mashed potatoes is totally ineffectual.  Might work on amateur picky eaters, but not on my champ.  I bought The Sneaky Chef in hopes of getting some nutrition into her, but so many of the recipes are about sneaking vegetables into things like meatloaf, spaghetti sauce, and macaroni and cheese, none of which my kid will eat in the first place.  The other problem is she may be a supertaster.  Despite Missy Chase Lapine’s assurances that all her recipe shenanigans were undetectable to test audiences of real children, Chloe immediately called out my attempt to include a smidgeon of orange puree in a cheddar quesadilla.  My best friend says the truly epic level of Chloe’s sensitivity to flavors came home to her when she made macaroni sprinkled with cheddar cheese for her kids, and saved out a bowl of plain macaroni for my kid.  Much like a gustatory Princess and the Pea, Chloe politely declined the pasta, saying it tasted funny, and my friend found one lonely shred of cheese at the bottom of the bowl.

We tried therapy for Chloe, and the therapist suggested we use Ye Olde Sticker Charte as a motivational tool.  Chloe chose a toy she reallyreallyreally wanted as her goal, and agreed to the plan.  But even when she was 100% invested in eating new foods to earn stickers, she would choke and gag.  I honestly think that for her, swallowing a pea or a bite of chicken feels as scary and gross as it would feel for the average American to eat ant eggs or maggot cheese.  Soon, she decided that it wasn’t worth enacting her own personal Fear Factor to earn a measly sticker, no matter how cool the toy at the end of the chart.  (Due in part to this total misread of Chloe’s personality and the fact that the therapist advocated meridian tapping, we fired her.)

Here is what has worked (however slowly and gradually): her pediatrician talked to her about nutrition, and asked her to agree to two rules.  She won’t have second helpings of starch – one serving only.  And she needs to try a bite of one unfavored food at dinner each day.  Chloe agreed, and she seems to take her personal integrity much more seriously than a sticker chart.  When she’s reluctant to try a bite of something, I remind her that she won’t feel very good when she goes for her checkup and has to tell the doctor she didn’t stick to their agreement.  She still doesn’t like trying new foods, but she’s becoming much more inured to it.  Each time she survives having a bad taste or weird texture in her mouth, it helps her move away from her dread.  It’s very slow going.  Last week she opined that if Italian sausage was the last food on Earth, she would probably eat it, and her dad and I did a celebratory dance once we were out of her sight line.  The important thing to us is there’s progress, even if it’s extremely gradual.

The other thing that has helped is giving her control.  I taught her how to make scrambled eggs (using the only correct method – Alton Brown’s).  No kid can resist the allure of being allowed to crack eggs.  She will now make eggs for the whole family, all by herself, and she will eat them.  For a child whose sole sources of protein were peanut butter and cheese, that is HUGE.  I’m letting her help plan meals and cook more and more, and the kids are also helping us plant and tend a garden.  Perhaps a zucchini or blackberry that she observed forming from a flower, and which she tended herself will be less scary than an anonymous vegetable plunked on her plate.

Next week, I’ll post my review of The No-Cry Picky Eater Solution, as well  as a couple other tips that have helped us get our kids eating better.

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