I think I have written to you before, directly to "Best Foods". The problem is the same, but has developed! Here goes.....

Thomas had a slight reflux problem as an infant which meant he choked a lot when nursing. He was 9lb 1oz at birth and thrived for the first 6 months. He seemed to grow out of the reflux thing by then, only left with sensitivity in swallowing..hence solids have been slow.

Then still only breast fed, between 6 and 9 months he had difficulty pooping..well he just didn't. Maybe every 15 days!! Abdominal pain in the evenings. Screaming when he did go. Not feeding much. At his 9 month check he'd gone from 90 percentile down to 25 percentile all round. Tests followed. It turns out that he has a slow stomach emptying problem. The doctor prescribed "Cisapride" and he seems a normal child again APART FROM THE FACT THAT:

1. He still is fussy with food at 1 year old. He is still breast fed.
2. Has to feed himself finger food and it gets all over the place so its hard to tell how much he's actually getting.
3. At his year check up his height percentile has gone down to 7%. Weight remained at 25%

Thomas is my third child, both the others are big kids. My husband is 6'2 and I'm 5'2. The doctor thinks he may just be taking after me but I'm not sure. SO HERE'S MY QUESTION:

How can I give him the best chance nutritionally? What foods should I concentrate on that contribute to growth. He eats cheese, bread, olives, bran flakes in whole milk, pear, and a little meat. CAN I TRY HIM WITH PEANUT BUTTER? I am worried about possible allergic reactions. Sorry to ramble on but its a complex situation and one which I worry a great deal about. Suggestions welcome.

Georgina

Dear Georgina,

It is not uncommon for babies who have had problems with gagging and choking to fear eating solids and therefore refuse them. Your son needs to increase his confidence in his ability to eat solids successfully. The more oral stimulation he gets, the better it will be. Allow him to mouth foods as much as he wants, as well as appropriate toys. Try a little teeth brushing as oral stimulation.

Don't expect less fussiness about food as you enter the toddler years. Toddlers are notoriously picky eaters. They are also small eaters since their growth rate is down from infancy. Since he is your third child, you are well experienced in this area. However, your concern about Thomas's growth is understandable. The foods you say he eats are a nice variety. However, I do see a lack of vitamin C in the selection, and very little iron. Both would be important nutrients to try and get into his diet. Breast milk does not supply adequate amounts of either.

Try to add to his diet a vitamin C fortified juice or fruit puree, or add kiwi, oranges, or ripe melon. Also high in vitamin C are red peppers and broccoli. He should be eating an iron fortified baby cereal or getting iron drops if he refuses the cereal. Iron contributes to proper cognitive development, and helps with appetite. You may want to try and get him to take a child's multivitamin in order to assure the proper intake of vitamins until he is further along in eating solids. Do not concentrate on any one food to the exclusion of another, but you do want to keep the bulk of his diet low. That means include nutrient and calorically dense foods. Because he is so little, he won't be able to eat a large volume of food so has to get his nutrition in a small package. Higher fat foods like peanut butter, meat, eggs, and cheese are good choices. He will still need fruits and veggies, but don't overdo them since they can crowd out other foods.

It may be that your son is taking after your side of the family, or it may be that he is waiting for adolescence to do his growing. To ensure his optimal growth, making sure he gets the proper nutrition is very important as you already realize.

I see no reason not to try peanut butter unless there is a family history of food allergies. It would be a high protein and calorically dense food that would be a great addition to his diet. Have you tried high quality frozen yogurt or ice cream? They would also be a good idea. Also, eggs in any form, hard boiled and chopped up, or scrambled make good finger foods.

Thank you for writing again!