F.E.A.S.T's Around The Dinner Table forum

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Yogi13
 My 13 y/o D was diagnosed with AN about a month ago.  Under the care of a Maudsley Based program (outpatient), and we are in the process of re-feeding.  Weight gain has been slow so far, and I am looking to up the ante a bit.  D is lactose intolerant and allergic to tree nuts (not peanuts), but I am giving her dairy with a lactase supplement.  Any ideas to help this process?  

Any help would be greatly appreciated.  
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scaredmom
Welcome Yogi13, 
Although I am sorry you needed to find us, I am glad you are here. 
I do hope we can provide the support and information you need to help your d.
Please read around the forum and visit the FEAST site for more information. https://www.feast-ed.org

You can add lactase to cream as well or lactaid tablets before a dairy meal. We have lactose free milk and cream here in Canada. You can add oils to the food she is eating to bump up calories without increasing the volume of the food. Once she is able to eat well, you can increase volume as well.
What is she eating now? What will she NOT eat? We can help.

Please ask all the questions you have. We are always willing to share our experiences and hope that you find some ideas to help you help your child. Also please remember that advice here is based on the person's experience with their own child and  is  not meant to be prescriptive advice. We can only share what did and did not work for us and hope you find some ideas in that. 
Sending my support,
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Yogi13
Hello.  

Thank you for your advice.  At first she was eating a limited amount of foods.  I have currently expanded her meals to include more "carbs", which 3 weeks ago she was terrified of.  I add oil and butter when I can to anything and everything I make her.  A few foods to mention that she will eat:  pancakes, eggs, pasta, beans, and sandwiches.  I also give her snacks and juice.  Foods she won't eat:  anything she thinks is "junk food" (chips, candy, things of that nature) and red meat.  When it comes to meat, my family tends toward lean protein, but I would love to give her a fatty steak (apologies to the vegetarians, and I think she might throw it at me), but I thought I had an understanding of health and nutrition until I began feeding her.   I am just looking for ideas.  I know that every family is different.  

Thank you again.  
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scaredmom
Well you are doing very well to add the oils etc...
I understand about the steak and how that would be nice for her.  I added cream to scrambled eggs. Will she eat cheese, peanut butter? You can have the lean meats, just fry them 😉. I used "lean" ground beef and added oil to it. I do that with all meats and veggies. 
Will she eat a grilled cheese, I would butter both sides of the bread. Also going to the grocery store and looking at labels can show you that some items are more calories per serving than others. Some brands of bread and yogurts have more calories. I would buy a loaf of French or Italian bread and I would slice into thick slices. I would add cream to the yogurt and milk to get more calories as well per serving. 
How about juices? Grape has more calories than others 180 per 250ml vs apple juice at 120 or so. 

I  thought I understood nutrition too, it is hard stuff, taking care of ED. IT is a topsy turvy nonsensical world. 

It is great that she is eating more now for you!! You are doing well. 
The other stuff ie "junk foods" will come. It just takes time.
I know others will be here soon and offer their perspective/ideas as well
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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scaredmom

I just remembered the high calorie suggestion thread:

I do hope there are recipes you feel you can use and d will eat.
XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Yogi13
Thank you. Your suggestions are just what I need.   

Much appreciated.   
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scaredmom
https://www.aroundthedinnertable.org/post/high-calorie-suggestions-696425?highlight=high+caloriese&pid=1308424181
I forgot to post this sorry.😊
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Yogi13
Thank you.  Exactly just what I needed.  
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sandie
Hi, small volume highly calorific pasta sauce has worked well for us with lots of rapeseed oil, butter, grated cheese, cream if she"ll take it, blended with tomatoes/ tomato puree. My D wouldn't eat red meat for ages so i made meatballs from turkey mince with oil, breadcrumbs or oats and eggs. You can add granola and seeds to yoghurts. Grated almonds and almond butter can be added to lots of things. But maybe she is allergic??X
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debra18
Smoothies and shakes. You can get in over 1000 calories by adding more topics. Chopped nuts, syrup (vanilla syrup has no color or taste), heavy cream, ice cream, etc. If you want to make it look healthy you can just use fruit, juice, and honey.
My daughter always preferred healthy foods. We used only healthy looking foods like oats and honey at the beginning of refeeding. Than we went through a time that she got tired of that and now she can eat a variety of "healthy" and "unhealthy" foods in a normal way. She used to prefer at home the "healthy" foods but could go to a party and eat what they had. Now she can do that again with most foods.
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Yogi13
scaredmom ,sandie and debra18, 

Thank you for all of your suggestions.  My d is def partial to "healthy" foods at this point, but I am slowly working the other "unhealthy" options in.  It's eye-opening the foods one can "sneak in" during this process.  She is unfortunately allergic to almonds, and other nuts, so they aren't an option.  She also has an aversion to smoothies and shakes (boy oh boy what I could add to those).  I guess it's a work in progress-meal by meal.  Thank you again for all of your suggestions.  So happy to have found this.  
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debra18
I used a laddered approach to the smoothies . At first she was cold all the time so made tea with milk and honey. As she got better it got warmer and she wasn't cold anymore so she asked for milkshakes. Started with the ice cream, than ice cream and milk than ice cream and heavy cream and added more in when needed.
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tina72
Hi Yogi13 and a very warm welcome from me from Germany! Sorry that you need to be here with us!
You are already doing great with working on more variety and adding meat and carbs to her intake. It took us 6 weeks to find out how much she must eat to gain constantly and yes, milkshakes and smoothies were a game-changer here too. You can add a lot of ice cream and cream to a milkshake and you can add a lot of oil to a fruity smoothie, it disappears in the blender.

A question ahead: please do not get that wrong but is your d truely tested lactose intolerant? I ask that because a lot of AN patients fake that to achieve not need to eat diary. So if she was her whole life before forget my question. But if she is since AN walked into your house, please let that be checked.

All sauces are great to hide butter and cream. No meal without sauce here.
All casserolls are great. You can hide cheese, butter and creme in it. You can prepare double portions and freeze the rest so you do not need to cook each day.
Meat: what about tiny meat balls from minced meat/ground meat? Like swedish Köttbullar? They are way more fat than chicken breast and co.
Keep feeding. There is light at the end of the tunnel.
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tina72
"She also has an aversion to smoothies and shakes (boy oh boy what I could add to those)."

They all have at the start! 🙂
Start with a healthy looking fruit smoothie. 400-500 g fruit and juice (whatever she likes) and add 50-100 ml rapeseed oil/canola oil in the blender (that has no taste and no colour). Increase the amount of oil slowly. If you get to 100 ml it will give you 1000 calories extra with 2 glasses a day (served instead of juice to the meals for example).

How can you get her to drink that:
1) You can have one for yourself (without oil) and drink it with big pleasure right in front of her. Have some comments how good and how "healthy" it is. She might then ask if she can have one also.
2) Tell her that extrem sick kids must drink a special ensure to make sure all vitamins get in and the professionals gave you the recipe. That worked in some cases here. They like to be one of the extreme sick kids at that state.
3) Start with a shot glass and get that into her and then increase portion size by changing glass size every day until it is a normal juice glass. Sometimes it helps to chose a bigger glass and fill it only half to make the portion look smaller (although it is not).

Without calories to drink we would not be where we are now. Drinking calories is in that state much easier than eating them.
My d drinks that fruit smoothie still in year 3 just to make sure she has enough intake.
Keep feeding. There is light at the end of the tunnel.
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Yogi13
To all of the ladies on this thread,

Thank you for being so welcoming and offering me your food suggestions.  Smoothies are my next mission.  I am going to introduce them today.  

Heart felt appreciation from New York.  
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sandie
Go girl!!!!! LOVE your attitude. Xx
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Yogi13
One more question-smoothies in addition to the meal?  Or as a substitute?  Or as a snack?  Just curious.

Xx
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scaredmom
I used smoothies as a snack. Some have done it in the morning while the child was not yet fully awake. ED seems less upset in the mornings for some. Some added a bit to a meal. there are so many ways to do it. 
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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tina72
Yogi13 wrote:
To all of the ladies on this thread,

Thank you for being so welcoming and offering me your food suggestions.  Smoothies are my next mission.  I am going to introduce them today.  

Heart felt appreciation from New York.  


Here are also some dads around so please do not close them out🙂.
Keep feeding. There is light at the end of the tunnel.
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tina72
Yogi13 wrote:
One more question-smoothies in addition to the meal?  Or as a substitute?  Or as a snack?  Just curious.

Xx


Whatever you need it for. We had it in addition to afternoon snack (milkshake) and in addition to supper (fruit smoothie). Substitute only for emergency cases. Better to offer normal food and not substitute.
You can also add it when the normal meal plate is not finished.

By the way, if it is not so hot there as here at the moment, hot chocolate is also great to sneak some cream in!
Keep feeding. There is light at the end of the tunnel.
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Yogi13
Thank  you. 

I did not mean to leave the dads out.  My husband is an integral part of this journey.  I am grateful to know that there is so much support out there.  Thank you again.  xx 
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sk8r31
Jumping in with a warm welcome....and second-and-thirding all the suggestions on smoothies.  We didn't get good weekly weight gain happening until they were added in....and my d resisted with all her might!  What helped for her...she was 17 at the time...was looking at the volume of food that I laid out on the table that she would have to eat instead of drinking the smoothie.  That visual was a real eye-opener for her.  Might not work with a younger kid, but could be worth a try.

Since d was so resistant, I gave her a choice of time of day.  She chose evening snack, and we watched a short (30 min) comedy show while she drank the smoothie.  She would sort of lean into me...the only physical contact she allowed for months (and she was a very demonstrative kid previously...lots of hugs).  Those smoothies really tipped things over in terms of strong weekly weight gain.  We were able to get 2 lbs/1 kg happening weekly.  
Aiming for weight restoration as quickly as possible is a good goal.  

The high-calorie meals/snacks thread that scaredmom provided contains a wealth of good ideas that you can use or adapt according to your d and your family's needs.  Our d did not eat red meat or pork at the time, and we successfully refed.  For someone who is lactose intolerant, coconut milk/cream is wonderful.  And we made the most calorific pancakes imaginable...d's friends loved them too!  Once you get the hang of adding in to your regular menu items, you will be on a roll!

Sending warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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tina72
Yogi13 wrote:
Thank  you. 

I did not mean to leave the dads out.  My husband is an integral part of this journey.  I am grateful to know that there is so much support out there.  Thank you again.  xx 


I know you did not mean that. 😁
It was just for the dads that feel sometimes they are aliens here...
Keep feeding. There is light at the end of the tunnel.
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Yogi13
A follow up to the smoothie idea.  I was half successful today as she drank half of it (I'll take it).  She seems more open to a milkshake.  I see that people add oils to the smoothies.  Have any of you tried adding oil to a milkshake?  The thought...????
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debra18
I am also in New York. Good to have a neighbor here. I give one milkshake in the morning with breakfast and the smoothie with supper. Something I did recently as my daughter is getting tired of them from drinking them for over a year. I bought fancy cups with lids and straws from Amazon. The presentation looks a little nicer. I remember once I put muffin liners for the cupcakes (another way to get in calories is with cupcakes). My daughter said "I am worthy of muffin liners?" From my experience sometimes the atmosphere (music and calm) or the presentation of the food can help
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