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Old 10-13-2011, 05:07 PM   #1
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Ideas for increasing calories...

Back story...

My DD has been failure to thrive since a little after birth. The routine they've had her on since about 4 months (7 months now) is 3 solids a day which need to be essentially bananas and sweet potatoes based since those have the most calories. We also added yogurt. So a typical day is a breastmilk bottle approx 3 oz (she's never been able to nurse micrognathia, macroglossia, tongue tie-we still try ) fortified with Similac Sensitive (essentially everything is fortified with formula for extra calories), then a whole Stonyfield Yogurt, then another bottle, then a banana/grain mix jar of food fortified with, then a bottle, then a sweet potatoes, then 1-2 more bottles before bed and sometimes a bottle in the middle of the night. We tried avocado today, but she wasn't a fan.

All of this makes her horribly constipated (frankly, if it weren't for the failure to thrive, I don't know that her system is ready for all these solids), so now they've layered a laxative/stool softner on top and glycerin suppositories. Add to it, starting on Tuesday she decreased her urine output dramatically. Pediatrician was concerned it was congestive heart failure (she had heart surgery 6 weeks ago), but cardiologist doesn't think so and wanted me to back of the solids to try and get her urinating again, which is fine, but she doesn't take in enough calories on the liquid alone, sigh. I think part of the problem is all the fortification which is high in sodium, coupled with only taking about 15oz a day if I'm doing the math right with the stool softner/laxative.

So with all of that said, I'm looking for creative ways to make non-constipating baby food. Does anyone have any expertise in that area? I've wondered if using butter or oils in regular veggies, might be one way? What about oatmeal? How constipating is that? Is Yogurt really that constipating-she loves it. Are there any pasta's that are better?

The goal is-as high calorie high healthy fat as possible! Preferably natural and preferably something that gets us off synthetic stool softeners/laxatives (oh-prunes...don't work for her, she can eat jars and not go...) I've also wondered what options I have for natural fortifiers for her breastmilk bottles.

TIA!
Court

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Last edited by court3189; 10-13-2011 at 05:09 PM.
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Old 10-13-2011, 05:37 PM   #2
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Just a thought, what about a smoothie with the yogurt, adding cocunut oil and avocado, apples, rice, the fortified formula. And any other things. Your lo probable wouldn't taste the avocado in it.

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Old 10-15-2011, 01:24 AM   #3
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Coconut milk! If you don't shake the can it is especially creamy. I read on a few websites that these were healthy digestible fats for babies (for whatever that's worth). My son 6 mo loves it mixed in with things and it hasn't been constipating for him. If anything we've had the opposite problem!
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Old 10-19-2011, 11:54 AM   #4
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Re: Ideas for increasing calories...

Bananas are constipating, so if she is having a lot of them that might be part of the problem. I mix banana with oatmeal for my LO and he loves it. He also loves avocado. You can try blending the avocado with fruits to make it sweeter and more palatable. Have you tried and proteins with her yet? We recently tried chicken which was a hit You could also try pears and apples for the constipation.
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Old 10-19-2011, 08:33 PM   #5
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What fortification recipe are you using? Are you fortifying to 22 kcal/oz? 24? 30? Using a higher kcal formula to fortify with should decrease the amount of total sodium. We use 0.5 tsp per 3oz of ebm of similac neosure 22kcal/oz (enfimil enfacare is the same thing) to get 22 kcal/oz. But right after we came home we were on 28 kcal/oz which was 3 oz EBM + 1 tsp neosure + 0.8 ml corn oil.

Its interesting that they want you to use solids to increase kcal intake. Oz for oz there isn't much that is better them EBM/formula. Bananas and sweet potatoes are NOT EVEN CLOSE to 22kcal/oz. I suspect she is on a total fluid restriction however since you mentioned heart surgery. If that is the case it does make some since but standard for heart kids is 30 kcal/oz if they can tolerate it.

Anyways, as for solids, we use The Greek Gods full fat Greek yogurt instead of standard baby yogurt as it is higher in kcal (240ish kcal per 6 oz vs 100 kcal per 4 oz) and lower in water. Also think about beans. They are fairly caloric, smooth pureeing, and can have fats added such as oils and avocado. Whole wheat pasta is pretty kcal dense too and can be coated with butter or oil. Oh and eggs if allergies are not a concern.

Ill come back if i think of some more!

GL mamma! We just now got above the negative tenth percentile at 12mo!
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Old 10-19-2011, 11:17 PM   #6
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Yes banana's can be very constipating for some people, my DS was that way and we had to be very careful to keep up the fiber with him. If it were me I would try making Oat Bran or high fiber oatmeal (Quaker makes both types) with organic whole milk, butter, and brown sugar. That's calories and fat but lots of fiber. Anything sounds better than suppositories, poor little dear Pears have a lot of fiber as well, and raspberries. You could do a raspberry smoothie with full-fat yogurt. That's calories plus fiber also.
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Old 10-22-2011, 02:17 PM   #7
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Re: Ideas for increasing calories...

Thanks everyone, great advice!

Monika, they told me to add one tsp of formula per tsp of breastmilk. I think they added the solids for two reasons-in case reflux is part of the issue and she seems to do really well with them. She'll often only take a 2oz bottle, but I can almost always get 4oz of food in. They also had me adding formula to her solids as well.

So on my list I have:

Avocado Smoothies
Greek Yogurt
Cocounut Milk
Whole Wheet Pasta
Oat Bran

Anyone know anything about oils? Is it safe to use olive oil in her food?
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Old 10-23-2011, 05:39 AM   #8
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Re: Ideas for increasing calories...

I'd like to hear more, too -- I haven't started solids with my DS yet (should be today or this week; he's almost 7 mos), but I'd like to introduce healthy but more-caloric-bang-for-our-buck types of foods. We're planning on starting with avocado.
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Old 10-23-2011, 08:21 AM   #9
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Re: Ideas for increasing calories...

I second the Greek gods yogurt; that stuff is amazing!

And I'd keep offering avocado, both in smoothies and plain.

The most calorie-dense foods DS can't get enough of are olives and nuts, but he's obviously much older than your LO. I wonder if you could make an olive tapenade and spread it on things (like rice rusks). Nuts you might want to wait a while on, but of course nut butters are full of good fat and protein.
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Old 10-23-2011, 01:07 PM   #10
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Re: Ideas for increasing calories...

Hmmm... my only concern with the focus on high fat calories is that they aren't a good replacement of what the baby is intended to be getting - i.e. breastmilk or formula. Both of these sources are nutrient dense calories and breastmilk is richer in fats than formula, ounce per ounce so the theory behind wanting baby to be gaining a certain amount by a certain age is linked to wanting baby to get certain nutrients in her diet. Does that make sense? So adding more fat doesn't really accomplish that.

Avocados are nutrient rich, as far as solids go, and they are a great source of good fat. However, they are not a rich in fats or nutrients as breastmilk or formula... See the problem? Plus, if constipation is a problem, it seems like more solids wouldn't really help. If she has a heart condition and is on a limited liquid diet, that presents some challenges...

If I were in your shoes, I would call up your baby's primary care provider and ask them to hold a meeting with all of her specialists and have you and Dad involved. This is the "health care TEAM" and they need to work together for your baby's benefit. To do this, everyone needs to get on the same page. And I would also request that a Nutritionist who specializes in infant nutrition get involved, too. Doctors are really good with managing disease and illness but not so great with nutrition. I'd want someone who specializes in that to be in on the team to make sure my baby is getting everything she needs to work around whatever special condition she has AND what she needs to grow and develop to her full potential. It might be the difference between surviving and thriving. She should be given the opportunity, if possible, to thrive.

It sounds like you've got a lot on your plate and I hope you find solutions that will help your little one. She's lucky to have a Mommy who is so concerned and making such efforts to do what is best for her! One loved little girl.
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