Monday, April 11, 2011

The Battle of the Dieticians

Josh, Maya, and Julia

With Sunny
Last week, the pediatrician was alarmed that Maya has not gained any significant weight since she was 4 months and insisted that we schedule a visit with a nutritionist at UM. Meanwhile Naomi went to apply for WIC benefits as money is tight: a minimum wage salary does not go far in supporting 3 people especially if they want her to buy formula. Since the visit 5 days ago, Maya is being fed around the clock. Maya is thrilled with the "Fatten me up program" and has only turned a few items down. To receive WIC benefits, one has to see a WIC nutritionist first. So today, Maya and Naomi saw 2 (two!) nutritionists. Did they give the same information?  Of course not! Though they both agreed that Naomi should skip formula (elixir of the devil) and that Maya seems to be fine.

Here's a math problem: If it takes 3500 excess calories to gain a pound and if each baby fruit or vegetable cup contains 70 calories, how many baby cups need to be consumed to gain a pound? Assume that the baby does not spit up half of what you give her. Assume she is completely immobile and is not burning up these calories just as fast as you shovel them in. We are assuming that Naomi is producing 400 calories of breast milk based on what she can pump out. Nutritionist 2 believes half of the calories should come from breast milk. The total calories for someone Maya's weight and age should be 820. That doesn't sound like much but remember she is one tenth the size of an adult. Any rate, we quickly figured out that these baby cups weren't going to do the trick. Cheese, butter, meatloaf, high fat yogurt..might.

Nutritionist one weighed Maya..a gain of 1.6 pounds. Her verdict: height and head circumference 75% tile; weight 50%tile. She said that there are a variety of different charts used. She uses the WHO one which is for breast-fed babies. Breastfed babies have different growth curves than formula ones. They gain weight fast and furiously in the beginning but formula babies start out-gaining them in the 2nd half of the first year. Later in life, the formula babies have a greater tendency to be obese. She said no formula and hardly any table food. Adult food has too much sugar, salt, spices..etc. No red meat whatsoever, no fruit juices at all. The only permissible fresh fruit would be smashed bananas..absolutely no strawberries (which Maya was happily munching on the night before). Naomi went to the store nearby with her new card that was good for 22 little jars of fruit or vegetables. But all the baby food was in tubs. The cashier, who was very snotty, said only JARS would be covered and no they don't have jars. How convenient! I think the other store does though but Naomi was too upset to go there too.

Nutritionist 2 thought Maya looked great and took our word about the new weight. She agreed it would be very difficult to gain weight with the WIC menu and that Maya was old enough to enjoy, in moderation, foods that have salt and sugar in them. She found nothing wrong with strawberries. Even people who are allergic to many things rarely react to them. Tree nuts and eggs are the usual culprits in causing reactions (see grandsons' prohibitions). She gave a review of what things are choking hazards.

But at any rate, the skinny baby scare is over.

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