Nutritionist, in brief

It's been a long day--not a bad day at all, just long and busy.  I've been up since 5:30 AM (It's 11:30 PM now), and I'm exhausted, so I'm going to make this brief.  I did, however, want to let you all know about Roo's appointment with the nutritionist today.

First of all, I use the term "Roo's appointment" loosely--he honestly did not need to be there for any of it.  But that's OK.  The nutritionist was nice, and she answered my questions and appreciated my concerns.  She agreed with me that a swallow study does not seem necessary in Roo's case, which was nice.  She also agreed that replacing ALL of his milk with sweet drinks (like PediaSure) was probably not a good idea.  (That is what the doctor had recommended.)  She gave me some practical ways to increase his calorie intake, and some good handouts.  I think we'll be making 2 key changes: 1-Switching half of his "milk" to a toddler formula fortified to 27 calories per ounce and the other half to whole milk (I had still been doing mostly infant formula with just a little whole milk here & there--I didn't want to make any big changes until after this appointment.), and 2-Feeding more table foods.  I've said it before, Roo will eat just about anything... as long as I put it in his mouth for him.  I've given him ham, pieces of mango, pieces of green beans, bites of muffins, you name it.  His problem isn't pickiness or even chewing--it's just that he can't pick the foods up himself.  So for now I'll just have to help him with that.  And speaking of which, I was reminded today of a conference on Down syndrome that Mr. Fantastic and I attended last fall, where they stressed the importance of "hand-over-hand teaching."  In other words, sometimes we just need to take Roo's hand and help him do what we want him to do.  So I've started (you know, for the last 2 meals since his appointment) putting food on his tray, then taking his hand and helping him pick up the pieces between his thumb and forefinger.  It's likely to be tedious, but hopefully will be worthwhile in the long run.

Oh, and one of my main concerns was his formula/milk intake.  The doctor had made it sound like he was only taking in about 1/2 of what he should be drinking, and despite my attempts to increase that, he's just stuck to what he wants to drink.  Well, the nutritionist said that what the doctor had told me was the minimum was actually the maximum of what he should have been drinking (24 oz/day).  She also said that she would like him to have close to that amount--20 ounces--per day in dairy, but that his formula/milk amount was fine and that I should just add some yogurt or cheese to his diet to make up the difference.

So there's the new plan.  I do have a question or two that came to me after the appointment, so I'll likely be calling her tomorrow, but overall I feel good about how things went.  I hope as he starts growing better, it'll aid every area of his development.

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