Living and thriving with a limited diet can be challenging and overwhelming, and is especially compounded when coping with a new diagnosis. Patients and families living with FPIES may experience social, emotional, and developmental difficulties that accompany limited diets. This can lead to feelings that there are few options as well as restlessness and isolation. In rare cases, some families must cope with longer periods of “gut rest” and pauses between food challenges.
It is normal to long for that comforting feeling of seeing your child pain-free, thriving, and engaged in their eating experience. With a dash of planning and a sprinkle of creativity, you can learn to navigate a limited or foodless world. With these creative and fun tips, you will learn how living with even just one food item, can go a long way!
Think Outside the Can
Is your child on a diet consisting only of breastmilk and/or formula? Feeling like there are few options? Let’s get cooking! Thinking outside the can opens the door to variety and engagement for your child.
For a sense of variety, consider different ways to present the liquids that your child consumes and label each a different “food name.” Here are some examples:
- Warm formula in bottle = “Bottle”
- Cold formula in sippy cup = “Milk”
- Formula provided in boxes = “Juice Box”
- Hypoallergenic semi-solid foods = “Yogurt” if spoon-fed, “Cookies” when baked in a circle shape, or “Crunchy Sticks” if baked into strips
- Frozen formula in popsicles = “Ice Pops”
- Frozen formula in Dippin’ Dots molds = “Dippin’ Dots”
- Seltzer water = “Fizzy Water”
If your child tolerates flavored formula, you can use it to create different flavored ice pops and Dippin’ Dots (as an occasional treat only, but not as a daily serving of an important source of nutrition because the freezing process results in loss of important nutrients in the formula). You can also combine the flavored formulas with seltzer to create flavored spritzers. In addition, once you resume food trials and find safe foods to add to the diet, you can incorporate those flavors to create new menu choices.
Blend in the Good
If your child has a few safe foods, creating smoothies, juices and dehydrated chips can provide variety. Marrying safe liquids with safe fruits and/or vegetables not only expands your child’s culinary experience, but also provides them with multiple textures and tastes, enhancing the development of motor skills and speech.
Appliances such as a blender, dehydrator, ice cream maker, snow cone machine and juicer can turn one ingredient into multiple options. For example, strawberries can be used to create frozen strawberry ice cream, sherbet and sorbet, strawberry chips, and pureed spreads.
**Note: Frozen formula loses some of its nutrients, so be sure your child is taking in enough formula by other means as well to ensure the minimum required caloric intake is met.
When All Else Fails, Count to 11
Struggling in the kitchen? Count to eleven! By utilizing different cooking methods you can develop different sensory experiences and transform one ingredient into eleven different meals. For example, a potato can be cooked eleven different ways:
| 1. Bake
2. Boil 3. Steam 4. Fry 5. Saute 6. Roast |
7. Stew
8. Blanch 9. Puree 10. Dehydrate 11. Blend |
Each option provides texture variety and taste expansion. By creating different options, your child can become engaged in the cooking experience while expanding his or her dietary repertoire. Creative engagement will also help shift the focus away from limitations and towards possibilities.
It’s All About Packaging
Fancy china or paper plates? Having a variety of cups and plates in different colors, shapes, and sizes enables you to offer your child more choices at mealtime while giving them the opportunity to be in control. Engaging dinnerware helps support mealtime fun and can also make your child feel special at the dinner table. Why not start a tradition and purchase a new, cool cup each month. Or pull out the “fancy china” for new food trials or special events. Provide your child with limitless options. Does he want his water in a sippy cup or an open cup? Would he like it with or without ice? Which color cup does he prefer?
There’s More than Meets the Eye
Nothing stimulates the appetite more than presentation and visual stimulation. While working with few foods and a limited diet may present creative challenges, one food can be transformed into anything from a turkey to a tree!
Purchasing cookie cutters or cutting your child’s safe foods to create visual imagery on their plate develops excitement and anticipation at mealtimes. Working with strawberries again? Try to create a strawberry tree by slicing the strawberries into quarters then securing them to a foam cone with toothpicks. Only have peppers for variety? Gobble, gobble. Why not arrange them into a Thanksgiving turkey on your child’s plate with multi-colored feathers and a cute little beak?
Ice Is a Treat When It’s All You Can Eat
Invest in a crushed ice or snow cone maker. At mealtimes, your child can practice feeding and chewing skills by feeding him/herself crushed ice off a baby spoon. As your child’s diet expands and fruits are added, pureed fruit can be added to flavor the crushed ice. Keep the oral motor skills going by offering Chewy Tubes for oral stimulation and chewing practice.
Sugar and Spice and Everything Nice
Sugars, salts and refined oils are generally protein-free and can often be added to the diet without the same rigorous trial process as a food. Although, you may want to introduce these elements slowly and under the guidance of your physician.
If you know your child tolerates sugars and doesn’t have any secondary diagnoses (e.g., fructose malabsorption, etc.) sugars can be a protein-free way to give your child some additional choice occasionally. Some examples of products that are protein-free and mostly sugar and artificial flavoring include:
- Dum Dums lollipops
- Smarties®
- Cotton candy (check ingredients, depends on brand)
- Spangler Candy Canes
- Pixie Stix
- Can be sprinkled over crushed ice to create different snow cone colors
- Can be mixed with plain water in ice pop molds to create different colored ice pops.
- Can also be sprinkled into Dippin’ Dots to flavor them
- Maple syrup (can be cooked and cooled into molds and lollipops)
- Some brands of Italian ice
It can be hard to process why your child may be able to have a Dum Dums lollipop made from sugar and artificial flavors, but can’t eat a fresh, natural piece of fruit or a vegetable. You may also be concerned that introducing sweets early on will damage teeth or make your child less willing to try real, whole foods later on. Your medical team can help provide guidance and recommendations on the use of sugars, spices and oil. In many cases, children may find the flavors of real foods so pleasing once tolerated, that they slowly begin to develop a taste and preference for them. Again, everything in moderation, and remember that when no or few other food choices are available, these can be a great way to bring small moments of much-needed joy and normalcy for your child.
Be the Apple of Your Child’s Eye with Foodless Fun
Start new family traditions on birthdays and holidays. Creating themed, foodless “cakes” helps develop new traditions and excitement surrounding holidays and events. All it takes is a few boxes (we love hat boxes), some wrapping paper, stickers and small decorative items to celebrate big. It is an even bigger surprise when the cake serves as a piñata or gift holder. After all, what child wouldn’t enjoy the experience of “digging in” to his/her own cake and finding birthday “goodies” inside?