Friday, October 16, 2009

Entry #7: High-calorie Cooking

Kids with cystic fibrosis require more calories than kids without CF. In fact, some days it seems my 4 year old requires more calories per day than I do. Which, is probably true.
Trying to cook with his caloric needs in mind can be a challenge. Meals need to be balanced and beneficial to the whole family, but he needs more calories packed into each bit. At the same time, those bites need to benefit his whole body--not just those affected by CF. Oh wait, one more thing--it has to be pleasing to the ever changing, very select tastes of a kid.
Praise God that I enjoy cooking and a challenge.

When O was first diagnosed I was told I'd have to give up breastfeeding. Nope.
We were also told that cow's milk was the way to go. Nope.
They also said to let him eat cake--or, any other sugary food he desired. No way.
Now, our dietitian's are scratching their heads. O is big--even for a "normal" kid. He's never dropped below the 80th percentile. He's tall and lean (just like his dad), and rarely has any tummy trouble.

We avoided sugar for the first two years of life. Sure, he had the occasional bite or lick of a pudding spoon, but for the most part he did not have sweets until he was 2. We also did not give him cow's milk until he was 2--avoiding all cow's milk products (cheese, yogurt, ice cream, etc.). I breastfed O until he was 22 months--that was the main source of his "dairy" intake. We supplemented with goat's milk toward the end of breastfeeding, and continue to this day. He really loves goat yogurt. Yes, occasionally he gets cow's milk products, but it is limited.

I don't really make any changes to our cooking. Yep, that's my big secret. I don't add extra cream or butter. I use healthy fats, and make balanced meals. That doesn't work for every kid--they're all different. I found these tips online, that I'm sure would help some CF kids out there:
  • Add extra butter or margarine to sandwiches, sauces, and potatoes.
  • Use dressings on salads or vegetables; add extra oil to the dressing.
  • Prepare entrees with gravies and creamy sauces.
  • Add bacon to burgers and chicken.
  • Add dried skim milk powder to sauces and beverages.
  • Add extra cheese to scalloped potatoes or macaroni and cheese; order extra cheese on pizza.
  • Top salads and sandwiches with avocados or guacamole.
  • Add nuts to cookies, cakes, pancakes, and salads.
  • Add extra cheese and deli meats to sandwiches.
  • Grill sandwiches in butter or margarine.
  • Use heavy whipping cream and whole milk when cooking.
  • Make milkshakes.
  • Add instant breakfast mixes to milk-based beverages.
  • Make high-calorie smoothies.
  • Prepare calorie-rich desserts such as pudding and cheesecake.
  • Top hot chocolate, pudding, and other desserts with whipped cream.
  • Provide high-calorie snacks like peanut butter crackers or trail mix.
  • Prepare high-calorie versions of popular family recipes.

Of these tips, the only two I like are the adding avocado and adding nuts. The rest involve cow's milk or oil/pork fat. Good for calorie intake, bad for the heart. Adding ingredients like hemp seeds or flax, or other omega 3 fats are a much better idea (in my opinion). Get your kid hooked on fish as early as possible. (No pun intended.)

So, are you scratching your head now? Wondering what to do? Below are meals that my kiddo enjoys--taken from various sources, and some slightly adapted. They're not overflowing with calories, but they're definitely not on the lean side. They are balanced, and it works for us. If you want any of the recipes, please feel free to comment, and I'll get it to you. (I've attempted to give credit to the recipe creator in paranthesis. RR indicates a Rachael Ray recipe.)

BBQ Roasted Salmon with green beans and rice
Turkey Meatloaf with mashed potatoes and peas (Martha Stewart)
Cinnamon-Zucchini Whole Wheat Pancakes with maple syrup and/or fruit (serve with scrambled eggs and bacon for more calories) (A Cramer Family original)
Pizza Wheels (CFnutrition4life)
Pumpkin Polenta with Chorizo and Black Beans (RR)
Chicken and Cheese Flautas (CFnutrition4life)
Chicken Fingers (made with hemp seeds and flax meal) (CFnutrition4life)
Spinach Artichoke Burgers (RR)
Butternut Dumplings (Alton Brown)
Acorn Squash Lasagna (Everday Food/Martha Stewart)
Chicken and Gnocchi (A Cramer Family original)
Grilled Cheese-and-Chicken-Sausage Waffles (RR)

O's daily routine of food is important too. Eating non-stop during the day doesn't allow your body the "down-time" it needs to digest. Also, making sure WATER is available throughout the day (and especially during meal time) is important. Yep, water. Dehydration can trick your brain into thinking it's hungry. When your kiddo says he/she is hungry--first offer some water. See what happens. Drinking water during meal time also helps your body digest food.
Another tip: slow down. Meal time should be relaxed. No t.v., no toys, and limit distractions. Try to sit at the table, and enjoy talking with your kids.
We start the day with a nebulizer treatment, and sometimes chest physiotherapy. Which, means O is VERY ready to eat at breakfast. Our typical breakfast is cereal and goat's milk. Sometimes 2 bowls. Whole grain and low sugar. Other days it's goat yogurt and granola, and other days we have eggs, bacon, and toast (or bisuits, pancakes, or waffles--depending on the time we have). He has a 6 ounce glass of juice (white grape), or sometimes I make whole fruit smoothies (no dairy).
Lunch time is typically either pb (all natural, no sugar added) and jam (whole fruit, no added sugar), or turkey and cheese. Sometimes he eats 2 sandwiches. Crackers/chips/pretzels and fruit (apple, banana, or apple sauce) are accompaniments. He has water to drink. If he finishes the water, and the majority of his food--I'll offer him milk.
We do have snacks during the day, from time to time. He goes to preschool twice a week, and the snack varies there--it seems applesauce, crackers and cheese, and yogurt are popular. At home, we do crackers, raisins, granola bars and similar items.
Dinner time includes a lot of vegetables, a protein, and grains. I'll shred zucchini into pasta sauce, chop veggies super fine and add to sauces, batter, or broth--whatever it takes. Again, water before milk is served. Dessert is available if an adequate dinner has been consumed. Dessert is small. Always small. A scoop. A cookie. You get the idea.

One last thing to keep in mind: Always give small portions, less than what you think they'll eat. At some point we became obsessed that we clean our plates. This makes meal time frustrating for kids and parents. Just start small. There's nothing wrong with asking for seconds, or thirds.