When Molly was diagnosed with reflux we had a whole new world of food issues to sort out. Suddenly the allergies seemed straightforward. Turns out reflux (in layman's terms this is when the muscle in the throat doesn't work properly, so the stomach contents don't stay where they should - so regurgitating food, vomiting, killer acid indigestion and stomach aches are the consequence). Molly was put on Omeprazole, and Ranitidine to try and control the vomiting (she vomited every night, at least once, and regurgitated constantly through the day). To stop the reflux she was supposed to sleep 'sitting up' with bed blocks, no food for 2 hours before bed (those bedtime snacks were a challenge). She was exhausted, she was losing weight, she was in pain all the time. I was determined to do everything diet wise I could - triggers are sugar and fat.
She was 7 years old before she slept through the night. Seven years old before she had a pain free day. Seven years old before she stopped going to bed hugging a bowl.
Here's what I learned about controlling reflux.
Like allergies and intolerances, acid reflux spells the end to convenience foods. You have to be organised as you can't just grab a couple of biscuits and run out the door. Standard kid food like jam or cheese sandwiches are now 'no go'. Pizza, lasange - anything high in fat isn't going to be good for your child, so you have to limit fat while still making sure they get the 'good fat' they need to grow. Not to mention the challenge of getting enough calories into them when they are vomiting or suffering chronic stomach pain.
If, like Molly, you have to go low fat and low sugar, then cutting out hidden sugars/fats is important. It's the only way to enjoy the occasional treat of a biscuit or an ice lolly.
And here's the killer bit of advice - you eat as your child eats.
You can't expect co-operation from a child if they have to watch everyone eat the treats they want.
You can't expect them to listen to you if it's 'do as I say, not as I do'.
You can't expect them to feel understood and safe if they are excluded everywhere. So...if Molly can't have it, we don't. If there is an appropriate subsitute - dairy free chocolate for instance - then others can have 'their' chocolate and Molly can have hers.
I'm 53 - if everyone else was sitting down to lasagne and garlic bread while I'm expected to eat steamed fish and vegetables I'd have a temper tantrum! What else could I expect from a 9 year old?
What to do?
1. Never make them eat up everything on their plate. An overfull stomach will result in reflux and pain. This is not an excuse for not eating vegetables by the way...
2. Plan on 4 to 5 meals a day. So afterschool snacks are more substantial than just fruit and biscuits. A bit of pasta, porridge, a sandwich or wrap (chicken, ham, beef, tuna), a small baked potato with tuna or baked beans (although tomato can be a trigger, so be careful with the amount of baked beans) are all good ideas - as is soup or sushi.
3. Keep breakfast as sugar free as possible, let them have any treat you think is okay at lunch with their mates from school, then clean eating once home again. This helps to ensure they don't feel too isolated/hard done by, which is important.
4. Depending on the age and temperment of your child let them have a 'few' crisps, hula hoops etc at parties so, they are part of the fun. Molly will quite happily eat a few crisps and leave the rest of the pack as a whole pack will make her sick. Ditto sweets. A couple is okay, not more. We 'take home the rest for later'. But really they just go in the bin.
Things to avoid:
Dried fruit - honestly, its about 95% sugar. There are you thinking that its a healthy snack when its a terrible thing to give.
Fruit Juice - packed with sugar. If you need to introduce the 'water habit' get some nice cordials and put a tiny bit into water. It takes the 'edge' off and kids get to think they are having juice. Abandon watered down juice, or kids cordials. From now on it's water, and very weak cordials only. Freeze juice in ice cube trays to put in glasses of water for fun.
Fizzy drink are now a thing of the past - even at parties (Molly used to vomit after every birthday party). A quarter cup of a diet drink is what Molly gets, so she's not excluded.
Yoghurt - these are packed with sugar, often between 12g-20g per 100g. Bin 'em. Co Yo yoghurts are no added sugar which is fine (the chocolate Co Yo yoghurt as 3.9g of sugar per 100g). Don't introduce these until your kids have been off yoghurt for a while, as the comparison won't help. My policy was to let Molly have a bit of ice cream rather than load up with 'healthy' snacks that had a lot of hidden sugar. Better a little bit of a proper treat in my view.
Prepared Sauces - Pasta/Bolognese, curry, ketchup (!) - all high in sugar. Limit quantities and, where possible, make your own.
Fruit - on an empty stomach the acid and sugar are a killer. Only give fruit after a meal, or after carbs such as crackers, breadsticks, bagels.
Especially Granolas - again packed with sugar. Stick to Shredded Wheat or Weetabix and learn how to make porridge (if you've shuddered at the thought of porridge, go check out our recipes. The chocolate one is great and has NO added sugar). Top with fruit to make it interesting. Oh...and it's not just the cereals you'd expect, check sugar levels on well known 'plain' cereals. Go for cereals with under 8% sugar.
Rice cakes, breadsticks, bagels, bread and Marmite are all your friends now, as are carrot sticks, cucumber and avocado and Sushi. Sandwiches and wraps are good - chicken, ham, beef. Bananas are a good fruit - remember nothing citrus, as they don't need more acid. Pears are nice. If you are okay with peanuts then a bit of peanut butter is better than jam. Did I say 'no fruit on an empty stomach?' - this is one to watch out for with other mums. They think they are being healthy, when in fact it's one of the worst things they can give a reflux sufferer. After a full meal? Perfect.
To begin with, and to get things under control, you will have to be really strict. It's hard, but the only way to calm the tummy down. We lived on rice, potatoes, grilled meats/fish, grilled/steamed veg, gluten free bread, and low sugar puddings. Agave nectar is a good sugar substitute, as it's easier on the stomach. If you are baking at home, just reduce the amount of sugar in the recipe and see how it goes. Start checking the sugar content of everything you buy and keep it low. If you let them have a cookie - then the rest of what they eat must be 'clean', low sugar food. Visit Holland and Barrett and get diabetic ice cream and sugar free sweets. Ration them and see how it goes.
The park is a nightmare now, as the kids all run off to the ice cream van. Make sure you have carbs with you and make sure your child eats some, before going to the park or having a treat. If you are under so much pressure you can't stand it, then do a deal with them to share a lolly, and make sure you eat most of it . Better still, make ice lollies at home and let them eat it on the way to the park. You'd be amazed at what you can get away with with a bit of food colouring, water and a bit of cordial/fruit. It's mainly the experience your child is after.
This is not a temporary diet. This is a way of life. If you've other children, they can eat what they want when they are grown up, or at a friend's house, or when they are teenagers walking home from school. Don't make a big deal of it; just change the way you eat. If you're clear and firm and don't attach blame - 'we have to eat this way because of...' everyone will soon get used to it. For a few years...a few important years...you have to eat as a family, and eat for reflux.
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