Friday, March 26, 2010

Houston, we have a tooth!

Well, my B is toothless no more! She has a very sharp edge poking through as of this AM (not all the way in but the tooth is completely exposed!!!) and apparently, there are more to come. There is at least one more that should show up in a day or so (potentially three more) and oh boy, is teething fun. She has had a huge build up (started exhibiting what we thought were teething symptoms at 10 weeks old. She is now almost 13 months!!!!!) and apparently there will be fireworks! At least no FPIES reactions right now, though it is pretty hard to have one when you are eating the same foods that have been safe for months :). Maybe with the arrival of teeth we can purchase those lovely corn chex (certified gluten free and only contain corn products!!!!)

Thursday, March 25, 2010

Why homemade baby food? Part 2--- Time Management

I know a lot of people will say that they don't have time for this and well, they might not. I will not judge anyone, as I know how crazy life is with little ones! However, if this is something you want to do, don't let the thought of time deter you.

At this point, it takes very little time for me to invest.

B's cookies--- she eats about 2 a day and a batch makes about 40-50. So when I make a batch, I cut out all of the little shapes but I only bake 16 (enough for one week plus a couple extra) and the shapes I didn't bake, I place on wax paper (in layers) inside of a freezer safe container (so they don't get smushed) and when I am ready to bake some more I can just defrost them in the AM (the amount I need only, of course!) and pop them onto a cookie sheet in the afternoon and voila! More cookies for the week! SO really I am only mixing up the batter every 4 weeks or so.

B's pears--- I am currently in "pear panic" mode, as pears are going out of season here soon, and it is very difficult for us to get produce off season. I also can't get any canned pears except the ones in heavy syrup and well, that just won't work for us! So right now, I am buying them whenever I am out, then pealing, slicing, steaming, pureeing and freezing immediately. This way I have a stash!!!! They should be fine in the freezer for 3 months, up to 6 months if they hang out all the way in the back.

B's bananas--- the only thing I make right before she eats them! We buy bananas around here like most people buy eggs. We go through at least a dozen a week, often more, because not only does she eat them by themselves, but all of B's baked goods use bananas as the egg substitute (with double action baking powder, my new found friend!!!!). So for normal eating, I slice the banana lengthwise, chop it into 1 inch long chunks, and then slap it in the skillet on medium heat, turning occasionally until it is dark yellow and syrupy. I then throw it in the food processor, with or without a little water, and bam! Fresh bananas! I have recently been contemplating trying the different forms of bananas here (there are at least three different types at our grocery stores-- hooray for nearby tropical climates!) but have not yet been brave. If I am, I will report back. . .

B's muffins--- These can be made weekly and I make mini ones and full size ones. Again, that lovely corn flour to the rescue. . .. This recipe was also the one I used for her "birthday cake." It is a really tasty muffin and they rise very nicely. They are moist and very easy for my still toothless one year old to eat. The batter makes about 12 full size muffins and 12 mini muffins, so more than enough for the week. As a result, I sometimes just cut the recipe in half.

B's Treats!--- Special occasions require special treats! We use the muffin recipe for cakes and use the Happy Birthday Girl frosting for well, the frosting. Sorbet can be kept a little longer than the cake, because it is frozen of course. I keep mine for up to two weeks, although I am sure you could probably keep it longer. I did not notice any change in the texture, flavor, or any addition of freezer burn. I just had to pitch it for the freezer space!!!!

So in other words, her food takes about 1-3 hours weekly time commitment, which really isn't so bad. A lot of things can be done simultaneously. I can steam the pears while I am baking cookies and muffins. All will be finished in less than 2 hours. It takes 2-4 minutes before a meal to make her bananas. And I ususally make the new foods for use to trial in the evenings after B has gone to dreamland. We still stick to mostly purees and baked goods, so there is some down time when I am preparing foods for her.

If you want the recipes we use, go to the recipe pages. I am trying to keep them updated, especially the one about recipes under construction. My trials with coconut continue and after learning of my new friend (double action baking powder!!!!!!!!!! I feel like music should be playing here. . .) I am anxious to see how it improves the coconut recipes.

Helpful homemade baby food resources:

and of course, modifications can always be made to recipes. Remember, it really is just all chemistry and some experiments take a little longer than others to turn into something edible! :)

Thursday, March 18, 2010

Why homemade baby food? Part 1-- the equipment

Because it takes so much of the hassle out of reading labels and it removes so much of the stress regarding cross-contamination!!! Also, we are limited to the prepared foods we can get anyways because of where we are, so it really just makes sense. Fortunately, I was planning on doing mostly homemade food for my B long before any of this FPIES business was suspected, so I already had some recipes and the equipment that I needed.

The equipment:
I have a mini food processor (about 3 cup size), an Oster blender with a baby food setting (as well as 13 other settings), a dishwasher safe colander (for steaming), a medium size skillet, a medium size saucepan, a large spatula, a brownie pan (which doubles as a cookie sheet), and ice cube trays, two of which are covered and made especially for baby food freezing (set of two was 9.99 at amazon and they are dishwasher safe!) I use other dishwasher safe utensils, bowls and plates that we already had and I just sanitize them on super high heat in the dishwasher in between uses. I like having a set of cookware for B's food because I don't have to worry about our foods potentially contaminating her stuff. 

Sound crazy? Here is what triggered it: I had just started making all of her food after being fed up with the guessing game of "what is really in this?" with premade baby food. So I found out she will only eat bananas if they are cooked and then pureed. Ok, awesome. So I cooked them in our regular skillet (my fav one that we got as a wedding gift!) and after eating the bananas, she was colicky acting and had some really bad diapers. I did it a second time and we got a repeat performance. At this point she had been safe with bananas for a few months, so I was pretty sure they weren't giving her issues. I thought to myself, well, it is cheap enough to go buy a decent skillet to keep for just B's food and if it doesn't seem to really solve the problem, I can at least always use another skillet. And the result? Worked like a CHARM!!!! No more problems! Just normal diapers and no tummy aches! So at that point, I was sold! Any baking/cooking implement that cannot go in the dishwasher on high heat, we buy a separate one for me to make B's food with. Obviously, she doesn't have as many cookware items as our family set has, but we have all of the basics. And if spending an extra 50 bucks overall can help my little girl feel better and actually succeed with a food, I will do it!

So I have this great cookbook and although it is not FPIES specific or even food allergy specific, I really like it and have found useful ways of using it. It is called

"Cooking for Baby: Wholesome, Homemade, Delicious Foods for Kids From 6 to 18 Months"

I like it because it gives you some great recipes, excellent directions on preparing foods, but most importantly, it tells you why and how certain foods work or don't work for your baby. It tells you excellent nutritional info and how to cook the item so it has the best flavor and nutritional makeup. It is really a great stepping stone to coming up with your own recipes and whatnot.

The ice cube trays I use our "Fresh Baby" brand and they have covers for them. However, you can just use cheapo dollar store ice trays. Just make sure to not have anything smelly in your freezer and have the trays in a safe place where they can't be spilled or have something spilled on them (you could also wrap them in plastic wrap to help with this!) And take them out after 12 hours or less. I usually make the food at night and then take it out first thing in the AM. I then separate the cubes into prelabeled freezer bags (label with item and date) and then double bag all of the bags of one food inside a large freezer bag. Making a three week batch of food usually takes about an hour, sometimes less depending on the food.

More to come. . .

Wednesday, March 17, 2010

So Disappointed. . .

Not really sure what I expected to hear, but it certainly wasn't this. A couple weeks ago, B had a severe FPIES reaction to avocados on a Saturday and so we went into the pediatrician's on the following Monday for a follow-up. They seemed to finally really be taking us seriously and talked with me and my husband for a long time; I was able to ask many questions, to which they had no answers to but said that they would be asking the pediatric allergist and gastroenterologist they have been in contact with stateside regarding my daughter's case. So I was hopeful that we would get some answers or some guidance, right?

Fast forward to today. Someone from the pediatrician's office called me today to read back the report from the consult. This is essentially what they said: "Don't feed her any foods that she has reacted to." Really?! I never would have thought of that! UGH!!! Still no letter for the ER (hoping that they come through for me on that when we go in next week for her "well baby" check up), still no suggestions for whether or not to try anything new at this point, still no real support or signs that they think we should do anything about this, despite the fact that her reactions continue to worsen and despite that there are some concerns about her weight gain. I am not expecting a lot or anything unrealistic, and I know there is a lot of uncertainty that goes along with this condition. I get that. But I feel so alone in trying to make heads or tails of what to do next. I am so scared to try anything new--- everything new that we have tried since mid-December (other than arrowroot starch, which can only be used in small to moderate amounts in baking) has failed.

I want to try some new things, I want her to have more options. But at the same time, I am so afraid of her having another severe reaction and it becoming worse yet. . . . We don't have the facilities here to deal with a severe reaction, we don't have the medical professionals who know what to do with this. She can't even be hospitalized at our hospital if it came to that-- we would have to be sent out into our host country's medical system which is good, but I am so horrible at speaking the language and the hospital she would have to go to is at least an hour's drive away. . .

So I know I am ranting. . . just a little. :) Thank goodness for a sounding board! I am just so frustrated and don't know what to do next. Hopefully we will get some clarity at her well-baby visit. Only a week away. . . .

Monday, March 15, 2010

How can you throw four ingredients up and the air and come up with something interesting (and edible!)?

So as I have mentioned, B can have corn meal/corn flour (masa!!), arrowroot starch, bananas and pears. All basic "cooking chemicals" (sugar, baking powder, salt, etc) are freebies and we can use canola oil. I have also found that we are solid on vanilla extract, so hooray for a little added flavor! My main goals when trying to create/modify/find new recipes are simple--- nutritional value, introducing new textures, and most important for me, finding foods that will resemble "normal" little kid foods for B. For instance, she had a kind of corn/banana muffin with allergen free frosting and fruit sorbet for her birthday; the closest I could come to cake and ice cream. And it was still good!!!

We have a few more options than some, since our safe foods are fairly baking friendly, but it is still tricky coming up with home cooked goodies that exhibit some form of relative variety. So far, our recipe file is growing (I keep a working notebook with original recipes, modifications and ideas for modifications, recording later on if they actually work) and includes two sorbets, a frosting recipe, a muffin/cake recipe, a cookie recipe, a pancake recipe, and basic purees. I am currently working on a modification of banana bread, a new pancake recipe, a different version of the cookie recipe, and a few others that I need to wait until B passes a few of the ingredients.

So why bake? It is really a great way to introduce new foods and in an interesting manner. I have a couple "staple" recipes that B loves and when trying a new food that can be used in baking, I simply take a staple recipe and substitute the new food in place of something else. Now, I do have to look at the recipe and determine what that ingredient could replace, obviously, since certain foods react different ways (chemically speaking) when baking.

Bananas, for instance, are an awesome egg substitute and we actually go through bunches of bananas each week like some households go through cartons of eggs. Bananas are not only similar in texture to a raw egg (when the banana is mashed) but they expand when baking and really help to hold other ingredients together. When substituting banana for egg, you take 1/2 cup of banana (mashed) mixed with 1 tsp baking powder (if you can't have baking pwdr due to the corn starch, use 1/2 tsp baking soda with 1/4 tsp cream of tartar in place of 1 tsp baking pwdr.) It works great in most recipes.

If you want to learn more about what I call "baking chemistry" (how different ingredients react and interact chemically) and "baking math" (how much of each thing to substitute for how much of another), I have found my "Baking Illustrated" cookbook to be helpful. It was written by the lovely people of the Cook's Illustrated magazines, another excellent resource.

So check out my recipe pages if you need/want some ideas, or are simply curious about our weirdo recipes. :) I will warn you since pretty much everything we bake does contain corn flour/ corn meal and bananas, flavors often resemble varying degrees of banana-dipped tortillas, but with this in mind, my LO LOVES the recipes. And, if you were wondering if she just simply has strangely unique taste buds, I have tried my recipes on other unsuspecting and suspecting babies (who are of the non-FPIES variety, lucky little ones!) and on my wonderful husband, who will try anything that pops out of my kitchen, but is pretty honest about whether or not something is edible or awful.

Also, a word to the wise, when using fruit purees or mashed fruits in recipes, I found that fresh fruit or frozen fruit pureed before throwing it into the recipe works SOOOOO much better than baby food. You may have never thought of using baby food for that purpose, but a few times when experimenting with new recipes, I ran out of ingredients and for one reason or another, couldn't go out to get more, and foolishly turned to the baby food cast-offs in the back of my cupboards (from before I swore off all premade baby food for my daughter). It was a very VERY bad idea. Things never set up very well and the flavor was usually ten degrees to the left of nasty. So use fresh. Or frozen. Or maybe canned. Use something still resembling the fruit from whence it first came. You will appreciate the results so much better.

Sunday, March 14, 2010

Baby B and FPIES Part 2

     So where I left off. . . . So we had gotten support from the pediatrician, but still weren't really sure WHAT we were dealing with and had a limited number of resources. So I tried finding out about common triggers and apparently missed that sweet potatoes was one of them. We started B on sweet potatoes and I started noticing that her reflux was getting significantly worse, or so I thought. She wasn't sleeping at all during the day (which was normal for her at this point) and was barely sleeping more than a couple hours at night, not consecutively. She also had the hiccups constantly and displayed this really weird sucking behavior-- I had bruises all over my arms from her sucking on them. She also had some really nasty diapers on a regular basis. Now I can look back and say that she was starting to have issues with sweet potatoes, but at the time I thought it was a combination of reflux worsening (no idea why), teething, and her outgrowing our co-sleeping situation. It wasn't until on day 15 of sweet potatoes that she had her full-blown FPIES reaction. Two hours after ingestion she was vomiting violently every five to ten minutes for about 2 hours. She was really funny acting and seemed "glassy," but she would try to at least sip water and nurse a little in between vomiting, so I think that is why she didn't become dehydrated at the time. She had nasty diapers and bad reflux for several days following, but now we knew sweet potatoes were out.
     We took her off solids altogether, thinking her system needed to take a time out. She had always been a fabulous nurser and had excellent height and weight and was hitting her developmental milestones, so it wasn't a big deal for us. It took a few weeks to get back to "normal" for her, but as soon as she was, her reflux was all but gone, no more nasty diapers, no more diaper rash, still some sleep issues but we were at least back to her baseline (she has been a horrible sleeper since she turned about three weeks old).
     About 6-8 weeks later, we started trying her on bananas (she had done well with them prior to the evil sweet potatoes) and then pears, though she wouldn't touch pears with a ten foot pole. At this point we were still giving her premade baby food. We tried Kix after a suggestion from a friend who has FA kids and that was also a success. We had tried applesauce previously, but it had always given her a nasty diaper rash, so we didn't really offer that very much. After Christmas, we decided to intro peaches, but after three days, she developed some nasty mucousy, acidic, and green diapers as well as reflux symptoms, so we ditched peaches. We then tried blueberries and noticed similar symptoms pretty quickly, but foolishly decided to see if she was "just adjusting" and pushed forward. A note--- when we start a food, my LO only receives one small baby spoonful of the food per day for the first 3-4 days, then we increase to 2 spoonfuls for a few days and so on, until at 3 weeks of a food trial, we have worked our way up to 1-2 oz per day, and only in the AM. So back to the blueberries (blueberry applesauce to be exact). After a week of her symptoms worsening, we pulled that food, and after it was taken away, she continued having the initial symptoms for a full two weeks and developed a nasty diaper rash requiring prescription intervention. It took another week to even begin to clear up.
     At this point, we were frustrated. Our then 10 month old was only able to eat bananas, Kix and pears (though she refused to eat the pears in any large volume). It was at this point that I abandoned all premade baby food and began completely making my own. We found that she was a much more pleasant baby and had significantly less problems with the homemade food. For bananas, I cooked them in a skillet until syrupy and then pureed them (she refuses them raw in any form, chunks, puree, frozen, etc). For pears, I peeled, cut, steamed and pureed them and it was then that she started eating them like they were going out of style! Hooray! We stuck with the Kix and then decided to trial arrowroot starch, since I wanted to start baking somethings for her. I tried a biter biscuit recipe first, using Masa and arrowroot for flour and bananas for the egg. The cookies were a huge hit. I had three trials of the recipe before finding a consistency I liked, but it finally worked!!!
     So following our arrowroot trial, I got brave. She hadn't had a severe reaction in almost 5 months. The milder reactions gave me pause, but I thought we should try avocado. It was supposed to be a great baby food and it was so nutritious-- high in protein and good fats! Initially, it was like pulling teeth to get her to eat it. By day 10 she was eating 1/4 oz 1x a day. By day 11 we upped it to 1/2 oz and by day 12 we had a nasty reaction. It is significant to note that when starting avocado, she had a couple days of some sketchy diapers, but they went away so we thought she was just adjusting to a new food. The thing we should have paid attention to was the hiccups. From day one she started getting the hiccups an abnormal amount during the day. They increased gradually and became more prolonged. When she had her big reaction, it was about 4.5 to 5 hours after ingestion, and in all, it entailed 15 episodes of vomiting (mostly projectile), two ER visits, one ambulance ride, and her losing consciousness twice. NOT an experience I want to repeat any time soon. This was a little over two weeks ago and we are almost now back up to the same amount of "safe" foods we were eating before (bananas, pears, Kix, and arrowroot and Masa and corn meal in baked goods). Next post-- how we make four foods seem interesting!

Saturday, March 13, 2010

Baby B and FPIES

     So it all began with that awful rice cereal. We decided to wait to start solids until B was 6 months old and until my husband got home from his summer deployment, since I wanted him present for this milestone. She started out ok with it, but then after the first time she ate it (about 5 hours later to be exact), she had what we thought was a very bad episode of reflux when asleep, right after going to bed. Her reflux symptoms hadn't been great lately, so we foolishly chalked it up to that.
     Fast forward a couple weeks later, when we decided to try it again. This time she threw up a couple times at about 4 hours after ingestion, and later on she had some nasty diapers for a brief period of time. This time, I called the nurse line and they thought it was a stomach bug and I also thought it could be that as well, despite the fact that my daughter has never been in the care of anyone other than myself (or my husband or close friend) and no one around us at the time was sick. So the more I thought about it, I wondered if the added iron in the cereal was bothering her (when she was a newborn, she couldn't tolerate the iron supplements I was on through the breastmilk and once I stopped taking them, she seemed to do much better). So I decided to make homemade rice cereal (very easy to do, btw) and try it another week later.
     Fast forward again. This time, she only would take two tiny bites of the rice cereal and within two hours, was profusely vomiting. A few hours after the vomiting stopped, the nasty diapers began. So once she was settled down and I decided this was no stomach bug, I consulted Google. Not the best medical source, but I wanted to see what I could come up with. After googling reasons that would cause her to have such a delayed reaction to a food, I stumbled across FPIES. Reading the symptoms, I got chills. It described her reactions to a T and reading on, there was a lot of information to be concerned about. Stories of babies going into shock, experiencing low blood pressure, multiple foods that are not tolerated, etc etc. So we ditched all ideas of solid foods (I was still breastfeeding her just as much as always, of course, so it wasn't a big deal) and awaited her well-baby check up scheduled for a week later.
     I took the information I found into the pediatrician's office and lo and behold, he supported my assumptions. There really wasn't anything he could do for her, but he agreed that there was good reason to suspect FPIES and that we should proceed with solid foods as if she indeed had the condition. So we extended our food trials to one week instead of a few days, tried avoiding all common triggers, and tried to go on about our normal lives. . . Stay tuned for part two!

Friday, March 12, 2010

Baby B

My Baby B. . . . she is all spirit and personality! She just had her first birthday and she is ready to take on the world as a "toddler!" (Or is she a waddler? I have no idea. . . ) She loves everything to do with animals-- her first word other than Mama and Dadddy was "duck"-- and is crazy about books, trucks and people watching. She loves music and will "sing" along to many songs-- specifically "Octopus's Garden!" Baby B also enjoys "reading" us books, which we definitely appreciate! She does not sleep much and never really has (we think she is too afraid to miss anything that is going on!), although we now have her taking a 1-2 hour nap almost every day!!!! VERY exciting! She is not yet walking by herself, but can walk behind something she pushes or by holding onto our hands. She says some words-- favorites are animal sounds!-- and she signs some words. I sling her often and still breastfeed her 8-10 times a day (this is mainly because of her FPIES, but I must say, I love breastfeeding!). We co-slept until she was 6 months and I think this helped a lot with her attachment and definitely helped when she was a VERY colicky infant. In a nutshell, that is Baby Girl! And, of course, she has FPIES. . .

Don't we all deserve a cookie?!

Well, here we go! After months of several friends and family suggesting I start blogging, here I am, despite my initial resistance! I am hoping that this blog can serve as a resource and/or support to other parents and their little ones dealing with food issues, specifically with FPIES (Food Protein Intolerance Enterocolitis Syndrome) as we are here. My main focus, however, will be our adventures in FPIES cooking, as I am constantly in pursuit of a seemingly "normal" diet for my now one year old daughter.
This all started with a cookie. I wanted to find a cookie or biter biscuit that my daughter could actually eat without worry that the ingredients would cause an FPIES reaction, some of which can be very scary. Once I figured out a recipe for that, I thought we could try other things beyond the typical fruit puree-- a birthday cake, frosting, sorbet, maybe pancakes? So in my never-ending exploration of recipes, with the successes and often very gross failures that entails, I feel the need to share these with other parents, or help others come up with something their child can eat that looks and feels at least a little "normal." Everyone deserves a cookie!
My secondary focus involves our location. We don't have access to an allergist, gastroenterologist, or any FPIES specialist for our daughter because we are currently stationed overseas and have limited resources at our hospital. Our pediatrician is very understanding and helpful as much as possible, but our resources are still limited. So we are navigating this somewhat without a compass, and I would like to reach out to other families in similar situations. FPIES alone can be confusing enough with the help of professionals accustomed to working with this diagnosis, to say the least!
So most of these posts will involve cooking/baking information, but we will include all of the other stuff too--- milestones, victories, not-so-victories, and just the typical adventures involved in raising a VERY spirited one year old. I hope our experiences can help the rest of you out there, even if it is only to provide amusement once in awhile! Happy reading!