Thursday, January 3, 2013

Lots of Calories: The CF Diet

Children and adults with cystic fibrosis need many more calories than everyone else, and the best way to get this is from fat. Add in his requirement for extra salt, and you realise Victor is on the world's most delicious diet.

He started on solid food at around four and a half months old, about the same time as Felix did when he was a baby. Once he had tried a few different pureed fruit and vegetables (as well as baby rice cereal) we moved onto 'everything', at the advice of his dietitian. We started adding butter and a tiny pinch of salt for the extra calories and to get him used to the flavour.

I quickly discovered it is next to impossible to find baby food with any decent amount of fat in it. Pre-packaged baby food typically caps at around 4g of fat per serving (which is around 250ml, or 1 cup). Strictly speaking about jarred baby food here, the best I've found is Ella's Kitchen 'Fabulously Filling Fish Pie' with 9g of fat and Rafferty's Garden 'Old Fashioned Chocolate Custard' at 3.9g of fat. I know what you're thinking...9g of fat! Amazing. Yes, but unfortunately it leaves much to be desired in the taste department. Victor did not particularly enjoy that one and when I tasted it, I understood why.

So generally what I do is buy whatever baby food I want, disregarding the fat content, and just add butter or olive oil to bring the fat content up. 1 teaspoon of butter/oil = 4g of fat, which means he needs 1 full scoop of Creon (his enzymes) to digest it.

Now he has decided that he doesn't want to be spoon-fed mush any more and prefers to eat finger food. The hardest part about feeding him is that unless I'm feeding him bought baby food, I have to work out the fat content of the food so I can give him the appropriate dose of enzymes. Turns out I am not all that great at estimating the fat content of food. (Possibly the only downside to having never dieted).

I have a little book called 'Calorie, Fat and Carbohydrate Counter' by Allan Borushek. It is essentially a giant list of every food imaginable, from fruit and vegetables, meat, take away, drinks, even chocolate covered ants. So from there I look up the food, work out the serving size and how much fat is in it, and then I can work out how much Creon Victor needs to have.

Here we are, having lunch today. The boys had eggs and toast. Victor's toast had peanut butter on it for a few extra calories! Then they got to have Nutella on milk arrowroot biscuits. They usually have them plain but Felix asked for 'something special', and there really isn't much better than Nutella on milk arrowroot.

Check out the huge mess he made with egg and toast!

"Chocolate!"
So for lunch today, not including the scoop of Creon Victor had with his milk beforehand (still breastfed), he had 1 scoop for the peanut butter toast, and then 1 scoop for the egg. Since he only ate about half of it I figured he could have the little bit of Nutella and it would still be 'covered', so I didn't give any extra enzymes for that. (But if I did, it would only be around half a scoop of enzymes).

I love this stage, as it's fun to get a bit more creative with their meals (and it is so much easier when babies start feeding themselves!). Toast is a bit of a winner, which is good because it's easy to add fatty things to it. He had ripe avocado spread on toast the other day and seemed to like it, and peanut butter is a good standby. Last night he entertained himself by grabbing little fistfuls of dinner off my plate...so I guess that means he is truly ready for 'big people food'!

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