Week 47: Questions

You'd think after nearly a year of being a CF Mama, I would no longer be surprised by new challenges with caring for Lemon. But, at this week's clinic I got thrown for a bit of a loop.

So, what's throwing me for a loop this week? Pediasure.  It's a high-calorie drink/shake thing that is supposed to help underweight kids gain weight.  At Lemon's check-up this week, we learned that he is gaining an average of 10 grams/day, which is exactly how much a baby of his age should be gaining, and he's right on his growth curve.  But, the nutritionist set an aspirational goal of 20 grams/day, so that he would make up some ground in terms of his weight-for-length.  He's not scrawny by any means, but he isn't quite at the 50th percentile for BMI like they want him to be.  So, she recommended that we try to get two 8-oz containers of Pediasure into him every day.  She gave us samples in a variety of flavors, and said we could request more of his favorite flavor once we'd figured out what that is.  So, I took the samples home with every intention of following her instructions.

Then I read the label.  The first three ingredients are: water, sugar, and corn maltodextrin.  One bottle of Pediasure has as much sugar as a two-pack of Reese's peanut butter cups, 50% more total carbohydrates (ie that corn maltodextrin, which is just a bunch of glucose molecules linked together, basically more sugar), and about the same number of calories.  Actually, they are more or less nutritionally equivalent, except that the Pediasure is vitamin fortified.  Also, Reese's peanut butter cups have the distinct advantage of being palatable, rather than tasting like overly sweetened chalk.

Now, I'm wondering how to square everyone's recommendations that you limit your kid's intake of refined sugar with the nutritionist's recommendation to essentially give my 19 lb kid the equivalent of four Reese's peanut butter cups every day on top of his regular diet.  I'm thinking that CF comes with a high risk of diabetes anyhow, and thus how can it make sense to pump my kid full of sugar now, which will just put more metabolic stress on him, and also give him a taste for overly sweetened things that will probably be hard to break later? Also, if he is staying on his growth curve with the way he is eating already, isn't that good enough for now?  His activity level went way up in the past couple of months, so the fact that he's eating enough to keep up with his growth plus all that motion on his wonky digestive system is a major accomplishment.  Never mind the fact that on his thirstiest day he drinks maybe 6 oz of liquid (he may be a lizard, we're not sure).

In the mean time, I'm leaving the Pediasure on the shelf and will try to come up with even more ways to sneak nutritious calories (not pure sugar) into my child.  Fortunately, he is turning one soon and has some teeth, which opens a lot of new doors in terms of food possibilities.