AN ALLIANCE BETWEEN

SPOON Foundation Joint Council on International Children's Services

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Nutrition Profile

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“Oh, are they twins?” The question is raised every time I am in public with my children and elicits an inward sigh and a smile as I gaze at their nearly identical measurements but 16 month age difference.

In August of 2009 my husband and I made our final trip to Smolensk, Russia to gain custody of our daughter. At the time Mireille was 17 months old and weighed just under 14 lbs., 27 inches in length. What she lacked in placement on the growth chart, she more than made up for in personality and zest for life. She was a tiny ball of energy and curiosity.

And to our wonderful surprise, just one year and three weeks later we would be returning to Smolensk to gain custody of our son at 14 months old. He was our daughter’s biological brother and we were thrilled to be able to keep them together as a family unit. Merritt was nearly the same size as his sister when he came to the United States, despite the fact that he was over a year younger than her. We found it striking that the two children had such similar experiences during their first year or so of life, but their physical stature would not attest to that. Merritt was still small for his age compared to US born children. At 14 months of age he weighed in at just over 18 lbs., 29 inches in length. To us, he seemed like a giant. We recognized that he still had some gaps to fill in his growth, but we had been prepared for a much smaller child given our experience with our daughter.

When Mireille came home we connected with our International Adoption Clinic at the nearest children’s hospital and instantly knew this was the right group of professionals to guide us. Within the first few months home, we decided it was time to work with a feeding specialist regarding our ongoing concerns for Mireille’s difficulty eating.

What we knew from the orphanage was scant. We were able to discern that Mireille often chose not to eat at mealtimes. (We would later learn this likely had less to do with a lack of appetite and more to do with her own protective instinct preventing her from eating foods she could not physically swallow.) The foods she was offered included porridges (buckwheat and oatmeal), omelets, milk with tea, soup, mashed potatoes, meat loaf, meatballs, stewed fruit, kefir, yogurt, and cottage cheese.

Mireille

What we instantly noticed about Mireille was that she was ready and willing to eat almost anything set before her. In our hotel in Moscow, Mireille seemed insatiable for any form of bread or cheese in particular. We were cautious to try to help assuage her appetite but not allow her to make herself sick. I will never forget eating an apple whole while holding Mireille. Knowing she had not been exposed to fresh fruit and would be unfamiliar with it (and uncertain she was even able to chew it), I had not even thought to offer her any. Before I could sink my teeth into the first bite, Mireille lunged for the apple and started gnawing away like she might never eat again. My husband and I could only stand back in amazement.

Once home, it was clear Mireille was having trouble swallowing anything that was not the texture of mush. And she avoided drinking anything at all. While she clearly wanted to eat, she did not seem physically able. The feeding specialist taught me that Mireille’s chewing abilities were premature. Fortunately, we could conquer that with some simple techniques to practice during meals at home. Knowing children are introduced to an open cup in a Russian orphanage much earlier than we would typically do in the US, the feeding specialist and IA pediatrician agreed Mireille had likely aspirated on liquid at some point in her infancy and was now avoiding liquids as a survival technique.

We thickened her milk with yogurt and her water with applesauce and she gradually became willing to drink more and more. We practiced chewing crunchy foods with her back teeth (demonstrating this while we ate) and made sure she always had at least one crunchy food on her plate for practice at each meal. We also watched her like a hawk while feeding since she was considered a choke risk. This led to all sorts of household rules that made me OCD about cleanliness to the outside world ….in reality it was me protecting my child. No eating in the car; no eating while walking around the house; checking for an empty mouth before leaving the high chair. It all paid off and over the course of the next year she began to progress in leaps and bounds. She is no longer a choke risk, enjoys a wide variety of foods, and is still working through some of the tricky meats that seem to catch so many toddler teeth off-guard.

Our son, Merritt, had a very similar experience to Mireille during his first 14 months of life. Same orphanage, same caretakers, same meals. However, his challenges after arriving home were quite different. Unlike his sister, he was not interested in every food placed before him. Initially this caused me a lot of stress. I felt responsible to make up for over a year of malnourishment and every bite of every meal mattered! For him to prefer a tantrum to a meal set the anxiety bar pretty high at our table. Once home, it became clear Merritt had stronger physical abilities to eat than his sister, but also much stronger emotional fears about food. He sobbed and cried hysterically when any snack time was over. As we had done for Mireille, we allowed Merritt to carry pieces of snacks in his hands anytime he wanted, providing security that food would always be available. We reverted to bottle-feeding Merritt at breakfast. He seemed to take comfort in being fed this way and I was happy to provide that. We also made mealtime a very predictable event so he could know exactly what to expect; a bottle with me in the rocking chair and then scrambled eggs, fruit, and bread in his high chair. Without fail he screamed every morning when the bottle was empty.

Merritt

We still worked briefly with the feeding specialist to improve and strengthen his chewing ability, but his biggest hurdle at the meal table was his own behavior. I heard numerous adoption professionals in the health field emphasize the importance of making mealtime a pleasant time for the newly adopted child. This would prove to be the most difficult task of my day. Mealtime made me crazy! I couldn’t bear to allow Merritt to eat only what he chose (even though his choices were limited to nutritious options I had put on his plate) as I felt this would not bring the well-rounded developmental benefits he needed in order to make healthy progress. But fighting a stubborn child who refuses to eat little more than cheese is a losing battle. Feeding a choosy toddler is certainly no exceptional experience. But feeding a choosy newly adopted toddler comes with a host of questions, “mommy guilt”, and even a little grief at not knowing the source of the fears, dislikes, and tantrums. After consulting with the team of professionals at our IA clinic, I vowed to try my best to be only responsible for what went on Merritt’s plate and how it was presented. What and how much he ate was entirely up to him. Even though I had severe doubts, progress has been made. Occasionally he even volunteers to eat a vegetable. Occasionally. And I still slip into my old ways of coaxing and prodding occasionally, too. It is a daily challenge that continues even now as we approach the first anniversary of his homecoming. Many days feel like we have taken two steps forward, one and three quarter steps back, but progress is being made.

Mireille, home two years, now stands 35 inches tall and weighs in at 23 lbs. I know this is still petite, but 8 inches in two years is a victory for her!! And Merritt, home almost one year, is also 35 inches and just shy of 23 lbs. Six inches in one year even without as many veggies as mom had hoped.

My children are little super-heroes in my eyes. The physical, emotional, and developmental protective habits they created to survive and thrive in sub-standard conditions astounds me. As I watch those survival traits develop into little pieces of their personality, I can do nothing but stand in awe of the stark contrast between “what could have been” and “what is”.


Read more about the diet in Russia, including common foods and recipes: http://adoptionnutrition.org/nutrition-by-country/russia-and-the-former-soviet-union/


The Nutrition Profiles on this site express the views of the individual authors and not SPOON Foundation. SPOON Foundation has not conducted any independent verification of the information contained in the Nutrition Profiles. As a result, SPOON Foundation makes no representations concerning, and assumes no responsibility for, the accuracy of the information or the appropriateness of advice contained in the Nutrition Profiles. You are encouraged to confirm any information obtained from the Nutrition Profiles with other sources, and review all information regarding any medical condition or treatment with your child’s physician.

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