When you have kids with hypoglycemia food is often the most important medicine. That is something that can put a lot of pressure on both kids and parents around meal time. For us, situations around food and eating have been heartbreaking, full of conflict and coercion. This is partly because our kids are still too young to understand their disease and the consequences of not eating in time. We have been through almost every situation imaginable when it comes to eating. At times we have been so desperate that we let the kids eat under the table, on the table, in bed, in the bathtub, and while they were playing. We have tried coercing them into eating vegetables, rolled oats, potatoes, raw pasta, boiled pasta, whole grain bread and so on. In the end, three year old Noah was crying in his bed every time he had to eat. Out of pure desperation our solution was for both kids to have access to their own candy drawer in the kitchen. It would be full of sweets and snacks for them to eat whenever they felt like it. It meant that the kids would eat, but they were living on foods that were high in calories and simple sugars and low on other nutrients like vitamins and minerals.
A life-changing decision
When we reached that point we had been living in a state of emergency for about four years; we knew that this way of living was not sustainable for any of us, or the kids blood glucose. A big decision was made, and we reached out to a nutritionist, Susan Helany, and she agreed to help us. We made this top 10 guide because we want to pass on the strategies that worked for our family as we hope this might inspire and help others in a similar situation.
I would like to add that we are not super-hypo-parents. Some days are better than others. Sometimes we fall back into old habits, sometimes eating situations go completely wrong and we end up telling our kids off instead of looking at what we could have done differently. The advice we pass on here, are the things that always help us get back on track – sometimes we get back to our new routines quickly and other times it takes much longer. Either way is fine and every small step counts. As you know, time and energy is a rare commodity as a hypo-family. That is also why we are going to say the same thing that Susan Helany said to us: Take one small step at a time. If one step is too much, take half a step. The changes need to be manageable for you and your family. Once you have the first step sorted, take the next one, and hopefully you will see the positive change in your kids’ blood glucose and hypoglycemia.
1. Veggie snacks, veggie snacks and more veggie snacks!
Available snacks! Vegetable sticks or vegetables cut into mouth size pieces need to be available at all times, to make sure the kids has access to stabilizing their blood glucose at all times. Sometimes we also include berries and fruit. The foods that are available are the foods that will be eaten (again pretty much a quote from our nutritionist). Our kids have now learned to regulate their low blood sugar by eating more intuitively as they know that (healthy) food is always available. We use this strategy in many situations. When we go to the playground, we bring snacks in a bowl or a small bag. However, when the kids are playing, they will often forget to eat. For any other kid that is not a problem, but when your kid suffers from hypoglycemia, it can be disastrous. This means that we have to help them remember their snacks to keep them at an acceptable blood sugar level. We might give them some snacks when they have a break from playing or sneak them in whenever we see a chance to give them something. At the moment their favourite vegetables are:
- Carrots 🥕
- Bell peppers/capsicum
- Cucumber 🥒
- Cherry tomatoes 🍅
- Broccoli 🥦
We have used great inspiration from this blog, to find new snacks and new ways to prepare veggies
2. Include your kids when you are cooking – and see your kids grow with the task
Include your kids! They would love to be includet when you are cooking, and get familiar with different foods, tastes and textures. In the past cooking was one of the most stressful things on my daily to-do list, because of my ongoing lack of sleep. It was just something I needed to fix and be done with so I could spend time on some of the other things that needed to be done. Our nutritionist pointed out that our kids love spending time with us, and instead of seeing the cooking as something that took time away from the kids, we could consider making it a family activity. That meant that my view on cooking and preparing meals completely changed. Noah is turning five this year and Savannah will be three years old soon. Even though they are young, there are still things they can help with in the kitchen. We will give them a task each such as rinsing vegetables, grating carrots, stirring the pot, tasting the sauce or similar things that they can accommodate at their age. But every day is different. Of course there are days where we are tired and feel like it would just be easier to cook the meal without the kids – BUT seeing the joy in their eyes when they are about to eat a meal they themselves helped prepare, gives us that little nudge we need to find the grating iron and a carrot or finding that extra spoon for the pot so they can get involved in the meal.
This blog helped us when we needed to find inspiration to what the kids task in the kitchen could be, fitted by age:
3. Messy but goodie
Let your kids get messy with their food. We found this one to be especially important as we have young kids. Let your kids use their hands to investigate new foods. When they make a big mess of things, don’t worry about it. Instead, focus on enjoying the meal with your kids. Yes, you will have to clean up after them, but in time, they will make less of a mess. No matter what age your kids are, trying new foods can be a big thing. Let them touch the food, and let them investigate the texture and flavour of it in their own time. If they refuse the food when you first introduce it, don’t fret. Introduce it again at another meal. And again. And again. It might take two, three, ten or even 20 times before your kid is brave enough to try the food.
Susan, our nutritionist made this very clear! You HAVE to be introduced to and taste the food several times, before making any conclusions to whether our kids like the food or not.
When it’s hard to handle the mess, take a look at this amazing blog, writing about all the benefits of messy kitchens and happy kids!
4. Be the good example
This one is absolutely essential in all aspects of raising a child. Unfortunately, it can also be really hard. In this case, being the good example is about your own eating habits. If you haven’t grown up with vegetables and many different foods as a part of your diet, it can be tough being a good example – at least in the beginning. You don’t like broccoli? Well then get in the kitchen and figure out how to cook broccoli to your taste. Maybe you don’t like it raw, but what if you boil, bake or marinate it in your favourite spices? Or make it even easier and start with the vegetables you know you enjoy eating. Luckily I found my veggie-bible here:
https://www.nerdfitness.com/blog/vegetable-haters-how-to-start-eating-vegetables/ . Read it, love it and give it a try. And until then: Fake it until you make i – your kids are wathing!
5. Include at least one vegetable at every lunch and dinner
Make sure that you have at least one visible vegetable at lunch and dinner. Including more vegetables has been a big change, but also one of the changes that have made the biggest difference.
We have found that including more vegetables in the diet makes for better regulation of blood glucose and happier kids. We have found that the more we expose the kids to vegetables, the more they accept them as a part of their diet. Our kids love love love broccoli and always choose broccoli over other vegetables. Your kids might find another vegetable that they enjoy. Remember! Try to find the kid inside of you, when you try to think creative in preparing your veggies. Broccoli, in every shapes and forms, is my Noahs favourite veggie of all time! Specially fried in just a bit of butter, and a good bunch of garlic. He will then dip in ketchup like you would with chips – the more ketchup the better if you ask Noah. We found great inspiration in this blog, to make the veggies fun and welcomming to look at:
6. Include your kids when you go grocery shopping
Like the cooking, grocery shopping was one of the things on my daily to-do list that I just wanted to get done as quickly as possible. That meant that I saw it as a time consuming daily task that took time away from my kids. I had to make sure that my husband was home so I could go to the shops alone. As with so many other things, Susan questioned this. We learned that we could plan the grocery shopping as a weekly activity or even a daily activity if needed. I learned that I didn’t have to wait until my husband got home to do the grocery shopping. I could just bring my kids and include them in the shopping – just like we did with cooking. Maybe the grocery shopping takes an hour instead of 20 minutes, but I promise you my time is well spent. Our kids enjoy the trip and they have more influence and ownership over the food that is bought and prepared for meals. Before we started doing this our kids didn’t know the difference between a cucumber and a carrot. Today, they know what eggplant, zucchini, broccoli etc. is and will help me put it in the basket when we are grocery shopping together.
This super cool Australian super-mom, made a post about how to prepare for the grocery-shopping-date with your kids. You can do this! https://picklebums.com/kids-grocery-shopping/
7. No food is forbidden! No, not even chocolate
After a life of dieting and being on more or less extreme diets, I was a bit shocked and very confused when Susan Helany told us that no foods were off limits for us or the kids. This was an advice that I didn’t follow straight away, but Susan convinced me to try it out as Noah was affected by the no sugar policy I had been trying out. The issue was mainly in social situations out of the home – for example if there was birthday cake at the kindergarten.
Susan’s words didn’t mean that the kids could just eat sweets whenever they wanted to. It did however mean that they could still have sweets, chocolate, popcorn, cake, crisps and so on, but we would put a new structure around it. That meant emptying the “candy-drawer” so sweets were no longer freely available in the kitchen. In the first couple of weeks we did remove all sources of refined sugar to see how well their blood sugar stabilized. We then reintroduced different sweets and snacks in moderation. We followed Susan’s guidance carefully in terms of when, how and what amount to introduce to the kids – Not just to regulate their blood sugar, but also to ensure that they weren’t affected negatively in social situations. For example going to birthdays or dinners with family members or friends, we would do our best to make sure that the kids had a main meal before they would eat something high in sugar. It would also only be in smaller amounts so they wouldn’t end up with hyperglycemia just to crash into hypoglycemia. Popcorn, crisps and chocolate works really well for us, but we have to be more careful with jelly beans and similar sweets.
If you haven’t already checked out pinchofyum.com now is the time! This blog is made by the amazing former 4-th grade teacher, Lindsay, and now full-time blogger. It is a marketplace of recipies that will secure an entrance for food-heaven! This article about small low sugar snacks, is a pinchofyoum favourite of ours:
8. Listen when your kids tell you that they are not hungry
If your kids aren’t hungry, don’t coerce them into eating. If they are not hungry, save their plate of food. Put it in the fridge so when your kids are hungry, they can have that meal. This took us a long time to implement. The strategy was that if the kids didn’t want to eat or didn’t feel hungry when we were eating at the table, we would put their plate in fridge for later. They would be no snacks for them to nip on instead. When they then came to one of us because they were hungry we would find their plate from before and reheat their food for them. Our kids weren’t used to vegetables and in the beginning; they didn’t really want their dinner. Most evenings we would have to put their plate in the fridge for later. After about three months, the kids figured out the strategy, and today they almost always finish their meal.
We struggled. A lot. But when we read about the longterm damage, we knew we needed to stop trying to coerce hem to eat. Take a look at this:
Remember that if there is a new food on the plate that they might leave it on the plate. That is okay. The point of this isn’t to get them to finish the plate (it is always okay to leave food on the plate when you are no longer hungry). The point is to set a structure to the meals so they know that if they can’t eat it now, it will be there for them later. Getting the kids to eat a regular main meal will help keep their blood sugar more stable and keep them from crashing.
9. Meal time is family time
Meal time is family time! Make meal time about being together and enjoying each other’s company. It still baffles me to realize that the fact that my kids didn’t thrive. I realized, the fault was on us. We realized how much stress meal time had been causing us, and that was why we had never had a meal together as a family of four. Basically, we were just in the kitchen or living room doing chores and commanding our kids to eat their food. The entire situation would be tense. We were a pair of seriously frustrated parents that would just overwhelm our kids with our feelings. Today, we eat together. Tension has been replaced with calm and commands as be replaced with casual conversation. If someone isn’t hungry at meal time that is respected, but it is still expected that every one sits at the table and join in family time. We made some research about the importance of family-dinner. With a scientific approach, fatherly.com made this article to sum op the importance of family dinner, and why it should be a high prioritize in the every day life: https://www.fatherly.com/health-science/6-reasons-eating-family-dinner/
10. Hypoglycemia is always an emergency !
When your child has hypoglycemia, you should always have an emergency kit ready at hand. That means keeping things such as juice, soft drinks or other beverages containing sugar nearby. Hypoglycemia is always an emergency, and when you reach that point, you do whatever it takes to raise the blood sugar. Simple sugars are first priority, and after that you can think in terms of more starchy carbohydrates such as bread, pasta, rolled oats and even corn starch. If your child has a g-tube, use it!
All rules and well-meant advice goes out the window. Hypoglycemia is an emergency and you should treat it as such. You know your child best, and know what works better. Popcorn works well for us if the kids don’t want to eat anything. Now that we have the G-tube we also have the option of tube feeding using cornstarch dissolved in water.
The advice in this guide is based on the dietary changes that were made under the guidance of our nutritionist Susan Helany as well as the endocrinologist who has been treating the kids since they were diagnosed. The dietary changes were deemed safe for us as the kids had just gotten their G-tubes and tube feeding was an option for emergency situations. We hope that you find inspiration from our story. If you plan on making major dietary changes make sure you include your child’s doctor and consult with a nutritionist or dietician.
The dietary changes have changed our lives. We have gone from having kids with disordered eating and well on their way to obesity to having kids that happily eat a variety of foods and they are now a normal weight for their age. The biggest reward of all is to see how the kids are thriving in spite of their ketotic hypoglycemia.
If you have not yet read our background story, take a look at
http://hypomom.com/hypo-story/ were you will get a short view of our life living to stabilize blood glucose with ketotic hypoglycemia