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Daughter not eating all of lunch

Discussion in 'Parents of Children with Type 1' started by Momto3, Oct 4, 2011.

  1. Momto3

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    Hi everyone,

    For a while our seven-year-old DD was going low at lunch, so we started adjusting basal rates and ratios with good luck for a few days then back to going low. We finally figured out, after heavy questioning, that our DD wasn't eating all of her lunch. She is a very picky eater. It did get much better after DX but still tricky.

    We talked to her about the importance of eating and how serious it was if she didn't eat. That same weekend her friend slept over and told us her mom has type 2 and her grandfather had type 1 but died from going low. I thought we might have gotten through to her because our daughter looked scared. (That was not a planned conversation, this girl decided this is what she would tell us.) We had two good weeks then yesterday DD had a low again. When I say low, I mean 39.

    I didn't handle the situation well at all. I yelled at her out of frustration (please no judgments). I realize this is about control and not the food but it still needs to stop. She is going low at recess (which is after lunch) and has to leave the playground to go to the health room. I have tried including her in the lunch-making process. Talking to her only helps for a short time.

    I spoke to the nurse yesterday. She wants DD sitting near the teacher at lunch. Right now the teachers eat together at a different table. Her concern was getting DD's "non-compliance" under control. For some reason that wording struck a nerve.

    I am going to call the endo's office today to get some help. I am also going to talk to a friend of mine who is a social worker. Has anyone had a similar experience? If so, how did this get handled?
     
  2. Beach bum

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    Question, are you pre-bolusing for lunch? Is she having a morning snack, how close is that to lunch?
    My daughter at that age was incredibly social at lunch time. She also was not a predictable eater, so we ended up bolusing her after. Not ideal, but necessary. Also, we found am snack was just too close to lunch and she really, truly, was not hungry. So, I started giving her a bigger morning snack and smaller stuff for lunch.

    I would just talk to your daughter about how important it is to have energy to fuel her body for the rest of the school day, so she really needs to eat. There were some days that my daughter would need to go eat with her teacher just because a morsel of food didn't even pass her lips. This seemed to cramp her social style and that problem was nipped in the bud. But, I can honestly say 1st/2nd grade she could have not eaten any lunch and be perfectly happy.

    Try not to let the food frustration get to you. I know how hard it is, but you don't want to have a power struggle with food. As for the non-compliance comment, she is not being non-compliant, she's being 7. The nurse had no right to say this, and I think a chat is in order. Her idea of non-compliant and mine is very different.
    As for the friend, I think if she brings it up again, I would just say to her, "I'm really sorry about that, but things have changed since then, and lets not talk about it any more." Don't downplay her loss, but also don't let her continue to keep talking about it. Just reassure your daughter that the reason every keeps an eye on her is to keep her safe and healthy.
     
  3. hawkeyegirl

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    My son is 7 too. How we deal with this is that he is bolused for a certain number of carbs before lunch (15-20), then after lunch, he brings his lunch bag/tray to the nurse, she looks to see how many carbs he actually ate, and he is bolused for the rest. That way he doesn't have to eat everything if he's not that hungry.
     
  4. Momto3

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    Thanks for the positive reply with great suggestions. I was feeling really crumby when I posted and your response helped me reframe my thinking.

    I do think the time DD eats lunch may be a factor: she eats breakfast at 6 a.m. (she's at school by 7:30 a.m.). There is no scheduled morning snack; If DD wants one she is free to have one but she's had no interest. Lunch is at 10:20 a.m. The class has a scheduled snack at 2 p.m. and she has an afternoon snack daily. By that time she is hungry.

    I just received an email from the teacher who plans on rewarding the kids with the ability to eat with a buddy as a reward. Right now they have assigned seating. Guess who was chosen for this week? The only rule to the new system is the two buddies have to eat and not just socialize. DD's teacher chose a boy who she has a crush on - she's going to be thrilled so this may help. He's a very sweet boy.

    I agree with your comment about not making this a struggle over food. Let's face it, food is a very big deal in our children's lives. I feel horrible about losing my temper yesterday - bad mom moment definitely. We are going shopping for foods DD loves today - may change tomorrow but we'll take it one day at a time.

    I agree I need a chat with the school nurse. Her heart is in the right place, it's presentation that is often an issue. I have bitten my tongue a number of times because we need her on our side and I know she's easily offended, but the non-compliant wording was a bit of a slap in the face. I'm not sure what is not sitting well with me about it but it is really bothering me. I'm going to have to choose my words carefully when bringing it up.

    Thanks again!
     
  5. Momto3

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    OH and to answer question about bolusing - we do it before lunch. Making food consumption all the more important!
     
  6. Momto3

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    That might be another great idea! I am going to suggest this to our nurses!
     
  7. Christopher

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    I am assuming your daughter is on MDI? If she is on a pump then I don't see what the problem is. You can split the bolus without having an extra shot. Or just bolus after she eats for whatever she eats, most school lunchtimes are very short.

    One thing I would NOT do is make her sit away from her friends at the teachers table.
     
  8. Amy C.

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    I would reevaluate this. She should be allowed to eat what she wants and get the shot after lunch. There is no reason to have this battle when the timing and amount of the insulin can be adjusted to what she eats.
     
  9. tiger7lady

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    I also agree that you should just bolus after lunch for what she ate rather than pre-bolusing. For as short as school lunches are and one meal out of the day is not going to make all that bit of a difference. Until she is older and more reliable on what she is going to eat this would be the way to go to keep her safe.
     
  10. DsMom

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    My son gets his bolus before lunch, too...we've found it not as effective to bolus afterward. He had a small issue with finishing his milk at the beginning of last school year. We simply have the lunch aides check to be sure he has eaten and drunk everything given to him at the end of the period. It is written into his 504 plan. It is a simple fix, no drama. Now, there is no problem. He does not like to sit there after everyone else has left the lunchroom to finish his food...so he always finishes on time and eats everything.

    At home, if he really does not or cannot finish what is on his plate (which is rare, we start with probably less than what he might want, and then can bolus again if he wants seconds), I will estimate the amount of carbs left on his plate and give him glucose tabs to cover the difference.
     
  11. kyle and ryans mom

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    My son is 7. He eats lunch and brings the tray to the nurse. She then boluses for what he ate. Some day he eats a little, some days a lot. It just works for us at his age.
     
  12. NaturallySweetSisters

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    I have two little girls with Type 1 Diabetes. All through elementary, the girls were post-lunch bolused.

    In each of the their lunch boxes, I pack a little slip of paper that has each item, the portion size, the amount of carbs per item in the portion and the total carbs for the entire portion.

    For example,

    Item Serving Size Amount per Total
    Apple 10 slices 2 carbs each 20 carbs
    Sandwich 1 sandwich 20 carbs 20 carbs


    Total Lunch 40 carbs

    If one of my kids chooses not to eat the entire apple, for example, and only eat five slices, than the aide deducts the proper amount of carbs and doses only 30 carbs in total. This was the only way we could figure out in being able to handle partially eaten lunches. But it works and the food is not an issue at all.

    By 5th grade, my oldest daughter is mature (and hungry!) enough to eat all of her lunch. She does pre-bolus before walking down to the lunchroom. I still fill out the same card and she reviews it and doses. Then she glues it into a spiral bound notebook with her BG written on it. Kinda like a running log book. It is super easy to keep track of that way too.

    Hope this helps,

    Amy

    www.naturallysweetsisters.com
     
  13. hawkeyegirl

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    It works really well for us. We still get a predose in, which prevents a huge spike, but he doesn't have to eat anything he's not hungry for - just like the other kids. :)
     
  14. Sarah Maddie's Mom

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    Will the whole class participate to the same degree in the "buddy for eating " scheme? It just concerns me that if she's not all that interested in food at 10:20 AM "lunch" but is hungry and eating at the 2:00 PM snack then quite possibly she simply isn't all that hungry at "lunch" and making it a competition with a reward is just complicating an already complicated situation.

    As Karla said in her last, "just like the other kids" which I think, as much as possible it the overarching goal. If the buddy system is going to be more aggressively enforced due to her diabetes, then I'd look for other solutions, many of which have been articulated by previous posters.
     
  15. virgo39

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    I can understand your frustration -- and I've certainly BTDT in terms of reacting to my own DD in a way that I later wished I hadn't. It is hard to be vigilant and relaxed at the same time!

    Like some of the others, my 7-year old DD usually gets a pre-lunch bolus for any correction plus 15 g of carb and is bolused for the rest after (she takes the remainder of her lunch to the nurse.)

    We are STILL adjusting basals for the school day (I can't believe we haven't figured this out yet!).

    Good luck!
     
  16. AlisonKS

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    our son has low muscle tone, which makes it harder for him to eat-his mouth gets tired of chewing. So we solved lunch by not packing that much-sammy and fruit roll. He gets wheat thins for a 9 am snack so he's not starving. We load him up on calories/carbs that he needs for bfast and dinner ;)
    A lady in the lunch room makes sure he finishes, if for some reason he doesn't, there are some fruit snacks in the office for him to eat-he'll always eat those lol. We also give the shot before lunch, it's just easier with timing so he can run off to recess right after lunch.
     
  17. Beach bum

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    Talk to your endo about this. You may want to revisit your school lunch bolusing plan for the time being. Some do half up front, the remainder at the end or as we do, wait for the whole meal to be finished. This would also put an end to the "non-compliant" situation as your nurse calls it.

    We also found with my daughter that the lunch period was just too short. So, I started making lunches of quick easy things to eat like yogurt, 1/2 sandwich etc.
     
  18. hawkeyegirl

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    Yes! My son is a big eater and a relatively quick eater, but there is just not a lot of time at lunch for most kids. I cut his sandwiches into strips, break cauliflower down into little pieces, only include a few chips, etc. Somehow if the lunch doesn't appear as "overwhelming" to him, he can eat more overall. (And cutting the sandwich into strips really helps the nurse carb count if he decides not to eat all of it.)
     
  19. Momto3

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    I spoke with our endo office and that was their solution too.

    When do you take blood sugar when bolusing after eating? Sorry if that was a dumb idea.


    To the person who asked if the entire class is in on the buddy system - yes. Nobody knows why it is being done except the teacher and me.
     
    Last edited: Oct 4, 2011
  20. Amy C.

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    You test before eating and get the insulin after eating based on the before lunch reading. No need to do another test.
     

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