Blood work results

We received the report from the University and it indicates that Favorite Girl is a healthy little girl. Thank goodness! Thank you for all of your prayers.

The speech and swallowing report state, "The Bzoch-League Receptive Expressive Emergent Language Scale , with both parents as informants, revealed that FG's receptive and expressive language skills are at expected levels. In fact they are somewhat above expected levels. FG's speech and language development appear to be as expected, at this time. Her parents reported that they thought her language development was at the same level as other same age peers at her day care. FG's oral motor skills and swallowing appear adequate."

The report from the Pediatric Growth Clinic states...

Review of Systems
"FG is a healthy girl with occasional colds as noted in HPI, all other review of systems negative."

The report then lists the results of FG's blood and the acceptable range for a girl her age. There were 40 different tests ran on her blood. The only thing that came back to "review" was her Mean Corpuscular Volume. Hers was 79FL and the acceptable range is (75-90). I looked this up in a lab book at the hospital and it stated that it may be low in strict vegetarians and people that are anemic. I guess it makes sense that she is on the lower end of the range since she will not eat very much meat...other than hot dogs, and I'm not quite sure what nutritional value comes from a hot dog.

Impression
"Twenty-five month-old female with lack of normal physiological growth and behavior concerns"

Plan
1. FG should be fed in a high chair instead of a booster chair, so that she cannot remove the back of the chair. The high chair should be far enough from the table that she cannot kick he high chair over. Mealtime should be a pleasant time, avoiding tension and fights over food. If parents feel frustrated with feeding, they should hide their frustration from FG.
2. Distraction should be limited during mealtimes. TV off and put dog in a separate room during dinner.
3. Parents and children should sit at the table together during mealtime. If children want to get up from the table, they should not be allowed to return to the table to eat until the next meal or snack.
4. Meals should be limited to 3 full meals and 3 snacks per day without grazing between meals. Meals should last 20 min, and snacks 15 min unless active eating is taking place in which meal times may be extended.
5. FG should be offered solid foods first during mealtime and a drink at the end of the meal to prevent filling up on liquids.
6. Juice should be limited to 4 oz per day.
7. Water, pop, Popsicles, Kool-Aid, and other low calorie dense foods should be avoided. Instead, FG may eat fudgesicles, fruit with Cool Whip, whole milk or other calorie dense foods.
8. Meal time recommendations should carry over to daycare, so that FG receives calorie dens meals at daycare and avoid behavioral conflicts.
9. FG's father should take responsibility for the majority of the tooth brushing times to avoid conflict.
10. A follow up appointment will be scheduled in the Growth Clinic for 2 months from original appointment to discuss progress.

Everything they told us was common sense and things we were already doing except for FG did eat in a booster at the table, we did not limit meal and snack times to 20 and 15 minutes respectively. Each meal lasted about 1.5 hours at our house. We also offered water all through out the day, and prior to this appointment our kids did not get to dunk everything they ate into some high calorie dip or frosting.

We have made the changes they recommended and I thought we were doing really really well until Monday! FG and mommy were at their wits ends with one another and then on Tuesday mommy discovered FG's 2 year molars are coming in. I can tell she is in a lot of pain and the feedings definitely are not going so well but we will get back on track as soon as the teeth are in.

Daddy continues to live in CR helping everyone recover from the flood. We miss him lots!