Toddler diet - not enough fat

[AnneLovesGilbert]

DD2 has had a funny tummy for a couple of weeks and not been herself for a few days so I had a call with the GP today. He said it sounds like Toddler’s Diarrhoea and I need to change her diet. Since this started I’ve cut out fibre but he thinks she might be short on fat. She’s my only and I feel like a bit of a dick if I’ve been on the wrong track so could really use some advice.

We’re veggie and she’s always been a good eater but she’s not keen on eggs so she eats loads of pulses.

Typical day:

Porridge - oats and full fat milk

Fruit - banana, easy peeler, apple etc or Greek yogurt

Daal and brown rice/veg lasagne/veg soup with wholemeal bread/homemade pizza/wholemeal pasta and homemade tomato sauce/toad in the hole with veg sausages/lentil burgers with homemade wedges

Crackers and cream cheese/piece of fruit/hummus and veg sticks/dried fruit/piece of toast

Supper is something else from the lunch list

So I need to cut out pulses, wholemeal carbs and veg. I’ll switch to white rice and pasta and up potatoes. She won’t eat eggs like omelette or eggs on toast.

She’s been miserable without the stuff she likes the last week and not impressed by plain rice or pasta and eating way less than normal. I’m stuck on what to give her beyond stuff on toast and plain carbs.

I need her to stop pooing 10 times a day!

That advice sounds strange to give to a vegetarian. The normal advice would be to drink more water, reduce wholemeal / fibre not cut it out entirely, and increase fat. I would suggest speaking to another GP and looking at this link

patient.info/childrens-health/acute-diarrhoea-in-children/toddlers-diarrhoea

*More water if they aren’t drinking enough. Less water if drinking too much

That’s the link he sent me after we spoke. He said, and the page says, to reduce water. She has two normal toddler bottles a day and a bit of mint tea sometimes. I was thinking of getting her on hot chocolate to up her dairy as she won’t drink cows milk cold.

I got off the phone thinking I’ll just start giving her white pasta and chips a lot but that doesn’t seem great.

He was really clear about the fat part, maybe worth talking to someone else as you say.

Maybe just reduce the pulses rather than eliminate them?

Fatty (healthy) foods my kids like are: nuts, avocados, seeds, olive oil, olives, nut butter, coconut.

We put nuts, seeds and coconut flakes onto breakfast cereal in the morning. They love olives for a snack.

Cheddar
Nut butters on toast or used as a dip for wedges of apple
Yogurt
Ice cream

As a general rule wholemeal versions of bread, pasta extra should only be given occasionally to under 5s.

Ye seems like he has only skimmed the advice. I’m part Indian and over Toddler Diahrrhea is often treated first by giving all fluid via warm drinks like milky tea or warm milk or, my favourite, the ‘broth’ from a traditionally made dal. You could maybe try that first with her normal diet while you wait for an appointment?

We're vegan and get lots of fats in, although we eat plenty of pulses too.

Can you add seeds to her porridge? I add chia, flax and/or hulled hemp seeds to my toddler's porridge every morning for the omega 3s.

Nut butters on toast?

Hummus with plenty of tahini and olive oil?

Avocado?

I also bake refined-sugar free cakes and add ground almonds to them. E.g. banana mini muffins or porridge bars.

Can you add in peanut butters snd avocado daily?
We alternate between white and brown rice/pasta/ bread.

DD like this. Turned about to be cow's milk protein allergy.

But that's a lot of fibre for a small child. Can interfere with nutrient absorption.

As a general rule wholemeal versions of bread, pasta extra should only be given occasionally to under 5s.

Christ, I had no idea. She’s always just had what we do. What does it do to them, just too much fibre?

She’s 3 in the spring and never had issues till a fortnight ago.

She eats loads of peanut butter, loves it. And avos. I’ll up those.

I make the hummus and can put more oil in but I thought the pulses might be bad.

Thanks for all the advice. She’s always been such a joy to feed and this has really thrown me if I’ve been giving her the wrong stuff.

Thank you Ozanj. He said he’ll see her in two weeks if no improvement but it was a mission even getting a phone call.

@AnneLovesGilbert

As a general rule wholemeal versions of bread, pasta extra should only be given occasionally to under 5s.

Christ, I had no idea. She’s always just had what we do. What does it do to them, just too much fibre?

She’s 3 in the spring and never had issues till a fortnight ago.

Too much fibre so they can feel full before they’ve had enough calories.

If it doesn’t improve with any of these changes that have already been suggested, it might be worth eliminating gluten ( wheat barley and rye ) for 4-6 weeks to see if that changes the symptoms.

It will only be a tiny change for her, she won’t even notice.

It won’t be hard for you as you already eat a good diet with lots of naturally gluten free food, like dairy, veg fruits and pulses, rice, potatoes.

Just use rice cakes or Gf oat cakes instead of bread / crackers. You can buy GF bread but most of it isn’t very nice.

She won’t be able to tell the difference with GF pasta and pizza bases.

If you buy sausages , yoghurt etc etc you will need of check the label as many contain gluten .

Treats need to be ice cream , Crisps, chocolate or sweets ( check labeLs ) and not biscuits or cakes of course ( unless you bake them Gf) .

Good thinking Double, I have gf flour in and bake quite a few gf things as a close friend is coeliac.

If you have diarrhoea, eating dairy foods can make it worse ( I was told this by a paediatric bowel surgeon ) so you might need to cut them out until it stops then reintroduce it.

@chaos76

If you have diarrhoea, eating dairy foods can make it worse ( I was told this by a paediatric bowel surgeon ) so you might need to cut them out until it stops then reintroduce it.

Only if you have temporary lactose intolerance caused by illness

I make a curry for my veggie son where you sauté sweet potatoes and onion until softened, then add a large dollop of peanut butter, small tin of coconut cream and some mild curry powder and / or garam masala. Simmer until the sweet potatoes are soft and serve with rice and plain yoghurt. There are three kinds of healthy fats in it and it always goes down a treat.

Should also add my son has had a dodgy tum for a few weeks and we were advised to cut dairy in case it was temporary lactose intolerance caused by a bug. He has been dairy free for two weeks and he has improved a bit, we’ve been told to do another two weeks and then we can start re-introducing it and see how it goes. Might be worth considering if that could be the case with your wee one.

@chaos76

If you have diarrhoea, eating dairy foods can make it worse ( I was told this by a paediatric bowel surgeon ) so you might need to cut them out until it stops then reintroduce it.

The thing about trying Gf for a month or so is that is a bit of a hassle for you but it won’t upset your DD . I’m assuming she won’t get us out if she had rice cakes or oatcakes or GF bread ( if you can find a decent one or bake your own).

And it’s not got any nutritional implication as you are not cutting out a food group ( though it’s amazing how many people seem to think that wheat is a food group ).

If it makes no difference to her symptoms than at least you have ruled out one possible issue. But you will need to check Labels for any processed foods - it’s in random things like crisps, yoghurt, rice crispies. And you will need to give it a few weeks .

@AnneLovesGilbert

As a general rule wholemeal versions of bread, pasta extra should only be given occasionally to under 5s.

Christ, I had no idea. She’s always just had what we do. What does it do to them, just too much fibre?

She’s 3 in the spring and never had issues till a fortnight ago.

This has been widely debunked. You can still provide these foods regularly to under 5s (aside from your direct gp advice in this instance)

As someone with a coeliac child I shy away from recommendations to go GF before diagnosis.
If there is a chance of coeliac, being diagnosed (blood tests / think they skip biopsy for children these days) requires eating loads of gluten at the time.
Going GF and seeing a benefit may then require going back gluten for 6 weeks before testing to get the full coeliac diagnosis which could lead to worse symptoms as they've partly recovered while GF.

My Son had toddler diarrhea. We had to change his diet to hight fat, low fibre which seemed so strange when trying to give him 'healthy' food! We found a comprehensive NHS food list for toddler diarrhea. There were loads of fruits etc that he had to avoid eg grapes and raisins.

Toddler diarrhoea is a separate condition from 'normal' diarrhoea. It is a chronic condition that can last years. It needs to be treated differently to acute diarrhoea (eg stomach bug).

We had exactly the same circumstances and got told the same advice. I was skeptical, given I considered his diet to be very healthy but the dihorrea did indeed stop once he had more fats and plain foods.