Thursday, January 20, 2011

A sneaky parent’s guide to getting your child to take their vitamins

For those of us parents that take the biomedical path in treating our kids with autism, we are often completely stymied as to how to get all of those expensive vitamins and supplements down the gullet of our ever-moving children. This is made even more complex if you have a child who is too young to understand how to swallow pills, or if you have kids like mine that lack the motor coordination to get their tongue to cooperate in the pill-swallowing process. Some day they’ll figure it out. I hope. Sooner than later. Please.
Since I’ve agonized over the vitamin dilemma, I am going to give you some free advice based on the successes I’ve had with this issue. But unlike most free advice, mine is actually good. Trust me.
Things to Consider
1.       Does your child eat anything you put in front of them, no matter the color/temperature/texture/taste?
Okay, so this is sort of a trick question to see if you’re paying attention. I imagine that your answer is a resounding “NO!” Most moms struggle with picky eaters at some point, and that includes moms of neurotypical kiddos. If your answer is no, then welcome to the club. Be prepared to change your game plan as often as necessary. We’re going with the flow here, or at least, we’re trying to make a good effort while our teeth are gritted behind a Stepford-like smile.
2.       Does your child have difficulty swallowing or do they have a strong gag reflex? 
If your answer is yes to either part of this question, then teaching your child to swallow pills should probably wait until they are older or have learned to better overcome their motor/sensory issues. Feeding therapy might be a good idea to aid what you’re already doing at home. If you, like me, do not enjoy your child making the face and sound of a cat coughing up a hairball (rendering any vitamins in their mouth into a slobbery and unusable mess), then just wait to cross this bridge. But, don’t fret! There are things you can do to help your child take their vitamins. More on this in a moment.
3.       Can your child only palate certain textures?
If your child can only tolerate certain textures in their mouth, then giving them the wrong thing could cause a tantrum, hunger strike, flying food, or other ghastly calamity that us worn out parents don’t have time or energy to deal with. You might want to stick with what you already know. There’s actually a lot that can be done with different textures, so hooray for that! And yes, I know you’re still waiting. Patience is a virtue, people.
4.       Does your child respond to rules, a picture schedule, or rewards for positive behavior?
If your answer is yes, then we’ve got even more to work with here. Do not despair! We have options. Let’s check them out now, shall we?
Hiding the Goods
If you have a child with feeding-related motor or sensory issues, this is where your creativity comes into play. I used the hiding method for a long time. Each day I would create a concoction for my boys based upon what I knew they could handle at that time. To aid this process, I looked for as many supplements as possible in a capsule form. This way, I could open and empty the contents into my culinary creation du jour. If something wasn’t available as a capsule, I purchased the tablet form and then pulverized it in my mortar and pestle. OK. So now we have vitamin powder ready to use. What do we do with it?  
Tried and True Vitamin Vehicles
Juice – I dusted off my juicer when my kids were diagnosed, and guess what I discovered? Juicing is an excellent way to not only provide wonderful nutrition to your kids, but vitamins can hide inside the delicious juice! This can depend on the solubility of the powdered vitamin and sometimes how well you mix it. Trial and error works best with this. Unfortunately, you might lose a few vitamins in the process of learning what will mix in well and what won’t. Start out with simple juices like apple or orange, and then you can move on to more complex things like kale and strawberry. Yes, you read that correctly. If you juice something “yucky” (you know, anything green), you will be amazed how adding a nice supply of rich berries can mask the flavor. I used to call my green juices funny names, like Silly Strawberry juice. “Yes honey, the juice is a funny color, but that’s what makes those strawberries so silly!” Get it? You can get really creative and do things like carrot, apple, beet, spinach, cucumber, and blueberry juice. As long as the fruit taste outshines the vegetable taste, you can call the juice the name of the strongest fruit flavor (like in this example, it would be crazy blueberry juice). You can also joke about the color. If color is an issue, try serving the juice in a covered cup with an opaque straw.  
Smoothies – Along the same lines as juicing, smoothies are an excellent way to hide vitamins and introduce additional nutrition. The bonus with this method is that you can hide more without the child noticing. This was my preferred method for over a year. In times past, I would toss the following into a blender: frozen organic fruit, liquid cod liver oil, protein powder (I used yellow pea protein because my kids were allergic to everything else), their daily vitamin powder (from all of the capsules I emptied), and then I would add freshly-made juice, spring water, or coconut milk. The key here is to get the consistency correct so that it’s not too thick for them to drink, and that it’s not too thin where they can taste the grit of the various powders. Experiment! You’ll find something that your kid likes.
Mixing – On more difficult days, rather than making a smoothie I would mix the vitamin powder into things like applesauce or oatmeal. I’ve even gone so far as to mix the powder into sunbutter or jam before I added it to their sandwich. If the food can hide the powder, then it’s worth a shot. This is where your knowledge of what textures and tastes your child can tolerate can really help you in selecting the right food. I alternated this method with using smoothies for over a year, and it worked well.  
Sprinkling/Baking – If none of the other methods work, try sprinkling the vitamin powder on top of a couple of pancakes and gently press the powder into the batter before you flip it on the griddle. Keep in mind, some vitamins are sensitive to heat, so this may not be an appropriate method for you. Baked treats also hide vitamin powder well. Try adding the powder to a couple of cookies or muffins that you designate in a batch as ones that need to be eaten first. Again, some vitamins will not tolerate the heat of this method and you also need to do this in perspective of what your child can handle with food textures, tastes, etc.
Many vitamins and supplements can be found in a chewable form, which is actually one of the simplest ways to get vitamins into children. Since the vitamin count has gone down for my boys, this is our current method of choice. It took me awhile to figure out what brands they liked the most, and there were a few big-time losers along the way. Right now our fish oil of choice is Minami Nutrition’s MoreEPA in strawberry flavor. We also use Nature’s Plus Source of Life Animal Parade products for much of our remaining vitamin cocktail. These vitamins are free of common allergens like wheat, milk, soy and yeast and there are no artificial colors or preservatives. What I like the most about this brand is that the nutrients are derived from food, which the body recognizes and can use. Pardon me while I step on a soapbox… Traditional vitamins you find in most stores are synthetic, and the nutrients are created in a lab. The body isn’t able to utilize synthetics in the same way it can with naturally-derived vitamins, which means those vitamins are not being absorbed and there is little effect. You might as well throw those vitamins in the toilet, because that’s where they end up! So, I stick with food-based vitamins because I know I’m actually getting some bang for my buck. Alright, I’ve stepped off the soapbox… I buy all of our vitamins and supplements at a local vitamin/health store, and in the past I’ve purchased them online from vitamin retailers. There are many great brands out there that are bioavailable and formulated for kids. A popular brand among autism families is Kirkman Labs, although I have no personal experience with this brand. In my opinion, the cost and a child’s taste preferences can heavily influence what brand(s) you choose.   
Sometimes there are significant issues with getting a kid to take vitamins, for many different reasons. When all else seems to fail, you might look into high-quality liquid vitamins. The only company that I know of that has a whole line of liquid vitamins is BrainChild Nutritionals. I have never used them myself, but know families who recommend them.
Supportive Structure and Rewards
Did my kids always cooperate with my sneaky attempts to give them their daily vitamin regimen? Heck no! This is where setting up a supportive structure and reward system rescued me. Most kids on the spectrum respond in some way to rules and boundaries. If not, then they might respond to a picture schedule or social story. If not any of those, then a reward system can often help. I actually used all of these systems in my home with great success. Want to learn more about this very topic? Well, I hate to disappoint you, but my fingers need a break from typing. Tune in tomorrow and learn how these techniques can help, not only with vitamins, but with other daily tasks and difficult behaviors. Remember, patience is a virtue! ;-)
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