I met with a nutritionist yesterday to talk strategy for Ceeya's feeding issues. It was very helpful, and I walked out of there feeling poorer, but optimistic.
For one thing, the nutritionist (known henceforth here as "Dr. Eats") was very encouraging about what we are doing right, such as all eating together as a family at the table without the TV on, saying grace before meals (SPD kids need routine and ritual), and pushing fresh as opposed to processed foods as much as possible. She also liked that we are doing sensory activities that are related to food, such as putting uncooked rice and beans in a large Tupperware container, hiding small toys in the rice and having Celia dig through to find them, and "painting" with whipped cream.
Her primary concern as we talked about what Ceeya eats is that she's barely getting any carbs, since she doesn't eat rice, pasta, bread or potatoes (except in French fry form). So she wants us to begin trying to get her to eat those at every meal—to keep giving her the core foods she loves but also at each meal to offer a food she won't currently eat, preferably a starch. She made the point that when Ceeya rejects a food that she has been accustomed to eating, we should respect that, keep it out of her diet for a few days and then bring it back.
Interesting: when I told her of Ceeya's vestibular issues (i.e. she becomes anxious with unsteady or unpredictable movement), she asked whether she sits in a high chair. She does, so Dr. Eats suggested simply moving her to a child-sized table and chair, so her feet are firmly on the ground and she doesn't feel like she is floating in space. Despite the high chair having a platform for her feet to rest on, she may simply have issues with eating that far up off the ground. That had not even occurred to me, but it makes perfect sense.
Other tips: make everything bite-sized and stick a toothpick in it. Since Ceeya hates touching things, she may be more amenable to eating food when holding it on a stick. (She certainly loves popsicles, so this is familiar to her.) Dr. Eats suggested making really tiny meatballs, cream of wheat "snowballs," and rice balls to be speared with toothpicks. Sweet Dub, ever the dedicated father, has declared Friday night "Toothpick Night," and claims he is making food the whole family can eat and it will all be on toothpicks.
Dr. Eats says we should make the most of Ceeya's willingness to dip things to get more protein into her—since she loves tortilla chips, she suggested pureeing black or pinto beans into bean dip, or making "baby" guacamole with mashed avocado and a little salt. She is already into dipping fruit into yogurt, so we will just continue with that.
Portion size is another thing. We don't tend to give Ceeya a lot of food at one time, because it overwhelms her and she will just throw it all off her high chair tray and look at us blankly. Dr. Eats said that even giving her a lump of mac and cheese is too much—we basically have to differentiate each noodle. "Pull out five individual noodles from the mac and cheese," she said. (Dear Lord.) Dr. Eats also suggested getting Ceeya more involved with food prep—for example, in making homemade chicken tenders. She advised putting cornflakes in a Ziploc bag and letting Ceeya bang on the bag until they're pulverized, then putting boneless chicken pieces in the bag and letting her shake it until they're coated. She can then watch me fry them. "Now, she may not eat them the first few times," she said. "In fact, you might have to make them that way twenty different times before she'll actually eat them. I'm not saying she's going to eat a new food tomorrow, but she may eat it in three months."
So, pretty much as expected, there is no quick fix. We're in this for the long haul, but there is at least light at the end of the tunnel.
And my little lambie pie is so worth it.