Monthly Archives: September 2013

Bringing keto to kindergarten, part 2

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Me: “Mmmm, Nora. These pumpkin bars are so good. You are the luckiest keto-kid on the block.”
Nora: “No, I’m the only keto-kid on the block.”

And that pretty much sums up the social issue with starting school. Nora has been so amazingly compliant about her diet that the last 20 months has been relatively easy emotionally. Also, she has been home with her beloved Laura while I’m at work, socializing mostly with other families that we know and who know Nora. And if someone offers her food, our assertive little Nora clearly states: “no thanks, I can’t, I’m on the ketogenic diet for epilepsy.” I have heard it with my own ears. But I was also there to step in if Nora did not assert herself. When she is at school, she is on her own.

Starting kindergarten means that everything is new. All new people and kids who eat together 3 times per day. Nora is in school from 8:15 to 2:40, where they eat breakfast, snack and lunch together. Of course, Nora’s teacher and school staff are informed about her diet (I will address that in part 3), so it is not up to a 5 year old to explain it to the adults.

But she is her own advocate with her peers and she is well aware that she is the only keto-kid on the block. Other kids have other food issues to navigate, such as nut, dairy and gluten allergies. Plenty of other kids bring their own lunches and a few opt-out of breakfast. But after just the first day she was aware that *everyone* was drinking milk with their breakfasts and lunches and she wanted milk too.

IMG_4103I was trying to avoid liquids in her school meals, which are only asking to be spilled. But when she really wanted to have “milk,” I felt like it was more important to honor her wishes than avoid the risk of spilling. We’ve been giving her “keto milk” made with cream (an amount needed to achieve the ratio in the meal), diluted with water and with a drop of vanilla or other flavoring (she also likes banana). Our standard packing method is an 8-oz mason jar, the kind you use for canning jam. This summer I punched a hole in the top of a lid to fit in a straw. To make it spill-proof in a lunch bag, you just add a second solid lid under the screw cap, then to serve remove the second lid and insert a straw.

The straw is great for avoiding big spills while drinking, but I think that the changing of the lids is a bit much for a 5 year old who has 25 minutes to eat while surrounded by other kids. After the first day of school I tested her on unscrewing the lid to drink directly from the jar like a cup, which worked fine for the few days that we tried it.

IMG_2273I also started searching for small travel-and-kid-friendly cups that we could send to school. We came up with these reCAP mason jar lids and have used them successfully for the last week. They are plastic and have a rubber gasket to create a good seal. Nora can pop open the pouring lid herself. I am still nervous that the pour top will not stay closed in a lunchbox, but so far, so good. I check and double check it before I send her off.

I also brought in 6 of her Mexican Chocolate Protein Cupcakes with frosting and put them in the school freezer, so that she has a snack on hand if the class has a special treat. The question will be whether everyone remembers that she has a treat in the freezer. But if I tell Nora about it, she will be sure to inform everyone. Next I have to figure out how I will be informed that she had the extra snack at school. I suspect that I will hear it from Nora first, and they are at-ratio so if I don’t hear about it the ratio is fine, she just gets lots of extra calories that day.

She has been to school for 8 days now, and every day she comes back with empty food containers and no stories of spilling. It all seems to be working so far from her end. I feel pretty confident that Nora will tell me her wishes so that her lunches are appealing and easy to eat with her class, because the top priority is to keep her happy and independently choosing to stay on the diet.

The only mishap so far was one day when the whole class did not get morning snack because their schedule was rushed. When I picked her up the teacher reported that she had an emotional day, then when we got home I discovered that she had not touched her morning snack. She was adamant that no one ate snack, so the next day I told her teacher that if they don’t eat snack she needs to get that food at lunch time. Her calories are apportioned over the day, and missing some will make a girl cranky. It’s in everyone’s best interest to feed Nora.

Bringing keto to kindergarten, part 1

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Nora started school this week! Our school district does a “gentle start” for kindergarten. We met with her teacher for a half-hour last week, when we got to talk to her directly about the diet and Nora’s needs. Then Nora went on Monday for a full day with half of the kids in her class. Today she is there for the first full day with the whole class and it’s the regular schedule from here on out.

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We are happy that Nora is in a school for full-day kindergarten, which goes from 8:15 to 2:40. The kids eat 3 times in that span–breakfast, snack and lunch. Three times the meal packing every day. But we are so excited that it is a Spanish-immersion school, where she will be learning exclusively in Spanish every-other day or every-other week (depending on how the teacher decides it works best for this group). She is in a classroom with one bilingual teacher rather than switching teachers weekly. Nora loves language and has been trying to speak Spanish for a few years, with a convincing accent. I can now leave it to the teacher to give her real vocabulary.

Because there is so much involved with sending Nora to school and the story will be unfolding for the rest of the week and next, I am going to write several blog posts about different aspects of bringing keto to kindergarten.

For now, the only sure thing is our parental perspective. Every parent feels anxiety and excitement at sending their child off on the first day of school. My feelings tend to run toward pride and joy that they are growing up and entering their own worlds. Nora makes that feeling easy because she is eager to join in, with only a trace of shyness or anxiety at the new situation. I don’t have to leave her crying; she leads me right to her classroom and gets herself settled in. I feel fortunate for that.

But she has lived a sheltered keto-life. She was enrolled in preschool when her epilepsy was at its worst in 2011. We took her out of school and hired a nanny, our beloved Laura, to care for her at home when I was at work. Laura has been with her ever since. She has had a dedicated adult with her to open containers and scrape out dishes for all of this time. Now taking her to school means that she doesn’t have that kind of one-on-one supervision, which raises anxiety about whether she will eat all of her meals as prepared for her, while resisting any temptation to share food from other kids.

We are also retelling Nora’s story over and over again–to the school nurse, to the teacher, to other parents that we are meeting or don’t know well. I brought in the newspaper article about her 1-year seizure free anniversary because it’s an easy to read explanation and lends it legitimacy. And every time I say that she is doing so great now, we are feeling confident that she will continue to stay seizure free, I want to knock on wood or throw salt over my shoulder. Those feelings of anxiety are lessening as time goes on, but they are still there. Bringing her Diastat prescription to the office just in case she has a prolonged seizure is a prudent and necessary step, but brings up frightful images of seizures at school that I don’t want to see in my mind. For all of the hope of the last 20 months, there is still the fear of a relapse. Somehow we have to continue to hope for the best and prepare for the worst, which is front and center during this transition.

To cope with that anxiety, I have looked for strategies to make her meals as simple as possible and ease any social issues that she will feel. Even though the adults are supposed to watch out for her (more on that in another post), I would rather avoid the risks by making everything as independent for her as possible. Then she can also avoid a little of the stigma that may come from being “different” (more on that later too). Other kids will bring their own lunches too, so if Nora can sit down, open her own meal and eat it all herself, all the better.

IMG_4096I baked a lot over the last weekend to store up some easy high-ratio finger foods rather than relying on liquids like cream or oil to achieve her 3.5:1 ratio. We are trying not to include too many foods that require eating with a spoon so that there is not much left behind in the dishes. We are also trying to avoid anything that can spill easily, which would most likely be cream and critical to keeping her ratio where it should be (more on that later too).

All of this comes at a time of transition for everyone on our family. Anders is also back at school. Both kids are playing soccer this season, Ted and I both work at OSU and are preparing to teach again this fall. I was off all summer, so I was preparing Nora’s meals as we ate rather than preparing and packing the night before in a lunchbox. New routines means that everyone is a little off-kilter as we get busier, and everything is a little more rushed and a little more difficult.

Did you ever have one of THOSE keto-baking nights? I had one last night. Sometimes it is harder than usual. I was trying to make Nora’s pumpkin bars (which, if I have not raved about them yet, are at http://ketocook.com/2012/10/03/pumpkin-cheesecake-bars/). They have been a staple in the breakfast rotation for the last year and are so good. I always start measuring with eggs because I try to hit some multiple of the recipe based on getting the eggs to come out even. I hate storing and wasting eggs.

By my version of the recipe (altered a bit to get 3.5:1 for Nora), I cracked 3 eggs and came out pretty even at making 18 bars. That was a fairly reasonable number; next I went to the computer to calculate how much of the rest of the ingredients to add. Then I went to add the macadamia nuts. I keep some ground in the fridge for easy cooking, but of course I was almost out. Got out the food processor to grind more. Done with that. Measured a few more things…now my small jar of coconut oil was almost empty. Got out the 5-gallon jar to refill the small one. Always a messy job. Poured a glass of wine (I already did the math, so it was good timing). Finished measuring everything out and put it in the mixer. Went to help Nora out of the tub…came back 10 minutes later with the mixer still on–excellent, the bars will be well mixed. Measured them into individual silicone baking cups, so many that I had to bake them in shifts…then there is clean up. But for a night of baking, we have plenty of breakfasts ready to serve. Beats the morning rush.

Today and tonight we were strategizing about lunch packing, getting ready for tomorrow. It must be fall, for the evenings in front of the gram scale are here.