>How To Give Supplements

When doing biomedical intervention, it consists of multiple tablets, capsules and liquid supplements. The child has to take up to 20 different supplements a day, for some many more. And getting your young child to take it all is a herculean task, even more difficult when dealing with a child with Autism Spectrum Disorder. No amount of rationalizing, bribing, encouragement and begging would force our kids to open their mouths, and if they do, they end up spitting it in your face. Some children including Maya are so resistant to taking anything remotely suspicious, their long-term feeding issue makes taking supplements even harder. And I don’t blame her, those supplements tastes horrible!

When first starting biomedical, we had a really tough time with Maya. We found out very quickly that ‘tough love’ did not work with her whenever we forcefully fed her with the supplements. Apart from spitting, she would usually end up vomiting everything in her tummy, she would cry and rage for a long time.Because our girls are physiologically too young to be able to swallow capsules and tablets, we end up opening a capsule and dissolving it into milk or juice. Previously I would grind up tablets in my lesung tumbuk, however I have since found pill crushers which grinds it up into a very fine powder. We tried feeding the liquid supplements with a spoon, but that turned out to be a disaster too. She would knock the spoon out of our hand, precious supplements flying everywhere.
We experimented by mixing and hiding it in milk or juice. Tried different coloured sippy cups, drinking from a straw, only putting in 1 capsule into a big bottle of milk, hiding it in rice, mixing into peanut butter, mashed bananas, we tried everything. It took us a long time to find a groove; we now know which supplements are better tolerated taste wise in milk, which ones are better in juice. Maya is very sensitive to taste, she would refuse to drink the milk constantly when we added in supplements. We wasted so much money, milk and supplements down the drain. We would start very slowly, adding just 1 supplement to the milk, and at only a quarter of the dosage. We would then slowly build up the amount till she can tolerate the whole dosage. Then we would add on a 2nd supplement and start at 1/4 dosage. This worked very effectively for us, we can now add 3 to 4 supplements into 1 bottle of milk.
There are supplements that turns the milk pink or green, we would give these supplements in milk in the middle of the night while they are asleep. We also find that the girls are more tolerant of stronger tasting supplements when drinking it in milk when they are deeply asleep. We take turns to feed the girls their milk at midnight, for now this is what works for us.
I have melted precious organic gfcf chocolate, mix into some rice crispies for some crunch and add the supplements in. And chill them in tiny paper cups like candy. It worked beautifully for 1 day. The next day onwards she refused anymore chocolate. Because both the girls don’t like soft slimy food, I couldn’t try adding supplements to jelly. One desperate day, I mixed some of the more bitter supplements into ice cream – this worked the best! However, there are no GFCF ice cream available in Malaysia so the thought of giving Maya dairy-filled ice cream everyday went against our GFCF principles. I’m still considering buying an ice-cream maker, hopefully I can create a delicious homemade GFCF ice cream.
I bought a box of colorful straws and this worked wonders in getting Maya to drink the supplements mixed with juice in a cup. Everyday she would request for a particular colored straw and will happily drink the supplements. She may not drink it all in one go, we would still have to chase her around the house and coax her to drink it all up bit by bit. Slow but steady I say.
We enlisted the help of our wonderful ABA team to start a tolerance program for taking supplements with a syringe. We supplied the team with a large box of 5ml syringes and the team got to work. After a couple of months into the program, it seemed to me to be a complete waste of time and precious syringes. Maya would only tolerate taking water from a syringe if it was from a therapist, she refused to do it with us at home. It has now been 3 months since Maya started the program and this week we managed to give her supplements in a syringe! We have managed to give her 3 different types of supplements in a syringe, but there are still 20 more to go. Perhaps next year we will do a program to teach her to swallow tablets using ABA.
Maya has always had an intense fear of syringes, ever since very young. She would run away screaming whenever she saw a syringe, she would be so scared and agitated she was inconsolable. We still have to smuggle in supplements in milk bottles at midnight, however there has been great progress.
For any parent feeling frustrated trying to figure out how best to administer these many supplements, only know that the gains and benefits are enormous. Every precious supplement that you successfully manage to give your child is another step closer to improving his health and mind. By being creative, consistent and resilient, you will find what works best for your child.
Don’t feel discouraged, you can’t compare your child to Maya. Don’t compare your child to the neighbor’s son who learnt to swallow tablets at 4 years old. Don’t compare your child to your nephew who’s compliant and meekly takes any vitamin given to him. Each child has their own preferences, each child has their own diagnosis to battle with. Also remember that it took us 9 months to get to where we are now. It has been some time since Maya rejected a milk bottle complaining of the taste. I feel an enormous sense of pride for Maya, allowing us to put the much hated syringe in her mouth and swallowing those nasty tasting supplements. She is the one who has worked the hardest, her accomplishments and improvements are testimonial to her strong spirit and amazing strength.

>KL Biomed Forum

>There is now an active forum on Yahoo Group where Malaysian parents can post queries or information regarding biomedical intervention. KL Biomed is a forum for parents of children with Autism Spectrum Disorder who are doing biomedical intervention in Malaysia. Members can post questions to the groups and any member can reply. Group members are also welcome to post relevant materials and information with regards to biomedical.

This is a private group intended as a form of communication and sharing of knowledge with other parents. Any advice given in this forum is not to be construed as medical advice. So far, we have had many postings and queries relating to diets, medical testings, nutritional supplements and DAN treatments.

>Almost One-Stop Shopping

>We’re all too busy with out daily lives to go running all over town to find GFCF and organic foods. The closest to one-stop shopping for all these items is probably the Lower Ground floor, The Gardens shopping Mall (connected to Mid Valley) Right next to each other is VitaCare Pharmacy and Just Life (Just Life is closed for renovation from 1-4 July 09, but call to check) and right across these 2 shops is Cold Storage.

Vita Care Pharmacy LG-220 – stocks Ogran range of products – bread mix, cake mix, cookies, pasta. Also Epsom Salts if you’re doing the baths
Just Life Organic Shop LG-208 – Huge range of organic veggies, organic cleaning products and Epsom Salts
Marketplace by Cold Storage LG-229 – – Biologique & Freedom Foods brand for cookies, breakfast cereals. Lay’s potato chips. Possibly Pacific and Aussie Dreams rice milk
Another favorite one-stop shop is Village Grocer in Bangsar Village 1. They stock Red Bob Mills (bread mix, pancake mix, brownies mix, choc chip cookies mix, gluten-free flour mix) Biologique (several types of breakfast cereals & breakfast bars) Freedom Foods (3 types of cookies), Pacific Rice Milk (plain and vanilla), Aussie Dreams Organic Rice Milk (plain only), Ogran (only bread mix), several different types and brands of GF pasta, a small selection of Japanese rice crackers, Lay’s potato chips and a good selection of organic vegetables and chicken. They even have different cuts of organic beef, including mince.

>How to Be a Domestic Goddess


The best source of food & nutrition is always home-cooked meals with organic produce. But not all mothers are full-time domestic goddesses. And trying to achieve GFCF whilst juggling family, careers & part-time medical research necessitates us taking several shortcuts. High-fives to those mums who are able to do all that and more. But for us mere mortals, I’d like to share some of my tips and tricks on faking it as a domestic goddess.
We don’t get as many brands as in the U.S especially of the gluten-free, casein-free and organic variety. However, there are several substitutes that we’ve found in our Malaysian supermarkets & health food stores. But I find that most of the imported products are more easily found in expat-oriented shops like Village Grocer in Bangsar Village 1 and Cold Storage in Bangsar Shopping Center. My other favorite shops include Body Basics in Bangsar Shopping Center and Vitacare in LG, The Gardens. Here’s a few of my girls’ favorite snacks & GFCF substitutes;
Freedom Foods – they have several types of cookies and breakfast cereals
Biologique – cornflakes, rice puffs & other cereals
Ogran – bread mixes, cake & muffin mixes, vanilla & chocolate ready made cookies, pastas
Red Bob Mill’s – bread mix (contains yeast), brownie mix, pancake mix & gluten-free flour, chocolate chip cookie mix (I would make up a batch, bake 1/3 and freeze the rest. When needed, I let it defrost, get the kids involved in rolling it into balls & press into the baking tray)
Lay’s Classic Potato Chips – only Classic flavor, the other flavors contains non GFCF ingredients
Pacific Rice Milk – Original & Vanilla flavor rice milk (I can no longer find CF chocolate milk)
Aussie Dreams Organic Rice Milk Original Flavor – RM2.00 more expensive than Pacific, but it’s organic. Only comes in original flavor.
Japanese rice crackers – there are many brands, read the labels carefully
Frozen french fries – many brands & again, check the ingredients. Chicken nuggets & potato wedges are usually coated in wheat.
Whenever in Singapore, I stock up at Brown Rice Paradise in Tanglin Mall. They stock many brands of GFCF foods, organic cleaning products & personal care products. I try to cook home-made meals for breakfast, lunch and dinner. However, when going out or for teatime, packaged snacks are the easiest option. However, a friend pointed out to me recently to watch out for trans-fats. Yes, there’s always something to watch out for.
Paul is Australian, I’m Malay and our maid is from the Philippines. So with 3 adults from 3 different countries and 2 little girls who are very picky eaters, planning a meal is pretty challenging as every one has different preferences. Starting the girls on GFCF was pretty hard initially, but as time went by it does get easier and easier.
Here are some of our favorite crowd pleasers;
Stirfry one dish meal – We would vary the stirfrys with different meats & vegetables. Garlic, ginger, onions, thai red curry paste, lemongrass, galangal, tumeric, soy sauce occassionally or sesame oil for variation. Serve with rice.
Fried Meehoon – pre-soaked meehoon with onions, garlic, chicken & veg.
Local dishes like ayam masak merah, pumpkin & spinach in coconut milk, masak lemak ikan, fried cod fish with tumeric or tamarind, beef curry, dalca, lamb kurma, steamed fish, local chicken & veg soup
Rice dishes – I would vary different types of rice, eg. basmati for veg & lamb pilaf or briyani, jasmine rice for nasi lemak (rice with coconut milk, pandan leaf, ginger & shallots) & fragrant rice for stir fries, local dishes & fried rice, arborio for risottos (Paul makes an exquisite chicken, pumpkin & sage risotto) I’d like to introduce brown rice to the girls diet soon.
GFCF pasta – spaghetti or spiral pasta served with bolognese sauce (organic mince beef, chopped onions & organic pasta sauce) or olio style (olive oil, onions, garlic, mushroom, chicken & zuchinni)
Sandwiches – GFCF bread with fillings such as peanut butter (unless you have peanut allergies) roast chicken with mayo (this used to be a favorite but Maya tested allergic to eggs. I got the egg-free mayo, but the taste is quite tangy, will have to get her used to this) I’d love to introduce hummus or chicken & avocado soon.
I have served lambchops, steaks, roast chicken, chicken with BBQ sauce or roast beef and a side of steamed veg with mashed potatoes for Paul and I but for the girls I serve it with rice. We’re constantly trying to expand the girls diet with some success.
Take it step by step and start with the GFCF first, then concentrate on eliminating yeast & sugars. If you see adverse reactions to soy & corn, target that next. You will never know for sure what diets are suitable for your child until you do the IgG test. There’s Specific Carbohydrate Diet (SCD eliminates most carbs including rice, corn, potatoes), low-oxalate diet, feingold diet, low-phenolic diet and many more which are much more restrictive than GFCF.
6 months ago, Maya will only eat plain white rice, toast and occasionally fried rice. And she would fill up on gluten-free chocolate biscuits, cakes & muffins. Slowly I weaned her off chocolate flavors and sugars and she would get a sugary treat maybe once a week. Also, we make more effort to eat together, setting the table with adult-type plates & cutlery made the girls feel grown up and excited to join us. Doing individual small portions helped, so the girls didn’t feel overwhelmed about having to finish it all. We try to eat the same things as they do, we play games like `Monster Bites’ and ‘Princess Eat’ and ‘Everybody Drinks’ to encourage them to eat more. And occasionally we resort to putting on the video to encourage the girls to sit at the table a bit longer.
So for the mothers out there who are going through the very difficult process of changing your child’s diet and worrying about what to cook and the frustration when your child refuses to eat anything – you are doing one of the most important changes in your child’s life, you will have to experiment with different recipes and you will need tons of patience. Slowly but assuredly, you WILL become a Domestic Goddess of the GFCF variety.