Best School Lunchesby Jan Gambino Patient Expert
I opened the Sunday newspaper last week and saw an article about healthy and fun lunch ideas. It sure didn't look like anything those suffering from acid reflux would eat As the mom of a daughter who suffers from reflux, I have learned to smile and ignore these articles.
That being said, here's my list of healthy and fun ideas for combatting acid reflux symptoms at lunch:
Tip #1: Reflux Diet
While there isn't an official "reflux diet," there are several types of foods that trigger acid reflux symptoms -- acidic foods (tomato, oranges and orange juice), high-fat foods, spicy foods, carbonated beverages, chocolate and caffeine.
Suggested lunch foods:
A baggie of deli meat and a baggie of breakfast cereal or crackers may provide similar calories and nutrients to a standard sandwich.
Substitute a lactose-free nutrition drink or lactose-free milk for milk.
Offer 100% juice or water rather than sugary drinks.
Substitute yogurt for a high-fat pudding cup.
Give the carb junkies their fill of pretzels, popcorn, crackers, breakfast cereal and granola bars.
Add protein from peanuts and peanut butter (if no peanut allergies).
Make or buy trail mix with peanuts, soy nuts, raisins, etc.
Add calcium and protein from drinkable yogurt, cheese sticks and yogurt cups.
Sneak in some veggies and fruit with dip.
Throw in that Hershey kiss if you child tolerates it. You can attach a small note that says I love you!
Tip #2: Think Outside the Box
Think outside the box -- the lunch box, that is!
Remember the study in the press recently that found packaging food in a McDonald's wrapper made the food more appealing to children? Your job is to provide healthy foods that are packaged so they will actually get consumed by your picky eater.
So with a great deal of fanfare, help your child select a very cool lunch box or bag to transport her food to school. Fun little containers, colorful spoons, stickers on the baggie and a note from mom can go a long way toward making your picky eater at least try to nibble on something in the lunch bag. There is nothing worse than opening the lunch bag after school and finding that the food was untouched, a common occurrence according to many parents of refluxers.
Tip #3: Make good choices in the cafeteria line
The typical school cafeteria lunch menu is full of reflux trigger foods such as greasy pizza covered in cheese and tomato sauce and fried chicken with tater tots on the side. There is evidence that high-fat or fried foods take longer to digest, triggering discomfort and reflux symptoms. You may need to avoid high-calorie/high-fat foods if your child is overweight or obese since there is some evidence that childhood obesity leads to an increase in acid reflux symptoms.
Most schools provide a menu in advance so you and your child can look at the options and choose foods that are tolerated. Many refluxers are such picky eaters that they won't eat anything on the menu, preferring a familiar lunch from home. When my daughter, Rebecca, was in the middle of her picky-eating phase, she would comment on the cafeteria food and mentioned that a few of the selections looked pretty appealing. I wanted her to try new foods and have the experience of buying lunch at school. We scanned the menu and chose a day for our trial run, then packed her lunch money and a light lunch as a back-up. She ate a combination of the cafeteria lunch and the food from home.
I know this approach is somewhat wasteful, but it was important for her to have access to her safe foods if she could not tolerate the new foods. Over time, she became a regular in the cafeteria line and got to the point that she just brought water from home to substitute for the drink options that were reflux triggers for her (milk or orange juice).
Tip # 4: Put Your Child In Charge
It is likely your child will eat more of her lunch if she has packed it herself. A younger child may need to be in charge of smaller decisions. An older child may be able to select foods and prepare the entire lunch. I know a parent who keeps a lunch food chart with columns on the refrigerator. The columns represent the food groups (protein, carbs, drink, fruit and other) and acceptable choices for each category. For instance, the protein column lists ham, chicken, protein bar, cheese, and yogurt. The drink column lists water, sports drink or 100% fruit juice pouch. Her refluxer needs to pick an item from each column to create a well rounded lunch.
Tip #5: Use the Power of Peers to Increase Food Choices
If you are eliminating foods that trigger acid reflux and foods that cause allergies and intolerances, what in the world is left? Many refluxers are carb junkies and seem to live on bread, cereal and crackers. In addition, your child may believe that only a few "safe" foods are acceptable. Therefore, your job is to make sure you stock up on massive quantities of the preferred foods.
On the other hand, perhaps you can expand her food choices. Your child may be lucky enough to sit next to a non refluxer who eats exotic foods like string cheese or apple slices dipped in a special sauce. Use this positive role modeling to your advantage by inviting your child to go food shopping with you and select a new food each week. I bet your child will select a food that she has seen another child eat at school. Don't worry if she selects the gummy snacks or cheese curls that are full of unknown, unhealthy ingredients. The goal is for your child to take a chance with a new food and add to her menu selections. Once she has become a bit more adventurous about new foods, you can narrow the selections to healthier foods.
Good luck to you and your child as you start a new school year!