After years trying to figure out my daughter's mysterious tummy issues, she was put on a low-FODMAP diet by her GI in June. The diet is actually an elimination of several types of carbohydrates called FODMAPs. FODMAP stands for Fermentable Oligo-, Di-, Mono-saccharides and Polyols – types of carbohydrates that break down to a certain sugar by enzymes in the small intestine. When the enzymes don't break down the sugars and they move unchanged into the large intestine, the bacteria in the gut use them and the effects cause gas and bloating as well as other unique digestive issues. For some people it's diarrhea and for some it's constipation. One of my daughter's main symptoms was gas.
When she was put on the low-FODMAP elimination diet, I thought that it would be a couple of weeks long. We packed a lot of the off-limit foods in bags to be opened later and began making lists of everything she put in her mouth and how it made her feel. A lot of the foods I cut out were convenience items like cereal bars that contained sugar alcohols (polyols) and high fructose corn syrup (fructose). It's almost sickening to read ingredient lists and see these items over and over and over.
The two trickiest items to deal with were apples (fructose and polyol) and garlic and onion (oligos) as they are in everything. I included garlic and onion together because they are almost always together in products.
At a follow up appointment, we learned that the elimination wouldn't be completed in weeks, but rather months.
Anytime I talk to people about my daughter's low-FODMAP elimination diet, they comment admiringly about how hard it must be to have to read ingredient lists, to know and research which foods she can and can't have, and to cook most foods from scratch. Those things aren't easy by any stretch, but they aren't the hardest things to deal with.
Listed are the five hardest things to deal with when you have a kid on the low-FODMAP diet (listed in no particular order).
1. Telling her no ALL the time.
I'm a mom and part of the job title is to tell my kids no. Saying no to requests of watching TV all day, new toys, and unnecessary candy and sweets are a non-issue for me. But when your child is told no for requests of corn, apples, watermelon, simple cereal bars, and most of the normal everyday foods that a family eats, it gets frustrating. To see my sweetie hold up something like deli turkey from the refrigerator and then be told no because it has natural flavors (that most likely contain garlic and onion) then you feel like a real jerk.
2. Controlling portions.
I've worked hard to find foods that I know she'll like and keep those in the house. Strawberries and raspberries are a good example. But low-FODMAP foods can become high FODMAP when servings go beyond a certain amount. A low-FODMAP serving of strawberries for an adult is ten and for a child is five. Giving your child this treat but telling her she could only have a few is a heartbreak. She can have one medium carrot. She can have one cup of rice. She can only have half a cup of pretzels. Monitoring these measly portions feels mean in a way that saying no to candy doesn't.
3. Birthday parties.
The routine goes like this when my daughter is invited to a birthday party: I ask what food will be served then I make the low-FODMAP version of whatever they are having. It's as good as it's going to get, but my homemade pizza will never taste as fun as the delivery pizza that the rest of the kids are having. I also prepare a treat (brownie or ice cream) and send that as well. Of course the portion is pretty small, so once again, she is standing out from the group. I'm not trying to make sure she never feels uncomfortable in her life, but birthday parties are a bit much. My controlling of her ingredients and portions takes some of the fun out of the event that in a big way revolves around food.
4. Lack of variety.
If you look at a list of foods that a person on the low-FODMAP diet can't eat, you begin to wonder just what they can eat. A quick tutorial goes like this: almost every meat that's not seasoned with off-limit foods, a handful of vegetables that most children don't like, a handful of fruit that most children don't like, a handful of grains that most children don't like, and baked goods as long as they don't contain off-limit foods. It doesn't leave much to choose from. I have found one cereal that she can eat and she quickly got bored of that. I have a rotation of about five fruits she likes and I keep in the house. Vegetables are tricky – she mainly sticks to her carrot, green beans, and broccoli. She gets bored and I find myself either getting frustrated with her being spoiled (she's really not) or forcing her to try new things (which isn't all that bad when she actually likes them).
5. Not sharing.
This is the jerkiest one of all. To a certain extent, my family of four has changed some of the foods we eat out of respect for my daughter's feelings. We don't sit at the table with her eating cookies and cakes or breads that she can't have. We certainly don't eat out often as she really can't have what most restaurants serve. But, the three of us aren't on the low-FODMAP diet and she is going to have to be accustomed to being around people who eat food she can't have. She's eight now, but in high school when her friends go out to eat, she will need to know how to order only appropriate foods while her friends get whatever they want. So occasionally we do go out to eat. At an Italian restaurant we go to, she gets a salad with carrots, gluten free noodles, broccoli, and chicken with no seasoning. She doesn't get to eat the bread that comes before the food, but we all do. And sometimes we get dessert. It's not fun and has only happened once so far, but it's part of the process. My husband brought home some baked goods one Sunday. She asked to smell them but never begged for a taste.
While this elimination will probably only last a few months before we start reintroducing foods, some of the FODMAPs will end up being the problems foods that she'll never be able to eat. I hope that she'll always be around people who understand her issues and won't be offended when she brings her own food or doesn't eat something being served. I hope that she'll find more joy in being with people than focusing on what she can't have.