The therapeutic keto diet is very high in fat, and it's important to vary the types of fat - so like, not all animal fats. Plant-based unsaturated fats are considered "healthy fats" that are associated with better health outcomes than a diet high in saturated fats like animal fats. Oils aren't always super easy to incorporate into M's foods (most things would literally be swimming in oil if we relied solely on that) so we look for other ways to get those fats in. Unfortunately, as you may recall, nuts are out. (We think. More on that coming soon.) He's a little over coconut. Avocados are a wonderful option, but he won't eat avocado straight, even though that's like my favorite thing for breakfast. It's frustrating.
The other thing I try hard to do is make sure he has foods he has to chew. It's very tempting to puree the crap out of everything to ensure the macronutrients in his all-in-one meals are evenly distributed with each bite, but that's no good for oral development - he needs to chew, and crunch, and generally use all of his mouth muscles because that's as important for developing speech as it is for eating skills - and speech development is one of those things that you have to monitor closely with Dravet.
But in the last week, the little dude has been dealing with multiple teeth coming in at once (including a couple of molars) and when he's teething, he's not big on chewing anything. And fair enough. He's been drinking plenty of his "keto shake" bottles - that combo of milk and heavy cream - but that's been almost all, other than some berries here and there followed up by a syringe of oil. It's not the most balanced diet, and it also means he's not getting a ton of calories during the day, so he's been waking up hungry almost hourly at nighttime. And I'm tired of daytime meals being a battle right now.
So as one often does in parenting, one chooses the lesser of two evils. I just want him to eat something. Anything. Real food. Not just milk. He needs something other than dairy fat. He needs to effing SLEEP. I give absolutely zero craps right now about his oral development. So let's make some smoothies.
And here we are with a ratio-complete strawberry-banana smoothie that has avocado hidden in it, to solve all of my problems in a single squeezable go. I fill reusable squeeze pouches (for this recipe I used up some disposable ones someone gave me a long time ago, but I also bought these reusable, recyclable ones) to make portioning and serving easy, and M is really pretty good about eating out of these without making a giant mess. I'll also note that this smoothie objectively tastes pretty good - even our daughter was a fan (until I told her it was healthy for her and offered to make her one for breakfast; then she decided it "tasted a little bit funny" and that she preferred Rice Krispies).
Ingredients for a 200 calorie, 2:1 smoothie:
33g 40% cream
10g Fage 5% Greek yogurt (note: this is usually our go-to yogurt, though Greek yogurt is quite high in protein. I recently found this Stonyfield Organic Plain whole milk yogurt that does slightly bit better on the ratio than the Fage stuff, so I actually used it instead for this recipe, but I calculated in the Diet Calculator using the lower ratio Fage since it was already loaded into the database)
15g banana, sliced
35g strawberries, hulled and halved
30g ripe Hass avocado
Directions:
Throw everything into a blender or the blender attachment of your immersion blender and blend until smooth. Use a spatula to push larger chunks of fruit down into the blending blades (WHILE THEY ARE STOPPED) to make sure everything is evenly incorporated. Pour into squeeze pouches, label, and refrigerate or freeze until needed.
And in case you were wondering, he devoured one of these at dinnertime last night and we didn't have to get up for a bottle feed until 5 AM.
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