So now I have a hypoglycemic child, or at least a child with frequent low blood-sugar events. It’s always something.
Summer is in full swing around here, which for us means projects, no regular routine, and lots of unstructured time. All that lack of structure means meals are sometimes hit or miss, and for snacks you are generally on your own. It’s always worked fine for us, especially since our kids are all old enough to fend for themselves, and conventional wisdom is that hungry kids will eat when they need to. But now, not so much.
Our First Big “Crash”
On a recent Friday, my 11 year-old daughter and I were hanging around the house for most of the morning. She was reading and playing Lego and I was working on digging out my office. Around mid-day, we decided to run some errands and then grab some lunch. By the time we got to the restaurant and ordered our burgers, the kiddo was not feeling well at all. She was pale, trembling, and had cold, clammy hands. Just a few minutes after our food arrived, she insisted on going home, which was completely unlike her. So we wrapped up our food and high-tailed it out of there. I suspected that she was just really hungry, so I encouraged her to take some sips of her soda on the way home.
Once home, she was already feeling a little better, thanks to the soda. I got her to eat and then take a rest. After talking about her morning, I realized she had only eaten a single slice of cinnamon toast and some tea for breakfast, nothing since, and that was 6 hours earlier. No wonder the poor kiddo was shaky with hunger. Being the sensitive one, she was a little freaked out by the whole ordeal, and was more than happy to take it easy.
Unfortunately, that’s not the end of the story. Despite regular high-protein meals and snacks, she had at least four more “crashes” over the weekend. By Sunday evening, we were both a little freaked out about it. Each time, we were able to end the shakiness with some juice followed by yogurt, peanut butter, or a hotdog, which was a relief. But I was still pretty concerned. When she woke up early Monday morning with the shakes, we decided to go see the pediatrician and were lucky enough to get an early appointment.
Seeing the Doctor
So off to the doctor we went. On a hunch, I also asked the doctor to measure her height in addition to taking her weight during her initial exam. It’s been nearly a year since the kiddo’s last well-check exam. We learned that she has grown 3 inches in that time, and has not gained very much weight at all. As a result her BMI, which was pretty low to begin with, had dropped 20%. So she’s working with very little reserves on her lanky frame. The doctor agreed that this “sudden” onset of low blood-sugar events is probably related to the growth spurt and her lean body. Her dad is 6’4″ and she’s only 11, so this is likely just the first of many growth spurts over the next few years.
A Diagnosis of Sorts
I am glad that we saw the doctor, but I’m not sure that I’m completely satisfied with what she recommended. She agreed that it sounded like low blood sugar, but there was not a practical way to test for it (other than buying an at-home blood glucose monitor.) And barring any other symptoms, there’s really no treatment necessary. The doctor ultimately said the way to deal with it is to eat more, and eat more often. Protein with every meal and snack, and eat at least every three hours. Consider adding protein shakes. And make sure to drink a lot of water, too. So it’s a relief that it’s not more serious, but the engineer in me wants to “fix it” with something more than a reasonable, healthy diet.
The kid is still a little freaked out, though. She’s pretty clingy and cuddly, and she asks me quite often if I think she feels “shaky.” Of course, I am happy for the extra cuddles and mom-attention. But I try to explain that only she can tell if she’s feeling shaky. I have been emphasizing that she needs to take some ownership in how she feels, what she eats and when she eats. But I know that it will be an ongoing process.
Educating the Hypoglycemic Child
Part of the on-going process is making sure my child is equipped with the information she needs to take care of her own blood sugar, or at least begin to. Here are some of the things we have been emphasizing since starting this journey.
- Learning macro nutrients: Protein, Carbohydrates and Fat. She now can list them, and give examples of eat from her list of favorite foods.
- Graphing macro conversion to blood sugar: She’s only 11, but she’s a very visual learner, so we drew out this graph together to show how different foods affect blood sugar over time.
- Learn the difference between simple and complex carbohydrates: Simple carbs = white foods: sugar, rice, bread. Complex = color: fruit, vegetables, beans. We talked about how simple carbs have higher “spike” on the graph, and complex carbs have a lower spike.
- Eat regularly and frequently: For her, that means every three hours. Three regular meals, and three healthy snacks, including a good snack before bedtime.
- Eat protein, carbohydrates, and fat with each snack and meal: Yogurt and granola, PB and banana toast, bean and cheese mini burrito – all good examples of snacks that have all three macros.
- Drink plenty of water: Water doesn’t affect blood sugar, but is essential to the body in maintaining blood-sugar levels.
- Learn to monitor your own hunger signals: Hunger is not always a rumbly tummy. Tired, distracted, or jittery? It might be hunger.
- If you feel hungry, eat! You would think this would be obvious, but it’s not always something kiddos are willing to stop and do when they are absorbed in an activity.
- If you feel shaky, have some juice and eat a snack – and then tell an adult. When she has a “crash” warning sign, juice is the best way for her to get her blood sugar back up, but it’s important to follow up that sugar with protein to even out the “spike” from the juice. And it’s important for Mom or Dad to keep tabs on when this, so always tell someone after it happens.
- Always have a snack with you, always: Just in case. Usually Mom remembers, but it’s important she doesn’t always depend on Mom.