Pinky Cat: And her adventures through Food Avoidance.

It happened at some point on the London Underground, Piccadilly Line, possibly as the train moved through Hounslow. It was the very final journey of our two-week visit to family and friends. The five of us had been burdened with 4 suitcases and numerous shoulder-slung, hand-held luggage as we moved between locations in both Essex and Yorkshire. We also carried another burden during our stay. The youngest member of our cohort had stopped eating solid food. In fact, she’d eaten her last morsel on June 17th. An elderly gentleman of possible South Asian descent remained expressionless on the morning of August 1^st, as, sat across from us on the train, he witnessed an animated tableau of praise, clapping and whooping and the overwhelming relief felt by all. Maybe he never had children, and this was baffling; maybe this wasn’t the first time he’d seen a two-year-old eat a ginger biscuit. It was the first time in nearly two months I’d seen her chew. I nonchalantly watched her move the damp, heavily licked biscuit into her mouth – I held my breath, smile widening, trying to catch my wife’s eye. I witnessed our daughter bite the head off her biscuit (she is merciful like that) and chew. In that delicious second (for us all), we knew the seven weeks of patience, controlled emotions and bright, positive communication had actually worked.

So, what was the cause, what was the diagnosis, what was the treatment and what, in a very Sesame Street way, did we all learn?

First of all, some context. Aubrey was born with allergies. We didn’t learn of them until she was just under two months old. In October 2020, whilst we were living in Qatar, my wife had to return to work seven weeks after giving birth. She was obviously not thrilled with being parted so early from our daughter but, as they say in Texas, this wasn’t our first Rodeo, and so we viewed the early adaptation with stoical resignation. Fortunately, there was a marvelous nursery on the compound. To facilitate the move, we switched to mixed feeding and duly one morning, whilst my wife was getting ready for work, I gave Aubrey her first bottle of formula. Five minutes later our daughter had swelled. Her lips, yellow puckered and blistered; breathing raspy and difficult to catch. That awful aluminum taste in your mouth when you realize something unknown has wrestled the control of your child’s wellbeing from your own hands and placed it into a future unknown and terrifying. Our eldest son, who was thirteen, sprang into action, comforting our nine-year-old and maintaining a focus and calmness that fills me with admiration to this day. The ambulance was called, EpiPen administered, and after a year of tests she was proclaimed allergic to all dairy products and nuts. Aside from this, she is an all-round healthy little girl.

With that in mind, we reckon the cause of her reversal from mastication stemmed from a soft ‘Haribo’ type jelly. We live in Uzbekistan, in its capital Tashkent. Here all product ingredients are presented in either Russian or Uzbek. We’ve become adept at checking ingredients via Google Translate, but small candy packaging can have font which requires less a phone and more a magnifying glass. She had a favourite brand of sweets with a white foam base and on that day, the day the eating ebbed away, I picked the same style of foam treat but a different brand. This brand had yoghurt in the foam base. I didn’t check the tiny writing and our daughter’s reaction, whilst not serious, was immediate and very uncomfortable for her. As the weeks went on, she requested smaller portions of rice, pasta and vegetables; pushed away from treats such as crisps and chocolate and on one evening rejected her rice milk. By the time term ended on June 23^rd she would only ‘eat’ very smooth soup and the reason I have hyphenated ‘eat’ is because she wasn’t eating – she was only licking. Like a cat. In fact, over the period of her food avoidance she developed an alter-ego for herself…Pinky Cat. Pinky Cat liked to give food ‘kitty licks’ (patience-testing tiny whips of her tongue) and ‘kitty nibbles’ (fortitude- taxing introductions of food stuff to her teeth which she then mimed ‘nibbling’ and inevitably pushed away). All in all, ‘Pinky Cat’ was not popular but, as we learned at the end, wholly necessary.

At least we knew the cause. The diagnosis? Well, here in Tashkent access to English speaking specialists like pediatrically trained dieticians is sparse. So, we turned to Dr Google and sure enough we were able to correlate her behaviour with the phrase ‘food aversion’. Clearly, her choking and coughing experience those weeks previous had had a profound effect on her frontal lobe and she decided that no more solid food would be invading her esophagus for the foreseeable and like an exclusive nightclub she put up the velvet rope to her pallet with an instruction which read ‘Sorry lads, if I have to chew you – you’re not coming in’

The treatment? Well, this was simply the most challenging part: Patience. Now, we had a few things in our favour. First of all, we are both teachers and were on summer break. We had time on our hands to make a plan. Secondly, irrespective of her decision – she was absolutely fine. Her decision to accept only rice milk and slowly and deliberately lick up soup as ‘Pinky-Cat’  had no impact on her energy, demeanor, sleep or personality.

This was our rational anchor.

Between the weeks at home under the hot Uzbek sun and the classic fortnight of a changeable British summer, the four of us kept each other’s ‘cool’. We applauded any brave step towards sustenance more robust. We blended, we cajoled, we sieved, and we sneaked in different food experiences. What we learned was that she needed time to process her fear. We literally started from scratch – weaning her back to solid food. The silver lining was that she made a firm cognitive step. A new schema had developed (to borrow from Piaget). As we boarded the plane back to Tashkent, we were able to help her understand that some food had ‘cow’s milk’ and she couldn’t eat it, but most foods would do her no harm. In tandem with her own cognitive development, we re-constructed her understanding of her own diet. Now, our daughter is able to rationalise (as much as a three-year old can) what is good for her and what she needs to avoid.

“No pizza daddy! Pizza has cow’s milk!”

And yes, Pinky Cat still makes an appearance now and then. This time as an endearing way to catch a snuggle. And no, we don’t feed her from a saucer.