It's 6:30 a.m. in Huntington, West Virginia, and James Lewis is up and running. Having already showered and dressed for work, he's in the kitchen getting breakfast ready for his hungry children, who will soon be ambling in, looking for something to eat.
Among them is 11-year-old Josh, who has been diagnosed with ADHD and needs lots of guidance to get himself out the door in the morning.
Before Josh takes his medication (one of the long-acting stimulants) and moves into his own routine, his parents and siblings - including Josh's twin brother, Jesse, who doesn't have ADHD - attend to logistics. Josh's clothes are laid out, his backpack is packed and waiting by the door, his meal prepared. To avoid distraction, TV, radio, computer use, and Game Boys are forbidden in the morning.
So what's for breakfast?
"Corn dogs and chocolate milk," Lewis replies cheerfully.
Not your traditional morning meal, but if anyone knows anything about feeding children with ADHD, it's James Lewis. Not only is he the father of two children with ADHD (one is a 21-year-old who is away at college), he's a developmental pediatrician specializing in the condition.
Begin with breakfast
According to Dr. Lewis, breakfast is your best chance of the day to fill your child with calories and nutrition. The first meal of the day should supply a child with long-lasting energy. It's not the time to worry about a balanced diet or typical fare. Lewis knows Josh's food preferences - and goes with them.
Eight-year-old Jason's mom, Shari, agrees with Dr. Lewis' advice, but she had problems getting her son to eat after he started taking a stimulant medication. He didn't want breakfast, lunch, or dinner. Around 8:30 every night, however, he'd become ravenous.
"Just when I was ready to settle down for the night, I had to become a short-order cook, making four or five dishes for him," Shari recalls. "His behavior was better, but he wasn't eating at all during the day. He also wasn't sleeping well."
Tip: If a stimulant medication results in a significant loss of appetite and/or sleep problems, it's always best to try a different one. If the child still has a loss of appetite and isn't gaining weight after switching medications, it's important to try a drug other than a stimulant.
Medication and meals
Although longer-acting medications work well for many children, these drugs may peak at the times when a child would typically be eating meals. For some families, that's an unacceptable side effect. Shari and her pediatrician put Jason on four-hour doses of Ritalin, which means that his first dose of the day wears off at lunchtime. After the school nurse gives Jason his next round of medication, but before it starts working, he sits down to his favorite meal - a turkey sandwich, chocolate milk, carrots, yogurt, and a sweet or salty snack. After lunch, he's less agitated and less prone to emotional meltdowns later on.
Dr. Lewis' strategies for breakfast also apply to lunch, dinner, and snack time, no matter when or where these treats are eaten. Prepare snacks ahead of time, minimize distractions, and have your child's favorite foods available just before his medication takes effect and when it starts to wear off. This will smooth out critical transition times - from waking up right through early evening into bedtime.
Foods for thought
Here are several ADHD-friendly ideas for quick snacks and small meals that can make up for lost-cause lunches, nutritional shortages, missed meals, and other food dilemmas.
A basic cheese sauce adds calories, calcium, and vitamins A and D, and it can add zest to many foods.
Recipe: Combine 8 ounces shredded cheddar or American cheese, 2 tablespoons olive oil, and 1/2 cup milk in small saucepan. Stir over low heat until melted. Set aside to thicken.
- Use with hot cooked macaroni for classic mac 'n' cheese.
- Spoon over baked potatoes.
- Use as a sauce or dip for vegetables, French fries, bread cubes, or with fruits, such as apples and pears.
- Season the basic sauce with chili powder to make a warm nacho dip for chips and vegetables.
Quicker yet: Use canned cheese soup.
Kids love to dip and dunk their food, especially if they are too impatient to sit at the table. Peanut butter provides the base for a high-calorie dip rich in protein, B vitamins, and vitamin E. The dip can also double as a sauce.
Recipe: Stir together 1/2 cup creamy peanut butter and 1/2 cup boiling water until smooth. Add 3 tablespoons lemon juice or cider vinegar, 1 tablespoon soy sauce, and 2 teaspoons sugar. Adjust seasonings to taste. Serve warm or at room temperature.
- Use as a dip for steamed and raw vegetables.
- Serve with chicken or meat kabobs.
- Toss with hot cooked linguine; serve warm or chilled.
Quicker yet: If your child likes spicy food, pick up a jar of Thai peanut sauce in the specialty food section of your supermarket.
A fruit smoothie is rich in protein, vitamins, minerals, and calcium. You can increase the taste appeal and calories by adding some ice cream.
Recipe: Start with a base of yogurt, milk, or milk substitutes, such as soy, rice, or almond "milks." For extra nutrients, stir in a spoonful or two of dry milk powder or fortified instant breakfast powder. To increase calories and sweetness, add a fruit spread, flavored syrup, or canned fruit packed in heavy syrup.
- Chocolate ice cream + banana + peanut butter
- Vanilla ice cream + canned peaches + seedless raspberry jam
- Strawberry ice cream + banana + lemon yogurt
- Vanilla ice cream + pineapple + coconut milk
Quicker yet: Store a variety of ready-made yogurt smoothies in the fridge. Before serving, melt a scoop of ice cream in the microwave and mix it into the prepared drink.