Hellobee

How could I help our little guy eat solid food, after choking so many times? Thankfully, I didn’t have to figure this out alone. His OT had some great tricks, tips, and a strategy to tackle his feeding issues. Some of these I wrote about here.

The first and most important tool his OT introduced was resistive straw drinking. Our little guy started with the easiest level of resistive straw drinking. We gave him a stage one puree, and had him drink it through a short, wide straw. Sucking through a straw does amazing things for the mouth. It builds up muscles in the tongue and cheeks, helps with muscle coordinator and forces a mature suck, swallow, pattern. As his muscles strengthened, our little guy progressed to using longer and thinner straws with thicker drinks. Now, he is at the level of sipping yogurt through a coffee stirrer. Hopefully, he will reach the highest level — drinking a thick smoothie through skinny, long straws with several loops and swirls in it.

Some of the straws we use for resistive straw drinking  |  lollipop, z-vibe, chew tube

He tolerated the straws well, but was anxious about the other feeding tools. We started with a z-vibe, to help with textures. Next, we gently pushed a tootsie lollipop down the inside of his cheeks to strengthen the muscles. Finally, a chew tube for him to bite down on and strengthen his jaw muscles.

One by one, we tried each tool. And each time he would scream, grab the tool and launch it across the kitchen. I thought this was a horrible first start to therapy, but his OT was happy he wasn’t completely defensive with feeding. Some kids cry when they go into the kitchen and see food. He was only fighting the high chair and tools.

We worked in and out of the high chair each day, for four months straight, trying to keep the experience positive for him, and using toys and music to distract him. However, feeding therapy was becoming frustrating and stressful for me for a number of reasons.

Adequate nutrition was a constant concern. His doctors were adamant that he receive enough nutrition for his heart to continue to heal from surgery, and to catch up on growth. Secondly, I was still apprehensive he would choke. Lastly, his OT described the problems our little guy would face if he didn’t improve.

Obviously, choking would still be a problem, and as a defensive mechanism, he might start packing food in his mouth and not be able to swallow. He might drool excessively, well beyond the age of teething. Later, the lack of muscle tone and poor coordination in his mouth would affect his speech. Then speech issues would affect his success in school.

These feeding problems, like most developmental issues, had a domino effect. If we didn’t resolve the feeding issue, he could have problems well beyond being a picky eater later. We went back to work in the high chair, and I took up running to ease the stress. However, it was difficult to stay motivated. Partly, because he hated the therapy. Mostly, because I couldn’t tell if all the hard work had an impact on his feeding.

Aside from the resistive straw drinking, there were no gradual benchmarks for improvement. For three months we were stuck; he couldn’t swallow bits of chicken. Then one day he could. I was so happy when he could eat a new food without choking. But the unpredictable improvements added to the stress of not knowing if he was progressing.

After a few months, he began to tolerate these tools and show consistent improvement. Then we worked out a strategy for what types of foods our little guy could eat. We started with scrambled eggs and toast. Eggs have a rubbery consistency and are difficult for the mouth and tongue to move. His OT suggested we pair it was toast, because starches are much easier for babies to eat. We learned to always pair a new food with a starch. We served chicken with a roll, fruits with waffle and had more success this way.

I still became nervous when we introduced a new food because it was a struggle for him. However, his OT reassured us. She explained coughing was ok, but gagging and choking were not. When he went into a coughing fit while eating, we couldn’t race to pick him up. We had to let him work it out.

He was finally doing well with purees and easy solid foods, but he was still not eating any fruit because of his acid reflux. To address this, I started each feeding with something easy he enjoyed, like half a puree. This took the edge off his hunger, and he was more likely to try new foods.

However, I have to credit BeBe for motivating him to eat fruit. She loves fruit and would happily sit and eat watermelon or cantaloupe next to him. We started with the less acidic fruits. And just like with toys, he wanted what she had. For once, sibling rivalry worked to my advantage! He started eating a variety of fruit.

Our little guy worked extremely hard for four months. He was eating a wide variety of foods and not choking. The last issue to tackle was drinking fluids. I assumed he would stay on this positive path with therapy and keep progressing. However, an unexpected problem brought his feeding progress to a halt.