Adventures in OT: Feeding Therapy

My last blog post, read it here, was about my gratitude towards my ability to breastfeed my 10 month old son.  He is thriving on breastmilk and is quite the chunky monkey – as we affectionately refer to him.  He is over a whopping 19lbs – much larger and heavier than my first son was at the same age.  Although food before one is just for fun (or so they say), a growing boy cannot survive on breastmilk alone forever.  My son needs to be able to eat and systemically tolerate solid food.

We first introduced both boys to solid food at 6 months of age but while my older son took to it right away, my younger son wanted nothing to do with it.  After eating just a couple of bites (which we had to convince him into) he would cry and cry until I allowed him to nurse and then he would nurse for literally HOURS afterwards.  After consulting a few specialists and our pediatrician it was decided that my son’s digestive system needed more time to mature and we were advised to hold off and re-introduce solids at 8 months.

Our second try at introducing solids did not go much better.  In fact, it was almost worse.  We started with baby oatmeal because it was a food that my other son had loved and because I figured it would be gentle on my son’s digestive system.  On day one my son refused the food entirely, on day two I made it so soupy that it barely stayed on the spoon and he begrudgingly took all of three bites.  On day three I made it a little thicker so that it would stay on the spoon and he actually seemed to be enjoying it – he ate a little over an ounce of the stuff but then – just two hours later (while I was holding him on my lap during a zoom meeting) he projectile vomited EVERYWHERE exorcist style.  Not only that, but the projectile vomiting persisted for six HOURS.  I didn’t know what to do and I have to admit I totally panicked.  Our pediatrician advised us to just keep an eye on him and keep him home unless he spiked a fever or became dehydrated.

Mathew was already receiving occupational therapy and craniosacral therapy for his torticollis (stillness in his neck and torso) but when I mentioned to his therapist that he was struggling so much with solids she wasted no time jumping in.  Our therapist and her speech therapist on staff sat down with Matthew and did a one on one evaluation to see what was going on with him.  They worked together to brainstorm what to do.  It was the first time that I felt really listened to and taken seriously.

I had brought a few different types of pureed foods to this appointment because the children’s hospital had advised us against trying baby-led weaning due to Matthew’s small airways but Matthew wanted nothing to do with them.  He pursed his lips together and refused to open his mouth.  Thank God, his therapists were not so easily deterred.  They played with him and were so gentle – not forceful or impatient and convinced him to at least play with a teething toy so that they could see what oral motor skills he had to work with.

And then his occupational therapist had a genius idea.  When Matthew wasn’t looking she smeared a spoonful of applesauce onto the teething toy that he was playing with.  The next thing I knew, Matthew was licking the applesauce off of the toy.  It seemed like we all sort of held our breath while we watched him to see what happened.  He just looked at us like we were crazy for staring at him and went right on chewing/licking the toy.  And so this is how I fed my son for the first week of solid foods.  After two nights it got to the point where I didn’t even have to hide it – Matthew would hold out the toy and wait for me to spoon the pureed food onto it and then lick it off and hold it out to start the process again.  I’m sure to anyone watching the process looked absolutely ridiculous but my son was eating and I wasn’t going to question the method.  I think Matthew liked being in control of the situation and being able to lick the food off on his own terms.  After a few more days he was willing to take pureed food off of a spoon for me.  I couldn’t believe it. We had come so far in only a week!

Next came introducing a straw since Matthew won’t tolerate a bottle and isn’t quite able to use a cup yet.  Using a therapeutic honey bear straw cup (like this one) we were able to teach Matthew to suck and drink water.  This was huge!!!!

In less than two weeks my son had gone from not being able to tolerate solids at all to being able to eat some pureed food and use a straw to drink water. Amazing.  We still have a ways to go.  Matthew sometimes goes on food strikes where he decides that he doesn’t want to eat and just wants to live attached to my boob but it’s a process.  Getting him to swallow anything other than a puree is also hard but with the help of his therapists, I am confident that he will get where he needs to be in time.  If you have a baby who is struggling with solids I highly recommend seeking help from an occupational therapist as well as a speech therapist.  Until now I had no idea that speech therapists did things other than teach kids to speak correctly. I feel silly for assuming that is all they do!  If you happen to be in Connecticut, I can’t recommend Advanced Therapy Solutions enough. They have changed our lives for the better in so many ways.  Not in CT but struggling and searching for answers?  Give them a call anyway, they are also providing telehealth sessions right now and may be able to help anyway!  As a parent with a child who is struggling, having a team who listens and treats your child like a person and not just a number is worth everything.  Matthew’s therapists are always brainstorming new ways to help him and have gone above and beyond to ensure his success.

Trying to eat food is exhausting…