Today was our three week feeding therapy follow-up at St. Joseph's Center for Pediatric Feeding and Swallowing clinic. Just as I expected, there hasn't been much of a change yet, so we didn't walk away with much to talk about.
We met with the Nurse practicioner first who asked us questions about Colin's health. Two of the areas that we have made progress with are internal issues regarding the reflux and regulation of Colin's constipation. As was explained to us on the first visit, when children have issues with reflux and constipation, it often affects feeding for several reasons. Reflux obviously affects feeding because if food and stomach juices are constantly coming up, it irritates the lining of the esophogus and often turns kids off to eating. Just before the initial feeding assessment, Colin's pediatrician started him on Zantac 2x a day and it took a week or two, but we finally started to see a decrease in his spitting up. As of today, I have maybe seen him spit up once all week.
At the initial visit, we discussed the fact that Colin has often pooped "rabbit pellets" for as long as we can remember, even though he has always gone regularly. The NP explained that when children are constipated (as is evident with the rabbit pellets), they are often "backed up" and affects how well the stomach can empty as well as the want for food (because you often feel more full and bloated). She started us on either Maalox or Mylanta (although we went with Miralax at many recommendations including our pediatrician's) to turn his poop into "mush". Well, I can assure you that in the past two weeks, we have successfully turned his poop into a LOT of mush. The NP was very happy with this because she said that he is finally emptying completely, allowing for better food movement through the GI tract. She feels that these areas will improve feeding.
They watched us feed Colin and he still continues to do more work than necessary with pureed foods. I told them that there are days when he has successfully been able to move the food the way they want him to, but it is not regularly just yet. We need to continue to give him pureed foods until he is able to get this technique of proper tongue movement down. Unfortunately, until he can move food from the front to the back and swallow appropriately, we will not be moving forward. However, she did want us to introduce pancakes and bananas back in to his diet with us sticking the pieces in the far sides of his mouth to give him the practice he needs to move the food from the sides back to the center again.
Yes, it's a lot of work, but we will keep plugging along. Colin's eye teeth on the top are BOTH are about to break through and he is still working on a molar, so feeding has been challenging to say the least these past few days. He pretty much spit all of his dinner out at me, but at least I know the reason this time. Hopefully those teeth are through soon so we can move forward again!