Bean Breakthrough - Intro to Feeding Therapy

In March I took LB to a follow-up visit at our international adoption clinic. We saw them right away when we got home and then they advise a follow-up visit after the child has been home for 6 months. They have been very thorough and it was nice to have access to a doctor, nutritionist and physical therapist all in one spot. LB was about 14 months old at that second visit and the big thing I wanted to discuss with them was his feeding issues. In a nutshell, he doesn't chew. When he was around 9-10 months old we started offering him little pieces of food. He showed no interest and it almost seemed he was afraid of it. We tried putting those puffs in his mouth and he would panic. He just held the puff in his mouth and had no clue what to do with it. He knew he couldn't just swallow it the way he does with pureed baby food so it would either dissolve enough for him to swallow or he would gag and spit it out. Not a pretty sight. We backed off for a bit and stuck with his baby food, which he enjoys. We would occasionally keep trying non-pureed foods although looking back we probably didn't try enough. He also would not eat any of the stage 3 baby foods. It seemed that they were either too thick or chunky for him and he would gag and then throw a fit. I talked all of this over with the nurse and physical therapist at the clinic and they agreed that LB probably needed to work with an occupational therapist who specializes in feeding. There is even a clinic at our Children's Hospital just for this type of issue. It was good to know that LB was not alone.

We met with the OT for the first time in early May. I have to say that going to the clinic at Children's Hospital really put things in perspective for me. I had honestly been getting pretty frustrated and discouraged but I quickly learned that his problems are minimal compared to most of the kids we saw in the OT room. It was eye opening and I am grateful for that. By the time the appointment rolled around he had started to eat several stage 3 foods and actually really liked some of them. Progress! The therapist was incredibly kind and patient and initially just watched me feed LB. She noticed that he wasn't really moving his tongue from side to side, which you have to do in order to chew. She thought that LB's lack of chewing was probably due to a combination of things but she said it was impossible to know exactly what caused it. I can't help but look back and wonder if it is because I did something wrong or is it a result of his rough beginnings or both or what? I will never know and just need to move forward. That type of stuff is hard for me to let go of.

We have been working on the OT's suggestions for the past month and we go see her again next week. She has had us give him large pieces of food that he can hold and are too big to swallow. He loves to chew on apples and will also chew on carrots. He rarely actually swallows any of it but he does use his gums to chew it. She gave him a special toothbrush to use that will help him with his tongue movement. We dip the toothbrush in his baby food and he chews on it and moves it around his mouth. It took him a few days to get comfortable with the toothbrush but now he loves it. We are also positioning his spoon back towards his molars, even though he doesn't have molars yet, to help him get the concept of moving food back there to chew. He will eat slightly mashed bananas but if you just cut up some banana and put it in front of him then he won't eat it. But the therapist said the first thing we want him to do is to move beyond the pureed to mashed. He has started to eat hummus like a champ and seems to prefer spicier versions like roasted red pepper and chipotle pepper. Obviously, hummus doesn't require much chewing but it is thicker and chunkier than pureed fruits. Two nights ago D and I were having enchiladas. D took some of the refried beans from the enchilada and gave it to LB. He ate them! They were pretty chunky so I expected him to spit it out, which he did several months ago when we tried at a Mexican restaurant. I know for most parents giving their 15 month old refried beans is no big deal but for us that was a huge breakthrough! He let them sit in his mouth for a bit but then he mashed them up and swallowed them. I was clapping so enthusiastically and cheering for him that he asked for more. So proud!

We obviously still have a long road ahead of us but LB is making steps forward. I imagine that hot dog eating contests are not in his future but I am hopeful one day we can go out and eat sushi together. Or at least he will look a little happier when he eats.