Recently we took our little boy Avin to his nth therapist. This lady is a very experienced SLP (Speech Language Pathologist) who specializes in feeding.
After evaluating Avin she said that he does not have any behavioral issues. My husband and I were shocked by her diagnosis.
Every single pediatrician that we met and even all the GI's we met were able to convince us that our son feeding aversions and sleep-feeding were completely 'behavioral', however, going to a behavioral therapist had proven to be disastrous too. So we decided to switch to a more experienced SLP because in the back of my mind I had a nagging feeling that my son had some real difficulty swallowing and gulping. Several doctors/GI's had ruled out dysphagia. At one point I insisted on a swallow study and it came back negative for dysphagia.
In any case, when we went for our first appointment to the new SLP, she asked us to come prepared with solids (puree) and utensils that my son was very familiar with. She also told us to bring Avin ‘hungry'....When we reached her clinic, she asked us to start feeding him without wasting any time. Sure enough Avin started gagging and choking after feeding a few spoonfuls and we told her that this was labeled as "behavioral" by all the doctors and therapists who had seen Avin. She showed us two simple tricks:
- 1. Liquid wash: Giving formula, juice, water (if your child is at a good weight on the growth chart) during solid feedings. This can be done using sippy cup for children who have bottle aversions. This helps the solids move smoothly into the stomach. She said that a swallow study cannot always detect a brief swallowing difficulty due to messed up motility (delayed, slow or reverse peristalsis) that most of the reflux children seem to have. Poor motility of the esophagus and stomach is the root cause of acid reflux in infants.
- 2. Allowing your baby to "stretch" while feeding-arms above head and legs straight down. When an infant who cannot sit completely upright is seated in a feeding chair, the infant has a tendency to slouch. This does not allow the esophagus to remain straight and the solids tend to move much more slowly through a bent gut. Stretching helps creating a straight passage for food.
Well these two tricks have helped Avin with his gagging and chocking.
We are still struggling with total quantities of his solid and liquid feeds but a visit to a good SLP has helped us make his feeding experience more positive and with fewer "gagging and choking" interruptions.
The SLP also recommended that we see another GI (this one will be our fourth GI) but this time our new GI comes highly recommended from our SLP and several other parents of the children that she has treated. Proper medical care and right amount of medication is equally important while dealing with aversions. All the therapists who saw Avin had one thing to say: First the doctor/GI has to give the right medication so that your child is free of pain and discomfort, only then therapy is helpful.
Hello Sonja,
Thank you for sharing your experiences with us. Thank you also for the message you sent me, that helped me feel like I'm not alone in this struggle. I will surely write back to you when I have some time.
I want to wish you all the best with your son Avin. I will read all your posts when I have some time. Before we got a GERD diagnosis for our son, I asked his pediatrician if his feeding aversion could be behavioural and she said definitely not. We are going to start cereal in a few days (when he turns 4 months old). I'm scared to death because his sleep feeds are not going well. Should I put the ceral in his bottle or spoon feed it to him? He's sleeping less, consuming less, and regurgitating more.
I will be in touch. I just wanted to say hello and let you know I'll be thinking of your 'lil boy and sending him a (((hug))).
Sandeepa
Dear Sandeepa,
Thank you for you comment. I would think that you should try to avoid spoon feeding until you get all his symptoms under control. For that you need a good GI with lot of experience in reflux and aversions. Zantac is very helpful for a milder form of acid reflux but more severe reflux has to be treated by a PPI. As the therapist said--- make sure you help the child overcome pain before you try out different methods of feeding. I wish you the very best and hugs to your little boy too.
Take care.
Sonja