Author: Stefanie @ The MD & Me

I feel like I live at the Pediatric Therapy Clinic. We (I had to take Nadia too) went this morning to Nora’s feeding evaluation. I had no idea what to expect, but they asked me to bring three foods she will eat, and three she won’t. The first half hour or so was just information gathering, we discussed Nora’s premature birth, acid reflux as an infant, her breastfeeding issues in the NICU, her posterior tongue tie and upper lip tie, how even after correction she still took forever to finish a bottle… I gave a list of what Nora will eat, how we still rely a lot on Pediasure and toddler formula, the how she spits out a lot, even before she’s really had a chance to taste.

The therapist really wants to see Nora twice a week, but we’re already there once a week for Nadia’s physical therapy, once a week for Nadia’s speech therapy, and now once a week for Nora’s feeding therapy. Adding three appointments a week to our schedule is enough for me, I can’t do four. I feel bad, but I can’t, not now anyway. Maybe in a month when I get a new sitter hired and we’re into a routine.

I was able to see a little bit of the actual therapy today…  The therapist started with one of the foods that Nora likes, sour cream and onion goldfish crackers. A few were put on a plate for Nora, and the therapist put a few on her plate at well before going on to talk to Nora about how crunchy the crackers were when chewed. She made a big display of it, and of course Nora thought it was hilarious and then wanted to crunch them as well. Next they moved on to a food Nora doesn’t like, pumpkin banana snack bars from Plum Organics. Again the therapist took a bit of the bar as well, talked to Nora about how it was soft, didn’t make noise when she ate it, could be smashed with her fingers, etc. She asked Nora to first touch the bar, then kiss it, etc. until finally asking her to ‘send it down to her tummy’. Apparently they aren’t supposed to always or even often use the word ‘eat’… This process went on with the other foods I’d brought, almonds, fruit snacks, yogurt, and bits of actual fruit.

The therapist seemed to focus a lot of Nora’s acid reflux as an infant, suggesting perhaps Nora has learned that eating is actually painful and thus she has somehow learned what she can eat, a very limited variety of foods, that won’t cause her reflux. I’m not sure I believe this theory…

One of the questions I was asked was whether or not Nora is overly concerned with her hands being messy. I’m not sure on this one. She does ask me to wipe them off if she gets a lot of food on them, but she certainly doesn’t freak out about it. Looking back though, I never really let Nora eat with her fingers… You know that spaghetti picture everyone has of their child? We never did that, rather tried to teach Nora from a young age to use silverware. I more blame giving up on the idea of baby food so soon for the issues we’re having now. Nora spit out a lot of baby food at first, and being a first time mom I figured she didn’t like it and quickly moved onto baby led weaning. Having seen Nadia spit the baby food out a few times before liking it and figuring out how to eat it, I now think maybe I just didn’t give Nora enough time. Who knows… Can’t go back now I guess.

Our next feeding therapy session with Nora is this Friday, so rather soon. We were given a few instructions to work on at home in the meantime:

• continue our usual routine, sticking with the Pediasure and toddler formula for the time being
• during family meals prepare for Nora foods we know she likes and will eat, even if that means mac and cheese and fruit snacks for every meal; the goal for now is just to make sure she is eating with us
• during family meals talk a lot to Nora about what we are eating, meaning about the foods we want her to eat; for example if I’m eating a green bean tell her how it’s soft and green, doesn’t make a sound when chewed, can be cut into smaller pieces, how yummy it is, etc.
• plan time for one-on-one therapy meals with Nora, perhaps when Nadia is napping (ha); during these ‘meals’ introduce Nora to new foods but also incorporate familiar items she likes while completing this feeding log 
• the idea with the log is to start at the top and attempt to move down the list by encouraging her, playing with the food, doing these things myself with the food, etc.; if she won’t move down the list, go back to the top and start over

So… this all sounds great and wonderful, but ah, finding the time, and preparing new foods to try is already a bit overwhelming to me, not to mention also finding foods to take to the actual therapy sessions, oh, and going to the therapy sessions. I know, this is just one more thing I’ll look back on and think, oh, remember that? But still, right now it feels like a lot for me. Especially since my specialty is accounting, not playing with kids and their food!