OT eval
Okay, so I called my Ped this morning, because my DD threw up from gagging on Mum Mum's yesterday. Only, this happens every time she puts something in her mouth. She can take a bottle alright, and BFs during the night, she only eats 15ish oz (on a good day) and 6-8 oz (on a day when she is sick- which seems like all the time these days). We have been battling ear infections and the flu (reoccurring) for the last month. So, I called the Ped to find out if it was normal for a child to gag on a mum mum, then throw up (violently). She threw so much up (I was surprised there was that much in her, but I had just gotten a 2 oz bottle in her) that she was down to yellowish color curdled milk. It went all over. So, my Ped said that it was finally enough, and we needed to get her in for an OT eval. I am so scared. I am a social worker, and help people get therapies daily, but, when it is you.....
So, I have been on the verge of tears ever since hearing this this morning. I know it will be a good thing, it is just... I keep hoping for a miracle, something that just clicks that she wants to start eating. It causes so much anxiety for me. I feel chained to the house, because every night after work, I work on getting her to eat, since DC has difficulties. I am sure this is uttered many times, but why can't my kid want to do something so basic- like eat??? I had a ENT tell me, that we are lucky, that kids like her 100 years ago wouldn't have survived. Okay, I am sure he was right, but, um, I don't need to hear that right now! On top of it all, she has had about 4 ear infections in the last 2 months, and the flu several times in the last 4 months.
Anyone have experience with a 7ish month old OT eval for problems eating? I know this is very specific, but I am at a loss and feel very helpless and alone.
Re: OT eval
Yes - my DS had a g-tube put in at 7 months for failure to thrive and then promptly stopped eating what little he had eaten. We had to fight with the feeding clinic to get us in before the 1 year mark (so be glad on one bright spot, they'll see you now).
I don't know your story, but your description brings a couple of questions forward for me, based on our experience. Have you had any allergy testing done? Have you tried nondairy formula and cutting out dairy in your diet for BM?
We had NO idea our DS was allergic until he had his g-tube placed. Luckily, his GI surgeon is married to one of the leading allergists studying eosinophilic esophagitus, so even though he wasn't looking for it, he knew it when he saw it and did some biopsies. DS had already had blood testing done that was negative for everything but pork, so we did not expect to find out that he has a possible dairy & soy allergy.
I can't help but wonder if we had known about the allergy if we could have avoided the g-tube.
As for OT, I'm not a big fan of our OT and am trying to figure out how to move to someone else. DS didn't eat after working with OT for almost 5 months...ONE 30 minute appointment with a Behavioral Psychologist and she got him to eat. He's been eating 3 meals a day (purees) since then.
Thank you for the replies! Well, I have cut dairy out for about 3 months now, and had tried the elimination for a little over 2 weeks, but saw no improvement, so just went back to cutting dairy. If I do have some dairy, she ends up waking up around 3 in the morning and screaming horribly, until I give her some gas drops, and even then, it doesn't always do the trick.
We have been trying purees since a little before 6 months old, and she wants nothing to do with them or cereal (rice or oatmeal). I have tried several things (avocado, sweet potato, peas, squash, mac and cheese, etc). She has never wanted to even open her mouth for them, so it makes me wonder if it is medical, or behavioral. If it is behavioral, what do I need to be looking for? What referral needs to be made?
Our whole eating issue started when I introduced the bottle at about 7 weeks, because I had to go back to work at 9 weeks. I only did one bottle a day, because she absolutely would not even put the nipple in her mouth. We tried 8 different bottles/nipples, different environments, etc. At the 9th week, she refused eating at all from the bottle and drastically went down with BFing. She has since done better with breastfeeding during the night, while she is half-sleeping, but she does not do great with the bottle during the day. It is very sporadic, and I have yet to find an antecedent for why she eats well/poorly that feeding. When I was at home on maternity leave, and she was just BFing, she gained 5 lbs in 2 months and was on the boob the entire time she was awake (she fell asleep at the boob most times, and I tried to wake her, but I didn't force her to wake up).
Some days I just want to throw in the towel, and have her get a feeding tube, and others I am so scared that she may have to have a feeding tube. Since she is gaining okay (in the 80th percentile), I am not sure what they will do with her. Even the Ped mentioned that she is confused as to why she is eating so little, and gaining so much. She may be getting more in her at night, which would explain her only sopping wet diaper of the day in the morning (she has 4 or so more during the day, but they are marginally wet at best).
And, you would think I would have a clue, because I have another child, but, sadly, I don't.
I wish that I could hire a doctor to live with me, and tell me what to do. I am so bad at this
Thanks again for your help. Sorry to be such a Debbie Downer
Have you looked into reflux? My DS had SEVERE reflux. He would eat great one day, and then because he refluxed it all he would not eat for 2-3 days afterwards. DS also had a nasty feeding aversion from the severe reflux.
We ended up on Prevacid (7.5mg 2x day) and thickened formula. He couldn't have ANY thin liquids because they would come up immediately. Even with the Prevacid the pressure from the refluxing and discomfort was enough to really bother him. Once he finally started eating we tried purees. It took a LONG time for him to even want to open his mouth because of the stupid feeding aversion. We did lots of singing noisy toys to distract him while we snuck bites in. We never used stage 1 baby food because it was too thin.
and babies don't have to throw up to be refluxing.
and it sounds like she is getting a lot more from the breast at night than you think. If she's eating a lot at night, she is most likely holding off from eating during the day knowing she has free access to the breastmilk at night. It's like reverse cycling. When DS was eating minimally he gained 1oz in 2 weeks on average. He went from the 95% to the 5% when we were admitted to the hospital for Failure to Thrive.
As for the gagging on Mum Mums, 7 months is nowhere near delayed enough to be worried about it. DS only just learned how to eat them, he's 2. Some kids just really don't love solids. I would back off on the mum mums, it doesn't sound like she's ready to chew yet and just go to purees, or look into baby led weaning methods of introducing solids. Our pedi said they don't worry about solids intake until about a year. The general rule of thumb is "food before 1, just for fun".
My DS had issues with bottles as well (never breastfed after trying for a long time), but did fine on purees, and fought solid foods that were not "meltable." So, I'm not sure my DS has the same issues as your DD, but I can totally relate. In a society where food is such a social/enjoyable thing, every meal and all food is a struggle with him. We've come a long way with the help with speech 2X a week and OT 1X a week.
My only suggestion is also have a speech eval through Early Intervention or somewhere else. Our speech therapist knows SO much more about swallowing/gagging/vomiting than our OT.
And I totally feel the same way, but I wish our speech therapist could come live with us. My DS will eat almost anything for her, but will refuse the same food with me the next day. =(
Good luck and ask many questions here. The ladies here are so knowledgable and relate to these struggles when no one else understands. For example, very few parents could relate to when I almost cried when my son ate his first Happy meal, chicken McNuggets and all. It was a huge step to go out to eat with him and NOT bring him different food.
I/m so sorry you have to go through this. I agree with PP who suggested an SLP eval instead of OT. Some OTs have specialized training in pediatric feeding/swallowing but it is rare. It is not part of standard curriculum. I'm an OT and did work with one of these gems and even the SLP deferred to her, but that's not usually the case. Really I suggest OT and SLP, even though I know it probably feels overwhelming already.
Know that you aren't alone, and you're helping your little one by asking questions, calling the ped. etc. They are resilient!
I am wondering more about what the ENT said. I know I can't eat with a sore throat or ear ache.
How does your LO do with chewing on things, like pacifiers, a wet cloth, etc?