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ShieldMaiden
member
XP: Feeding Therapy
ShieldMaiden
member
Hi ladies. I posted this over on Parenting, and several posters suggested I try this board for my question.
Has anyone's LO had feeding therapy? If so, what did it entail and how long did it take to see results? In this case, I believe my DD's issues are not motor-related. Her therapist is an SLP.
Some background: DD is in EI for a speech delay, sensory issues, and because her diet is so limited. She's not a big eater to begin with, and only eats French toast, waffles, blueberry muffins, Greek yogurt, apples, bananas, and white potatoes. Often when she's presented with foods she doesn't eat (strawberries, grapes, cheese, meat), she gags and drools almost to the point of throwing up.
During the consult we had with the therapist, she said it seems as though eating at some point probably caused DD a lot of discomfort, and so she has a strong negative association with food. She has never been a good eater since she started solids.
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Re: XP: Feeding Therapy
I don't have much advice, but... my DD has a g-tube so we receive feeding therapy with both the SLP and OT. For tube weaning, we may have to go either inpatient or to an outpatient program at a hospital.
From my research there are several approaches but many favor a behavioral/reward approach. Have you had your DD checked by GI or for food allergies?
I asked the therapist whether she would recommend we see a GI based on our description of DD's history and current issues. She said she didn't think it's necessary now, because she thinks at this point DD is just conditioned to not find eating enjoyable. She mentioned it would probably be invasive tests, and often there's not much they can do to help.
I think I'll discuss with her pedi at her 2 year visit in a couple weeks, though. The pedi is aware of her eating issues, and said EI should be able to help us, but didn't suggest any testing at the last visit.
My 5 year old sounds a lot like your DD. She eats a very limited selection of foods (plain milk, vanilla yogurt, cheddar cheese, peanut butter, crackers, chocolate chip muffins/pancakes/waffles, French fries, potato chips, tortilla chips, and some other junk foods/candy). She's been this way every since she started on solid foods. She had speech therapy from early intervention for an expressive speech delay and got some sessions with an OT who specialized in feeding therapy. They encouraged us to make food fun, not pressure DD, and use the methods from the book Food Chaining.
For my DD, it hasn't worked. She actually eats fewer foods now than she did three years ago when she had the feeding therapy. She has no curiosity to try anything new, even if all her friends are eating it. She couldn't care less about playing with food or eating a sandwich that looks like a silly face. She gets upset if we just put a non-preferred food on her plate. If we "make" her taste a non-preferred food, she will gag herself until she vomits.
Everyone kept telling us that DD would outgrow this, but she clearly isn't. My DD has an appointment with a developmental pediatrician in a couple of weeks (we've been waiting 4 months for the appointment) and I hope maybe we can find out what's going on with DD and figure out what we can do to help her.
DD is seeing an OT as well, and they've (and we've) been working on textures with the hands/feet as you suggest. Unfortunately, we haven't seen a benefit in the food department yet. The feeding therapist mentioned it took her a year of working with one child to get him to eat grapes, so I probably just need to come to terms with the fact that this will take a long time and a lot of work.
Yes, feeding therapy was immensely helpful for my lo. She's regressed some in the past month since she was recently dx with epilepsy and anti seizure meds have destroyed her appetite but its still a million times better than it was.
Eta-it took 2-3 months before we saw real change.
Oh, goodness. I understand what you're going through. We started DS in ST at 16 months for a slight language delay, but mostly for feeding issues. At the time, he was still eating baby food, and some meltable solids (mum mums, graham crackers). It was thought that not only did he have some oral motor problems, but also a negative association with food from having bad reflux and MSPI. The ST wasn't getting much progress because she was focusing more on speech, so at 22 months we started with OT as well for feeding therapy specifically.
I'll tell you this much, your therapist is right, it is a really slow process. We've had the OT for almost 9 months now. Have we made progress? Absolutely! But he's still not a "normal" eater, and has a limited amount of foods he eats (currently - pasta of all sorts with different sauces, rice, quinoa, yogurt, oatmeal, Mac and cheese, cheese slices and shredded, applesauce, and he still gets some stage 3 baby foods, as well as those squeezable pouches). No solid fruits, veggies, meat, or bread. And we lost crackers after he had a bad illness in January. His acceptance of non preferred foods being around his other foods has increased (he allows non preferreds on his plates, allows them to touch his other food sometimes, will pick them up to hand to you, currently working on him kissing, licking, and biting non preferreds). His therapist feels like he's doing great. I get bummed out sometimes because I think I thought by now we'd be finished with this whole process. Obviously we still have a lot of work in front of us.
I agree with checking out the book Food Chaining. It didn't change anything major, but it did help me get the idea of changing up his preferred foods so that he can see that things are similar even if they look different. I think it helped him not get stuck on one kind of pasta or cheese, for example. We can actually go to a restaurant and order one of those kinds of things and he will eat it. I know it's not much help, but good luck! I know it's hard sometimes!
Well, it could be worse! When my DS was your daughter's age he ate only pediasure and gerber puffs. We went through therapy for about a year and he made slow improvement. Basically, the therapist got to the point of saying he was "better" and there was nothing more she could really do.
Feeding issues suck. My son is about to turn four and is still a picky eater but will eat actual food (he still drinks pediasure). I think there is really no way to tell how long it will take her to improve. I have a special place in my heart for all parents who have kids with feeding issues because I know how much it sucks! It will get better, but it's likely going to be a long haul...
We had ds in feeding therapy starting at 13 months. He was never a good eater from day one (born with severe growth restriction, reflux, and mild hypotonia) and when we started solids, he only took a few flavors and very limited quantities. We did feeding/speech twice per week. We would see some minor progress, but never anything mind-blowing. Then, at 18 months old, ds became even pickier and more resistant to the few things he would eat. Somehow we stumbled on videos during meals and that led to ds finally eating a normal quantity (though still only a few foods--less even than what you list). With videos, he jumped from 3rd to 30th%ile for weight and 20th to 60th for height over the next several months. Huge gains. We don't like relying on a 'bad habit', but clearly he needed the nutrition given the tremendous growth in height. We continued with the feeding therapy too and at some point she felt ds was 'so close' to a breakthrough. She recommended an intensive where we meet daily for 2 weeks to push certain foods and techniques. Well, it caused a huge regression and weight loss that we never fully recovered from. Huge mistake.
Anyhow, for us, feeding therapy did not help at all. We had consulted with a GI several times, but I just now decided to revisit GI stuff with a new doc/fresh eyes. We have an upper endoscopy planned, testing for sensitivities, etc.. and he now needs his adenoids out from inflammation due to reflux. I'm convinced that while he probably will not be agreat eater any time soon, there are important medical components to this puzzle that have been missed, so hopefully we can address those now.
I responded on Parenting, but this post just makes me feel better that there are other kids out there like my DS. I haven't met anyone that has had the same issues and it gets a little frustrating when people don't understand.
The progress has been slow for us as well. He's still not a good eater, but he does eat a little more variety. Not much protein or fruits/veggies. I'm still waiting for those.
We had a second team evaluation at that point and added a behavioral psychologist and it was the greatest thing we ever did. In that first appointment, he ate almost an ebntire jar of pured baby food Nd he hadn't taken anything by mouth in months.
We continue to see both periodically and he still doesn't eat enough to maintain and gets tube fed overnight but that one appointment changed our lives.
If your OT thinks it might be behavioral, ask to see a behavioral psychologist. It may help to har someone look at things from a different point of view.
For us, what our behavioral psychologist did made me what to smack myself with a why didn't I think of that. She started out by playing with him for a bit. He was about 17 months old at the time so she just played around to see what he liked most. After playing for a few minutes, she put him in the high chair and continued playing with him. For him, it was a couple of balls. She put the balls where he could see them, put the spoon to his mouth and told him he had to take a bite to get a ball. Nearly 20 minutes later, after giving and taking the ball, he ate almost 4 ounces of baby food. Now, it isn't always that easy, but it seemed to get him over the initial hump.
He has CF and with that for him has been a ton of digestive issues, including very severe reflux and what, for the moment, has been diagnosed as eosinophilic esophagitus (but there's some serious question about this diagnosis now). His starting to eat was largely behavioral.
He still struggles with solids and because he needs about 2000 calories a day, thanks to the CF, he still doesn't eat enough to sustain & gain, so we still use the feeding tube.
It hasn't been an easy process and we've learned new tricks along the way. Now, he watches his favorite shows on the ipad while he's eating. It's not ideal, but he's eating, so i don't really care that he's watching tv. We still have good days and bad days and he still isn't very open to new ideas, but by applying some of those same concepts, we get him to eat.
Once he started eating, it was counting how many bites/sips you had to do before you could get what you wanted. For instance, now, to introduce more solids, he has to take 5 bites of the solid he doesn't want to get to the food that he willingly takes.
In the end, it largely depends on the child, but for us, BP was a huge blessing. We were getting nowhere with OT.