Have you ever thought about how you eat? Not using your fork or spoon, but how we know how to eat? I had never given eating a second thought. It's something we just do. We put food in our mouths chew, swallow and get the nourishment we need. It seems so simple, doesn't it?
Well, when Shana was 15 months old and still unable to eat anything thicker than yogurt without gagging and vomiting, it seemed that there was something wrong. Our pediatrician referred us to a feeding clinic (I never knew such a place existed). We made an appointment for the earliest date, 3 months later.
During this time Shana started refusing to eat baby food. Who could blame her, usually by the time you are 18 months you are eating many regular foods in cut up pieces. The food has salt and flavor, unlike the bland baby food. By the time we went to the feeding clinic Shana would only eat Safeway brand yogurt and milk. She was still gaining weight as she should but it took a lot of yogurt and milk to keep her going.
When we arrived at the feeding clinic with Shana we were taken to a room with a table facing a mirror, we knew the staff was watching us. They did this because having a herd of people come watch your child eat would be a little scary for the child. We fed her the foods she could eat and then some things she struggled with. At 18 months the foods she struggled with were pretty much everything.
After observing then the really interesting part started. The doctor came in and spent over an hour explaining to us exactly how we eat and how difficult it really is. She started with showing us how Shana had a hard time sitting up in the seat and leaned to one side on her arm to prop herself up. This made it difficult to eat because as the doctor so eloquently explained "how can you think about chewing when you feel like you may fall on your head". We got pillow to prop her up and this was the start.
We then learned that what we had called daintiness was actually a problem. Shana hated to touch anything messy, even her first birthday cake she poked at with one finger to get a tiny bit of frosting. This we found out was tactile defensiveness. She didn't like the feel of the food on her hand, so she would touch as little of it as possible.
Did you know that your tongue is controlled by both sides of your brain? I had not thought about it but it makes sense. It's similar to your arms. Now the tricky part is to eat you have to be able to move your tongue from side to side. When you do that your brain has to tell both parts of your tongue to do opposite things. This was Shana's other problem. She didn't move the food in her mouth to the side as she chewed and then swallowed. She swallowed off her tongue and would gag. Try chewing up a saltine cracker, then before you swallow move the pieces to the center of your tongue and try to swallow, it's difficult to do.
These are a few of the things that led us into feeding therapy and we were also referred to Child Find the program for children with disabilities. After many other tests we were told Shana had mild sensory issues, speech and motor delays.
Shana spent 10 months learning how to eat. Since she had already started refusing most foods, there was very little she could eat. We found out that when this happens she would eventually get tired of the yogurt she liked and stop eating it too. It's called a food jag, eventually without help she could have stopped eating entirely and would need to be fed though a belly-tube.
We had to get her trying new things and teach her how to chew and use her tongue. We started with pretzel rods to "explore" and we would always have to show her what to do and try to get her to mimic us. When we were in a restaurant, I'm pretty sure people thought we were crazy, going "chew, chew, chew" and playing with our food. We didn't care, it was working. Shana progressed from exploring to eating meltable foods. She would eat chickpea crackers called Papidi, puff Cheetos, Pirate Booty (puffed rice) and lots of other fun things. We shopped in a totally different way. We didn't look at the price or the nutritional value, we looked for things that were meltable in with little chewing. We also explored new options for the yogurt, we bought Trix yogurt in bright colors (changing the color helped avoid the food jags), we tried hummus, flavored cream cheese and eventually peanut butter. She didn't eat this on bagels and muffins, she ate them off a spoon like baby food. To this day Shana will still get the peanut butter and scoop a pile into a bowl and eat it with nothing else.
After 10 months of feeding and speech therapy, speech was necessary because feeding and speech are related, she was finally discharged from the feeding clinic. We were so thankful for their help. Shana continued speech and occupational therapy at home through Child Find.
I will end there for today. So the next time you sit down to eat, think about everything you are doing, which muscles are you using, move your tongue and swallow and think about how this action you do three to five times a day is so much more complicated than you ever realized.
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