Welcome back to “101 things you never wanted to know about feeding therapy!”
We were stagnant for a while, in the feeding sphere. No real improvement in skills or interest. Not uncommon in the brutally slow world of teaching a kid how to eat, but frustrating nonetheless. We were due for a breakthrough, but how to get it?
Apparently, the answer is to try to teach Ellie what it means to be hungry. In two years, she has barely ever been hungry. She is fed an exact amount on an exact (ish) schedule. And it’s a completely passive process for her, she doesn’t have to do anything. She long-ago lost the connection between a rumbly tummy and any version of “eating.” So the question is, how do we get it back?
About a month ago, we cut 100 calories out of her daily ration of formula. And while the difference wasn’t striking, she suddenly seemed a little more attentive and willing at her feeding therapy appointments. We even progressed to little bites of soft food – bananas, sweet potatoes, bits of American cheese, as well as some favorite crunchy ones like graham crackers. But while those were good for new tastes and textures and oral-motor skill-building, I certainly wasn’t getting enough into her belly to make up for those 100 calories.
Enter: prescription medication. Our GI doctor wrote us a script for an appetite stimulant. (Which is apparently also an antihistamine, and also helps settle her GI tract after she gets sick? I don’t know, man, I just work here.) Though the first dose made her a little bit loopy, it seems to have had a near-immediate effect.
When I try to feed Ellie at home, I can never get as much into her as our feeding therapist can. I don’t have as much practice or as much patience, and sometimes I think Ellie is deliberately being a pill just because I’m her mom. So the best I can usually do is to get an ounce or so into her, with a lot of stress and cajoling and the need to rest afterwards.
This morning, with the help of an appetite stimulant and a generous helping of iPad games, I got the vast majority of a 4-oz container of yogurt into her. No fighting. No stress. Stopped after 20 minutes, and I could actually see the bottom of the cup. By my math, nearly 120 calories. And while that was the best I’ve ever done, I had three or four times last week that we did nearly as well.
Three cheers for modern medicine. Three cheers for getting a big enough volume and enough calories into her belly in a short enough period of time that she might actually start to connect “eat food” with “my tummy feels good.” Miracle of freaking miracles.
There are so, SO many other skills that we need to work on, it blows your mind to think about having to teach someone how to do it. Use your upper lip to get the food of the spoon. Use your tongue to move the food to your teeth so you can chew it. Tastes and textures galore. But this particular barrier, making the connection between hunger and food, feels like such a huge step that will allow more of it to happen. I think we’re getting there.