Feeding Update (2)

Someone has been making some semi-great gains in the "feeding" department.  Landon is slowly becoming more tolerant of different textures and is a little more open to new table foods.  And this mama couldn't be happier!!

For the past two months, each feeding session has begun with a palette of flavors.  Landon wasn't all that crazy for the "palette" which generally consists of: chocolate sauce, strawberry sauce, caramel, lemon juice and maple syrup.  At the beginning, Landon was very resistant to most of the flavors.  But I am happy to say we are having a major breakthrough.  Not only is Landon tolerant of "all" the flavors, he actually enjoys many of them.  He definitely has his preferences, but he is always willing to impress Miss Chris.  So with his handy little chew tube, Landon will dip the tube in the sauce and give it a great big chew (or lick).  And on some occasions, Landon feels like the tube is way over rated and reverts back to old faithful.....his hands!!  lol

Next on the list was to begin to add in some textures.  Honestly, I was so happy that Landon accepted new flavors..........BUT........I thought there was going to be MAJOR resistance to the textures. Well, what do I know, I'm just the "mommy"!!!  Not only did Landon "accept" the toothette.........he was chomping on it and dipping it in the palette like it was a lollipop!  Say whaaaa???!!!  Who's child is this anyway?!

All this practice is really starting to pay off.   S-L-O-W-L-Y......but we're moving in the right direction.  I am happy to say that Landon's menu is gaining some new items which consist of: veggie stix, cheese curls, Ritz crackers, fishies, graham crackers, pudding, rice krispies and kix cereal!!!  Although Landon is tolerant of all of these items.......he is not quite at "consistently" yet.  But we are working on it.  

Scott & I are constantly offering Landon new foods.  But I assure you, Scott & I are "always" put in our place.  Landon is the "BOSS" of this feeding thing!!!  But like any good boss...........on occasion, they surprise you with a bonus..............and Landon didn't disappoint...........

(a whole dinner role)

AND..........

(a small order of french fries)!

Next plan of attack is the bottle-sippycup-straw thing!!!  Wish us luck;)

Feeding Update (1)

Wow, it's already been 4 1/2 weeks since we had our official "Feeding Intervention"!!  Last time, I reported our new "game plan" and we are continuing with it........just tweaking it as we go along. Oh yeah, and remember THIS post, when Landon conquered his 1st stage 3 meal.......he hasn't done it since (SURPRISE)!  LOL  That's OK, the most important thing about that isolated event is the fact that Landon CAN.DO.IT!!

Originally we were suppose to add 2 pediasure's to Landon's feeding schedule, and after a week of trying to fit those in, Landon's teacher's and I have decided that that is nearly IMPOSSIBLE!!  We have already battled reflux, and after 3 months of medication, I am happy to say.....Landon has been "spit up" free.  However, adding this much more fluid to his diet has slowly brought back the reflux, and that just isn't working for Landon (or me).  With much help from Landon's teachers we have played around with his eating schedule over the past couple of weeks to get the most into him without stirring up the reflux.  Small steps are the key!  Amazingly Landon has been taking his multi-vitamin, straight up!!  No masking it or hiding it in any food. We have now worked our way up to 3, six ounce, bottles a day.  Those bottles (yes, BOTTLES....remember, I was given strict orders NOT to STRESS Landon out, ha!) are a 1/2 & 1/2 mixture of whole milk and pediasure.  Landon was not very accepting of pediasure alone. I am happy to say that this seems to be Landon's "happy medium", and it is working.  Just 2 weeks ago I brought Landon to the pediatrician for an ear check (which was clear) due to a bacterial infection, and he weighed in at 19 pounds, 4 ounces........that is almost 1 pound in 4 weeks!!  WOOHOO!!  That is Landon's BIGGEST weight gain since birth!!!  20lbs........HERE.WE.COME!!!!  lol

We have been continuing to do our exercises with a palette of sweet/sour sauces (i.e. fudge, caramel, strawberry sauce, lemon juice, etc.) and we have been dipping his chew tube in the sauce and letting him explore the different tastes.  The object is to introduce Landon's palette to a variety of different flavors in hopes that he will be MORE willing to try new things.  By approaching it this way, we are allowing Landon to "control" the situation......stress free!!   For "homework", we started off having Landon watch Mason & Elijah use the chew tubes (without giving him a turn).  I know, sounds cruel!!!  If he saw how much fun his brothers were having using these tubes then maybe he would willingly do it on his own.  Once he showed interest in the tubes, we would then give him one and have him copy us dipping it in a sauce and putting it in his mouth.  SUCCESS!!

Each session always begins with a palette of flavors!  The past 2 weeks Landon's feeding specialist (Ms. Chris) would follow the palette with different types of crunchy foods (Kix cereal, graham crackers, veggie sticks, cheese curls and Ritz crackers).  I am actually quite impressed with how much easier Landon will transition between the two...........and how accepting he is!  Ms. Chris approaches each session very playfully (taking turns) and Landon really seems to enjoy this!  Of all the crunchy foods that Landon has been experimenting with, the one that I find he does very well with is the Ritz cracker.  When Landon takes a bite of the cracker it breaks immediately into a bunch of pieces.  His first reaction is to push the "bigger" piece out of his mouth, but those particular crackers leave tons of crumbs on his tongue that forces him to use his tongue to move the crumbs around to form a bolus for him to swallow.  Spitting it out becomes more difficult when it becomes wet (because it sticks to his tongue).  The alternative is to give his tongue a good workout by moving the food back and forth until it works its way to the back of his mouth and he eventually swallow it.  WOW, never in a  million years would I have put  that much thought into the art of eating!!  LOL  Crazy as it sounds, it IS actually working!!

So, I am happy to report that so far, this has been a positive experience, albeit a SLOW one!!  But Landon is at least willing to TRY some new things.  Landon does continue to mainly eat stage 2 purees, but his menu IS increasing on the textured side!  SMALL steps.........hey, I'll take it!!

Time for Intervention (Feeding Specialist)

I confess, my patience regarding Landon's feeding/weight issues has finally gotten the best of me.  I have pretty much exhausted all possibilities and have felt that it was time for an intervention.  Landon turned 21 months yesterday and he has only gained 1/2 a pound since his 18 month check up!  That's right folks, Landon now weighs a whole whopping 18 1/2 pounds=(  FRUSTRATING!!  I have been getting tips from other blogs, friends, "professionals" and nothing has seemed to work LONG TERM (or long enough to pacify me)!  I am a pretty patient person, but I do have limits!

Landon's pediatrician gave us a referral to a local feeding clinic.  Although Landon is an outpatient at Children's Hospital Boston (Down syndrome clinic), it was unanimous that Landon have his initial evaluation done locally (in case he needs to be seen weekly) and he would be seen in Boston at his next clinical in January!  That works for me, as traveling 45 minutes once or twice a week just does not fit in to our schedule!

This afternoon we met with a feeding specialist.  The events that have led us there are as follows:

- Landon officially dipped off the Down syndrome growth chart (at his 18 month well-visit in which he weighed in at 18 lbs.)

- Landon still eats stage 2 purees......will not give stage 3's the time of day

- Landon has added "MINIMAL" solids to his menu (Gerber cereal bars, cheerios, Gerber cheese curls, toast w/ hummus, cream cheese and a thin layer of peanut butter, pirates booty, a slice of American cheese (on occasion) and yogurt (well, this is still a puree)

- Landon drinks 3 "bottles" of whole milk a day (at 5oz. a shot)  I admit, I have issues with him still taking the bottle.

- Landon recently went to the Dr.'s  for his flu shot (2 weeks ago) and weighed in at 18 1/2 lbs.

- Landon "WAS" drinking from his honey bear cup/straw and has since decided that he is so over it!

- Landon will drink from a sippy cup......FOR ME.......but will not consistently do so for others.

- We are not really sure if Landon is "chewing" his food or moving it around his mouth (so that it melts) and then swallows it.


So, I am a bit bothered by the whole bottle thing (it's just not part of MY plan, diagnosis or not, I want him off the bottle by the time he is 2) Selfish on my part, YES!!  It frustrates me that he will not take the sippy cup consistently since he is quite capable of drinking from it (STUBBORN on his part, MOST DEFINITELY)!  I am frustrated that he can eat purees and pieces of toast (crunchy and all) but will not combine the textures or at least be willing to try something new.  We have been stuck on this same menu much longer than I expected.  If I give Landon a noodle with alfredo sauce, he will suck the sauce off and spit the noodle out.  If I give him a french fry dipped in ketchup, he will suck the ketchup off and spit the french fry out.  We have tried mashing and small pieces and putting dinners through the food processor.  We have tried different textures and different techniques and the list just goes on.  Frankly, I'm tired.  I'm tired of TRYING!!  Maybe I'm the problem!!!  Whatever the case may be, in the best interest of Landon...............I.NEED.HELP!!

We met with the feeding specialist today for about an hour and a half.  We went over EVERYTHING from Landon's birth to where he is today.  I was asked to bring in a bunch of things that Landon eats (and I took that VERY seriously, lol).  I brought a little of EVERYTHING from his menu.  I even brought in ALL the different "cups" that we have tried to offer him.  YES, I was prepared!!

We began with transitioning between the different foods, and don't you know, that little bugger did so like each bite was the same!   HA!  The consensus has been that Landon tends to "munch" rather than actually "chew" his food.  WELL, today he showed signs that he was actually chewing!  Surprise, surprise!!  Hmmm, maybe the 6 teeth that he now has, is helping!  Then we moved on to drinking.  Landon generally will drink (unassisted) from his bottle, for me (pretty consistently).  But, lately at home (with grandparents) and at school he has been a little naughty boy taking a sip from his bottle and then throwing it across the room.  There have been consequences for that (like having his bottle taken away)......thanks Melissa=)  But of course the little show off that Landon is, drank his whole bottle (unassisted) for this complete stranger.  Ugh!  Finally, we moved on to the sippy cup, which he will drink from "the most" consistently but will whip it at your head as equally consistent.  Not today my friends, with a little applauding, he drank from that sippy cup and placed it ever so gently on the table after each sip.  SERIOUSLY???!!!

The outcome of this meeting was that the feeding specialist felt like Landon was a good candidate for this program.  The pros are that he has no health issues (no underlying problems that are preventing him from progressing).  Thyroid and Celiac have already been tested for and ruled out.  His tongue thrust is not bad, she feels like with some extra prompting techniques used while eating, that she can help him control it better.  Now that Landon has teeth, they will help him break down his food a little better (to avoid choking, giving him more confidence in trying new things).  She is very confident that Landon will progress (rather quickly) through this program.  However, she felt that we need to place Landon's issues in order of importance.

Our first goal will be to get Landon back on the Down syndrome growth chart.  Although it is expected that he will be a bit smaller, we do not want to overlook a "potential" problem.  It's best that we address this issue now and stay on top of it.  We will be adding a liquid multi-vitamin and we will add 2 bottles of pediasure a day.  This will require me to adjust MY plan.....if Landon chooses to do this by bottle only......then the bottle it is.  The goal is not to stress him out by changing too many things all at once.  OK, I'll give him that (well, maybe a little extension)!!  Also, Landon eats about 5 containers of Gerber baby food a day with snacks in between his 3 meals (for a total of 5 "meals" a day).  She would like us to add an extra container (to make 2) at breakfast.  Hopefully, this will help him to pack on a few pounds.

Landon will have his official weigh in next Friday.  We will monitor him for one month.  And adjust his plan as needed.  The feeding specialist will address some minor issues as we go along.  To this day, this has been the one area that Landon and I struggle with.  Some days it's just so hard when you see him progressing in every other area. You start to wonder if you are missing something........some significant sign that you are overlooking.  And yes, I have a HUGE fear of that!