Angel was seen at the feeding clinic today--first stop was a GI--very nice warm friendly fella who changed her reflux meds,checked her over and wants to do a swallow study on the 18th of October to rule out aspiration because she is coughing some at meals(will be like her 4th swallow study )but he likes to do -*test*-('")ing by people he trusts--put her back on periactin because she lost from 45 during the summer and currently a whopping 40 pounds. He is also thinking of doing a scope on her to check the damage done by reflux since she hasnt had one in a while.

Feeding team was very informing--no self help tips this time because they want me to go back to totally feeding Angel at this time because she has regressed in her eating since school started. She never has acted hungry on her own so if they ask her if she wants something she is doing a little fake gag and topic closed--it has become a behavioral eating issue now,and one she is trying at home as well. We were told we have to be firm with feeding and her private therapist need to be firm with therapies. She was also seen by a nutritionalist who wants the carnation instant breakfast given at breakfast,lunch and supper at the end of meals. We also have to change our language at feeding times--instead of asking Angel "can you" take a bite we have to "tell her" to take two bites of spaghetti(example)and then she can have one bite of lemon pudding(example). I thought we were finished with all the feeding issues(except self feeding) but guess not. Oh yea--instead of prompting the school has to feed her as well.
Thats our update until the 18th when she will have the swallow study and see the feeding team again--it was also very nice to talk with people who have dealt with preemie feeding issues and know about causes,regression,treatments and how long issues can last!!

The feeding team stressed the importance of no distractions in a way that will allow your child to control you to get what they want using their feeding issues as this causes behavioral issues. Talking is a redirection that they can not use to control you. You are going to be talking with your child during mealtimes anyway just as you would do with your spouse. Make it a fun conversation about something they like, enjoying doing or may be doing. Instead of conversing about the meal itself which will make the child not want to eat even more make it about something they like. Distractions are objects or things you DO that they can use to control such as t.v., games, sticker books, no toys during mealtimes, no singing and dancing to get a bite in etc. Also change the language to take away the control of them making the decision of if they want to eat the food. Be consistent. Don't say can you take a bite, say you are going to eat this but allow them some control by saying do you want 1 or 2 bites of your sandwhich before you eat your soup, do you want that to be 2 big bites or 2 small bites etc. I do believe Angel's regression is all about school and her not eating there combined with the sensory input that has her on overload. How do we feel about it? It sucks, but we have taken a deep breath and ready to tackle this again.

Another bit of information we received was use a small plate,almost saucer size with characters on it. Eating from a larger plate can be overwhelming to a child with feeding issues because they feel defeated before they even get started knowing they can't finish all on that big plate. With the characters on the plate it will give them incentive to clear the plate to find the characters. Only put a few bites of each food group onto the plate. Small servings will not be overwhelming.