Feeding Therapy

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I want to thank all of you who sent sweet comments, Facebook messages, emails, and more about the Autism post I wrote. I have read every single one, and I promise I will reply to all of you, I just need more time. Thank you for caring.

Adam’s appointment is scheduled for March 19th and I will try to keep everyone in touch with what’s going on.

I get asked quite often about Adam’s feeding therapy. What does he do there? How do they help him? How is he doing? I thought I would write a post about each type of therapy he’s in to explain a little about what he’s going through, and the things I try at home to help him as well. You can find out more about Adam’s problems here: My Little Boy is in Therapy.

The first therapy he started was feeding therapy. Adam was only in the 5th percentile for weight because he was not eating enough. When people see Adam eating they say to me, “See? he eats!” Of course, Adam eats, if he didn’t he would be in the hospital…or worse.

Adam eats, but the problem is he doesn’t eat enough. He doesn’t eat like normal children. And no this feeding disorder is not called “being picky.” Adam is not just “a picky eater.” He barely eats enough to be healthy and to help him grow. That is the difference.

The thing I’ve learned about Adam and his feeding problems is that every day is different. Just because he might try a new food, or like a food today, does not mean he will try it again or like it tomorrow… or next week. You just never know what he may or may not eat. Every day is just trying to get him to continue to eat and try new things. Every day is a struggle.

So what is feeding therapy? Feeding therapy is something we go to weekly to help Adam learn how to eat different textures and new foods.

I found a good definition from this site and thought I would share it:

“Pediatric Feeding Therapy is a combination of treatments that help children with feeding disorders.  A child with a feeding disorder has difficulties related to eating or drinking. There are many different types of feeding challenges, and no two children have the exact same one.

For example, some children do not eat anything at all. These children may be fed through tubes. Some children eat very little and do not gain weight or grow. Some children do not have a healthy or balanced diet because they only eat a few or certain kinds of foods. In some cases, a child may have behavior problems during meals that cause mealtime to be very stressful for the family. Other children have problems with chewing or swallowing.  Finally, medical problems such as vomiting may play a role in a child’s feeding disorder.”

Do they force him to eat in feeding therapy? No. Do they try very hard to get him to try new things whether it be just touching it or putting it in his mouth? Yes.

So what kinds of foods does Adam eat? I made a list so that I could better figure out what to buy for him, and what things to offer him for meals. The therapist had us split all of Adam’s foods into categories. There are “Desired Foods” those that he likes and will eat most of the time, “Tolerated Foods” which are foods that he may have tried or will try and chew, but not actually eat and swallow, and then “Undesired Foods” which are those foods which he will not eat or try. Here is Adam’s list:

Now, you have to remember these are all subject to brand, season, and mood. For example. Adam will only eat waffles that are frozen and he will only chicken nuggets that are frozen and by a specific brand. He will not eat chicken nuggets from chick-fil-a or muffins from a local bakery. It has to be the brand he is used to, and it all depends on his mood. Another example is yogurt. Before we left to visit family for Christmas, Adam would yogurt every morning. The entire time we were at my in-law’s house he would not touch yogurt. We know he likes it, but sometimes he will just not eat it.

Before therapy, Adam ate a lot of yogurt, crackers, and chips. I was at the point where if he would eat it then I gave it to him, even if it was unhealthy. I hated watching him not eat, it was very hard for me. The therapist set some rules and from there I have tried to put them in place as much as I could at home. It’s not always this way, but I try.

Rules:
1. Crackers are for snacks, not for meals.
2. 3 meals a day at the table, 2 snacks a day at the table.
3. Offer Adam choices for snacks.
4. Provide at least 3 different foods at every meal (the desired food, a tolerated food, and an undesired food).
5. Use a divided plate.

Here’s what a mealtime looked like for Adam one day a few weeks ago:

The reality of this is that he ate most of the yogurt, only tried one piece of waffle, tried a piece of toast and spit it out, and didn’t even touch the bananas. That is what almost every mealtime is like.

So now that I have explained a lot of what goes on at home, let me tell you what we do at therapy. We have one 30-minute session each week. We go in and Adam sits in a special chair at a little kid’s table and I strap him in just like a highchair. The therapist will start off by singing a song with him while she washes his hands and face for “snack time.”

Then she uses some special brushes to put in his mouth to try to get him used to the texture. That only lasts about 30 seconds as Adam usually bites it or spits it out. Then she a special rubber toy that she gets Adam to chew on to strengthen his chewing muscles. (Adam used to have problems chewing and food would fall out of his mouth or he would have to hold it in so he could eat).

After, that she asks me what food I brought and I get it all out, and she sets it up. Every week is different. She tries different methods of getting him to play with the food and getting him to try stuff. Some days he tries new things, and some days he won’t. The goal is to get him to go from touching and playing with the food, to touching the food on his arms, then on his face, then his lips, then his tongue, then chewing, then, swallowing. Until he’s eating.

Some food he just touches. Some food he just chews and spits out, some he doesn’t eat at all. But it’s all progress. Slow progress, but progress nonetheless.

After Adam is done eating or when gets frustrated with us for trying to get him to eat new foods, then we get him cleaned up and talk about the goals for the week for me to do at home. I also have to keep a notebook of everything he eats, everything he was offered, and everything he didn’t eat. I have to bring it each week to show her.

That is pretty much it. It’s a lot of work. We are supposed to keep Adam on a tight feeding schedule so he gets to know when it’s time to eat when it’s snack time and all that. Sometimes I do it, and sometimes it just doesn’t fit into my day to do it so tightly.

For those of you who are wondering how Adam is doing. He has gained weight since he started therapy. He was at the 5th percentile, and as of a few weeks ago, he was at the 21st percentile. It’s a start, and I’m so happy that we are getting him the help he needs. Is this something that we may be doing for a long time? I don’t know. We are just going to have to take it one day at a time and go from there.