8-Month Feeding Therapy

In my opinion, it is communication (not money) that makes the world go ’round. Many problems can be solved with clearly expressed feelings that help avoid misunderstandings and misjudgments. To think that feeding therapy can start us off on the right foot was surprising to me at first.

We are already taking the steps to ensure that she is able to communicate to the very best of her ability.

Speech.

It may seem like such a natural thing when we are surrounded by it everyday, but for someone with low muscle tone, it is a challenge to form words correctly. We use about 100 different muscles to form words. These muscles are in our chest, neck, jaw, tongue, & lips and they must all cooperate to be successful.

Since it is extremely important for Kara to be able to communicate, we started her with a Speech Pathologist when she was around 3 or 4 months old. We have seen much progress. Kara blows my mind with her abilities and I find the whole process very intriguing.

This subject is very broad. There are many ways to work on speech, but our main method is through feeding. Please remember that I am no therapist, but I am learning so much and I wanted to share what we do, what we use, and why.

Kara started solids for the first time on Valentine’s Day ❤. We started her off with thisrice cereal and started mixing in homemade purees two weeks later. We eventually replaced the rice cereal with thisoatmeal cereal about a week before taking it out altogether.  

Now, she loves to eat pureed fruits and veggies on their own. Breast milk is still her main source of nutrition. We aim to get 20-25 oz in her a day, but then she is fed solids twice a day. Once by spoon and once by straw. Practice makes perfect!

GOALS 

Tongue Retraction

Alignment in High Chair

Strengthen Cheek and Lip Muscles.

TOOLS

Highchair

Toothette Oral Swab

Spoons

Honeybear

GETTING STARTED

First, it is important to note how essential a routine is for babies. They do not have a good concept of time so sticking to a routine can help them understand what is going on and what is going to happen next. Kara knows that when I pull out a bib and put it around her neck that food is coming shortly.

Once she is properly aligned in her high chair, I wake up her cheeks and lips with a quick facial massage (her favorite time of day, wouldn’t it be yours?) Then I stroke the inside of her cheeks with my finger and a toothette to twirl on her lips. The whole purpose of this routine is to stimulate and wake up all those tiny muscles.

It reminds her that hey, my tongue can move from side to side and I can wrap my lips around that spoon or straw!

THE SPOON

When spoon feeding, we use flatter spoons because it is easier for her lips to enclose arund the food. Think of eating peanut butter off a butter knife versus a spoon. Your lips would have a much easier time getting the pb off of the flat surface. The same is for Kara when I offer her something like pureed squash. It gives her the opportunity to strengthen the right muscles.

There a couple of rules we follow while spoon feeding.

1. Pull spoon straight out. No scooping upwards.
2. Offer small portions.
3. Maintain alignment.
4. Practice patience.

The end result is a messy yet satisfied baby that I just tricked into doing therapy 🙂

If you read one of my previous posts I Cried In The Middle of Target, you know that I had a hard time moving beyond bottle feeding (even though I never enjoyed it). I found out that sometimes change is a GOOD thing! Spoon feeding my baby has been So. Much. Fun. I am finally enjoying meal time with her!

That is, until the day her Speech Path. said to me, “You know, I think Kara would do really well with a straw…”

THE STRAW

Kara was only 6-months old when the straw was suggested which is earlier than most would recommend, but her therapist is incredibly perceptive and I trust her every word.

Sure enough, after many long weeks and a rocky start, Kara is starting to get the hang of it! I feel confident that we made the right decision in starting her early. The big goal of the straw is to teach her tongue to retract instead of protrude. Again, it all circles back ’round to the low muscle tone.

{Did you know that people with DS don’t necessarily have larger tongues? They can have smaller palates which makes their tongue seem bigger.}

When practicing with the straw, we use a tool called the Honeybear. Mr. Bear and I did NOT get along at first. I hated that bear. I felt so much pressure every time we sat down to use it, but I was somehow able to muster up my best and most encouraging “mommy voice” and put its skills to use.

It all starts with alignment so I use rolled up towels on each side of Kara’s high chair every time she’s in it. I do her facial massage routine and then get my positioning. Kneeling on the floor helps me to get at eye level with her and support her chin with my non-dominant hand. The straw is placed either in the corner of her mouth or in the middle (depending on her strength that day) and I deliver the liquid by squeezing the Honeybear with gentle pressure.

In the beginning, she would get a taste and her reaction was to treat it like a nipple. Eventually, she has learned that she needs to withdraw her tongue and suck inwards with her lips wrapped around the straw. A lot of the time, her muscles need the extra support so I will help by squeezing her cheeks around the straw.

Then we practice.practice.practice.practice.

The progress seemed slow. The days passed like weeks and the weeks passed like years. I felt like we were getting nowhere. It was a learning experience for me as much as it was for Kara.

…but then one day I got the hang of it.

…& then she picked it up.

…& then her Speech Path. came by and was so impressed with us that she EXCLAIMED! Apparently she was only expecting Kara to take a sip or two, but girlfriend sucked down 1 oz through her straw. She was holding out on us!

I am so happy to say that we’re finally over the hardest part of learning the Honeybear!

Our next step is to slowly reduce the length of the straw sticking out to ¼” (we are currently at 1″). We are also working towards thinning out the liquid (right now, she drinks a combination of purees and milk). Once Kara is strong enough to drink 2 oz through her straw, we will be ready to re-evaluate (we’re halfway there!) All of this will pave the way for drinking out of a cup later down the road.

A summary of my thoughts on the Honeybear:

Did I hate that damn bear? Yes.

Would I still recommend him? Absolutely.

SUMMARY

Think of this feeding therapy like working on your posture. When you’re tired and weak you start to slouch. Your shoulders hunch over and your neck comes out of alignment. You have to train & strengthen your muscles until they start do it on their own. We are just training & strengthening Kara’s lips, cheeks, and tongue. Her low muscle tone makes it a slower process and requires more repetition, but if there’s anyone I believe in, it is my Baby Lemonade 🍋