Hi Robynne, I am glad you are availble here. I have read many of your previous replies and have learned a lot.

I am writing about my son Sam. He is 14 months, had fundoplication surgery, pyloraplsty surgery, and has a g-tube, and FTT. He has always had a bottle aversion and will not even hold it. He is learning to drink from a cup. My question is about his eating. He eats 1 jar of stage 2 baby food on a good day. He has such a preference for frozen things like slushy style, lemon ice, popsicles, freezies. It's not only sweet stuff, I have froze his neocate with different fruits and he eats it. I never thought too much about it, but today his GI said it is a texture aversion. He has always prefered his baby food from the fridge and his bottles cold. I guess I never thought of cold as a texture. Right now he is seeing an OT 1/week and he goes to feeding clinic. Both OT's handle him so different that I get confused and a bit frustrated. If he has food that doesn't melt in his mouth then he sucks on it and pockets it. He is going Wed. for an evaluation handling harder food at feeding clinic.

Here are my questions:

do you have any suggested material or can you offer knowledge on the cold/texture issue?
am I encouraging the aversion by making frozen treats that he'll eat?
I have to bring food for him to try at feeding clinic, are there some that are better to let them see him eat than others (he is gluten-free)
Are there specific questions to ask at feeding clinic (we only get follwed every 6 months and I never really know what to ask)
Thank you so much! It is very appreciated,
Kerri

Hi Kerri:

I always send out a questionnaire before my parents bring their kids to my clinic. In addition, I always want to look at all the food textures and how the patient reacts to them, prepares them for swallowing, vomits them across the room :sign11:, etc. The textures I like to look at are liquid, puree, a mixed consistency, and a couple of solids. Bring the bottle and nipple he is drinking from and any straws or drinking utensils he is using. I would stick to his gluten-free foods.

Sam is one smart boy! He is not seeking out texture by drinking the cold. Instead, he is seeking out the thermal SENSATION. Cool liquids are what we call an ALERTING liquid and they are actually better for our kids because they "wake up" those over 50 muscles we use to swallow with. This is especially important when we see little ones with dysphagia, or weakness in the swallow. In addition, if you had GERD and you were frequently refluxing stomach contents to your hypopharynx, which would feel better? A nice cold drink or something room temperature or luke warm? No Kerri, you are not encouraging him, you are helping him. Besides, if he does have any dysphagia, he is going to prefer a thicker liquid vs. a thinner liquid.

Questions to ask: (For you) Has Sam had a modified barium swallow study? Any time I have an aversive kid, I look at his history closely. Frequent upper respiratory infections/colds, congestion, coughing while drinking may warrant such a study. What kind of approach do they take with feeding (sensory, behavioral, both???)
Are they going to take an intensive approach (several days a week) or 1-2 days a week? What are their goals for Sam going to be???? Are you going to be allowed in therapy sessions with Sam? Does an OT need to do a Sensory Profile on him? Absolutely NO forced feedings!!!!! I hope this helps you :)

Robynne