jnbmom
08-21-2007, 09:55 PM
My 14 month old was sent to see an OT for an evaluation for a feeding disorder, offical diagnosis, his real issue is drink from a bottle or sippy cup. Hes had a bottle aversion since his GERD showed up when he was about 3 weeks old. Hes doing much better with a straw cup here recently and the OT said she would like to see him for facilitaion thereapy. She said she doesn't think he needs intensive therapy because my goal is to get to him drink well enough to be weaned from the bottle. So no intensive because we're not trying to break his bottle aversion only try to help him like the sippy and drink enough fluids. Whats the diffrence between intensive and facilitaion and what should I expect? Thank you!
pedi-ot
08-22-2007, 05:47 PM
Hi Heather:
First of all, let me apologize to you and all of my GERD mom's for my absence the past month. I was preparing for my son's first trip. Drew is 6 years-old and we took he and his sister to Vancouver. Drew also has a metabolic disease, so it was not an easy trip. I literally returned today and I am in need of another vacation.
What I need to know about Brenden or Joshua is his current weight %, was he a term twin, does he vomit or gag when presented with food/drink, and what is he eating by mouth (purees, mixed consistencies, solids, liquids, etc.) These bits of information will help me get to know your little guy better. Most pediatricians want our babies off of the bottle at 12 months. This is different for our GERDlings and babies with severe oral aversion.
Each facility may use a slightly different protocol for feeding therapy. Some therapists use a strict behavioral feeding protocol whereas others combine behavioral with sensory protocol. I personally do not get worried that a 14 month-old is still on the bottle, especially if they were premature or have severe oral aversion. I draw the line at 18 months though.
Each patient should have an individualized program according to their needs and goals. Your therapist may feel your son's needs are not as serious, thus requiring a facilitative program (maybe treating him 1 to 3 times weekly). An intensive program is more for medically involved patients that require sometimes frequent daily treatments or even an inpatient program. Write back with more information about your son if you have more questions.
Robynne
jnbmom
08-22-2007, 10:15 PM
What I need to know about Brenden or Joshua is his current weight %, was he a term twin, does he vomit or gag when presented with food/drink, and what is he eating by mouth (purees, mixed consistencies, solids, liquids, etc.) These bits of information will help me get to know your little guy better. Most pediatricians want our babies off of the bottle at 12 months. This is different for our GERDlings and babies with severe oral aversion.
The therapy will be for Joshua, he is still currently off the charts for weight. He was 3# 12ozs at birth and currently weighs about 17#, I hope, he will have his 15 month checkup next month. Hes about 29 or so inches height wise. He was a 34 1/2 weeker and spent 2 1/2 weeks in the NICU. He does not vomit or gag when given food or drink. He used to gag and vomit with the bottle for a while when he was younger but that hasn't happened in a long time. He is on table foods 100% his favs are chicken nuggets, carrots, apple sauce, and pratically anything you give him. Hes a really good eater, he will actually over eat and make himself vomit sometimes, we are only struggling with drinking. Both his ped and GI want him to stay on the bottle for a while because he is having such a hard time staying hydrated with a cup. He plays with it and will suck up a mouth full and spit it out. He is doing much better now that I've found a straw cup that he likes and have stuck to my guns that if he spits out the drink I take away his cup. Now we don't deal with that as often but its still a work in progress. He will only drink apple juice or yogurt smoothies from the cup though. Hes absolutly refusing anything other than alimentum in his bottles. I've tried weaning him to 2 diffrent formulas and whole milk always with the same result, he will go on an all out bottle strike and refuse to drink for about a week til I can convince him that its only alimentum again. Right now he is taking about 3-5 ozs from a bottle 3 times a day. And has a cup of apple juice with every meal. He has acess to a cup of water through out the day but thats the cup that usually gets spit out all over the house so it normally gets taken away. Hope this additional info helps. Thanks in advance for your reply!