Low tone and feeding

[Anonymous]

DD2 is 13 months. She’s been in EI for gross motor delay since 9 mos. she is crawling and we are working with her on pulling up.

But feeding is an issue. Solids have been a slog since day one. She won’t permit others to feed her and pushes most spoon foods out of her mouth. She likes strong flavors and food that gives her sensory feedback (Cheerios, nori, apples, crunchy things). It’s becoming very hard to get her past a primarily liquid based diet. Oh and she is a bottle refuser and has always only taken one as a last resort.

This is mostly status quo — it’s not getting hugely better but she is also gaining weight and growing normally. (Oh and she has gorgeous baby cheeks which are no doubt related to the low tone.)

Big sister has/had motor delays and planning issues but past breastfeeding issues feeding has never been an issue. Do we get a ST eval? Keep working with the PT/OT? Thoughts?

[Anonymous]

There’s a lot here that speaks against feeding issues. She is normal weight and growth. She eats vigorously. She wants strong flavored hard foods.

Bottle refusal and preference for liquids in a 13 month old infant does not strike me as a feeding issue I would seek attention for when you already have a team attending otherwise. These are her preferences. She will grow and change.

[Anonymous]

Yes, get an evaluation by an SLP who works with infants and gets sensory issues. If you are in the DC metro area, Speech Kids is great.
Speechkids.com

[Anonymous]

Because of the sensory issues and low tone, I would get a speech evaluation. When you call around, make sure you use someone that has experience with feeding issues. I learned that not all do and that it was actually very difficult to find someone who had a lot of experience with this - but that was 10 years ago. I used The Language Experience.

[Anonymous]

Anonymous wrote:There’s a lot here that speaks against feeding issues. She is normal weight and growth. She eats vigorously. She wants strong flavored hard foods.

Bottle refusal and preference for liquids in a 13 month old infant does not strike me as a feeding issue I would seek attention for when you already have a team attending otherwise. These are her preferences. She will grow and change.

I agree.

[Anonymous]

Start introducing a cup or sippy cup.

[Anonymous]

Thanks all. We’ve been introducing a cup/Sippy since she was 8 months. She chews on it, that’s it. My biggest concern is developmental — that she just isn’t learning to eat solids because of texture. Medicating her has been a nightmare (we had to do rocephin shots) as well. I’ll bring it up with her PT but assume that as long as she’s gaining she’s ok, even though much of it is still from nursing.

[Anonymous]

Anonymous wrote:Thanks all. We’ve been introducing a cup/Sippy since she was 8 months. She chews on it, that’s it. My biggest concern is developmental — that she just isn’t learning to eat solids because of texture. Medicating her has been a nightmare (we had to do rocephin shots) as well. I’ll bring it up with her PT but assume that as long as she’s gaining she’s ok, even though much of it is still from nursing.

If she's eating a variety of foods, I wouldn't worry.

purées at this age aren't necessary so I'm not sure if that's what you mean by spoon fed foods.

Let her practice with a spoon herself as well. She's eating other things so it's no big deal if it's hit or miss.

[Anonymous]

Anonymous wrote:Thanks all. We’ve been introducing a cup/Sippy since she was 8 months. She chews on it, that’s it. My biggest concern is developmental — that she just isn’t learning to eat solids because of texture. Medicating her has been a nightmare (we had to do rocephin shots) as well. I’ll bring it up with her PT but assume that as long as she’s gaining she’s ok, even though much of it is still from nursing.

What I see as a mom who has been there done that is she is clearly learning to eat solids, some of the most difficult solids in fact. The fact that at 13 months she isn't welcoming every single solid you put in front of her and eating from the dinner table/breakfast table is not a feeding issue. She's not ready for that. She's still an infant. It sounds to me like in her feeding she's developing well.

Step away from her medical issues (I know it's hard) and look at her feeding pattern. She's breast feeding for a majority of her calories, which is just fine. She's also enjoying a variety of hard foods which she self feeds (a huge deal for kids with low tone) and which are not bland foods (again, huge deal for kids with motoric and other issues). She's also crawling and pulling up.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Thanks all. We’ve been introducing a cup/Sippy since she was 8 months. She chews on it, that’s it. My biggest concern is developmental — that she just isn’t learning to eat solids because of texture. Medicating her has been a nightmare (we had to do rocephin shots) as well. I’ll bring it up with her PT but assume that as long as she’s gaining she’s ok, even though much of it is still from nursing.

What I see as a mom who has been there done that is she is clearly learning to eat solids, some of the most difficult solids in fact. The fact that at 13 months she isn't welcoming every single solid you put in front of her and eating from the dinner table/breakfast table is not a feeding issue. She's not ready for that. She's still an infant. It sounds to me like in her feeding she's developing well.

Step away from her medical issues (I know it's hard) and look at her feeding pattern. She's breast feeding for a majority of her calories, which is just fine. She's also enjoying a variety of hard foods which she self feeds (a huge deal for kids with low tone) and which are not bland foods (again, huge deal for kids with motoric and other issues). She's also crawling and pulling up.

A 13 month old should not be getting the majority of calories from breast feeding or formula if at all possible. It doesn't sound like this kid is though.