7.5 month old can't swallow(9 Posts)
I'm seriously struggling to feed my 7.5 month old. We initially tried purée and he would turn his head away and refuse the spoon. If you managed to get him to eat any he would spit it out. We then tried blw when he was about 6.5 months and we haven't had any real success with it. He seems to have a very good pincer grip and will happily put food in his mouth, but again he won't swallow it. He just lets the food stay in his mouth. If he does swallow it he will gag, go bright red and then vomit everywhere. The hv is at a bit of a loss as to what to suggest. I'm due to see the peadatrician in a few weeks about his milk allergy but wondered if anyone has had a similar issue.
He won't drink if he's sat up, that goes for both milk and water, which he will happily drink lying down.
My 12 month old was the same, I was tearing my hair out. Then all of a sudden he was eating like a horse, the day after he cut his first tooth. I don't know if it was coincidence but once he 'got' it, he was like a baby bird with its beak open!
Definitely a good idea to see the GP but it could just be a question of time.
Hang in there, it's so worrying but in the end, we all eat!
Sorry meant to say, it all came together at about 7.5 months
Referral to SLT if you think there is a swallow issue. They can assess and give you some ideas. I suspect it will sort itself out though.
(Am assuming you have never had any issues from chest infection from aspiration etc?)
Dd2 was basically weaned on quavers at our SLTs advice. (She was actually born without a gag or swallow reflex though, so was tube fed for a while.)
But anyhoo - ultimately a good feeding SLT referral is best if you think there is anything other than immaturity going on.
Have you seen a speech therapist? They would be your best bit as they can come to the house and watch him eat. If they have any concerns they will do an x ray swallow study. I'd ask your HV to refer you as what you've described doesn't sound normal to me. The lying down to drink milk strikes me as needing that angle to get the milk to slide down rather than having to swallow it. He might be struggling to get a bolus of food/milk to then be able to swallow. Could be any number of things but I do think it needs to be looked at.
Thanks for that everyone. He has teeth (8) so if he's waiting to cut more teeth god help us! Hopefully it will be the case that he will just 'get it'. The most worrying thing is he's gone from being 50th percentile to 9th percentile. He's taken 3 months to gain 1lb. He's meant to be seeing a dietician, but still waiting for an appointment to come through.
I've got an appointment to see the peadatrician about his milk allergy. So hopefully he will be able to offer some insight.
My gp is awful, they won't prescribe prescription milk for his lactose intolerance, so I can't imagine them helping to refer him anywhere.
What's an SLT?
Speech and language therapist. (SLT) Not all are feeding specialists though. Dd2 had SLT from birth (which was kinda bizarre) but obv nothing to do with actual speech (that was later lol). A good SLT will probably be able to get a good idea from assessment (they basically just watch you feed them) and may see if a swallow study is needed.
As a thought (something else for you to try anyway) we had to put food into the sides of dd2's mouth (she has really crappy oromotor) in order for her to be able to feel it/ move it (bizarrely, despite 3 or 4 years of brilliant SLT - where we had been doing this for years, we didn't work out until she was 4 that she had no lateral tongue movement).
There are lots of exercises you can do - I really like the website www.new-vis.com
(We used it with a toddler/ pre-schooler rather than a baby, so not sure how useful it is yet - the 'feed your mind' section was our go to. Interesting stuff. Our SLT suggested it as a source years ago)
I give you that for interest only - it's obviously aimed at much more involved children, but you might be able to have a think and see if anything sounds familiar.
NHS dietitians are shit for kids with feeding issues that are related to oromotor skills. I went once and never went back. To refer you to a dietician because he is losing weight is too simplistic. He's losing weight because for whatever reason, he's not swallowing the food. The best they could do would be to suggest different textures, and in my experience that's easy enough for anyone with half a brain cell to try - and you probably already have.
Dd2 found more solid textures easier (she struggled with thin liquids/ purees, and it was impossible for her to cope with mixed texture baby food - like that baby pasta in a sauce, for example.) so we added thickener to everything and out it in the side of her mouth so she could get a grip of it. (Obv with her oromotor, she couldn't handle stuff sloshing about as her tongue couldn't manipulate it to form a bolts, as belle said)
No need to freak out though - dd2's issues were well documented all the way along - she was tube fed and no gag reflex. We already know your chap has a good gag reflex and by the sound of it, a really good regurgitation reflex
Dd2 would do the barf thing too, later, especially with unexpected textures. So essentially, the first mouthful was always the one that was going to shock her system and get thrown back up, and then after that it was as if her body was able to recognize what was coming and hopefully deal with it better. (Our rule was three spoonfuls - if none of them stayed down we gave up, but usually by that point she had worked out how to deal with it).
We had SLT advice all the way though. In discussion with SLT we avoided a swallow study (they aren't particularly nice and we didn't want to trigger any avoidance issues!) it was pointless as we pretty much knew what was going on anyway. We had a repeat prescription for antibiotics that we could always access at the doc, because we got to be able to tell when she had an aspiration level choke and gag, rather than a 'normal' gag and clear. so we would just go and get the anti-bs and wait for the chest infection to start, rather than hassling the doc every time.
The paed will refer to SLT. We barely saw the gp as they were terrified of her. I'd walk in, in tears about the feeding (for three months she could only drink at night, as her muscle tone was so high during the day that she couldn't coordinate a suck and a swallow, so I spent most of the time like a zombie trying to fit in all the feeds at night) and they would just send us straight to the hospital. They had no idea what to do with her.
It's become clearer over time what her issues are, and you'll be pleased to know that since about 4 she has managed pretty ordinary food, so even for crazy kids like mine it does get better!
Get thee to a decent feeding SLT.
autocorrect sagas in there - hopefully you can work it out. (I assume you have got him on the right milk anyway, notwithstanding the crap GP?) Possibly the dietician could prescribe a higher calorie milk supplement in the interim? (I say use them for what you need)
And apologies if you do get a decent dietician. I'm sure there are some out there who do more than say 'add cream and butter'
In fact, to be strictly honest, we avoided a swallow study (on our lovely SLTs advice) as the likelihood was that they would advise she went back to being tube fed. We discussed it with SLT and she felt that we were doing the right thing by essentially feed-training, rather than moving to other methods of feeding, as we were doing it with choking and aspiration protocols in place. So as safely as possible. Obv I wouldn't ever advise anyone to do this without proper advice. (We knew that for reasons of prudence the consultant was likely to say 'no oral feeding' so we didn't ask him...)
It wouldn't be right for everyone, but it was the right choice for dd2.
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