DD2 still struggling with lumpy food. Referal to S & L Therapist and concerend. Help!

[Izabella]

Hi everyone,

Not sure this is the right place to post but I could do with any advice going...

My DD will be 2 at the end of this month but I still can't get her to take lumps and have to puree her food (other than this she is perfectly happy & healthy). This is not for lack of trying but she gags and then the whole lot comes up. It doesn't help that she is barely on the centile chart and has had regular periods of vomiting since she was a baby (she was also on meds for relux for a while but it made little difference). She does eat bread sticks and will takes the tiniest bites from bread and grapes, but not enough even to snack on. I am still spoon feeding her as she refuses to feed herself. I know I might sound like an over protective mum but I am a nursery nurse and I know what she should be doing at this developmental stage. I don't want to push her because I don't want food to become a contentious issue. I am getting her referred to a S & L therapist for a swallow test (her speech is acually very good and on track) but until then I could really do with some advice from anyone else who has had a similar experience.

She is also a very bendy baby and has been slightly delayed at sitting/crawling/walking. She runs now and her balance has improved now and again but she still trips and falls quite easily. Could she have hypermobility? Very concerned.

Many thanks.

[ouryve]

I don't know about hypermobility, but dyspraxia does sound likely and would explain the inability to deal with lumpy food. Hope your referral comes through soon, as I know the waiting can be so frustrating when you're wondering what's going on.

Menatime, if he likes breadsticks an biscuits and similar crunchy food, try dipping a bit of one in some yoghurt or tomato sauce or something you know she likes the flavour of. DS2 is similar, but it's smooth foods he can't cope with and I've had best success by gradually introducing a small amount of hte foods he can't cope with alongside foods he is safe with and by overwhelming difficult textures with nice flavours, which encourages him to try them more than once.

[Nat1H]

Don't know about hypermobility (my son has Cerebral Palsy), but we had a swallowing assessment. Are you giving her lumps within quite liquid food eg. soup with lumps in, or are you giving separate hard and liquid(ish) foods? Some children find it hard to separate different consistencies of food in their mouth which may explain why she likes everything to be pureed.
You say she has had periods of vomiting. Maybe if she is finding harder foods difficult to deal with and then she is sick, maybe she is trying to avoid being sick? (Just an idea)
Hope everything goes OK with the SALT and you get some answers and advice soon. And try not to worry - I am sure once you have got some questions answered and some strategies in place, then you will begin to feel much better.

[moondog]

The salt will be aspecialist one trained in this fied (known as dysphagia) and will be able to provide alot of helpful advice.

[Romy7]

get lots of bite/dissolve foods to get her used to different textures - ie quavers, wotsits, those weird skips things etc. our slt recommended them as a transition and i thought she was barking, but it was fine.
i also found that dd2 would always struggle with lumps etc, but that solids (real actual solids) became easier - her main problem was coping with two different textures in one mouthful - way too complicated, and gagging and regurgitation was mostly the outcome. You can also get muslin 'pockets' to put food into so that the littlie can practise chewing etc with no danger of swallowing anything to trigger gag reflex. dd2's gag was a monster, but she can overcome it if she concentrates now... new stuff is always an issue, so we have a 'taste' mouthful where she doesn't get it in her mouth, then a second go to see if she likes it or not.
you could try a bit of face tapping etc to stimulate before food - sometimes just 'wakes the mouth' up a bit. your slt will have loads of ideas - ours was fantastic from very very tiny. (dd2 has cp and is now a walker and a talker! her muscle tone is now low and she has a fair amount of hypermobility, but she was v tight, so tone can change a lot over time)

new-vis is a good website with lots of info on dysphagia...

[Arabica]

Just to second the advice about Wotsits and Quavers--these worked for DD, who does have hypotonia, and has in the past thrown up lots of lumpy foods and now shows a real unwillingness to eat solids. She has had an assessment by SALT who isn't worried about her ability to swallow and she isn't aspirating.

It seems to be a complex issue, however--DD's just 2, but is functioning at around the level of a year-old baby, so spitting out most of her food, being unable to use a spoon etc are kind of what you'd expect.

Just to let you know how much help is out there, DDS's been referred to the feeding clinic at GOSH. First she is seeing a gastro specialist just to rule out any organic cause. Then she will be observed by a a multi-disciplinary team incl SALT, OT, physio, psychologist, dietitian, and gastro person. (whether she will want to eat surrounded by so many people is another question!) and hopefully one of them will be able to assist.

[Izabella]

Thank you so much everyone. I've known there's a problem for quite sometime but my GP dismissed her as simply being a 'sicky baby'. I will try all your suggestions and I'll let you know how it goes.