Wednesday, May 05, 2010

How do you get your child to learn how to Chew?

On my last post I had a few readers ask me how I got Kaitlyn to chew. Here are the readers questions and my answers...

Here are some answers as best I can as this is NOT easy...

“Did Kaitlyn suck from the bottle ever in NICU or at home? “
--Yes, and she breast fed some too, but at about 3 months post due date she stopped and at that point we knew we had to go from an NG tube to a Gtube.

“Did she have feeding tube from the birth? “
--All micro preemies get fed via feeding tube, as they do not have the ability to suck as they are too premature. Normally at about 32 - 35weeks gestation babies can feed orally, but because they are so small they tucker out and are still supplemented with a feeding tube.

“I know she learned to eat at one feeding program but before this program did she ever suck, chew or swallow? “
--again she used to "suck" but after she lost the suck reflex at about 4 months post due date (8 months old from birth). We tried and tried to feed her other foods orally but she took very little and did not know how to chew.

“How old she was when she started to suck and swallow?”
-already answered above.

“ How did you motivate her to chew and eat like regular kid?”
--Chewing was VERY VERY difficult. We first had to teach her to eat (only purees) all intensive feeding therapy will start with purees to teach a child/baby to learn to swallow first. MANY months after that we started trying to work on chewing. It was VERY difficult. Even though she started taking most of her nutrition via mouth at that point, she had no idea how to chew food (even though she was 3 years old) . WE worked VERY hard with a Speech OT as well as our feeding therapist. We did chewing exercises with her every day. She “chewed” on slim jims as well as therapeutic Chewy Tubes. This was not easy and it took a LONG time. I never thought she would “get it”. But FINALLY she did. My main point is you can’t do this alone, you need help and you need to know it’s a lot of work and a lot of time. You may think that children should “know” how to chew, but they don’t If they never learned to eat along the “normal” baby timeline, then they have to be taught. Eating is NOT reflex, it’s learned. So if the baby doesn’t go through the normal self learning at an early age, you have to teach the child what to do.

“My daughter had feeding tube from the birth so she never sucked or swallow. She is three and half years old and we have been taking her to the feeding therapist last two years but she still can't figure out how to chew. She takes only liquid and semi liquid food and she does not have feeding tube anymore. She had tube three years. She packs everything inside of her cheek and our therapist always says that she never learned to suck so that's why it's taking that much time but it's been two years so it is really long for anybody to learn and also she does not have any motivation so she doesn't care for chewing and never feels hungry. Feeding is a biggest trauma for her. Is it true that if they have tube that long that they will never learn to chew?”

-no they will learn to chew, but as I said, it’s hard and you need help. Don’t give up… I never thought Kaitlyn would chew. BUT she does now eat like a regular toddler! It’s possible. I’m proof.

Just a few more thoughts to add to the above:
Slim Jims were one of the first things that K liked to "chew on" She didn't bite pieces off (good thing as she wouldn't' have known what to do with them anyways) but because it had some flavor to it she would bite. Our OT made her do bite practice on chewy tubes. (you can by them from the TalkTools website). We would have her do bites on both sides of her mouth. The OT always felt that K didn't have the jaw strength to chew, I personally didn't think that was the main issue, it was really that she had no idea what to do. The OT also had K chew on chewing gum. She would put sugar chewing gum (and let K choose the flavor) inside a cheese cloth bag and put it between K's teeth and worked with her to do 5 bites on each side. We would work up to more bites over time.

With food at home, we eventually would use a NUK brush to "place" pieces of food on her back molars. I remember telling her over and over use your back teeth, as she would always try to chew with her front teeth (this was months after we started chewing training). We would place a piece of soft food (like canned green beans were a good one) on her molars. We would practice on both sides before we then moved on to the puree meal.

Hope this helps!


Micro Preemie Mom said...

Oh my, thank you so much for this blog post! I am going through the nightmare of my son not chewing too.. 26 week preemie, sensory integration oral defensiveness, didn't tolerate any foods, then only certain purees and now no concept of chewing. We have no experienced feeding therapists in our area and are in the process of applying for acceptance to a program 2 hours from us (which the waiting list is approx 1 year long if accepted). Your blog is very helpful. I will keep following and any suggestions would be soooo great!! Thanks :)

Mel H. said...

Liz, thank you so much for going into detail. It's so easy to panic that because they are not picking up this stuff organically, they will never learn. Micro-preemies are hard workers. Patience doesn't come natural to me, and Daphne has taught me that there's no way I can rush anything with her. Thanks again.

Anonymous said...

thank you so much for your answer.
Your blog helped me in many ways.


kathy said...

Well, I am going through the nightmare of my son not chewing too.