Feeding Tips for Preemies
Every child will respond differently! However, some things have been more successful with children with feeding problems than others:
Textures & Flavors:
Textures are very important to kids with oral aversions or poor oro-motor skills. Trial & error are the best ways to find what works best for your child. Don’t give up the first time the child rejects a food, but be very aware of the physical reaction (i.e choking or gagging). Never force any food on the child! It is extremely counter-productive.
Try the food yourself, but look at it from your child’s perspective. Did it dissolve easily? Did you have to chew much? Did you have to maneuver it around in your mouth a lot? Now multiply your reaction by 10 or 20 or even 100 and that’s how you child may perceive it.
Some things to try:
If pudding and yogurt work, try adding Thick-it or Thick & Easy to other pureed foods or liquids to give them a similar texture. Thick-it is a product sold at the pharmacy (it may have to be ordered) that thickens liquids and pureed foods to a proper texture without changing the taste of the food. Or call 800-333-0033 to find where you can get it. Another brand of thickener is called Thick & Easy and is made by Hormel.
Ensure Pudding is high in calories and nutrition, it is however, intended for adults, so it is best to consult your doctor before trying this with your child. Also, it does not have the same taste and texture as traditional readymade puddings.
Pureed food -- if your child has trouble with chewing or lumps, puree everything or buy baby food! Slowly increase the lumpiness as the child progresses. Add 1/4 tsp of wheat germ to 4 oz of food. Increase by 1/4 tsp as the child accepts the new texture.
One company I know of sells pre-pureed "entrees" for people with dysphagia and ships them directly to your home. Their advertisement claims it provides great tasting, nutritious meals with a delicate souffle-like texture that makes it easy to swallow. The entree featured is a pureed Apple Cinnamon Frenh Toast. For more information call 1-800-225-2610 and ask for Menu-Direct.
Food that are easily chewed and swallowed include: graham crackers, tofu, soy burgers, fast food hamburger meat (high fat & grease content help the texture), meatloaf, processed breakfast sausage (not the kind that comes in casing), red & black beans like the ones found in chili, chocolate in small portions (i.e.chocolate chips), pretzel thins or sticks, chips (potato, corn etc...), breakfast fruit & cereal bars, pop tarts, Cheerios.
Foods that are particularly hard to chew and swallow include steak, chicken, bread and many cheeses such as melted mozzarella. Toast bread lightly, most children with poor oro-motor skills can eat toast easier than regular bread.
Many kids are aversive to slimey foods such as pasta, fruit and veggies.
Many children have a problem with mixed textures.
High protein foods such as milk, eggs and beans are important for growth.
Polycose is a product available at pharmacies that adds calories to food without making it more filling.
MCT oil or MCT Fuel can be added to bottles for extra calories. This is very expensive as it is only sold in quarts, which is a lot since you use it in 1 cc amounts. It is also available without a prescription at pharmacies. I have been told the MCT Fuel dissolves better.
Add Carnation Instant Breakfast to Pediasure or milk to increase calories without increasing volume. There is a "homemade" version of Pediasure that includes milk, Carnation Instant Breakfast and half&half. I'm looking for the recipe to post here. Please e-mail me if you have one.
The makers of Ensure (Ross Laboratories) have recently introduced a clear liquid nutritional supplement called Enlive. Enlive is 300 calories per 8 oz (most juices are about 100 calories per 8 oz serving). It comes in apple & peach flavors. It is Fat Free, Lactose and Gluten-free. Call Ross Products Division of Abbott Laboratories in Columbus, OH, for a dealer near you. One distributor I found will ship throughout the US, but you must buy by the case-pack (27/case). 1-800-719-0711.
Add fats such as butter, cream, milk, mayonnaise, sour cream or cream cheese to whatever you can. We put cream cheese on crackers, waffles, toast, cereal and even spoon feed it to Conor.
Flavor your own cream cheese by adding cinnamon & sugar for more calories!!! Add chocolate syrup, strawberry syrup or even maple syrup for a different flavor and higher calories.
Add 2tbsps of heavy cream to 4oz of yogurt or pudding (ready made) for 100 extra calories of fat and no difference in taste, texture or volume!!!!!
Another high fat, easy to chew food is avacado or guacamole.
Spread pesto on bread, pasta or pizza.
Add ground seeds such as sunflower seeds, sesame seeds or wheat germ to foods.
Mix cooked egg yolks with mayonnaise for a creamy, smooth egg salad. Yolks are 50 calories each!!
Some say giving the child small sips of water throughout the day (hourly) will increase appetite.
Have your child checked for a zinc deficiency. This has been rumored to affect appetite.
Have a picnic with play food. Play a game with chocolate chips as the reward for success. Let the child paint with pudding. Make funny faces out of pretzels & cookies & cheerios. Read books that show eating in a positive light. Help them play with their food. Try having the child smell many different things including food.
An infa feeder, made by Sassy helps children who can not eat solids off a spoon because of oral issues and sensory defensiveness.
Another product called a Haberman Feeder that is generally used in place of a typical bottle for children with cleft palates has been used very successfully with children with poor suck and swallow
Spin-pops, lollipop holders that spin the pop around, with chartacters on them can help break down some sensory defensiveness. They also now make "Sound bites", lollipops that make sounds inside your mouth. Vibrating toothbrush holders also help. For very defensive children you will need to proceed with caution as not to further traumatize the child.
Try lightly wiping the face area with different textured cloths to break down sensory defensiveness.
Use anything other than a spoon or fork to bring food to the mouth -- i.e. chopsticks, ice cream pop sticks, a toothbrush, tongs etc.
Many therapists use body brushing techniques.
Sand or rice therapy also help in desensitizing aversions. A bucket full of sand or uncooked rice with toys hidden in it makes a great search game. Proceed slowly with very aversive children.
Here are some things they may do:
Use a mirror to help the child copy tongue movements.
Repetitive sounds mimicry such as "La, la, la" "Ba, ba, ba", "Pa, pa, pa" help many diferent mouth movements.
Blow bubbles, whistles or harmonicas to encourage lip movement and closure.
Using your hand to support the jaw will also help in proper chewing. Either lightly cup the chin with your palm aor use two fingers for light support. Be gentle! Do not force chewing.
There are many other exercises a therapist will use to help strengthen skills.
Propper positioning of the upper body can greatly improve feeding and digestion.
The High Chair helper is an insert that can help your baby sit better for feeding. It can be found at baby stores such as Babies R Us.
The SteadySpoon was designed for children and adults with poor coordination and fine motor skills. It keeps food balanced on the spoon until it gets into the mouth and is easy to hold. The spoon gives a little indepedence and a lot of self confidence. Tell them Laura Williams sent you!!!! Call Toll Free: 877-849-CARE (2273)
Other feeding utensils, cups and bowls made specially for children with poor motor skills can be found at the following websites:
Homeopathy can be used to treat a number of preemie related conditions as well as other general medical conditions. To learn more about homeopathic medicine contact the National Center for Homeopathy website: www.homeopathic.org or email: nchinfo@igc.org
Puddings and yogurt -- some kids with feeding problems do very well with pudding or yogurts while others do very poorly depending on their aversion and oro-motor skills.
Try the kids’ yogurts in the 4 oz containers. The flavors are much more appealing to kids and have no clumps. Be careful with custard styles as your child may react differently with these.
Consult with a pediatric dietician. Please check with your physician before changing your child’s diet.
Try giving your child a daily multi-vitamin. Many say they see a marked increase in appetite after a few days.
It is important to help your child associate pleasure with food. At least once a day, away from the table or the place where serious eating takes place, make a game of eating.
A speech therapist will have many techniques for helping to improve oro-motor skills.
Use twizzlers or beef jerky sticks or drink swizzle sticks or wet gauze pads to improve biting.
Poor fine and gross motor skills can contribute to poor eating skills.
New Visions
Abilitations
Ableware
Flaghouse
Winsford Feeder (for children who have no use of arms)
We took Conor to a homeopathic doctor who spent 1-1/2 hours discussing his whole history from whether or not his head and feet sweat to what position he sleeps in. After this long discussion, the doctor chose a constitution remedy that most closely matched Conor’s characteristics, both medical and behavioral. Shortly after the remedy Conor’s chronic vommiting (4-6 times a day for almost a year) STOPPED. It started up again a few months later and a second dose immediately stopped the vomitting.