Feeding Evaluation

Today (Dec. 23, even though I’m blogging this after midnight) was Allison’s feeding evaluation with the occupational therapist. I wasn’t really sure what to expect and I’m still processing the information. I don’t completely understand it all, but I’ll give you my own dumbed-down version.

Thankfully, Allie had a terrible feeding in front of the therapist. I say “thankfully” because I learned (back in the days of my many lactation consultations) that she doesn’t always perform on demand. Sometimes EVERY feeding at home would be terrible, but she’d nurse like a pro at the office. Very frustrating. (“I promise I’m not making it up!”) So in anticipation of this visit, I made videos of several feedings so that I could show them footage of her typical problems. But I didn’t even need to get out the footage because Allie put on quite a show. There was plenty of bobbing off the bottle, arching her back, screaming, etc.

It was pretty validating to have the therapist say, “Wow, is this what it’s been like?” It makes me feel better that even the professionals think this is pretty bad – not because I want it to be bad, but because I want to know we’re not just crazy or making a mountain out of a molehill. Nope, we have a mountain going on.

Anyway, after I answered a lot of questions about Allie’s behaviors and history, the  therapist’s opinion is that beyond the reflux (which she and the previous GI specialist have agreed is likely a major factor), Allison has some sensory processing and state management issues. I don’t understand it all, but basically she has trouble 
“organizing” her body and her responses to stimuli. There are normal “states” that babies are in; imagine them as a stair case with deep sleep at the bottom, light sleep as the next step up, then drowsy, calm alert, active alert, and crying as the top step. Allie spends too much time in active alert, especially during feedings, so she’s often flailing around and moving too much while trying to feed. She also escalates too quickly through the stages (skipping steps), so she can go from calm alert right to crying.

The main solution we’re going to try to help is infant massage. Apparently, the therapist believes that using specific steps of deep pressure massage will help Allison tremendously. Research has shown that infant massage can contribute to a calmer state of being, enhanced motor development, reduction of stress, and even improved immunity, as well as improved sensory awareness & sensory integration. So that’s the plan! We’ll have several more visits with the therapist, but hopefully the massage will begin to help us soon. I don’t know if these issues were caused by all the difficulties with nursing, perhaps combined with my own stress level about how hard nursing was and then our (super-stressful-for-me) move. But it doesn’t really matter what caused it because the next step is to deal with it.

I should add that Allie’s feedings have gotten significantly better in the reflux end of things – we think it’s because she’s now been on a prescription med for several weeks. She doesn’t spit up as much and she doesn’t cry in pain as often. So little by little, we’re moving in the right direction. We’re about to reintroduce milk into her diet to see if she has any reactions (she’s been totally off of milk protein and soy for 3+ weeks now). I don’t think milk is a problem, but we wanted to rule it out for sure. I’m off of dairy right now so that my breast milk is dairy free and, wow, would I like to gripe about how hard it is to be avoiding dairy during Christmas, the season of delicious baked goods and party food! But if it helps me lose the remaining baby weight, well, I’ll just have to forget about the griping. :)

We appreciate your continuing prayers. It’s sad that things can’t just be “normal” when it comes to feeding Allison. But she is an otherwise happy, healthy, wonderful little girl and we are so blessed to have her in our lives. We are thankful that her issues are things we can work on. With God’s grace and help, we’ll make it through.