Sense-Able Baby Website

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Great resource on sensory processing problems in infants. Also provides ideas on calming babies, understanding why they are crying, and body signals they give off to let you know when they are hungry, sleepy, or ready to play. Great links page on a variety of resources for babies who are typically developing and special needs.

Heart Defects in Babies Contribute to Feeding Problems

So often, I work with babies that have various heart defects and more often than not, the babies have feeding problems too. Even after the heart problems have been resolved through surgery or the child "growing out of it", the feeding problems linger into toddlerhood. Why? The number one reason: if you can't breathe well, it is really hard to chew and swallow! This may initially be a poor latch on to the breast or bottle and failure to thrive, because not getting enough ounces during a feeding and burning lots of calories during the feed don't exactly help the infant gain weight. Then, medical staff decide to switch to a high calorie formula that unfortunately has an "yuck" taste, or at least I think that is what the babies are revealing to me. Then, there is feeding tube discussion. Because if the baby can't consume enough calories orally, then an NG (nasal gastric) or (G) gastric tube may be necessary. What a mess! It is a vicious cycle of trying to get the baby to gain weight, especially if surgery is in the future. Then, parents get anxious and the baby "feels" it, which impairs the feeding session even more...uggh! So, then I or another occupational therapist steps in and works with nursing, GI doctors, the pediatrician, and any other person that can help. Often, within a few months things do improve and the baby gets on the right track of gaining weight...yeah! I often recommend strategies to calm the baby so that the suck-swallow-breathe during a feeding is more organized, check out www.sense-ablebaby.com for strategies on calming a baby and the environment.

Once the baby is learning to chew and eat table food, it is often easier for the child to just swallow the food whole than it is to take the time to chew. Many of these children become picky eaters because they know that it is way easier to consume yogurt than it is to chew string cheese! I start out helping the baby learn to use the proper mouth muscles and eat small pieces of food. If you don't work on feeding, you risk a child with an extremely limited diet that may need a feeding tube! Double uggh! However, if a tube is necessary, then so it is. But, feeding skills go backwards unless it is worked on hard! Also, often a swallow study is necessary to make sure the baby doesn't have reflux or doesn't have mechanical problems that would cause the infant to aspirate.

I think that anyone who has a baby that fits the description above, really needs a well-trained occupational therapist (OT), or maybe a speech-language pathologist, to work with the child. OTs can address the other motor delays as well such as not rolling or sitting up on time. So often, babies who have had heart surgery aren't able to lay on their tummy for awhile which impairs rolling and crawling skills. The therapist really needs to communicate with the physician on the plan of care! During therapy sessions, it is a must for the parents to be trained and replicate to the best of their ability what the therapist shows them to do during a feeding. If the baby is medically fragile, a home health nurse may be assigned; in this case, it is a great idea for the OT (or SLP) to work closely with the nurse. Depending upon the nurse's experience with feeding babies, they may need ideas on nipples, positioning, etc.

Back to the Basics: Breastfeeding

I just finished attending a 2-day conference on breastfeeding. Why did I attend this? Well, not only am I very pro-breastfeeding, but I am an occupational therapist who works alot with infants and toddlers with feeding problems. At all of the feeding conferences I have attended in the past along with other occupational therapists and speech language pathologists, much of the information is geared towards bottle feeding. So, I decided that I am going to learn more about breastfeeding. Now, I nursed both of my children for one year, so I knew some about the subject already. But after attending this conference, I realized alot about atypical situations and breastfeeding the medically involved child. I thoroughly loved the conference, and left knowing that I had done the best thing ever by nursing my two kids. Of course, we know that breastfeeding helps boost the immune system of the baby, reduces chances of breast cancer in the mom, and aids in parent-infant bonding and attachment, but there are also so many other benefits to it.

I just think it is so bizarre that in third world countries pretty much everyone breastfeeds, and the few babies who aren't nursed often don't survive. This is because the formula doesn't offer anti-bodies to the numerous diseases they are exposed to. Yet, in a developed country like the US, so many women don't breastfeed. Now, I can't judge women who don't. They have their reasons. And as I learned at the course, some women just can't produce breast milk for various reasons. But many of the women who can successfully lactate, choose not to breastfeed. Maybe that is because our society doesn't really promote breastfeeding like it should here in the US. Over in some European countries, breastfeeding rates are much higher, maybe because they can take a maternity leave up to a year.

The reason I named this blog "Back to the Basics" is because there is not one single baby formula out on the market that is superior to breastmilk. They can simulate the DHA and some of the other nutrients, but not all of them! The best thing for our baby is free, and no matter the country or the amount of salary you earn, you usually can lactate. It is so basic, yet here in the US we make it so complicated!

The only person or thing that cow's milk is perfect for is a baby cow (calf)! There are so many formulas out on the market because so many children can't digest a standard formula. There is formula for sensitivities, allergies, and lactose intolerance. But for those women who can't lactate or who choose not to breastfeed, I am thankful for the numerous choices so that babies can be as healthy as possible.

Next week when I return to work, I hope that I can help all of the babies with their feeding problems whether they receive breastmilk from a bottle or directly from their mom, or if they receive formula from a bottle or g-tube. My mission as an OT is to help the babies and their families to be as functional as possible.

So much of feeding is related to understanding the signals given by the baby. Some of these are discussed on my website: http://www.sense-ablebaby.com/