Wednesday, May 14, 2014

Cheeks don’t lie: Helping James to safely eat foods with a variety of tastes and textures




Eating is James’ favorite- these cheeks don't lie.



It wasn’t always. When he was born, the newborn sleepiness plus the low muscle tone made eating difficult, and James would fatigue easily. 

Though this experience was a bit stressful (just like a lot of new parents in general experience), the plus side was that we started speech therapy when he was three weeks old, and we received a lot of early help when it came to building up that oral strength for feeding, making sounds, and speech.  When we started solids around 6 months, we hit the ground running.

At 14 months old, James has come a long way with feeding. He’s drinking exclusively from a straw on his own (recommended to help develop oral motor skills and speech) and eating a variety of finger foods with different textures and tastes.  And with no teeth. :)


Some of the stronger tastes that James enjoys:

    -       vegetables or chicken with spices like thyme and cumin
    -       hummus (there's that cumin again)
    -       olives
    -       spinach and feta cheese

He’s definitely a Mediterranean guy.

So how did we get there? I picked out a number of the things that I think helped us the most when it came to eating solids.  Of course, each child is different, but if there’s an idea that you think might work for your kiddo, great!  As always, check with your doctor or speech or occupational therapist, if applicable, first before trying something that your child might not be ready for.

1. Making our own baby food- We were able to mess around with tastes and textures by making our own purees. Those who know me well know that this concept is very foreign to old Maria, who lived off of cereal and Chipotle burrito bowls.  But a friend and I were very determined to try and make our own, and once we got into a routine, it wasn’t so bad! One batch of puree can be frozen in ice cube trays and last a couple of months! I followed this website religiously: http://wholesomebabyfood.momtastic.com/, while also of course talking to James’ pediatrician about introducing new foods.

If making your own food seems like a daunting and time-consuming task, you might just try focusing on a couple of things.  For example, mash up a banana with the fork until it’s pureed.  Easy! When your baby becomes very comfortable with smooth and thin purees, you can mash a little less to add just a teeny bit of chunk in there to get him/her comfortable with a different texture.

2.  Try and try again- If James hated a certain food (broccoli puree was probably on the top of that list), we would keep exposing him to it just a little bit at a time while talking about how delicious it was and sometimes even eating some of the loveliness in front of him. When he was old enough, we would add a little bit of spice, like we would to our own vegetables. There were some foods that he continued to dislike in the puree form, but when we moved on to table food, he was used to their taste and he loved them.

3. Practice with the mesh feeder- The mesh feeder is a great tool for learning and practicing chewing in a safe way.  James’ favorite things to put in there are probably slices of oranges and pineapples.  Though he’s on table foods now, our speech therapist recommends that we still use it a few times a week to continue building jaw strength, and James is pretty happy that it's still in the repertoire.


4. Gumming on veggie sticks- Because James was, and is, still toothless, our OT recommended giving him big sticks of celery or carrots to hold and gum for a good sensory experience.  We loved this idea since it also allowed him to get accustomed to these veggie tastes.  She emphasized BIG- no baby carrots or snack-sized pieces of celery- and mentioned to of course supervise him while he explored them.  We also tried asparagus (not the leafy part) and this went over well!  One thing NOT to try with this strategy is pieces of bell pepper.  I was bold one day and gave him a strip of green bell pepper.  James loved it, but gummed it a little too much, which resulted in breaking off a piece in his mouth and me giving him a couple of back slaps over the knee- a good thing to know how to do during this phase. We stuck to the really large, thick sticks of celery and carrots after that! 

Yum
And yum.



5. Thickening purees-  Our speech therapist recommended using graham cracker crust crumbs (the ones you can find in a box) to thicken purees and prepare James for more solid finger foods.  It really worked, and because they’re almost like dust, it’s a nice, safe way to thicken foods.   To avoid getting him too used to the graham cracker crumbs with fruit, I limited the use of this trick to one meal each day and also tried to find ways to thicken the texture through other foods.  Quinoa mixed with banana was one of our favorites. Who knew?! Crushing Cheerios into crumbs also worked, though it was harder to do than I anticipated.


6. Finger feeding with yogurt- Around 10 months, when James wasn’t quite ready to safely start Puffs and Cheerios, our speech therapist recommended putting yogurt on his tray and showing him how to finger feed.  When he was used to that, we would throw in some of the graham cracker crumbs or Cheerio crumbs.  He had a blast. This kind of feeding was a great sensory experience and also prepared him for when he was ready to finger feed other types of foods. Just had to be ready for a big mess. :)


7.  Letting him explore new foods on his own- Our OT mentioned to put new foods on the tray and let him explore them on his own instead of giving them to him immediately and making them the sole focus of the meal.  Because James likes to be in control so much, this strategy is especially effective with him.




As noted, James does love lots of tastes, including strong ones, and there’s a theory that this could be because of low muscle tone—that the stronger tastes give the input that little peeps with low muscle tone are looking for.  I’m not sure if this theory applies to James, if it’s the multiples exposures to foods, or if it’s just James being James, but it does make our life a bit easier when it comes to meals...at least for now!

Bon Appetit!







SEE BELOW FOR OTHER ORAL MOTOR STRENGTHENING TIPS WE’VE LEARNED


We also do a number of techniques to strengthen and stimulate cheek, jaw, and tongue muscles.

Here are a couple of things that we have learned and try (emphasis on try) to do regularly.

   1.     We do the following sequence to stimulate oral muscles
a.     With index and middle finger together, we do large circular motions over both cheek areas and around the lips.
b.     With index and middle finger alternating, we tap lightly around the same areas (cheeks and around the lips).
c.      Using the same two fingers, we do three downward, fast strokes.  The first right along the jaw line, the second down the middle of the cheek toward the mouth, and the third down the upper part of the cheek and toward the mouth.  Repeat on both sides.
    
   2.     When we clean his face, we use a damp washcloth and do the three downward strokes described in 1c on both cheeks. This strategy is quick and can be easily incorporated in the daily clean-up routine!

   3.     We use a z-vibe to stimulate the muscles in the cheeks and tongue.  When we use it to stroke downward on the tongue, the tongue retracts backward into the mouth.  This technique helps to keep the tongue inside the mouth (something using a straw also does), which can be a struggle for kids who have low muscle tone.

I’m not an OT or speech therapist, but I’ve found that when I read other parents’ blogs with these kinds of ideas and bring them up to my therapists, they’re usually excited to adapt them to what works for James OR they have another idea that works better.  So hope something was helpful!



2 comments:

  1. I am glad that little James is learning to eat like his Tia! Love you!

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    1. That's right!! You've taught him all he knows <3

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