Fussy Feeders - Dysphagia - a possibilty other than reflux

[Luke-n-Me]

That's really great  news, make sure to let me know when the tests are scheduled and how it goes.  Your pediatrician may not think that it sounds like he has dysphagia, but as a professional who works with this on a regular basis, I wouldn't have told you it sounded like dysphagia if it didn't!  I'm not a huge fan of thickening with cereal, mainly because you can't get cereal through a regular nipple meaning you have to make them larger or use cross-cuts.  If you do this, you're kind of making the whole point of thickening moot.  To thicken and then make the larger nipple basically like leaving it thin liquid and staying with what you have.  You also cannot get cereal to thicken the liquid uniformly.  You will have some thickened formula and some runny.  That's my opinion on that. 

As for you question on Simply Thick, I've had a nutritionist/pharmacist with the Ohio State University look into if it blocks nutrient absorption.  Her reply was that over a huge period of time it may deplete a small amount of a few nutrients (I forget which ones off the top of my head, but I believe there were 3), but the benefits of unsing the thickener far outweighed the the minimal amount of nutrient absorption that may or may not occur. The only other option is to try feeding in different positions and giving frequent breaks from the bottle during the feed (not meaning let him eat 2 oz. and then 20 minutes later take 2 more and so on, what I mean is let him suck 10 times, more or less, and then take the bottle out and keep doing this throughout the feed).  That's the other option, well...........or try side-lying or sitting completely upright with the frequent breaks(sorry, I'm rambling).   

Glad to hear things are going well.  Just using the thickener alone will also decrease reflux and keep things down.  Once I started thickening Luke's formula, not only did the swallowing problem disappear, so did his reflux!

Keep me informed!

[sfamily]

OK its me again.  So we have had a few full days on SimplyThick and I also called the company and spoke with some great people about infant studies and any issues that our LO might have with it.  If you have question call or email the company they were very responsive.

Some questions and observations that i forgot to ask ST:

Our little one seems to have many more bowl movements then pre-ST.  He was always a once a day pooper and is now going 2 to 3 times a day with a very yellow mustard type appearance.  Is this normal when adding ST to their bottles ?

Twice this week he has thrown up his complete bottle after eating 5.5 to 6.5 oz?  We are actually using a Y cut nipple as the standard level 2 nipple didn't seem to give him the ability to flow the ST formula. 

Thanks for all the advise,

[Luke-n-Me]

I don't have many people complain about changes in stools after using the simply thick, but it's certainly possible.  And I say I don't have MANY, but I do have few.  For some it's more constipating and for some it creates full-fledged diahrrea, but in most cases it's tolerable.  So, yes, I think it's probably normal for the changes to be occuring.

I'm not certain why he would throw up complete bottles, is this still occurring?  Unless he has a weak suck , he should be able to get the ST through a regular nipple.  The Y cut may be causing too much/too fast and hence the refluxing.  I only recommend a Y or X cut for babies who can't suck strong enough to extract liquid and typically these babies have low-tone otherwise.  Do you see that in your lo?  Hopefully things will continue to get better, let me know if you have more questions!

[Nikkivdm]

Hello, I am new to this forum, and so have not read every post, but I just wanted to say what a relief it has been this past half hour to read about this problem and know that this is what my DD must have been (midly) suffering from.  She is now 5 months, but at 3 months I went through 3-4 weeks of many of these sympotoms.. mostly the screaming at the breast, arching away from the breast and bottle, only feeding at night, wanting to feed upright, gagging, choking, hiccuping a lot etc etc.  The DR couldn't work out what was wrong so in the end when she wouldn't take the breast milk from me or a bottle I gave her a bottle of formula and what do you know we have been fine ever since. Have been through all the questions re the breats milk and nothing seemed to answer my questions.  So clearly a very, very mild case, but thank you for helping me realise it wasn't something I was doing wrong!
All the best to those Mum's out there who are suffering with their little one's.
Take care

[Sugarmama]

Nikkivdm,
I am wondering about my DD. She too hiccups, arches, etc. But so far we have decided not to go through the testing, as she still gains weight. I am able to get 4-5 oz. in her over a 45 min. feed with frequent breaks.

Did you lo ever lose weight? But you never had testing, did you? I just still hold out that something might be up because my DD is 20lbs. and 30 inches despite and only takes so little.

-Jodi

[Nikkivdm]

Hi Jodi,
No she didn't loose weight, although the gain wasn't much through that difficult patch.  I have a health check after the weekend, so will find out then how she has gone over the last two months.  My DD only takes about the same amount at each feed as your DD... and it has been worrying me.  My DD is closer to 17lbs at the moment I think though so a little smaller than yours.  Anyway intersting that they both prefer smaller feeds.. and I only feed 3-4 hourly, so it is not as if my DD is eating small frequent meals.

I hope things are settling for you and your DD?

[Sugarmama]

Hi there--Pretty much the same. Had her weighed yesterday. It should a 5 oz. increase in one week, so she's gaining. Tho I think her constipation as of late weighs her down--lol But anyway, no noticeable loss.
Let me know how you get on.
-Jodi

[Aspen_chloe]

My dd is 4 mo and is already being treated for reflux with Zantac, reglan and levison and Nutramigen, however she has started refusing bottles again.
Would there be any harm in trying the thickeners as a treatment without all the testing? Is there really any other treatment than thickeners?  My dd will eat bottles fine when she is sleepy. She will have an occasional good bottle but most are very fussy and very squirmy. She should be taking 6 ounces and will often scream after 3 ounces. She might even cry when she sees us putting the bottle to her mouth. We just introducted rice cereal 2 days ago and she LOVES it.  She will eat it fine and be happy but refuse her bottle at the same feeding. 

[Jasalyns Mama]

Hi... this is my first time to this site, and this was the first posting I cam across.  I hope someone can help.  It seems this problem may just be popping up with my daughter.  She's a month tomorrow, and has recently been very fussy when she starts eating.  I switched to pumping and giving her a bottle at 2 weeks old (we use Avent).  She was doing fine, but now fusses, and it seems like either she's taking it in too fast (when before it was fine) or not fast enough.  She starts drinking, and then cries when it starts coming out.  As soon as I take it away, she's fine, but it seems like she wants more.  And, I notice at night, she takes much more in, I guess since she's sleepy.  She has been gaining weight great, but I hate to see her start loosing weight.

Can someone help me on this?  Does it sound like Dysphagia.  When she's sleepy, she'll take 4-5 oz, but when she's not, she'll only take about 2, maybe 3 if I'm lucky.  I feel bad because I know she's hungry.  Please help... I'd hate to start having problems now since she's been doing so good.

Thanks!

[clarapist]

Hi there,
I am sorry you are having problems. If you scroll back to look at my posts, you know I've been there. In the end, I think that my son did have reflux, but I was pretty convinced at the time that dysphagia was also a culprit, but I'll never know.

 I assume that you have been using the slowest flow nipple. Does she have any other symptoms at all?  Does positioning her differently help while feeding? More upright, versus on her side, versus more flat- try all of them (Try putting her on her R side.  If it's BETTER, it MIGHT be dysphagia).  Do you live in the USA? You could also try thickening the feeds with the Simply Thick Gel. It was the magic bullet for my son. You can order a trial box for $10.  The problem is- that thickening feeds is a treatment for BOTH reflux and dysphagia, so hard to tell what is the problem if it works. Also- call your pediatrician.  It might be worth it to try reflux meds. (We did Prevacid and that, plus the thickener helped a LOT).

You are doing great- I KNOW how frustrating it is.  Email me if you need further help. I know you'll also get other helpful replies. I am not a Speech Therapist, but am a Physical Therapist so know the lingo. 

[Luke-n-Me]

Hello Jasalyn's mommy and Aspen_Chloe.  Sorry I didn't reply sooner, I wasn't getting email's to my regular address that I had a response and I must admit that I rarely check this website anymore unless I'm actually alerted to a response so...........sorry. 

Anyway,

clarapist has probably read so many of my posts that she knows what I"m going to say.  It doesn't hurt to thicken without the testing to see if it helps, it's just hard to tell what amount of thickening is the best.  Because starter packs are now available from simply thick, that's probably a great route to try.  Try nectar thick first and then try the honey and see if you get any results.  Both of your lo's are showing signs of dysphagia and Jasalyn's mommy, the "drinking too fast..........too slow" is also a sign of incoordination of the suck-swallow-breathe mechanism.  Strangely enough, these lo's don't always lose weight; however you want feeding to be a pleasant experience and fussing and squirming while feeding isn't pleasant! 

You can try positioning. Side-lying is somtimes helpful if you're lo is still small enough that they will let you hold them this way and of course sitting up as close as possible to a 90-degree angle for feeds may help-also breaking suction from the nipple every few sucks to make them "restart" the suck-swallow-breathe mechanism may help too so they don't have an opportunity to become so incoordinated.

Please email with more questions if I haven't answered them all.  I apologize for not being more prompt.  I will be out of town Fri. 6/29 through Mon. July 2.  Hope things get better for all of you, I know it's difficult/frustrating!

[JAKESMA]

This sounds about right... I've been dealing with a feeding issue for the past month. However - he seemed to be doing okay up until then? Was eating about 3-5 oz every 3 hours when he was 2-3 mths. Now, he's stopped taking the bottle period when he's awake. He occasionally wakes up when he's feeding, realizes that a bottle is in his mouth, gags or something, then pushes it away. It's so frustrating to say the least. And... the sleepier he is, the better he eats - so sleeping though the night is out! I'm not sure though if this problem would just get worse - as it has? Because as I said, before about 1 mth ago, he was doing fine. We started on solids in there too... so I don't know if maybe this is just a problem with the solids giving him a tummy ache so he doesn't want to eat or what? Very confused...

[Luke-n-Me]

I can tell you that it's not uncommon for this to become more of a problem when lo's are around 3/4 mos. because that's when they "wake-up"-become more alert which means they are often more awake for feeds and they become more sensitive when things aren't going right (like when food/liquid is compromising there airway).  Does this help? Let me know if you have more questions!

[JAKESMA]

  Today has been the worst day probably yet. Days like these make me long for when he's majoring in solid food... there's no issue there! Is it normal at this age then that they don't want their bottle when awake? Should I mention this dysphagia to the doc and see what he says? He gags a lot and that's normally the end of the bottle session. Maybe we're using nipple that's too fast? But he was fussy a lot on the last, which is why we went up one. Also.. is very gassy lately. Do solids sometimes make their stomaches hurt? Just don't know what to do with the little guy!! Thanks a lot!

[sfamily]

Long time since i have logged on but wanted to give a quick update.  We have been using simply thick now for two months and it has made a night and day difference.  Our LO has no problem eating now and will put a 7-8oz bottle down in 10 mins or less without any pulling away or getting upset.  We are going to try reducing the thickener amount now and see if he continues the same successful eating.  As mentioned earlier we changed pediatricians so that we could get a barium swallow test done but then got cold feet the day of and decided it was better to just thicken without a definitely diagnosis given the great results.  Thanks for all the help and we will keep you updated.