Today's MFB Therapy

Wow! Today's therapy was interesting! After talking with the therapist and nutritionists about the insurance company (see my post "the next step...), we started Jordan's therapy.

After a brief evaluation of Jordan, we worked on drinking from sippy cups. I have spent the past month working with her to get her to take formula from a sippy cup at mealtimes. She normally takes between 1-2 oz per meal. Today her therapist, Ellen, experimented with 3 cups that I brought from home. She ruled one out immediately because she was getting too much at once from it. The other 2 were okay, but she was drooling down her chin after every sip as well as coughing and sounding very wet. She said that Jordan was very active and busy and that she loved immediate gratification. She wanted to gulp it even though she didn't really know what to do with it when it was in her mouth. She was very concerned with her aspirating it into her lungs. She also like to feed like a bird and she would push out her chest and lift up her chin. That makes it difficult to swallow and more likely for liquids to go down the wrong tube into the lungs.

She also noticed that she didn't seem to have a cough reflex. Normally a person that had liquids go down the wrong tube would reflexively cough to get it out. Jordan didn't do that. She would just continue to breathe for a little while until finally she would cough and clear it. She said that this may be something that has been happening for so long, that the nerve endings in her lungs are no longer reacting normally to the liquid there. She tried thickening the liquid into a nectar and that seemed to help a little bit with the drooling but she still coughed after almost every sip. She said we might go to a honey mixture if this continues to be a problem.

She decided that the sippy cup wasn't going to work for Jordan. She went and got a clear plastic Solo cup and tried to use that. Over and over again she gave Jordan just a little bit of liquid at a time. She stopped coughing!! She eventually had me take over so I could learn to give her the adequate amount. It was amazing that her cough was gone!! I was so used to hearing her cough when I gave her a drink that it was almost strange to not having her do it anymore. We were thrilled that Jordan was doing so well! Quite often she would start to bird feed again and I would have to push on her chest and wait for her to lower her chin before I could put the cup to her lips. Then if she started to chew or mouth the cup, I would wait for her to get suction with her lips before tilting the liquid for her. It was quite a process!

Ellen sent me home with a Solo cup to use at home as well as thickening recipes to make a nectar. I guess I will just need to plan a longer time for feeding her because it takes quite a bit longer when she only gets a small sip at a time. I am amazed at how the therapists at MFB have the ability to find such a small change and the big difference it can make!