Joshua's Journeys #36 Eating

I have been waiting to do a Joshua's Journey about his feedings: tube feedings, bottle feedings, and solids. I knew I would have so much to say and wouldn't know where to start. But with Jillian starting solids, I thought I'd start with a brief (as brief as I can) look at solids with Josh and I will definitely revisit this subject again!

Maybe it is the dietitian in me, but I love, love, LOVE feeding babies their first solids. I love seeing their eyes of surprise at the new texture, smacking their lips figuring out the mouthfeel, the tongue push and look away when they are overwhelmed, and I even enjoy the mess on their face and anywhere else it may land! Josh had his first taste of food in the NICU which was yogurt from a q-tip. I would dip the q-tip into yogurt and put it on Josh's lips to get him to first accept something touching his lips since he had quite an aversion to that, and to get him to start taking tastes. Josh had a hypergag, so anything going into his mouth made him gag and it took a bit of work to get him to even take tiny little tastes in the beginning. After a while we graduated to trying some bottle feedings which is pretty backwards. Most babies take a bottle before solids, but Josh had his tastes of yogurt well before Joey ever tried solid foods. When we finally started to try bottle feedings with Josh his record consumption was 8 cc's. For those that may not know cc's, there are 30 cc's in and ounce, so 1 cc is pretty much a droplet. It would take working for a good 10-15 minutes putting a nipple to his mouth to get him to accept it without gagging, and then another 30-45 minutes of working with him to try and get those droplets out of the bottle. Of course this also required a lot of suctioning since he'd often get upset, and after any feeding we'd have to suction to see if he was aspirating anything. In order to check if he had aspirated anything we'd dye the milk blue so once we were suctioning we could see if it was the milk in the suction catheter.

Even though it was a test of patience and persistence I loved feeding Josh bottle feedings and spoon feedings. Mondays were my favorite days because we'd go to speech therapy to see Cathy and work on his feedings. Cathy allowed us to do so many things with Josh because she believed in us and our care for Josh. In order for him to really taste something (since a lot of taste is smell as well) we would try a taste of yogurt when changing his trach. We would simply cover the stoma with some gauze and the pressure of one of our fingers and give him the vanilla yogurt (Activia!). I remember the bright eyes and delight in Josh's face the first time we did that. Not only was he happy to have the trach out at the time, but to get the taste of vanilla must have been quite a deal for him.

Solids were definitely easier for Josh to tolerate (bananas being his favorite- and oddly enough to this day Joey will not eat bananas at all), and it was expected that Josh would eventually use his g-tube for liquids only and eat solids regularly after a couple of years. Josh seemed to enjoy his time eating as well. I think he liked the one on one attention with the bottle feeds, and the interaction with his brother during solid feedings, sitting in his chair next to his brother eating just like he did. After a lot of practice from the early days of trying to get a q-tip past his lips Josh would insist on holding his own spoon while I fed him, or take the spoon I was feeding him with to assist me in feeding him. Again, I can go on and on about feeding him, and I know I will revisit this subject in different ways later on, with so many stories about his unique feedings, but for now I thought I'd just put up some pictures of Josh eating.