Seems like there's a lot to update everyone on from last week, so Jenn asked me fill in today. We've learned a lot about the feeding situation since Tuesday, when LJ had an appointment with the GI doc.
Some background. Lewis is down to one visit a week from the speech therapist, starting this week. Basically, the therapist felt that Jenn had learned all the tricks she had, and that it was unlikely she'd be able to do much for the time being. Initially, we were pretty upset by this, especially since Lewis seems to have regressed recently in terms of feeding/sucking skills. In our conversations with various experts since then, there seems to be a consensus that kids don't generally make much progress learning to eat with the NG tube in the back of their throats. As they get older and more aware of it, it annoys them more and more and makes them more averse to anything around their mouths. (Makes, sense, when you think about it). Unfortunately, the only other options are a tube in the stomach or intestine. Either one requires surgery.
Jenn discussed this with the GI doc earlier this week. The doctor had a couple of important points. First, LJ isn't ready for surgery. When he is, the doctor thinks he'll only be a candidate for a J-tube (intestinal feeding) rather than a G-tube (stomach feeding), due to the scar tissue and overall condition of his stomach. This is tough news, since a J-tube doesn't allow for "bolus" feedings (quicker, high volume feedings). That means more time hooked up to a feeding pump. However, the Doc didn't feel that that was the only option, or even the first choice. She suggested that we look into two intensive, inpatient feeding programs for kids. One is at UVA (Kluge), the other at Hopkins (Kennedy-Krieger). Both programs specialize in teaching kids like Lewis to eat by mouth.
We've been in contact with both programs. Short version, they don't take kids until at least 1 or 2, and only that early on a case by case basis. I had a very long, very helpful conversation with the head of the program at UVA. After listening to Lewis' story, she agreed with all the current assessments and gave us some great pointers. The main take away is that kids can't learn to eat until they are 'teachable' (debatable when that is, but definitely greater than 5 months) and that the process involves letting the kid get hungry. At this stage of the game, Lewis needs the calories for growth and brain development, so skipping meals isn't safe. All this makes lots of sense, but also leaves us in limbo for a while. She suggested that we focus on physical and occupational therapy and tone down speech therapy for a while - any mouth feedings should be just for fun and positive associations, not for calories.
Now back to our regularly scheduled program...The rest of the week was fun and busy. Jenn and LJ went to
baby & me yoga at a place near our old house in DC. (No, I'm not kidding, just to save you an email). Jenn used to do this with Nate all the time and this was LJ's first run at it. He did pretty well until the very end, even with 17 other babies in the class. Turns out lots of the stuff they do is very similar to LJ's physical therapy. All that and Jenn got to talk to some adults and do a little yoga herself. I think I'll submit the bill to insurance.
Nate's friend Zoe (and Zoe's mom) came over for a challah baking playdate on Friday. I missed out, but the results were delicious (see pics below) and Zoe is very photogenic. We had a great time eating the challah with Aunt Annie and Uncle Dan for Friday dinner and both boys got plenty of aunt and uncle love. Lots of other fun stuff this weekend, birthday parties, movie night and even a quick dinner out for Jenn and I (Thank you Fran & Dave!).
Oh, one more feeding note. The doc switched LJ off of the continuous feeding overnight, to see whether he might sleep a bit better. LJ's sleep schedule has been hit or miss since we got the Farrell valve bags (see earlier post). He's had a couple of very good nights, sleeping 4+ hours at a clip. Last night, he and I stayed up pretty much all night - we aren't quite there yet, but hopefully this is progress.