Dear Diary...

Over the course of two years trying to wean Amelia off her tube, I have never kept a food diary (even after many suggestions from nutritionists and speech therapists). In my line of business, I often hear the quote "What doesn't get measured, doesn't get done." And it really is true. About two weeks ago, I finally began to keep track. Her speech pathologist wanted to know what we were doing and I have a rotten memory, so it started out as a typical diary stating what she gets fed, how often, and how much. But then I started noticing other likes and dislikes of hers and took notes on what kind of utensil, what type of texture, whether she preferred hot or cold. My hope is to find some patterns we can take advantage of, but just writing it down every meal has already gotten my creative thought process going.

Some things I have noticed lately: I can get her to eat more by using an adult spoon. We have the smaller baby and toddler spoons, but she manages whatever size you put in her mouth. So in order to get more volume in her, more quickly, I have gone to the adult spoon.

In speech therapy they use a textured wash cloth to stroke the sides of her mouth, her lips and chin. The idea is to wake up those muscles and nerves in order to get it ready to eat food. I have incorporated this into meal times by wiping her mouth and lips, chin and throat with a paper towel or textured cloth while she is eating. I do it when she gets her mouth all messy and then continue to the parts that aren't. I kept track of what I observed by doing this, which is that she seems to swallow more quickly, allowing me to get more volume.

Her speech therapist tried Flaming Hot Cheetos (a personal weakness of mine, especially the ones with lime -- thanks Aydee for introducing those to me!) with her and said she drank half of a bottle of Pediasure after eating them to cool her mouth down. I had noticed this in the past and would like to try to incorporate more spicy foods into her diet including Mexican, Indian, Cajun, Chinese and Thai dishes. She seems to enjoy more flavorful, highly seasoned foods anyway. It stimulates the taste buds in her mouth and makes her thirsty. So win-win-win.

I have noticed for a long while that Amelia likes coffee (in fact during her speech evaluation she could only say a handful of words and she said coffee for the first time). Specifically lattes. Whenever I get a skinny caramel latte from Starbucks, Amelia is trying to rip it out of my hands for a sip. Her Pediasure is milky, so I tried heating it up in the microwave (making sure to add cold on top and stir so there are no hot pockets in it), adding some of my coffee syrup in it and whip cream on top. She drank 100mL of this today. This idea is definitely a winner. The whip cream added even more calories and if she were to get nothing but the Pediasure, it would be a complete balanced meal, so BONUS!

After trying about 271 different types of sippy cups, I think the best kind of cup for her is one with a lid and a straw. We noticed this by going out to restaurants. We would ask for a cup of water for her and this is what they would bring. It would occupy her for a long time and we could tell she was enjoying the experience of sipping with the straw. Recently, I bought her one of those insulated kind everyone carries around with them these days, but it is a little large for her. I went to Wal-Mart and found some inexpensive cups with lids and straws (they are not leak proof, but she is past her dropping the cup and throwing it on the floor stage) and these seem to be just the right thing for her.

She is still not chewing enough food for volume and we rely on purees to do this. I tried making my own food for a while, but for the effort I have to put into and the amount she wastes, I just decided I would buy jars of baby food instead. I never understood the whole baby food labeling system until recently, I must admit, but after studying the shelves, I finally get it now. I just used to shop for interesting combos, but now I get the whole texture thing too and I am buying her the stage 3 meals which have multiple flavors and texture that she must swallow. The only thing about these meals is that they are very bland which makes them not very desirable to Amelia, but I have some ideas on how to add other flavors to "kick it up a notch!"

I also noticed the veggie/fruit combos in the pouches for the first time and decided to try those on her. They are things like apple/blueberry/spinach which sounds totally revolting, but is very tasty. The idea is to squeeze them into a bowl or on a spoon and feed them to a baby, but I have started squeezing the directly into her mouth and she will eat the entire package this way. This has been a revolutionary discovery. I have tried them 3 times with her and each time she eagerly eats them.

This got me to thinking...does she like the taste of them that much? Or is it the delivery system? Today she had pudding off of a spoon, but after three bites she was not wanting any more. So I spooned her pudding into a 60cc syringe and shot some in her mouth. She swallowed instantly. I did this for the entire Pudding Pack and she ate the entire thing super quick. Based on this knowledge, I think I will try some of those squeezable yogurts on her in the near future.

After that, I was pushing my luck and decided to put in some food she had rejected earlier into the syringe to see if that would work. Well, kinda. I think she was getting so full that she didn't want to eat any more, but she still had about three squirts of the food and swallowed when before when she tried it, I eventually made her spit out the food because she just kept holding it in her mouth.


So using a variety of the above mentioned methods for today's meal, I think she met her entire 250 calorie meal goal by mouth. This is the FIRST TIME EVER. She ate: 50 calories in apple/blueberry puree/, 110 calories pudding, 100 calories PediaSure. Plus she had some of the bland baby food and a good helping of whip cream on top of that.

In addition to this, I have banned the automated pump from use in our house. We were getting lazy and putting her in a high chair in front of the TV, running the pump and not interacting with her or making her eat by mouth. The pump, running at maximum speed, with the amount that she requires, was taking over 30 minutes for a meal. She used to need this control retching and vomiting, but she is long past those days. She would get very antsy and aggravated that she was trapped multiple times a day in the chair. Now she sits at the table like a big girl in a booster seat. She likes sitting in it and does not try to get down. Maybe the novelty will wear off soon, but so far so good.

Today, I broke away from the booster seat and let her sit on the couch and watch TV while I fed her. She wants to hold food and not swallow and I tried using the TV as a motivator. I would turn it off and tell her I would turn it back on when she swallowed, but all she did was cry. I leaned her head back against the pillow of the couch so that her neck was extended and gravity was working with her and she swallowed quickly. I did this when she would not swallow and it worked every time. Not sure what this means or how to incorporate it (I do not want to feed her on the couch every day, but it is something else to note that may come in handy later.