Feeding Issues Q and A
Through necessity many parents of preterm babies become practical "experts" when it comes to understanding and dealing with certain health and/or behavioral difficulties. New parents of preterm babies can benefit greatly from what parents before them have learnt. Preemiehelp has enlisted the assistance of numerous parents with preterm babies to help new parents learn from their wisdom and experience.
Roz, parent of a very special Aussie premmie named Emma, has generously answered some questions on the topic of sensory processing disorder and feeding difficulties. Preterm babies are at increased risk for feedig issues as well as sensory processing disorder.
Parent of a preterm baby feeding difficulties due to sensory processing disorder
About Mother of Preterm Baby
- A little about you:
I am a mum to three prem cherubs. Emma born at 27 weeks, James at 34 weeks and Jazz at 33 weeks. Emma was the tiniest weighing only 510grams - or 1lb 1oz.
About your Preterm Baby
- A little About Your Premmie
Emma is now 5 years and 9 months old - and starting Primary School this year. She is tiny for her age. Has just cracked the 15kg mark and measures 96cm. She hovers somewhere between the 1st - 3rd percentile in height and weight. - Has your premmie experienced any difficulties due to being born preterm?
We have had no significant issues with her except for her sensory processing disorder (SPD) - which has manifested itself as severe oral aversion - she has never eaten solid foods. She exists solely on formula, and with the close monitoring from her dietician and paediatrician they are keeping her ticking over... JUST!!! - Are premmies more susceptible to feeding problems and sensory processing disorder than babies born full term?
Premmies are more susceptible to eating disorders due to their early birth simply because when solids are introduced, it is quite possible that their system is not ready for it and the learning mechanism required to eat has not be activated. Contrary to popular belief, feeding is a learned behaviour and is not instinct. Around the 8 month age, that is when children start to really get the eating technique. There are many factors involved in learning to eat, and it is unfortunate that at that stage of life, most prems are no longer in the care of an occupational therapist (OT) and/or Speech Therapist who have the skills or the knowledge to identify when feeding behaviour is not being learnt. - Do you know what “caused” your premmies feeding problems?
Emma, due to not learning to feed properly at critical times in development, has gradually got worse and worse. One observation that was made, was that while Emma is extremely co-operative, she clearly wants to please adults, especially us as her parents. As a result of this, Emma apparently engaged in tasks that were too difficult for her body. She then "shut down" in response to the overwhelming stimulation and stared into space or began to seek out other avenues of aversion such as pulling her feet behind the foot rest of the chair, or tensing up her shoulders (what they call "proprioceptive input"). Proprioceptive input is the most calming on inputs, which is why doctors prescribe exercise for depressed patients because this creates proprioceptive input the body is craving. - What different techniques have you tried?
Techniques that have been tried to get Emma to eat - well we have been attending speech therapy since Emma turned 1 year of age. At that stage, they spent a long time de-sensitising her to hopefully enable her to eat.- touch
- hearing
- taste
- smell
- vision
- balance
- body
- awareness
- Do you have any tips for other premmie parents with children with feeding difficulties?
One of the main tips I have for parents is that do not think that it is your fault. It has taken years for me to get over the guilt that somehow is was something that I had done which had caused Emma to have this aversion to food, but no - it is a recognised illness. - Can you tell us about the STAR program?
The STAR Centre in Denver, CO is where we are at the moment. It is a clinic for research-based treatment of Sensory Processing Disorder (SPD) and other sensory challenges in children. They especially work with children with feeding disorders through the SOS program. Dr Kay Toomey is the developer of the SOS (Sequential-Oral-Sensory) Approach to Feeding Program used worldwide to treat feeding issues in infants, children, and adolescents. She heads up the feeding program at STAR. It focuses on teaching a child the basic rules of eating through exploring different properties of foods, including texture, smell, taste and consistency. The SOS approach allows a child to interact with food in a playful, non-stressful way.
Now if we knew then what we know now, we would have known that while this was the correct thing to do, it should have been done in a different order. Unfortunately there is not the professionals with this skillset in Australia. It is going to slowly improve as more and more people get trained in the SOS program, but to have all the necessary back up and support is even more important.
What people fail to realise is that there are 8 senses to the body, and you need ALL of them firing to enable a child to learn properly.
Emma is listed as severe because she is over or under what is considered normal behaviour in 6 out of 8 of these areas. Though with the taste, she could be over reacting and under reacting at the same time, creating even more confusion in her brain.
IF there are any issues, make sure you seek out OT and or speech therapy as soon as possible. It is important to have access to these services to help with diagnosis and to make sure you are not alone.
The SOS approach follows a hierarchy to feeding, from tolerating foods in the room, interacting with the food, smelling, touching, tasting and, eventually, eating the food. Parent education and involvement is an essential part of this feeding approach. Parents watch each feeding session to identify and learn their child’s body language in order to learn this approach for home programming.
To read more about Emma's story, follow Roz's blog by clicking on this link
For more detailed information on interacting with your preemie and many other topics download our popular ebook; "The Complete Preemie Guide; to Surviving the NICU", by following this link
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