Feeding Clinic Update

We had our repeat visit at CHOW today. We went in with a steadfast goal of weaning Charlotte off of the tube by her 2nd birthday. Dr. Arvedson (feeding specialist), Dr. Long (behavioral psychologist), and Midge Kirby (dietician) re-set our expectations, once again, to what is realistic.

Here’s what we know:
--When Charlotte is hungry, really hungry, she eats whatever is in front of her. She does not seem to have a strong dislike for any particular food. But, she doesn’t finish a meal. She will stop eating after some amount—typically 1-2 ounces. This happens about twice a week. On occasion, she’ll thrill us with a 4 ounce feed.She can drink 4 to 5 ounces of water in 30 minutes when she chooses.
--She likes all kinds of solid foods--crunchy, soft, sticky, and chewy.

--She’s interested in whatever I’m eating and will taste or smell just about everything.
--Basically, she likes food. She also plays with her food, like any other 12 month old.
--She nearly always vomits after her naptime feed.

Here's Charlotte with her "sword & shield" protecting herself from bad, bad food

Here’s what we learned:
--Our team of experts is thrilled that Charlotte will eat with gusto, even if she falls way short of taking all of her calories. She has a very strong hunger drive. Apparently, a lot of kids with reflux don’t have that.
--We are letting her get away with driving when meals end, to some extent.
--We can look forward to weaning her when she is at or above 90% of ideal body mass (weight to height ratio).

Here's the plan:

--We’re going to work on “boring” her for the next week. She’ll get exactly the same meal each time we sit down to eat. For a week we’ll offer Pediasure to drink. After that, we’ll try a yogurt drink for a week, and then maybe fortified milk. The idea is to determine if she willingly drinks one thing more than another.
--We’re reducing her nap feed to avoid vomit. Hopefully that will make her hungrier at dinner, too.
--And, we’re going to be in charge of when a meal ends. Our job is to make sure that her last sip, last bite our on our terms, without triggering too much stress for baby.

If we get lucky, she'll increase her intake on her own. We won't be "officially" weaning just yet, but it would be ideal if she did a bit of weaning on her own.