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I am wondering if anyone has gone through this. Our 100% tube-fed DS (almost 6-years-old) is all of a sudden interested and willing to eat orally. For 2 1/2 days he has taken all of his daily calories orally. So far I have only been giving him baby food purees and mashed up food that requires little to no chewing at all, but has more texture than the purees. However, I have not seen him attempt to chew at all, even with the lumpier foods. We are working with an ST and an OT, but I am curious if others have gone through this and what they have done. He really has had no need to chew in the past, but he also is extremely orally defensive and has never really chewed on toys either. I am wondering if this might be due to neurological damage from being extremely premature, which may mean I will always need to puree his foods, or if this is something that we will be able to teach him or that he might pick up with more practice eating? Any experiences?<br><br>
TIA!
 

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<span><b>First of all. <span>CONGRATULATIONS<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/bouncy.gif" style="border:0px solid;" title="bouncy"></span> ! on DS's eating by mouth!<br>
I have no experience in this but, I would imagine that if DS has been not eating by mouth for 6 years, it may just take time to catch up.<br>
I would also experiment with different slightly lumpier but melts in the mouth texture. It may take much trying different things and see which works.<br>
Good luck and again, that's wonderful that he is eating!!!</b></span><br><br><span style="color:#C0C0C0;"><b>Mary</b></span><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/redface.gif" style="border:0px solid;" title="Embarrassment">
 

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Discussion Starter #3
Thank you for your response! That is what we are hoping - that it will just take him time to figure it out since no, he has not eaten by mouth other than tiny bites here and there of the baby food purees (sometimes weeks or months apart), so has no experience at all with chewing. The part that worries me a little is that he does not chew on anything at all except his thumbnails, and that's only with his front teeth - no chewing at all with his molars on anything. I hope it's the sensory defensiveness and that he will be able to overcome that as he becomes more confident with eating and having things in his mouth.<br><br>
And yes, we are definitely doing a happy dance here!!! Honestly, we are so stunned by his sudden interest in eating that we almost don't believe it's happening. I have not had to give him food through his tube since Monday! And today he made another great stride - he figured out how to drink through a straw by himself, whereas before I had to squeeze the container in order for him to get any liquid out. He is one amazing little guy and we are incredibly proud of him.<br><br>
Thanks again for the response!
 

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I taught DS1 to chew one tiny Rice Krispie at a time. But he only had a sensitive gag reflex, he was never tube-fed.<br><br>
By the way, congratulations on this huge milestone!
 

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My oldest dd had feeding issues and some sensory issues as well as trouble chewing more difficult textures. What helped her gain the most strength and ability was using "bite blocks" and other oral motor tools to bite on between her molars. You can also use stale twizzlers or slim jims or similarly chewy foods that won't break off, just used for biting practice. I couldn't find a link to just the bite blocks, but they are in <a href="http://www.talktools.net/s.nl/it.A/id.1104/.f?sc=2&category=714" target="_blank">this pic</a>...the group of 6 red sticks.<br><br>
Sounds like he is starting to make some small strides towards the larger goal. For us it was almost a year of feeding therapy before I was comfortable giving her harder to chew foods and now we're up to the petite baby carrots which is a huge accomplishment. Good luck!
 

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Fantastic News! What are his favorite flavors? I thought the dried licorice/slim jims idea was good for sweet and spicey. Maybe a dill pickle if he likes sour? Something that will loose its flavor when you suck on it, till you chew again. Also, making the pureed foods gradually thicker; not that they would really have to be chewed, but will help him get used to the feeling of lumps in his mouth. The straw drinking skill is pretty difficult - makes me think this guy is going to continue making progress. All in all - fantastic news!
 

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My son had a mild-moderate oral sensitivity problem and delayed oral-motor development, and he absolutely could not graduate from pureed food to mixed texture food (i.e., purees with lumps of more solid food). We worked with a feeding team at the local children's hospital and they suggested skipping over the whole mixed texture category--they said kids with sensory issues often can't deal with the different textures--and introduce small pieces of regular table food, not anything difficult like meat but small pieces of fruit and similar stuff. They also said that in terms of oral motor development mixed texture foods can be challenging because there's a lot going on at the same time in the mouth.<br><br>
It worked! It was slow going at first, and he did gag a bunch (he has a very strong gag reflex) but as it turned out he liked crunchy foods (he is a sensory seeker) and didn't mind chewing them. He is 7 and still won't really deal with mixed texture foods!<br><br>
Of course, YMMV and all that but I thought I'd mention my experience because the advice we got was so counterintuitive.<br><br>
Beth<br>
DS (7), DD (4)
 

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Congratulations!<br><br>
Mine didn't face the same issues, but I just wanted to echo the PPs thing about a kid with sensory issues not handling mixed textures well. Mine can't really handle that either.<br><br>
I would get with an SLP who does work with feeding therapy for more concrete suggestions, but I wonder if a chewy tube or other jaw rehabilitation toys might help develop jaw strength for chewing. My ds uses an "Ark Grabber xt" to help with oral cravings and it was designed originally for that type of use. They have plain ones, textured ones and scented ones. They look sort of like "P". There are tons of other oral toys/tools also, this one was just particularly good for us because he had a strong bite, just craved the input.
 

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In teaching kids with CP to chew, we didn't use mixed textures - we used foods with a good "crunch" (because it gave rapid and satisfying feedback) but that also melted into softness fairly quickly in case they missed the crunch (so, like potato chips and NOT like carrots or celery).<br><br>
Also, if your DS will allow, place the food in through the side of the mouth (not forward into the front where it then has to be repositioned on the molars by the tongue) directly onto the molars, and press down a tad on the molars with the food which normally results in a bite reflex (although some kids don't seem to have the reflex).<br><br>
French fries are good foods to eat coming in from the side, since you can hold a portion on the outside of the mouth with your fingers (his fingers) for better control, although they don't always have a good crunch, sometimes feeling in control is better for anxiety.
 

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Discussion Starter #10
Thank you everyone for your responses!! We are still going strong almost one week into our switch to the oral feedings - to the absolute amazement of everyone in our family, including me! He will accept the lumpier foods (as long as they are very soft, consistent lumps anyway) but is a little hung up on juice boxes - I have tried the milk subs that come in those same style containers but no luck so far. Even a cup with a straw in it is not acceptable, but we will keep trying. He definitely has a sweet tooth!<br><br>
As far as the crunchy textures, I really appreciate that input. I am going to try those crunchy but quick dissolving foods - he has been accepting the biting sticks in his mouth, although does not actually bite them yet, but is still resistant to the crackers. He will accept small amounts of crushed crackers, though, as long as they are not mixed in anything (like yogurt or something), so I do have hope that we will get there eventually. I do see him starting to make very subtle chewing type motions with the lumpier foods before he swallows. I have to keep reminding myself that these changes over the past week are monumental for him, and the rest will take some time. I think I'm still in shock that he's actually eating!<br><br>
Thanks again for all the great replies!!
 

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I am so glad it is going well.<br><br>
I keep on thinking I should reply and congratulate you but my fingers just keep typing "I'll teach your child to chew if you teach mine to swallow." <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol"><br><br>
My baby loves to chew, but he gags and throws up if he can't push it out with his tongue when he is done chewing. Really they would make a good team.
 

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Congrats on making gains in the feeding dept. It is such a frustating area....but the rewards can be fantastic! When we were working on chewing our therapist told me to have her chew on a washcloth. You can stick part of it in his mouth and hold onto the rest....make it into a game.....also, if you do the same thing with your mouth the child really responds. It teaches placement of food. Also, we used a food called "Pirate's Booty" a lot. It is similar to cheetos...but more nutritious. It comes in different flavors, and it tastes pretty good. To this day my child's favorite food is cheetos, but I TRY to offer the more nutritious<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">. Also, if you put carrots in a cup of water and put them in the microwave for about 90 seconds it makes carrot sticks that are really soft. The child can hold them, but bite and chew easily. I hope this helps. Just a couple of things that helped us<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">. Good luck<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">.
 
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