Thickers for aspiration

I'm going to copy this to Nutrition and Good Eating to see if you get any other ideas.

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I have a son with swallowing issues myself, actually, he has a gtube so doesn't take much by mouth at all. Anyway, Thick It! is made of modified corn starch and Maltodetrin. It is wonderful stuff for thickening foods. I use it for my 16mth old as well and had some in the pantry I had to look at for this post. It isn't cheap either, but some insurances cover it, have your friend see if insurance covers it, if not, then Walgreens have their own version and it is much cheaper and work just as well. Baby cereal would work great but much harder to come out of a bottle unless you find the tri-cut nipples or feed by spoon which if he is under a year old, he probably is still using a bottle I would assume. I had such a hard time finding the tri-cut nipples, but www.drugstore.com does carry them and also the gerber fast flow ones work well for thicker feeds but only with thick it, not cereal it gets clogged. Wonder how boxed mashed potatoes would work, just add some to the goat's milk before feeding, adds calories, thickens it without altering the taste too much. Huh, may have to try that for my little one. Oh Yeah, how about adding a little instant pudding, at least it comes in flavors.

Did your friend find out by swallow study that he is aspirating? He will also need Speech Therapy if he isn't already getting it. They can help out tons to overcome swallowing issues, may take time, patience and work but well worth a happy, eating-by-mouth successfully kid at the end.

Let us know if you have any other questions.

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Rice cereal is used commonly. But I know that thickenning up breast milk with rice sometimes makes if funky, so at work if we need to thicken the milk of breastfed babies we use pureed bananas. The rice works fine with formula though. So I don't know how it would work with goat milk. We get the cereal thickenned formula to come out fine out of the regular nipples, we don't use tri-cut or big hole nipples, just standard ones. The milk is thick, but not that thick. I think it's about a teaspoon or two of cereal or banana per 2 ounces depending on the kid's needs. We use the cereal or bananas to thicken milk for babies who are aspiration risks. But different kids are different.

I think she should consult with an OT. The doctor isn't trained to give her the specific detail she needs about this. An OT will know. Or at least an OT she has trained in this area.

I just wanted to add that an OT does things to assist, encourage activties for daily living and yes, that includes eating, however when you have problems with the suck/swallow/breathe pattern then Speech Therapy is needed. They can target areas of weakness and show what you should work on, how to do it, how often, for how long etc. Jonathon now 16mths has made tremendous strides with Speech Therapy and his facial paraylsis, not no where near as noticable and we have his 6mth follow up for another swallow study next week. Jonathon went from not being able to swallow at all and it came out of his nose, to swallow with only a trace of aspiration in 6mths. Yes, I am a proud mama!

Also, adding rice cereal for a GERD child, like I had to do with my 4yr old as a baby is much different than adding it for a swallowing problem. You have to add much more cereal to a bottle for a baby that is aspirating, which is a very serious problem and a cause of pneumonia, I should know, been there, done that. Jonathon's for example has be of a pudding consistency in order for him to have better control over it.

Thickening the goats milk with cereal would work fine, ds had GERD and we used rice cereal in goats milk, but mom would need to put in a lot of cereal and it may not come out of a regular nipple at all, the poor kid would pass out trying suck it out of the bottle. Thick it! is a good thing to use and have a good control over consistency and it wouldnt change the taste at all.

So he needs to be evaluated, regardless of all our opinions and who he needs to see, we all do agree on that!

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The way I was taught was that Speech Therapists handle the actual intake, chewing, movement & swallowing of food. OT's handle the mechanics of getting it to the mouth, including specialized equipment. They do overlap, but aspiration is definitely part of a swallowing disorder/dysphagia & is a specialized ST's domain.