Your Preemie Has Feeding Issues? You Are Not Alone!

February 21, 2014

95-2010-03-08One of my happiest moments during my daughter’s five-month NICU stay was one morning when I called her primary nurse, and she told me Daphne had drunk an entire bottle of expressed breast milk. A whole 40ml of milk, by mouth (that’s just slightly over one ounce, for those not versed on the metric system.) I thought we were over a major hurdle. The child would learn to feed, grow, and come home.

Silly me. Feeding would become our post-NICU bugaboo. She started showing signs of major reflux still in the hospital. A young resident said to me “some babies are just happy spitters, Mom.” This was not my first child and I knew that this baby was not happy. She arched her back uncomfortably while drinking, and she threw up. A lot. Once she came home, it only got worse. She took forever to drink a bottle, only to spit it back out not long after. Needless to say, all the formula that she gave back to the rug was not helping her grow. We began a long process that ultimately led to appointments with several GIs, feeding therapy, and a team of doctors who recommended a g-tube because she had to grow. I am going to make this awful and long story incredibly short. Now, at almost five years old, she eats anything and everything, in great quantities. She still has reflux. I am convinced she always will. We have tried to wean her medications and failed each and every time. But she eats, and loves food.

How did it happen? We tried so many different things, so many different approaches. I hesitate to share the process in detail, because I know that what worked for my child may be a terrible idea for yours. Or vice-versa. What I write here are some very general suggestions that I think apply in most cases. Please remember I am not an expert in feeding issues – but if you want advice on how to clean baby vomit off your rug, I may be your girl.

A Preemie Mom’s Guide to Solving Feeding Issues

  1. Investigate a possible medical cause – babies will not eat if eating makes them miserable. Some families see huge improvement when they try elimination diets and discover underlying allergies. Other babies have swallowing issues and need their milk thickened. Whatever it may be, if there is a medical cause that can be treated, that should be the first step.
  2. Nobody has all the answers – sometimes you will need a team of people working with your child, trying different approaches. This team may include a gastroenterologist, a dietician, a pediatrician, a feeding therapist, even a child psychologist. Get the experts talking to each other, and write down what seems to work, and what doesn’t. It is OK to take advice and tips a la carte.
  3. Work with your child’s strengths – if your child won’t eat anything solid but will drink caloric smoothies and is growing well, I suggest taking a deep breath and giving him or her some time with a good feeding therapist. We invested in a powerful blender and started offering concoctions that filled her up with the necessary calories and allowed her to play with solids without pressure.
  4. Feeding therapy comes in all shapes and sizes – there are different styles of feeding therapy, and I cannot honestly say that one style is the best one. I can only say that for my child, the SOS Approach worked best. The therapists very patiently allowed her to experience the food any way she wanted, whether by touching, licking, chewing and spitting, or just sniffing. Slowly, she started getting bold and trying bigger bites of food.
  5. Connect, connect, connect – you probably know that many preemies have feeding issues, and their parents are an invaluable resource for sharing ideas, frustrations, even caloric recipes. Sometimes it helps just to have a friend who understands the rage you feel when another parent complains that their “horrible eater” only eats chicken nuggets, macaroni and cheese and pizza. You would kill to see your child eat a bowl of mac n’ cheese!
  6. This is my final and most important piece of advice – do not blame yourself. This is not your fault. I know that it does not feel good when you can’t accomplish the very basic parental task of feeding your child. It hurts, but it is not your fault. Reach out and get help, for the child and for you. The tears you cry into your baby’s oatmeal while begging her to eat are not going to make it any more appetizing.