Feeding Therapy from Sherean Malekzadeh on Vimeo.
I usually dread writing these posts; progress is slow. The system we’re using is what our OT calls “progressive de-sensitization” based somewhat on the SOS feeding therapy protocol developed by Dr. Kay Toomey. In the beginning of his therapy, we worked on getting him to tolerate the SIGHT of table food. I remember putting a few pretzels or puffs on his tray and watching him scream and twist his body to get away from it. If he tried to brush the food off, I had to say “food stays on the table.” I was to do that while trying to make mealtime pleasant and fun. Not easy.

So he got through that. Then we had to work on getting him to TOUCH the food. We set up “snack therapy” times where we had all sorts of different shaped food and textures and played with it. We pretended cookies were cars. We stuck pretzels in the middle of doughnuts to make wheels. Slowly, over a period of weeks, he started touching and playing.

Once he mastered that, we had him KISS the food. He’s still not crazy about this. At the end of snack therapy, he has to clean up by picking up each piece of food on his tray and throwing it away into a little garbage can. Some kids have a harder time with “wet” foods (like lunch meat) but Hunter did all right. He seemed happy to throw the stuff away! But getting him to kiss it before he tossed it – not so easy. So we had to touch it to his lips and then give it to him to throw away.

OK so we survived that and the OT declared he was no longer averse to SEEING or TOUCHING food. Now we’re working on introducing new TEXTURES. In addition to his regular, pureed baby food, we started giving him fork-mashed food like sweet potatoes and avocado. He does well in therapy with it but at home, he puts up a fuss. That’s because he has the skills but has a BEHAVIORAL aversion and thinks he can get away with more at home. So after one particularly successful session at the OT, my husband was feeding our son. One bite of avocado and he vomited all over the place. Two steps forward . . . one step back. This is typical, I’m told.

Fast forward two weeks and he can’t get enough avocado. He will eat an entire one at dinner. Yay!

He’s up to eating small bites of ravioli, spaghetti-o’s, banana, peaches, pears, potatoes – all spoon-fed. He does not want to pick food up and feed himself. And he still struggles with the table food we give him. Lots of choking and gagging but he’s learning to work through it and chew, chew, chew first.

The process is exhausting for me and I can only imagine for him. He RARELY wants to eat the table food. The protocol is we have to tell him to “take your bite” and then stick the spoon in front of his lips until he opens his mouth. Well, any of you with toddlers knows what happens next, right? He smacks the spoon away, shakes his head vigorously “no,” and SCREAMS and CRIES bloody murder. In the face of all that, we are to remain calm, block his waving hands with our arms, lean in some more and hold that spoon there until he takes a bite.

It feels like forced feeding to me and to be honest, I’m not crazy about that. But what I’ve learned is that eating is a LEARNED behavior and if they don’t practice, they won’t learn. So hopefully, we’re not screwing him up and setting him up for a lifetime of eating disorders.

Yesterday, he had his first meal of entirely table food. No baby food. He fussed at first, but then ate pretty well. It’s a huge moment for us. I’m so proud of him and of course, I’m crying as I write this. We still have a ways to go – working up to self-feeding. I cannot wait to see his grubby little hands shoveling Cheerios into his mouth.

Last week, we had dinner with friends whose daughter is 12 days older than our son. I actually teared up watching her feed herself. She can pick something up and take a bite off it which I know is normal for her age but seems so far off . . .We’ll get there, I know. My little man has had to be so brave. Understand that eating anything other than baby food absolutely terrifies him and yet, he’s learning to push through his fear. I am so proud of him!