During this same time, our feeding clinic team was given the opportunity to attend a private workshop with Suzanne Evans Morris at the New Visions/Mealtime Partners program in Faber, Virginia. Suzanne is a well-known SLP in the areas of oral aversion, oral-motor delays, and feeding/swallowing disorders. She co-authored the pediatric feeding disorders “bible” Pre-Feeding Skills and has taught and lectured all across the country.
Suzanne’s approach was so simple it made me smack my head in frustration. Why should tube feedings be any different from oral feedings? If a child is uncomfortable during a tube feed they are very unlikely to ever put anything else in their stomach voluntarily. Suzanne’s suggestion was to allow the child to control their tube feeding. In a small child or infant, this included teaching the parent to read their child’s cues and stop and start the flow accordingly. In older children, this included asking the child to say “stop” when they needed a break and “go” when they felt ready again. This, in combination with standard relaxation techniques and positioning strategies, gave the child control over their own body and what was happening to them. Eventually the anxiety of having something done to them would reduce and the child would become more open to new experiences involving food.
Lesson #5: Always be open to the “magic” of learning something new!
When I returned home and started therapy sessions again with Sarah, I embraced my new-found knowledge and attempted to implement these child-directed tube feedings with Sarah and her family. After two sessions, Sarah was still struggling with the feeling of formula in her stomach, but was actively requesting breaks and letting us know when she was ready for the flow to begin again. No longer was she crying and screaming through the entire experience. Sarah was learning about her body! She was beginning to recognize that she had some control over the experience and that seemed to greatly decrease her fear of the tube feedings.
At several points in my career, I thought I knew “a lot” about treating feeding disorders. Even when I was just starting to treat, I thought I had most of the answers. What I’ve learned over time is that there is ALWAYS something new to learn. Whether it’s new research, new treatment approaches, new books to read, or new experts to learn from; I now take pride in the “magic” of building my knowledge and resources. It takes humility to admit that you don’t have all the answers, but the adventure of finding out is incredibly rewarding.
Stay tuned for Chapter Five: The Finish Line