Monday, September 14, 2009

Mary's Pediatric Therapy Evaluation

This morning I took Mary for her pediatric physical therapy evaluation. As I mentioned previously, she has some oral motor issues that prevent her from nursing properly, or even taking milk from a bottle properly. And after a visit with the lactation consultant, we were referred to Pediatric Therapy Services for help.

Upon entering the facility, we were made to feel very comfortable. They knew who I was when I walked in with Mary and we didn't have to wait at all for our appointment. Nikki was the therapist assigned to evaluate her and was in agreement with my goal of exclusive breastfeeding for Mary. I have been pumping every 2-3 hours around the clock and giving Mary milk from a bottle, but that is not a situation I can maintain for very long before I collapse from lack of sleep.

Nikki watched as I tried to nurse Mary and could see that all Mary was able to do was chomp down, no latching at all. Then, she observed me giving Mary my milk in a bottle and how it dribbles out of Mary's mouth. Eventually, she asked to feed Mary the bottle herself so she could get a closer look at the situation.

After what seemed to be about 5 minutes, she had seen Mary dribble milk, chomp on the bottle, and gag on the milk (something that has been happening at home too). Nikki played with Mary's cheeks and did some therapist-y things until Mary was taking the bottle a little better, but with the flow increasing, Mary gagged some more.

Finally, she gave me her opinion. Mary has a lower jaw that is set back, kind of like an overbite which makes it hard to latch. And, she has week jaw and cheek muscles which make it hard to suck. Put it all together and you have a very poor nurser. The only red flag she mentioned was that Mary didn't seem to respond to some nerve stimulation in her cheeks, but said it might just be that her reflex is so weak we aren't seeing it yet. So Nikki said that we would just focus on the muscle strength for now.

I have been given several techniques to use for 'waking up' her oral muscles before each feeding session. Plus, instructions on a new way to hold Mary's face while she is eating to help her get a better latch. In addition to that, we will be doing cheek stretching exercises 4 times a day, 3 times on each side. Then, we are set up for weekly therapy sessions to check progress and make any adjustments as necessary.

Nikki made me feel very encouraged that we will solve this problem, even though we didn't discuss time lines. So, I'm still pumping and bottle feeding Mary, but we now have some direction to improve the situation. I'll share more as I learn and experience more. Thanks for all your prayers as we try to sort this out.


  1. Hang in glad the therapist will be good to work with. I'll keep you guys in our prayers.

  2. Good luck. I hope the therapy goes well.


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