Here is an update for any of you following Levi's eating and growing situation. Levi had an appointment at the pediatrician yesterday. He has gained about 4 grams per day in the last month. The goal is 6. That's not too bad, he is staying steady at about the 5th percentile. The doctor was fairly happy with his progress and pleased that he is starting to sleep through the night better. As far as following advice and directives from Levi's various care providers we are doing our best. Some of the advice seems to be conflicting. Here is a summary:
From the pediatrician at Georgetown and the feeding team nurse at CNMC (they confer often) :
1. Get him to sleep all the way through the night without nursing. (working on it)
2. Nurse him no more than five times during the day. (will start working on it after we succeed at the first one)
3. Do not nurse him in the two hours before a meal. (see previous one)
4. Do not nurse him directly after a meal. (see previous two)
5. Try to get him to take 24oz of Pediasure or other nutritional drink a day. (seems impossible at this time - working on it)
6. Do not give him juice/juice smoothies, as they are more filling than nutritional. (hmm)
From the feeding team child psychiatrist at CNMC:
7. Remain emotionally neutral during meals. Do not scold for not eating or praise for eating. (a good idea in theory - we try)
8.Give him a meal or snack every three to four hours and nothing in between. (not working out - see number 4)
9. No playing during meals. (hmm)
10. Time out in high chair for misbehaving during a meal. (tried it once, didn't work, may try it again eventually)
11. Keep him at meal for 20 minutes. (mostly successful)
From the occupational therapist:
12. Brush him with a soft brush and run a thumb across the roof of his mouth every two hours. (we are trying, there is some biting, some forgetting and some schedule conflicts)
13. Bounce him on a ball and tip him sideways regularly to build his abs and help with his balance reactions. (we do this sometimes)
14. Give him things like twizzlers to chew on. (he won't try it)
15. Give him tubs full of different textured things, ie a rice box, a pasta box, a bean box etc. (we've done the rice box)
16. Buy him toys that have unusual texture or vibrate. (have some, always looking for more)
17. Get him to carry around heavy things to work on his strength. (hmm)
18. Give him more advanced textures of things he likes, like juice smoothies. (see number 5)
19. Have him blow out candles, blow bubbles, blow into a straw etc to work on his mouth muscles. (do it every day)
20. Give him lots of stuffed animal kisses around the mouth. (do it)
21. Engage in lots of rough play including air swinging and swinging him in a sheet or large towel. (do it sometimes)
22.Attempt to narrow his base of support when he is sitting. (try, he is not very cooperative)
From the develpmental evaluator at Georgetown:
We are terrible parents and everything we do is wrong and selfish. (we aren't going back to her)
