Monday, May 31, 2010

"Thumbs up!"

Today was my first full day of swallowing/feeding therapy. It was quite an experience! Caroline is so great and I feel like we are already learning so much. When we first got to Haven 1, Caroline introduced us to the babies that have feeding issues and gave us a brief history of each baby.



Me, Dennis, and Sidney. . . .2 members of our feeding group :)


me and little matt. im already in love with most of these babies! so precious.
Bennet ready for therapy in all his gear to keep him from scratching himself.


Many things such as a baby's fine motor skills, gross motor skills, language and of course feeding skills are assessed to qualify them for our swallowing/feeding therapy group. Of course not all the babies at the Havens have feeding difficulties so we try to target the ones who need it the most. Gross motor skills are tasks such as sitting on their own unassisted, pulling themselves up during "tummy time", and working on head support and stability. We also play attention to their fine motor skills such as if they can reach for objects, fisting (which shows if they are tense or relaxed), tracking (holding your finger up and seeing if they follow), if they bring objects to their mouth or not, etc. We then assess their language. We want to know if they are cooing, smiling, laughing, babbling, have eye contact or not, turn to sounds, respond to their name, etc. All of these things play a big role in how a baby is feeding. The feeding issues we have seen in some of the babies also qualify them for our group including: anterior liquid loss (milk coming out of the front of their mouths), weak- to no suck, shallow breathing, weak non-nutritive suck (i will explain later on), overactive gag, spitting up, tongue protrusion, aspiration and abnormal oral facial structures.

After learning about each babies histories, Caroline also went over what a typical therapy session will include and how to perform each task. (The order of the tasks depends on the baby and his or her needs) but usually the first thing we do when we get into therapy is change them and get them clean and happy. (This is a big deal and can really play a big role in a baby's feeding) Next, we have "tummy time" where we are trying to get the babies to pull their heads up and get their muscles working and stronger.
Tummy time with Miller and Lushomo! They did an AWESOME job! So proud!

Sometimes tummy time is really difficult for these little guys! :( but we try to encourage them and not give in to their sad little cries as much as possible. We want them to get better!

We then perform Beckman exercises, which are oral motor exercises that are used to stimulate the baby's muscles used for feeding. This was really new to me. She instructed us on how to massage their upper and lower lips, outer cheeks, and inner cheeks in a soothing pattern to stimulate their muscles. We also use a “z vibe”, which uses vibrations to stimulate their muscles as well. For some babies, it relaxes their muscles causing them to gain more control of their tongue for feeding. Some of the babies absolutely LOVE this, and some think it is the devil. I had the pleasure of working with Teagan this morning and she has a love hate relationship with the z vibe. She is okay with holding it on her own and putting it in her mouth when SHE wants it there, but if I tried to put it anywhere near her she cried and threw a fit! Towards the end of the session she got more used to it though. YAY.



angry Teagan



happy Teagan. haha :)

We also give the babies pacifiers to work on their non nutritive sucking. Non nutritive sucking is different in the fact that they are not actually feeding so this type of sucking is generally faster and has shorter pauses than normal nutritive sucking. Non nutritive sucking is really important because it can increase their oxygen levels in the blood, decrease heart rate, and increase weight gain. Which is a big deal! So we make sure to incorporate this into our sessions as well.
After all this is completed we sing to them, show encouragement, give them their bottles and document their progress and look for more things to work on…and if we notice any particular problems while feeding during the session. It is only day one of my week of feeding therapy and I can already see what a difference these exercises and the z vibe can make. Caroline said some SLPs don’t believe this type of therapy approach works, but I have seen it work already with the two babies I worked with today. After doing this on Sidney, (a child with TB and that is also HIV exposed) her tongue was way more relaxed and she was able to drink more controlled with less anterior liquid loss. I am so excited to be able to help these little guys!

After a busy morning at Havens 1 and 3, we headed to lunch. I wasn’t feeling too good by this time and was having some stomach trouble. (slightly caused by being spit up on so much…but I’m getting more used to it) After lunch, Kaylee, Rachel and I walked back to the house together. When we got there Rachel went to unlock the door. After a long struggle Kaylee took a try at it, and then I followed..... NO LUCK! The lock was broken and we were locked out of the house! AHHH. After everyone else got there we each took a turn trying to wiggle the key into the door….. Still no luck. Catherine’s “bobby pin idea” was a FAIL as well. Haha. We ended up going to get Ian to climb through the bars of the window (since he is the smallest of course)…. SUCCESS! After about 30 minutes of struggle, we were finally inside, this time through the back door! WHEWWW. What a “situation!” haha. Props to Ian for being able to fit through this tiny spot!

The weather was still kind of blah today. It rained a good bit yesterday so everything was still a little wet and the sun didn’t show it’s face hardly, thus taking it longer for our laundry to dry! (still havent gotten that back...Ha) It was around 65 degrees with a breeze, but not chilly enough for a jacket. It is so crazy to see the natives around here. Since this is their “winter”, they think it is “SOOO COLD”. When we got to Haven 1 this morning we all laughed to see how some of the children were dressed. You would have thought it was below freezing outside in their “Eskimo gear”.


Little Lisa the Eskimo


Tomorrow we will continue our feeding/swallowing sessions at Havens 1 and 3. Please continue to pray for all the babies!



P.S. Matt says "THUMBS UP FOR FEEDING/SWALLOWING THERAPY!!" haha :)
Nighty Night!

2 comments:

Brooke

I am just overwhelmed at this....I think your such a great person for what you are able to do. Keep up the good work! I would love to do this....helping others...i imagine it breaks your heart to see some of them and what they have to live in....but atleast you do know you are helping them... Your a wonderful person Lacey, im so proud of you! See ya when ya get back I want to hear all about it!

Jan Traughber

I am so glad that you are enjoying the time with the little ones AND the swallowing. It's fun and encouraging, isn't it? How is the research going for the giggle girls? What did you settle on????