ENT, Swallow Studies, and 1 Year Check-Ups

I am a little behind. I have been dreading this post because it doesn't involve pictures and it will take me forever to type it all, but I don't want to forget any of this since I am now using my blog as a journal of my girls.

***June 2 - Brittyn to the ENT
I took Brittyn to the ENT because she was referred by our pediatrician for an evaluation for tubes. Brittyn has had 5 sets of double ear infections in 5 months. The ENT said the recommended amount for tubes is 4 in 6 months or 6 in a year. She has hit that, so he recommends putting tubes in her ears. I was very nervous about doing this because they have to put them to sleep. But he told me they don't use general anesthesia or IV's, they just use a gas mask. He said it only takes about 5 minutes and then she is done. I have been warned that when she is coming off of the anesthesia she will likely have screaming fits. So I have prepared myself for that. She will be getting them on July 24th at the outpatient surgery center in Little Rock. The doctor said that is where he likes to do all his pediatrics. We are a little nervous but spent several days praying about it before scheduling. We are just tired of fighting these ear infections every month.


***June 10th - Swallow Studies at Children's Hospital
Last week Ben and I took the girls for their follow-up swallow studies at Children's Hospital. They have been on nectar thickened liquids since they were 2 months old. The study last week showed the Lexyn is still aspirating some but she is protecting her airway. Brittyn had one episode of aspiration, but she too protected her airway. Since they are protecting their airway, they have decided to let us start trying to ween down the thickening. For 6 weeks we are to put 1 teaspoon of rice cereal to every ounce of liquid or 1 packet of Simply Thick to 6 ounces of liquids. If they handle that well after 6 weeks we can try eliminating all thickening. They also saw on the study that neither Lexyn nor Brittyn are chewing food, like fruit loops or goldfish. They are just mashing them with their tongue a few times and then swallowing them whole. The Speech Pathologist recommended that we start feeding them chunkier foods. Instead of pureeing the baby food smooth, we need to start fork mashing it. He said that leaves it bulkier where they have to learn to chew. He also recommended putting the fruit loops or goldfish in their mouths for them and pushing it to the side so that they have to use their tongue to move it and they will hopefully soon pick up on the whole idea. They haven't been choking on food, but I do watch them carefully and break things up real small. When watching Brittyn intake her bottle they realized what was causing her to drink so slow, and not be able to suck a sippy cup; she has not developmentally picked up on the suck, swallow, breathe. She is having to suck 3 to 4 times to get one swallow. She doesn't have strong enough muscles in her mouth or tongue. We have put a bigger nipple on her bottle so that it will come out easier and won't be as much work. He suggested that could be part of her weight gaining problem. She is burning some of her calories that she is in taking because she is working so hard at sucking. Hopefully her speech therapist will have some suggestions on how to help.

***June 12th - 1 Year Check-ups
The girls pediatrician was very proud at their development. He said walking around furniture and taking a few steps alone is right on target with a full term 1 year old. Their therapy has really helped them. On the other hand, he wants them to be fatter!

Brittyn:
weight: 14 pounds and 14 ounces
Height: 28 inches

Lexyn:
weight: 15 pounds 7 ounces
Height: 28 and 1/4 inches

He said they don't look skin and bones, and that they will probably just be smaller kids but he wants them to have every opportunity to be chunkier. I told him they were only in taking 18 to 20 ounces of formula a day but that I make them a 5 or 6 ounce bottle each time and they only drink 4 ounces. They eat lunch and dinner and usually a snack in between, as well as fruit loops or goldfish throughout the day. They are just VERY active little girls. Because of their weight, he is referring us to a high risk clinic at Children's Hospital. He said they like to send preemies or ex-preemies there. There is nothing wrong with my girls and they aren't really behind developmentally anymore but he thinks they may be able to help us on the eating issue. I just don't understand how you can make a baby eat more when they are full or don't want to. So I guess we will see. I don't want to go against what the doctor recommends, but he is also very cautious and likes to try everything. He did say he wants to keep the girls on formula for at least 3 more months since they are under weight. I asked what the recommended age was to be off the bottle, and he said 14 to 18 months but for my ex-preemie girls to aim for 18 months. Somehow I am going to have to figure out how to get them to take the sippy cup and how to break the warm liquids. I figure switching to a sippy cup is the right time to start offering cold liquids or at least room temperature since I won't be warming up whole milk, but they just aren't taking them. If you have any suggestions please let me know.

So all together there wasn't any real bad news or set backs from the 3 appointments, just some goals to aim for in the future. My girls have come a L-O-N-G way.

****By the way, Lexyn finally cut her first tooth on Saturday. It is on the top in the front. That explains her extreme fussiness the past week.