Oral Defensiveness, From a Parent's Perspective
Little B has come a long, long way in the past year and a half in so many areas of his life. I guess all kids do make tremendous leaps from 18 months to 3 years, but Little B has had to come a bit further than most. One of the big leaps is in that of oral defensiveness.
When Little B had a NG-tube (which is a naso-gastric tube, or a tube that goes down his nose and to his tummy for feeding purposes), there were so many things going on with his face -- the tube, the tape, and the vomiting -- that he became somewhat orally defensive. He seemed very uncomfortable with someone touching his face or mouth. And if you tried to get a washcloth near him, well... things got ugly. He did enjoy his toothbrush, though. Although he was the only one who could be touching it. My personal theory is that he liked the baby toothpaste we had, as it freshened his mouth.
In any case, four things seemed to help in terms of oral defensiveness.
First, I tried not to push eating and worked (for myself) to be OK with tube feedings for a bit. This is so freaking hard. I mean, truly, truly difficult at a primitive level. As parents, we want to feed our children. Eating socially is just pervasive in our culture. It seemed for us that the more stressed out we got at getting something in his mouth, the worse things got. So, my response was to just stop fighting. Eating by mouth was not a big deal for us for a time. It was ever-present in the back of my mind, but it was not our focus. Little B's mouth and thereabouts was his own, and we were going to respect that. Now, he did get bathed, but we kept it to a minimum to respect his space as much as possible.
Second, love and snuggle your child. Lots. For so long, Little B had so many medical things going on that it was hard to remember that he was my little monster and not a "diagnosis-waiting-to-happen." So I very deliberately started snuggling with him and getting close to him. While we snuggled, I slowly and softly caressed his hair. If he seemed uncomfortable, I stopped. This was our "parent-child bonding time," and I wanted us to have a better relationship (Little B REALLY preferred G at that time). In any case, I slowly worked up the courage to touch his face closer to his mouth. It took a while.
Third, as Little B got old enough, we let him try putting things in his mouth, specifically toothettes (see: here). He had them in the hospital and enjoyed them, so we got some for home. Be sure to wet the toothettes slightly, so that they are more fun to maul. We also got some "chewies", as well (see: here).For these, we just let Little B use them if he wants to do so. There was no pressure on him. Lately, however, we have started "waking his teeth up in the morning" by chewing on chewies 10 times on each side of his mouth. We do this early in the morning and he seems to be more interested in trying foods throughout the day.
Fourth, we tried to keep Little B engaged in the social sides of meals. He has always sat with us for meals, even though he got bored and didn't sit still for long (and still doesn't sometimes...). We did allow him to bring small hand-sized toys to the table for diversions. Also, since I cook at home a good bit, I would plop him in his highchair and let him play with measuring cups and stirring spoons. I would put some foods on his highchair tray more for play purposes than anything else. If he touched them, great. If not, "no big deal, banana peel!" (Sorry, we say it all the time in our household of perfectionists!).
I will say that I personally believe that you have to take a long-term view on feeding issues. It is so easy to despair about all the things your tube-fed kid can't or doesn't do. But little, consistent steps for us have returned results. Now, Little B is not a oral-feeder at this point, but he has great skills to start feeding when we are done with chemo (which could be as little as *eight* more weeks).
When Little B had a NG-tube (which is a naso-gastric tube, or a tube that goes down his nose and to his tummy for feeding purposes), there were so many things going on with his face -- the tube, the tape, and the vomiting -- that he became somewhat orally defensive. He seemed very uncomfortable with someone touching his face or mouth. And if you tried to get a washcloth near him, well... things got ugly. He did enjoy his toothbrush, though. Although he was the only one who could be touching it. My personal theory is that he liked the baby toothpaste we had, as it freshened his mouth.
In any case, four things seemed to help in terms of oral defensiveness.
First, I tried not to push eating and worked (for myself) to be OK with tube feedings for a bit. This is so freaking hard. I mean, truly, truly difficult at a primitive level. As parents, we want to feed our children. Eating socially is just pervasive in our culture. It seemed for us that the more stressed out we got at getting something in his mouth, the worse things got. So, my response was to just stop fighting. Eating by mouth was not a big deal for us for a time. It was ever-present in the back of my mind, but it was not our focus. Little B's mouth and thereabouts was his own, and we were going to respect that. Now, he did get bathed, but we kept it to a minimum to respect his space as much as possible.
Second, love and snuggle your child. Lots. For so long, Little B had so many medical things going on that it was hard to remember that he was my little monster and not a "diagnosis-waiting-to-happen." So I very deliberately started snuggling with him and getting close to him. While we snuggled, I slowly and softly caressed his hair. If he seemed uncomfortable, I stopped. This was our "parent-child bonding time," and I wanted us to have a better relationship (Little B REALLY preferred G at that time). In any case, I slowly worked up the courage to touch his face closer to his mouth. It took a while.
Third, as Little B got old enough, we let him try putting things in his mouth, specifically toothettes (see: here). He had them in the hospital and enjoyed them, so we got some for home. Be sure to wet the toothettes slightly, so that they are more fun to maul. We also got some "chewies", as well (see: here).For these, we just let Little B use them if he wants to do so. There was no pressure on him. Lately, however, we have started "waking his teeth up in the morning" by chewing on chewies 10 times on each side of his mouth. We do this early in the morning and he seems to be more interested in trying foods throughout the day.
Fourth, we tried to keep Little B engaged in the social sides of meals. He has always sat with us for meals, even though he got bored and didn't sit still for long (and still doesn't sometimes...). We did allow him to bring small hand-sized toys to the table for diversions. Also, since I cook at home a good bit, I would plop him in his highchair and let him play with measuring cups and stirring spoons. I would put some foods on his highchair tray more for play purposes than anything else. If he touched them, great. If not, "no big deal, banana peel!" (Sorry, we say it all the time in our household of perfectionists!).
I will say that I personally believe that you have to take a long-term view on feeding issues. It is so easy to despair about all the things your tube-fed kid can't or doesn't do. But little, consistent steps for us have returned results. Now, Little B is not a oral-feeder at this point, but he has great skills to start feeding when we are done with chemo (which could be as little as *eight* more weeks).
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