Swallow Study

Yesterday Fiona and I traveled to Sacred Heart for the final of three studies. This one was the swallow study which shows through x-ray what happens when Fiona takes a liquid orally. Sound simple, right? Not so much. Through the few images that the feeding therapist was able to get, these are her findings:

*Tongue retraction in response to any nipple presentation besides the paci.
        -when a bottle nipple is present Fiona blocks the liquid going down by bunching her tongue up in the back of her throat.
*Avoidance of feeding once somewhat engaged.
         -If she does take down a few swallows, she stops quickly
*Safe pharyngeal swallows for limited swallows taken today.
         -What she does swallow does not aspirate. (Does not enter her lungs)
*No direct relation to bottle type with increase skill and interest in feeding.
         -No matter what bottle/nipple we try, the results will be the same.

These are the recommendations:

*Recommended continued non-oral nutrition. Will likely need g-tube.
          -she sees a g-tube needed within a few months. It is very unlikely that Fiona will receive her nutrition orally, at least until she is in solids.
*Continue oral trials 10-15mls of puree solids or thin fortified breast milk to maintain oral skill but decrease pressure and negative relation to feeds.
          -Holding Fiona in our arms to feed her is the same position that we use to put her to sleep. So, when we do offer the bottle we place her on her day wedge, smile, feed and treat it lightly. While she may take some time to receive full nutrition orally, we don’t want her to lose the skills necessary.

The next steps are conferencing with her medical staff to see where we go from here. Just like a friend put it, “cdh babies are like snowflakes, everyone is unique.”

Please continue to keep her in your thoughts and prayers.