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I have a bunch of thoughts swimming in my head about preemies with feeding issues and really just want to get some of them off my chest.  If this seems a little disjointed…you were warned.  :-)  Compared with a lot of our other preemie pals, Aidan’s feeding issues really look mild.  But this is really the one area that Aidan is still a bit “behind” in for his actual age.  I had really come to a place of peace about the feeding stuff until I recently had several different people make inquiries about something having to do with Aidan and food and it got me thinking and riled me up a bit.

So…some background.  Aidan is a former 28 weeker, vented for 7 weeks.  Came home appearing to have no oral aversions and did well bottle feeding.  Right around the time I started trying purees and cereal, he immediately began having gagging issues with the solids.  I presumed it was just new to him and plowed through.  But I became concerned as I began reading more and more on the preemie groups how common feeding issues were.  I asked for a referral to a feeding therapist when Aidan was about 1 year actual/9 months adjusted.  Aidan was vomiting on me anywhere from 4-6 times a day.  The sheer amount of time spent feeding and refeeding was enough to make most people lose their sanity.

My thoughts about his gagging and aversions were confirmed by the therapist.  During the time we were in feeding therapy, Aidan also began developing an aversion to his bottles.  I think the stress of the gagging and aversions were spilling over into something he had always done well.  As he began to make progress with crunchy foods (cheerios, crackers, etc), I decided to switch him to whole milk and sippy cups.  This actually worked!  I think the fact that a new container held his new kind of milk was really a nice mental clean slate for him. 

 The feeding therapist began having me try crunchy combinations such as really crispy grilled cheese sandwich and things of that sort.  About 3-4 months after beginning feeding therapy, Aidan was on the right track and we were discharged.  Things were slow going and he was still getting a lot of his calories from milk and purees.  But Aidan’s growth has always been great, so his pediatrician was ok with what we were doing.

A few months later, Aidan decided that macaroni and cheese could be added to the menu.  This was a HUGE leap, because it added a lot of calories to his diet.  Still I fed purees at least once a day until Aidan was almost 2.  Yikes, huh?  Thank goodness Aidan has always done very well with yogurt and cheese, so calorically we haven’t been very challenged.  But it wasn’t until about age 2 that he stopped doing the occasional gag.  The chance that he could gag not only worried me, but it made it hard to want to try to new things and create a new aversion.

I followed the central piece of advice of our feeding therapist throughout it all.  She advised me that our relationship with food is intricate, delicate, and lifelong.  That I should really try to foster the best relationship possible with it for Aidan.  If this meant that his diet was very narrow for a while, so be it.  So I started giving him great vitamins (Nordic Naturals Berries) that gave him all of the vitamins he might not be getting through food and added a 3-6-9 omega in for good measure.

Aidan is thriving.  He is closing in on 40″ tall and 34 pounds at 33 months actual/30 months adjusted.  He is at about the 50th percentile for weight and 97th or better for height.  We have been doing something right!  Aidan’s relationship with food is a good one.  He has a narrow food menu, but I hadn’t given it a lot of thought in a while.

Recently, my MIL asked me about his diet while she was here.  (Paula, if you’re reading this….I know you meant well…no worries!)  She said she noticed I hadn’t fed Aidan any vegetables.  You know…I immediately felt defensive and went back to this scared space where I wondered if I was doing this feeding issue thing right.  I told her that for a while it was hard to get him to eat *anything* and that I was focusing on that first and foremost.  But this inner being inside me (the one still scarred with PTSD from a premature birth, feeding issues, etc) wanted to ask her if she knew what it was like to watch a child gag on everything you fed him.  What it was like to have him vomit the entire meal you had just fed him on you?  To know that if you couldn’t overcome this somehow that you might need to resort to a g tube or inpatient feeding therapy?  I wanted to be recognized for patiently feeding and refeeding a child who vomited on me for 6 months straight.  I know my MIL really doesn’t understand the feeding issue…nor should she.  I think this is the central problem.

Parents that have kids with feeding issues are off on an island.  Everybody else has great ideas about how you should be doing it, but they’ve never been out there with us on that island trying to feed our kid.  I can’t tell you how many times I had somebody watch me making Aidan consume a certain volume of food and comment, “Kids will eat when they are hungry.”  Really?  Because I know a bunch who won’t.  I know a bunch who would starve first. 

I was even concerned about Aidan’s hunger drive for a while.  I wondered if spending weeks and weeks on continuous feeds via NG in the NICU messed up his hunger drive.  It is really just in the last couple of months that Aidan will tell me he is hungry.  Yay…another victory!

But here comes my big question.  How do you know when to give your kid a little push?  Recently he has tried some things he would never have eaten before.  He is now eating cheeseburger, turkey or ham and cheese sandwiches, egg scrambles with meat and some chopped veggies, and even asked me for a bite of my halibut the other night.  Is it time to start pushing more veggies?  And how does a mom who is a picky eater herself feed veggies she doesn’t like?  Do I start by trying something new once a week? 

He now has all his 2 year molars in and is much more adept and chewing.  He could never eat meats like deli ham or turkey before and now he has one of the two kind of sandwiches for lunch almost every day. 

I really want to abide by the central tenet from our feeding therapist (who is many ways saved my sanity way back when) and make sure Aidan has a good relationship with food.  I fear that I was so scarred by the months of gagging and vomiting that I don’t know how to make neutral choices about this.  It has been weeks since I heard even the slightest gag from Aidan and months since a vomit.  But I am scarred enough that to this day, if Aidan gagged on the other side of the house, I would probably hear it and feel that same sense of panic come rushing back. 

Help me out, readers.