Eating/talking

my daughter was diagnosed with acid reflux, with her only simptoms being her refusing to eat, and hiccups. She takes prevacid in the morning daily 30 minutes before she eats, and within 6 weeks, she started eating normally. It takes a little while for the medicine to do its job.

I have a friend who I wish you would talk too. Her name is Brandi. She has 14 month old twins and her son is going through something similar. Her # is ###-###-####. She may be able to help.
J.

My son had reflux as a baby and did not talk much until he was around three. He is not almost 16, was rediagnosed with reflux, eats everything not nailed down and I can't stop him talking...lol........Please take him to a good gastro doc...Kendall Brown is awesome and we see Jane Keng at Cooks in Fort Worth........meds are what helped my son, then and now, but they need to be prescribed by a specialist as you may need more than one to accomplish stopping the reflux....if a doc used the word aspiration then you need to do this very quickly.......best of luck in finding a solution..

M.,

I shudder when I read some of the responses to your inquiry - surgeries, "feeding" clinics, tummy tubes, etc. Positively frightening!

First, use your own logic. If your child is throwing up every time he eats, isn't it quite logical that he has developed an aversion to food? Woudn't you? Food is a source of pain and discomfort for him, not pleasure. Don't allow the "experts" to convince you that your child has some sort of maladjustment problem that he must be "trained" out of. Your child is wiser than the experts. He knows the food he is being given is bad for him. It is the FOOD THAT IS THE PROBLEM!! He doesn't need some technician to teach him how to eat. We're human beings. We instinctively know how to eat. He needs someome to help weed out the food that is irritating him. If he is like most kids, you've been feeding him a typical American child's diet of processed dairy and processed foods with gluten, gluten and more gluten (goldfish crackers, cheerios, teething biscuits, etc.)

Have your child's stool tested through www.enterolab.com. This is a food intolerance testing lab in Plano. Director is Dr. Kenneth Fine, former director of GI research at Baylor. He left his post at Baylor to start the lab when his research led him to conclude that our population is suffering from massive undiagnosed food intolerances. You order the test yourself online, no doctor referral needed. They send you the test kit, you send in the specimen, they email you the results. Careful about going to a GI doctor. Many of them are astonishingly clueless about food (e.g. see Toxic Tots article in April Dallas Child magazine) and will run blood tests (ugh, poor child who has to undergo this procedure!) which are not state of the art. If you want to know whether your child's gut is reacting to something, you have to test in the gut, not in the blood. Stool test is the way to go. And what could be easier for babies and children!

Gluten and casein are the biggest offenders, with half the population suffering from either or both of these. GERD is a classic symptom of this.

OH, FYI - Doctors generally don't understand much about food. Less than half of med schools teach any nutrition course at all, and those that do it is questionable and paltry (old fashioned food pyramid that emphasizes high carbs). They don't understand that different foods are best for different people. Food intolerances are grossly missed and misunderstood. They think it is a rare event. Dr. Fine's research proves it is not. Do your child and your family a favor and get educated!
WWW.enterolab.com!!!!!!!!!!!!!

Dr. Bain in Frisco is a good pediatrician who understands food intolerances, though I am not fond of her blood testing protocol. I would get the Enterolab test results FIRST, then send them to Dr. Bain.

Good luck!!

I would look for "alternative" practitioners. Your child has definite issues that will be much easier to address if begun young. Perhaps check out Deborah Bain in Frisco.

I have a tad bit of experience in this because my youngest has issues with her throat area - laryngo/tracheamalacia. Her doctors thought for a bit that she was aspirating and so I studied it a lot. It is incredibly painful and actually really dangerous to the lung tissue. You know how sometimes you "swallow things the wrong way?" And it hurts/burns? That is aspiration. The food will go into his lungs and burn his tissues, cause inflammation and possibly infection. It's not good at all. That's why he's stopped eating. He's trying to protect himself.
Did you see a speech therapist to do a swallow study? Is that how they found out about the reflux and aspiration? If your son is indeed aspirating, the speech therapist should be meeting with him teaching him how to eat. That's what they do. I'm not sure where you are, but I got a referral to a great speech therapist when my daughter was having issues a few months ago. If you're interested in a referral, let me know.
The speech therapist would teach him how to manipulate his food to help it go down properly. With babies, they thicken their milk so that it's thick enough for the babies to move properly. If the aspiration is really intense, an ENT (ear, nose and throat specialist) should be consulted to study if there is a simple procedure they could do to help him. I would see one anyways regardless of what your speech therapist says because if he's been aspirating for 19 months, you must want to know what kind of damage his esophagus has sustained.
Gosh, it's so stressful having kids huh? I have three kids and this is my first one to have issues and I'm so overwhelmed with guilt that she has problems. I know that I did nothing wrong, but I just feel so bad that she's been in pain and I couldnt stop it. It's really hard being a parent. Good luck with your son's problems and I hope that you find specialists to help you that are kind and helpful.

Hi M., I feel for you and your child. It sounds like you need to see some specialists right away. We saw Dr.Baker- I think his name is John in Carrolton at Trinty . He is a Pediatric Gastro. He is a very kind man and a father of many kids. I saw that some people suggested a Pulmonlogist. We have a wonderful one in Plano. Dr. Richard Rembecki with Kid Lungs. He is also a father of 5 children and a very kind man. I wish you luck . Keep us posted. B.

Please, if you haven't already, check into food allergies. My nephew had severe allergies and his responses were similar to what you are explaining. That's my only advice....Good luck.

I have a son that was premi at 24 weeks and I had a stomach tube for him for 9 months. he vomited at times but now I have forgotten about. He eats all food but it needs to be blended for him, He was diagnosed with cerebral palsy (so totally different to you) but ECI will assess you child free of charge and occasionally Speech therapy will look into helping you.
My child gets mouth ulcers very easily. He is 5yrs born last saturday but his behaviour is 1 yr old - 1 1/2. I am going to scottish rite to follow up drooling and this should take the mouth ulcers into review also.
Good luck.
J.

He sounds just like my 3 year old grandson. At 18 mo. he weighed 17 lbs. & threw up all the time. We took him to Dr. Oganmola, a gastronologist at Cooks Children in Ft.Worth. After testing him, he found that the valve in the bottom of his stomach that goes in to the intestine was the size of a pencil & should be the size of a nichol. He went to a simple surgery & dialated the opening & he is now 39lbs & very healthy except all of the throwing up ruined his teeth. Please try that. He also was dangerously low on iron. It can be serious. My prayers are with you.
K. H.

Hi M. M, My son who is now 22 spit up/vomited quite a lot when he was a baby....no where near what you are experiencing though. His solution was to just change his formula to a soy based formula. He now has major problems with acid reflux. We just had a scope study done and it showed that the muscle that closes his stomach off from his esophagus is very relaxed....doesn't close well and lets acid back up into the esophogus.

I did some researching and found that without adequate pain relief measures the feeding clinic will not be very successful. I will give you links to all I have read. Also, it would be best I think for you to find a pediatric gastoenterologist...there is one in Plano (Dr. John Baker) as well as several in Dallas. Good luck with your sweet baby and I hope these links will be of some help.

E.

site with lots of info: check out the "reading room" link for lots of articles

http://www.reflux.org

same site as above but page specific to info about the feeding clinics:

http://www.reflux.org/reflux/webdoc01.nsf/(vwWebPage)/Fee...

also may be of help:

www.naspghan.org

www.cdhnf.ord

www.kidsacidreflux.org

Your physician should be able to refer you to a proper therapist to retrain the muscles system in order to swallow properly despite the injury to his esophagus.

I am the mother of a blind 4 yr old girl. Because she is blind(completely) she has a textile disorder so she is very picky and for the longest wouldn't eat anything that was not completely pureed. Its a big challenge to get her to eat alot of things. She has never ate a Cheeseburger and she doesn't like to chew. However with lots of therapy she has gotten alot better and eventually she will be alot better. She also has speak problems and will be delayed in this area. Blindness presents alot of learning issues and yes it is frustrating. Just know you are not causing him any harm, rely on your mommy instinct though and if you think you need a 2nd opinion get one! I also have an 18 mnths old boy who is 100% on target and believe me it hurts to look at things he can do that my daughter still cant and may never do, but you cant do that to yourself. Grief your loss of a "normal" child and remember its okay to get frustrated and want to pity yourself. Although this is something your child will grow out of it is still hard and no mother wants to see there child struggle. Keep your head up and be strong but don't forget to realize your human and its okay to be a little frustrated and upset. God bless
S. Ashcraft

M. just one more thought to the other 2 emails I have sent you. Nearly all kiddos that have acid Reflux with deal with some degreee of Asthma. Some more than others. Jenna has had it pretty bad at times and even this past Thanksgiving we had to call 911 due to her system shutting down from an acute onset of Croup. She has had Croup a dozen or so times and never did it do what it did this last time.
We see Dr. John B Meiser in Frisco off of Lebonan He is one of the Top leading Asthma Doctors in the Area and trained in Dever at the National Jewish Research Hospital where they are the #1 Respiratory Hospital in the US. Give me a call when you can.

OH by the way I totaly agree with what Katy B has said. She is right on including all of the respnses that have given the advice to call your Local ECI office. Jenna had OT therapy for over a year and also has Sensory problems. She has outgrown many of them but some will always remain. I too have it. I have the opposite of Jenna. Mine is too much info getting thru and Jenna has to have the loud and rough stuff to get thru. Her's may totaly go away with age or may not. I still have it. If too many things are going on around me I can't filter out what needs to be and just totaly shut down.
The Speech Therapy was awesome by ECI and when she reached 3years of age ( This is where they have to stop and the school district takes over if more is needing to be done) If needed or you want you can go the priviate route too. But I would stronly recomend ECI. If I remember correctily we did not have to pay anything and our insurance fought it but still paid some. We never had to pay a thing. now this might have changed since she took though. If your son is Aspirating Katy is right it is serious and needs attention asap.
I was very rattled to see one persons comment of it strickly being something that he is allergic to. Yes he could have some intolerance like being lactose intolerant (like myself and Jenna) but it is much more than just that. I know that you are getting tons of emails and advice. I would stronly think that your Pedi would give you some names of Gastro docs that he/she is familiar with. I have heard of most of these doctors and they are all good. You and your family just need to find the right one for your situation. Jenna takes 30mg of Previcide solutabs 2x's aday (1/2 morning 1/2 at night. This was the med's that wrks for her. We also like I mentioned before see a local Chiropractor that also deals with the nutritional side of things too. They all go hand in hand and have to deal with each little piece of the puzzle until it all fits . i'll keep you and your family in our prayers.

Here are the doctors info that I have Dr. Annette Whitney @ Digestive Health Associates of Tx 7777 Forest Lane Suite B304 Dallas Tx 75230 ###-###-#### at Medical City.

Dr. John B Meiser M.D., P.A. Board Cert Specialist in Pediatiatric and Aduld Allergy,Asthma, and Immunology at Allergy & Asthma Center of Tx. 7002 Lebanon, Suite 103 Frisco TX 75034 ###-###-####

Dr. Michael J. Norman with Norman Chiropractic Center, Inc. and Comprehensive Nutrional Analysis 3740 N Josey Ln ste216
Carrollton, TX 75007 ###-###-####

I hope these help you. Just listen to what your heart tells you as a mother( If we listen it always tells us, that inner voice we all have thru God!!

C. L

I've never been through this with a child but I noticed nobody had responded to your question yet so I'm looking in my medical books trying to find any information. so far this is what I've found:

Aspiration is defined as the penetration of secretions below the level of the true vocal cords. Primary or direct aspiration results form penetration of oral secretions, while secondary or indirect aspiration occurs with reflux of gastric contents. Premature spill of food or secretions from the oral cavity into the pharynx, lack of coordination between oropharyngeal motility and glottic closure, ineffective glottic closure, or incomplete bolus transport can cause direct aspiration. Indirect aspiration can result from an impaired lower esophageal sphincter mechanism or delayed gastric emptying.
Intractable aspiration is defined as aspiration not controlled with medical treatment or minor surgery. These patients are incapable of protecting their airway from their secretions. Surgical options for these patients are numerous. Laryngeal closure procedures include epiglottic flap closure, vertical laryngoplasty, and glottic closure. The epiglottic flap closure is reversible, allows swallowing and speech, and low risk to vocal cord injury. Injury to the superior laryngeal nerve and flap dehiscence, need for a tracheostomy, and subglottic stenosis after reversal are the major disadvantages to this procedure. Glottic closure is successful in preventing aspiration in over 90% of cases, but reversal is more difficult. From what I see can find it sounds like he will most likely need to have surgery but some at home treatments are find a hypoallergenic milk for him which may keep him from spitting up so often and also find an acid reflux medicine that he can take which may help. Also, from what I can find, aspiration is tied in with GERD (Gastroesophageal Reflux Disease). If you would like to learn more about GERD try this website..... it sounds helpful http://www.webgerd.com/GerdInInfants.htm

Hi M.,
It sounds like you ARE seeing a speech therapist. The "feeding clinic" may or may not be what it states. But I am an occupational therapist who works with speech therapists who work with kids on feeding and swallowing and all I can say is please give this some time. If all your child knows is that feeding causes discomfort then they will be resistant to feed. This is going to take time and intervention to correct. As far as speaking goes, I can see how it can present a delay as there is a general discomfort in the throat and it may delay speech production. Also please take note, my neice didn't actually speak until after two because (and I consulted therapists) she had a big sister who never stopped talking! That being said her motor skills developed early. I personally did not speak until I was four. I could, but didn't and they actually held me back prior to starting kindergarten. My point being is please give your child some time. And, appropriate intervention like you are doing. Kids are amazing in how resilient and adaptable they are and many kids, especially one who experience difficulties early on, can adapt. But continue to have the professional intervention as they can track the development and guide it.

Hello M., I understand totally what you are going through. My 6 yr old has horrible reflux and is a silent aspirator. In his first year of life, we were in the ER 4 times for borderline pneumonia. It was chalked up to his prematurity. However, when he was 18 months, the immunologist diagnosed it. Andrew has been on meds, a low dosage of erythromycin before meals and bedtime. That has helped a lot. Metaclopramide (or Reglan) had horrible side effects. We thicken his juices and pediasure with thickener. He will not eat solid foods either. He eats a lot of pureed and softened foods. It did wonders for him. He gained weight and grew. He does not aspirate and has not had breathing treatments or pneumonia since he was 18 months. However, Andrew's condition is contributed to his Ring 18 Syndrome, he was diagnosed with at 2 weeks of age. Also, we give him prilosec every morning to help heartburn. We break the pill in half and dissolve in water then add to his food. He has made remarkable strides. We go to a gastrointerologist and speech therapy for his issues. We also go to a developmental pediatrician, who gives great suggestions. You son might qualify for ECI services (Early Childhood Intervention). We used them until Andrew turned 3 years old. They will come to your home to work with you. The speech therapist came at lunchtime and we worked together on this. One suggestion she had was to crumble up crackers or vanilla wafers and put in his food. This introduces texture. AS he tolerates it then gradually add bigger and bigger chunks. Then he will get used to it and build confidence with it. I know I threw a lot of information in your direction but I fully understand your dilemma. Hang in there. Remember you are not hurting your son as long as he is growing and happy. Good luck! Feel free to get in touch with me for more information. -H.

I asked one of my really good friends about this because she went through the same issue with her youngest. Here was her advice:
"Yes, i know all about asipration! If he is truly aspirating, it can be serious. My daughter had several swallow studies done to confirm she was aspirating which was causing her to have breathing issues/mild bouts of pneumonia. First step would be to go to a good pulmonologist and figure out what is going on. "

Hi M.,

Our daughter (6) had problems eating although not to the same extent as your son. She finally got medicine for reflux (Prevacid)and now meal time is a good time instead of a frustrating time. Her doctor diagnosed that problem and then we had a pediatric pulmonologist that got her alergies under control. So everything is a lot better! Go talk to your son's doctor about the reflux. They can't eat well if they have this problem.

Contact Rodney Russell in Southlake. He's amazing.

Rodney Russell, D.C.
325 Miron Dr. #100
Southlake, TX 76092
Phone: ###-###-####

His website is under construction, so forgive the errors, if you choose to check it out. If he thinks he cannot help you, he will tell you right away. He does a lot of work with people of all ages, and understands that many of our problems come from before we were born, no fault of the parents... just something that happens sometimes.

He's amazing, gentle and very kind and compassionate. He's great with children. His website is here:
http://www.findyourhealth.com/index.html

Tell him N. recommended him.

Good luck to you,
N. F.-Khosraviani
Little Elm

Hi, did your dr. mention anything about prevecid? My son takes it, but he has a different situation. I know another boy though, who takes it everyday, cause if he doesn't, he will double over in pain. Ask your dr, if not the med, maybe another. And, my son just started saying words at 2 1/2, so I feel your pain. I was counting calories, and every one of them too, to get him to gain weight. Good luck, maybe get a second opinion.

I have second hand knowledge of my son's school mate who had acid reflux when he was little. He goes to food therapy now. He is 3. He didn't want to eat. His mom said it's much like if you threw something up, then had a strong adversion to it for a long time. For example, I threw up tomato soup and hot dogs when I was 10. I still don't eat hot dogs (lots of reasons for that), but I probably didn't have tomato soup for 10 years or so.

I know this is such a challenge. I have a picky eater too, but we just take vitamins and figure he'll grow out of it.

Best of luck to you. Go with your instincts! He'll eventually eat like the rest of us, so don't stress out too much!

Contact your local ECI-ABC program for speech therapy. They can teach him how to move the food around effectively. They can also very effectively address the talking. You should also talk to your pediatrician about getting a referral for a swallow study. If your little guy is aspirating, it's pretty dangerous and can even cause aspiration pneumonia (where stomach acids and/or food burns the lungs and causes infection). He might be refusing to eat to protect his airway.

P.S. A good pedi pulmonologist is Dr. Schultz @ Cook.

M.,

I know exactly what you're going through. One of my twins had Dysphagia (the aspiration you were talking about), but it was with breastmilk. She would choke on it and throw it all up. They ran some tests with an x-ray to watch her swallow and found something wrong. To this day, she does not drink as much milk as her bigger twin. She's MUCH smaller than her twin sister as a result of not liking liquids. She's turning 1 year old tomorrow and only weighs 15 lbs. I'm not sure what they say about your son, since he is older, but they do grow out of it. If I were you, I'd just ask if there is any sort of procedure that can be done to help him be more comfortable with eating. Are there any foods that he tends to do better with eating? Certain textures that he seems to like?

If you have any, more specific questions, please feel free to email me. Best of luck,
K.

Sounds like you need to see more doctors. Lots of children have sensory issues to different food textures. But of course this situation sounds more serious than this. Do you have a GI doctor? Perhaps an ENT?

Hi M., well, this is a pickle isn't it. Are you giving him toddler food in the jar or making it from the food you cook? I would think the food you cook would be better for him (his tastes). One of my kids was just a picky eater so it was a matter of discovering what he would eat - and he was always skinnier than the other kids but he was healthy so I didn't worry too much. My husband was born with acid reflux and his mom told me of how difficult it was until he got older but she said it got easier. Keep your chin up!

First and foremost, get a referral for a good speech therapist! (ECI as mentioned before is a good resource, that's actually where I currently work as a pediatric physical therapist, but there are other home health or private clinics that provide these services as well-make sure they specialize in pediatrics though!). I would assume that at a feeding clinic, he would be seeing speech therapists, and possibly occupational therapists as well. If that's the case, you're on the right track. If not, I would get a referral ASAP so you can get more information and start working on the problem. Good luck!

My daughter was a preemiem born at 25 weeks. She has acid reflux. It used to be pretty bad. She also aspirated as well. We took her to Cooks Children (downtown FW) and we had an upper GI and a swallow study. THe upper GI showed that everything funtioned properly. THe swallow study showed that she had a delayed swallow function. What happens is that when she eats or drinks something her body doesn't automatically swallow so as the liquid (or food) is sitting in her mouth some of it goes down her wind pipe. What we have to do is make her liquids nectar consistancy so its thicker. She also had a GI procedure down where they enlarged the sphinter at the bottom of her stomach that goes to the small intestines. That procedure helped alot with her reflux. She sees a speech therapist 2x times a mouth to help develop her swallowing and eating. I would suggest that you talk to your peditrican and ask to have an upper GI and swallow study down. you may also want to ask for a referral to a GI doctor as well. Our daughter is 18 months and she was 12 months when she had the GI procedure down and about 8 mths when she had the upper GI and swallow study down.

M.,
please try to give him cod liver oil. You can get a good brand like Nordic Naturals from Wholefoods. My son (now 2 and a half) did not even say ma ma, da da or what-have-you till about 13 months. Cod liver oil helped him get started. My son also had major acid reflux at birth that continued till about 10 months. He was on prevacid. He is not a great eater even now. He would rather have liquids but I don't think or don't know if he has/had aspiration. Please try alternative health doctors too like chiro & homeopaths.

Have you had this problem for the past 8 months? Most children tend to start on solids at 10 months of age. They start with cheerios and peas for fine motor skills along with mashed potatos *with help*.
If you have waited until your child is 18 mo. to start solids, then that is where your problem is. It will just take a while longer to get him/her to eat table food. He had developed a habit for baby food and likes it.

Contact your local Early childhood intervention chapter. they will send therapists to your home to evaluate his speech and and OT to help you with feeding issues in most cases the treatment is free.

Also, Asperation can cause a feeding aversion. That is when they think every time they eat it will hurt and it becomes a conditioned response to eating.

Keep up with the feeding therapy and he may still need reflux meds to treat the esophoegus (sp?) damage that was done...

you might also want to see a Gastroentestinal specialist.

Good luck-
A.

I just took my daughter to Dr. Kendall Brown at the Digestive Health Association in Richardson. Its at the Pediatric Pavillion. He is amazing and is a pediatric gastroentologist (sp?). I've heard so many good things about him from everyone. He really will listen to your needs. Perhaps he can help.

Hey, M.. I am a speech pathologist, and I actually specialize in treating kids with swallowing and feeding problems. My heart goes out to you! I know it can feel so defeating when your child has trouble with something as fundimental as eating! You are doing your best, I'm sure. I want to give you a little info, and I urge you to talk to your doctor or therapist to clarify some things for you. Firstly, aspiration means food or liquid is going down the airway, to the lungs, RATHER than into the esophagus where it is supposed to go. If your baby is really aspirating, that is a dangerous problem. Food shouldn't be in the lungs--it can cause chronic pneumonia, choking, or worse. So if your son is really aspirating, you MUST MUST MUST find out how to prevent that. That may mean giving him only very specific types/consistencies of food, or even considering non-oral nutrition (i.e., a small tube in the tummy) TEMPORARILY until he gets stronger and can swallow safely. Aspiration is not something to fool around with. I am curious as to how they diagnosed that. The only definitive way to do so is with a special XRAY test called a Modified Barium Swallow. You can get some idea of what is going on by a clinical exam, but if the therapist thought he was aspirating, she should have set up an MBS. Maybe they only think it happens once in awhile...but still. They MUST give you more info on that.

Yes, sometimes chronic reflux can cause damage to the swallowing mechanism, but sometimes it just causes kids to have what we call a feeding "aversion," meaning they just avoid eating b/c it causes unpleasant feelings (vomiting, etc). Eating and talking are not necessarily tied together, but if a child has a speech/language delay, he may be delayed in other areas. One thing we see is that kids with developmental delays may have "sensory" issues. This is often manifested in eating. For example, some kids don't like certain tastes and textures in their mouths--I know, we're all like that, right?! But some kids have it to an extreme (e.g., won't eat anything crunchy or slimy, will only eat bland food, etc).

Since I don't know the whole story, and I haven't seen your precious boy, I don't want to undermine what the therapists have told you. But it does sound like you need to clear up some things. If you're more comfortable with your doctor, you might call him/her for advice. Maybe the doctor can look at the therapist's reports and give his opinion.

Good luck, M.. PLEASE email me anytime about this. This is something dear to my heart, and I want your son to get the best care he can. I am happy to try to find you another specialist if you continue to be unhappy with the clinic.

Hi M.,

I haven't had time to read all the other responses but wanted to mention about seeing a chiropractor? check www.maximizedliving.com.
Good luck and get to the bottom of it (and hopefully w/out meds) follow your gut!~C.~