The Swallow Study

The first time I heard the words “swallow study,” was back in May when Little A was only a week old.  Swallow studies are done to determine how milk goes down when he drinks and make sure it is the correct pipe.  Little A was brought down to the radiology department of the hospital. They mix some barium into his milk. Then as they feed him the bottle the radiologist takes a series of x-rays.  When they put them in sequence you can actually see the liquid flowing down. Back then, unfortunately, Little A aspirated---meaning he couldn't coordinate sucking, breathing and swallowing so the milk went down his windpipe.  That is why the feeding tube was put in and he started off with tastes of milk from his pacifier.

      Little A has come a long way already at almost 8 months old.  For the past 2 weeks he has been CONSISTENTLY drinking 4 oz of milk from his bottle every time.  He eats baby cereals, fruits and vegetables from a spoon and pouch. He even thinks he is a big boy and tries to feed himself from the pouch. As far as we can tell he doesn't aspirate (or no more than any other baby). On occasion, he coughs like the milk starts to go down the wrong pipe, but only when he is distracted and it is not every time he drinks the bottle (like in the beginning). At the suggestion of his Craniofacial Team, Little A is having another Swallow Study done tomorrow (1/8/19) to ensure he doesn't aspirate while drinking a bottle or eating his solids.  It is being performed by a specialist in NYC. The appointment is unfortunately between his feeds and he can't have any food or bottle for 2 hours prior. Let's just say I am not looking forward to dealing with a hangry baby. I know how far Little A has come so far and I know that he has been doing well with his drinking and eating, but I am still worried about the results. Is he going to cooperate? I keep praying that he stays focused and doesn't have his once in a while coughs or aspirations during it. I just want good results to show all those doctors the hard work my mom and I have done with Little A has paid off with only the guidance of his E.I speech therapist.  Hopefully it doesn't take too long to get the results--i definitely can't deal with that anxiety.

1/8/18 The results are in and Little A is doing Amazing!  After parking and walking a couple of blocks I realized I left the bottles I made in the fridge at home...oh boy!  Good thing there is always formula, a bottle of water and an empty bottle in the diaper bag and the crisis was averted quickly.  When we got to the speech and swallow center, we had to wait of course. Luckily though, since he was a baby fasting for about 2.5 hours at this point, the receptionist made sure the speech therapist didn’t diddle daddle long.  We followed her back just to her room and I was a bit confused at this point. She asked us some questions and then just wanted to see him drink and eat. Little A was bringing his A game. He not only sucked down about 2 ounces of that bottle, but did it without dripping or coughing. He got extra points for showing her that he can even hold the bottle sometimes.  As he drank she listened with the stethoscope to his breathing. She could tell that due to his narrower windpipe he stops to take a few more breaths than maybe a typical baby therefore takes him a little longer to drink. But he is doing great coordinating his sucking, breathing and swallowing with no aspiration! She said he sounded a bit congested, but it sounded nasally and not like liquid in his lungs (all good signs!).  The best news was she didn’t feel it was necessary to do the barium test in radiology at this time and felt it was only necessary when we were ready to take his tube out just to double check everything was fine. Then she watched him eat some banana puree off the spoon and said he sucks off the spoon. She showed us how to put the spoon in, wait for him to close his mouth around it and pull the spoon out so he scrapes the food off.  Other than that, he was moving the food around in his mouth correctly and swallowing without a problem. Little A has accomplished the harder goal of drinking, swallowing and breathing and coordinating eating food and taking breaths is an easier task. The next thing we are working on with Little A is eating more solids. We really feel once he accomplishes this we can be on the road to weaning from the g-tube. In March we are following back up with the speech/swallow therapist and a nutritionist to hopefully make a plan to wean him off the tube ::fingers crossed::