Swallow Study

I knew I was forgetting stuff on my last update with Cora, forgot to document her last swallow study!

• Weak tongue control of liquids and solids but otherwise appropriate chewing and sip patterns
• Premature spillage of liquids and solids to level of valleculae & pyriform sinuses. Delayed swallow initiation.
• Deep penetration with nectar liquids by sip cup. Improved control with open cup.
• Silent aspiration of juice from mixed consistencies but safe swallow with all other solids taken. Needs additional time to swallow bits of residue.

Recommendations:

• Continue general toddler diet with nectar liquids. Avoid mixed consistencies. Combine 1 packet Simply Thick (nectar) with 4 oz. juice/water. 40 cal/oz Elecare appears appropriately thick at this time.
• Continue with open cup. May attempt spouted cup with decreased flow or open cup trainer.

So she graduated from half honey to nectar consistency and is not allowed to use any sippy cup (soft or hard plastic). I was glad I brought oranges! I had a hunch that once she bit into the orange, the juice would be too thin for her to handle. And indeed it was so she can't have oranges or watermelon or any other foods with mixed consistencies, like soup.

The best part of this appointment was about 3/4 of the way through we took a break. The xray video is a live shot and when the video stops, it'll freeze the frame. So during the break Cora saw herself on the monitor and kept pointing to the monitor and then back and herself, then pointing the monitor and then back at herself. She knew she was her on the monitor!! Clever girl.  :)