“It's all practice ...”
– Bethany, Mom
Within an hour of her birth, it was discovered that Anabel was born with a congenital diaphragmic hernia. The condition impacted vital organs, putting the child’s life at risk. At four days old, Anabel had surgery to repair the problem.
“Her stomach and intestines were pushed up into her lungs,” said Bethany, who lives near Gaithersburg with Anabel, husband Mike and their six-year-old son Sam. Both of the children are adopted, the decision to go through with Anabel’s adoption despite her health problems never in question.
Anabel went home from the hospital with a feeding tube through her nose but her parents and doctors realized she wasn't gaining weight as she should. At three months old, the cheery, blonde-haired girl was surgically fitted with a more permanent feeding tube in her stomach. At the same time, her surgeon operated on her stomach to decrease vomiting.
Now two, Anabel recently completed an intensive out-patient feeding program at Mt. Washington Pediatric Hospital, a six week program where she learned to chew and swallow. Though less intensive now, her training to consume food and keep it down continues in weekly sessions expected to go on “for the foreseeable future,” her mother said.
“We chose Mt. Washington because of their comprehensive approach to feeding,” said Bethany. “The whole staff works together to find solutions and it gave us a really good feeling. We knew they cared about her and all of us.”
Bethany said that while the staff at Mt. Washington “came up with a great plan,” to teach the girl to eat on her own, Sesame Street superstar Elmo gets some of the credit with an assist from the Australian singing group, the Wiggles.
“She responds to watching videos on an iPad or the TV during feeding,” said Bethany, noting that her daughter’s superb verbal skills has made the experience easier. “We turn it off when it’s time for her to swallow a bite and then turn it back on as a reward. Now she often eats the whole time she’s watching her favorite shows.”
And it’s not so much that Anabel is a picky eater. The taste of food is not the issue so much as texture. When she began at Mt. Washington in January, Anabel “had trouble eating anything with texture,” said Bethany.
Learning to chew and swallow solid foods – something as simple as a cracker – was difficult for Anabel, her mother said, “because of the texture, a cracker would make her vomit. She has a strong gag reflex so she wasn’t able to put anything on her tongue.”
Anabel worked on chewing using a chewing tube. Therapists instruct her to put the device on her teeth (not her tongue) and then they demonstrate the chewing motion, first on one side of the mouth, then the other. This improves coordination and builds up the muscles in her mouth required to chew.
A small piece of solid food is then placed on the child’s teeth and she then imitates what was just practiced.
When Anabel began the intensive feeding program, she was almost exclusively fed by her feeding tube – “very little by mouth,” said Bethany - and could neither suck nor swallow.
After learning to take solid food – helped by about a dozen baby teeth - she typically spit up at every meal. That only happens once or twice a week now with almost 40 percent of her nourishment coming by mouth and the feeding tube is used at night. Her family is confident that Anabel is well on her way to the day the feeding tube is removed and all of her food is taken by mouth.
“They came up with a great plan that built on what we were already doing at home,” said Bethany. “We felt like the therapists at Mt. Washington were miracle workers when we first began taking Anabel there - now we know it.”
To schedule outpatient appointments or learn more about our programs, call us at 410-367-2222.