S.M.I.L.E.S. - Speech-Language Pathology & Education - Satisfying Many in Lasting Eating Success
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Children should be transitioned from the bottle to an open cup by 12 months of age. Developmentally, the skill level is present and each additional month the child remains in the bottle is time to grow more dependent on it thereby becoming more difficult to transition.
If you haven't introduced a pacifier to your child I recommend you don't. If your child is taking a pacifier we recommend removing it by 6-9 months of age. Child quickly becomes dependent on pacifiers. They need to learn to comfort themselves instead of using a foreign device. It can also interfere with speech development, acquisition, feeding, and dentition.
Developmental studies tell us that children should begin babbling at 3 months of age and first words to come between 9 and 12 months of age with at least 10 words by 15 months of age.
We have found that flavoring the vegetables with garlic and serving the same vegetable 1-2 times per day for at least 7 days and up to 14 if this child isn't eating them easily by 7 works very well. Insist the smell and touch the vegetable the first introduction, next he should touch it with his tongue, then bite at least twice (each side of mouth) and allowed to spit out, and then have to bite and chew1 time, etc. until the child is consuming at least 1 portion per day.
Aside from projective vomiting, parents should notice if the child is a restless sleeper, wakes (sometimes for drinks) at night, has difficulty transitioning to chunky foods, rather drink than eat, etc. There are many more overt signs and symptoms which can be found at www.reflux.org.
Several things could be causing this. We recommend providing thicker and more flavorful liquids to your child such as buttermilk, V-8 juice, yogurt smoothies, etc. and speak with your pediatrician about this. If it continues we recommend getting a FEES (fibro-endoscopic evaluation of swallow). If this is not available, then we would recommend a MBSS (Modified Barium Swallow Study).
There are many things which may be going on with your child in the realm of feeding and this is the time when it's most noticeable. Try not offering your child snacks during the day, ensuring there are at least 3 hours between the end of eating to the beginning of the next, making everyone remain at the table until the last person has completed his/her meal, turn off the T.V., play classical/instrumental music, etc. If this behavior continues we recommend seeking an evaluation from a specially trained speech-language pathologist to evaluate for possible feeding issues.
We never recommend transitioning to a sippy cup. The sippy cup works exactly like a bottle it just looks more like a cup. Children do not need this product for transitioning to cup drinking and a sippy cup can actually hinder this natural progression. Playtex and Gerber are currently making several good open cups that are spill resistant/proof which was the reason the sippy cup came to be in the first place.
Just like other areas gross and fine motor development, children with Down syndrome need more leading to each developmental milestone with feeding and oral function. There are specific nipples/bottle systems that promote significantly better intake rate made by Playtex, coordination, and endurance. They need to be introduced sooner to solids and transitioned quickly through each stage to table foods.

Your child could possess low oral muscle tone and sensation. Please see a specialized speech-language pathologist for an evaluation to further evaluate this issue.

Hypotonia generally does affect the muscles in the face and neck at well. A child needs strong abdominal muscles for air flow for speaking.
We always recommend breast feeding when possible. Children with Down syndrome and other disorders can be very successful with breast feeding, however may take then up to 2-3 weeks to build up strength and endurance for longer feeds. As long as your child isn't losing weight and can maintain then be patient and work with your newborn to be successful. You may have to feed more often and not allow a feeding to go longer than 30 minutes so you might be feeding every hour and a half initially. As always ensure your pediatrician is on board with your decision to ensure that there aren't any additional medical complications (i.e., significant heart defects, tracheomalyasia, blocked nasal airway, etc) that are prohibiting your child from being a successful breast feeder.

There are many approaches available for treating apraxia. We have received the most success with the PROMPT (Prompts for Restructuring the Oral Motor Phonemic Targets) approach. This is a fully 'hands on' approach and assists the child with creating sounds. We are advanced trained in this technique. To learn more about PROMPT, you may visit the PROMPT Institute web site.

 
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