Feeding Update

Adeline has been sick and pukey all week. All three girls are snotty and I am sure food doesn't taste right in their condition. Basically, I have turned all of my focus on Savannah and Lila Grace. Savannah has taken to eating three bites of everything and, for the most part, doesn't give me problems at the dinner table. She is eating foods that she would never try before because she is in control of the bite size and knows there are only three to take. Often, one of the foods she is eating will disappear (hunger does have a role in this). We have adopted carrots or apples dipped in yogurt for an after dinner snack.

Things have been moving along for Lila too. She has found herself in timeout many times and oddly enough, she sits for the entire five minutes without trying to get up. She still tries to pull her little tricks and is very impatient when it comes to food. Overall, I feel that she has become more independent but I am still never more than a foot away from her at the dinner table. Just to give you an example of what my Miss Grace does whenever I turn my head, take a peek at the picture below and see if you see anything strange. NO, I didn't put the sippy cup there!

Like I mentioned, Adeline has been put on hold for the week until tonight. Instead of letting her sit on the sidelines and eat veggie sticks, I tried the feeding protocol. First, I set Savannah and Lila up and then I got the cars out for Adeline. She was clearly hungry and signing "I want" when she saw the french bread slices. I thought that was very good sign since most feedings she would fling it onto the ground. I started with little bites of bread and then moved to bites of baked potato on a spoon. These bites were very small and, initially, hard to get in but by the third or fourth bite, she was willingly taking them. They graduated to the size of two peas. I dipped a few in ketchup which she didn't like but ended up taking to get her car back. I even snuck in the tiniest bite of meat. All in all, I would say she had quite a bit to eat. Potatoes, bread, meat (well sort of) and applesauce. I realize this was all so successful because the afternoon bottle was dropped. I still have a hard time doing it to her because I know she is hungry and never has the sensation of a full tummy until bedtime. That is 12 hours between bottles!!

Savannah loves getting Lila Grace up from her naps. You can typically hear the screams of laughter and jumping all through the house. It is certainly fun to watch their relationship evolve.

The last two nights we have gathered in the twins' room to listen to a half an hour of our Theraputic Listening music. Lila Grace loves to relax in the chair with her Bunny and Binki. Savannah has taken it upon herself to read Lila her two bedtime stories. She does a really good job and Lila seems to enjoy it just as much as when I am reading to her.

Before I Forget

I feel that there are so many things that I am going to forget about my girls once the weather turns cold. We spend countless hours outdoors and the girls absolutely love it. Months will go by before we are playing in the cul-de-sac and they will be very different girls by then. The things that I love to watch them do today, won't be the same in the spring.

For Lila Grace, this summer has been about rocks. It began with her eating rocks which gave me a heart attack on a daily basis. She was so predictable about putting them in her mouth that I could yell across the driveway for her to show me what was in her mouth and she would open up and take the rock out. I was barely able to function during this time because Adeline wasn't really walking outdoors and Lila would take off and before I knew it, have a rock in her mouth.

Her love of rocks has blossomed into a little perch at the end of my driveway. There is a pile of dirt and rocks which happen to be conveniently located next to a large storm drain. Miss Grace loves to hunt for the two medium sized rocks that she can hold in one hand. She will keep hold of these the entire evening. If they fall, she carefully examines the rocks in order to find the exact rocks she was holding. With the other hand, she picks out large rocks and throws them down the storm drain. She will also load her many cars, or in tonight's case it was stroller, and take her rocks for a walk. I know I would have never let Savannah play in the dirt or street for that matter but I just can't keep Lila away from something she truly loves. She will most likely find a different "spot" in the spring but for these last few days of nice weather, I know where to find my little blue eyed girl - playing with her rocks.

It's That Time of Year

We woke up to this


And went to bed with this


In between. . .

103.9 fever
vomiting
Savannah stepping out of the room to pray for Adeline's speedy recovery(such a sweetie)
writhing in pain
Heart rate of 190
Sats 90

So. . . I am gearing up for a tough week ahead. Adeline and Savannah are my fever queens. I am sure Savannah will catch this and run with it up to 105. Let's just hope it doesn't happen on her birthday like last year (9/28).

Luckily, Adeline was able to keep down the Tylenol which allowed her to take a few walks around the cul-de-sac in the stroller. Every time we stopped, she said, "Go!" It was better than watching her tug at her cannula and say and sign, "All done" over and over again.

Here is hoping for better tomorrow. Maybe Savannah's prayers will be answered. She is sitting at the island making get well decorations for Adeline's room.

This one is a picture of God and Adeline. God is giving Adeline love (the heart) and an Easter Egg. I love the ponytail in Adeline's hair. Savannah is such a sweet little artist.

Feeding Clinic

Yesterday, I spent the afternoon with Adeline at the Hershey Feeding Clinic. Her speech therapist also accompanied us which was above and beyond the call of duty. We met with Dr. Williams and discussed Adeline's food routines and food related behavior. It was hard to describe how hard she could be during a feeding when she was a sweet angel for the two plus hour consultation. By the end of the visit she was curled up in the doctor's lap saying, "Hi!"

After spending much time discussing her eating habits, Dr. Williams placed her in a high chair with yogurt, applesauce and bread on the plate. I informed him that she really likes matchbox cars and that is what he used for motivation. He would take the tiniest bite of bread and place it on the spoon. After telling her over and over again that she had to take her bite if she wanted to play with the car, Adeline would finally give in. She wasn't real willing but she wasn't fighting him as hard as she does me at home. Each bite was followed by time playing with the cars. The car would be removed after 30 seconds or so and the process would start again. The timer was set for 15 minutes and when it beeped she was done.

In the 15 minute minute time period, Dr. Williams was successful at getting Adeline to eat all three foods. There was very little caloric value due to the small quantity but he assured me that practice makes perfect. She will eventually like food, stop gagging and WANT to eat. He does this day in and day out so I guess I will believe him.

After her feeding we went back into the consultation room and talked about family mealtime. I told him it was the most stressful part of my day, especially dinner. When most families are finding relief during dinner, I am low on patience, fighting three kids to eat food they typically don't want to eat and doing this on my own as there is no Daddy at the end of our day. This lead the conversation to both Lila Grace and Savannah. Both girls contribute to the stress. Savannah never wants to eat what I cook and Lila Grace is either hot or cold. Some days she will shovel it in and then want down in two seconds and other days she will scream and tantrum over what I put in front of her. Dr. Williams wrote a plan for both:

Lila Grace - When behavior isn't acceptable put her in time out for five minutes. Let her come back and try again but adhere to a "three strikes you're out rule." He promised she would learn to sit quietly for 15 minutes. I am not supposed to push her to eat if she doesn't want to.

Savannah - She is supposed to try pea sized bits of all our food. If she doesn't like them she doesn't have to eat it. The only after dinner snack she can have is fresh veggies and fruits. No more bowls of cereal and bars. She is what he considers a classic "avoider" by using a bowl of cereal as her supplement to dinner.

The above sounds great but putting it into practice is another issue. I will give it a week and see where we are. I think Lila is still going to exhibit behaviors that put me over the top.

Once I have the other two under control it is his belief that I will have a nonstressful environment and at that point I can turn my focus to Adeline. I think he is simplifying the stresses of dinner time or any meal time for that matter but I am going to try.

Adeline's plan is as follows: Decrease the amount of Pediasure she receives through a bottle. Set the timer for 15 minutes and use pea sized bites of a variety of foods. Gradually grow the bite when she is no longer showing refusal. Eventually, she is supposed to self feed. Boy, won't that be the day!

Dr. Williams thought Adeline would resolve most of her issues in a week's time if admitted to the day treatment program. However, he didn't admit her. Due to the family dynamics of the meal, he felt that there wouldn't be any carry over when brought back into the natural environment. Thus, the intervention must be done at home! Yikes!!

I don't know how I am going to do this on my own. Dinners are a disaster, breakfasts are all of five minutes and then we are rushing to get Savannah to preschool and lunch is squeezed in between preschool pick up and therapy. It isn't like we have all day to work on feeding. I understand his point though. It has to be done at home because there are so many behaviors that are tied into her successful outcome. Savannah and Lila are going to have to step up to the plate in order to allow me to have time with Adeline - undistracted time that is. Any mother of three kids four and under knows how how tall of an order that really is.

Keep your fingers crossed for us.

Words are Emerging

Adeline is finally talking!! I couldn't be more excited. We have moved away from signing and are now working on vocalizing. She gets it!! Adeline concentrates on my mouth as I say a word repeatedly and then with a little grin she tries to say it back. Most of her words only I can understand but that doesn't matter one bit. She understands the purpose of language and she is applying it to her everyday life. Words she has recently picked up:

Sticks (veggie sticks)
no
yogurt
Charlotte
night night
car (she transitioned nicely from the sign to using the word)
Oscar
Cookie
Ernie

I am surprised how much influence Lila Grace has on Adeline's speech. I figured most of the learning would be done when observing Savannah. Today, as we were pulling away from Charlotte's house Lila Grace was saying, "Charlotte, Charlotte." Adeline chimed right with her own version of the name.

Sisterhood

Today, when unbuckling the girls during preschool pickup, Lila Grace grabbed Savannah's Bunny from her car seat and yells, "Anna!" She hops out of the van and walks very purposefully (holding my hand of course) to the school's door. Once in the basement, I let go of her hand and she ran right for Savannah's classroom. She got a bit confused and poked her head in the wrong door and then was thoroughly confused by the door being shut to Savannah's class. She ran around the large room and looked in every classroom in hopes of finding her sister. Once the door to Savannah's class opened, Lila darted in and handed Savannah her Bunny. She was so proud. She can be so sweet.
Even better is watching the two of them navigate the parking lot hand in hand. Lila behaves much better for Savannah than she does for me.