Follow these helpful hints to ensure your spouse a healthy pregnancy:
* Get all her essential vitamins and minerals every day. According to the U.S. Department of Health & Human Services, women need a lot more iron when pregnant. And sometimes it's hard to get enough by eating alone. Ask your doctor if your spouse should be taking a daily prenatal vitamin or multivitamin.
* Get 400 micrograms (or 0.4 mg) of folic acid daily in her diet. According to the U.S. Department of Health & Human Services, getting enough folic acid (or folate) reduces the chances of some birth defects. Some women eat lots of certain foods and others take multivitamins to get enough folic acid during pregnancy.
* Eat a healthy diet. Load her up on fruits, vegetables, and whole-grains (such as whole-wheat breads or crackers). Eat plenty of calcium-rich foods (such as non-fat or low-fat yogurt, milk, and broccoli) that your baby needs for strong bones and teeth. If you live in areas where fruits and vegetables aren't in season, frozen vegetables are a good option. Avoid giving her a lot of fatty foods (such as butter and fatty meats) to eat. Choose leaner foods when you can (such as skim milk, chicken and turkey without the skin, and fish).
* Let her gain a healthy, not excessive amount of weight. Research shows that women who gain more than the recommended amount during pregnancy have an elevated risk of obesity. On average, 25 to 30 pounds is a healthy weight gain over the 40 weeks of pregnancy. Check with your doctor to find out how much weight your spouse should gain during pregnancy
* Make sure she gets enough sleep (seven to nine hours every night). Aches, pains, anxiety and bathroom runs keep many pregnant women awake at night. To get some sleep, try getting your spouse to eat any large meals at least three hours before going to bed, get some easy exercise (like walking) and avoid long naps during the day. Make sure she sleeps on her left side and uses pillows between her legs and under her belly to help her get comfortable
* De-stress. If she can, your spouse should control the stress in her life. When it comes to work and family, she should figure out what she can really do. She should set limits with herself and others. Tell your spouse that she should not be afraid to say NO to requests for her time and energy
* Get Her Moving! Getting regular, low-impact exercise is good for your spouse and your baby. Talk to your doctor about what is safe. Get more guidelines on exercising while pregnant.
* Get a handle on health problems. Talk to your doctor about how your spouse’s health problems can affect her and the baby. If she has diabetes, make sure she controls her blood sugar levels. If she has high blood pressure, monitor it closely. If she is overweight, talk to the doctor about whether she should lose weight.
* Ask your doctor before taking any medicines. According to the U.S. Department of Health & Human Services, prescription, over-the-counter, and herbal medicines all can harm your baby. Find out if your spouse should continue taking prescription medicines.
* See your doctor regularly. Prenatal care can help keep your spouse and the baby healthy, spot problems if they occur and prevent difficulties during delivery.
* Consider getting a flu shot. The flu can be dangerous for some moms-to-be. The Centers for Disease Control and Prevention (CDC) suggests vaccinations for all women who are at least 14 weeks pregnant during the flu season. Ask your doctor if your spouse should get a flu shot.
* Make sure she wears her seat-belt correctly. Seat belts used correctly protect your spouse and your unborn baby during a crash. The American Academy of Family Physicians recommends that pregnant women use seat belts that have a lap belt and a shoulder strap (3-point restraint). Seat belt straps should never go across her belly. The lap strap should go under the belly, across the hips. The shoulder strap should go off to the side of her belly and between her breasts. If she are not driving, the back seat is the safest place for her to sit.
* Ease the aches and pains. Don't just accept discomfort as a necessary part of pregnancy. Your spouse can easily be helped with problems related to hemorrhoids, heartburn, and leg cramps.
Saturday, May 10, 2008
Tuesday, May 6, 2008
Pregnancy Dos and Don'ts - The Don'ts
Help your spouse steer clear of these pregnancy no-nos to help keep her and the baby safe and healthy:
* Avoid fish with lots of mercury in her diet. Get correct information from your dietician on what fish to eat and what fish to avoid when she is pregnant.
* Don't disregard food borne illness. Eat, cook, handle and clean food safely! According to the U.S. Department of Health & Human Services, food borne illness can cause serious health problems - or even death for both mother and baby.
* Protect her from using chemicals. Products including herbicides, pesticides, paint, stains, and some cleaning solutions may be harmful to your baby. If she must use these things, make sure she wears gloves, a mask, and keeps the room well-ventilated.
* Don't let her clean or change a cat's litter box. This could put her at risk for an infection called toxoplasmosis. Toxoplasmosis is caused by a parasite that cats can carry in their feces. Toxoplasmosis can harm a fetus.
* Don't let her take very hot baths, hot tubs, or saunas. According to the U.S. Department of Health & Human Services, high temperatures can be harmful to the fetus, or causing the mother-to-be to faint.
* Discourage her from using scented feminine hygiene products. Pregnant women should avoid scented sprays, sanitary napkins, and bubble bath. These products might irritate your spouse’s vaginal area, and increase her risk of a urinary tract infection or yeast infection.
* Don't let her douche. According to the U.S. Department of Health & Human Services, douching can irritate the vagina, force air into the birth canal and increase the increase the risk of infection
* Avoid optional x-rays. X-rays are a form of radiation that is linked to a very small risk of cancer for an unborn baby. But x-rays are usually safe during pregnancy. So if your doctor says your spouse needs x-rays for a health problem you should follow her advice. But sometimes doctors can use other tests in place of x-rays. And other times, x-rays can wait until after the baby is born.
* Don't let her smoke tobacco. Tell your doctor if your spouse smokes. Quitting is hard, but she can do it. Ask your doctor for help. Smoking during pregnancy passes nicotine and cancer-causing drugs to your baby. Smoke also keeps your baby from getting needed nourishment and raises the risk of stillbirth and premature birth (a small baby born too early).
* Discourage her from drinking alcohol. Your spouse should stop drinking alcohol if she drinks it regularly. Experts are still unsure of the exact amount of alcohol needed to cause problems in your baby. But, both drinking every day and drinking a lot of alcohol once in a while during pregnancy can harm the baby.
* Don't let her use illegal drugs. Tell your doctor if your spouse is using drugs. Marijuana, cocaine, heroin, speed (amphetamines), barbiturates, and LSD are very dangerous for your spouse and the baby.
* Avoid fish with lots of mercury in her diet. Get correct information from your dietician on what fish to eat and what fish to avoid when she is pregnant.
* Don't disregard food borne illness. Eat, cook, handle and clean food safely! According to the U.S. Department of Health & Human Services, food borne illness can cause serious health problems - or even death for both mother and baby.
* Protect her from using chemicals. Products including herbicides, pesticides, paint, stains, and some cleaning solutions may be harmful to your baby. If she must use these things, make sure she wears gloves, a mask, and keeps the room well-ventilated.
* Don't let her clean or change a cat's litter box. This could put her at risk for an infection called toxoplasmosis. Toxoplasmosis is caused by a parasite that cats can carry in their feces. Toxoplasmosis can harm a fetus.
* Don't let her take very hot baths, hot tubs, or saunas. According to the U.S. Department of Health & Human Services, high temperatures can be harmful to the fetus, or causing the mother-to-be to faint.
* Discourage her from using scented feminine hygiene products. Pregnant women should avoid scented sprays, sanitary napkins, and bubble bath. These products might irritate your spouse’s vaginal area, and increase her risk of a urinary tract infection or yeast infection.
* Don't let her douche. According to the U.S. Department of Health & Human Services, douching can irritate the vagina, force air into the birth canal and increase the increase the risk of infection
* Avoid optional x-rays. X-rays are a form of radiation that is linked to a very small risk of cancer for an unborn baby. But x-rays are usually safe during pregnancy. So if your doctor says your spouse needs x-rays for a health problem you should follow her advice. But sometimes doctors can use other tests in place of x-rays. And other times, x-rays can wait until after the baby is born.
* Don't let her smoke tobacco. Tell your doctor if your spouse smokes. Quitting is hard, but she can do it. Ask your doctor for help. Smoking during pregnancy passes nicotine and cancer-causing drugs to your baby. Smoke also keeps your baby from getting needed nourishment and raises the risk of stillbirth and premature birth (a small baby born too early).
* Discourage her from drinking alcohol. Your spouse should stop drinking alcohol if she drinks it regularly. Experts are still unsure of the exact amount of alcohol needed to cause problems in your baby. But, both drinking every day and drinking a lot of alcohol once in a while during pregnancy can harm the baby.
* Don't let her use illegal drugs. Tell your doctor if your spouse is using drugs. Marijuana, cocaine, heroin, speed (amphetamines), barbiturates, and LSD are very dangerous for your spouse and the baby.
Monday, May 5, 2008
G-Tube Tips
I found this stuff called New Skin at the pharmacy (Rite Aid). It’s for burns, has breathable hydro-gel, and is also in a sticky bandage form. If you slit it to the center as you would a piece of gauze, it works beautifully. It attaches itself to the stem part of the button, it breathes, it cools the burn from the stomach acid, and it heals, while stopping the leakage from oozing out. - M.C., Alameda, CA
My daughter has had a G-tube since birth. She now has the button, which is much better. Her tube has always given us a problem with leaking. I have tried gauze in many sizes and make-up sponges that are circular with the hole cut out of the middle. These have worked, but I have found that taking 2 pieces of toilet paper or ½ a piece of a tissue, rolling it up like a cigarette, and then wrapping it around the tube works very well. This can be replaced wherever and whenever needed. This has kept my daughter dry and very clean. Even her doctor has bragged about this idea and how great her site looks. - J.L.S., Cleveland, TN
When my son began continuous feeds through the night with a pump, I was worried about the tube wrapping around his leg or arm and the pump alarm going off all the time. Then, I came across an item that holds him in one position, yet he has room to turn and move in. It’s called The Tucker Sling and it has been a life saver!! Their website shows pictures of the sling, and they have various sizes depending on the size of your child. - D.F., Modesto, CA
Our daughter had terrible granulation tissue before someone told us about eucalyptus oil. We now use it everyday and have no build-up around the tube. It will also bring down the tissue. It has to be diluted: 2 drops of oil to 10-20 ml. of water. I swab it around the tube area with Q-tips. You may want to test it on another area first to be sure there will not be an allergic reaction. For my daughter, it worked wonderfully. I know of lots of other parents who have also tried it and had very good results. No more silver nitrate burns! I would recommend trying it. The oil can be bought at health stores or off the Internet. - L.J., city and state unknown
My daughter has had a G-tube for about five years. Her nutrition is solely from her G-tube feeds. I use a creme around the site that’s called Calmeseptine. It's fairly new on the market and works very well for that area. I put the creme on 3 times a day and then cover it each time with a 2 x 2 gauze. My daughter very rarely has any problems with granulation or infection by the G-tube site. - J.K., city and state unknown
To clean the G-tube, pour flat Coke/cola through the tube. It works wonders. Also to prevent leakage and skin irritation, use 4 x 4 tracheostomy drain sponges. They can be purchased at many drug stores. - D.T., Kenner, LA
We try to make our son's feeding bags last a few days, but to avoid bacterial growth, we refrigerate the bag between cleanings. Works for food, and for food bags! - K.H., Rockford, IL
My son had horrible problems with granulation tissue around his G-tube since the day it was placed. We were using silver nitrate every 2 to 4 days. We tried creams, antacids, Cholestin, and IV sponges, but none healed him. Someone told us about foam dressings. It worked! My son's G-tube site has been healed for the first time in 4 years! The brand name is called Hydrasorb. It is a foam dressing, and it absorbs any leakage and it cuts down on the scar tissue. It took about two months to fully heal while using this dressing, but his stomach is now dry and tight and the scar tissue has lessened. Try it! - D.M., Traverse City, MI
I have a 16 year old daughter who has cerebral palsy, is non-verbal and is G-tube fed. I have found from my life experience that there are not a lot of products on the market to help with different situations. So I have taken in hand, marketing different products to help. One is called the "GT Pad." I use to spend approximately $150 Canadian per year on gauze for her site, not including the prescriptions to help clear up problems. I have been using "GT Pads" for 4 years and am very happy with them and the money I have saved. I have found ten pads can last up to two years. - J.G., Medicine Hat, Alberta, Canada
We've found that, in addition to putting a 2"x2" split sponge between the skin and the button, using Silvadene cream regularly is the most effective way to keep the site mostly irritation-free.
Also, the best tape ever to hold the gauze against the skin (or an NG-tube to the cheek, or a nasal cannula) is Hypafix dressing retention sheet tape. The adhesive is very sticky, but doesn't hurt when pulled off, and it's hypoallergenic. The fabric is pliable and doesn't poke and it does need scissors to be cut. Most hospitals don't know about it, so you should ask for it to be ordered.
Bolus-feeding: when my son needed to be bolus-fed or vented with a 60cc barrel, we attached velcro to the barrel, and the corresponding piece to his feeding chair. For travel, we attached the corresponding piece to his car seat and his stroller. - L.S., Altadena, CA
My daughter, Marissa, has a G-tube and we have gone through the same horrors of granulation tissue as a lot of you. Marissa just recently had to have surgery to remove this tissue as the silver nitrate did not help. I received a good tip from a friend of mine on the G-tube network: simply place a makeup square or round under the tube. I have to cut a slit in it, but it fits great under the "peg." It was tried by many and seems to work miracles with preventing the tissue from growing back. - T.S., Glens Falls, NY
My daughter is 2 ½ years old. She has been on continuous feeds since she was 13 months old. I found a great way to keep her G-tube from coming out at night and at play. Take the tube and snake it through her diaper. Make sure to leave enough slack between her diaper and the button. To do this before I really had the system down, I would stand her up. The best diapers to use are the cheap ones with the tape; the Velcro ones don't keep the tube in place as well. - Initials, city and state unknown
Silver nitrate is needed for our child to keep granuloma in check. However, we find the nitrate can discolor and irritate the adjacent skin. Petroleum jelly or other such substance (we use an anti-bacterial jelly called Bactraban) can help protect this area of the skin surrounding the tube site. What also helps is to keep our daughter flat for awhile after application of the silver nitrate. My understanding is that the nitrate reduces the granuloma a bit, which may permit gastric oozing, causing the nitrate stains. - J.D., Haverford, PA
My son had a G-tube for years before I figured out the best way to clean the connector tubing. All you need is water and a table knife. WHILE YOU ARE RUNNING WATER THROUGH THE TUBE, hold the tube between your thumb and the dull side of a table knife, and act as if you were curling a ribbon on a birthday present. Press the tube hard between your thumb and the knife and run the knife/thumb the full length of the tube, in the direction that the water is flowing. The pressure of the "ribbon curling" action will loosen all the gunk, and the water carries it away. It takes 10 seconds, and it works on all tubes, even tubes too small for a pipe cleaner. This method also unblocks plugged tubes. - D.M., Traverse City, MI
To keep tubing from crimping at night due to rolling, I took an old toddler size sock, cut off the toe end, feed the tubing thru it and put it on his leg. This keeps the tubing in a general area and stops it from crimping. I have also heard of using a wrist sweatband. - T.H., Hilliard, OH
I stumbled on this site after my son's G-tube was removed, but kept the address. It is a great site for new or old G-tube users or people dealing with a loved one that has one: www.iinet.com.au/~scarffam/gtube.html. As far as traveling with my son, who by the way was a continuous G-tube feeder, it was very difficult until I got the hang of it. I made a hook out of a coat hanger for the bag to hang on and put it on the handle above the door with the pump on the floor. After stabilizing the pump, we were ready to ride. It is a process that takes practice getting from the house to the car and back again, but it can be done. I got tired of being home thinking I needed someone to help us go some place - being dependent on someone else's schedule. So, I experimented when I did have help, just in case I needed an extra hand to figure it out. Now, my son is fed by mouth only, and the G-tube was removed in December '98. Everyone isn't as lucky as we are, but if I can help one person out there with our quirky ways of doing things, I have accomplished more than I realize. - C.M., city and state unknown
Try putting a coat of clear nail polish over the numbers on a syringe to prevent them from washing off. - R.B., Calgary, Canada
For those of you crushing vitamins, I have a better solution. I crushed them for years until one day I decided to try placing the vitamin in a little medicine cup and adding about 10cc of water. The next morning, the vitamin is dissolved and needs no crushing. - J.P., city unknown, SC
My seven year old with HD used to have a G-tube, but this was replaced by a button (which is heaven sent). The button is so much easier than the tube and there is no bulk. It is pretty much flush with the skin. We do have a problem with the button leaking though. We use split two by twos to put under the button (2 packages). This makes the button a little tighter and helps to control leaking. I put a piece of tape across the gauze to keep the button closed during the day. - Initials, city and state unknown
For granulation tissue around the G-tube site, our doctor has prescribed Carafate suspension. We use a Q-tip to dab this on 2-3 times a day; this works really well. We also clean the site with normal saline (not the kind used for irrigation, but the kind used for cleaning) which is available over-the-counter in a large bottle (which lasts a long time). My 16 year old son has had a G-tube for about 9 years, so we have tried many remedies, but these work the best for us. There is also a very good multi-vitamin available in liquid form that we have used for years. It is Vi-Daylin, and is over-the-counter, but the pharmacy usually has to order it in. - B.S., Opelika, AL
I have found that using gauze around the G-tube works well to prevent irritation and granulation tissue as well. To avoid having to have scissors handy to make the ½ cut, I found that 2x2 I.V. split gauze works great! - C.C., Milwaukee, WI
For those who don't want to go through all the hassles of crushing vitamins, we have found that Shaklee makes a water soluble vitamin powder, called Vita-Lea. It dissolves readily and stays in suspension pretty well. The directions suggest mixing a teaspoon with several ounces of water, which can be a lot of additional fluids to administer. We use a smaller amount of water to mix the vitamins, and follow each syringe-ful with a plain water chaser, to keep the tube clear. - B.R., Forestville, CA
Our son is G-tube fed and has had lots of trouble with granulated tissue. We tried everything - cortisone cream, Destin (allergic) and silver nitrate - but nothing seemed to work. We started putting 2x2 gauze, cut in the middle, with Maalox on the area around the tube. By cutting the gauze, you can fit it around the tube next to the skin. This will leave the G-tube site open to connect to the pump. He has not had anymore granulated tissue. This is easy for us and painless for him. At the first sign of irritation, we get the Maalox out. - R.H., Cookeville, TN
When mixing medications for G-tube use, dilute the medication with a small amount of fairly warm water and when the medication is dissolved enough, add a small amount of cool water to make it a comfortable temperature. Most medications will dissolve well this way. - L.A., Colts Neck, NJ
To clean the extension sets for G-tubes, use extra-long pipe cleaners and hot soapy water. The long pipe cleaners can be bought in craft supply stores and work really well to remove the build up from inside the tube. - M.O., Ontario, Canada
A caution on the use of cortisone cream to treat granulation tissue: cortisone should only be used on an "off-again, on-again" basis, as it is a steroid, and can, over time, cause the skin to become thin and weak. Used three days on, three days off is reasonable. Used only on an "as-needed" basis is best. It is also great to combine cortisone cream with an over-the-counter antibiotic ointment (e.g., Bacitracin) and an antifungal cream (e.g., Lotrimin). This triple-combination approximates a commercial product called Kenalog cream (triamcinolone), which is popularly recommended by many parents on the G-tube mailing list. - S.G., Sudbury, MA
My daughter, who is G-tube fed, needs to take a multivitamin with minerals. The best ones I have found are the Bugs Bunny brand. They are sugar free and crush much easier than the others I have tried. Another plus is that they are cheaper and a child under 4 only has to take ½ of one instead of a whole one! - J.J., Denton, MD
I use the wooden end of the long Q-tips to clean the extension tube to my son's G-tube. I just put in a drop of soap and then rinse well. Also, once a week, I soak it in 1/2 strength vinegar and then wash. - T.H., Hilliard, OH
Our son has a G-tube and has had problems with granulation tissue. I have found that cortisone cream shrinks the granulation tissue, and Desitin heals the irritation. Works wonders for us. - D.B., Dubuque, IA
For those of you who need to crush pills to put in a G-tube, I highly recommend a syringe by Nestle called the HandiCrush. You place the pill in the crusher and put in the plunger. One turn and the pills are crushed. Then, you suck up water or whatever to mix it. No more trying to get a little bit out of the medicine cup. - T.R., Dickinson, ND
Our daughter has a G-Button that continually leaks due to granulation tissue. We have tried silver-nitrate and that didn't seem to help. So we took a disposable nursing pad and folded it into fourths and cut the corner off, leaving a hole in the center. We then cut two vertical lines opposite of each other. We clean her button, dry it, and put Desitin under it. Then we gently ease the nursing pad over the button and underneath it. It collects all of the moisture and draws it away from her skin. It stays in place all day or night. I am pleased to say, the granulation tissue has all but disappeared on its own! - K.T., Avon, IN
Recently, we took our 15 month old daughter, who is G-tube fed, on a trip to Australia to visit her grandparents. She gets a bolus feeding every few hours, so we have to take her tube and syringe with us, whenever we venture out. I had tried wrapping them in paper towels and putting them in her diaper bag. They usually ended up unwrapped and at the bottom of the bag or worse yet, on the ground, after we had rummaged through the bag a few times - yuck! We found a travel case in K-mart for a toothbrush and toothpaste that fit perfectly. If you detach the tube from the syringe, they lay on top of one another! Now you have a wonderful G-Tube travel case. - K.T., Avon, IN
My daughter has had a G-tube since birth. She now has the button, which is much better. Her tube has always given us a problem with leaking. I have tried gauze in many sizes and make-up sponges that are circular with the hole cut out of the middle. These have worked, but I have found that taking 2 pieces of toilet paper or ½ a piece of a tissue, rolling it up like a cigarette, and then wrapping it around the tube works very well. This can be replaced wherever and whenever needed. This has kept my daughter dry and very clean. Even her doctor has bragged about this idea and how great her site looks. - J.L.S., Cleveland, TN
When my son began continuous feeds through the night with a pump, I was worried about the tube wrapping around his leg or arm and the pump alarm going off all the time. Then, I came across an item that holds him in one position, yet he has room to turn and move in. It’s called The Tucker Sling and it has been a life saver!! Their website shows pictures of the sling, and they have various sizes depending on the size of your child. - D.F., Modesto, CA
Our daughter had terrible granulation tissue before someone told us about eucalyptus oil. We now use it everyday and have no build-up around the tube. It will also bring down the tissue. It has to be diluted: 2 drops of oil to 10-20 ml. of water. I swab it around the tube area with Q-tips. You may want to test it on another area first to be sure there will not be an allergic reaction. For my daughter, it worked wonderfully. I know of lots of other parents who have also tried it and had very good results. No more silver nitrate burns! I would recommend trying it. The oil can be bought at health stores or off the Internet. - L.J., city and state unknown
My daughter has had a G-tube for about five years. Her nutrition is solely from her G-tube feeds. I use a creme around the site that’s called Calmeseptine. It's fairly new on the market and works very well for that area. I put the creme on 3 times a day and then cover it each time with a 2 x 2 gauze. My daughter very rarely has any problems with granulation or infection by the G-tube site. - J.K., city and state unknown
To clean the G-tube, pour flat Coke/cola through the tube. It works wonders. Also to prevent leakage and skin irritation, use 4 x 4 tracheostomy drain sponges. They can be purchased at many drug stores. - D.T., Kenner, LA
We try to make our son's feeding bags last a few days, but to avoid bacterial growth, we refrigerate the bag between cleanings. Works for food, and for food bags! - K.H., Rockford, IL
My son had horrible problems with granulation tissue around his G-tube since the day it was placed. We were using silver nitrate every 2 to 4 days. We tried creams, antacids, Cholestin, and IV sponges, but none healed him. Someone told us about foam dressings. It worked! My son's G-tube site has been healed for the first time in 4 years! The brand name is called Hydrasorb. It is a foam dressing, and it absorbs any leakage and it cuts down on the scar tissue. It took about two months to fully heal while using this dressing, but his stomach is now dry and tight and the scar tissue has lessened. Try it! - D.M., Traverse City, MI
I have a 16 year old daughter who has cerebral palsy, is non-verbal and is G-tube fed. I have found from my life experience that there are not a lot of products on the market to help with different situations. So I have taken in hand, marketing different products to help. One is called the "GT Pad." I use to spend approximately $150 Canadian per year on gauze for her site, not including the prescriptions to help clear up problems. I have been using "GT Pads" for 4 years and am very happy with them and the money I have saved. I have found ten pads can last up to two years. - J.G., Medicine Hat, Alberta, Canada
We've found that, in addition to putting a 2"x2" split sponge between the skin and the button, using Silvadene cream regularly is the most effective way to keep the site mostly irritation-free.
Also, the best tape ever to hold the gauze against the skin (or an NG-tube to the cheek, or a nasal cannula) is Hypafix dressing retention sheet tape. The adhesive is very sticky, but doesn't hurt when pulled off, and it's hypoallergenic. The fabric is pliable and doesn't poke and it does need scissors to be cut. Most hospitals don't know about it, so you should ask for it to be ordered.
Bolus-feeding: when my son needed to be bolus-fed or vented with a 60cc barrel, we attached velcro to the barrel, and the corresponding piece to his feeding chair. For travel, we attached the corresponding piece to his car seat and his stroller. - L.S., Altadena, CA
My daughter, Marissa, has a G-tube and we have gone through the same horrors of granulation tissue as a lot of you. Marissa just recently had to have surgery to remove this tissue as the silver nitrate did not help. I received a good tip from a friend of mine on the G-tube network: simply place a makeup square or round under the tube. I have to cut a slit in it, but it fits great under the "peg." It was tried by many and seems to work miracles with preventing the tissue from growing back. - T.S., Glens Falls, NY
My daughter is 2 ½ years old. She has been on continuous feeds since she was 13 months old. I found a great way to keep her G-tube from coming out at night and at play. Take the tube and snake it through her diaper. Make sure to leave enough slack between her diaper and the button. To do this before I really had the system down, I would stand her up. The best diapers to use are the cheap ones with the tape; the Velcro ones don't keep the tube in place as well. - Initials, city and state unknown
Silver nitrate is needed for our child to keep granuloma in check. However, we find the nitrate can discolor and irritate the adjacent skin. Petroleum jelly or other such substance (we use an anti-bacterial jelly called Bactraban) can help protect this area of the skin surrounding the tube site. What also helps is to keep our daughter flat for awhile after application of the silver nitrate. My understanding is that the nitrate reduces the granuloma a bit, which may permit gastric oozing, causing the nitrate stains. - J.D., Haverford, PA
My son had a G-tube for years before I figured out the best way to clean the connector tubing. All you need is water and a table knife. WHILE YOU ARE RUNNING WATER THROUGH THE TUBE, hold the tube between your thumb and the dull side of a table knife, and act as if you were curling a ribbon on a birthday present. Press the tube hard between your thumb and the knife and run the knife/thumb the full length of the tube, in the direction that the water is flowing. The pressure of the "ribbon curling" action will loosen all the gunk, and the water carries it away. It takes 10 seconds, and it works on all tubes, even tubes too small for a pipe cleaner. This method also unblocks plugged tubes. - D.M., Traverse City, MI
To keep tubing from crimping at night due to rolling, I took an old toddler size sock, cut off the toe end, feed the tubing thru it and put it on his leg. This keeps the tubing in a general area and stops it from crimping. I have also heard of using a wrist sweatband. - T.H., Hilliard, OH
I stumbled on this site after my son's G-tube was removed, but kept the address. It is a great site for new or old G-tube users or people dealing with a loved one that has one: www.iinet.com.au/~scarffam/gtube.html. As far as traveling with my son, who by the way was a continuous G-tube feeder, it was very difficult until I got the hang of it. I made a hook out of a coat hanger for the bag to hang on and put it on the handle above the door with the pump on the floor. After stabilizing the pump, we were ready to ride. It is a process that takes practice getting from the house to the car and back again, but it can be done. I got tired of being home thinking I needed someone to help us go some place - being dependent on someone else's schedule. So, I experimented when I did have help, just in case I needed an extra hand to figure it out. Now, my son is fed by mouth only, and the G-tube was removed in December '98. Everyone isn't as lucky as we are, but if I can help one person out there with our quirky ways of doing things, I have accomplished more than I realize. - C.M., city and state unknown
Try putting a coat of clear nail polish over the numbers on a syringe to prevent them from washing off. - R.B., Calgary, Canada
For those of you crushing vitamins, I have a better solution. I crushed them for years until one day I decided to try placing the vitamin in a little medicine cup and adding about 10cc of water. The next morning, the vitamin is dissolved and needs no crushing. - J.P., city unknown, SC
My seven year old with HD used to have a G-tube, but this was replaced by a button (which is heaven sent). The button is so much easier than the tube and there is no bulk. It is pretty much flush with the skin. We do have a problem with the button leaking though. We use split two by twos to put under the button (2 packages). This makes the button a little tighter and helps to control leaking. I put a piece of tape across the gauze to keep the button closed during the day. - Initials, city and state unknown
For granulation tissue around the G-tube site, our doctor has prescribed Carafate suspension. We use a Q-tip to dab this on 2-3 times a day; this works really well. We also clean the site with normal saline (not the kind used for irrigation, but the kind used for cleaning) which is available over-the-counter in a large bottle (which lasts a long time). My 16 year old son has had a G-tube for about 9 years, so we have tried many remedies, but these work the best for us. There is also a very good multi-vitamin available in liquid form that we have used for years. It is Vi-Daylin, and is over-the-counter, but the pharmacy usually has to order it in. - B.S., Opelika, AL
I have found that using gauze around the G-tube works well to prevent irritation and granulation tissue as well. To avoid having to have scissors handy to make the ½ cut, I found that 2x2 I.V. split gauze works great! - C.C., Milwaukee, WI
For those who don't want to go through all the hassles of crushing vitamins, we have found that Shaklee makes a water soluble vitamin powder, called Vita-Lea. It dissolves readily and stays in suspension pretty well. The directions suggest mixing a teaspoon with several ounces of water, which can be a lot of additional fluids to administer. We use a smaller amount of water to mix the vitamins, and follow each syringe-ful with a plain water chaser, to keep the tube clear. - B.R., Forestville, CA
Our son is G-tube fed and has had lots of trouble with granulated tissue. We tried everything - cortisone cream, Destin (allergic) and silver nitrate - but nothing seemed to work. We started putting 2x2 gauze, cut in the middle, with Maalox on the area around the tube. By cutting the gauze, you can fit it around the tube next to the skin. This will leave the G-tube site open to connect to the pump. He has not had anymore granulated tissue. This is easy for us and painless for him. At the first sign of irritation, we get the Maalox out. - R.H., Cookeville, TN
When mixing medications for G-tube use, dilute the medication with a small amount of fairly warm water and when the medication is dissolved enough, add a small amount of cool water to make it a comfortable temperature. Most medications will dissolve well this way. - L.A., Colts Neck, NJ
To clean the extension sets for G-tubes, use extra-long pipe cleaners and hot soapy water. The long pipe cleaners can be bought in craft supply stores and work really well to remove the build up from inside the tube. - M.O., Ontario, Canada
A caution on the use of cortisone cream to treat granulation tissue: cortisone should only be used on an "off-again, on-again" basis, as it is a steroid, and can, over time, cause the skin to become thin and weak. Used three days on, three days off is reasonable. Used only on an "as-needed" basis is best. It is also great to combine cortisone cream with an over-the-counter antibiotic ointment (e.g., Bacitracin) and an antifungal cream (e.g., Lotrimin). This triple-combination approximates a commercial product called Kenalog cream (triamcinolone), which is popularly recommended by many parents on the G-tube mailing list. - S.G., Sudbury, MA
My daughter, who is G-tube fed, needs to take a multivitamin with minerals. The best ones I have found are the Bugs Bunny brand. They are sugar free and crush much easier than the others I have tried. Another plus is that they are cheaper and a child under 4 only has to take ½ of one instead of a whole one! - J.J., Denton, MD
I use the wooden end of the long Q-tips to clean the extension tube to my son's G-tube. I just put in a drop of soap and then rinse well. Also, once a week, I soak it in 1/2 strength vinegar and then wash. - T.H., Hilliard, OH
Our son has a G-tube and has had problems with granulation tissue. I have found that cortisone cream shrinks the granulation tissue, and Desitin heals the irritation. Works wonders for us. - D.B., Dubuque, IA
For those of you who need to crush pills to put in a G-tube, I highly recommend a syringe by Nestle called the HandiCrush. You place the pill in the crusher and put in the plunger. One turn and the pills are crushed. Then, you suck up water or whatever to mix it. No more trying to get a little bit out of the medicine cup. - T.R., Dickinson, ND
Our daughter has a G-Button that continually leaks due to granulation tissue. We have tried silver-nitrate and that didn't seem to help. So we took a disposable nursing pad and folded it into fourths and cut the corner off, leaving a hole in the center. We then cut two vertical lines opposite of each other. We clean her button, dry it, and put Desitin under it. Then we gently ease the nursing pad over the button and underneath it. It collects all of the moisture and draws it away from her skin. It stays in place all day or night. I am pleased to say, the granulation tissue has all but disappeared on its own! - K.T., Avon, IN
Recently, we took our 15 month old daughter, who is G-tube fed, on a trip to Australia to visit her grandparents. She gets a bolus feeding every few hours, so we have to take her tube and syringe with us, whenever we venture out. I had tried wrapping them in paper towels and putting them in her diaper bag. They usually ended up unwrapped and at the bottom of the bag or worse yet, on the ground, after we had rummaged through the bag a few times - yuck! We found a travel case in K-mart for a toothbrush and toothpaste that fit perfectly. If you detach the tube from the syringe, they lay on top of one another! Now you have a wonderful G-Tube travel case. - K.T., Avon, IN
Monday, April 7, 2008
Feeding Tips
We have a child with Down syndrome. At around age 5, we wanted her to drink from a cup using a straw - just like all the other kids do. She could not understand the concept of "sucking" on the straw. By accident, after many attempts, we told her to "kiss" the straw. This produced the "sucking" motion and she caught on from that point forward. We have told several other parents who have children with DS and it has worked for them too. This allows the child and parent the freedom to buy things like drinking boxes. - L.F., Winnipeg, Manitoba, Canada
I saw the comment on the lack of large bibs for adults. One suggestion would be to get a length of ribbon and sew on clips, such as alligator clips, onto both ends. That way, you can use anything as a bib; just hang the ribbon on the person's neck and clip it to the towel, napkin, etc. I got this idea from a Teletubby travel kit that came with a sippy cup, a bowl and a gadget such as the one I just described, so we can use the restaurant's paper napkins in an emergency. - C.P., Midwest City, OK
If your child is on a pureed food diet, and you are going out for the day, heat the food before leaving and put it in a thermos. It will stay hot for hours. You can also use these for cold food. I even bought my daughter her own special little lunch bucket, so now she can have lunch anywhere we go. - L.J., Sioux Falls, SD
When I finally got tired of just feeding my daughter the tasteless baby food, I looked for something else that would puree smoothly in the blenders. I buy the Hormel microwave cup (they have potato and ham, broccoli and cheese, spaghetti, beans and wieners, chicken noodle or dumpling, etc.), and my daughter loves them much better than baby food. If your child is still doing baby food, it’s a quick and fast meal. Also, I puree bananas and canned fruit and vegetables. I give her a very high protein drink: one banana with a package of Carnation breakfast and 7 ounces of whole milk with a cup of ice cream. I throw it in the blender and when I pour it in the cup, I pour on chocolate milk. Cereal I grind into a power and then add milk until smooth. For other ideas, you can order a great pureed recipe book by Randy Wilson called Non-Chew Foods. - L.J., Sioux Falls, SD
My 17 year old daughter has difficulty handling foods like soup or cereal that have different textures in the same bite. We solved the problem by mixing her breakfast cereal with low fat yogurt instead of milk. She loves to decide which flavor and no spilled milk!! - B.P., Oklahoma City, OK
Johanna has quadriplegic athetoid cerebral palsy, accompanied by marked oral motor deficits. After 15 years, we've found that the best way to prepare her food is still the "Happy Baby" brand baby-food grinder (formerly made by Bowland-Jacobs of Yorkville, IL; I don't know if they're still made). The problem with food processors, or any motorized food preparation method, is that they tend to turn the food into soup. The perforated metal plate of the Happy Baby grinder, with slow manual grinding, leaves enough texture in the food to exercise what oral motor skills Johanna has. We suspect the old-style metal grinders used about 50 years ago for meat grinding, would also work well. - E.A., Boulder, CO
When your child is just beginning to eat, or if your child has some feeding problems, use a baby food grinder to grind up small portions of your leftovers. Freeze them in ice cube trays to use when your child needs a quick nutritious snack. - C.U., city and state unknown
My son won't eat vegetables, so I grate them finely and add them to ground meat for hamburger patties, cornbread, spaghetti sauce, stuffing, etc. I use any combination of carrots, zucchini, squash, mushrooms, celery, eggplant, and/or bell pepper. I also add fortified baby cereal to gravies, mashed potatoes, sauces, etc. to increase vitamin content. - J.J., New Orleans, LA
Use pudding or other thick sticky food for children learning to feed themselves. It will stick to the utensils and provide the child with success getting food to their mouths without it falling off by the time the utensil reaches the mouth. - D.S., Fayetteville, NC
My son loves to eat in his room, in front of his TV/VCR, on a tray. To keep the spills at a minimum on my carpet, I went to the office supply store and bought a mat that goes under your computer chair. The short end fits under the TV and he doesn't try to pull it up because it is hard, heavy plastic. It stays put on the carpet and works like a charm - wipes up perfectly. Just spray a little bleach type cleaner and wipe away... it's sanitary, a cinch to clean and no more stains on my carpet. The small ones run around $9.95 at Office Depot. - M.G., Louisville, KY
I have a 17 year old severely mentally handicapped daughter. She has severe motor deficits in all areas. She walked at age 6 and was toilet trained at age 10. A way we taught her to use a straw and even helped with the sippie cups was using a drink box, with a straw. We would put the straw into her mouth and squeeze the box and the liquid would come out. Through this we were able to teach her how to drink with a straw. - M.H., Springfield, LA
My son is 15 months old and requires all of his fluids to be thickened for him to tolerate them. I have found the best product so far (after trying a number of them) to be the Novartis Nutrition/Resource Product Range. They supply Thicken-Up powder and also pre-thickened juices - which are very convenient for traveling. Also, they have a product called Dairy Thick. They have an office I believe in Minnesota. - N.B., Brisbane, Queensland, Australia
I was just at a vendor fair and was looking at one of the catalogs and saw a bib for larger kids. I was about to try to sew something to use for my 9 year old so she wouldn't get food all over her clothes when she eats. This large bib made me think of the plastic art smocks that you buy for art at school. It has a pocket at the bottom to catch food. I haven't found one yet, but that might give someone an idea. - S.S., Aurora, IL
Several years ago, I was a teacher of orthopedically and multi-handicapped children, along with being a camp counselor for children with a variety of special needs. In an effort to escape the perpetual "graham cracker and juice" snack routine at camp, I decided to try Jell-O jiggles; I had tried them in my classroom, and they had been a big hit. One of the campers began chewing for the first time ever(!), and his mother was thrilled enough to continue fixing them for him! They are easy to prepare, and the recipe is on the box of most Jell-O packages (regular and sugar-free). I have also used pure juice and gelatin; they taste great, but the lack of preservatives keeps them from staying firm as long. That was fine (and preferred) for our own children, but the length of time required to feed some of my "other" children warranted the longer-lasting variety. - H.B., Jefferson, NC
I am a single parent of two wonderful children, Samantha, 5 years old, and Henry, 9 years old. Henry has special needs. He has cerebral palsy, is blind, delayed, has seizures, and more; a great kid nonetheless. Anyway, he does not have a G-tube and eats by mouth. I have to feed him, but I prefer that to the G-tube. He doesn't have any vision, and I didn't want to take taste away from him. Well, we've always had a hard time getting him to drink so that he doesn't dehydrate, especially in the summer. We used cups and 10cc syringes, but they would always spill and it would take over an hour to drink 8 ounces of water. We wouldn't even bother with other drinks, like milk or juices, because of how long it took to get him to drink. Water was essential; the benefits of the other drinks could be found in foods he could eat. Anyway, one day, while on my way back from a trip to California, I was in the car and knew that he needed to drink. A general rule I have is if I'm thirsty, he's thirsty, so if I drink, he drinks. Well, no cup and I couldn't find the syringe amongst the chaos in the van. I did have a spray bottle though, which is what I used to spray the kids faces and necks in the heat. IDEA! I pointed the squirt bottle into the side of his mouth and squirted. He was startled at first, but the spray tickled his throat and he started laughing. The spray was enough to stay in his mouth and he swallowed it with no problem. From this day forward, I use squirt bottles to make sure that he drinks enough. The nice thing about it is that I have bottles for milk, bottles for juice, for soda, for water and in the same time it used to take him to drink 8 ounces of water before, he can drink any of his drinks, plus water, plus finish his meals. I always have a squirt bottle on his chair wherever we go - to spray his face and to quench his thirst. It works great! - C.W., Phoenix, AZ
My son tends to want to push his food towards him when he is eating finger foods. Well, since I have yet to see someone come up with a feeding tray, such as one on a wheelchair (completely lipped all the way around), he was pushing food into his lap and the chair. What helped was a cheap ($2.99) half-round, plastic chip and dip dish. I attached velcro strips to the bottom and matching strips to the tray, so that it was more difficult for him to push the dish off of the tray. Hope this helps. - M.H., Adrian, MI
For Madeline (age 18), who is a messy eater because of her disability, we cannot find suitable sized bibs at an affordable price to protect her clothing, so we use towels. We use some so-called "guest towels" which are too small in our minds for towels (large enough to dry hands on once), but are larger than a face cloth. Also, we had some towels which we didn't really like (a free gift from a shopping catalogue), so I cut them down to what I though was an appropriate size and sewed cotton ribbon for the ties. Some home-made bibs don't have ties, so I just tuck them into her collar and spend a lot of meal time re-tucking them in! - T.H., Bristol, UK
My son is hyposensitive in his mouth and can't feel foods or liquids until they hit his gag reflex, and then we get aspiration, etc. We tried "Thick-It" and that helped a little but we couldn't use it with his medications because of problems with binding. We hit the jackpot when his occupational therapist suggested making everything REALLY cold, almost freezing. He can feel that sooner and giving him 5 cc's of medications has dropped from a 30 minute choking ordeal, to a 3 minute regular kid kind of thing. He is even starting to eat cereal (thick and cold). It sounds disgusting, but it works! Talk to your doctor to be sure your child's medications can be put in the fridge. - T.S., Santaquin, UT
I saw the comment on the lack of large bibs for adults. One suggestion would be to get a length of ribbon and sew on clips, such as alligator clips, onto both ends. That way, you can use anything as a bib; just hang the ribbon on the person's neck and clip it to the towel, napkin, etc. I got this idea from a Teletubby travel kit that came with a sippy cup, a bowl and a gadget such as the one I just described, so we can use the restaurant's paper napkins in an emergency. - C.P., Midwest City, OK
If your child is on a pureed food diet, and you are going out for the day, heat the food before leaving and put it in a thermos. It will stay hot for hours. You can also use these for cold food. I even bought my daughter her own special little lunch bucket, so now she can have lunch anywhere we go. - L.J., Sioux Falls, SD
When I finally got tired of just feeding my daughter the tasteless baby food, I looked for something else that would puree smoothly in the blenders. I buy the Hormel microwave cup (they have potato and ham, broccoli and cheese, spaghetti, beans and wieners, chicken noodle or dumpling, etc.), and my daughter loves them much better than baby food. If your child is still doing baby food, it’s a quick and fast meal. Also, I puree bananas and canned fruit and vegetables. I give her a very high protein drink: one banana with a package of Carnation breakfast and 7 ounces of whole milk with a cup of ice cream. I throw it in the blender and when I pour it in the cup, I pour on chocolate milk. Cereal I grind into a power and then add milk until smooth. For other ideas, you can order a great pureed recipe book by Randy Wilson called Non-Chew Foods. - L.J., Sioux Falls, SD
My 17 year old daughter has difficulty handling foods like soup or cereal that have different textures in the same bite. We solved the problem by mixing her breakfast cereal with low fat yogurt instead of milk. She loves to decide which flavor and no spilled milk!! - B.P., Oklahoma City, OK
Johanna has quadriplegic athetoid cerebral palsy, accompanied by marked oral motor deficits. After 15 years, we've found that the best way to prepare her food is still the "Happy Baby" brand baby-food grinder (formerly made by Bowland-Jacobs of Yorkville, IL; I don't know if they're still made). The problem with food processors, or any motorized food preparation method, is that they tend to turn the food into soup. The perforated metal plate of the Happy Baby grinder, with slow manual grinding, leaves enough texture in the food to exercise what oral motor skills Johanna has. We suspect the old-style metal grinders used about 50 years ago for meat grinding, would also work well. - E.A., Boulder, CO
When your child is just beginning to eat, or if your child has some feeding problems, use a baby food grinder to grind up small portions of your leftovers. Freeze them in ice cube trays to use when your child needs a quick nutritious snack. - C.U., city and state unknown
My son won't eat vegetables, so I grate them finely and add them to ground meat for hamburger patties, cornbread, spaghetti sauce, stuffing, etc. I use any combination of carrots, zucchini, squash, mushrooms, celery, eggplant, and/or bell pepper. I also add fortified baby cereal to gravies, mashed potatoes, sauces, etc. to increase vitamin content. - J.J., New Orleans, LA
Use pudding or other thick sticky food for children learning to feed themselves. It will stick to the utensils and provide the child with success getting food to their mouths without it falling off by the time the utensil reaches the mouth. - D.S., Fayetteville, NC
My son loves to eat in his room, in front of his TV/VCR, on a tray. To keep the spills at a minimum on my carpet, I went to the office supply store and bought a mat that goes under your computer chair. The short end fits under the TV and he doesn't try to pull it up because it is hard, heavy plastic. It stays put on the carpet and works like a charm - wipes up perfectly. Just spray a little bleach type cleaner and wipe away... it's sanitary, a cinch to clean and no more stains on my carpet. The small ones run around $9.95 at Office Depot. - M.G., Louisville, KY
I have a 17 year old severely mentally handicapped daughter. She has severe motor deficits in all areas. She walked at age 6 and was toilet trained at age 10. A way we taught her to use a straw and even helped with the sippie cups was using a drink box, with a straw. We would put the straw into her mouth and squeeze the box and the liquid would come out. Through this we were able to teach her how to drink with a straw. - M.H., Springfield, LA
My son is 15 months old and requires all of his fluids to be thickened for him to tolerate them. I have found the best product so far (after trying a number of them) to be the Novartis Nutrition/Resource Product Range. They supply Thicken-Up powder and also pre-thickened juices - which are very convenient for traveling. Also, they have a product called Dairy Thick. They have an office I believe in Minnesota. - N.B., Brisbane, Queensland, Australia
I was just at a vendor fair and was looking at one of the catalogs and saw a bib for larger kids. I was about to try to sew something to use for my 9 year old so she wouldn't get food all over her clothes when she eats. This large bib made me think of the plastic art smocks that you buy for art at school. It has a pocket at the bottom to catch food. I haven't found one yet, but that might give someone an idea. - S.S., Aurora, IL
Several years ago, I was a teacher of orthopedically and multi-handicapped children, along with being a camp counselor for children with a variety of special needs. In an effort to escape the perpetual "graham cracker and juice" snack routine at camp, I decided to try Jell-O jiggles; I had tried them in my classroom, and they had been a big hit. One of the campers began chewing for the first time ever(!), and his mother was thrilled enough to continue fixing them for him! They are easy to prepare, and the recipe is on the box of most Jell-O packages (regular and sugar-free). I have also used pure juice and gelatin; they taste great, but the lack of preservatives keeps them from staying firm as long. That was fine (and preferred) for our own children, but the length of time required to feed some of my "other" children warranted the longer-lasting variety. - H.B., Jefferson, NC
I am a single parent of two wonderful children, Samantha, 5 years old, and Henry, 9 years old. Henry has special needs. He has cerebral palsy, is blind, delayed, has seizures, and more; a great kid nonetheless. Anyway, he does not have a G-tube and eats by mouth. I have to feed him, but I prefer that to the G-tube. He doesn't have any vision, and I didn't want to take taste away from him. Well, we've always had a hard time getting him to drink so that he doesn't dehydrate, especially in the summer. We used cups and 10cc syringes, but they would always spill and it would take over an hour to drink 8 ounces of water. We wouldn't even bother with other drinks, like milk or juices, because of how long it took to get him to drink. Water was essential; the benefits of the other drinks could be found in foods he could eat. Anyway, one day, while on my way back from a trip to California, I was in the car and knew that he needed to drink. A general rule I have is if I'm thirsty, he's thirsty, so if I drink, he drinks. Well, no cup and I couldn't find the syringe amongst the chaos in the van. I did have a spray bottle though, which is what I used to spray the kids faces and necks in the heat. IDEA! I pointed the squirt bottle into the side of his mouth and squirted. He was startled at first, but the spray tickled his throat and he started laughing. The spray was enough to stay in his mouth and he swallowed it with no problem. From this day forward, I use squirt bottles to make sure that he drinks enough. The nice thing about it is that I have bottles for milk, bottles for juice, for soda, for water and in the same time it used to take him to drink 8 ounces of water before, he can drink any of his drinks, plus water, plus finish his meals. I always have a squirt bottle on his chair wherever we go - to spray his face and to quench his thirst. It works great! - C.W., Phoenix, AZ
My son tends to want to push his food towards him when he is eating finger foods. Well, since I have yet to see someone come up with a feeding tray, such as one on a wheelchair (completely lipped all the way around), he was pushing food into his lap and the chair. What helped was a cheap ($2.99) half-round, plastic chip and dip dish. I attached velcro strips to the bottom and matching strips to the tray, so that it was more difficult for him to push the dish off of the tray. Hope this helps. - M.H., Adrian, MI
For Madeline (age 18), who is a messy eater because of her disability, we cannot find suitable sized bibs at an affordable price to protect her clothing, so we use towels. We use some so-called "guest towels" which are too small in our minds for towels (large enough to dry hands on once), but are larger than a face cloth. Also, we had some towels which we didn't really like (a free gift from a shopping catalogue), so I cut them down to what I though was an appropriate size and sewed cotton ribbon for the ties. Some home-made bibs don't have ties, so I just tuck them into her collar and spend a lot of meal time re-tucking them in! - T.H., Bristol, UK
My son is hyposensitive in his mouth and can't feel foods or liquids until they hit his gag reflex, and then we get aspiration, etc. We tried "Thick-It" and that helped a little but we couldn't use it with his medications because of problems with binding. We hit the jackpot when his occupational therapist suggested making everything REALLY cold, almost freezing. He can feel that sooner and giving him 5 cc's of medications has dropped from a 30 minute choking ordeal, to a 3 minute regular kid kind of thing. He is even starting to eat cereal (thick and cold). It sounds disgusting, but it works! Talk to your doctor to be sure your child's medications can be put in the fridge. - T.S., Santaquin, UT
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