Tongue Tied?
Greetings to everyone!
Today, Xavier transitioned from physical therapist to occupational therapist. To help with the transition, both therapists met with him, spending about an hour with Xavier. The reason for the transition is to see if an occupational therapist can get Xavier to eat better, and to be happy about it. Rebecca managed Xavier's eating schedule this morning so he would be hungry when the therapists arrived. The intent was to let the OT observe how he eats.
Xavier, for his part, was in rare form. Rebecca said she has never seen him so excited. Apparently, he was a shameless flirt, smiling and racing around putting on a show for the two ladies.
The occupational therapist's name is Neve. Interestingly, Neve is the same therapist who worked with Xavier last summer, while he was still on oxygen. At that time, we were still deciding between PT and OT. We had Xavier home from the NICU a week or two when Rebecca and Xavier first met Neve. At that time, she thought Rebecca was detached from Xavier. That statement did not set well with Rebecca, and it haunted her for months afterward. The re-introductions today ended on a more positive note.
Neve thinks Xavier's lackluster eating habits may be due to a fairly rare condition. She used a phrase which perfectly describes how Xavier manages food offered to him, be it by bottle, spoon or finger: he "guards his mouth." Her more lengthy analysis wholly encompasses everything we've noted about Xavier's eating behaviors, as well as some other behaviors we have observed with some concern.
One of the observations Neve made was that Xavier should be sticking his tongue out further than he does. When he does "stick his tongue out," it never comes out passed his bottom lip, and his bottom lip pulls backward in toward his mouth. At Xavier's first meeting with Dr. Abbey, he also noted the same condition Neve diagnosed. He stated it as a passing comment and did not appear concerned, so we thought little more about it.
Xavier has Ankyloglossia. He is tongue-tied. This explains why he does not eat as much as he should be eating. It limits Xavier's ability to manipulate food in his mouth and to work it back where he can comfortably swallow. It also makes sucking on a bottle more difficult for similar reasons. It also is and will interfere with his ability to learn and practice speech.
Neve told us to discuss this with Dr. Abbey next week at Xavier's 1-year checkup. The correction is straightforward, requiring the skills of a dentist. Basically, it involves a minor surgery in cutting back the lingual frenulum to loose the tongue. We will know more about this next Wednesday.
If this turns out to be the case, it's amazing how simple a thing affects so much. Here we had Xavier seeing liver specialists and gastroenterology specialists to solve his slow growth and refusal to eat doctor-prescribed amounts of food. The whole problem may come down to Xavier's little tongue not having the freedom it needs.
Changing to an occupational therapist may well be Father's hand once more guiding us through the adventure of parenting Xavier!