I seriously cannot believe I'm typing this, but BODIE PASSED HIS SWALLOW STUDY!!!
Yes, for real - he passed it! What an unbelievable answer to prayer! I am still in total shock! THANK GOD!
So what exactly is a "swallow study" and what's the big deal with passing one? Oh, I'm so glad you asked. :-) I found a great description of a swallow study from the Children's Hospital of Boston's website:
A videofluoroscopic swallow study (also commonly referred to as modified barium swallow study) is an objective assessment of swallow function.
How is the test performed?
The child is seen in radiology in conjunction with both a pediatric radiologist and speech language pathologist with specialized training in pediatric dysphagia. The parent remains with the child in the radiology suite.
What happens during the study?
The child is positioned in a typical feeding position consistent with their age and development. They are given a variety of food consistencies (thin liquid, thick liquid, puree, soft solid, hard solid) injected with barium. The study assesses all 3 phases of the swallow from the oral preparatory phase, oral initiation phase and the pharyngeal phase.
Why is the study conducted?
The purpose of this test is to assess for aspiration (food/liquid entering the trachea) from above with oral feeding.
What happens after the study is complete?
Results of the test are given to the family immediately upon completion of the test. The family is given specific instructions on what diet level and textures are safest for their child, what diet consistencies to avoid and when supplemental (NG-tube/ g-tube) feedings may be necessary.
Bodie had his first swallow study done at about a month old, during which he took thickened liquids just fine, but immediately aspirated the thin breastmilk. At the time, they recommended a repeat swallow study no sooner than 3-6 months. We finally had the repeat study done this morning.
Because Bodie is still coughing a fair amount from time to time (and throws up sometimes), we didn't expect to see much improvement from the swallow study (particularly because his scope 2 weeks ago still showed very minimal left vocal cord movement - the vocal cords are what prevent aspiration). But, lo and behold, not only did Bodie do great on the solids and the thickened breastmilk, but he also did just fine on the thin breastmilk!!! Seriously, I did not expect such great news. PRAISE GOD!!!!!
So what does this mean??? Most importantly, it means Bodie will no longer have to have thickened feeds!!! Presently, we thicken all of his bottles (we add one packet of nectar thickener to every 4oz of breastmilk) and meds (we more or less eyeball this one). But the OT today thought he would do absolutely fine if we stopped thickening! I think we will probably do 1/2 thickened for a week or so (1/2 a packet to every 4oz of breastmilk) and then stop the thickening entirely. It's really more for our peace of mind than anything - the OT thought he'd probably be fine stopping cold turkey. But we'd like to let him adjust - and given that he's been on thickened feeds for almost his entire life now, there's no hurry to rush him off if we can make it a bit easier to adjust. The OT told us to expect him to cough a lot as he adjusts (think of it like you've been drinking thick milkshakes your whole life and someone hands you thin milk without telling you that's what it is - it's going to take a while to adjust how hard you suck to drink it).
This will be SO MUCH better for Bodie. Most days, he drinks between 24 and 28 ounces of thickened breastmilk (with 10-15 ounces of solids on top of that) and a fair amount of that is thickener. It's not bad for him per se, but it's taking up empty space with no nutritional function essentially. It will be nice for him to get more bang for his buck with his bottles and hopefully gain weight even a little easier.
It also means that I could try to breastfeed him. I know, it sounds crazy, right? I mean, who seriously tries to breastfeed an 8 month old whose been bottlefed his whole life? Well, me. I absolutely intend to try. You never know - it's pretty much unheard of for a baby that old to take to breastfeeding, but that doesn't mean we won't try. One of my big sadnesses has been not being able to breastfeed Bodie. And you guys know me - when have I ever been afraid of a challenge? If you wouldn't mind being in prayer about that, I'd really appreciate it!
Thank you SO MUCH for all of your prayers for Bodie's vocal cords. Clearly, they have worked !Please, please keep them coming as we wean him off the thickener and pray that all goes well. We could not be prouder of our little guy. And if you need reason to be proud along with us, take a look at this pic, taken right around the time of his first swallow study. He has come so very, very far. :-)