Radiology- The Swallow Study

Colton was always a good eater. He'd drain his bottles and spit-up very little. He actually was better at eating than his brother. The only thing that we started to notice was that he'd get really congested when he ate. When I'd go to burp him, he'd cough a lot. I thought it was because he was still getting over a cold, but our Pediatrician recommended at his 2 month check-up that we have a Swallow Study done. I left her office thinking, "What the heck is a swallow study? Guess I'll find out pretty soon!" They told me that it would probably be another 3-4 weeks until our appointment. So, I waited for Children's Hospital to call me with our appointment time. They actually called me a few days later and said, "We have an opening for tomorrow morning at 10, can you come?" Well, sure. My new life as a stay at home mom allows me to be super flexible, thank goodness!

At 10 weeks old, Colton and I made our way to the Radiology department of Children's Hospital. I didn't know what to expect. They told me not to feed him anything 3 hours before the appointment. A Speech Language Pathologist came and got us and we went back to an X-ray room. They put Colton in a highchair/car seat looking thing, next to an X-ray machine. We all had to wear those thick vests.



They made Colton a bottle of Barium, which in my opinion, looks like white-out. It was about the thickness of a regular bottle of formula. We used my regular Playtex bottle and I fed Colton some delicious Barium. As he drank, we could see his little body swallow it on the X-ray machine. It actually was pretty cool to watch. He drank just a little and they saw him aspirate, so they made me stop feeding him, immediately. They took the bottle and changed the thickness. Then, we tried to feed him with a little bit thicker bottle of Barium. Same thing happened, he aspirated. We kept doing this until we found a thickness that would keep him from aspirating. The three thicknesses they use are: Nectar Thick, Honey Thick, and Pudding Thick. They also noticed that it was taking him 4 sucks for every swallow on the Playtex bottle I was using. They decided to try a new bottle, too, because they wanted him to have 1 suck for every swallow. If he has to suck more to swallow, he will wear out faster, so they want the ratio to be 1:1. We finally got to a thickness that they were happy with, so they told us we were finished. We cleaned up Mr. White-Out face and headed to a room to wait for our results.

The Speech Language Pathologist came into our room and talked to us. He said that the results showed that he was silently aspirating on regular formula. This can be scary because some of that formula is going into this lungs and causing him to sound congested. If this keeps happening, it can lead to major respiratory issues or pneumonia. They wanted us to thicken his formula to Honey-Thick. They also wanted me to switch from a Playtex Bottle to a Nuk Bottle. The swallowing problems are caused because of Colton's low tone. His muscles in his throat aren't strong enough to push the liquids down the esophagus, so some goes down the respiratory tract. This is a common problem in DS babies/kids. Their tongues don't cup as well, either, so changing to a Nuk bottle would be a better fit for Colton because it has a flatter based nipple. They want him to suck and swallow more effectively, so he doesn't wear out.



Playtex Nipple (completely round)



Nuk Nipple (flat base)

We left the Swallow study and were told to go buy Nuk bottles with a Medium flow nipple. We also were given a thickener called "Thick-It 2." We were told to add 3 1/2 tsp of Thick-It to every bottle we give Colton. Once we add it, allow 5 minutes for it to thicken before we begin feeding. So, off to Babies-R-Us I went to purchase all new bottles. I got to go home and box up all of the old bottles and boil all of the new bottles.

The first few days and weeks of thickening Colton's formula were very stressful. I knew we'd have a learning curve and man, it was not fun! I was trying to feed my baby a thick milkshake out of a bottle. He would suck and suck and suck and we'd hardly make any progress. Feedings would take over an hour, when they were supposed to be taking 20-25 minutes. Sometimes, I'd have to tap out after an hour before I'd go absolutely insane. Luckily, my mom and dad were in town to help me when I couldn't sit there any longer. I just felt like he was trying so hard to eat and couldn't get it out of the nipple. Colton and I were very frustrated! Also, the Thick-It really upset his tummy. Poor baby was miserable. He got horrible diaper rash because of it. After a few weeks, I decided that this was not working. In order to keep myself sane, and Colton sane, I'd have to do some changing. They told me I could use Rice Cereal to help thicken his bottles; however, I'd need to use 16 tsp. FOR EVERY BOTTLE!!!!! 16 teaspoons....are you kidding me? So, I tried the Rice Cereal just to see if it would help with his tummy issues, and it did. I decided that I'd make my own concoction for his bottles....part rice cereal, part Thick-It. I didn't want him to get too many calories from the rice cereal. I also wanted his tummy to feel better. So...this combination is working well for us. Colton has finally learned how to drink his milkshake from his bottle. He's eating better, he's sleeping better, and we are happy! The problem is, my new concoction makes bottle-making a little bit more challenging. 4 ounces Nursery Water, 2 scoops Similac Soy, 2 scoops Beech Nut Rice Cereal, and 1 1/2 tsp Thick-It. I have to shake that bad boy really hard and then let it sit for 4-5 minutes to thicken. My ingredients take up most of my counter. Hunter said he has no clue how to even make Colton a bottle! Haha! When I leave him with family, I just have everything ready to pour in so that they don't have to mess with it! Oh well, I just want my baby to feel better and not aspirate. We go back for a follow-up swallow study in 6-8 months to see if he still needs his formula Honey-Thick. Stay tuned...