I used to blog a lot about Malcolm's feeding issues and I haven't provided an update in a while. That's because he has been doing really well! In the photo above he is relaxing in my lap eating some crackers - taken at Christmas. In terms of an update...
He is actually able to eat small pieces of meat quite easily now, and he seems to quite like meat. He is doing much better with chewy bread as well, though he still doesn't eat a lot of it and tends to prefer crackers or toast, given the choice. He tends to stuff his mouth way too full to the point that he can hardly chew and sometimes bits of food fall out (which sounds really gross but we are so used to it I don't even blink anymore). I am told that this is because of the low tone and delayed muscle development in his mouth. He may have trouble feeling how full his mouth is, or he may be stuffing food in to help move the chewed up food to the back where he can swallow it, because his tongue and other muscles are still not doing this effectively. My feeling is that he will continue to improve slowly and I expect that he will eventually be able to handle all foods quite easily.
His fine motor skills are quite good. He is very adept with his spoon, just needing a bit of help at the very end of a bowl as he has trouble scooping or scraping out the last bit. He is getting better at spearing food with a fork. He understands the concept of cutting but his not able to cut very well on his own, though to be honest this is an area where I haven't given him much practice - I should be giving him a dull butter knife so he can cut his own soft foods like cooked carrots.
I wish I had a video of some of his mealtime habits. He's a cute little guy who will have food smeared all over his face, dripping down his chin and falling out of his mouth, but if he gets the least little bit on his hands all of a sudden it's a major catastrophe and he wants a cloth right away to wipe his hands. So in some ways he is quite particular and fastidious. He also gets really frustrated when he drops food from his spoon. He has taken to refusing to pick it back up himself (this may involve getting a finger dirty, after all) so fusses until I give in and help him out. I think at daycare he is a little more independent and less concerned about messy fingers but at home it continues to concern him.
He can drink from a regular cup perfectly well and in fact does so regularly at daycare. At home I prefer to give him his little cup with a lid and straw as he has a tendency to chuck his drink off the table once he's decided he's not thirsty anymore.
He still sits in his highchair most of the time which is a real lifesaver. He is Mr. Grabby at the table and likes to grab whatever is in reach, play with it briefly, and then throw it across the table or onto the floor. I think as he gets older he'll grow out of this behaviour (obviously, we don't encourage it and seek to correct it whenever he does it) but in meantime he will remain strapped in and slightly apart from the table.
Malcolm is 30 pounds now and three feet tall. His legs are quite short (just starting to wear size 2 pants - mostly still wearing 18 mos pants!) but he is definitely stretching up. In the photo above he is having fun throwing a ball down the hallway. As he starts to eat more meat and bread, I will have to be a bit careful about how many calories he is eating each day as obesity is a real concern for kids with Down syndrome. Luckily he also really loves fruit and many vegetables, and so far (fingers crossed!) doesn't like really sweet stuff and hardly ever eats dessert (except occasionally ice cream) or candy.
A quick note that Malcolm's bowel issues seem to be getting better. He is waking far less at night and is more regular. He still strains a fair bit at times but I think if things continue as they are we will assume it is normal and follow-up with his doctor at his next scheduled appointment in April.
