Tuesday, October 2, 2012

The Battle

As I have mentioned previously, a lot of what I do at Chiquitines is related to feeding. After starting to work with the little ones, it didn’t take me long to realize that there were major delays in oral motor and self help skills related to feeding. It did, however, take me a while to figure out just how complex the problem is. Every day I feel like I see another piece to the puzzle. Lack of time, lack of staff, learned aversion, prematurity, neurological complications, respiratory issues, cultural norms… the list goes on. And yet, after spending nearly two months here, I still don’t know how to solve the puzzle. There are days when I feel like I am making progress and days where I feel like nothing will ever change, which would be a giant disservice to the kids here. Last night Angelica helped put things in perspective for me though.


As I was talking to her about feeding issues, she told me I shouldn’t expect things to change overnight. Not the consolation I was hoping for, right? “Todo en tiempo” (all in time), she said. “Poco a poco” (little by little).

As I worked with the kids today, I tried to keep that in mind. Maybe it was that after that conversation I felt hope in that I am planting the seed that may eventually lead to the change these kids needs. Maybe I just chose to see the world with more love than yesterday. Either way, today I felt like I was winning the battle.

On Wednesday, I met with the nutritionist, caregivers, doctor and head nurse to discuss feeding issues. Together we decided it would be best for the kids and the caregivers if the volunteers could work with the kids with the most feeding issues, since they are not under the same time restraints as the caregivers are. Operating under the theory that practice makes perfect, we generated a list of the most difficult children to feed and chose two toddlers and two infants the volunteers would try to work with everyday for two consecutive weeks. As I explained the new system to this morning’s volunteers, they fully endorsed the idea, singling out those four kids to patiently work on tolerating new textures and being more independent with self-feeding. As they devoted their attention and time to those little ones, I showed them some simple techniques involving positioning and spoon/hand placement. Bonus: one of the caregivers voluntarily fed a little one in an upright position using the new positioning pads I was able to purchase for that specific purpose using the generous donations of friends and family. AND she pointed out their usefulness to one of the volunteers before I could even get around to it! Post-lunch, the volunteers were happy they were helping, the caregivers were happy they didn’t feel as rushed, they kids were happy that feeding was less of a traumatic experience and I was happy the kids were safer and developing the skills they need for proper nutrition and development.


The unstaged, hilarious yet oh-so-bad-for-feeding alternative to the positioning pads…

Thirty minutes later, tired, covered in food, but happy



New positioning pads in action. I have yet to tackle the giant spoon issue…



Who knows how I will feel about the feeding battle come Monday or how many changes will continue after I leave next week but today – if only for today – I’m claiming a victory.

Abby