As a proud big sister, Molly Beson, 2, shows her special toy cat, Kitty, to friends, family and passersby. Kitty has a gastrointestinal tube (G-tube), just like Molly’s little sister, Lucy. Since coming to MassGeneral Hospital for Children (MGHfC), Lucy, with Kitty and Molly by her side, has learned to transition from her G-tube to eating by mouth.
Lucy, now 1, was born five weeks premature and developed oral aversion during her first week of life. She was vomiting 15-20 times a day for months. In May 2019, after multiple tests and hospital admissions, and a drastic drop off the growth chart, Lucy’s parents, Leigh and Michael, and her care team decided the best way to get nourishment into her little belly was formula through a nasogastric tube (NG-tube).
For about two weeks, Lucy had just five episodes of vomiting a day before it went back to 15-20. In June 2019, the NG-tube went away in favor of a G-tube, but the vomiting persisted for another two months. This was when Lauren Fiechtner, MD, MPH, of the Pediatric Feeding Team, proposed the idea of starting Lucy on a blenderized diet.
Providers typically recommend a commercially blenderized formula for babies who are at least 1 year old. Whole foods, like fruits, vegetables, proteins and fat are blended with liquid and pushed through the feeding tube. At the time, Lucy was just 6 months old, but Fiechtner and her team were confident she would benefit.
“Lucy was our youngest patient to date to try a blenderized diet,” said Fiechtner, director of MGHfC’s Center for Pediatric Nutrition. “Most infants transition to solids around 6 months of age, so after doing some research and looking at the data, we felt comfortable doing this with Lucy.”
To help the family adjust and learn about the G-tube, Child Life Services at MGHfC also presented Molly with Kitty – a furry friend who helped her embrace her sister’s slightly different way of eating.
“We felt like our whole family was included in Lucy’s care,” said Leigh, of Rochester, Mass. “That meant a lot to us.”
Almost immediately after starting a blenderized diet, Lucy stopped vomiting. Six weeks later, Lucy was eating exclusively by mouth and rocketed into the 31st percentile on the growth chart.
“It was miraculous,” said Fiechtner. “We’d never seen anything like it before.”
Lucy also attended weekly feeding therapy, which focused on creating a positive experience at the dinner table. At first, Lucy simply played with food that was placed in front of her – an important first step that families sometimes overlook. This gave Lucy a chance to touch, smell and eventually eat her food. After a few tweaks and trials, the Besons learned that Lucy eats best seated in a booster seat with Molly sitting next to her.
“The Pediatric Feeding Team always has a new trick or new food to try, and they help address our struggles and concerns,” said Leigh. “It is the little things, like holding a spoon differently or having Lucy hold a mirror to watch herself eat. Everyone at MGHfC is so proactive and we appreciate that because that’s how we are as a family too.”
Lucy’s feeding tube will be removed in the next few months. It is common to leave feeding tubes in place during flu season in case children become ill and cannot eat by mouth. In the meantime, Lucy happily munches on oatmeal with peanut butter, sweet potatoes, lentil pasta and cheese, avocado and asparagus.
“She also loves a good grilled cheese,” said Leigh.