By: Smita Joshi, CCC-SLP, Founder and Director


Baby Joe, exclusively nursed. He was diagnosed with GE reflux, failure to thrive, and failed to transition to solids. His GI specialist suggested supplementing by adding formula powder to the breast milk to help with the weight gain. Mom however felt that she had a healthy supply of breast milk and did not want to give up nursing. Baby Joe did not take to the formula well. Mom had been trying to introduce cereals and baby food since Baby Joe was 5 months old however she had no luck. Baby Joe would gag and choke every time mom attempted to feed him purees.


Baby Joe’s feeding skills were evaluated via tele health, he was then seen for a total of 5 tele health feeding therapy sessions over a period of 2 months. During our first visit we taught Baby Joe’s parents on how to facilitate swallowing of thin purees without gagging. Parents practiced this skill at home. Baby Joe had mastered purees by second visit. During the second session we taught Baby Joe to eat Gerber puffs and thickened up his purees to further to improve his tongue movements. By the third visit Baby Joe was eating a lot of Gerber puffs and enjoying 3 meals of purees each day. During the third visit we taught him to chew and eat a variety of crackers and taught parents to safely introduce mashed foods. By the fourth visit Baby Joe ate mashed fruit and vegetables. In the fourth visit we taught him to chew and swallow small bits of ground meat. At the end of 2 months he was discharged eating cereals, purees, Gerber puffs, crackers, and mashed foods such as cooked vegetables, soft fruit, noodles, bits of ground meat etc. He gained over a pound of weight and no longer needed supplementation with formula. Therapist and the parents never met face to face with each other.