W had his checkup with GI a few days ago. It was a pretty good appointment--he continues to grow, albeit very slowly. Dr A is pleased, though, because it IS growth and he's sticking to his "new" curve. He's four point something percent on the growth charts and that percentile creeps up slowly so he periodically jumps up to the next curve.
He saw a nutritionist the other day but not his normal nutritionist. She wanted me to put him on a low fat diet. Said if we were really worried about calories, I could stir vegetable oil into skim milk. Told me to push whole grains on him, particularly whole wheat bread. His neurologist wants him to avoid breads and some other grains because they can trigger migraines and he just started treatment for migraines--the nutritionist said she'd never heard that and he needs more grains. I must admit that the nutritionist annoyed me :p GI advised that I not listen to her because her advice was contrary to what GI and W's regular nutritionist want and goes against what we are already doing that has proven successful. I was already planning on ignoring her since much of her advice was outdated but GI was also adamant that we ignore her--keep the whole milk and butter, avoid migraine triggers, and keep that boy growing :p
We've scheduled his next swallow study for August 10th. We are cautiously optimistic that his swallowing has improved due to his habit of stealing unthickened drinks and hiding while he drinks them--while we try to prevent that, it happens and he's been doing ok. No infections, no major choking/coughing spells unless he spots me coming and tries to chug it. Dr A has relaxed so much about his getting some unthickened liquids (he's still nursing, steals drinks, etc) because he's never ever had any type of respiratory event because of it. We are really really lucky because I know lots of kiddos (and adults) who aspirate have to deal with aspiration pneumonia and tons of respiratory issues and we've managed to avoid all of that. Perhaps because his aspirations seems to be a muscle coordination issue so it doesn't happen often? Even on his swallow studies, he has lots of swallows that are just fine and then one will penetrate, sometimes shallowly, sometime deep. I just hope its better because he HATES the thickener. Hates it so much :p