Every crumb on my floor has the potential of ending up in Nathaniel's lungs.

I type that sentence and do not know what else to say. There should be something funny inserted here. But facing the gravity of life with this child, I struggle to keep it light. Twice today he has picked something up off the floor, put it in his mouth, and then had a coughing spell that required immediate suctioning.

Daily I am realizing new ways that knowing Nathaniel aspirates will affect our lives. Daily I am realizing how out of the ordinary it is not to be able to eat anything. A playmate's veggie straw snack can not be shared. Explain that to two toddlers who heard "Let's share," for most of their play date when tugging at toys. Sometimes things make so little sense that repeatedly stomping your feet is the most logical answer.

We stopped Nathaniel's oral feedings at the end of July. For the first few weeks, he would grab at our food or sign 'want' when he saw his puffs container. I tried very hard to schedule the needed swallow study as soon as possible so that he did not lose his desire to eat or lose the skills we worked so hard to develop while we waited for the test.

Nathaniel was seen by therapy services at the children's hospital for a swallow study in January 2014. At the time, the evaluating speech and occupational therapists felt his eating skills were too premature to conduct the test. We were sent home with instructions to work on eating. By late spring Nathaniel had improved, but he coughed and vomited every time he ate orally. Our weekly occupational therapy sessions worked on feeding as instructed, but never addressed the coughing and vomiting. We sought an occupational therapy evaluation with a different therapist who strongly suspected that Nathaniel was aspirating. Precious time lapsed in waiting for the second evaluation, waiting for that report to be sent to the doctor, waiting for the doctor's order to be submitted for a new swallow study, and waiting to schedule the study.

I made a very hard decision to discontinue all of Nathaniel's oral feeding today. He is aspirating.

I have know something was wrong most of this last year. Nathaniel's occupational therapist through early intervention has spent half her weekly therapy session on oral feeding. It always causes coughing fits and increased suctioning needs. Often the coughing spells end in vomiting. The occupational therapist solution: the more he eats, the better chance he will get over his gag sensitivity no longer makes sense.

Nathaniel had a new occupational therapy evaluation today with a private therapy group. I was told that all his feeding behaviors scream, "I'm aspirating!" The OT advised discontinuing all oral feeds immediately. I called Nathaniel's ENT and Pulmonologist's office to share the therapist's observations and everyone agrees. Discontinue all oral feeds immediately. Tests are needed.