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Old 05-08-2008, 06:40 PM   #1
Litterbox
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Guarding with the shoulders
Okay, so we went to see a speech path. in St. Louis and they said everything looked normal, except that he has a raised rib cage and shoulders. He said this body carriage was indicitave of guarding. What does that mean??? Is Denver in pain when he eats then and that's why he does it? Could this be the reason that he is not reaching his developmental milestones? He is supposed to be reaching for toys and he isn't. He also does not hold the bottle.
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Diagnosis: ALTE, Bradycardia, GERD, Laryngomalacia, Dysphagia, Gastrointestinal Webbing

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Therapies Tried: Infamil AR, Nutramigen, Reglan, Prilosec, Zantac

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Old 05-08-2008, 06:42 PM   #2
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Re: Guarding with the shoulders
Sorry, didn't want you to wait for a reply...we haven't had an SLP for quite awhile. We're hoping to find a new one!!!!!!
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Old 05-08-2008, 07:21 PM   #3
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Re: Guarding with the shoulders
I'm not entirely sure about the guarding, but I believe sort of a defense mecvhanism.

As far as milestones, I don't think there really are any so young. My baby (who is my only reflux free child) is over 4 months and just started reaching, and isn't close to holding a bottle.

I remember with Sam we had to wait to not only miss milestones but by a long time for a delay. Like he didn't sit up at 8 months and it wasn't a huge deal to them, KWIM? I guess what I am trying to say is that they are probably more concerned with his eating right now. Hopefully thinks will get figured out for that adorable baby! He is sooo cute!
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Old 05-09-2008, 04:42 PM   #4
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Re: Guarding with the shoulders
Bethany did some of that--often, when kids are in pain, they will adopt defensive positions like this. In our case, B would absolutely NOT roll over or twist her torso until she was 12 months old. She sat in a "W" position (on her knees with her feet under her tush--still does this) with her back stooped over and shoulders hunched. She also would absolutely not walk--instead, until she was about 18 months old, she would amble around on her knees.

Our PT told us that these were all defensive postures that kept her belly from hurting more than it already did. She said that many kids with GERD will adopt various defensive positions in response to the pain they're feeling. In B's case, she was in PT (at the feeding center), where they addressed her walking/gait, helped with posturing in the sitting position and worked on crossing the midline with regard to her torso.

When your ST made this comment, did s/he recommend any sort of treatment or give any indication of the severity of Denver's issue?

As far as batting at toys and holding his bottle, I probably would not worry *too* much at this point. If his reflux is not yet under control, he will likely not be too interested in doing some of these things--many of us have found that our kids were a bit delayed (or just on the later end of "normal") with regard to some motor skills just because they were so uncomfortable that they couldn't do certain things.

I would, if you can, either call the ST back and ask for clarification/recommendations OR take her comment to your ped and see what s/he says.

It's hard not to worry--especially when you get a lot of jargon, but not enough explanation/answers.
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