D is for Drain Sponge and Developmental Delays
Drain sponges are often used around the trach and the g-tube to soak up the excess moisture and gunk. They are split so that they fit around it and stay put, which is rather convenient. We never really used them around the trach because we didn't need to, but we did keep them around Abby's g-tube for a while until our GI said to just let the site breathe. There's some argument as to the advantages and disadvantages of the drain sponges, but we don't use them too much.
Unfortunately, developmental delays are very common when you have a young child with a trach--especially if he or she is vented. The inconvenience of the tubing makes it difficult to do tummy time, which is so important during those early months! For Abby, she was also kept on her back for the majority of the first three months of her life while she was hospitalized, so that didn't help things either.
Speech therapy is also extremely important, as pretty much every trach kid is going to need extra help with that. Kids who have a g-tube will also need non-nutritive stimulation, which is when you massage the cheeks and stimulate the inside of the mouth to get everything working. If you don't start that early, the child may develop a food aversion later on from lack of oral stimuation....which is no fun at all!
With kids who may have developmental delays, early intervention is the key!!! The sooner your child is identified and begins therapy, the smaller the gap will be. Don't wait to see whether your child will catch up. Get him or her identified and let the therapist be the one to make that judgement call. Early on in the hospital, I fought long and hard to get Abby the therapy she has. I think that has made all of the difference in her progress. I started range of motion exercises with her as soon as she recovered from her tracheostomy, and we've just worked our way up from there. I'm so thankful for the therapists who took the time to teach me how to work with Abby. I'm pretty sure the doctors just agreed to the therapy to shut me up. It worked. :)
We are now working with Infants and Toddlers, which is an early intervention department in the county, and they have been fabulous. Both of our therapists have been so helpful and accommodating. We can tell that they have high expectations of Abby and really care about her.