Emma, eight months old, was born at 32 weeks gestation with fetal alcohol spectrum disorder and a heart murmur due to maternal alcohol abuse. She has lived with a foster mother, who would like to adopt her, since she was two months old. Emma has had multiple complications from her premature birth (e. g., needing to be tube fed via a nasogastric tube for the first eight weeks of life) that have necessitated the use of tubes in her nose and throat. This has resulted in an aversion to having anything placed in her mouth including a feeding tube or a spoon. Emma has been fed regular infant formula through a gastrostomy tube since she was two months old. Her current weight is 15 pounds 5 ounces and her length is 26”. Emma’s foster mother is looking forward to starting solid foods with Emma this week per her pediatrician’s advice.