Inspiration

Meet fearless Frankie and her parents

Posted on by amberhj

Update: In March of 2010, her parents announced that Frankie discovered the joy of eating and left tube-feeding behind for good!

I’d like to introduce you to Francesca and her devoted parents.  Their extremely touching and wonderfully written blog, Frankly Frankie, documents Francesca’s struggles with eating. They need our morale support–right now.

Adorable two-year-old Francesca, or Frankie, has a story that begins very similarly to Stella’s: severe reflux (GERD) and cow’s milk protein intolerance, signaled by bloody diapers, led her to refuse to eat as a newborn. Frankie’s mom, Brett, eliminated dairy from her diet to no avail (sounds familiar). As with Stella, a reluctant switch to amino-acid-based formula and bottle feeding was made. But Frankie was unfamiliar with the bottle, the very expensive formula caused terrible constipation (not to mention its horrible taste), and she soon shut down orally, with near-total refusal to eat. Diagnosed with Failure To Thrive (FTT), she descended through the ranks of the growth chart until she fell off, despite valiant daily efforts to feed her “normally.” A g-tube (PEG) was surgically inserted into Francesca’s stomach in order to prevent severe malnutrition. Francesca remained off the growth charts until very recently, a truly hard-earned achievement for her parents, a milestone that prompted celebration.

She is now two years old and has been 100% tube-fed. (For the full story, click here.) But not for long. Frankie’s parents very recently embarked on an intensive and heroic weaning effort. What touches me so much about their story and current efforts isn’t, as you might expect, that Stella could easily have wound up in the same exact situation. What gets me is the absolute dedication and above-and-beyond efforts of Frankie’s parents. They are doing everything humanly possible to help Frankie discover the joy of eating. They have turned their home into a play picnic, a highly successful and messy therapeutic Graz method used during weaning that allows tube-fed kids to explore and play with food without pressure, on their own terms, and become comfortable enough with food to eat. The floors and walls in Frankie’s home are sticky.

A few days into the weaning process, Frankie’s parents are trying hard to keep the faith, as Francesca still prefers ice cubes over the many treats offered, including (hold on to your hats):

“oatmeal with soy milk and brown sugar, dried cranberries, pita chips, cherrios, sharp cheddar cheese, bread with seeds, coconut rice, apple sauce, carrots shaped like coins, vegetable and goat cheese frittata, whole wheat spaghetti noodles, steamed broccoli, carrots shaped like flowers, potato chips, medium cheddar cheese, slices of banana, cinnamon rolls, acorn squash, swiss chard, butternut squash, sour cream, rice krispies, puffs, bacon, scrambled eggs with cheese in a tortilla, spinach, red bell pepper slices, coconut flakes, frosted animal cookies, miniature strawberry yogurt covered pretzels, dried mango-pineapple, dried banana, egg noodles with green onion, salt and pepper, salad greens, baked potato chips, polish sausage, red cabbage, mini marshmallows, dried apples, chocolate yogurt covered pretzels, dried apricots, corn chips, dried cherries, croissant, peaches, banana bread, colby jack cheese, graham cracker cookies shaped like bugs, french bread, fresh mango, cookie bars, pear slices, candy corn, gummy bears, lettuce, chocolate frosting, gingerbread cookies, white frosting, salt and pepper potato chips, chocolate, quinoa, garlic bread, french toast, popcorn with butter, pink pixie popcorn, yogurt, celery with cream cheese and raisins, wheat thin crackers, apple slices, turkey soup with dumplings, uncooked pasta wheels, yellow raisins, brown raisins, fruit loop cereal, orange cinnamon rolls, parmesan cheese, tortillas, dried mango, tortilla chips, grated cheese, beef chili, pancakes with butter and maple syrup, chocolate cookies shaped like bears, jelly beans, deviled eggs, toast with raspberry jam, carrots with ranch dressing…”

Francesca is undergoing huge psychological and biological changes, and needs time to adjust. As such, with this type of weaning, there is a lot of anxious waiting and hoping, and often, a good measure of sheer desperation. (Hek, I threw bottles.) The outcome rests squarely in the hands of the child. As a parent, you feel helpless. Your role? To make food available (really, without even “offering” it), to remain calm, and have faith in a child who has rarely if ever shown any interest in eating.

Tube weaning is extremely stressful, even when it is going well. It’s an incredible leap of faith, and a very lonely journey. Please take a moment to visit the blog, Frankly Frankie, and send your warm, supportive wishes in comment form.

I’ll sign off by simply stating that I have absolute faith in Frankie, and her parents.

Holiday sweetness

Posted on by amberhj

A couple days ago, Stella and I made a gingerbread house. Actually, I put it together following step-by-step instructions, while she ate the chimney, tree, and most of the roof’s structurally necessary frosting. Later, the same frosting would come out of my nose, because I can’t resist it either, and Stella made me laugh while I bent over to pick her up.

Even slightly off-kilter peace is worth striving for.The gingerbread house experience leads me to wonder how babies “know” about candy upon seeing it for the very first time. I opened the gingerbread house kit from Williams-Sonoma, and Stella immediately began gnawing on the package of gumdrops and clawing at sealed cookie components, whining and panting because she could not wait to eat them. Mind you, she’d just eaten a man-sized dinner. I thought she was absolutely full. Besides, this kid had never before seen anything resembling a gumdrop. I asked Cody how she knew instantly what the sweet gems were all about, and he gave a pretty good explanation: “It’s instinctual!  Gum drop detection is part of our evolution.” Of course it is. They’re like berries, but with high fructose corn syrup. Totally necessary for survival–of the holidays.

It’s not just the season’s sweets that get Stella excited. She loves the Christmas tree. She dotes on it with gentle, arms-wide-open hugs. She does laps around it, and inspects all the eye-level ornaments every hour or so, touching them while saying a nasal-y “no.” Because without realizing it, that’s what I taught her to do.

Our new tree bling.For the first several days, the tree was star-less. So I ordered a wonderfully simple star tree topper from Red Envelope, and it arrived during Stella’s nap early this week. I put it up atop the tree right away, admired it proudly for a moment, then promptly forgot about it. Not long after, Stella awoke from her nap. The first thing she did? Gazed up at her new best friend the Christmas tree, smiled, and with her sparkly blue eyes growing ever wider, pointed at the star in dramatic, overly excited fashion. She did the same when I hung my “PEACE” banner on the mantle. She not only smiled and pointed, but actually applauded. The banner isn’t exactly what I’d hoped it would be, but I did put some real work (not to mention money) into it, and the fact that Stella appreciated it so much almost brought tears to my eyes. She’s just so incredibly sweet.

As you can see, Stella understands holiday magic. So do I, and so does my mom. This appreciation, and a general affinity for wonder, has been handed down along with the most unruly cowlicks imaginable. On Tuesday, my mother’s latest act of kindness arrived. It was carefully tucked in tissue paper in the bottom of a large box, in which we also found a package of adorable, unbreakable (genius) ornaments and a classic, wooden, German ornament of a little chef holding a large wooden spoon, which Stella immediately grabbed and pretended to eat with.

This delivery is probably the millionth treasure–holiday or otherwise–that my mom has created for me during my 32 years. For example, on game day throughout high school, I’d consistently find a bit of crafty motivation in my lunch or backpack, like a construction-paper basketball with multi-colored flames shooting off the sides and a markered message along the lines of “Light ’em up!” or “You’re on fire!” Sometimes I really did light ’em up, and I think she’s largely responsible for that. She saved every newspaper article, even the smallest mention of me, and attended just about all of my games. Christmas? Well, that was always magical, even when my parents were young and completely broke. I know, I’m lucky.

I will probably wear the tree skirt to Cody's office Christmas party.So, you’re probably wondering, “What on earth did she give you? A giant diamond she’d made by crushing carbon with her bare hands?” No, it was better. I opened the box to discover that she’d made me the most gorgeous tree skirt ever in the history of Christmas. If Jesus Christ himself had a Christmas tree and accompanying skirt, I’m sure it was nowhere near as holy and beautiful as this. Honestly, I’d searched Etsy for tree skirts last week and found nothing that even compared to my mom’s work of art. In fact, this tree skirt is probably the most wonderful thing I own. It embodies my ideal style, with a design that’s charmingly simple but not at all stark, and plenty of cheerful but balanced color and splashes of bold, joyful pattern. The luxurious fabric and perfect trim are so incredibly stylish yet timeless, and even incorporate the specific colors or our decor. As anyone who has given or received a truly thoughtful, handmade gift knows, it’s more than a tree skirt. It’s even more than an heirloom. It’s a symbol of something much greater. Love, of course! And Martha-Stewart-esque skills that I’ll probably never have.

My holiday banner is too busy and warped by over-gluing. Martha would not eat leftover gingerbread house frosting “glue” straight from the bag, and she probably wouldn’t allow her edible creation to be smudged on all sides with sugary toddler handprints. But who cares? What I lack in skill I make up for with holiday cheer. More importantly, I’ve got an amazing daughter and mother with whom to share it.

Enjoy a quick holiday “hi” from Stella, on one of her rounds…

“Babies”

Posted on by amberhj

(Update: YouTube took it down, so here is the Babies trailer on Moviefone.com, all legal and whatnot.)

I can’t wait to see this documentary.

I suspect that “Babies” will provide some much needed perspective for neurotic U.S. moms like me. For example, lately I’ve been a bit worried about whether Stella will be completely safe when, over the holidays, we stay in a home with a very large dog. Meanwhile, in “Babies,” little Ponijao of Namibia plays on an open, dusty African plain and casually explores the open mouth of a dog. And in Mongolia, Bayarjargal travels in his mothers arms on a motorcycle and has his bath water stolen by a goat. How can you not fall in love with this film?

I wonder, will “Babies” focus only on the magic and wonder of babyhood, or attempt to reveal the full reality? Either way, I’m in. You had me at “Babies.”

3 reasons to smile

Posted on by amberhj

Stella’s Auntie Corinne (my youngest sister) and Uncle Colin (the duo also known as “C squared”) flew in from Boston for a few days, but now they are gone, and Stella and I are suffering from withdrawal.

Just before C and C’s arrival, Stella’s stranger anxiety went through the roof. As we entered the park a few days ago, we saw a couple approaching from the opposite entrance, all the way across the green expanse. Upon spotting them, Stella retreated to her hiding post behind my knee. She remained there until they passed, which took a while, and eyed them intently the whole time, eliciting a laugh from the two suspicious characters. In light of experiences like that, I was wondering how quickly she’d warm up to our house guests, whom she hadn’t seen since April. Well, five minutes after they arrived, she was doing stuff like this:

Kicking back with C squared

Kicking back with C squared

I think they share some kind of bond. It was a given that Stella would take to Corinne, having spent more time with her in the past. But I was impressed by how she fell in love with Colin. They really connected. But then again, come to think of it, these three have something in common. They are survivors.

At one point during the visit, Uncle Colin carried Stella up our steep front steps, of which there are many. This brought tears to my eyes. In fact, this was never supposed to happen. Colin is lucky to be alive. A couple years ago, he was in a devastating single-car accident. To keep him alive, they had to pump more blood into him than the human body actually holds. He was told he’d never walk again. His spine literally moved sideways within his body, and that was just one of many horrific injuries. From the blog that documented his incredible recovery:  “Colin has endured four very difficult surgeries: one to remove a portion of his lung torn from broken ribs and to stop internal bleeding, two back surgeries to repair the spinal cord and stabilize shattered vertebrae, and a fourth to mend three breaks in his right arm.”

During their visit, Corinne thought back about their natural defiance, their bold assumption that he would indeed walk again–their refusal to accept anything else. After waking up from the surgery on his spine, Colin was asked to move his toes. To everyone’s astonishment, he could. The doctor blew it off as spasms–he told them not to get their hopes up, that Colin would not walk. But C squared knew spasms could not explain this on-command movement. They KNEW he would walk again–in fact, they thought it was obvious. Corinne laughed on recalling it: “We were like, ‘he can move his toes!’ DUH! He’ll totally walk again, no problem!” In hindsight she realized that the leap from slight toe movement to walking again was Grand-Canyon-sized. But the important part of all this is that they had hope. Hope! Hope is huge. Hope is what makes us and keeps us human. Granted, it was a very, very long road. Colin worked his ass off. They fought insurance battles and had about a year’s worth of dark days, but they knew he’d get there. Against all odds, and with the support of the community that rallied around him, he did.

Oh, did I mention that Colin’s accident happened five weeks after their wedding? And a several years after a sleeping Corinne rolled out of her third-story dormitory window, cracking her skull and vertebrae, and shattering her arm? She sat in the gutter alongside the building until someone heard her moaning in pain. I remember the moment I got the news about Corinne’s accident and how I could not breathe. I remember flying to Boulder, Colorado to see her, and wishing with all my might that I could trade places with her yet being blown away with how strong she was during the recovery process. And I recall feeling similarly sucker-punched when I got the call about Colin, whose life was dangling by a shredded thread. Those are those frozen moments that stay with you–slaps in the face that keep you from sleeping on the job of life.

While not really comparable to the life-threatening injuries Colin and Corinne endured, Stella went through quite a bit in her first year, the lowlights being a scary feeding aversion, blood in her diaper, and The Tube. So when I saw Colin, Corinne and Stella all together, happy and healthy, I could not help but feel amazed, and overwhelmed with gratitude. Miracles do happen, and my family is proof of that. I could not be more proud.

"Just tell 'em we're survivors!" (I love these three people. And the movie "Cars.")

"Just tell 'em we're survivors!" (I love these three people and, I'll admit it, the movie "Cars.")

P.S. I’m also thankful that we had gorgeous, sunny weather for their visit. “C squared”, being bionic and all, have enough metal in their bodies to shame Wolverine. Their joints get uncomfortable as rainy weather approaches in the distance–nevermind when gloom settles in for days on end. It will surely descend soon, but Colin and Corinne left enough of their light to keep us going for a while.

P.P.S. Corinne and Colin helped Stella embrace her sippy cup. This is also a miracle. Trust me.

Behold: Tube weaning research and guidelines

Posted on by amberhj

Invigorated by our walk

Back in her tube days.

When is the last time a research paper made you cry? Around the time of Stella’s wean, and since then, I’ve come across information that moved me on many levels. I’d like to pass along these sought-after papers to as many parents (of children and babies with feeding aversions and NG tubes or g-tubes) as possible.

Supremely helpful insights and guidance are offered in the article, “Prevention and treatment of tube dependency in infancy and early childhood.”

Details and analysis can be found in the research paper itself: “Standardized tube weaning in children with long-term feeding-tube dependency: Retrospective analysis of 221 patients.”

Update: Also, from Spectrum Pediatrics in Virginia, check out this pediatric feeding tube weaning case study! This case study breaks down exactly how a well-managed and supported wean takes place.

It is with great excitement that I share with this research on tube weaning. When Stella’s NG tube was placed, I immediately started researching the topic online and only found horror stories. I went into full-on panic mode immediately, because there was no helpful information. No hope. Only desperation and despair.

This is now.

Lean but healthy, and happily eating, just months later.

These resources seemed to illuminate our world, bringing light to what was previously a dark informational void. They completely validated my feelings and my husband’s feelings–our whole struggle, our crazy experiences, our obsession–surrounding Stella’s feeding aversion and tube placement. It’s fair to say that in this case, reading was healing. It’s so helpful to understand how calories are reduced and what a respectful, child-centered wean looks like.

Why are these papers such a big deal? Because so little research on tube weaning exists, and therefore most parents and doctors are really just “winging it.” Yes, some children require tubes for long-term survival and the authors of these papers fully acknowledge this, of course. But many children who are capable of eating on their own, whose core feeding or other issues have been addressed but who remain *unwilling* to eat, are tube-fed for years, which needlessly and often dramatically lowers quality of life and impairs development. There’s a better way, and we need to spread the word.

Children and their parents are sent home from the hospital with feeding tubes in place, but without anything resembling a clear time-frame or plan for tube-feeding, and certainly no plan or support for weaning. Children and families deserve better than that.

I find these two excerpts from the tube weaning article and research to be particularly powerful:

“Tube dependency is a distressing and unintended result of tube feeding in infancy. The condition of tube dependency can be defined as active refusal to eat and drink, lack of will to learn or the inability and lack of motivation to show any kind of precursors of eating development and eating and drinking skills after a period of gastric feeding. It is characterized by overt disinterest, food avoidance and active refusal, gagging, vomiting, oversensitivity, fussiness and other oppositional and aversive behavior. It may influence the quality of life of the affected infants and their families to such a degree that all other troubles fade into insignificance besides the nightmare of a child who will not eat or drink. Nevertheless, tube dependency is not recognized as a problem by many pediatricians.”

“Parents of tube-fed children feel unhappy about their plight. If the duration of tube feeding exceeds the predicted period of time, they will wish to start tube weaning but lack the means to do so. A vicious circle of insecurity and desperation may result. Pressure and adult expectation build up, causing the child to resist any steps towards autonomy. Parents report feelings of anger, guilt and sadness at the sight of other children eating normally. In earlier studies (Lit 42,43) we reported that 86% of parents of tube-fed children suffered from overt depressive symptoms that disappeared after their children had begun to eat normally.”

The following excerpts should give you a quick, high-level view of the study (its purpose and outcome) as covered in the papers:

“Results: 203/221 patients (92%) were completely and sufficiently fed orally after treatment. Tube feeding was discontinued completely within a mean of 8 days, the mean time of treatment was 21.6 days.”

“The rationale for this retrospective study is to specify a successful tube weaning program in infancy. Many children remain tube dependent after successful healing of their underlying disease. Tube dependency often is accepted as ‘unintended side-effect’ of the treatment.”

“The main hypothesis of the study is: specialized treatment is highly effective and allows weaning severely impaired children even when numerous previous attempts had failed. The primary objective was complete weaning from long-term tube feeding based on sufficient, self-regulated oral intake.”

“The most important point of the model is the concept of full oral autonomy of the infant from birth and the implementation of this concept into the daily handling of parents and caregivers dealing with eating disorders, feeding disorders and tube-fed infants. Hunger is the main motivation for the attainment of self-regulated eating behavior.”

“[Tube] Placement must be preceded by clear criteria and a decision as to the indicated nutritional goal and time of use. The placement of a temporary tube must generate a plan covering maintenance issues including time, method and team for weaning. Aspects of tube feeding that go beyond purely medical and nutritional issues need to be considered in order to minimize the frequency and severity of unintended tube dependency in early childhood.”

In Spectrum Pediatrics’ detailed case study, you’ll see many references to honoring and respecting the child and being attentive to the child’s cues. The goal is to allow hunger while minimizing stress, and to create a situation wherein the child chooses to become an eater by mouth:

“The team members utilized intuition and developmental knowledge in order to read the “cues” of the patient to know what the child wanted to eat, as well as with whom and where. All of the eating scenarios were very relaxed and focused on fun and play. The tube weaning program team members were cognizant of ensuring an eating environment that was comfortable and low-anxiety. If the child was ever afraid to eat, the therapists and parents would return to enjoyable play activities. He was able to cope with his post-traumatic feeding disorder and its negative effects through play in the low-stress, enjoyable environment.”

“The patient continued to exhibit changes in his hunger and sleep cycle on the third and fourth day of the tube weaning program. He had difficulties with sleeping based on his new sensations with hunger and self-regulation. The team continued to make the eating situation as comfortable as possible for the patient by “following his lead”. This led to feedings of his most desired foods and in a variety of locations, including outdoors, indoors, on the floor, in the bathtub and in the car. The team also continued to provide water-dense foods, such as melon and cantaloupe, in order to ensure that he was keeping well hydrated. It was evident that he was growing in his familiarity with new sensations, foods, and oral motor skills.”

I hope these resources are as helpful to you as they were to me! Best weaning wishes.

Meet Diego

Posted on by amberhj

Back in mid-November, when Stella’s NG tube was put into her cute nose and down into her then-hungry and confused tummy, I was understandably freaked out. I wondered if it was the right thing to do. I worried about how it would affect her. So I did the worst possible thing I could do. I turned to the internet for answers. What I found, mainly on message boards and on random, unofficial-looking “medical” websites, was horror story upon horror story about how NG tubes make feeding aversions worse. How they lead to complete oral aversions, make reflux worse and pave the way to surgically inserted g-tubes. I was so scared.

Rocio and Diego, bonding not long after his premature birth.

Rocio and her precious and miraculous Diego, bonding not long after his premature birth.

I did have the good sense to realize that the people most likely to turn to the web are those who, like myself at the time, are struggling. If things are going well with your child, or if you’ve overcome an issue and are no longer in it, you’re less motivated to go to the web and tell your story. You don’t need answers and support. You’re not desperate for any tidbit of information you can get. I knew that out in the real world, there were probably lots of babies who’d been on NG tubes for a short time and then resumed normal eating. Through my occupational therapist, I learned about the amazing Libby. And then, one night, through comments she left here on this blog, I met an incredible mother named Rocio and her son Diego.

That evening, Rocio did what I had done. She felt a rising sense of panic after reading terrible anecdotes about NG tubes online. She then came across Stella’s story and was encouraged to see that Stella was making progress with eating. Rocio and I began to communicate regularly via email. In a sense, it felt like we were in this together. This woman I had never met who understood everything I was going through and vice versa. We were going to get our babies off the tube. And no other outcome was acceptable. As scared as we were, we knew they could do it.

Rocio’s son Diego was born prematurely, at 28 5/7 weeks gestation. He was tube-fed from birth, first through his mouth, then, after graduating to “level 2” in the NICU, through his nose via a nasogastric (NG) tube, just like the one Stella had. As Rocio explained, Diego developed reflux while learning how to eat, which set him back. As in Stella’s case, the pain all but eliminated his desire to eat. After spending three months in the hospital, Rocio pushed to have Diego sent home, so that he could enjoy a more comfortable, cozy, non-medicalized environment. So, Rocio and her husband bravely learned how to maintain the NG tube, and headed home with their son, unsure about what the future held.

Like Stella, Diego had a Merry first Christmas--even with the NG tube.

Like Stella, Diego had a Merry first Christmas--even with the NG tube.

Rocio was on the same nauseating rollercoaster we had ridden. So many ups and downs. Exhilarating upswings of hope followed by crushing disappointments. Early on in our communications, at the very end of December, she told me, Diego was “not passing the 25 to 30 cc mark of drinking his bottle per feeding.” (There are about 30 cc’s or mls per ounce.) It was a tough time. But once in a while, he finished entire bottles–it took over an hour, but he was FINISHING them. And more progress quickly followed. One day, she told me that Diego took 90 mls in 45 minutes. He was showing that he could do it.

On February 4th, I received an unforgettable, elated email from Rocio. She told me that Diego had been without a tube for three weeks, and that he was thriving. In fact, he was gaining approximately one ounce  per day! Based on all the research I’ve done and my learning from the director of the Austrian tube weaning clinic, I know that this is amazing weight gain, especially so soon after the tube’s removal. Rocio was thrilled, and I truly felt her joy.

A GI doctor confirmed that Diego’s tube was gone for good. At this point, Stella had been without a tube for exactly one month, and it was also clear that her tube was gone for good. We’d done it.

Like Stella, Diego still had some difficulty swallowing. For us, thickening Stella’s formula did the trick. Last I heard from Rocio, Diego was going to have “ECI (Early Childhood Intervention) therapy because the swallowing study projected that he still needs to learn how to swallow better.”

I asked Rocio what she believed was the key to Diego’s success. Her answer was simple. First, Diego needed time to mature. Having been born so early, he didn’t have enough practice. (Babies learn to swallow in the womb.) Then, Rocio needed to get over her fear. Naturally, she worried that he would get sick or be undernourished upon the tube’s removal–even if a deeper part of her knew he no longer needed it. Lastly, she pointed to the removal of the tube as the most important aspect of his feeding progress. Rocio explained, “Pray and have faith. Babies will eat without [the tube] once they feel the need and understand that if they do not want to eat the regular way, they will have no other way to do so.”

With his tube days behind him, Diego is radiant and thriving!

With his tube days behind him, Diego is radiant and thriving!

Rocio fought for Diego. She faced incredibly challenging circumstances with Diego’s premature birth and extended hospital stay. She had to push just to take him home. Then she found the support and therapy he needed. Then she made the big decision to follow her instincts and take out the tube. This is a beautiful, healthy boy who has overcome some daunting odds. And he’s very lucky to have Rocio as his mother.

Whenever I think about Stella’s challenges with eating, that very trying time in our lives and how we overcame it all, I’ll think of Rocio and Diego, too.

A freakout. A rant. And endless gratitude.

Posted on by amberhj

Don't worry, it's just prunes.

Don't worry, it's just prunes.

Early this afternoon, Stella got upset and took only 100 mls from the bottle. It was really weird. All my fears and worries came rushing back.

Granted, she took around 180 before and after that. But what a scare. I was so upset, I yelled at Cody like a maniac. He was holding her because he wanted to try feeding her again, after I told him what had happened and how she didn’t seem to want to eat and was getting fussy about it, but all she did was cry and cry so finally I screamed from the other room, “JUST GIVE HER THE PACIFIER!!!” The idea of trying to feed her when she clearly did not want to sent up an army of angry red flags. Forcing it never works–it makes her want to eat less. Not that he was really forcing it, but he was nearing that old territory in my mind and I could not handle it.

It will take a while for me to really accept that she will not always take what I expect and that this is okay.

In the background, I am feeling nervous about her six-month “well child” visit with her pediatrician. He hasn’t seemed to have fully understood how well she is doing. How huge it was for her to start enjoying eating and to not only not lose weight but to start to gain a decent amount after just three weeks without the tube. I mean, it doesn’t really matter what he thinks. And there is no chance of Stella the Tube Girl II showing in theaters–ever. That sequel will never be made. But still. The last couple of times I’ve left his office feeling pretty crestfallen. Like the feeling of letdown when you go on a great first date, then have a terrible second date. You just feel so deflated. The neurotic me (well, maybe that just is me) is afraid that if Stella doesn’t gain an insane amount of weight, he’ll act all concerned and I’ll get all riled up and strongly disagree with him and stand my ground but then secretly, after we leave, I will worry about everything he said and fall apart and it will be unpleasant for all.

So I weighed her today. It was totally unnecessary and probably counter-productive. But I just had to. She weighed in at 15 pounds, 14.5 ounces. So by our count, she’s gained about 8 ounces in ten days. It’s great! Of course, I hear the doctor’s voice in the background saying how he likes to see an ounce a day. But from what I understand, around this age, the rate of gain slows down naturally. And really, she’s happy and healthy and clearly gaining an appropriate amount of weight so who cares!

She’s a week away from her 6-month birthday and when she hits 16 pounds, and clearly she will surpass it by several ounces, she will be above the 50th percentile curve, I think. She was in the 50th when she was born. I will remind the good doctor of this if need be. Have I told you how much I hate percentiles? They drive me nuts. I think that unless a baby is in trouble, no parent should even know the percentile. What’s the point? There are chubba-butt babies that are completely off the charts and their parents know they are big babies. There are babies that are petite–I have a feeling their parents know they are small having looked at them every moment of every day–and very content in the 3rd percentile. And the vast majority of these babies, all over the spectrum, are healthy. So what’s with the percentile obsession? The growth percentile calculator on BabyCenter says, “See how your child’s growth compares.” So there we go, comparing our babies with their peers right out of the womb based on some number that, for the most part, means nothing. I doubt my parents knew what height/weight percentile my sisters and I were in. And I KNOW they didn’t chart our head circumferences! They just knew we were eating, pooping, sleeping and, overall, happy and healthy. That was enough! And it should be for today’s parents. Rant over.

Yesterday’s occupational therapy appointment went very well. Stella ate beforehand, so Robin didn’t get to see how fabulously she eats, but we were able to discuss her amazing progress, affirm the whole journey, and get some questions answered. We got some great tips on how to encourage her to get more comfortable on her tummy and with rolling and sitting up. We learned that we should definitely proceed with spoon feeding full steam ahead and not worry about it adversely affecting bottle feeding. We have some other decisions to make–like when to switch to 20-calorie-per-ounce formula and whether we want to see if the baby food in the bottle really is making it more appealing or if it was just coincidence. I think Cody and I are reticent to switch anything up just yet, but we probably will at least switch her to 20-calorie-per-ounce concentration, as it is the standard for breast milk and formula and may better allow Stella to regulate her intake.

I gave Robin a “thank you” card and photo to remember Stella by–one in which she is clutching a bottle the way Gollum held the ring. I remember our first meeting with her well. We were so thrilled to be there. To finally be getting the help we needed, from the best of the best. (Robin is a renowned feeding specialist.) I’d been trying so hard to get Stella to eat for at least a month at that point and I was falling apart. No one had been able to figure out what was wrong, and they didn’t see the daily struggle and didn’t have the sense of urgency that was needed to move things forward. I felt so alone and hopeless and worn down. During that appointment Robin said with such confidence, “I’m going to see you through this.” And she did. As I reminded her in the card, she listened to me cry and rant. She calmed me down, educated me and backed me up. I am forever grateful.

And that reminds me of all of the incredible people who helped us weather the storm…

Barbara Hescock, my mother, who stayed with us for almost three whole weeks and spent Thanksgiving cooking for three, two of them severely depressed, in our crappy kitchen instead of her new wonderful one with a crowd of eager company as she’d planned long before… she arrived during our stay at Children’s and got me through the worst days of my life, helped me rise to the challenge of dealing with the difficulties of the tube while feeding me (everything made from SCRATCH–even tomato sauce–with so much love) so I didn’t disappear just as she so graciously did during Stella’s first weeks–she was the hands behind my hands, just what every new mom truly needs–and who even tolerated me snapping at her a couple times without holding it against me

Robin Glass, MS, OTR, IBCLC, occupational therapist, who, as I just mentioned, was our rock and provider of wisdom, sanity and hope!

Devorah Steinecker, MD, cranial osteopath who treated Stella about a dozen times and helped to greatly decrease Stella’s reflux and aversion, who was 100% confident that Stella would get better and became one of our biggest supporters when we removed the tube, a time when we really needed positive voices around us

Sarah Tyack, RN, lactation consultant with whom I met several times who helped identify Stella’s reflux, a major breakthrough, and who saw me at my worst and instead of judging me, connected me with the help I needed to cope and the help Stella needed to recover

Janet Whalley, RN, co-author of Pregnancy, Childbirth, and the Newborn: The Complete Guide and lactation consultant that I met with several times who became a mentor and person to call when I got worried, who was always so understanding and concerned about us and provided any and all ideas and information she had

Ann Keppler, RN, co-author of Pregnancy, Childbirth, and the Newborn: The Complete Guide and very well known in Seattle for her mindblowingly helpful First Weeks seminars, she sent me the most amazingly supportive and helpful email in response to my random, frantic email to her

Judy Herrigel, RN, founder of First Weeks and longtime lactaction consultant to whom I reached and talked to about Stella’s issues and who expressed much compassion and understanding

Dr. Trish Raymer, one of Seattle’s VERY BEST family practitioners–my doctor and was Stella’s doctor until we switched to Numrych who had instant access to all of Stella’s lab results, appointment info, etc. at Children’s Hospital which made our lives easier–who got Stella in to see Robin and who admitted us to Children’s when she saw that we needed urgent help, and who was always so delighted to see Stella that it warmed my heart even on my soul’s coldest days

Dr. Thomas Numrych, Stella’s current pediatrician, who returns my emails and calls and spent a lot of time talking to me during our toughest days… I have been complaining about him a bit,sure, but I think he’s a good person and good doctor

Dr. Marguerite Dunitz-Scheer, director of the tube weaning clinic in Graz, Austria who always knew that Stella could do this and who helped convince me to let go of at least some of my fear

Kathleen Kendall-Tackett, Ph.D., IBCLC, a breastfeeding expert—whom I’d heard talk about postpartum depression and breastfeeding issues in a podcast and emailed out of the blue–who talked to me for quite a while on the phone trying to troubleshoot our issues and provide encouragement

Dr. Jessica Bloom, cousin who just so happens to be a pediatrician, who talked me down from ledges and watched Stella for a whole day (after all, if you can’t let a relative who is a pediatrician watch your child, then you are hopeless!), when I was really low and about to starve to death from anxiety

Barbara Reilly, a wonderful, funny, compassionate friend who provided much needed food on multiple occasions and insisted on watching Stella, allowing us to get dressed up and go out for five whole hours!

Susie Estok, a fellow writer and kick-ass friend who watched Stella while I got my hair cut then spent the day with us, making me feel a lot less lonely and lot more hopeful

Maureen Devine, a friend and co-worker with the most amazing heart who stepped up to provide nourishment and support

Rocio Carballo, a mom who was in the same boat with the same fears who contacted me through the blog… we were able to relate and helped pick each other up when we were down and I’m so happy to say that her precious Diego is also tube-free and eating like a champ!

Dr. Stephanie Farrell, an engineer and professor that I don’t know at all and emailed out of the blue about her experiences with tube weaning her own daughter and who sent me the most supportive, wonderful reply

Trish Norton, a mom (to whom I was connected through Robin Glass) who went through very similar struggles with her daughter Libby and who took time to talk to me, a complete stranger, honestly and openly about her experiences and how she got through it, making me feel so much more normal and less crazy and alone

I will always think of these people with such fondness and gratitude. When Stella was not gaining weight, before we had any idea of what was bothering her, that growth percentile curve felt like a cliff. We were careening around a narrow corner and about to fall into a deep, dark abyss when one by one, Team Stella stepped into our lives, and gently but firmly pulled us away from the edge.

Yes, these people are Team Stella, forever!

Thank you.

Days 22 through 25: Stella got her groove back

Posted on by amberhj

As Stella’s occupational therapist put it, “Stella has internalized the joy of eating.”

Her feeding aversion is, well, history. A memory. Though not a distant memory, of course. We still get nervous if she goes for a long stretch without eating. We still watch her eating behavior like mama and papa hawks, and breathe a sigh of relief when she finishes a bottle. But mostly, we are in complete awe of Stella’s incredible appetite. Her ability to down six ounces in less than five minutes. It’s nothing short of a miracle. But then, miracles don’t come easy. You have to work for them. You have to be patient. And you have to believe. There were moments when this wonderful outcome didn’t seem possible. But deep down, we always knew she could do it. That the tube had to go. There was no question.

Stella’s intake for the last week has been between 770 to 875 mls a day. Of course, her formula is made at a 20% higher caloric concentration than typical breastmilk or formula. So she’s getting quite a lot of nourishment, which is quite evident in her diapers! The really crazy part, for us, is that she now takes in 160-180 mls at a time. We remember the days of her taking only 20 to 45 mls, and thinking, “Well, that’s good! She’s eating, and we can build on that!” Then we were absolutely thrilled when she showed she could take 100 mls on occasion. We remember her screaming at the sight of the bottle, arching her back and tossing her head back when the bottle was offered. Now she lunges toward the bottle and pulls it to her mouth. She cries UNTIL she sees the bottle. It’s just astounding.

I remember driving one day, during a wind storm that hit at the height of Stella’s eating troubles, listening to Patty Griffin’s “Love Throw a Line” and singing and crying. This was back when I was so sick with worry, and so overwhelmed, that I couldn’t eat or sleep.  I stopped at a light and looked up to see a mighty, towering evergreen tree whipped up into a frenzy by the wind. The trunk was bending and swaying and the bows were being tossed about so vigorously that the tree looked angry, as if it were fighting back at the storm. Yet, it was clear that this tree could handle the winds. In fact, it was designed to withstand such a storm and had lived through hundreds of them. I saw myself in the tree and its wild, fitful dance. In that moment, even though I’d been feeling like I was losing my grip, I knew I could handle it. That I would help Stella recover, and that we would be okay. Even as Stella and I struggled, we were staying strong at the same time. Just like that tree. I’ll always remember it.

Yes, we’ve weathered a storm. That said, during our stay at Seattle Children’s Hospital, I was struck by how incredibly lucky we are to have Stella–a healthy, happy child, who had a temporary, treatable issue with eating. There are so many children and babies just struggling to survive. Babies like Kayleigh Freeman, who was born weighing just one pound and who has defied all the odds, and bounced back after countless surgeries and trials. (We bought bracelets to support her and will wear them with pride when they arrive!) This experience with Stella has truly opened my heart. I already loved all babies and children, but now there is a whole new layer to that love. A compelling urge to help little ones in need. Cody and I already sponsored a child, and recently, I signed us up to sponsor another little girl–her name is Anyi and she lives in Honduras.

We’ve learned and grown so much over the past five months. (Can you believe she is five months old???) We are truly blessed. Stella is thriving and, as always, an absolute joy. I want to help other parents find the same feeling of  happiness and relief that we have experienced. In the coming weeks, I will find a way to put my strengths, talents and passion to work for children who are struggling. If I can make life even just a little bit better for even just one other baby, well, it would make our experiences all the more meaningful.

You know that feeling after a storm has passed? Quiet and calm settles in over everything. There is a striking stillness in things recently battered by what seemed like relentless winds. The scents and colors of the earth are more vibrant thanks to the rain. That’s what it’s like around here now. Brighter and more peaceful. Except for the teething.

Ha! Now we get to focus more on all the “normal” baby challenges and happenings. Every time I bend down to pick up the teether toy that Stella has dropped for the thousandth time, I smile.

Tube-free Stella: Day 1

Posted on by amberhj

Taken just after the tube came out.

Taken just after the tube came out.

Stella is off and running. I am so proud of her. In short, she is responding well and our confidence is growing. She can do this.

It is expected that she will lose a little bit of weight. I am on strict instructions to NOT WORRY about how much she eats or when. To NOT PANIC if she goes a few hours without eating. That is the challenge. I am simply to trust her to know when she’s hungry and how much she needs. To know that she will tell me in her own way that she is okay–or if she’s not. This simple trust is a bit harder than it sounds, due to our scary experiences of a couple months ago.  But we are beyond all that now. I am ready and so is Stella. Her intake will increase as she adjusts.

The only remaining concern is her reflux and how much of an impact it has on her desire to eat. It definitely still bothers her sometimes. But I think she is comfortable enough to pull through it. I don’t think it will stop her.

This morning, we ventured over to Seattle Children’s Hospital for Stella’s occupational therapy appointment with Robin, who was incredibly helpful and reassuring as always. She is pretty central to this process and to Stella’s progress thus far. I am to call her tomorrow to check in. I feel very supported in this proces–by Robin, Stella’s pediatrician, and the Austrian doctor as well, who has been keeping in close email contact. It’s funny–the Austrian clinic’s approach to weaning is almost identical to what I’m hearing from Robin. It’s all coming together.

This is huge. The tube weaning process is no cake walk, but we are feeling good. Stella seems happy–even more so than usual.

As so many of you have already said, “Go, Stella, go!”

How will we play this hand?

Posted on by amberhj

In between feedings and worrying about feedings, I was flipping around the airwaves when I briefly paused on a news show. I caught the end of a remembrance montage that honored some of the incredible people we lost in 2008. Randy Pausch was one of them.

If you haven’t seen his famous “Last Lecture,” I command you to go watch it RIGHT NOW. Whether you catch the long version he presented at Carnegie Mellon University, where he was a professor, or the short version that he shared on Oprah, you’ll be changed  by it. I was.

Randy Pausch, a very loving husband and father of three little ones, was diagnosed with pancreatic cancer and given only months to live. With this lecture, which absolutely overflows with fatherly wisdom, humor, honesty, insight and an astoundingly positive attitude, he gives us all a great gift. Although it was initially presented under the title, “Really Achieving Your Childhood Dreams,” it’s truly a guide to living well, and not just that, but living joyfully in the face of obstacles and even gut-wrenching misfortune. I first saw his talk many months ago, and watched it again today. In light of the situation with Stella, his words had a whole new meaning. He gave me a good smack on the forehead, actually.

He reminded me that I must choose to be a Tigger instead of an Eeyore. To allow Stella to paint rockets and elevator doors and whatever else she want on the walls of her room, if someday she wants to. And to see brick walls merely as opportunities to show just how much I care about and want something.

“We can not change the hand we are dealt, just how we play the hand.” There are so many more amazing quotes from Randy’s lecture, but to me, that one pretty much says it all. When I scale this massive bit of wisdom down, it applies to every aspect of what we are going through. From our overall attitude as parents, to our view of Stella’s feeding aversion, to how we respond to an individual feeding that doesn’t go well.

Randy’s grace in the face of what amounts to a death sentence left me in awe, and allowed me to put our situation into perspective. The tube and Stella’s feeding issue are unexpected twists in our story. A bit scary at times, sure. But it’s nothing we can’t handle. The tube can’t stop us from having fun, being silly, reading Goodnight Moon until it’s seared in our brains, going on long, lovely walks, and loving and enjoying each other’s company like crazy. It’s just a brick wall that we are going to smash down. Then we’ll dance on the debris.

(Thank you, Randy.)