Hope in a bottle

Okay.

Some days, the bottle looms so large that it casts a shadow over everything–but only because I let it. Because I’m so very, very tired and incredibly discouraged and wishing to the point of physical aching that Stella would just eat.

I mean, can you imagine if someone begged you, on their hands and knees, to eat tons more than you actually do? Wouldn’t you lose your mind due to the sheer abundance of joy and calories? What’s so crazy about all this is that there was a time years ago when I went to really unhealthy lengths to stay thin. Not anymore. But nwo I have a daughter who at four months won’t willingly eat enough. It’s circular and messed up and if I think about it too hard my brain hurts.

We had a bit of a tough day. Well, to be more accurate, I had a tough day. Stella was fine. She wasn’t enthused about eating. But she slept a lot, had fun with mommy and a bunch of new toys from her aunties, went for a walk, and just generally had a grand old time.  Really, she was fine, even though her tube came out again. Ugh. I’d like to point out that she doesn’t yank it out on purpose. She has a habit of grasping whatever is near her, and guess what? Her tube is always near her and if you take your eye off her for .2 seconds, she’ll grab it and flail her arms in her usual fashion except this time, because the tube happens to be in her chubby, cute, scrumptious-looking little paw, the tube comes flying out, the tape is torn from her face and my stomach drops to the floor with a loud thud. It’s happened way too many times, so upon seeing her waving the end of the tube around, the end that is supposed to be inside her tummy and not flapping around in the air, I resolved to NEVER let it happen again. It’s torture to put back in, and Cody and I fear that it exacerbates her reluctance to eat due to the irritation it causes to her throat. So, I hereby declare that the excess length of tube will now always be shoved down her onesie/outfit when not in use. I will  secure the bit that extends from the “tape” (Replicare underneath the tube with Tegaderm on top) behind her ear. I will watch her with even  more hawk-like intensity, removing the tube from her stunningly strong baby grip as soon as she snags it. So that’s settled anyway. Stressful, but settled.

In related news, Cody and I started going to a couples counselor. Being a new parent is really stressful. And being a new parent of a child with an NG tube is, I am pretty sure, even more stressful. And conflict inevitably arises. And it helps to have an objective, educated, helpful and kind third party to help work things out before they blow up in our faces. We believe that maintaining a strong relationship between is as important to Stella as solving her eating issue. Really. Our energy, the way we treat each other, the way we deal with conflict and stress, it all gets fed to Stella just like her $43-per-can hypoallergenic formula. It’s an eye-opening experience that really just boils down to us both learning how to deal with stress in healthier, more compatible ways. I am learning to not take my frustration out on Cody. And Cody is learning to not withdraw from me. We realized in our first appointment that “The Tube” has become an entity unto itself. It is the focus of a lot of attention and fear. We talk about “The Tube” like it’s Darth Vader, tempting us to the dark side. Well, I do anyway, and I’m working on letting all that go, which can only be good for all of us.

So, after her Obama-like, hope-filled weekend of feeding pr0gress, she’s had a downturn. There are some clogged nipples to blame, as the thickener we use in her bottles requires intense emulsification efforts–involving whisks, shaking, large containers and gourmet chefs–to blend properly or else little blobs of the goo will block the flow from the nipple. There are also ripped nipples and impatient moms (me) to blame. In an effort to clear out and prevent clogging, I aggressively cleaned those problematic bottle nipples with a tiny little Dr. Brown’s bottle brush and, without realizing it, tore the holes wide open so that formula gushed out at a pace that probably traumatized Stella. I felt horrible upon realizing what I’d done.

But in spite of everything, tonight at 9pm, after a discouraging day of what seemed like feeding regression and a blunderful gmail video chat attempt with my family back east, Stella downed a whole bottle in five minutes. If we’d had champagne on hand, I’d have popped that cork in a second and sprayed the alcoholic fizz all over Cody and Stella as if we’d just won the Superbowl. But we didn’t have any bubbly available, so we danced to The Kinks’ “Picture Book” again and ate Boston Baked Brownie Cake. I couldn’t imagine a better Christmas eve, really. I hope yours was just as good.

Lucky 14?

Stella takes a step forward...

Stella takes a step forward...

It’s great that my appetite is back. Because I have some words to eat. In my last post, regarding Friday’s doctor appointment and weigh-in, I stated, “I’m certain that she won’t have gained the ounce per day that the doctor would prefer to see.” Over the two previous weeks, she’d gained ten ounces total, or five ounces a week. So I expected more of the same, since we’d only increased her intake by about 20 mls a day. It had been exactly one week since her last appointment, so a good gain would’ve been seven ounces. Well, Stella somehow managed to gain 11 ounces! She now weighs 14 pounds! We were amazed and encouraged.

Her doctor said that this type of weight gain suggests that there’s no obstruction or other structural problem. The food is passing through her system and being digested and utilized for growth. (Though, Stella will still have an abdominal ultrasound on Wednesday, just to be sure.) As her reflux and cow’s milk protein intolerance have been treated, the good doctor believes that this is now strictly a feeding issue that will resolve in time.

Friday’s second appointment, our foray into Cranial Osteopathy, was fascinating and uplifting. We are now seeing Dr. Devorah Steinecker, a holistic pediatrician–an M.D. with additional training in neurology, developmental pediatrics and pediatric osteopathy.  She was incredibly optimistic about Stella’s condition and totally confident in her ability to resolve Stella’s feeding issue.

I learned so much at this appointment, about an area of medicine I didn’t even know existed until a few days ago. My understanding is very limited, but in a nutshell, Dr. Steinecker believes that Stella’s issues were caused or exacerbated by compression to the skull that occurred during birth. An intense, 32-hour labor and the transverse (sideways)  positioning of Stella’s head put a ton of extra stress on her skull, focused mainly on the the occipital (rear) bone (which is composed of four parts in newborns), where the nerves controlling swallowing, appetite and digestion are located. The plates of the skull are designed to move and compress during birth, but Stella was subjected to an extreme amount of pressure, resulting in more compression of the bones and nerves in that area. Through gentle, hands-on manipulation, Dr. Steinecker can make tiny adjustments to the bones’ positioning, restoring balance, relieving tension, and freeing those nerves to function properly. That’s just my basic, quasi-ignorant understanding. If you have a question, please leave it in a comment and I’ll do my best!

We went back to Dr. Steinecker for a second appointment the next day, on Saturday evening, to speed things along. I’m almost afraid to say this, but we may already be seeing improvement. On the way home from yesterday’s appointment, Stella seemed hungry so I offered her the bottle. She took 50 mls while in her carseat, as we were driving. She didn’t fight the bottle, and gulped it down quickly and comfortably. This is pretty much unheard of. To feed Stella, I have to hold her in my right arm while standing and performing deep squats to provide her with a calming, steady bouncing motion while facing Christmas lights or another mesmerizing visual distraction. Later that evening, she took 100 mls, easily. As you may recall, her first bottle of the day is “always the worst” (more words to eat?). But this morning, she took an entire 115-milliliter bottle in five minutes. At her second bottle, she took 85. Holy crap.

Of course, other efforts may help explain this apparent upswing in bottle feeding. The new ratio of formula to thickener (one packet of Simply Thick to eight ounces of formula) along use of a number three Dr. Brown’s brand nipple (instead of a number two) seems to be a great combination for Stella. We don’t want to get ahead of ourselves, and we anticipate more ups and downs, but we are seeing progress!

Last night, it snowed in Seattle. The first flakes fell as we left her appointment with Dr. Steinecker. Snow always sparks excitement in me, probably due to giddy memories of sledding and snow days, crucial parts of any east coast upbringing. At the same time, snow makes the world seem more peaceful. At that moment, as we walked outside and admired the flurry illuminated in the street light, all seemed right in the world. Tube and all. There was, and is, a sense that the tube will be gone soon. When Stella is ready.