Hooray for Heath, his mom, and inspiring tube weaning success!

Mighty Heath

Meet Heath. Ain't he sweet?

Remember Zander? Well he’s got company. (The tube-free ranks are growing.)

Sadly, I kept putting off this post because the hugeness of the triumph deserves a truly well written, heartfelt description. Which takes time and energy that I’ve been lacking, though I’ve so wanted to muster it! But then I realized that I can’t tell the story any better than Jenny, Heath’s mom, an incredible writer and an amazingly intelligent and unstoppable mother. So I’m just going to give you the highlights and point you toward the blog that documents Heath’s journey: The Crunchy and the Smooth.

Heath is 15 months old and was 100% tube fed until a couple weeks ago. The need for his g-tube (gastrostomy button) was prompted by his difficult birth and the immediate, medically intense aftermath. The fly-by overview, in Jenny’s words: “cord wrapped tight around his neck, Apgars of 0, ambulance transport from a country mouse hospital to a city mouse NICU, diagnosis: hypoxic brain injury.” As the result of many necessary and lifesaving but overwhelming and traumatizing medical procedures that took place in the area of his nose and mouth (mainly intubation and suctioning), Heath developed Posttraumatic Feeding Syndrome. Until recently, to defend himself from further invasions, he batted away any food presented to him. He was scared, and who could blame him? The answer, his parents realized, was to build trust, apply no pressure, and to let him feel hunger and interact with food on his own terms (play picnics, for example).

I want to pause here and clarify, because “brain injury” is vague and doesn’t paint an accurate picture of Heath. While motor areas of Heath’s brain suffered injury during his birth, Jenny explained to me that his brain is repairing itself thanks to the amazing processes enabled by infant neuroplasticity. The ongoing repairs are evident, as I’ve noticed leaps in his development in the short time I’ve known Heath.  Anyone who lays eyes on him can see that he is thriving in every way. He  is one of the happiest, sweetest, most engaged and engaging babies I’ve ever met. He’s got a sense of humor. He communicates and makes friends easily. His weight is great. He’s meeting developmental milestones a little later than most, but he’s getting there–at his own happy pace (just like all babies, really). Of course, his mother has sought out various ways to support him in his physical development, including occupational therapy, movement sessions and even yoga–and he’s way better than me, seriously.

After much research, various forms of therapy, eye-opening revelations, and inspiration from the Graz model, an intensive wean was planned. The journey began on May 9th, with hands-on support from Dr. Markus Wilken, a psychologist with specialized expertise on feeding adversity. He came to the U.S. to help wean Heath as well as two other tube-fed children, who began eating faster than anyone expected! (You can read about Kai and Rosie’s simultaneous weaning successes at The Crunchy and the Smooth, as well.) Over his career, Wilken has helped wean more than 400 children from their feeding tubes.  He leads the tube weaning program at Princess Margaret Hospital in Darmstadt, Germany and together with Martina Jotzo runs The Institute for Psychology and Psychosomatics of Early Childhood.

Jenny’s blog has all the weaning specifics, but I’ll say that it’s been quite a ride (as in nauseating ups and downs) for Heath and his parents, as most weans are. But, with no doubt, the weaning effort has been successful. The progress Heath has made is staggering. In short, and I am in complete awe though I never doubted he could do it, Heath has become an EATER. He is enjoying a diverse array of foods, with more and more being added to the menu each day. I’m smiling because Heath’s life is forever changed. And because any parent of a tube-fed child who reads this will experience the sensation of their heart doing a back flip within their chest. Brave Heath is going to help so many babies and kids escape from the limitations, pain and decreased quality of life (for the whole family) that comes from extended tube feeding–not just the physical and psychological effects of the tube itself but from the anxiety and helplessness of tube feeding with no end in sight, when your child has (often after much hard work, therapy, recovery) the ability but not the willingness to eat. The parents who stare into a proverbial black hole whenever they ask doctors or wonder to themselves about whether their child will ever be able to eat–they will discover hope in Heath.

To say that Heath’s mom deserves credit is such a vast understatement. The roller coaster ride she (and her wonderful husband) have been on since his birth, when Heath literally had to be brought back to life and the 35 terrifying days in the NICU that followed, is a testament to not only her strength, but her inestimable love and grace. I know why Heath smiles so much.

Practically speaking, this very smart woman is an accomplished journalist. You can tell by the quality of her writing–and the research and outreach to experts across the globe that she executed in her quest to empower Heath with the gift of autonomy and the joy of eating. So, parents of tube-fed children, please check out her Resources Page to hit the jackpot in terms of insights and data and all kinds of valuable, rare informational gems on the topics of tube weaning, tube feeding and associated trauma.

To everyone reading this… I hope you’ll go to The Crunchy and the Smooth and post a few cheerful and supportive words in the comments section. Heath has come a long, long way, but there is still patience and perseverance required by this family as they follow Heath’s lead and adjust to a whole new paradigm.

To Heath, Jenny and the man known as “Peanut”…  big love, loud applause and quiet, awestruck respect from me, Stella and Cody. Enjoy every lick, bite and gulp! (We know you will.)

Open wide

So, as I reported earlier, we visited Seattle Children’s Hospital this week to see Robin, Stella’s wonderful and very wise occupational therapist. We wanted to check in and see how Stella is doing with solids. We were worried because she wasn’t eating as much as a nine-month-old is “supposed to” by now. She had not been showing any aversive behavior, and once in a while she’d chow down on bananas, avocado or toast, but overall, her intake of solids seemed pretty low–maybe 1/4 of a cup for an entire day and a few bites of finger food. And it was taking *forever*.

Well, Robin assured us that Stella was just fine. In fact, Stella has no feeding problems anymore, at all. I knew this deep down, but it was an incredible relief to hear it from our trusted expert.

We realized that the problem was us–not Stella. Robin gave us some very valuable pointers on how to feed Stella more effectively. It turns out that we’d been so afraid to push Stella, based on early battles over breastfeeding and bottle-feeding, that we weren’t offering her enough via spoon. We were way too timid. Stella doesn’t need to be coddled. Ever since our meeting with Robin, we’ve pretty much been “shoveling it in” and Stella has been enjoying 1/4 to 1/2 cup of baby food plus a few bites of finger food at each of her three meals. Just like she is “supposed to.” It’s amazing!

She seems to really enjoy my homemade blueberry puree mixed with a bit of cereal, and that makes me so happy! That said, Stella has a nasty cold, which is making food less appealing to her–especially chunky things like finger foods. She’s thrown up immediately after some of her meals due to coughing fits, but it’s tapering off as the worst of her illness appears to be over. It hasn’t slowed her down too much, but I’m interested to see how eating goes when she feels better.

Stella had been taking enormous bottles, up to nine ounces at a time for a total of 30 ounces of formula a day. Contrast that to the days when when 3 and a half ounces was HUGE! So in the two and a half hours before her first nap, she was getting 400-450 mls (that’s up to 15 ounces in the first couple hours!). No wonder she wasn’t into solids. She was full! As a result, we’re in the midst of a schedule shift. I’m almost embarrassed to admit this, but it’s made me anxious.

We had our old schedule *down.* I knew roughly how much she would eat when, and it created a nice comfort zone–for me as much as Stella. Well, as she grows we need to adjust, and that’s what we are doing now. But a low-level panic infiltrated my day. By fitting in these larger meals of solids, we are messing with the timing and amounts of her bottles. She doesn’t seem hungry enough to take a bottle RIGHT after solids. I don’t know exactly when she’ll get her 24-30 ounces for the day and it makes me nervous. I have to watch for hunger cues more closely. So, I am officially out of the comfort zone, and am figuring out what works and what doesn’t. It’s a bit of a throw back to when Stella had her tube and when we were weaning her. I never really knew when she would want to eat. I just had to pay attention and wait–not my strong suit.

I’m giving myself pep talks, and they are effective.  They sound a little bit like this:

“If I can survive the anxiety of a newborn that won’t eat, pumping around the clock, mastering the use of a god damned supplemental nursing system, navigating the complexity and chaos of hospitals and healthcare, inserting and maintaining an NG tube, getting no more than three hours of sleep at a time for two months, weaning my baby off of the tube and curing her aversion without (completely) losing my mind, I think I can figure out a new feeding schedule. Damn it, I can do just about ANYTHING.

And so can Stella.”