tube feeding

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!”

The tube is out. I repeat: The tube is OUT.

Posted on by amberhj

And we are leaving it out.

This weekend, I sent Stella’s pediatrician and occupational therapist an email outlining my concerns about the tube and research to back up those concerns. Today, they agreed to a tube-free “trial.” Her doctor said two to three weeks without the tube would be “low risk” given how healthy she is.

We will meet with her occupational therapist tomorrow, and see her pediatrician on Friday. I have been in contact with the Austrian feeding clinic, wired them the registration fee, and they will offer weaning guidance via email as well.

I’d intended on leaving the tube in tonight, and taking it out in the morning. But she yanked it most of the way out tonight, so we went with it. And let me tell you… her tube-free face was a sight for sore, exhausted eyes.

The plan is really quite simple. Feed Stella when she is hungry. When she TELLS me she’s hungry (with her whining). Give her no more than she wants to take. Don’t panic if she doesn’t take much. Wait for her to tell me she’s hungry again, whenever that is, and repeat.

Stella, the feeding reigns are in your precious little hands. Show ’em what you got.

The stubborn determination of hope

Posted on by amberhj

Good news. Stella is back to taking in about half of her daily calories from the bottle, just as she did before the recent regression.

However.

My feeling is that the tube is preventing her from recovering completely. I believe that it exacerbates her reflux and makes swallowing more difficult. I found and paid for two medical research papers that support my beliefs. I hope that she proves me wrong, and soon, but I am unconvinced that our current mode of treatment will enable Stella to return to 100% normal bottle feeding. I am ready to take urgent action. I am questioning the medical establishment and ready to try something else.

I learned about and have been in touch with a renowned feeding clinic in Austria. Their cold-turkey approach to tube weaning is radically different that what is practiced here in the states. They believe that the baby or child must drive their own intake, rather than the tube. They share my belief that tubes, over time, worsen aversions and lead to tube dependency. They have studied the topic for over 15 years and have a success rate of 92-95%, depending on the age group. The doctor who runs the feeding clinic told me that Stella’s age is ideal for weaning and that we may be able to achieve it through email coaching, rather than having to go all the way to Austria–although I am eager and willing to go to Pluto if that’s what it takes.

The drawback to this method, what is called the “Graz” approach, is simple. The babies and children treated may not gain weight for a month or two. I believe that Stella would be on the shorter of those timeframes, since she already takes half of her formula orally and the clinic treats many children who are 100% tube fed. Stella will be hungry and not fed until she asks for food. This may seem harsh to some, but I believe it makes sense. I believe that Stella, if able to have more control over her eating and freed from the discomfort and difficulties of the tube, would respond very well. But she would need some time to pull through once the tube is removed. Most doctors here are not willing to let a baby have low or no weight gain for any period of time, so the tube stays in. They, of course, have the babies’ best interests in mind, but they seem beholden to the tube and unaware of, or too willing to overlook, its detrimental effects in the name of weight gain. I believe that any short term weight gain delay would be more than made up for with the restoration of a healthy relationship with food and the resulting appropriate, baby-driven weight gain that would follow.

Stella’s life was never in danger. The tube was placed for therapeutic purposes, not just to help her gain weight. The tube was helpful in allowing Stella to say “no” and be heard, instead of constantly being force-fed, which must’ve been very traumatic for her. The tube took the fight away from eating. The tube has enabled her to make progress. But I believe that we have reached a point at which the tube’s negatives outweigh the positives. And I am ready to take bold action in the face of a lot of opposition in order to do what I believe is best for her.

Cody and I are going to consult with her occupational therapist and pediatrician on this. We will continue to bring Stella to a cranial osteopath. We are going to do some research into the Graz method and the Austrian clinic. And then we are going to decide how to proceed. Of course, in the meantime, we would love to see Stella down bottles left and right, thereby eliminating the need for tough decisions or new approaches.

Even on gut-wrenching days when Stella resists the bottle like it’s full of toxic waste, there is an incredibly wishful part of me that looks to the next bottle as a possible turning point. There is a clump of raw hope that sits smoldering in my chest like an ember in the darkness. It’s always there. And it’s going to light the way to a tube-free Stella.

Fear

Posted on by amberhj

Stella took a step back today. But I keep telling myself that it’s okay. That it’s to be expected. Just part of the process. And her total bottle intake today, on a decidedly so-so day, is higher than what we saw on an average day just a few weeks ago.

Of course, we can’t help but feel let down and look eagerly toward her next upswing.

At her first feeding, the nipple clogged four times (the thickener is likely to blame). She wanted to eat, but only had so much patience. The fact that she went back to the bottle three times in one feeding (after three nipple changes)  is encouraging. In the afternoon, I think her reflux was a major factor. I heard the telltale gurgles and gulping several times during the feeding, but she still managed to take 80 mls, which isn’t bad at all. This evening, after a very, very long nap, she “should” have been quite hungry but was fussy and only took 50 mls. We decided to skip the pump and try again with the bottle an hour later, at which time she took another 55, somewhat begrudgingly. After that, we had to give a bunch by pump as she’d fallen behind in terms of her caloric intake for the day.

It’s so perplexing to us how she can go from taking 135 mls in one feeding yesterday, to taking just 50 in one feeding today. While the overall trend is upward, it still feels like she’s all over the place, and the highs and lows are emotionally exhausting. I wanted to hurl the bottle across the room with all my might again this evening, but I didn’t. I guess I deserve a lame-ass pat on the back for that bit of restraint. *Overly dramatic sigh.*

Underneath all the pep talks and tears and thrown bottles and every other reaction and coping mechanism under our family’s sun is big fat ugly old FEAR. In just a couple of weeks, she’ll have had the NG tube for two whole calendar months. There’s a little voice inside my head, a tiny neurotic bastard, who keeps asking undermining questions and making incredibly stupid statements such as,”Shouldn’t she be further along by now?” “Wow, she really doesn’t want to eat this morning. We’re screwed.” “What if she never takes enough by bottle and has to have one of those surgically inserted tubes that goes right into your stomach?” “Is the NG tube making her reflux and swallowing worse and will it eventually ruin everything?” “That feeding didn’t go well at all–maybe she’s finally had it!”

The truth is that when I really stop and think about her feeding issue, I get very, very scared. So afraid that, at times, I can barely stand it. It’s physically uncomfortable. It takes the form of that deep pain in the pit of my stomach during some feedings and a stubbornly low appetite, which is so not me.

When I was pregnant with Stella, fear completely overtook me on more than one occasion. I worried that something I’d eaten or applied to my skin would hurt her. I also fell down our icy front steps one morning and proceeded to bawl my eyes out during a meeting at work. Yup. The shred of a thought of an inkling of a possibility of harm coming to her (combined with all the hormones) was too much to handle. Too many times, I became very concerned because I had not felt her kick in what felt like a reasonable time. But I swear to you that whenever I became really, really worried about not having felt her move, I would tell Cody about it, and at that very moment she would dance on my kidneys. It was absolutely uncanny. With her incredibly timely kicks, she was telling me to chill the hell out. I got the feeling that she could sense my worry and wanted to ease it.

In a way, she does the same thing these days. Just when we’re feeling sickenly worried and downright discouraged about her eating, she’ll go and polish off an entire bottle. And voila! All hope is renewed and there is light and justice and peace in the world. Birds and angels sing, rainbows appear, and for at least a little while, I am neither scared nor worried. I am free of all that heaviness, and we dance lightly around the house like the silly fools we are.

We set ’em up. Stella knocks ’em down.

Posted on by amberhj

Another triumphant feeding! Daddy and Stella celebrate after Stella takes 135 mls from the bottle!

Another triumphant feeding! Daddy and Stella celebrate after Stella takes 135 mls from the bottle!

Cody, Stella and I had a relaxing holiday weekend. I’m sad that it’s over and that Cody will have to return to work tomorrow. He’s been working a lot, which has been tough. Just having him around makes me feel better, and Stella loves it, too.

When I get down, he helps pick me up, and vice versa. Of course, when feeding doesn’t go well, we both feel discouraged and can sometimes work together to find the positives and pull ourselves up together.

This weekend, we realized that our standards had really risen in regards to Stella’s eating. We found ourselves feeling bummed when she took “only” 70 to 80 mls. We had to step back and remind ourselves that not long ago, that was considered a good feeding! 

Today is an interesting example. She had only four bottles because she slept so much, and because we gave her the usual two feedings via pump while she slept. The average number of mls she took per bottle was 111.75 (yes, we are that exact). Remember, her formula has 24 calories per ounce instead of the usual 20 calories per ounce, so she gets more calories with less volume–big feedings can really exacerbate reflux.

She complained a bit before her first feeding, but other than that, she accepted the bottle right away and was very comfortable while eating. Stella has come so very far! This whole feeding fiasco–or should I call it a “challenge” instead–has been an exercise in the power and importance of positive thinking. Slowly but surely, I’m learning.

Tonight, I returned the hospital grade breast pump that I rented two months ago. I was surprised by how emotional I got during this seemingly simple errand. I cried a lot and it really caught me off-guard. Then again, that pump and I, we spent so much time together. We worked so hard! We were side by side through the scariest times with Stella. When she didn’t want to eat and I thought her health was in serious danger and that it was my fault. When my milk supply was low because she wasn’t taking enough. When we had no idea what was going on with Stella and were desperate to get answers.

I tried. I really, really tried. Hundreds of ounces of breastmilk still sit in our freezer.

I tried. I really, really tried. Hundreds of ounces of breastmilk still sit in our freezer. Just can't bring myself to dump it. Too much effort and love went into making it. I'm wondering if I can donate it somewhere.

That huge, yellow pump became a fixture in our living room. It represented my long, last, and intense effort to continue breastfeeding Stella–and I suppose I had a hard time letting the pump go for that reason. Breastfeeding was what I wanted for her, and for me. I really miss the closeness that we enjoyed through breastfeeding. The proud and assured feeling that I was giving her the very best nutrition. The knowledge that I was nurturing her in such a direct and intimate way. I am grieving the loss of breastfeeding, though it’s not as sharp as when she had her first bottle of formula, or when I stopped pumping a couple of weeks ago. Even though formula truly helped Stella thrive by getting her comfortable and willing to eat, part of me really feels like Stella and I are missing out on something. However, toward the end of my time with this impressive piece of machinery, pumping was taking away more than it was giving us. 

At the hospital,  Stella was put on hypoallergenic formula “temporarily” to see how she’d do and to allow the doctors to do their assessment. (Of course, it didn’t turn out to be temporary, as stool testing showed that the switch helped Stella in many ways. I think that deep down, I actually knew that it would not be temporary, or at least I feared that would be the case.) I was pumping eight times a day even though it wasn’t clear if she’d ever safely be able to enjoy breastmilk again without jeopardizing her comfort and willingness to eat. I’d given up soy and dairy for the cause, which was difficult but wouldn’t have been as big a deal if anxiety wasn’t already beating the crap out of my appetite. 

Feeding Stella with the bottle, then the tube/pump is time-consuming and then to have to pump myself–it was too much for me to handle. I wanted more time to spend just being with and enjoying Stella instead of operating various pumps for hours a day. I needed rest, which was impossible with having to wake up to feed her via tube and stay up to pump. As my friend and cousin Regan pointed out, breastmilk is very beneficial to babies. But just as if not more beneficial? Happy, healthy moms.

Happy and healthy is how we can now describe Stella. Sure, I wish breastfeeding worked out for us. But it didn’t. It’s that pesky parenting lesson that keeps popping up! In short, sometimes things don’t work out like you planned or hoped or envisioned, and you just have to make the best of it. Besides, I have three months of fond breastfeeding memories to hold onto. I remember nursing her for 30 minutes right after she was born. I remember her first few weeks, when she’d wake up hungry in the middle of the night, and Cody would change her diaper and then place this beautiful, tiny, wriggling little baby next to me. She’d be crying and squirming and sucking on her hands–and then she’d latch on and suddenly be so peaceful. Later, that all changed and breastfeeding was not so peaceful, of course. But I’m so glad we had those early experiences together. And, stepping away from my emotional attachment to breastfeeding, I’m so very glad that the formula took away much of the pain Stella was experiencing.

She may no longer get my milk, but she’ll always get my best! I just love her so much. And that’s really all there is to it.

Hope in a bottle

Posted on by amberhj

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.

Daddy saves the day!

Posted on by amberhj

It was a curious morning. Stella was happy as could be. She wanted to eat and took right to the bottle. She started with such gusto! Then, would barely suck at all, doing the short, unenthusiastic sucks we referred to as “fake nursing” back in Stella’s breastfeeding days. It made no sense.

During her evening feeding, my arm was killing me from holding her for so long. And I’d had it! She was barely eating anything, and I had no idea why. Emotionally and physically drained, I stopped the feeding, handed Stella to Cody and went to walk (and cry) in the snow. I just had to get away.

I called my friend Kari, who is always such a comfort. It didn’t take long before I was a bit calmer, and a lot colder! So I headed home, expecting to see Cody sitting by Stella, running the pump to give her the bulk of her feeding through the tube.

I walked in to see Stella resting peacefully in Cody’s arms, finishing off a bottle. Framed by the kitchen doorway, it was a scene that melted my heart. I cried again, of course, but this time from relief, gratitude and sheer, unabated happiness. Later, he gave her the last bottle of the day, and she finished it as well.

It turns out that the nipple was clogged. Cody, using that handy engineer brain of his, figured it out. Puzzled by her behavior, he stopped feeding her and shook the bottle. Nothing came out. He replaced the nipple with a new, clean one, and tried again, and she drank it down. Honestly, I never would’ve figured that out. I couldn’t distance myself enough to think through it clearly. Plus, as they say in Boston, Cody’s “wicked smaht.”

So, Daddy is a hero tonight. Stella, too! I’m in awe of both of them, and feeling extraordinarily lucky.

Stella is four months old.

Posted on by amberhj

Love at first sight.

Love at first sight. (Four days old.)

On Wednesday, December 17th, Stella turned four months old.

It’s absolutely stunning to think that she’s only been here for four months. How is it even possible to love a virtual stranger so deeply in so little time? How can your world change so drastically in a matter of mere weeks? How can so much drama, change, growth and wonderfulness unfold in just one third of one year?

Today, we went to Dr. Numrych’s office for her four-month “well child” check-up. Stella continues to amaze. Sure, she’s had some setbacks with eating due to her reflux and dairy intolerance, but developmentally, she’s right on track. She’s supporting her own weight when you stand her up and help her balance. She’s grasping and pulling things to her. She recognizes her parents from across the room (you can tell by the big smile). She babbles and laughs often–her signature sound is what Cody calls “motorboat noises” while I see it as a cross between cooing and purring. Basically, all of this and a few other skills make her one fabulous four-month-old.

Of course, at these check-ups, you get the line-up of baby stats. So here goes. She now weighs 14 pounds and 6 ounces, which puts her in the 75th percentile for chubbiness. She is 24.5 inches long or tall, depending on how you look at it, which places her squarely in the middle at the 50th percentile. Her head circumference of 43 centimeters means that her noggin is in the 90th percentile, which should come as no surprise. Cody and I have giant heads.

Big heads run in the family.

Big heads run in the family. (Two weeks old.)

A couple summers ago, I headed to a nearby bicycle shop on a simple, safety-conscious quest to buy a helmet. To my embarrassment and salesperson’s awkwardness, the largest women’s helmet was way too small. My head looked like an orange with a mushroom cap sitting on top of it, so I had to head to the men’s section. Cody just bought a one-size-fits-all wool cap from our favorite coffee shop, Fuel, and it doesn’t cover his ears, so it’s practically useless in this cold winter weather and just serves to squeeze the top of his head while emphasizing his cheeks. It kind of reminds me of when we put Stella’s Red Sox cap on for the first time–we really had to squeeze it on. In a most adorable fashion, the hat accentuated her chubby cheeks and left an indentation on her forehead. (Later, I stretched it out and it fit just fine, but it took some doing.)

I woke up at midnight, 3am and 6am to feed Stella last night–I did it one extra time because we’d fallen behind yesterday. Each feeding takes 40 minutes to complete. We woke up at 8am. So some quick math should tell you how braindead I am right now. But even in the midst of sleep deprivation delirium I can tell you that despite all the challenges, fear and exhaustion of the past four months,  I wouldn’t trade them for anything. Not even a blissful eight-hour stretch sleep on a magic mattress made of soft, billowy clouds.

Stella celebrates her four month birthday.

Stella celebrates her four month birthday.

This blog is supposed to be about Stella, but I can’t help but reflect on how the past four months have affected me. I’ve become expontentially stronger and a lot more vulnerable at the same time. I’ve cried and laughed more in these four months than in the rest of my 31 years combined. I’m more tired than ever, but also more alive. I’ve lost my mind while becoming more responsible. I’m a different person, but more fully myself. It’s insane. Insanely difficult! Yet it’s truly been the best time of my life. Stella has brought me more joy than I ever could’ve imagined. And we’re just getting started.

The question I keep asking Cody is, “How did we get so lucky?”

Meet Libby.

Posted on by amberhj

Stella’s occupational therapist, Robin Glass, has fielded many a teary phone call from me. A great support to Stella and myself, she’s talked me through many tube-related worries and emotional upheavals. Knowing that I needed a boost, Robin connected me with a mom whose baby was similar to Stella in many ways. Due to the pain of reflux, this baby refused to eat, was hospitalized at Children’s, and had a tube–but not for long.

The baby’s name is Libby Norton. I called her mom, Trish, a couple weeks ago, on a day when I felt pretty scared and helpless. Trish was warm and wonderful as she candidly shared her story. She spoke about all the emotions she experienced as Libby “learned to eat.” Honestly, it was as if she had set up camp inside my head and was reading my mental diary aloud. It was so comforting to know that I wasn’t alone.

You can read Libby’s story at libbynorton.blogspot.com. Libby left the tube behind over a year ago. In fact, she is now a big sister to Sarah, who is fantastic eater–phew! Click here to read posts from that triumphant time.

Every time I get down, I remember that Libby pulled through. In her own time, Stella will, too.

Lucky 14?

Posted on by amberhj

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.