Teagan Update

So, here's an update for all of you out there in interwebland regarding the most beautiful daughter Amy and I have had the pleasure to have had so far. Well, at least the most beautiful human one we have, the cats are pretty darned cute in their own right. But first, a little background. Some of you will know some of this, a few will know pretty much all of this, but for most, this will all be brand, spanking new...

Teagan was born with a cleft in her soft palate. That makes breast feeding nigh impossible, and makes bottle feeding somewhat problematic, because she can't create enough negative suction to get the milk out of the bottle. Whilst in the hospital, the staff gave us a few "cleft lip/palate" bottles to try, but Teagan couldn't get anything out of them, so we returned to the standard bottles. When feeding her there, we were getting somewhere between 10-20 ml (~1/3 to 2/3) of fluid into her 6-7 times per day. Noone seemed too overly concerned, they just figured we'd all figure out the feeding thing and she'd go on her way gaining weight.

When we got home, we switched from the regular bottle/nipple we got from the hospital to an Avent bottle with a somewhat softer nipple. It didn't seem to help. Feedings took anywhere from 1 to 2 hours, with 1.5 being the norm. She'd normally take 20 ml (~2/3 oz) in that amount of time, sometimes as much as 30 ml (~1 oz). Our ritual was 1) try to wake the baby, 2) try to feed the mostly sleeping baby for 60-90 minutes, 3) change the baby, thereby finally waking the baby, 4) spend the next 60-90 minutes trying to get her to sleep, 5) wake her an hour later for her next feeding. It was exhausting and frustrating on all concerned.

End of background.

This past Monday, we had a nurse visit to do an evaluation on Teagan. She was absolutely alarmed how little she was eating, and how long it was taking. She told us she should be eating roughly 2 oz each feeding (~60 ml), 8 times per day, and each feeding should take between 20-30 minutes. The nurse put Teagan on the scale and she had lost about a half pound in the 4 days since her previous doctor visit. I think that was the point at which both Amy and I nearly lost it. Fortunately, the nurse calmed us down and made two suggestions. First, switch to the fastest flow nipple we could find (for the men in the audience, bottle nipples come in different flow rates for different ages of kids, slower flow are usually for newborns, while faster flow are usually for 6+ month), and second cram the nipple as far back in her mouth as we could get it. The nurse determined that, not only was she having problems because of the cleft, but she was also having problem because her tongue wasn't doing whatever it should have been doing correctly. Armed with this knowledge, we were able to feed her 60-80 ml (2 to 2-2/3 oz) per feeding over the next day. It took Amy longer than it took me, as she was somewhat more squeamish than I was about cramming the bottle down her throat.

That got us to yesterday, when we were finally able to get into the Craniofacial Clinic at Columbus Childrens' hospital. We had been referred there by our pediatrician to have Teagan's cleft soft palate evaluated. The first person we saw there was a nurse practitioner who also gave Teagan the once-over from head to toe. We explained to her the problems we had been having, and how the nurse had helped us the previous day with her feeding. She again suggested the cleft lip/palate bottle, and we told her that we had tried one with no success. Then she asked us if we'd been putting pressure on the bottle while feeding her, and we told her that noone had suggested that, so no, we hadn't. She ran and got a box of bottles and a couple of special orthodontic nipples, poured some milk into one of the bottles and showed us how they work. We both nearly cried with relief, because we were able to feed her the full 60-80 ml of milk in about 20 minutes without smashing the bottle into her face. She gave us the bottles and a supply of nipples and told us to call her for more when we run out. Feedings are no longer traumatic, and she's gained back in the last two days most of the weight she'd lost in the last week. The other good thing about the new bottles is that she's still encouraged to suck, which is important for the development of facial muscles she'll need once she gets around to thinking about putting words together to sass her dear old dad. We're quite relieved, as you can imagine.

The upshot of all this increased input is, quite naturally, increased output. We've had a couple of complete blow-outs, and at least three times in the last two days we've been in the middle of changing a soggy or poopy diaper when she lets loose with another volley. But, considering that peeing and pooping are signs that she's getting plenty of food and is no longer dehydrated, we really don't care.

So there you have it. In a nutshell, she eats, she poops, everyone is happy. In 10-11 months, Teagan will probably end up having surgery to repair the cleft in her soft palate, but that, in the inimitable words of Alton Brown, is another show.