Independent appetite

I should have known better.  Lord knows I’ve devoured enough television shows and movies marketed to thirteen year-old girls to recognize the moral of our recent story:  one person can’t desire something enough to make another truly want it for themselves.  Surely my younger brothers’ failed gymnastics careers ought to have taught me that lesson young.  Still, I became the Lyla Garrity to Viv’s Tim Riggins, the Jack Moseley to her Kate Moseley, the Thomas Novacek to her Lyla Novacek. 

Using added incentives like animal noises, songs, and pictures of babies (the infant equivalent of sex, drugs, and rock & roll), I coaxed Viv to drink formula by reading her books.  Through sheer force of my will, her weaning process progressed.  About two weeks ago, V drank six ounces at a time from the bottle, leaving her g-tube obsolete but for the few extra ounces of water we injected at night.  I arrived at Viv’s mid-May therapy appointment eager to bask in the edges of the praise Viv deserved for making such enormous strides toward normal oral intake, only to be told that Viv could “not be considered weaned” until she “owned the process.”  “Viv must eat because she wants to,” Robin cautioned, “not because you want her to.”

Screw the semantics and hippy talk, I thought, who gives a flying pork roast why she’s eating if she’s finally eating?!?!  Besides, Viv’s medical team set forth specific volume goals (i.e., at least 800 mls per day to maintain hydration), and Robin mandated certain procedures (e.g., expect Viv to eat about 50 mls per waking hour and offer her the bottle after an hour if she drinks 50 mls, after two hours if she drinks 100 mls, etc.) without giving me sufficiently detailed instructions to confidently feed Viv.  If she vomits do I offer the bottle sooner?  If she only takes 15 mls how long do I wait?  If she seems increasingly frustrated by the bottle’s presence do I wait longer?  Do I offer her the bottle right when she wakes up or give her some time to feel hungry?  If she sometimes bats the bottle away but then sucks eagerly on the second offer, what does a real rejection look like?  To an outsider these queries might seem devised by the same idiot to whom Gerber markets Viv’s spoons (the packaging instructs:  “[f]ill [end] with small amount of food”), but they’re just the tip of the anxiety iceberg upon which parents weaning (i.e., starving) their children float.  After asking Robin each of these questions and receiving frustratingly vague answers reminiscent of Meryl Streep’s therapy scene in “It’s Complicated,” I took Viv to a “picnic” at another tube mom’s home seeking a brief consultation with Markus, the visiting German weaning guru (for Jenny’s blog on his work with her son, see http://www.thecrunchyandthesmooth.com). 

After watching Viv successfully swallow a tiny chunk of banana, vomit after attempting a spoonful of hummus, drink from the bottle, and eagerly allow me to spoon feed her the puree known in our house as “bango” (we plan to rectify the situation before she wanders into a Whole Foods and asks for the fictional banana-mango hybrid, oh the humiliation), Markus essentially declined to take Viv on as a patient reasoning that we’ve almost licked her tube dependency.  Bolstered by Markus’s advice to stay our course, I decided to try my best to ignore Robin’s pessimism and cajole milk into Viv using her books.  What’s the worst that could happen, early literacy?

A week later, my baby girl decided to elucidate Robin’s point for her.  Some sort of developmental switch flipped, and Viv took over.  My attempts to provide her with constrained control, that mightiest of tools in the parental shed, no longer satisfied our increasingly opinionated little lady.  In the month prior she adorably deliberated between the two books I presented before batting at one with her sweaty little fist and settling back to calmly drink milk as she used her toes to turn the pages at her chosen pace.  In mid-May Viv suddenly started refusing to eat until I happened upon the particular story she wanted to hear and then proceeded to abruptly eject the bottle from her mouth each time a favorite page appeared so as to better squeal and clap.  As she giggled at an increasing number of images, eating time morphed into play time and the calorie and hydration totals she’d been almost meeting once again appeared unattainably high.  At the same time, she resumed her vendetta with sleep.  Ian and I executed her trusty nap and bedtime routines flawlessly only to watch Viv wrench her eyelids open whenever lash met skin, yank her pacifier from her mouth, throw her lovey on the floor, and squirm her way alert.

After a few days of wheedling milk down Viv’s throat and expending hours of effort to win each loss of consciousness, we found ourselves at Dr. Conn’s begging for help.  You working stiffs might recognize the biggest complaint I carried into her office:  partial micro-management, in other incarnations known as the separation of responsibility and control problem.  Don’t charge me with a goal, provide no guidance as to how you want the deadline met, and then criticize the method I choose if it accomplishes the stated objective.  When I arrived begging for more detailed instructions, the unparalleled Dr. Conn flipped my gripe on its head.  She set me free with only two guidelines:  call if Viv pees fewer than three times in a twenty-four hour period and schedule weekly weight-check appointments.  Otherwise, she said, treat Viv like a normal baby:  forget about all the numbers and strategies, offer her food when she seems like she wants to eat, and don’t sweat it if she doesn’t eat; do what your instincts tell you to do until we run into a hydration or weight problem.  Well hello, discretion, it’s nice to see you again.

Welcomed back into our home, discretion immediately struck up a fast friendship with Viv.  The day before we saw Dr. Conn, V drank over 600 mls and obtained about 80% of her calories from milk.  The day after, she drank only a little over 100 mls, but she downed over 500 calories in puree and slept like, well, a baby.  Over the course of the next week, she maintained the food-heavy, milk-light strategy, though her daily calorie intake steadily decreased.  The wet diapers piled up and she slept beautifully, but she lost half a pound, the entirety of her weight gain over the preceding month.  “Let’s not panic,” Dr. Conn said, kindly implying that someone in the room other than me might tend toward the dramatic, “let’s give her another week and see what she does.” 

And here I sit, relaxing as hard as I possibly can, praying that Viv decides she wants to eat.

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4 thoughts on “Independent appetite

  1. oh man, i feel for you gail. i like your ped, but i know what you mean about the tricks really working. heath will eat *two* packets of cereal if the teletubbies DVD is on or i show him videos of himself eating. sigh. and he didn’t gain this week as he did last week. then again, he seems happy and engaged and perfect aside from a couple ribs sticking out. let’s hang in there!

  2. Thanks for posting Gail! Its always good to hear the latest so we can continue to be with you and Viv and Ian- you are in our hearts! and that Ms Viv! little wild one! doin’ her thing…go go go for those calories Vivi! gooey good stuff!
    love and hugs to y’all

  3. right-o. so how exactly is viv supposed to “own the process” when you are being given mandates and procedures and volume goals??? (don’t get me started on how asinine those are, and how varied these “baseline hydration requirements” actually are if you check the dang merck manual). three cheers to chaka khan, er, dr. conn. amazing what a bit of common sense can do. yay viv! and happy birthday to the big one year old and to YOU as a mother.

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