Blue. Not breathing. No heartbeat. In this moment, chaos ruled. When my son, Ephraim, was born, he had 0 APGAR scores, which basically meant he was dead. After given 2-3 minutes of CPR, he was revived, but only left to fight a long road ahead. He spent the next three weeks in the NICU, relearning many characteristics that typical newborns have naturally. Around a month old, he was diagnosed with cerebral palsy. From the moment Ephraim entered this world, he has only known chaos, which has presented numerous stressors on his young life.
While I can focus on several different areas that have affected Ephraim’s life cognitively, physically, and socially, I have choosen to focus on a large struggle and stressor on him: eating!
When Ephraim was born, he was unable to handle breast feeding initially. He was placed on nutrients through an IV that went into his belly. Around two weeks old, we began a trial process of starting him on a bottle. While he took it with some ease, he still had a lot left over in his belly. Therefore, he was put on an NG feeding tube until he could master the bottle.
When he came home, he was reluctant to accept a bottle. When he did take a bottle or breastfed, he would be slow to latch on and fed very slow. This began to place a stress on him, as he grew to dislike feeding. When he would see a bottle, his entire body would tense up and his head would turn away. Not only was this a stressor for him, but I began to dread feeding times as well. With both of us frustrated and stressed, feeding times became overwhelming at times.
Around six months old, Ephraim was barely accepting a bottle. It would take over an hour to feed him eight ounces of formula. When we got to the point where very few people had the patiences to feed him, it was time to consult a specialist. Upon our first trip to the GI doctor, Ephraim was immediately placed on a new formula for babies with sensitive tummies. When I switched bottles and placed him on the new formula, I began to see a small improvement. Feeding was still a major stressor in his lifes, but we were actively seeking outside support and professional advice to help this become less stressful.
Unfortunately, his story doesn’t end here. While eating was a slow process, he then began to have severe acid reflux, which resulted in spitting up or throwing up almost daily. Around his first birthday, he was lower on the charts for weight gain. Therefore, he was placed on a higher caloric formula to help him gain a few more ounces. However, over the next year, his eating continued to decreased. Despite changing bottles numerous times, offering sippy cups, and introducing solid foods, he still threw up daily. This was becoming such a huge stressor on his life that eating was now beginning to take place while he was asleep. (He would suck the bottle while he was half asleep.) However, this didn’t always work, as he would sometimes wake up coughing, covering himself and me in a bath of formula up-chuck. He was so stressed out over his inability to eat properly that he turned his head away everytime the bottle was presented. If he were to take anything by mouth, he would get so upset that it would often be thrown up. Eating was a huge stressor in Ephraim’s life that didn’t seem to be getting any better.
About two weeks to his second birthday, eating was taking a negative toll on his body. He spent almost half of his day trying to eat, but barely took about 12 ounces in. He finally got to the point where he refused all food and liquids. This stressor on his life had now entered significant chaos, and outside intervention was required.
Upon hearing that he had been taking in very little nutrition, his GI doctor and rehab doctor decided it was best to admit him to an inpatient facility for intense feeding therapy. When he was admited on October 19, he barely accepted a 4 oz jar of baby food a day and was not taking in any liquids. His weight was barely hanging in there at 26 pounds (just about three times his birth weight at his second birthday.) He spent the next three months working every day with multiple therapists on learning how to eat. He learned how to accept food from a spoon, and then he began to increase his food volume very slowly. He also began to work on oral motor skills and started to accept some textured foods. By January, about three months into this intensive hospital stay, he was successfully eating about 10-12 ounces of pureed food for each meal, meeting his daily calorie intake. Eating became much less stressful for him, and he came to enjoy sitting down for a meal with someone.
After his discharge in January, Ephraim suffered with a small bout of acid reflux. With a change in medication, he resumed his new eating skills. I came to love feeding Ephraim. Rather than turning away and refusing food, he actually opened his mouth and accepted his food. His weight, however,, began to drop which became disconcering. Although his eating was not as much of a stressor anymore, he has lost 2 pounds. His GI doctor became increasingly alarmed that he was actually declining on the progress chart, rather than climbing the chart with his age range. He was then placed on a caloric powder substance to increase the amount of calories he recevies a day. Fortunately, he has managed to gain about a pound and a half over a few months. With the intense therapy that he continues to receive as an outpatient and his calorie additive, eating for Ephraim has now become successful and pleasent.
Since eating was a huge stressor for Ephraim, causing major chaos in his life, he now struggled to eat any textured foods. He will refuse lumpy or grainy foods. He will not accept any liquids from a cup or bottle, but rather takes it thickened by a spoon. He received feeding therapy twice a week to help him grow more tolerate of textured foods and accept some liquid from a cup. To help him cope with this stressor, he has adapted to accepting all foods by spoon. Since feeding was so traumatic for Ephraim during the first two years of life he has become resistant with any textures or cups. While I continue to actively pursue additional resources to help Ephraim get over this stressor, I suspect that he will struggle with feeding issues for a good majority of his childhood.
Malnutrition is a huge stressor in the development in the lifes of children in Africa. Malnutrition is a result from poor food absorption or intake. Malnutrition can stem from the poverty rates, the economic situation in Africa, and even the climate change (http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm). 1 in 5 children in Africa will suffer from chronic malnutrition, while 1 in 10 will have severe malnutrition. As many as 50 % of the children have lack of calcium, iron, and zinc. 1 in 5 children in Africa have stunted physical growth as a result from undernutrition (http://food4africa.org/).
When malnutrition occurs in a child, their development is is profoundly affected. They may struggle with more sicknesses during the year, significant increasing major disease symptoms. They can have issues with paying attentiion and retaining information. Malnutrition can cause delayed or issues in physical growth and has even resulted in death (http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm). When children don’t receive the nutrition they need, their overal physical, cognitive, and mental development are negatively impacted, rendering them helpless in this situation.
However, there are numerous efforts working to help reduce hunger and malnutrition among children in Africa. The SUN (Scaling Up Nutrition) Movement, which includes about 30 countries, is working to improve the nutrition for everyone, especially children and women. This program is working directly with the people by trying to support breastfeeding and increasing vitamin suppliments among children. In addition, they are taking indirect methods, like increasing farming practices, to help reduce malnutrition. Countless people and government agencies, including UN representatives, Head of States, and politicans are working together to fight against malnutrition and to help increase the lives of children and adults http://allafrica.com/stories/201209281286.html).