Saturday, December 31, 2011

At home with our newest addition!



My grandfather was driving through town & stopped by
to meet his first great-grandson


After 3 nights at the hospital, we finally got to bring Parker home to Rook Branch Lane- just in time for New Year's Eve.  Spence helped get us home and introduced Parker to Jack, our furry child.  He immediately went up to Parker and gave him a huge lick on the face.  He has been very sweet and loves to check on the baby.  Needless to say- very curious.  I think he's starting to realize that he is #2 behind his brother, so we really need to try hard to give him extra love!


Parker is wearing a gown made by Spencer's  great-grandmother.  His dad, Spencer, his brother Daniel, Daniel's son Jim, and now Parker have all worn it home from the hospital.  Super sweet!
Loved the staff from post-partum.  They were all super sweet!
Parker getting his first kiss from Jack in the driveway
Our first family of four picture- again, Jack kissing Parker!  Our home feels so much more complete!

Debbie (Honey) holding P in his new room and chair

Spencer's mom, Debbie, was sweet enough to stay for our first week with Parker to help out.  It was so nice have some help around the house, help with Parker in order to let me sleep more at night, and we just love having her around in general!  Thanks Debbie!

Parker in his crib for the first time.  He rarely cries- but looks very upset in this picture!
Welcome home Parker!
We have been so blessed to have so many visitors since Parker was born.  Spence's cousin, Nan, and her 3 month old, Luke, were driving through town on their way home to Charleston and stopped by for a visit.  
After a long day- both of the boys asleep.  Parker loves to sleep on his daddy's chest.

Thursday, December 29, 2011

Parker Fox Robinson


Spencer and I are so thrilled to announce the arrival of our sweet baby boy!

Parker Fox Robinson

was born on Thursday, December 29th at 0653, weighing in at 7lbs, 15.8 oz, with a length of 19.5 inches.

My sweet boy!
I have never felt so full of heart and love as I do right now!  I've had so many people tell me "you just will never know how much you can love someone as when you bring a child into the world....." At the risk of seeming cheesy, I couldn't agree more.  I just find myself staring at this sweet, tiny bundle and not wanting to do anything else but be with him!


Anyhow- a little recap.  We were so excited that my dad and both of Spencer's parents were able to be here for Parker's birth.  I went in Wednesday morning at 530am to be induced.  After, 2 rounds of Cytotec, Dr. Risinger broke my water at 630pm, and we started Pitocin at 800pm.  Long day, needless to say.  Fortunately, we had several visitors that helped us pass the time.  I did end up getting an epidural at about 1100- which made things a lot more comfortable.

My MICU friends came to visit- Kala, Jessica, & Jess
consistent late decels all night- only I would take a pic of it!
The late hours of the night were very stressful for Spencer and me, because we knew by watching my strip that Parker was having frequent and consistent late decelerations (heart rate) with most contractions.  My nurse was frequently making changes on the Pitocin, having me change positions, putting on oxygen, and trying to compensate for it.  Every time the door opened, we were anticipating that I was going to the O.R. for a C-section.  However, at 500am (the next morning), Dr. Risinger came back in, was not concerned, and gave me another hour to be ready to push.  This made all of us feel tremendously better, and for an hour and a half- all 5 of us slept (see pics!).
Spence & Debbie sharing a surface to sleep on
My Dad finally able to rest
Praise God- I only had to push a little over 10 minutes, and Parker came into the world with a vigorous cry, and very active!
Finally, he's here!  They laid him right on my chest as soon as he came out- I loved every second of it.
My Dad, Spence with Parker, and Spencer's Dad
Parker with "Sport"
Parker with "Big Daddy"
Some of our best friends, Wes & Erica, came to visit and brought Chick-fil-a
Some of our favorite people all showed up at once for a sweet visit!  Philip & Kelsea Walkley holding Parker (Memphis), Brett & Katie Sterba with J.P. (Charleston), & Collin & Meredith with Madeline (Columbia) 
Meredith with her daughter Maddie, and Parker and me.
Kelsea is one of my closest friends from college.  We were both in each other's weddings- she happened to be in town visiting family!  What perfect timing!  While I was laboring the day before- she took about 20 laps with me of walking around the unit!
Look at that head of hair!
the cleft is on his left- this profile
shot shows the less affected side
 So, as I've mentioned in previous postings, we knew after 20 weeks that he would be born with a cleft lip and palate.  The lip was exactly as we were anticipating.  It is on the left side extending up just below his left nare.  However, the palate is a lot more involved than we were expecting.  It is actually bilateral (both sides of palate) and not just a small amount on the left side.  If you take a pen light into his mouth, you can see openings on each side that go directly into the nasal passages.  Of course, this makes feeding a bit more difficult, and will require more repair than we thought.  Dr. Chen (Plastic Surgeone) came to examine him right after he was born, and said he would need at least 3 surgeries now.  Praise God, it could still be so much worse!

A good shot of the cleft lip
still an absolute doll!
However, I have to give major praise to our hospital, Palmetto Health Richland, for all of the incredible resources and consultants we met with daily during our stay.  We had awesome lactation consultants, breastfeeding consultants, and a speech therapist who gave us great information and help with feeding issues.  We felt we received excellent support!

The Haberman Feeder



The Speech Therapist showed us several different methods, and we finally decided on using a specialty bottle/nipple called the Haberman specialty nipple.  It takes a bit of practice, but Parker does GREAT with it.  Occasionally with feedings, milk does leak out of his nose and mouth, but we've figured out our own tricks and goals on what works best.  Please contact me if you have any specific questions- I'd love to give you my thoughts!

Here I am using the specialty bottle/nipple

Wednesday, December 7, 2011

36 Week Update

At my 36 week appointment yesterday, learned that Parker's head is engaged in the pelvis, and that the cervix is 50% effaced with no dilation....yet.  Very exciting- it's all starting to become very real that he will be here very soon!

Last night, we went to a Breastfeeding Class.  Spencer was not excited to go, but to my relief (and his)- there were about 9 couples there- all with the man in tow.  It was really helpful, and I think we both learned a lot about feeding a baby in general.  The lactation consultant who ran the class, Denise Altman, has her own private business here in Columbia and came highly recommended by a close friend, as well as my OB office.  She offers several great classes, in-home consultation, and is a wonderful resource!  If you are interested in what her company offers- check out their website:

http://www.feedyourbaby.com

Much of the information from resources and from some physicians has led me to believe that breastfeeding will not be an option, but I was very encouraged to hear from Denise that it is very much an option, and as Parker's cleft only extends ~2.5mm into the palate, he may be able to do well with it.  We also discussed specialty bottles/nipples in case he cannot.  We will just see when he gets here!  Fortunately, our hospital has great resources to help us after he is delivered.

This morning Spencer and I met with Dr. Chen, the plastic surgeon that we have chosen to do Parker's cleft repair.  We have heard glowing reviews about him from my OB office, the MFM specialist, speech and occupational therapist friends, surgery residents that Spence knows well, as well as multiple other healthcare professionals in the area.  He actually is the team leader of the Columbia Cleft Team, and did a fellowship in craniofacial abnormalities.  

Our appointment was great!  He will come see Parker right after he is born for his first exam.  Then, around 3-4 months, he will plan to repair his lip with his first surgery.  Between 6-8 months of age, he will then plan to repair Parker's palate.  We will know more specifically what his plans are when he first examines Parker.  Overall, he was very informative, and made us feel very comfortable with having him as our surgeon!


Tuesday, December 6, 2011

Cleft Lip & Palate Posting

Tomorrow I will be at the 36 week mark!  The time is flying by like crazy, and I am just in shock that he will be here so soon.  Expecting a baby soon around the holidays makes for a crazier than normal Christmas season, but at the same time- very exciting!

So, one thing that I haven't written about on here is the fact that Parker is going to be born with a cleft lip and cleft palate.  At my 20 week anatomy ultrasound scan, we found out about this.  I am minimizing a great deal on here what an emotional roller coaster that was and still at times continues to be, only because we have had our time of "grieving" an abnormality with our child, but also because over the last 4 months, God has really helped us to have a better perspective on the situation and move forward in how we will handle it.
At P's 29 week scan- you can see the cleft on his left lip.
It's the darker line from his lip border reaching
 up towards his nose.

One of the things that was helpful for me was to read information not only from clinical standpoints, but also a few blogs that people in our situation used to document and educate others on the challenges and surgical repair processes of their own children who had clefts.  I hope that maybe someone can be encouraged as we do the same with Parker over at least the next year!


What is cleft lip/cleft palate? 














A cleft is a separation in the lip or roof of the mouth (palate).  They can occur in anyone, but are twice as common in boys.  Approximately 1 in 600 babies born in the U.S. has a type of cleft.  Clefts are the fourth most common birth defect in the U.S.

Incomplete Cleft Palate

Unilateral Complete Cleft Lip & Palate
(What Parker has)

Bilateral Complete Cleft Lip & Palate

What causes it?
Exact cause is unknown.  For most cases, no single factor can be identified.  Some can be associated with syndromes or birth disorders.  Between 85-90% of individuals with a cleft have no other physical problems, and when it is "isolated" like this, the cleft is believed to result from an interaction between genes and the environment.  From all of our tests and extra ultrasounds, it appears that Parker's cleft is an isolated problem, meaning that there is no suspicion of a syndrome, and all of his other anatomical markers are within the norm.

Again, the cause isn't fully known, but the most important thing to remember is that it is NOT that you, the parent, did something wrong- it is not your fault.  In the first 10 weeks of life, the left and right sides of the face and roof of the mouth join together.  if they don't join correctly, an opening in either the lip or the roof of the mouth can result (cleft).

What are some issues to expect?
One of the biggest issues is with feeding.  Depending on the severity of the palate involvement, babies may or may not be able to breastfeed.  Regular bottles/nipples can also be challenging due to the baby's inability to form a good seal/suction.  There are many options for specialty nipples for bottles, and a lactation specialist can help in offering suggestions for feeding difficulties.

Hearing can be an issue, as cleft babies have higher risk of ear infections.  Most require tubes to be inserted by an ENT to drain fluid and prevent hearing loss.  Teeth can be affected with palate involvement, and orthodontics is usually a need.  Speech problems can also be common, and often it is necessary to work with a speech therapist starting as early as about 6 months of age.

How is it repaired?
Surgical repair is almost always needed to correct the cleft.  Virtually all children born with cleft lips or palate who receive appropriate care go on to lead normal, happy, healthy, and productive lives!  Each individual is unique, and their situations and surgical plans will all differ to some degree.

Repair to the lip is typically done first per standards of care and is done at about 10 weeks of life or later.The lip can be repaired in a single step or in multiple procedures.

Repair of the palate begins after about 6 months of age.  Depending on the severity and complexity of the palate, it can be done in one surgery, or can be done over a period of years in developmental stages.  The primary goal of repairing the palate is to achieve acceptable speech.

It is also helpful to be seen by a Cleft Lip and Palate Team of specialists available in many larger areas. Besides surgical closing of the clefts, these individuals may need additional help with feeding, teeth, speech, hearing, and social/psychological development over time.


What type of specialists participate on the treatment team?
-Audologist (assesses hearing, which can be affected with clefts)
-Surgeon (often a plastic surgeon, an oral/maxillofacial surgeon, craniofacial surgeon, etc)
-Pediatric dentist (if prosthetic pieces are needed for the mouth)
-Orthodontist (straightens teeth and aligns the jaws)
-Geneticist (screening for syndromes, counseling parents for genetic implications)
-Lactation specialists (help with feeding problems and alternative feeding options)
-ENT (Ear, Nose, Throat physician for issues affected in these areas)
-Pediatrician (monitors overall health and development)
-Psychologist (support family and assess any adjustment problems)

-Speech-Language Pathologist (assesses speech and feeding problems)
-Other specialists (treat specific aspects of complex craniofacial anomalies)

A dear friend of mine ordered me some fantastic educational references from the Cleft Palate Foundation. If you or someone you know is expecting a child with this condition, the contact information is:

Cleft Palate Foundation
1504 East Franklin Street, Suite 102
Chapel Hill, NC 27514
800.24.CLEFT (242.5338)
www.cleftline.org, info@cleftline.org



The facts I've shared on this posting were found in their resources.

Just for fun- a few well-known people born with cleft lips and/or palates:
Tom Brokaw- News Anchor
Cheech Marin- Actor
Peyton Manning- NFL Quarterback