Thursday, April 18, 2019

Quinnlyn's story: Feeding team helps picky preemie become a flourishing foodie

Come lunch time, Quinnlyn Fisher, 1, is far from picky. She savors foods bursting with flavor, like apples and mixed fruit pouches, and will gladly eat everything on her plate except one thing – guacamole.

 

Quinnlyn Fisher in the NICU
Quinnlyn Fisher relied on a feeding tube for the first few months of her life. Photo courtesy of Theresa Fisher.

It’s an impressive leap from where she was just after she was born. In April 2018, Quinnlyn’s father, Pete, arrived home after work to find his wife, Theresa, unconscious on the kitchen floor. Theresa was rushed to Massachusetts General Hospital with eclampsia and had an emergency C-section to deliver Quinnlyn prematurely at 27 weeks and five days.

Quinnlyn spent the next two months in the Neonatal Intensive Care Unit (NICU) and another two months in the Special Care Nursery at MassGeneral Hospital for Children (MGHfC). Along with blood pressure issues and underdeveloped kidneys, Quinnlyn struggled with feeding. She received most of her food through a feeding tube.

During her NICU stay, Theresa, of Methuen, Mass., became curious about her daughter’s feeding skills. “I am a teacher and I don’t like to enable kids. I didn’t want her to be too reliant on the tube,” said Theresa. One day during Quinnlyn’s NICU stay, Theresa noticed her daughter pull out the feeding tube three times. When doctors tried to place the tube again, Quinnlyn cried and screamed in disagreement, prompting Theresa to stay overnight at MGHfC to observe Quinnlyn.

“That overnight stay showed us and her doctors what she was capable of,” said Theresa. Three days later, Quinnlyn was successfully eating without her feeding tube. She also did well with breastfeeding, even though Theresa’s milk supply was too low to sustain her.

 

Quinnlyn Fisher in the Feeding Center
Quinnlyn Fisher, now 1, enjoys pasta and sauce at the Center for Feeding and Nutrition at MGHfC. Photo courtesy of Theresa Fisher.

With Quinnlyn’s newly-made progress, she was discharged from the NICU and continued with outpatient care at the Center for Feeding and Nutrition at MGHfC, where she continued to improve. Quinnlyn had a high palate and a sensitive gag reflex and it became her care team and family’s goal to help her eat without gagging or vomiting.

Her first few visits were trying. At the time, Quinnlyn was eating just 2-3 ounces of breastmilk at a time by mouth. “I remember Theresa holding Quinnlyn, bouncing her, walking around the room and trying to get her to eat,” said Lauren Fiechtner, MD, MPH, director of the Pediatric Feeding Program and Pediatric Nutrition Center at MGHfC. “That must have been stressful, and it’s such a contrast compared to how she is now. Quinnlyn really blossomed with the help of her amazing parents, early intervention and my colleagues at the Center for Feeding and Nutrition.”

 

Quinnlyn Fisher
Quinnlyn Fisher no longer struggles with gagging or vomiting while eating. Instead, she loves flavorful and colorful foods. Photo courtesy of Theresa Fisher.

When families arrive to the Center for Feeding and Nutrition, it is common for them to feel concerned about next steps in terms of their child’s feeding. This was no different for Theresa and Pete, who learned to let Quinnlyn be their guide on her feeding journey.

“She showed us that she didn’t like big meals in short windows and instead, she prefers eating small meals throughout the day,” said Theresa. “She now takes bottles and eats Stage 2 solids with no gagging. She also moves food to the side of her mouth with her tongue and uses a spoon, upside-down, but that’s okay. She will learn with time.”

With the stress of Quinnlyn’s feeding challenges, it was important to focus on every positive step or accomplishment, even if it meant something small, like Quinnlyn taking in one milliliter more of milk.

“Dr. Fiechtner is a mom too, as are many other staff from the program, so she is realistic,” said Theresa. “The appointments were never stressful and we walked out every time feeling confident and armed with knowledge.”

For Fiechtner, the difference between Quinnlyn’s first and most current visits are astounding. “She is just like any other baby sitting in her highchair, smiling and enjoying her meals. She loves purees and we are now working on crunchy dissolvables. When I see her now, it’s incredible.”

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