Baby B

How much of it is up to me?

October 1, 2009 at 11:47 pm

(The alternate title for this post is, “What’s up with the hat?”)

As I was walking along a path on the Tufts campus the other day, a black-and-white sticker on a lamppost stated, simply, “How much of it is up to me?” I have no idea of the creator’s intent, and I’m quite certain the message was intended to get people thinking about their role in effecting some kind of important change in the world, but at the moment I had been thinking about something much less weighty: Sylvie’s ears.

Oh, my sweet baby’s ears. I spend entirely too much time thinking about them. “Oh, good,” you’re probably thinking, “finally she’ll explain those pictures of Sylvie with some weird purple thing and tape on her ear. Or why she’s in hats all the time lately.” Or maybe you never even noticed. Or maybe you already know. But anyway, the back story, in a nutshell, is that Sylvie was born with some malformations of her ears. As she laid on my chest in the birthing room, I remember giggling as I briefly registered, through my oxytocin high, that my daughter had “pixie ears.” Both of her ears came to a point at the top. Additionally, one of them was a bit crumpled and smaller than the other. I thought little of it then, other than the fact that it was unexpected and cute. I assumed that her ears were just traumatized from the birth canal and that they would take a few days to right themselves. I had seen enough baby shows to know that ears, much like skulls, often look truly weird immediately after birth. If you’ve ever seen a newborn conehead, you understand. Sylvie certainly had that. I assumed that her ears would, much like her conehead, right themselves over the next few days.

However, as time went on, there really wasn’t any noticeable change. At her one-week appointment the pediatrician said that they would undoubtedly correct themselves soon. As the weeks went on, though, they didn’t, and I started to worry. I fretted about it at home, but everyone kept reassuring me that I just needed to give it more time and that I was making too big a deal of it. As a new mom, I was sleep-deprived and nervous about everything and assumed they were right and I just needed to relax . It wasn’t until her one-month pediatrician appointment that I finally got some validation. My pediatrician seemed somewhat surprised that they hadn’t yet taken on a new shape and gave me the name of someone at Children’s Hospital who did ear molding and splinting.

The idea of this procedure brought me back to my childhood dog, Barkley. He was a Cairn terrier who we had gotten as a puppy whose ears didn’t “prick up” after the normal amount of weeks, so my dad splinted them with popsicle sticks and duct tape. They did eventually stand up, but whether that was the result of dad’s homemade puppy plastic surgery or just nature taking its course, we’ll never know. I hated to think I was even considering a procedure used for dogs on my precious baby girl! However, after some internet research, I decided we should at least give it a try. Apparently infant ear cartilage is very moldable for the first few months of life, especially in breastfed infants (due to increased estrogen in their systems). It’s also a non-invasive procedure and, at least from other people’s accounts, doesn’t seem to bother babies in the least. There is actually even a line of products called Ear Buddies that parents can buy online to help correct a myriad of infant ear anomalies.

So, for the next month-and-a-half we were in and out of Children’s every few weeks. Using dental compounding, moldable tubing, and tape, we splinted both ears for one week, and then decided to just focus on the more folded ear. And in between appointments I did a terrible job reapplying the molds when they fell out, so there were many days and even weeks when she had nothing in her ear at all. Part of my problem with committing to the process was that I was very self-conscious about explaining it. People were meeting my baby for the first time and seeing me as a mom for the first time, and I just didn’t want to deal. The looks, the questions, the silent assessments of the choice we had made, the thought that they might see my baby as less than perfect or think that I did. I’m sure I wasn’t giving others enough credit, but that was how I felt. So, most of the time I would take them out if we were going somewhere, and, because I despised putting them back in, out they would stay.

And during those initial weeks, in true Philly fashion, I also managed to scare the utter crap out of myself with my endless Google-fu. Unusual or malformed ears seemed to be a sign of an endless parade of syndromes. There were correlations with chromosome abnormalities, deafness, mental retardation, and kidney issues (the latter of which we thankfully ruled out through post-natal ultrasound because her kidneys had measured differently in utero). Teratogens are sometimes suspected as a cause, so then, of course, I thought back to every possible contributor. Was it the many ultrasounds I wound up having because of my high-risk pregnancy? Was it something I ate? Was it the bit of wine I had before I found out I was pregnant? Was it that effing Sigg bottle I drank out of the ENTIRE time I was pregnant? I made myself sick and crazy just thinking about all of it. I really think I may need to be banned forever from this type of Googling, and I thankfully finally made myself stop. So far it’s just the ears. My little Sylvie is developing right on track and doesn’t show any signs of anything unusual. It’s just that she’s so little and so much about her future self is unknown. It was way too easy to convince myself of the worst.

As an aside, if you ever need anything researched, I’m your lady. I now know more about ears than I would have ever imagined. I know when they develop in utero, the name of all of the component structures, and all of the different types of malformations. Ears are complicated things! Sylvie’s anomalies are mainly in the helix, although she seems to have weak antihelices (the part that holds your ear close to your head) and her right ear is also smaller and wider and shows signs of not having had the opportunity to develop fully.  If I had to guess, I would say she was headed toward getting mini versions of Jon’s ears, but somehow part of their development was arrested or altered along the way.

While getting her fitted for her molds initially, I asked the nurse if medical professionals know why ear malformations happen. Her reply was, “It’s a wonder babies HAVE ears. It’s a wonder they’re born at all.” Oof. That was a shove back to reality that I probably needed and deserved. I respect those words and absolutely agree. I never take for  granted that my baby is healthy and seems bright and alert and I’m grateful that this is all we’re dealing with…yet, still, most babies ARE born with round and symmetrical ears. I think it’s valid to be curious and concerned about why mine wasn’t. I know it could be so much worse and to a medical professional who treats people for this type of issue on a regular basis we probably seem like we’re just striving for perfection. Both the nurse and my pediatrician instructed me to look at other people’s ears to see for myself that many people’s are asymmetrical. That was probably the worst advice ever. I went from never really noticing people’s ears to looking at absolutely everyone’s. And do you know what? Most people’s ears ARE indeed symmetrical, or at least very, very close. So that didn’t reassure me at all.

I hesitated to write about this. I want this blog to be a keepsake for Sylvie, and this is not the type of thing on which I want to focus. Hell, I hesitated and hemmed and hawed about even doing anything further as I am certainly not interested in trying to attain physical perfection for my daughter. I know there are people whose children are born with legitimate disabilities or disfigurement and that, in the grand scheme of things, this is nothing. Seriously, truly nothing. I also know there are people who undoubtedly disagree with what we’re doing and think it’s superficial. I found some pretty heated responses to a mom online who was considering a similar procedure for her infant daughter whose ears protruded significantly. People jumped at her for even considering doing anything and said some pretty nasty comments like, “what’s next, highlights for her hair? Breast implants?”

Yes, it is cosmetic, but where do we draw the line between what’s considered acceptable and what’s considered vain? Braces on teeth are practically a tween right of passage. And helmets to correct babies’ head shapes have become ubiquitous. I considered both sides of the argument and ultimately decided that what we’re doing is akin to those types of modifications. Supposedly the helmets help correct flattening and malformations of the skull caused by the Back to Sleep campaign. The thinking goes that the helmet-clad heads would have been round, if not for the outside interference of babies being repeatedly laid on their backs. Similarly, I think something must have happened in utero or during birth that caused Sylvie’s ears to form incorrectly/incompletely. Her ears look nothing like Jon’s or mine, and we have no family history of pointed ears. I’m not trying to make my baby look in a way that she was not intended. I’m not trying to modify her. I’m just trying to correct whatever happened. And I certainly don’t hate her ears. Remember, we chose her name at least in part based on the fact that she resembled and elf or a wood sprite. I think it gives her character. I mean, how could a pointy-eared baby not be cute? And yet, babies grow up. I think about 5-year-old or 8-year-old Sylvie, and I imagine her being teased by her peers or becoming self-conscious about wearing her hair up, and I cannot stand the thought.

Which brings me back to that sticker: “How much of it is up to me?”  That enigmatic quote stopped me in my tracks that morning as I contemplated treating Sylvie’s ears once again. It reminded me that, by choosing to give birth to a child, I immediately relinquished control over so very many things. How much of it is up to me if my daughter is outgoing/shy, strong/weak, beautiful/awkward, and so on? The answer, I believe, is not all that much. Although I will, of course, exert my influence and provide as much guidance and support as I possibly can, she is ultimately going to be who she is. It’s not up to me to go against the mold from which she was cast. So if there are certain things about how she’s developing that aren’t what I expected, I’m just going to have to learn to get over it. One can’t go into parenting with any preconceived expectations. Yet, it is up to me to help her reach her potential and to be the best Sylvie B. she can be. And, I believe, it is up to me to help defend her from undue discomfort and self-consciousness. If I can potentially prevent that by doing something simple and non-invasive, then, as her mom and protector, I need to try.

So, the hat that she’s been in for the past few weeks is part of our latest attempt to try the molding once again. Well, the hat is just so we don’t have to constantly field questions and so she doesn’t inadvertently pull the molds out. We’re now going back to Children’s and we’re trying to keep her ears in the molds as much as possible. Now that she’s upright a lot more during the day (in the Bjorn, for example), the discrepancy between her ears has become more obvious. Her left ear appears much taller than the right. Since she’s only going to continue to be more and more upright from here on out, we figured it was worth it to try and pursue this once again, while there’s still a window of opportunity. According to several pediatricians online, any splinting or molding should take place before a baby is 6 months old. According to our nurse at Children’s, the cartilage really firms up by 5 months or so. We decided to continue trying (barring any discomfort or irritation) until she’s 5 months old, maybe a bit longer if we’re seeing any progress. We agreed that by Thanksgiving at the latest, we will be done forever.

To be honest, I’m quite skeptical of the procedure and the whole thing feels a bit like pseudoscience. Although we did it very sporadically, I would have thought we would have seen more progress than we did. Our nurse claimed that we missed a big window of opportunity by leaving them out for extended periods of time. I’m not so sure. On the Ear Buddies website, they claim that the splints work best immediately after a child is born and would only need to be worn for a week to be effective, whereas an older child would have to wear them for much longer (even months) depending on how old they were at the start. How do they know this, though? Where’s the control group? Who’s to say that those newborn ears wouldn’t have just corrected themselves naturally? And how do they know the older children who wore them for months didn’t just “grow into” their ears? Similarly, I’m wary of the efficacy of the helmets. Some of those children are in those things for months and months and then are deemed a success when their heads appear more round at the end of the treatment. But maybe it was simply the passage of time and their ability to roll over and be more upright for longer portions of the day that ultimately changed their head shapes. But who’s to know for sure? I’m sure the parents who have chosen to put their children in helmets have done so because they would rather know that they did everything they could for their child during the opportune moment. I can relate. I find it more comforting to be proactive than to sit around and stew about it and hope for the best. We chose to try it again, so that, if nothing else, we could say to future Sylvie that we did. Other than the application of the molds, which she sometimes protested, she has really never even seemed to notice them. As long as that continues to be the case, we might as well try.

It’s so incredibly hard, this making of decisions that will have a potential lifelong impact. What if you choose wrong? There aren’t any do-overs. It’s incredibly daunting. I just hope that grown-up Sylvie understands and agrees with what we decided to do. Actually, what I really hope is that she never even notices or cares about her ears, no matter how they turn out. Tara told me she really never noticed what her ears looked like until she was about 20 years old. That sounds perfect. I know that, in the grand scheme of her life, Sylvie’s ears are just a microscopic speck of who she will become…virtually inconsequential. I also know as I write this that I am being silly and spending entirely too much time thinking about it. But please try not to judge and know that I only do it with the best of intentions for her. Sylvie is my heart and soul, and I want absolutely nothing to hold that little girl back.

By phillygil | Posted in Uncategorized