About 12:30 p.m., Tonya Ratcliff pulls open the door to the Integris day care. Five adults and a variety of infants look up at her.
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"It's time to feed J.T.,” Ratcliff says. "How's he been doing today?”
J.T., 9 months, lies on his back with a pacifier in his mouth. He's wearing camo shorts and an orange T-shirt with the slogan, "Beware: I Block Shots.” He's a cute kid with a smile that melts hearts, but the most heartbreaking thing is how tough his life has been.
J.T. can't eat like most children. An apparent consequence of his fetal exposure to drugs is that he suffers from acute acid reflux. He aspirates his drinks, taking them down his trachea instead of his esophagus. Two weeks ago, he had a feeding tube installed.
His caloric intake comes solely from a special baby formula that is particularly gentle on his tummy. The hope is that one day he'll be able to eat normally, but when is anyone's guess.
In the kitchen, Ratcliff prepares his meal, mixing the formula with water and washing out two sets of tubing. One she leaves empty; the other she fills with water.
"He can't burp,” she says, "so the empty one is to relieve gas. I have water in the other one so he doesn't just get a tube full of air.”
Back in the crib room, she takes J.T. aside. A nursery worker helps as she pulls up his shirt to expose a still-healing 6-inch scar and the external portion of his feeding tube. The tube's lid pops open like the valve on a beach ball, allowing the feeding apparatus to link up in an air-tight seal.
It takes three cycles, none lasting more than 20 seconds, to drip all of J.T.'s formula into his stomach.
Ratcliff moves to another room at the day care. She picks up Coy, a 10-month-old with a generous crop of brown hair, and pauses to study a finger-painting he's done. A swath of blue drifts across the white paper; there's a dollop of red in the middle.
Ratcliff kisses him, says goodbye and heads back to work.
Ratcliff and her husband are adopting Coy and J.T., whom they took in as foster children last year. The adoption will be final July 3.
Both were born with drugs in their systems, but so far, Coy has shown no ill consquences. But he still has problems.
Just a day or two before J.T. got his feeding tube, Coy was admitted to the hospital with dehydration. He'd been battling diarrhea and a constant ear infection, which continues to bug him today.
Now, a few hours after the day care visit, he is on his way to see a specialist at Mercy Hospital.
By 4:45 p.m., it's official. Coy needs tubes in his ears.
"It's always something,” Ratcliff says. "But we'll get him taken care of, and he'll be a happier little friend.”
Staff Writer Ken Raymond
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