From the moment Joshua Sutterfield's son was born, he knew that something wasn't right. One-week-old Devon has never cried, and now doctors can't tell him if Devon ever will.
"Right when he came out he was squeaking when he cried. We thought he might have a little something that they didn't suction out," said Sutterfield, 24, of Cullman, Ala.
But some X-rays and tests later, doctors came to Sutterfield with some bad news. Devon's vocal cords were paralyzed. The squeaking noise was a stridor, a sound of air whistling through a blocked throat.
The vocal cords aren't just for speaking they are part of the complex system that affects a host of functions including crying.
Vocal cords, or vocal folds as doctors call it, affect how we speak, breathe and swallow – they close to let us swallow, they narrow to let us speak and open to let us breathe, explained Dr. Steven Goudy, assistant professor of otolaryngology at the Monroe Carell Jr. Children's Hospital at Vanderbilt in Nashville, Tenn
"Because you do have two vocal folds it could be one not working or both of them not working," said Goudy. "We see it several times a year, but it is still very rare."
Sutterfield said each time Devon tries to cry, he begins to have breathing problems and sometimes turns blue.
"The further it goes the less cry you hear," said Sutterfield. "When he'd cry -- he'd cry so hard that he'd lose oxygen."
Sutterfield and his fiancée Jody Woods, 20, are hoping the doctors at the Children's Hospital in Birmingham will find some answers for baby Devon. ABC affiliateABC 33/40 in Birmingham, Ala., first reported the family's story.
"As of right now they don't know what causes it. They're saying it might be many different things," Sutterfield said.
Devon is one of the one in a million children who are born with paralyzed vocal folds for unknown reasons, according to Dr. Christopher Hartnick, a specialist in pediatric otolaryngology at the Massachusetts Eye and Ear Infirmary in Boston.
As the Sutterfield family soon found out, the rare condition can also threaten a baby's survival.
Goudy said usually when the vocal folds are both paralyzed they're very close together and "it's basically like they're running a marathon because they're breathing through something that's like a straw."
The Sutterfield family is keeping Devon at the hospital so he can receive oxygen as needed until doctors decide on a course of action. Depending on how his vocal cords were paralyzed Devon may be talking within a year, or may never really regain his voice at all.
How Devon's vocal cords became paralyzed may also determine how doctors treat him.
"It can be hard to hear them, but the bigger issue is to make sure they can breathe and feed," explained Hartnick.
Between 35 percent and 50 percent of all cases of vocal fold paralysis in infants can be explained by doctors, said Dr. Michael Pitman, director of the laryngology division at the New York Eye and Ear Infirmary.
"There are a number of disorders that cause the brain to push down a little pit and it pulls on the nerves going to the vocal cords," said Pitman. Other situations, such as a congenital heart problem, or nerve damage from birth can also lead to paralysis of one or both vocal folds.