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Eating & Reflux (year 2, 2006)
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November 2006
November 1, 2006
My mother thinks I'm weird about bathing Anastasia. I insist on using a baby tub, whereas she always just plopped her babies in the kitchen sink or adult-sized bathtub. But baby bathtubs make accidents (like the baby toppling over and bonking her head) less likely. And that's why I use them.
In the NICU, they taught us to have one parent hold Anastasia while the other bathed her in a firm plastic infant tub. Once home, I used a similar tub, but because my husband wasn't always around when I wanted to bathe Anastasia, I used the type with a sling (or hammock). This kept her from slipping around. I loved it! When she got a little bigger, I removed the sling and just used the firm plastic tub by itself. Then we had a cute soft tub that a neighbor gave Anastasia.
I always put these baby tubs in the adult bath tub, hoping that when she got older, Anastasia wouldn't have a fear of the "big tub," but I had a hard time teaching her that bath time was also play time. There just wasn't enough room in these infant tubs for her to play.
So, now that she's really good at sitting up, I've bought her a soft toddler tub. It's much roomier, and it has a built in, squeaky duck and several stacking rings.
Yesterday morning, we used it for the first time.
For some reason, when I sat her inside the tub, Anastasia was afraid. I guess it was because she was sitting, not laying down. I comforted her as she cried and tried to distract her with the neat tub toys. It worked. Soon she was having a grand ol' time, and even got a little miffed at me when I wanted to interrupt her playing with bathing.
Yesterday was also feeding clinic day. Since it was Halloween, I dressed her up in a bunny costume. She was a big hit, of course. One other toddler was also in costume; Anastasia seemed surprised to see a baby dressed as a chicken.
Unfortunately, it's often tough to time the feeding clinic appointments so Anastasia is hungry but not starving. As it turned out, the feeding clinic folks were running a little behind, and by the time we got Anastasia into the exam room, she was actually crying for food. (She very rarely cries for food.) But once we took off her costume, put on a bib, and got her in a high chair, she chowed down on a variety of things: refried beans with lots of sour cream, breaded chicken with catsup, home canned peaches, and Ritz crackers with cheese on them.
The RN and PT were delighted with Anastasia's progress, and said she was doing everything a baby her age ought to be doing, eating-wise. They said that at this point, she can eat anything (except for the typical allergy foods like peanuts, peanut products, and honey) and choking hazards like hard veggies [unless grated]; solid foods that are hard, small and round, smooth or sticky [like candies, cough drops, raisins, gum and whole grapes]; and popcorn, nuts, and seeds).
The PT also had me try a special spoon that has ridges on the bottom (where the spoon touches the tongue). She thought Anastasia might have responded better with this spoon, which is designed for kids with sensory issues. (Children with sensory dysfunctions react unusually to touch. Preemies who've had lots of tubes down their throat, or who were forced to take a bottle before they were ready, often have sensory eating problems.) I've thought for a long time that Anastasia may have slight sensory issues. For example, she will often open her mouth wide for food, only to shut her mouth abruptly and make a face as the spoon touches her lips. Anyway, she gave me the spoon to try at home, so it will be interesting to see if it makes any difference.
The PT also suggested I try to hurry along Anastasia's eating. She said that toddlers (Anastasia is a toddler, even though she's not toddling!) will only sit in their highchair for so long, and yet they'll chew on one piece of food for a millennium. Therefore, she said, give her a little time to chew, but then offer her more food before she swallows. When we tried this in the clinic, every time I brought the spoon to Anastasia's mouth, she swallowed and then opened her mouth for more.
Then we talked about Anastasia's fluid intake. It's actually in the okay range for a baby her age, but she almost never drinks anything during the day, and she's frequently constipated. Anastasia usually takes just a little of her bottle in the morning, and then two big bottles at night...and that's it. The PT tried offering Anastasia various drinks with a cup, and could quickly see what the problem is: Anastasia doesn't think she needs fluids :) She makes faces and turns away and acts as though you're trying to poison her. But the PT said I should persist, anyway. She also said it was okay at this point to give Anastasia a little juice, if that made her more likely to drink something.
Other things that were suggested to help with constipation (which, naturally, can affect how much she eats) were to continue using flax seed in her avacado, but to also try wheat bran in some of her foods. They also suggested I try stewing some prunes and giving her a couple a day.
We discussed the fact that Anastasia is probably sick of the taste of formula, and that at this point I can stop giving it to her if I want to. Since I have one small can left, I think I'll go ahead and use it up, and then use Pediasure only. If she grows tired of the Pediasure, I can use whole milk, preferably with some Carnation Instant Breakfast in it to increase the calories.
The PT and RN said over and over how pleased they were with Anastasia's progress since the last time they saw her for feeding clinic. "What a great job you've done!" they said. "I couldn't have done it without you," was my reply...and I meant it!
Then the pediatrician came in and we discussed Anastasia's reflux. Interestingly, he said the guidelines for Prevacid are not very specific. They say that one pill (15 mg) is good for kids up to 30 kilos (about 66 lbs.). He was concerned about giving Anastasia too large a dose, even though side effects aren't that common. So we compromised and are now giving Anastasia 3/4 of a pill.
If Anastasia's reflux isn't better in two weeks, we'll add Zantac to the mix. And two weeks after that, if she's not improved, we'll have an upper GI done at the hospital. If that doesn't answer some questions, we'll need to take Anastasia to see a pediatric GI specialist who is several hours away.
Anastasia was exhausted after all this, and busy giving every medical person in the place suspicious (and sometimes dirty) looks. But we weren't quite done. We always save the weigh-in for last, since Anastasia tends to get very upset about it. Our girl is now 18 lbs. 5 1/2 oz. and 28 inches long!
November 1 (part II)
Apparently my last post wasn't long enough, because I forgot a few important things. :)
One is that the feeding clinic RN was quite pleased with Anastasia's growth curve. Her weight is almost in the 5th percentile (and increase from the 3rd percentile), and her weight for length is easily in the 50th percentile. These are according to the full-termer charts.
Also, I talked with our PT about our scheduling issues, and she readily agreed to put us into a different time slot. Now my husband will only need to take a half hour off work, which helps a great deal. Another mom of a preemie suggested I ask Early Intervention to send their PT out to us, anyway...so Anastasia could work with a PT every week. I think it's a great idea, and plan to call EI tomorrow.
November 3, 2006
One thing I forgot to bring up at the feeding clinic is the fact that I'm still getting up in the middle of the night to give Anastasia a bottle. This is a way to get extra calories down her (she always takes a bottle much better when she's asleep), but now Anastasia has come to expect it. If I don't come in with her bottle by a certain time, she's awake and asking for it.
I would love to omit that midnight bottle - for two reasons. One, I fantasize about sleeping through the night uninterrupted. (Although getting up once a night is a lot better than getting up every three or four hours like I did for about nine months!) More importantly, though, I'm teaching Anastasia a very bad habit. I really don't want a toddler who expects a bottle every night at midnight.
I'm not sure there's much I can do to change this just now, as Anastasia hates taking fluids when she's awake. I haven't tried it (yet!), but I don't think it would work to give her a bottle during her naps. For one thing, her naps are short (1/2 hour), and I think I'd just wake her up. For another, it would really mess up her eat-every-three-hour feeding schedule.
Fortunately, I'm in regular touch with the PT and RN from the feeding clinic, and they are the ones who'd try to come up with a solution to my dilemma. I'll mention it next time I talk to them and maybe they'll have some brilliant idea...I can hope, anyway.
In other news, I've added some sections on preemie development to this website. You'll find them here, and also listed on the menu at left. My hope is these pages (which include links to articles by experts, plus recommendations for great toys, books, and music) will help parents, family, and friends of preemies actively nudge their preemie along the developmental milestone road. Per many requests, I've also added a page of books about preemies. I think I've read just about every layman's medical book and memoir about the preemie experience, but I've only included information on those that I think are the very best.
November 4, 2006
This morning, Anastasia had her first Synagis shot of the RSV season. (Respiratory syncytial virus is the leading cause of hospitalization among infants in the U.S. Nearly all children get RSV before they are two years old, and it seems like any other cold. But with preemies, especially those born very small, RSV can be deadly. The shots help to protect preemies from RSV, but do not guarantee the child won't catch it. That's why we continue to sequester Anastasia away from crowds and other children.)
My husband and I were dreading the shot, since we knew (from last year) they really hurt going in, and require one shot in each leg. But while Anastasia cried big tears, she recovered more quickly than last year. Of course, now she knows what to expect next time we take her to the clinic and have her weighed...
Getting her into the exam room is always fun, too. I walk into the clinic alone and check in, then wait until the nurse giving the shot has the exam room ready. Then I walk back to the car and fetch Anastasia and her daddy. This clinic has no back door for us to enter through, so we take her through the waiting room, which today was filled with coughing children. We rushed her through as quickly as we could, but we also know it's possible for her to catch RSV just going to the clinic.
At any rate, we're thankful our insurance okayed the shots again. (Each shot is over $1,000, and Anastasia will get them every month until about May.) And we're especially thankful this is the last year we'll have to worry about RSV. We can hardly wait to be like normal folks again, and - for the first time! - take Anastasia out in public without fear.
While I was at the clinic, I also bumped into one of our NICU nurses. She asked about Anastasia, of course, and also got me up to date on a few other NICU graduates. A pair of twins that had twin-to-twin-transfusion and were in the hospital at the same time as Anastasia (but were born later and left home sooner) are now 25 lbs. each and walking all over the place!
November 6, 2006
Yesterday, Anastasia gave us a scare. She'd just awakened from what was (for her) a long nap, and I was holding her in my lap. She was not engaged with me and had an "out of it" look. That part isn't too unusual when she's just awakened. But she was also shaking.
I could mostly feel it, but if I watched closely, I could see it, too. I changed her position a couple of times, wondering if her muscles were just tired for some reason, but the shaking continued. And it didn't stop until I sat her in the high chair and fed her, about 15 minutes later.
My husband says he sometimes gets trembly if he's tired and has just awakened, but this is certainly something worth mentioning to our PT today - and our pediatrician next week.
Too, Anastasia's been incredibly tired. She takes a nap, awakes on her own, but minutes later is rubbing her eyes and doing all her "I'm sleepy" signals. Instead of taking one or two short naps a day, she's taking three or four, and they are not infrequently longer than her usual half hour.
To top it off, she's not eating well at all. Three mornings in a row she refused her bottle, and when I offered her solids instead, she would only eat about two tablespoons worth of food. During the day she's eating much less, too.
I have assumed this fatigue and disinterest in eating have been due to teething, but this has been going on for a couple of weeks now, and combined with the shaking I noticed yesterday, gives us pause.
On a positive note, Anastasia did take her bottle this morning (and ate all of 2 1/2 ounces), and yesterday - for the first time - we were able to get her interested in drinking from a sippy cup. My husband took the valve out of it, so she didn't have to suck, and she drank quite a bit of water. When we put the valve back in, she managed to drink a little, too.
November 6 (part II)
Our PT's initial reaction to the description of Anastasia's shakiness yesterday was that I was just noticing some ataxia - which might have been made worse by the RSV shot Anastasia had on Saturday. "No," I said. "I've seen her shift balance in the way you describe ataxia. This was different. Also, I looked up the possible side effects of the shot and the only thing that might describe what Anastasia was experiencing was 'muscle weakness.'"
"Well what you describe isn't muscle weakness," the PT said. "It is possible Anastasia's shakiness was just because she was very sleepy. But it's also possible she had a seizure."
She said she sees another baby who had something similar happen, and her mom took her to a specialist. The specialist said that if you're unsure what's wrong, flip at the baby's cheek with your finger. If the baby's unresponsive, she's probably having a seizure.
So...even though I don't really think Anastasia had a seizure, we will be watchful.
Our PT also told us to let our pediatrician know, which of course we will when we see her next week.
Physical therapy went as usual. Anastasia cried...although her cries are more about defiance than they used to be. Our girl did some really nice work, though, especially going from a crawling position to a sitting position all on her own.
The PT said we should start encouraging Anastasia to put blocks into a box or bowl, or to have her hand us toys. It's time for her to start learning to release items smoothly from her hand.
The PT also asked if Anastasia had any wooden puzzles to play with. "No," I said, "because I can't seem to find any rated for her age. Plus, I know Anastasia will just suck and chew on them, and I'm not sure that is such a good thing to do with plywood."
"So teach her not to put them in her mouth," our PT said.
That made me feel dumb. I was too busy thinking that it's good for babies to explore with their mouths; it never occurred to me to teach her to keep toys out of her mouth.
So the PT handed Anastasia a wooden puzzle of farm animals...and she loved it!
We also discussed Anastasia's dislike of her new bathtub, and the PT says it may be because the bottom of it (which is filled with air) feels unstable to Anastasia. Duh! Why didn't I think of that? So next time she takes a bath, I'm going to let the air out of the bottom of the tub and see if that makes a difference.
P.S. We've discovered that Anastasia loves olives. I slice them up, and she eats them as finger food. Hooray! Another fattening food that she likes!
P.P.S. While looking up the possible side affects of the RSV shot, I read that a nurse is supposed to observe the baby for 20 minutes after the shot to make sure there is no reaction. (A more common side effect is wheezing or difficulty breathing.) We've never had a nurse do that; they always send us right home, without ceremony.
November 7, 2006
I bought Anastasia a cheap wooden puzzle yesterday, and offered it to her this morning. I only had to tell her once to not put the pieces in her mouth. Who knew it would be that simple?
November 7 (part II)
I just weighed Anastasia and was delighted to find she's 18 lbs. 10 oz.! Though she may not be eating as much lately, it's apparently all she needs to put on some weight.
We're eager for her to reach 20 lbs., since then we can buy a new car seat and let her sit facing forward. (At this point, she's still rear-facing and spends most of her time craning her neck so she can see us.) She's outgrown her current car seat in length, but we're assured that her age, ability to control her torso and neck, and weight are more important than length, since spine and head injuries are far more serious than broken legs.
November 8, 2006
November is Prematurity Awareness Month. Unfortunately, despite gathering over 75,000 signatures, The March of Dimes petition asking Google to feature Prematurity Awareness Day (Nov. 15) was declined by Google. But there are lots of other ways to make people aware of prematurity this month.
For example, The March of Dimes expects that this November over 100 buildings will be lighted in Prematurity Awareness Month's colors of blue and pink. Perhaps most notably, the Empire State Building will be lighted in these special hues from Nov. 14th through the 16th. Click here to see some great photos of buildings lighted for Prematurity Awareness this year.
The March of Dimes website also offers some additional ideas, including: wearing special Prematurity Awareness pins and bracelets, emailing friends and family, "house of worship kits" designed especially for churches, and a list of prematurity events in your area.
I've quoted statistics about prematurity before, but here are some key facts to let your friends and family know:
* About 508,000 babies are born premature every year.
* This is an increase of 33% since 1981.
* Prematurity is the the number one cause of death and illness in infants.
* Prematurity is most often not the fault of the mother. It's not just drug addicts, alcoholics, and smokers who have preemies. Even mothers who take good care of themselves and their unborn child have babies that are premature.
Many people think being born early is "no big deal" these days. Nothing could be further from the truth. Not all preemies survive, and those who do go through great hurdles in the hospital. It's traumatic both for the baby and her parents. Too, some preemies have life long medical issues directly related to their early birth.
We need to work hard to discover the causes of prematurity, how we can help prevent it, and how we can better aid babies who are born early.
Help spread the word!
November 9, 2006
For many months now, after we say "I love you" to Anastasia, she will (about 40% of the time) say it back. Yes, I confess the words are garbled, but it's still clear what she's trying to say. At one point yesterday when I told her "I love you," she replied with "I love dada." I was impressed! But I pouted and asked if she loved me, too. She laughed heartily.
Today, my dad is driving in from out of state. He hasn't seen Anastasia since May; even though he keeps track of her through phone calls and this website, it's not the same as being with her in person. He's going to be amazed at what a big girl she is!
November 13, 2006
My dad left early this morning; we had a great visit.
The first day and a half or so, Anastasia did what she always does around people she doesn't know well. She stared. And stared. And stared. And didn't do much else. She was so curious that she didn't want to sleep, either, and spent most of the time rubbing her eyes to fight off fatigue.
By the end of the second day, she was warming up a little. She even said "Hi, gran'pa!" at one point...although she'd just spoken on the phone with her other grandpa, so the two grandpas argued over who she was speaking to. And at one point, someone described my dad as silly, and Anastasia quickly mimicked, saying "silly gran'pa!" We also ventured out just a little bit to look at a covered bridge nearby. Anastasia hadn't been outside in several weeks (because the weather's been so bad), so she really enjoyed it.
On Saturday, we got really adventurous. The bad weather offered a reprieve, so first we walked to the park. I could tell Anastasia had missed her stroller rides; she swung her legs and babbled the entire time. I'd also decided it was probably safe to take my dad to a couple of small, local museums. I figured there'd be nobody but the volunteer host at each of them, so the chances of Anastasia catching RSV were low.
As it turned out, there was another couple visiting the museums, but we braved it, since no one was obviously sick. (We used lots of hand sanitizer, too.) Then we stopped at a different local park and Anastasia saw live ducks for the first time. By the time we got home, she was ready for a long nap! I don't think she's ever had such a busy day.
On Sunday, we also took a walk, but it was much colder outside, and although Anastasia was bundled up, her cheeks, nose, and hands turned bright red. She complained a bit, and was glad to get inside, where her daddy bundled her inside his jacket and parked her close to our cozy wood stove.
By Sunday evening, Anastasia was touching my dad and his girlfriend's face...a sure sign that she liked them.
The visit was great for Anastasia on many levels, but perhaps her favorite part was that we did virtually no physical therapy all weekend.
During the weekend, Anastasia also switched from a half Pediasure/half formula bottle to an entirely Pediasure bottle...and didn't seem to mind one bit. Off and on, and she ate poorly, no doubt in part because she was excited by new people and changes to her routine, but also because she was teething. In fact, she gained two new teeth over the weekend. That makes a total of seven.
Anastasia also seems to have finally learned to use her sippy cup. We've been giving it to her without the valve, so she'd get the idea that yummy water was inside. Then we put the valve back in and hoped she'll figure out she needs to suck to get the water. Well, she figure it out this weekend, and was opening her mouth like a baby bird whenever she wanted a drink. Then on Sunday, she grabbed the cup by its handles and held it for herself while she drank. Yeah!
Today we see the pediatrician; she's been a little concerned about Anastasia's weight and just wanted to check with us on that. Anastasia is also due for a flu shot. In addition, I'll be asking the doctor about Anastasia's sleepiness (she takes half hour naps, and seems so tired in-between) and a little scrape Anastasia has on her hand that appears to be just a bit inflamed.
November 14, 2006
Anastasia's pediatrician appointment went fine yesterday. Our girl was really tired and grumpy all day (still worn out from grandpa's visit), so it didn't surprise me that the moment we began undressing her in the doctor's office, she began protesting...loudly. Funny thing is, she stopped to catch her breath long enough for the nurse gave her the flu shot...so she was quietest during the shot itself.
Not surprisingly, the doc proclaimed Anastasia's scrape just fine. (We'd placed a Band-Aid with antibiotic ointment on it for a couple of hours - until Anastasia tore it off. The ointment seemed to help. We couldn't really put just the ointment on, since Anastasia's hands are constantly in her mouth.) I also asked about Anastasia's ears, since she's been pulling on one of them a lot; she had no other symptoms, so I assumed this was just a bad habit. The doctor confirmed this.
In addition, I asked the doctor about Anastasia's very brief naps. I explained that she spends most of the day tired because she won't take long naps; a half hour twice a day is pretty typical. The doctor said that some kids don't get as much sleep as they need because they're too worried they'll miss out on something while they nap. (Yup, that's Anastasia, all right!) She suggested down time in a quiet room a couple of times a day, with only one stuffed animal or a book. We do that already, so I guess there's nothing more I can do to encourage Miss A. to sleep.
The doctor was also pleased with Anastasia's weight, noting that her percentile is rising just a bit. "She's starting to catch up," she said. We already knew this from the feeding clinic folks, but it was nice to hear it from another doctor.
In other news...
I read to Anastasia frequently, and she loves to listen to, look at, and chew on her books. One of her favorites is Moo, Baa, La La La by Sandra Boynton. The book begins with the sounds a cow and a sheep make, then proclaims that singing pigs say "la la la!" I always sing the "la la la," and yesterday, Anastasia tried to imitate me. She didn't really sing, but she had the words and rhythm down!
Since my dad's visit, she seems generally more talkative. (She has more to talk about?) This morning, when I told her our Early Intervention coordinator was coming to visit, Anastasia mimicked our coodinator's name quite clearly in a sentence of babble.
Oh, and for those of you who are curious about the textured spoon the feeding clinic gave us, I must say that Anastasia does like it. She tends to hold it in her mouth, as if she enjoys the feel of it. However, I don't think she actually eats more food when we use it.
November 14 (part II)
When I weighed Anastasia this morning, I had to do it three times before I'd believe the scale. She's 19 lbs. 3 1/2 oz.! (What's especially surprising about this is that I weighed her on Saturday and she was still 18 lbs. 10 oz.) As usual, I called the feeding clinic and left a message on the RN's voice mail. The RN called back within an hour, just to tell me how excited she was. "What have you been feeding her?" she asked. I told her I had no idea why she was suddenly gaining so much, except that she really loves her mashed potatoes and gravy.
November 15, 2006
Today is Prematurity Awareness Day.
To help everyone understand what it's like to have a preemie, The March of Dimes and Baby Talk magazine recently conducted a survey. One of the more interesting results was that "a quarter of respondents said that they felt that others blamed them – either subtly or openly – for the early arrival" of their baby.
I've never personally felt this way, and it saddens me that any mom should experience these feelings. The vast majority of moms of preemies take good care of themselves while they're pregnant, and the circumstances of their child's early birth is beyond their control. Click here for the complete survey results, and consider making a donation to The March of Dimes to help fund preemie medical cures and education.
Yesterday, Anastasia saw our Early Intervention coordinator. We were happy to learn that EI will be sending their physical therapist to our home once a month. It will be really great to expose Anastasia to someone else's approach. Too, it will help ensure that I'm doing the right exercises with Miss A. at home.
Our coordinator was more aggressive with Anastasia than she typically is, with some interesting results. First, she brought out an Aquadoodle. Anastasia found the non-ink, water-filled pen fascinating. Surprisingly, she only put it in her mouth a couple of times. We tried to help her see the correlation between the pen and drawing pictures on the mat, but when we tried to help her draw something, she pulled her hand away, a little mad. Ah yes. She may not be toddling yet, but her attitude is that of a toddler! Anyway, she loved examining the pen.
Next, our coordinator brought out a toy piano. In the past, Anastasia hasn't been the least interested in it, but yesterday she tried to take off the keys, then flipped the toy over and tried to figure out how to take it apart. Not exactly the reaction we thought we'd get, but a sign that she's maturing.
Then our coordinator pulled out some wooden blocks. Anastasia loved handling and looking at them, but we couldn't get her interested in stacking them.
Our coordinator was really glad to see that Anastasia can clap when we ask her to. (I taught her what "clap" means in about a minute a few weeks ago.) Anastasia is also beginning to learn where to clap when I sing "If You're Happy and You Know It." Pretty cute!
November 17, 2006
Yesterday, Anastasia learned about light switches. It was a joy to watch the light bulb go off in her head (pun intended) as I flipped the switch up and down. She'd watch my hand on the switch, then quickly look to the ceiling for the result. I tried to get her to flip the switch herself, but she preferred to watch me make the magic.
It was also a warmer day (the sun actually came out!), so we had another walk. I bundled her up a little better this time, putting some leopard skin trimmed mittens on her hands...Which brings me to a rant....
What are the makers of baby clothes thinking??? Surely, they've never had kids of their own. Someday, when I have my own line of baby clothes (insert laugh here), all baby jackets will have those flip down pockets for the baby's hands, just like infant sleeping gowns do. (I've never seen a baby jacket designed this way, but doesn't it make sense? For those who need warmer hands, the pockets would do the trick without the risk of loosing a mitten here and a mitten there. And for those who don't need warmer hands...well, they can just leave the pockets folded up.)
And while I'm at it, why do they make the neck holes in baby clothes so dang small? Anastasia isn't a large baby, but it seems that when clothes fit her well otherwise, the neck openings are so small I have to squeeze them over her head. Which, naturally, makes her cry. And if the small neck opening has snaps, they are very likely to scratch Miss A.'s pretty face. Why not add another snap or two to make the getting dressed part easier??
And why do they make newborn clothing that has to go over the baby's head? Newborns hate this. Why not just have front-opening stuff instead?
And why do they make preemie clothes that slip over the head and have no fasteners in the front? Most preemies small enough for preemie clothes are still in the hospital and hooked up to a variety of wires that must be threaded through the clothing; only things that snap or button in front are practical.
And those supposedly SIDS-safe sleeping sacks? The ones with zippered fronts are totally useless because the zipper inevitably develops a bulge right in front of the baby's mouth.
What I do like in baby clothing is anything that's pre-shrunk (which is unfortunately rare), things that don't need ironing (Like I have the time to iron tiny clothes!), things that are cute but also comfortable for baby, baby girl's clothes offered in colors other than pink (Pink is nice, but after a while you get sick of every outfit being the same color.), Robeez shoes (the only ones that stay on), and these smart "convert-a-foot" jammies that allow you to have a footed or a cuffed sleeper. (They make the sleepers last longer, too, since you don't have to worry about the baby getting too long.)
Ok, done ranting...at least for now :)
November 18, 2006
Our neighbor brought over a great toy this morning. "I saw this, and thought Anastasia needed it," she said. It's a set of colorful gears, and already Anastasia is trying to figure out how they work.
And here she is all bundled up for a walk:
November 20, 2006
Anastasia has really been maturing. In addition to all the cognitive things I've mentioned in earlier posts, she's almost crawled a few times. On Saturday, I was laying beside her on the floor, reading a book. She was busy playing, and I noticed her lean far forward to grab something. The next thing I knew, she was on her tummy, propped up on her elbows, "reading" a book. How I wish I'd had a camera handy! She stayed there for bit, quite absorbed in her book of nursery rhymes.
Then yesterday, my hubby was across the room from Anastasia and told her to come to him. She promptly got into a crawling position...but then seemed to realize what she was about to do, and rolled over onto her back.
Yesterday was also the first time my husband ever tried to feed Anastasia solids. He had no choice, since I was out shopping, but I don't think he was very happy about it. (He always tells me I do a better job of feeding Anastasia...) The highlight came when, after refusing to eat, Anastasia seemed to want to feed herself. So, naturally, my husband gave her the spoon full of applesauce. Probably thinking she was stealing the spoon, Anastasia pulled it away quickly...and the applesauce ended up in her hair.
It wasn't my husband's fault Anastasia wasn't eating, though. She's been distinctly un-hungry for a while now. She mostly refuses her morning bottle, and isn't eating nearly as many solids. It will be interesting to see how her next weigh-in goes.
Happily, though, she likes the home made applesauce I whipped up this weekend, and she's even started taking some watered down apple juice in her sippy cup.
Anastasia is also nearly ready for a new car seat. She's outgrown her infant seat in length, and it's getting increasingly difficult to get the shoulder straps on. So Sunday, my mom and I visited a bunch of stores to see what was available locally.
Not a huge selection, I must say. And my mom kept saying, "Why do they make them so ugly?" Why, indeed.
And there's such a wide range of prices, from the $270 model that everyone raves about, to the $80 basic model. I keep reminding myself that all car seats sold in the U.S. must pass the same safety tests, so the difference is primarily how easy the thing is to use.
I've narrowed it down to two models, but they vary a lot in price. The ease of use tests on both models are about the same. And when I go to Epinions.com, parents seem to like them about equally. But when I went to the Baby Bargains forum (a terrific resource when you're buying baby stuff), it's clear that the more expensive of the models is the best. The next question is: Will it fit in our vehicle? To make this a more difficult question to answer, we hope to buy a new (for us) vehicle shortly.
P.S. Some of you have written in response to my rant about baby and preemie clothes, suggesting I add a section to the website with tips on buying (and perhaps making) practical stuff. Great idea! I'll get to work on that and post something soon.
November 21, 2006
Physical therapy went fabulously yesterday. At first, I thought it was going to be trying for everyone; the minute we started down the hallway to the physical therapy room, Anastasia began crying. She continued while I took off her jumper and the PT brought in some toys. But as the PT began working with her, I started making funny faces, she laughed, and it was great from there on.
The PT said Anastasia did the best she's ever seen her do. She used a spring ball with our girl, to work on balance and coordination, and Anastasia acted like it was no big deal. The ball looks a bit like the planet Saturn; Anastasia stood on the ring, and sometimes sat on the ball itself. She did lots of squatting without help, and even stood repeatedly for seconds at a time.
Then the PT put her on a treadmill (which moves at a very slow pace). There were little handlebars at Anastasia's level, and she sometimes held onto them. The PT stood behind Anastasia and encouraged her to take steps. Anastasia kept looking up at her daddy and me, smiling. She thought it was great fun.
We all walked away from the session feeling encouraged and pleased.
Anastasia is still refusing her morning bottle. One might think this is related to teething, but she will eat something like toast or graham crackers, which I wouldn't think would feel good on tender gums. Yesterday, she ate almost no solids, and when I did get her to gobble down some mashed potatoes and gravy, she vomited up every bite. I think this was reflux related.
One of the problems with Prevacid is that it's very hard to dose for smaller babies. I to cut the pill into three-quarters, then dissolve it in water and give it to Anastasia in a syringe. But the pill doesn't completely dissolve. It only dissolves into tiny, heavy beads, which are time-released inside Anastasia's tummy. But sometimes those beads get stuck together inside the syringe and no amount of finagling will get them out. (I have to scrub them out with a tiny brush in order to clean the syringe.) Yesterday was one of those days...which means Anastasia didn't get her full dose. Hence the vomiting, I think.
It was a horrible vomiting session, too. Anastasia looked panicked; she had vomit in her mouth, but wasn't tilting her head down so it would come out. I had to do this for her. Those bibs with the plastic crumb catchers are good for more than just crumbs :(
I also wanted to mention a great toy I recently ran into. Every doctor's office we go to has one of those wooden cubes with activities on each side. Every PT or pediatrician we see recommends these cubes as a great developmental toy that will interest a child for many years. But the things are really pricey. A small one is at least $100. (I've seen a few for $10 or $20 less than that, but they were either quite small or chintzy.) But this weekend, I found one that was only $50, is made of wood, is a reasonable size, and has lots of interesting activities. It's called a Busy Zoo by Battan. I think it's such a great toy at a great price, I've added it to the section on developmental toys for preemies.
November 22, 2006
Ya'll remember when Anastasia had her first birthday, way back in early August? Well, tomorrow was supposed to be Anastasia's birthday. She was due November 23, 2005...
...Anastasia did a little better with her eating yesterday. I let her entirely self-feed, so maybe she's just a stubborn little girl and doesn't want mommy feeding her any more. Even so, her appetite was smallish. Here's to hoping she eats lots of mashed potatoes and gravy tomorrow!
Have a fabulous Thanksgiving, everyone!
P.S. As requested, I've written a little something about what types of clothes preemies need, where to find them, how to make them yourself if you so desire, and where to find charities that accept preemie and infant clothes. Hope you find it useful!
November 24, 2006
Our Thanksgiving day began with a discussion about what the heck we were doing on Thanksgiving 2005. I have absolutely no recollection. My husband thought maybe he remembered spending the day with my mother, then visiting with Anastasia in the late afternoon and evening. It was such a stressful time for us, with Anastasia in her third month in the NICU, that our memories are very poor.
So I thought I'd hop online and check this blog to see what we were doing last Thanksgiving. But apparently Thanksgiving, in the traditional sense, didn't exist while Anastasia was a preemie in the NICU. In my posts, I don't mention what we did...although I do mention that on Thanksgiving Anastasia was taken off the Vapotherm machine and put on ordinary oxygen prongs. I also note that she weighed 9 lbs. That means she's gained 10 lbs. in one year. That doesn't seem like much.
At any rate, Thanksgiving 2006 was quiet, but pleasant. Since Anastasia can't be around her cousins during RSV season, we stayed at home, and my mother joined us for the afternoon.
Anastasia still ate poorly, but I think she just wants to feed herself. If I try to feed her, she turns her head away sharply and sticks out her lower lip. If I offer her a fork with food on it, she'll take it, play with it a bit, then eventually put it in her mouth.
But only if I'm not looking.
It makes eating a long, drawn out process, especially since I have to limit how long feeding sessions go because she eats so frequently.
At the Thanksgiving meal, I gave Anastasia a bunch of mashed potatoes with gravy in a bowl that suction cups to her high chair. I hoped that she'd dig in, make a big mess, but learn how to completely self feed. No such luck. I had to put the potatoes on the spoon for her, and she didn't even try to eat the potatoes with her hand. Oh, and she very easily tore the suction cup bowl off her high chair.
So I placed a variety of small finger foods on her tray: stuffing, blueberry muffin, small pieces of turkey, olives...Her favorites were the blueberry muffins and the turkey.
I see this look so often! Each meal begins with very skeptical, wary looks from Anastasia.
Chewing on utensils is a lot more fun than actually eating. We received this bib as a gift at her baby shower, and while Thanksgiving 2006 is technically not Anastasia's first Thanksgiving, it's the first Thanksgiving she's been able to enjoy. Thanksgiving 2005, she was still in the NICU, being fed breast milk through a feeding tube.
Happily, Anastasia also drank more from her sippy cup than ever before. By evening, half of her apple juice/water mixture was gone. This is encouraging, since in the past she has seemed to think she needs no fluids at all while she's awake.
It was a very happy, exciting day for Miss A., and by evening, we could really see that she's a toddler now. She had her first "the day was so exciting and now I'm really hyper" night. And then she fell fast asleep.
And to show how far she's come, here's Miss A. last Thanksgiving, at the "woulda shoulda birthday" party her nurses threw:
And here she was on Thanksgiving of this year, at one year corrected age:
November 27, 2006
Anastasia can now go every direction in her walker, and is fond of stealing the dishtowels off the oven door. Having no concept of hurting anyone, she sometimes runs right into the cat. (You'd think by now the cat would get out of her way...) On Saturday, I think I heard her say "kitty," but when I responded with "Did you say 'kitty?'" Anastasia appeared self-conscious and very quietly said "dada" instead. "Dada" is her safe word. She seems to use it whenever she feels self conscious.
Anastasia also imitated the cat's meow this weekend. But because our cat is part Siamese, it wasn't a traditional "mew" or "meow." It was that awful whiney sound our cat makes.
My favorite thing she's doing, though, is saying "I love you." She used to say this only after her daddy or I said the phrase first, but now she says it out of the blue. Nothin' better than hearing "Mama, I love you!"
November 27 (part II)
Today is weigh-in day, so I just got off the phone with the feeding clinic. The good news is that while Anastasia lost a few ounces last week, she's gained them back. The not-great news is that she's the same weight she was at the last weigh-in (19 lbs. 3 1/2 oz.).
And the bad news is that Anastasia seems to be getting dehydrated. She has plenty of wet diapers, but they might only have a small amount of urine, and lately, they are very smelly. The smell is what's concerning.
Per day, she's only taking two 8 oz. bottles (actually she takes them at night while she's half asleep) and about 1/4 cup of juice (mixed with water, or she won't drink it at all) from her sippy cup. So the clinic wants me to try giving Anastasia smoothies and milk shakes, to see if the sweet flavor will entice her to drink more.
Last week, an online friend who has a preemie with feeding difficulties recommended a honey bear bottle. I ordered one a few days later. When I mentioned this to the feeding clinic this morning, the RN said they often use the honey bear for kids with sensory issues. "It can't hurt to try it," she said.
So...I need to go to the store and buy lots of ice cream and fruit!
November 29, 2006
Over the past two days, Anastasia experienced snow for the first time. On Monday, it snowed most of the day (although none of it stuck), so I bundled Anastasia up and took her outside. She didn't seem too impressed with the falling snow. But the following morning, the yard was covered with an inch or two of white stuff, and she squealed and clapped with delight at the sight. Later, I took her outside to the snow, but I think she decided it was more fun to look at than it was to touch. Brrrrr!
Yesterday our Early Intervention coordinator visited, and was impressed when I told her Anastasia says "I love you" out of her own initiative. "Wow!" she said. "'I love you?'" Hearing the phrase, Anastasia whipped her head around and stared at our coordinator, looking a little perplexed. You could almost see her thinking, "You love me, too?"
Our coordinator was also glad to hear that a few days ago, while I sat about a foot away from Anastasia on the floor, our girl reached over and tried to scoot into my lap. After she struggled a bit, I scooped her up onto my knee. Anastasia then stretched far forward, grabbed a book, and put it in my lap. Taking the hint, I began reading it to her, and Anastasia snuggled right in and enjoyed the story.
I also asked our coordinator about blocks. Of all toys, blocks are the ones developmental experts say are the best for kids, yet it's really difficult to find any that are rated for children under three years of age.
"It seems like Anastasia is a good age to introduce wooden blocks, but I can't find any for one year olds," I said. Our coordinator shook her head in sympathy. "I know! I can't find them, either," she said. We tried to dissect why wooden blocks aren't rated for young children, and only came up with two possibilities:
1. When babies are learning to walk, they stumble a lot, and we supposed they might have a mild injury if wooden blocks were laying around.
2. If the child tends to chew on toys, a tiny piece of wood might come off, we guessed.
Neither reason seemed a very good one to keep such a great developmental toy away from a one year old, though. So, if Anastasia doesn't get wooden blocks for Christmas, I'm resolved to buy her some to use with supervision.
Anastasia had her first milkshake and smoothie on Monday. As I suspected, neither was a panacea for her drinking issues. She took only a sip or two of the milkshake. Later, when I offered a peach smoothie (she loves peaches), she drank about 1/4 cup out of an adult cup. But then she wouldn't touch her apple juice for the rest of the day, so she didn't end up getting more fluids (although she did get a few more calories).
This morning, I tried giving her Carnation Instant Breakfast mixed with whole milk. That was a no-go, too.
I'll keep trying variations on the theme, but frankly, I think Anastasia just doesn't like drinking. Too, her morning attitude (as she cranes her head to see her toys) seems to be: "Mom, I can't be bothered with eating and drinking. I've got stuff to do!"
November 29 (part II)
Anastasia's honey bear bottle arrived in the mail this afternoon, so I decided to give it a try right away. I put some Pediasure in the bottle and showed it to Anastasia. She squealed, thinking it was a new toy. When I handed it to her, she looked it over with a smile and started chewing on the soft, pliable straw. (She's teething really badly just now, so that was no surprise.)
Suddenly, she gave a little suck and ended up with a mouth full of Pediasure. She was surprised, but not unpleasantly so, and ended up sucking some more. She definitely did more playing than drinking, but she did end up taking 20 ccs (almost one ounce)...which is more than she'd normally drink while awake!
November 29 (part III)
I don't know if I've ever posted three times in one day...but here I go! I just had to share these photos of Anastasia after our walk today. She's been pretty glum and sensitive due to teething, but a walk in the brisk winter air really perked her up.
P.S. Our county health nurse (who's been seeing Anastasia periodically since she came home last December) gave me a call this afternoon. She reminded me that last time I spoke to her (around May of 2006), there was some concern that Anastasia might have cerebral palsy. She was pleased to hear that Anastasia doesn't have CP and is doing so well; in fact, she decided to close Anastasia's file, knowing that our girl is already getting lots of help elsewhere. Hoorah!
Oh, and Anastasia took another 10 ccs from her honey bear bottle!