Tuesday, September 30, 2008

"Two-year old responsible for lock-down..."

On Tuesday, September 30, a large down-town facility was forced into a lock-down situation. Authorities report that a two-year old girl escaped from circle time by hiding behind another child who was leaving with a parent. Said child eluded teachers and administrators and her own mother for less than ten minutes, but this was sufficient time to merit a "lock-down" of the building until she could be located. When eventually tracked down standing next to a door and saying "Daddy!", the little girl laughed at the crowd of people obviously anxious to find her.

Yep, that's my girl. Tiny, sneaky, and just a tad malicious...

My sling... and why you need one too

Ryann is hosting Toolin' Up Tuesday over at Life as MOM today. Be sure to head over there for some great tools and tricks!

When it grew apparent we'd be bringing C. home soon, I started thinking about what items might make my life easier. We already had a lot of baby gear- our son had been born less than eleven months before her! But I tried to take into account all the differences.

While A. weighed in at a fairly hefty eight pounds at birth, C. would be coming home at 6 1/2 pounds and almost four months old. She was also still on supplemental oxygen through a nasal cannula, an apnea monitor through leads attached to her chest, and a feeding tube that was threaded through her nose. Lots of extra stuff going on. Having to juggle equipment in addition to a tiny baby added a new challenge. Also, don't forget I still needed to have at least one hand free to juggle her not-yet-walking brother! I decided that I needed a sling.

I did a lot of online research before ordering my sling and finally decided that this type would work best for me:

(Obviously not me in that picture, but doesn't she look so sweet with that little newborn???)

This type of sling is essentially a big, long piece of knit fabric that you wrap around your body a few different directions and it forms a wonderful little supportive "pouch" in which you can snuggle your baby. What I loved about it: it was rated for 5-35 pounds, it kept C. very securely against my body, it folded up into almost nothing, and it was very soft and comfortable to wear. What I didn't like? There was a steep learning curve in getting handy at wrapping that thing.

Despite the complexity of wrapping, I absolutely adored this sling. I can't imagine how I would have carted everything (and everyone!) around without it. No doubt, this was a very important tool to have for parenting our tiny preemie. I recommend you do some research and find a good sling if you're going to be juggling gear like we were-- I truly think you'll be glad you did.

Monday, September 29, 2008

How to Ask...

Earlier today I wrote about the importance of keeping your hands clean and germ-free in order to help maintain your preemie's good health. Without a doubt, this is the number one thing you can do to protect your child. It's also important to make sure that any friends, family, or strangers who will be very near to or handling your child also practice meticulous hand washing. What can be difficult is knowing how to ask without offending someone.

The most important thing, I believe, is to make sure that you always have the necessary materials available and (pardon the pun) handy. You shouldn't expect others to pack their own antibacterial gels or wipes, nor is it particularly kind to expect them to run off to a washroom all the time. Stock these products in convenient places throughout your home as well as your car and diaper bag. If you're having a family gathering, station someone at the door (a teen or 'tween girl is fantastic for this job) to hand everyone the sanitizer. You could even make it fun and put an assortment of scents in a little basket.

I also think it's smart to keep some masks at your home. Yes, it's a little odd having to wear a mask around, but it can really give you peace of mind when you (or someone else) is fighting a cold or tummy bug. If I asked someone visiting to wear a mask, I would usually wear one as well. My thinking was that this might make it feel less "odd" for the visitor.

Before you even bring your baby home, start talking about the importance of vigilant hand-washing with your friends and family. If you lay the groundwork, all you'll have to do is hand them the sanitizer later on and they'll already be expecting it.

It's a little trickier with strangers and that's part of why so many doctors recommend you limit how much you take your baby out. I agree with that recommendation, but I also know how hard it can be. Face it- some things just need to get done. And, well, sometimes you need to see people and things outside your own four walls. If you need to get out, try to follow one of these suggestions in order to avoid too much germy contact....
  • keep your baby in the infant seat either in the stroller or inside a cart and covered with a blanket
  • wear your baby in a sling
  • or, in a pinch, carry your baby close to your shoulder with a blanket fully covering him/her; it will look like you're nursing and people are far less likely to poke at your baby then
Finally, just remember why you're doing all this. I have found that I have more nerve and guts as a mom than I ever did before. I am able to speak up in ways I never would have imagined if it's what needs to be done for my children. When all is said and done, I worry far less that I'll have to look back and know I may have offended someone than I do that I may have not done enough for my children...

Keep it Clean, But Don't Obsess

When you find out you get to bring your preemie home, there's a natural reaction that kicks in. There's a sudden need to purge the home of every germ, dust particle, and smudge that may exist. Fears of RSV, Pertussis, and worse can send a normally easygoing parent into a tailspin of housekeeping frenzy. This is understandable. We met parents who took a full week off of work to clean their home from top to bottom. Others hired a service to come in and vacuum every duct in their home. These were going to be some clean places, I'll tell you.

I don't believe it needs to be that way.

It's important to protect your fragile infant from as many harmful germs as possible, this is true. The best way to do that? Wash your hands. Yep. That's it. And make sure others wash their hands as well. Learn to sneeze or cough into your sleeve. Carry antibacterial gel, wipes, or spray. Basically, keep your hands clean.

Don't get me wrong, it's always nice to have a fresh and clean home, especially when you're bringing a new little baby home. But a few dust particles won't hurt the average preemie. Smudges on your glass door won't send you running back to the hospital. Stained carpet or yellowed wallpaper won't make a bit of difference.

By all means, keep your preemie's surroudings clean- just remember that you're the most important thing to clean.

Saturday, September 27, 2008

Hop Over to "Life As MOM"!

Where else might you find me today? Guest posting over at Life As MOM while FishMama settles into a new home in a new state with six children!

Please head on over and read what I have to say on "Letting Go of the 'Why Me's"...

Just a little housekeeping...

Just a few quick notes:

First of all, I want to thank all of you who visit this blog. Our readership has grown and I am so very appreciative of this! The layout here and features presented are still rather, well, bland. I really plan to work on that. It's a little frustrating for me simply because we only have dial-up available where we're at (can you say, "boonies"?) and that, as you may imagine, makes things rather slow-going. Just when I get something almost down-loaded, I get disconnected. I'm a pretty patient lady when it comes to technology, but it does get kind of maddening over time. So please bear with me!

Secondly, my "Preemie Talk in Cyberspace" feature will be up again next Saturday with a new name. It will be called "JL's P.S. Fest" because, well, I am the queen of P.S.'s. Just ask my long-distance email buddy, Monica. Whenever I have random good thoughts or find tidbits I want to share, I end up sending her a list of 5-20 P.S.'s. It's just the way my little brain works sometimes. So, with that in mind, I'm changing my format. This will also give me the freedom to include some links I think will interest my readers but that may not be entirely specific to preemies.

Enjoy this last weekend in September and thanks for being here!

Friday, September 26, 2008

Free Diapers! No CVS Necessary...

Okay, so there is a bit of a catch. But it's not too bad, really!

As most of you know by now, my second child, my daughter, was born four months early. That meant a long hospital stay, a lot of nail-biting, and a very long-awaited home-coming.

Once we were settled in at home, I expected to make and receive a zillion phone calls about medical appointments and equipment. What I hadn't expected was a phone call from a research nurse. She wanted our permission to sign our daughter up for a feeding study designed to determine a better calorie formulation for preemies (and some other groups of babies, like those with specific heart defects, but we were not part of that group). I told her I'd discuss it with my husband.

We talked about it a lot that night and we came to the same conclusion: As long as these studies would not hurt or traumatize our daughter, we wanted to do everything we could to help them improve the precision of care for future preemies. There are a limited number of former 23- and 24-weekers who are healthy enough at four months (or newborn, corrected) to do these studies. Since we were blessed with one of them, we agreed to do it.

When I called the nurse back, she told me (regretfully) that it was not a paid study. That they would not be able to compensate us monetarily. However, she added, they would give us 14 bags of diapers as a "thank you". Fourteen bags of diapers? We considered that a paid study!

Between the three phases of that study and two other small studies (one was just a questionnaire), we have received over 50 bags of diapers and $150 in gift cards. That's not actually why we signed on... but it sure was a nice bonus.

To see if there are any studies you might be eligible for to help find solutions to causes near and dear to you, check out this site.

For more frugal ideals, check out Frugal Friday, hosted at Biblical Womanhood.

Thursday, September 25, 2008

Happy Birthday to My Hubby!

Only one relevant post today, folks, because it's my husband's birthday! Happy birthday to my wonderful husband, a super father, and the strength and support of this family...

And C's hero.

Three Things You Should Know About Brain Bleeds

I plan to do some more extensive posting on this topic in the future but, for now, if you know someone with a very early preemie, here are some basic things you should know:

  1. A brain bleed is technically called an intraventricular hemorrhage (IVH) and it is a condition that results from abnormal bleeding on or in the brain.
  2. Intraventricular hemorrhages are categorized into four different grades of severity with grade 1 being the mildest and grade 4 indicating actual bleeding into the brain substance itself.
  3. All early preemies are monitored for brain bleeds through weekly head ultrasounds (frequency may vary based on hospital protocol). If an IVH is detected, treatment will vary depending on severity and ranges from doing nothing to performing surgery and placing shunts.
Doctors feel that for some babies (especially those born weighing less than 3 lb 5 oz), IVH may be an unavoidable consequence of premature birth.

(source Your Premature Baby by Frank Manginello)

Wednesday, September 24, 2008

Be THAT Person

In my life, and especially in recent years when things got a tad tumultuous, I would say I could categorize a lot of well-meaning people into two groups-
  • those who constantly and incessantly offer to help, do anything, and be anywhere for you but then, ironically, are always busy or unavailable on the off-chance that you may need them
  • those who make sure you know you can count on them and, well, you know you can
Be part of that second group. Only offer what you can give. I tire of people who say all the right things but can never deliver. Just my two cents...

Giving Up Naps

Like so many elements of parenting, when to drop that last nap will vary tremendously from family-to-family and even from child-to-child. I've met perfectly content 15-month olds who barely napped at all and six-year olds who still require a little shut-eye during the day. There is no "perfect" age.

In my family, we tend to try to drop those naps pretty early though. By about 2 1/2. Is anyone gasping? Anyone want to send me off to the looney bin? "But they need down time!" "You need some quiet time!" "Little kids NEED naps!!!" I can hear it all in my head. And that's OK. Those are good responses. This is what I think...

My kids do great without that nap. Rare is the day when we experience late afternoon/early evening crankiness. And, truth be told? My kids weren't angels every single supper even when there were napping. So it's highly likely the lack of nap is not to blame.

They absolutely do need quiet time. So do I. And we get it. We curl up on the sunny love-seat in the playroom and they look at books or work on lacing cards while I read or do handwork. I love that closeness and we can all recharge.

I love that our daily schedule is not dictated by naps. I needn't worry about running errands at specific times or planning meals within a narrow window. I don't fret if "she hasn't napped by three because now she'll sleep til 5:30 and bedtime will be a nightmare". It's a non-issue for us.

And, I won't lie, I love my evenings.

My kids go to bed at about 7 PM. Yep, that's right. And they sleep until between 6:30 and 7:00 AM (which is perfect because we have to be up for school and therapies then anyhow!). I have at least three hours of time alone with my husband. And that's a beautiful thing. I love my children, flat adore them actually. And maybe that's why I don't need a "break" from them during the day. But you better believe I also love having them tucked snug in their beds so that I have time to reconnect with their father and be grown-ups together.

I am the odd-ball at the preschool. The one the other moms look at a little strange when I say, "Oh, she doesn't nap anymore." But I don't mind. It works for me.

Check out more great tips and ideas at Works For Me Wednesday, hosted at Rocks in My Dryer!

Tuesday, September 23, 2008

Lovin' the Latex!

When my daughter was released from the hospital, one of our beloved nurses pushed a box of green, size small latex gloves into my hands and said, "You'll find a use for them."

At the time, I didn't think much of it. Truth be told, I had a lot more important things on my mind as we prepared to drive our little girl HOME after 3 1/2 months in the NICU.

Fast forward to a raging, open-sore rash that required constant application of ointment with pristinely clean hands. I remembered the box.

When we faced a particularly gruesome bout of stomach bugs, I remembered that box.

And when I went to wipe the cat hair off our tabby's favorite chair, I remembered again. (Did you know that wiping upholstery with a latex glove picks up fur in a flash?)

I'm almost out of gloves now.... looks like I'll be working that into one of my drugstore deals.

Or calling a nurse buddy.

Homemade Yogurt Drinks

This is such a no-brainer, but I'm going to share it anyway just in case someone has a child like mine...

Most kids love those little drinkable yogurts that Yoplait and Dannon make for children. My kids are no exception. I learned long ago that it's very easy to make your own by simply dumping any old yogurt (preferably not one with fruit chunks) and an equal amount of milk into a lidded container (a sippy-cup will do) and giving it a quick shake.

This can definitely save you money in the long run. But it's not really much of a tip.

It's my tip because of this...

My daughter, while not actually allergic or sensitive to cow's milk, doesn't much like it. She, does, however love soy milk. In my neck of the woods, drinkable soy yogurt does not seem to be on the grocery shelves. By making my own drinkable yogurts, I can use soy yogurt and vanilla soy milk and she is one happy little camper. I love easy fixes!

(** added preemie bonus-- those drinkable yogurts are an excellent consistency for children who need their liquids thickened due to swallowing issues!)

For more great kitchen tips, check out Kitchen Tip Tuesday, hosted at Tammy's Recipes.

And, for more great drink recipes, be sure to visit Thirsty Thursday, hosted at A Little Birdie Told Me!

***UPDATE: Thanks to Allison who does PR for Yoplait Kids for emailing me to let me know there is a coupon for $1.50 off a six-pack of their yogurt drinks or cups available here. Many of my local stores frequently run $2.00 sales on these, making it a phenomenal deal! My daughter may be a soy-snob... but my son's not picky! Thanks, Allison!***

Monday, September 22, 2008

Thank Heavens for Progress...

The past
Twenty years ago, only 20 per cent of babies born weighing less than 2lb 2oz would have survived, according to the premature baby charity Bliss . Now 80 per cent do. When the current generation of neonatalogists were training, a 23-week-old baby would be left to die: now it is likely to be resuscitated. When abortion was legalised in 1968, the time limit was 28 weeks: it was reduced to 24 weeks in 1990 partly because of the increased viability of premature babies. In 1969, 5.3 women per 1000 aged between 15 and 44 had a termination.
--(Source: The Observer)

And still, in too many parts of our world, it would have been perfectly legal to abort her..


"My story..." Monday, The First Few Hours

C. was born at 12:32 AM on Christmas Eve. Her early arrival was both terrifying and awe-inspiring. As I wrote about in her birth story, she actually cried at birth which is pretty much unheard of for infants of this gestational age. While we were thrilled to hear her obvious survival of the birth, we knew we were not even close to out of the woods yet. Before being whisked off to the OR, the medical team had made sure to tell us that the next 48 hours would be critical. Even should she survive the birth, she had a less than 50% chance of making it through the next couple days...

Once they had removed her (bag and all) from inside me, she was quickly swept away with a large neonatal team. As she cried down the hallway, we realized that we did not know the gender of our child. The anesthesiologist called down the corridor, "Can we get the gender for the mom and dad?" A faint reply came, "It's a girl!" Daddy was permitted to go with her while I waited out the lengthy process of getting stitches through four separate layers of me.

She scored a 7 on her Apgar which is nothing short of remarkable given how tiny and early she was. The nurses showed me her teeny, tiny footprint which was exactly the same length as my thumbprint.

They wheeled me into recovery and, once I could wiggle my toes (a sure sign that the spinal was starting to wear off), they pumped me full of morphine. I wasn't there long before the neonatologist and her team breezed through with little C. tucked in her isolette (a kind of enclosed incubator) and stopped to let me see her for the first time. I was allowed to reach through a small hole in the side and touch her leg ever so gently. It is not the first meeting that one dreams of, but it was precious to me nonetheless.

From the recovery room, I called my parents in the wee hours of the morning that Christmas Eve and told them they had a granddaughter. My husband took over the rest of the calls. Everyone was scared, of course, but also excited. She was truly an amazing blessing that Christmas.

They cared for my daughter at a wonderful children's hospital that attached to the hospital where I delivered. Over the next few hours, I was heavily drugged and they monitored me carefully. I had lost three units of blood in the labor and delivery and they were about to prep a transfusion. Somehow, my body managed to replenish itself in record time. During that time, my husband basically ran back and forth between C. and me. He'd head over to Riley and then come back to me with a report. It was kind of surreal being so far from my child, but I was blessed to have his first-hand reports.

At 4:30 in the morning, my phone rang and it was C's doctor. My heart stuck in my throat. I waited for what she was about to say. This is what I heard,

"Your daughter extubated herself this morning. She's really feisty and strong! We let her try to breathe without the ventilator for a little while and she did well, but then she got tired. We had to reintubate her, but she's stable and doing well now."

I didn't know it then, but I was to receive many more phone calls along those same lines. C became famous (or infamous?) for pulling out tubes, IV's, monitors, probes, you name it. I would always apologize for her behavior, as if I had anything at all to do with it, and the doctors and nurses would always remind me that they liked them feisty. It's the feisty ones who make it.

About 9:00 that morning, a nurse came in and asked if I wanted to try and get into a wheelchair to go see my baby. Let me just tell you this, people. There is no greater incentive in the world to get up and moving after major surgery than the desire to see your child. I jumped at the chance (Ok, not literally, but I was ready!)

As they wheeled me through the breezeway, I could look out all the windows and watch a heavy, damp snow fall to the ground. It was pure and lovely and festive... and I was about to spend some time with my precious, darling daughter...

Merry Christmas Eve.

I'll write more about that first day of C's life next Monday. Thanks for reading.

Saturday, September 20, 2008

Preemie Talk in Cyberspace, #2

I feel so fortunate to have stumbled upon the blog of a neonatologist and I find this discussion on the value of life at 24 weeks gestation vs. 8 years of age so thought-provoking!

I was so comforted by Shannon's advice on potty-training and I hope some of you are too.

This new, fabulous site is perfect for helping friends and families coordinate their visits/support when a loved one is in the hospital... online scheduling... brilliant!

I love these recommendations for answers to "combat" arguments we often hear from those in favor of abortions. Actually, I really like the entire American Life League website.

Know of any other links that may be interesting and relevant to the readers here? Email me at:
micropreemies (at) yahoo (dot) com!

Friday, September 19, 2008

Some Milestones Worth Pushing For

Yesterday, I wrote a bit about some milestones you shouldn't worry too much about. In fact, in a lot of cases, those milestones were things worth putting off- often for safety and convenience reasons.

Today, I want to address a few milestones worth pushing for, things that I (and the experts, in some cases) feel are important developments for our children to achieve. While there are lots of important steps our kids must take, here are three biggies:

  1. Letting go of the pacifier- Studies now show that pacifiers are good for babies. There is evidence that sleeping with a pacifier may help to prevent SIDS and pacifiers are especially important for preemies who sometimes have only this means of fulfilling the sucking reflex (since many early preemies cannot eat by mouth, at least for awhile). Many experts now suggest that you let your child hold on to the pacifier, particularly at night, for as long as necessary. That's all well and good. But I firmly believe (and there are a lot of speech therapists who agree with me) that the pacifier needs to come out when a child is starting to talk. It is nearly impossible to understand a toddler trying to speak around a paci and it's not good for the child who's trying to learn how to form letter sounds. When your child starts talking? Ditch the pacifier except for naps and bedtime.
  2. Getting off the bottle (and the sippy cup)- There is no magic age for this. Many experts will suggest that a baby should be completely off the bottle by age one, the same age they can begin drinking cow's milk. The age for sippy-weaning is really pretty vague. Both bottles and sippy cups serve a purpose. But recognize when that purpose has been served. I firmly believe that children should be completely off the sippy by age 4. It's better for their teeth. It prepares them for settings with their peers. If drinking from an open cup is still too messy/challenging? Use a straw. Straws present less chance of aspiration (often a concern for preemies) and are socially acceptable even as an adult. And in my humble opinion, there is never a good reason to put soda in a bottle or sippy cup. I can't be swayed on that one.
  3. Leaving the lovey in bed- Yesterday, I addressed the comfort that children can feel from having a lovey. It's actually an encouraging thing that our little ones can feel that attachment and security. Those are great things! But it's also important as parents that we teach them how to feel those emotions without the object in hand. There's really no harm in finding comfort from an object like a stuffed animal or blanket and it can be very helpful in soothing boo-boo's. By the time our children are headed off to preschool or play-group, however, I think they need to be able to leave those things at home or, at the very least, in the car. It's a big step in learning how to cope with the outside world. And it's an important one. I want my little ones to always know they can seek comfort, to always know they have a safe place to fall. I also want them to know that Dolly doesn't have to be there for those things to happen.
I truly believe that we stress over giving these things up more than our children do. I know I fretted endlessly before weaning my son from the bottle, fearing he'd never sleep again. You know what? He did just fine. It was me making a big issue out of it. I think we have a better chance of success if we try very hard not to let our reservations and concerns get in the way. Children can pick up on our emotions, no doubt about it.

Enjoy your kiddos! Cherish each phase and don't push too hard... but do be the guide and encouragement our children need to make those important steps forward. They need you to be confident in them.

Collecting for Donating

This is the scene on my pantry counter. Notice the box on the surface. Notice the paper taped to the cabinet above...

When my daughter arrived so very early, we knew we'd be in for a very lengthy hospital stay. Since our home is two hours away from the fantastic children's hospital, it was important for us to find someplace to stay. A very helpful nurse got our name on the waiting list for the Ronald McDonald house right away. Fortunately, we received a call the day before my discharge saying they had a room ready for us.

I cannot say enough about the RMH. It is a remarkable facility that provides housing for as long as your child is hospitalized. We ended up staying there an even 100 days and nights. It was certainly our home away from home.

One thing that never failed to amaze me throughout our stay was how the house provided for all of our needs. They had a beautiful kitchen with a fully stocked pantry that we were able to use. They had diapers and wipes in the public bathrooms that we were free to use for our babies. There was always laundry detergent and fabric softener in the laundry rooms. They made sure to tell us that we should just ask if any needs arose; they would do their best to meet them. It only happened twice during our stay- once when we were running dangerously low on diapers and I was still on driving restriction, once when our son had rotovirus and I was desperate for some plain graham crackers, the only thing he seemed able to keep down. Both times, the staff there went above and beyond. I tried to pay them for the diapers, but they just shook their heads; it's all donated.

Now that we're home and C. is healthy, it's important to me that we give back to a place that did so much for us. I printed this list from our local Ronald McDonald House's website. They keep an updated "wish list" there at all times. I then posted it on my cabinet for easy reference. I highlighted the items I felt I was most likely to be able to pick up for free or cheap at CVS, Walgreens, Walmart, etc. I put a little check mark next to it if I've added it to the box.

The box just sits there, filling up, until I'm headed down that direction. It's so easy to fill because it's right there with all my storage space. When I'm driving that way anyway, I know I can just pop in, drop off the items I've collected, and head home to do it all again.

It's a very painless way to give. I think it's important to find ways to donate to causes that are near and dear to us. For me, that meant learning to collect needed items on a strict budget. I like to think that some of these things make people's lives a little easier as they endure one of the hardest journeys of their lives- having a child in the hospital.

For more frugal tips and ideas, check out Frugal Friday, hosted at Biblical Womanhood.

Thursday, September 18, 2008

Why You Shouldn't Rush These Milestones

I blame a lot of it on those "parenting books"... you know the ones. They tell us what our child "should be doing", "may possibly be doing", or "might even be beginning to..." at every given month of life. And thus the competition begins. I've had parents try to "compete" with me on all manner of things, from earliest first step, first word, and even first tooth. (And, for the record, it's a safe bet that my kids "lost" every one of those competitions...)

I think perhaps because we're so eager to see these achievements, sometimes we try to rush other things in our baby's life as well. Here are three things I think parents need to think twice about rushing, however. From all I've learned as a parent and all the discussions I've had with experts (and, believe me, I pick their brains every chance I get), these are things that needn't happen earlier rather than later...

  1. Car seat changes- I spoke a little bit about not flipping your car seat from rear- to front-facing before your child is both at least one year old and at least 20 pounds. I think it's also good to note that children can stay rear-facing for even longer and, in most cases, it actually offers extra protection in the event of a crash since it gives them better neck support. Most car seat experts I've spoken with also recommend sticking with a 5-point harness car seat for as long as you can. There's simply no reason to rush into a booster seat. In fact, I just checked in with the car seat "checkers" at the children's hospital this past weekend. They were delighted to see my 44" and 45 lb preschooler still in a car seat.
  2. Getting out of the crib- For safety's sake, you'll want to consider switching your child from a crib to a twin bed (or toddler bed if your crib converts-- but please don't ever buy a separate toddler bed) when your child figures out how to climb out of the crib. And some children do this pretty early on. Others are pretty content to stay in there. And you know what? It won't stunt their development to sleep in a crib. But it will prevent some falls and night-wandering that could be harmful. Our top-notch developmental pediatrician recommends you stick with a crib for as long as you can. She feels the benefits are great.
  3. Giving up a "lovey" at night- Babies and toddlers can get attached to strange objects (just ask my mom about a preschooler and his beloved underpants...). Some children love a special stuffed animal. For some it's a blanket. For my boy (and my sister's boys, for that matter), it was a burp cloth. When he was a baby, A. liked to always hang onto a burpie. In the car. At the doctor's office. Through the grocery store. It's not that way anymore. During the day, I don't think he even thinks twice about his burpie. But at night? That little hand still likes to curl around it and hold it to his face. There's comfort in that. And there's no reason for us, as parents, to take that away. I'm pretty confident he'll have given it up before he heads off to college... but we have fifteen years to work that out.
Babies grow and change so fast. They move from stage-to-stage in the blink of an eye, it seems. Enjoy it! And don't stress about or rush those little milestones...

Tomorrow, I'll be writing about a few milestones you should make sure you push for.

Three Things You Should Know About RSV

If you know the parent of a preemie, it won't be long before you hear them talk about RSV. Here are just a few quick facts you should know about RSV:

  1. RSV stands for respiratory syncytial viral disease and it is very common. Most adults and young children have contracted it and its symptoms present like those of the common cold.
  2. Babies who are at highest risk of complications from RSV (like preemies, especially those that have been intubated in the past) are sometimes given a monthly shot of a medication called Synagis to try to diminish the chances of contracting RSV.
  3. "RSV season" varies from year to year, but most often runs from late September through April.
The best things you can do as the friend or family member of a young preemie are to wash your hands frequently and avoid visiting/touching the baby while you or your child is sick.

Wednesday, September 17, 2008

A Checklist of Requests (When You're Heading Home)

I really hope I do not make any hospital employees angry by making these suggestions, but here a few things that I recommend you ask for before you leave the hospital. Keep in mind, of course, that availability will vary as will policy... but, as the saying goes, it never hurts to ask for:

  • A couple extra cans of formula (if you're using it for feedings OR to fortify breast milk)
  • A couple bags of preemie or newborn size diapers, whichever your child is in at that point
  • The phone number to the nurses who are used to caring for your baby (you will trust them much more with your questions in those early days than the people at your regular pediatrician's office)
  • A signed prescription form listing your child's height and weight (this can be used at the WIC office or supplemental insurance offices so that you do not have to cart your preemie through germ-filled rooms)
  • A spare pumping kit. One of the valves on my kit tore and failed and had it not been for my back-up kit, I would have been one frustrated lady in the middle of the night out in the country...
  • Two of whatever pacifier your baby is used to. It took me ages to track down just the right kind of Soothie pacifier after we couldn't find the ONE we had brought from the hospital.
  • At least a 3 day supply of any feeding, O2, trach, apnea monitor, etc. materials you will need including tubing, adhesives, syringes, and leads (those wires that attach to your baby).
Most of these things will prove essential just to keep you from having to leave the house for 2-3 days and, trust me, you will be hesitant to leave the house in those first few days. I'm sure I will think of a dozen more things it would be wise to request but, until then, any of you been-there-done-that preemie parents want to chime in with suggestions?

Closely-Spaced Siblings

I remember reading an article in a Parents magazine a few years back. It discussed sibling spacing and what was "ideal". The author of that piece referred to "two to three years" as "the golden gap". Apparently, when you tally up all the pros and cons, this is supposedly the ideal space between babies.

And I guess I'm not surprised. After all, most of the women in my family, most of the mommies at the preschool, in fact, most of the families I see anywhere seem to like this spacing. I can definitely see its advantages- you're out of all the "baby" things (cribs, diapers, bottles) before welcoming another infant, your older child is old enough to "help" and feel involved, they're not so far apart as to have to worry about all your gear being obsolete. I can see that.

But you know what works for me?

Two kids less than eleven months apart.

I love it. And here's why...

My children have never known any different. There has never been one iota of sibling jealousy simply because it's like they've both always been here. My son does not remember a time when his sister wasn't around. Neither one can remember a time when they did not have to "share" Mommy.

My kids like a lot of the same toys. We were easily able to avoid choking hazards because our kids were both in that phase at the same time. We can easily fill a book shelf with reading material that appeals to both of them. There are no arguments if we choose to let them watch a video because they're into the same stuff. Somehow I think widely spaced siblings may not both be interested in Little People.

I get to stay in the same "mode". Two cribs? Why not? Changing diapers? If I'm doing it for one child, how much tougher is it really with two? Baby-proofing? Already done. I really like the fact that I just stay in the same mind-set and keep on truckin'.

I truly believe that there is no "golden gap". I think what works for one family may not work for the next. And don't think I don't occasionally envy those parents with widely-spaced siblings especially when I see how downright helpful that older sibling sometimes is. I think you just do what's best for your family or, even more importantly, enjoy whatever you're blessed with.

But for me? I love having two kids born within one calendar year (2005 was a busy one!). It Works for Me.

To see what works for other people, check out Works For Me Wednesday, hosted at Rocks in My Dryer.

Tuesday, September 16, 2008

Using the Handy-Chopper

I have to admit something. When my husband received the Black & Decker Handy-Chopper as a wedding gift from one of his customers, I kind of laughed about it. I believe my exact words were, "Hmm, well that was nice of them. Not that I'll ever use this thing for anything, but still..." At the time, we were a young couple living in a condo in South Florida.

Fast forward to having two little ones and abundant fruit trees in the Indiana countryside.

Now, you can certainly buy perfectly good applesauce and pureed pears. Gerber, Beechnut, et al do a wonderful job. And it's rather easy and handy to grab those cute little jars (for I far prefer the old fashioned jars to those newfangled plastic packs) off the shelf.

What's even easier?

Picking apples and pears off your own trees, cooking them until they're soft, and tossing them in the Handy-Chopper.

I love the perfect "baby-food-making" size of it. I also love that it's tiny enough to toss in the dishwasher when you're done. I don't even mind admitting I was wrong.

For more great tools that make a mom's life easier, check out Toolin' Up Tuesday, hosted at Life as Mom!

Re-using Formula Scoops

While I was very fortunate that pumping went well for us and I was able to provide expressed breast milk to my preemie daughter, I still had to use specialty formula. Breast milk contains, on average, 20 calories per ounce. By design, standard formula contains the same. Tiny preemies like C. need all the calories they can get. We added powdered NeoSure Advance formula to the breast milk in order to nudge the calories from 20 to 24 per ounce.

When you find yourself buying formula, you also find yourself with a boatload of these little scoops:
They rolled around my utensil drawer and seemed to multiply exponentially. Eventually, I tossed a bunch of them, but I still keep a few around. And we no longer use formula in this house.

But here's why I like them: The ones that came in our formula cans measured exactly 1 1/2 tablespoons. In addition to measuring formula, here are some other great uses for formula scoops:
  • measuring baby cereal
  • measuring coffee grounds
  • measuring spices that tend to be used liberally, e.g. parsley
  • transferring spices from bulk containers to smaller "cabinet-sized" jars
  • adding streusel to the tops of muffins
  • applying glitter to small spots for crafts
  • measuring/scooping messy materials that you do not want to have to wash off- just measure and toss
Whenever you're met with dozens of the same item after the original product is gone, re-purposing is the name of the game!

For more great tips, visit Kitchen Tip Tuesday, hosted at Tammy's Recipes.

Monday, September 15, 2008

The Importance of Reconnecting

We had the great pleasure of attending a NICU reunion at our children's hospital this past weekend. It was such an absolute joy and delight to reconnect with some of the amazing doctors and nurses who played such a huge role in our little girl's survival. The greatest way I know to thank them is to, of course, tell them. But also to show them how far our daughter has come. To see their happiness when she runs up to them and says "Hi!"

Just as heartwarming as seeing the medical professionals is catching up with other parents. I've spoken of the H. family in the past as being our NICU mentors. Their sweet little girl was born at 23w5d a couple months before ours and they were always those few steps ahead of us. We always knew we could count on them to know how we were feeling at any given point.

It was a fantastic moment for all of us to reconnect back in 2006 at our first NICU reunion...

It was a fabulous time to see them again this past weekend.

Who do think has changed more?

"My story..." Monday, Filming the commercial

Have any of you noticed that new little addition on my right side-bar? The one labeled "Commercial Footage"? Check it out if you have a moment.

Our daughter was born on Christmas Eve of 2005 and over the next year or two, we stayed in close touch with the hospital that saved her. Notice I do not write "hospital that took care of her". The treatment she received went beyond that. I feel blessed beyond belief to have given birth to C. in the hospital adjacent to one of the best NICU's in the country.

Last summer (2007), I received a phone call asking if our family would be willing to film a commercial for a new campaign the hospital was launching called, "Hope Happens Here". Without hesitation, I agreed.

Our commercial ran consistently through the winter and spring of '07-'08 on NBC. I cannot tell you how odd it was to hear my voice ring out from the speakers. Or how odd it was to be "recognized" while grocery shopping. People delighted in reporting each time they "saw me on TV!" We still pop up every once in a while.

I also taped a radio spot, but I never actually heard myself. Others have though... my brother-in-law apparently heard me just about every time he drove to work.

Anyway, the YouTube clip on the right is not the actual commercial. But it is a piece that Riley Hospital compiled with some of the footage they taped. You can hear my husband and my honest opinions about the care we received and why we were so pleased.

The stories you can hear and the people you meet at an excellent children's hospital are absolutely amazing. I was so honored to speak on behalf of the one that saved our precious child...

Saturday, September 13, 2008

Is it right to save babies?

"For parents..., for all the health care providers involved in the care of handicapped preemies, and for the society in which they live, there is always the nagging question, "Was it right to save these babies?" No one has the "right" answer." -Your Premature Baby by Frank P. Manginello, M.D.


Friday, September 12, 2008

Preemie Talk in Cyberspace, #1

I am utterly fascinated with this view on keeping very premature babies alive...

I wish I could find more capable knitters to whip up a few of these hats.

Since I'm far more adept at crocheting than knitting, I might try my hand at a few holiday preemie hats. How cute are those?

Someday, I think I would love to volunteer as a baby cuddler.

I think the women who provide these beautiful burial buntings to grieving parents are performing a wonderful ministry and I admire their strength. I don't know that I'd be able to complete the project...

Know of some other great preemie articles or projects? Send them my way! I'd love to share them.

Why I am "Anti-Birth Plan"

In theory, the birth plan is a fabulous idea. It sounds ideal and logical and wise. What could make more sense than putting all your preferences and intentions down on paper to let the world know? Isn't it best to make a commitment and share that with your medical provider?

When a birth plan works out, it's a great story. I've read birth stories of women who had very specific desires for their birth experience and, because of their plan and because they found a like-minded medical provider, they carried it out to a T. I'm left in awe of these women and so encouraged!

Unfortunately, more often, I hear stories from heartbroken women who were so very determined to "do it naturally", or "avoid any stitches", or "deliver in water", or "have daddy catch the baby", or "never, ever have a C-section"... and it just didn't happen that way. Ask me about my vehement anti-C-section philosophy.. and then go read C's birth story. Hmm.

Why do we have to measure ourselves against a "birth plan yardstick"? Isn't it better to go in with an open mind? By all means, have an idea how you'd like the birth to play out. Just don't get yourself so incredibly hung up on how every little detail goes down.

At the end of the day, going "drug-free" or without induction does not make you a hero...

Bringing a new, precious life into the world makes you a hero. However that life got here.

Frugal Forays with Your Preemie

When you finally bring your preemie home, you'll be scared to go anywhere. And that's all hunky-dory for awhile. But eventually, you're going to get sick of staring at the same four walls. And that's understandable! Here are five inexpensive, essentially "safe" places to go with your baby:

  1. To a park. Preferably one with a walking trail. Getting some movement and fresh air will be good for both of you and this enables you to be in the presence of others without having them right on top of you and your infant.
  2. To a mall or grocery store at an "off-peak" time. Try hitting the mall at 10:00 AM on a Wednesday. You'd be amazed how few people are around. Walk around, window shop, enjoy the scenery without being part of a germ-y crowd.
  3. To a drive-thru ice cream or coffee shop. In my experience, the outdoor tables at these places are often almost deserted. Because I brought my daughter home in the late Spring, I loved to sit by myself at a picnic table with her safely tucked in her infant seat and enjoy a single scoop of peppermint stick.
  4. To a drive-in movie. This isn't a "free" option, to be sure, but it can be a nice way to "get out in the world" without sacrificing the safety of your child.
  5. To a church service. Just pick the least popular worship time and act like you're Catholic. By "act like you're Catholic", I mean, keep your child with you. Catholics, by and large, have their babies and toddlers by their sides throughout the whole Mass. You won't find a lot of church nurseries going on. And this is safer for your baby (though perhaps more work for you). By keeping your child with you, you can choose to sit in a more isolated section. Also consider keeping your preemie tucked in the infant seat with a blanket pulled up quite high. This will deter many touchy-feely types.

I firmly believe it's crucial to keep your child as safe and protected as possible. Preemies, by nature, are more susceptible to all manner of illness.

I was also not one to stay captive in my home. I think it's important to at least see other people. To get fresh air. To move around and experience things you love.

So get out there! Be safe. Be frugal. But have fun!

For more frugal tips and advice, visit Crystal's Biblical Womanhood!

Thursday, September 11, 2008

Listening to the Short-Timers Gripe

It never fails. You'll be entering your third or fifth or eleventh week of hospitalization and someone will strike up a conversation with you at the hospital. They will immediately launch into how sick they are of the hospital, how long they've been there, and how rough their road has been. Nine times out of ten? They've been there less than a week.

It's really frustrating to listen to these tales. It's really difficult to try to be sympathetic. It's just plain hard.

By now, you've probably watched dozens of babies come and go in the NICU. You've met some great people who breezed in and out of your life. When you give birth to a micropreemie, you know from the get-go that you'll be there for awhile. That doesn't make it any easier.

I honestly felt that perhaps I was more at peace with our lengthy hospital stay because I never anticipated anything else. It's not that I wanted to be spending months on end in a NICU, but I knew that was the only option I had if I planned on bringing my precious little girl home.

When you're facing a long, practically no-end-in-sight kind of hospitalization, you're just about guaranteed to have to listen to a few "short-timers" gripe.

My advice?

Just realize that these are people who need to talk. They need to vent. For whatever reason, they're not getting the support and communication they need from others in their lives. So let them. With people like this, you really don't have to say much. Just nod. Smile sympathetically. When they've run out of complaints, they'll often ask, "So how long have you been here?"

Three months.
Ah, the glorious silence...

Remember 9/11...

I have a vivid memory of being in junior high and having the history teacher give us a different kind of assignment. She asked us to go home and call our grandparents and ask them about World War II.

I really disliked history with a passion and I must confess that my memory and knowledge of it leaves a bit to be desired. However, I can tell you that I remember that phone call to my Grandpa H with great clarity. There was something about talking to someone who lived it that made it so much more real, so much more important.

Do you remember experiencing 9/11?

Do you remember where you were, what you were doing, what you were wearing?

Do you remember watching the replay over and over on the news in shocked disbelief?

Do you remember how everyone drove with their headlights on?

Do you remember the wave of patriotism that swept our nation? (and too quickly receded...)

Do you?

Try to remember. Try to lock those memories away. Do it for your children. For your grandchildren. Because, someday, some school-age child is going to call you and ask,

"Grandma, what can you tell me about September 11th?"

What causes prematurity?

There are three main groups of factors that impact prematurity:

  1. Maternal factors:
    • preeclampsia (also known as toxemia or high blood pressure of pregnancy)
    • chronic medical illness (such as heart or kidney disease)
    • infection (such as group B streptococcus, urinary tract infections, vaginal infections, infections of the fetal/placental tissues)
    • drug use (such as cocaine)
    • abnormal structure of the uterus
    • cervical incompetence (inability of the cervix to stay closed during pregnancy)
    • previous preterm birth
  2. Factors involving the pregnancy:
    • abnormal or decreased function of the placenta
    • placenta previa (low lying position of the placenta)
    • placental abruption (early detachment from the uterus)
    • premature rupture of membranes (amniotic sac)
    • polyhydramnios (too much amniotic fluid)
  3. Factors involving the fetus:
    • when fetal behavior indicates the intrauterine environment is not healthy
    • multiple gestation (twins, triplets or more)
Of course, then there's the rarely spoken of fourth... "Unexplainable preterm labor."

Wednesday, September 10, 2008

When It's Time to Stop Pumping

There are several different indicators that it might be time to stop pumping:
  • Your baby has reached an age where he or she is getting adequate nutrition through table food or other means.
  • Your baby is able to transition over to exclusive breastfeeding.
  • Your milk supply dwindles or runs out to the point that it is no longer worth the effort.
  • Your lifestyle changes in a way that no longer supports pumping- e.g. work/child-rearing demands do not allow the time, a subsequent pregnancy that leaves you drained, a health issue or illness makes pumping difficult, etc.
  • You and your doctor or your baby's doctor just decide that it's time to stop.
For whatever reason you stop, there are some steps to make it easier.

  1. Increase the time between pumping sessions until you're only pumping morning and night.
  2. Phase out night-time pumping if you're still doing it.
  3. Try to avoid known stimuli like warm water, certain smells, etc.
  4. Do pump if you feel the need, even if you thought you were done. I ended up pumping once two weeks after I thought I was "done" and then that was it!
  5. Do not pump unless you really feel the "need" to pump.
  6. Use breast pads (disposable or washable) to deal with any leakage.
  7. Give yourself a big pat on the back for what you've done!

What other recommendations or questions do you have regarding pumping for your preemie?

Hospitality in a Heartbeat

Throughout our daughter's almost four month hospitalization, one thing became very clear to me: It really is the little things that count. Whether it was the snacks from Trader Joe's that my brother's family brought or the big box of diapers that the RMH housekeepers left us for our son, these little gestures meant the world.

It's important to me to "pay it forward" and, to me, that means taking little opportunities to do something kind. To reach out. To provide "a little something" when nothing was expected. With not a lot of extra time or extra money, I've learned to pull this off quickly and cheaply.

For example...

What to do when a team of four young roofers shows up to replace your roof on a humid August day with temperatures soaring into the 90's? How do you show appreciation for the 14-hour work day they put in?

I went with cookies and lemonade. All plastic serving pieces mean there's no risk of breakage. Jumbo-sized tumblers are far more appropriate for grown men than rinky-dink paper cups.

Cookies bake up in a flash when you've frozen individual dough balls. I bag them two dozen at a time to give me two perfect cookie sheets worth.

I have an awful lot of Kool-Aid because of some recent "buy 3 Kraft products, get XXX free" deals. The pink lemonade version mixed with 2/3 the sugar makes a refreshing summer beverage.

When I carried out this tray, I was met with stunned gratitude. Such a little thing!

Brightening someone's day and providing hospitality... that Works for Me.

Check out more great tips at Works for Me Wednesday, hosted at Rocks in My Dryer!

Tuesday, September 9, 2008

Stop and smell the flowers...

It's the little things...
really and truly.
C. is proof of that.

Pump it up!: Getting started and maintaining your supply

Once you've decided to give pumping a shot, there are some things you can do to increase your odds of success. There are two main things you need to be focused on right now: getting started and keeping up your milk supply. With thanks to Ryann and Nancy B. for their replies to my plea for help, here are a few recommendations from those of us who have successfully pumped in the past:

Getting started:
  • Start pumping as soon as you can after the birth of your baby. The sooner you get started, the more responsive your body is likely to be. That being said, if you are physically unable to attempt pumping right away, don't write it off as a lost cause! It was almost seventeen hours before I could try to pump because they were too busy determining if I needed a transfusion.
  • Pump frequently, especially in the beginning. Your aim should be to pump just about as frequently as you would expect to nurse, so, about every 2-3 hours.
  • Talk to, and use, the lactation consultant at the hospital. These women really know their stuff and can sometimes turn a horrid experience into, well, at least a tolerable one with a few suggestions.
  • Stay hydrated, right from the get-go.
  • Keep a picture of your baby or something that smells like your baby close by. That will actually help stimulate let-down.
  • Capture every precious drop. Our hospital provided us with syringes to use in the beginning with the assumption that most new mamas pumping for their preemies won't produce too much. Keep in mind, however, that my daughter's first feedings were 2 mL at a time (there are 30mL in one ounce!). Even a little bit goes a long way.
  • Get yourself a good, supportive nursing bra. Or two or three. Being comfortable and feeling like pumping is convenient can make a difference.
  • Find out where pumps are available to you. Most hospitals not only let you use a pump while you're admitted, but they also have "pumping rooms" you can use while your baby is in the NICU. Some even let you pump by the bedside.

Maintaining your supply:

  • Feed yourself well. The quality of nutrition you provide can only be as good as the quality you put into YOU.
  • Keep pumping frequently, especially during the day. Once your supply is more "established", I (and Nancy B) encourage you to spread out your night pumping, but don't give it up entirely. Again, act like you have a newborn...
  • Find ways to entertain yourself while you pump. I loved to read mindless novels, Ryann mentioned playing Tetris. Whatever relaxes you and helps the time pass is a great choice.
  • Can't say it enough- stay hydrated!
  • Limit your caffeine intake
  • Do not be afraid to ask for what you need- I was amazed how willing nurses were to provide me with whatever I needed to make my pumping a success. When we went to Chicago for C's eye surgery, the hospital there used a different brand of pump. They gave me a whole new kit and supplies to ensure I could easily continue.
  • Find a good way to store your milk. I regularly produced over 35 oz milk a day, which was great, but was also a huge source of stress from me because I never really got a handle on efficient storage and transport.
  • Realize there will be "good days" and "not-so-good days" but, really, any day you provide custom-made nutrition to your preemie is a good day!
  • Talk to your doctor about Reglan or Fenugreek if you really struggle to establish any significant milk production-- but also consider using showers, compresses, etc. to encourage production.
  • Find a comfortable, convenient bag or backpack to use for carting your pumping supplies around. After a while, it will become habit to grab it on the go.
  • Find a comfortable position/chair for while you pump. And keep the temperature at a comfortable level.
Much like deciding to breastfeed, it's best not to go in with the mentality of "I'll try to pump" and instead view it as "I'll learn to pump". Because that's what it is- a learned skill, not an innate talent. Give it a real shot. Commit to the process. But, rest assured, if you truly aren't able to pump or if the stress of doing it becomes unbearable, there are certainly quality formulas out there to nourish your baby. Stay positive!

My Maternity Jeans

I mentioned in the birth story that I gained all of 4 1/2 pounds during my pregnancy with C, four of it in that last month. I wore regular old jeans into the hospital when I was in labor. I didn't show until into my seventh month with my first child, so this was not unusual for me. I was just over five months pregnant when I gave birth and I had not worn one single article of maternity clothing.

So why do I say that maternity jeans are a tool I could not live without?

Because after my extremely painful (but successful!) C-section, they were all I could stand to wear. My tummy may have been flat, but it was tender and raw and extremely sore. I ended up wearing them almost every day through my two months of recovery... almost the exact length of time I was able to wear them during my first pregnancy.

My opinion? Maternity jeans are wonderful things. They're so well-designed anymore, with fashion-forward denim colors and cuts. With a cute top, who knows?

Do what you gotta do, my friend. Maternity jeans can be your best friend.

For more great tools that make lives easier, check out Toolin' Up Tuesday, hosted at Life as Mom.

Fueling up for pumping...

Since I'm right in the middle of a pumping series this week, I thought for this week's Kitchen Tip, I'd offer some advice on fueling your body for pumping success.

Much like in pregnancy, it's important that you get a well-balanced, nutritious diet when you're pumping for your infant. What may come as a surprise is that you actually need MORE calories to support your body's production of milk than you did during the pregnancy: 500 vs. 300 (assuming singleton in both cases).

Lots of fruits and veggies are critical to good health but, honestly, at the end of the day what's going to keep you energized is a balanced combination of whole grains and proteins. And never, ever forget to stay hydrated!

Here is one of my very favorite "nursing breakfasts":

  • Whole wheat English muffin with peanut butter
  • Strawberry yogurt (this happens, conveniently, to be YoMommy, but any yogurt will do...)
  • Plenty of water
The name of the game? Quick, nutrient packed energy sources that will provide the fuel your body needs to make the ideal fuel for your baby!

For more great food related tips, check out Tammy's Recipes!