Tuesday, April 29, 2014

a small step toward foodie-dom

Our GI NP, Ginny, said GFI! We are making nearly all the changes the pediatrician suggested.

First things first, I had butter on my bread last night. It was divine.

I also learned today that the formula our NICU docs apparently told everyone to stay on until the first birthday because preemies need it for their brains, well, I guess we’ve been off it for some time now. Woopsies. Ginny was not at all concerned. I suppose we came off it because of Calder’s digestive issues, who knows. It’s easy to get confused when you’ve got multiple medical issues you’re tracking but short story, I’m going to forgive myself and bet his brain will be just fine.
And last night Calder had sweet potatoes. By the look on his face you’d think we were feeding him worms! Clearly, this was NOT the steak juice Kraemer had let him lick from his finger a few weeks back, when his eyes popped open like a Jack-in-the-Box.

apples taste best served on giraffes
Today we saw Anne for speech, who walked us through initiating solids. For the most part, I think we approach them just as you would with a healthy term baby. But Calder does have some oral aversions, so we expect it to be a little bit more of a challenge; in other words, the pucker-face wasn’t much of a surprise. She told us that with most babies, they tell you to try foods 16 times before giving up on it, and that in Calder’s case, his distaste likely has more to do with the texture than the taste. We propped Calder in the hospital’s highchair and then Anne approached the situation in a way I would never have dreamed of doing: the messier the better (and of course, I had forgotten a bib.) The moment she plopped a couple scoops of apple in front of him Calder was all over that business, spreading it all over the tray, smooshing it to his cheeks, slapping it on his forehead and absolutely getting it all over his sleeves. I had handed him his favorite mini-Sophie chew toy, which Anne said was perfect for achieving our end result of letting him put the food in his mouth on his own, letting him control entry.

We are adding a flush schedule to his G-tube feeds, as was recommended, though we hope those feeds will start becoming less and less frequent.

Friday, April 25, 2014

Mom Can't Keep Up

lunch break!
botanical gardens
So many changes!

First things first, Calder weighed in today at a whopping 17 lbs, 4 oz; 26.6 in long; 16.75 head circumference. The nurse had to come back into the room to double-check her head measurement, she said he’d had such a big growth spurt! Dr T was equally impressed with his growth. He’s on the chart now for all dimensions for his chronological age, even if it is just 1 and 2% for length and head circumference, and 8% for weight. I’ll take it!  We didn’t map it on the graph, but she said he’d be somewhere around the 25th percentile with his adjusted age.

With all this progress comes more change. Dr. T says it’s time to ditch the dairy-free diet and see how he fares. We were never SURE he had an intolerance or an allergy, although it certainly did seem to clear up some digestive issues. Even so, she says she thinks his gut is ready to handle it, and we can give it a try (but watch out for blood in the stools, she says – fantastic.) According to her it’s time to quit fortifying the breast milk with the special hypoallergenic formula, Allimentum Sensitive + Iron, and move to something more in the “normal” range, something for sensitive stomachs but not something designed for lots of allergies. Next, we should start adding water to his diet to help him move everything on through the system. Apparently, we should have been flushing his G-tube all along, but no one ever told us that. (I say that, but they could have – I’m sure we missed one or two important instructions on discharge day.) And, super exciting to me given how much I appreciate food myself, we get to introduce solids!

As if that weren’t enough craziness, Dr T told us it’s time to let Calder PO ad lib. In other words, let him eat by mouth when he wants and as much as he wants.

This could get tricky. Calder currently goes down (starts, anyway) around 9pm, may wake up once before we go to bed at 11pm, may wake up around 4-5pm, may not wake up at all. Regardless, we wake him at 6am to feed, and then let him sleep again until about 9:30 or 10. Dr T said, do you need to wake him up? For the most part, I felt like yes, I do. We had tried condensing his feeds into a shorter period before, but it made him throw up more, and he does not need any help in that department.

breaking in the new pack
Her response was to say, why don’t we let Calder drive his diet a little more? Why don’t you let him sleep through 6am if he wants to? Oh, and quit fortifying his food. BUT still make sure he gets all the calories he is required to have throughout the day. Let him take what he wants when he wants and just gavage him at the end of the day.


This is what moms of term babies deal with, right, taking cues from their kiddo, trying to make it mesh with their own lifestyles? We had JUST gotten into a really nice groove with Calder, where he was sleeping on cue during the day, sleeping through the night, digesting all his food in time for his next feed (which hadn’t always been the case) and now I’m told that I can treat him like a normal baby, AKA switch it all up right when I am going back to work? Don’t get me wrong, this is *great* news. But this should be really interesting. I can see us getting to the end of the day and being 20 oz short. You don’t get to just dump 20 oz in an infant’s stomach at one time, right before you lie him down for the night. At least not one who is already on medication for GERD.

I’m getting a little ahead of myself, though, because she suggested I run all this by our GI NP, who we see on Monday.

At PT this week he more or less refused to sit up on his own, but Cristiane said she could feel that he was much stronger.

Sunday, April 20, 2014

Happy Easter!

We have some consonants! Yesterday Calder started saying “duh” (repeatedly: it’s more like duh duh duh, duh) and today saying “gooh.” One could take the duh-duh to be Da-da, but Kraemer says he isn’t counting it. Not exactly clear that he knows who Dada is.


We spent Easter this year as we spend every holiday these days – confined! J But that is a-ok with me. I like my family. Judging by our documentation of the day, however, Calder may not have liked us very much! We took it easy, reading some Easter books and playing with new toys sent by Getch and Granddad and tearing into the Easter basket sent by Grandma and Grandpa (although I think he was most interested in the cellophane.)

Protect those eyes!

Friday, April 18, 2014

To the left, to the left

Kraemer had to go out of town at the last minute this week, leaving Calder and I to fend for ourselves. I can tell you there have been no gourmet meals with the chef out of town. Although, since I cannot go to the supermarket with Calder, but cannot leave him home alone, there has been a lot of creative cooking and baby-holding.

These days Calder is learning to pivot on his belly. The “steps” in the development process, I’m told, aren't really steps, exactly, since some could potentially be flip-flopped given their overlapping estimated time of initiation. They include movements such as rolling over; pivoting; crawling on his stomach; balancing while sitting up by leaning forward on his hands; crawling on his knees; balancing to sit up by leaning side or back on hands; pulling himself up to sit; standing with support; etc. Pivoting is one “step” in the process I likely would have missed in observation if I hadn't been told to work on it with him. Right now he can pivot to the right and is sort of pivoting to the left; we're working more on the left.

caption, this, Mom!
Pretty soon, I won’t be around to observe Calder’s PT sessions – but someone else will. A nurse! I have been working at this for months, literally. We need a nurse as opposed to a nanny because of Calder’s specific medical needs, particularly his oxygen and G-tube. (Not to mention that day care is out of the question for us, according to our docs.) Of course, the need for a nurse was much greater (in both a medical and number-of-hands sense) when he first came home around Thanksgiving last year, but with me going back to work (starting with teleworking) on May 1, there is now no question that we need more help at home. Finally, FINALLY, I have been told the nurse will be on our doorstep next Tuesday morning. We will have two who split the week, so this should give me just enough time to show them the ropes before I hole myself upstairs with my computer throughout the day.

Poop on Michigan. Calder took
this to heart.

Sunday, April 13, 2014

finally time to smell the roses (aka cherry blossoms)

After being cooped up for months, we’re unsurprisingly anxious to get outdoors at the first sign of warm, welcoming weather. Calder is pretty much off oxygen when he is awake and we are trialing him off it when he naps and sleeps the night. The process has been gradual so I could not even put my finger anymore on the real tipping point. But having him off it so much makes it so much easier to explore the great outdoors. We are getting out pretty frequently for walks around our neighborhood. I could take a walk every day here and ogle the architecture of the row houses, discover another park, peak into a new restaurant.

Anyone who has been to see the cherry blossoms in DC knows that during the small window in which they bloom, the whole city comes out to the see them. You have to be savvy if you want to avoid the crowds and even then, good luck!  Because the blooms are only so predictable, and can disappear with the first good rain, the smart sightseer makes time the day or day after they hit peak (and maybe even right before!) Most years, we head straight to the Jefferson Memorial to see the tree-lined Tidal Basin. Last year we woke up at sunrise, picked up some breakfast from our neighborhood bakery and hopped in the car – still, we had to wait for a parking spot (an improvement over not finding one at all) and even ran into someone we knew at that early hour.

We opted to go this past Friday this year, right as the blossoms were peaking, which fortunately coincided with me still on maternity leave and Kraemer on one of his days off. But instead of starting with the Tidal Basin, we opted to stray a little off the beaten bath southeast of the memorial. Mid-day, and we practically had the space to ourselves. It was a perfect afternoon. Cornflower blue skies, wispy clouds, a gentle wind, people I love and fluffy white cherry blossoms raining down from the boughs of the trees as we lay in the grass. One of those days you want to freeze time.

We had SO much fun being out and about that we tried again today. We waited until early evening, before the sunset but hopefully after the crowds, this time back to the popular spot between the Tidal Basin and the Washington Monument. We were kidding ourselves if we thought we’d miss the masses – throngs of people still streamed alongside the water. Still in isolation, we opted to admire the lake from afar. While the blossoms weren’t as captivating as they’d been on Friday, I took my pleasure today in overhearing the giggling and seeing the smiles people wore in reaction to Calder’s antics. We've always said he’s a funny guy!

Friday, April 4, 2014

Measuring Up

Grill buds

When you have a child, it's pretty typical to want to track her progress against achievement of common milestones. All parents do that, right? I have that urge, but I'm not sure I can do it, not exactly. Do I use his chronological age (9 months this past Wednesday), or his adjusted age (just over 5 months)? For this reason, I consider it a blessing, not being able to measure Calder against some standard, when I have read and been told over and over again that each child is unique and moves at his own pace, so it’s best not to get caught up in who rolls over when, when the first word is spoken, etc. On the other hand, the uncertainty makes it a little difficult to follow best practices, like, when do we introduce solids? Unsurprisingly to me, given how much I now know each week in utero means for a preemie, a month in baby-time can mean a big difference in development. There is some literature out there specific to preemies, but preemies have such a range of [major] issues that I have a hard time believing a one-size-fits-all applies to them, either. I even have a hard time knowing what answer to give when people ask Calder’s age. When we were out for a stroll a few months back I told a woman that he was 6 months -- she looked perplexed. I understand. He looked more like a newborn at the time.
Nobody every buttons me up.
Whoa. Take me to the light.

On his 9-month marker this week (chronological! :)) Kraemer and I also celebrated our 3-year anniversary. Funny, because I feel like we just celebrated our second. I have only some idea where the time went. Getch and Granddad were in town and facilitated a much-needed night out!
Celebrating three years and many more to come! 
Check out this mirror!
A homemade anniversary gift from my talented husband.