Ian is 2 months old!

Two months ago today, Ian was born! He was due just 8 days ago. For being born 7-1/2 weeks ago, he is doing really, really well.

Ian had a visit to the pediatrician today for his 2-month well visit. He had several vaccines administered (including Synagis to help prevent RSV) via two shots in the thigh and one orally. Tonight, he is a bit fussy when awake, but is sleeping a lot. A couple of weeks ago, he started having tears when he cries really hard so he teared up today when he got his shots and cried as hard as I have seen him cry yet. Poor baby!

Growth Statistics
Today at 2 months old:
- Weight: 10 lb. 8 oz. (23rd percentile)
- Length: 22 in. (18th percentile)
- Head circumference: 39 cm. (28th percentile)

Last checkup at 1 month old (2/25):
- Weight: 7 lb. 10 oz. (7th percentile)
- Length: 20-1/2 in. (15th percentile)
- Head circumference: ? (25th percentile)

At NICU discharge (2/17):
- Weight: 6 lb. 15 oz.

At birth (1/25):
- Weight: 5 lb. 11 oz.
- Length: 19 in.
- Head circumference: 33 cm.

Feeding
Ian gained almost 3 lbs in 1 month! At his 1-month well visit, he had only just started breastfeeding one or two full feedings per day and was on bottles of breastmilk or preemie formula for the rest of his feedings. A few weeks ago, we had progressed to him taking all of his daytime feedings via nursing and doing two preemie formula bottles and an expressed milk bottle through the night. Last week (7 weeks old), we stopped the two formula bottles and I began nursing him for those feedings so we were down to one bottle of expressed milk at 3 am. Until that time, Ryan and I were sharing the nighttime duties with me taking the 9 pm and 12 midnight feedings and pumping at 3 am, and Ryan taking the 3 am and 6 am feedings. As of Monday (8 weeks old), he is now taking all of his feedings via nursing. No more bottles and no more breast pumping for me! I made a trip to the hospital with the kids yesterday to return the breast pump that I had been renting. That means I get more time back in my day: 20 min. x 4-6 pumpings per day, 30 min. x 2 washing and drying bottles and breast pump flanges.

Ian loves nursing! When he gets hungry, he is known to try to nurse on my chin or neck when I have him upright against my shoulder or try to nurse Daddy's shirt. Because my milk production has been so good, I only have Ian nurse from one side each feeding and just alternate sides throughout the day (I did this with Keira too). Even so, he will often overeat at a feeding and then experiences what Ryan termed "Exorcist spitup" if we have a difficult time burping him. An "Exorcist spitup" episode is spitup which is expelled from the body with such force as to fly through the air more than a foot or two and with a volume that coats the surrounding area (or person). I experienced one such episode the other night and it startled me so much that I screamed loud enough for Ryan to hear me upstairs from our bedroom. Due to this episode, my shirt and jeans required changing, Ian's outfit, blanket, and burp cloth required changing, and cleaning of the carpet and couch was required. A good burping is definitely required with him!

Ryan and I both think we each possibly experienced a "spell" while feeding him during his first week at home, but since then nothing has happened to concern us in that regard.

Sleeping
Up until now, we have been waking Ian up every 3 hours for feedings. Because Ian is growing so well, we can now let him sleep and awake on his own for feedings. Ryan was getting pretty cranky with having to wake during the night to feed him, so he has been doing much better this week now that I am exclusively breastfeeding Ian, but that now means that I am getting up more often during the night now that I am taking the 6 am feeding too. So being able to let Ian sleep as long as he wants will be very nice for me! Even a stretch of 4-5 hours would be helpful. He is still sleeping in his mini-crib in our room, but we will be moving him into his room probably in the next month or so. We moved Keira into her room right before she turned two months old, but since Ian is still "younger" than she was, gestationally speaking, we are going to delay that move a little longer for him.

Wakefulness
Ian is still sleeping quite a bit, but he usually has a couple hour stretch of alert time during the day and then again in the evening. Now that he is no longer taking any bottles, he is sleeping better during the night since he doesn't have as much gas in his tummy to keep him awake (which means we get to sleep better too!).

Milestones
Because Ian is a preemie, many of his milestones will come later than the average child. He is holding up his head quite well when up on my shoulder or laying on his stomach, he will follow a close object with his eyes, and he startles in response to loud noises. He is not socially smiling or cooing yet. The doctor said that by nine months old Ian will likely have caught up and will no longer have much of a delay, if any, in when he meets his developmental milestones. At the end of July, we have an appointment at the hospital to have him evaluated to see where he stands developmental and see if any additional evaluations or "help" would benefit him.

Concerns
Because Ian sleeps on his back and LOVES to turn his head to the right when he sleeps, his head is getting a little flat on that one side. This is only of concern cosmetically because as a boy with short hair, a flat spot on his head would be much more noticeable than if he was a girl. His neck muscles are fine at this point, his turning his head is just a preference that he has.  If his head does not round out, he would get a helmet to help reshape his head which obviously we would like to prevent. Soooo...we need to work on getting him to turn his head to the left when he is sleeping and give him as much time on his tummy (and therefore his head off the mattress) as possible. When he is sleeping, I have been trying to get him to turn to the left by propping a blanket under his back to get him to go to the left and I also turn his head to the left whenever I can. Also I have him sleep on my chest a couple times during the day. His "flat head" was the only concern the doctor had with his growth so far!

Disposition
Overall, Ian is a really good baby. He does have some times when he cries, but it's usually due to hunger or a gassy tummy. He is very expressive and makes such cute faces while he sleeps and smiles a lot when sleeping (he must be having some good dreams about nursing!). When falling asleep, he grunts and groans A LOT and sometimes for quite a long time. He just makes all sorts of grunting noises while sleeping or stretching. The doctor even laughed about it today. Ian really seems to calm down quickly when he is in my arms and loves to sleep on my chest or next to me on the bed while I watch TV. When he is awake, he will spend a lot of time looking at me and gets his little mouth moving like he is ready to eat (one track mind!). He took a pacifier more often during the first week or so after coming home from the NICU, but doesn't really take it much now. I really only use it for emergency situations (like post-vaccinations today when leaving the doctor's office or a middle of the night crying jag when nothing else is working).

I'm excited to see him becoming more alert and interactive over the next month! And hopefully sleeping longer and longer stretches during the night time hours.  Now that I'm getting some more time to relax, I will get some pictures of him up, just not tonight!

Say Goodbye, Winter!

Yes, we are back from our trip to Seattle and have been for two weeks now. I have been trying to get myself back to normal. I have no idea what happened to the months of February and March! They have flown by...

Here is the list of things with which we have been dealing:

• Keira's high fever and seizure on 2/4
• drive to/from NJ on 2/13-2/16 to celebrate Christmas with Daddy's parents
• cough and cold on 2/18
• Grandpa ill on 2/20
• Grandpa passes on 2/23
• fly to Seattle on 2/24
• Grandpa's memorial on 2/28
• Keira's 3rd ear infection this Winter on 3/3
• fly home from Seattle on 3/9
• drive to/from NJ on 3/13-3/15 to see Grandma and Aunt Kelly for their birthday
  
• follow-up dr. appointment on 3/17

I think Spring has finally arrived and I, for one, am ready for it! Say goodbye, Winter. We'll see you in nine months! Don't let the door hit you on the way out.

Broken Fever

After another sleep-interrupted night for our family, Keira's fever finally broke sometime during the night. We woke her up at 1:45 in the morning and gave her Motrin even though she wasn't very warm. We didn't want to risk it! She of course fully woke up and thought it was time to party. She found laying in Mommy and Daddy's bed to be the most exciting thing ever. I finally had to put her in her bed and let her cry (she was very mad!) for several minutes until she figured out that we weren't coming back in for her. When she woke up at 7:45 for the next dose, her temperature was normal so we delayed giving her any meds.

Since she still had a fever last night, we decided to take her into see the pediatrician this morning despite not having a fever before we left for the doctor's office. Yesterday her temp hadn't been elevated until 7-9 hours after the last dose of Motrin. If we waited to see if she had a fever at 10, then we wouldn't have gotten to the pediatrician's office until 10:40 or so and then have to wait who knows how long to see a doctor. Better safe than sorry was our mantra! So we arrived at the ped's office at about 9:35. The waiting room was full! I guess that's what happens when you have three offices and only one of them has walk-in hours on Saturday. We waited two hours before they called us back to the exam room, then we were in there for about 45 minutes. Short story: fever gone with temp down to 98.6 with 10 1/2 hours since last dose of Motrin. White patches at back of throat almost gone. Urine culture from ER came back negative for UTI.

Baby all fixed up and in good spirits. She fell asleep within minutes of getting in the car to go home and I was able to get her take a nap when she got home. She slept for a good 1-1/2 hours and I did too. It's now time for Mommy to recover from the stress of the last three days! I took a nap too and woke up with a headache and feel not so good. Probably the release of all that stress!

Now we just cross our fingers that she doesn't come down with something from the waiting room this morning!

A high fever, a febrile seizure, and an ambulance ride...

Keira awoke at 3:30 am early Wednesday morning with a fever. I gave her Motrin and it was about an hour until she went back to sleep for about an hour. She woke up again at 6:30, but pretty quickly went back to sleep. I canceled our activities for the day, and we spent the day at home with my friend Gabrielle coming over for lunch. Throughout the day on Wednesday, Keira was in pretty good spirits despite the fever. At 4:30, I gave her the next dose of Tylenol and her fever was high at 103 degrees. I had a game night planned with some girlfriends so I went to that and got back at about 10 pm. I typed up the Chuck E. Cheese blog entry, then went upstairs to get Ryan so we could check on Keira.

Ryan and I woke Keira up at around 10:30 that night to give her the next dose of Tylenol. She was very warm and sort of disoriented. She did not want to take the medicine and it took us a while to get some in her. She was fighting us. Seconds after taking the first half of the Tylenol dosage, Keira had a seizure at 10:40 for about 2 minutes. She never stopped breathing or anything, her entire body just seized up and sort of convulsed (not violently) with her limbs stiff and her feet pointed down, her eyes open, and gurgling, ragged breath coming out of her mouth. Ryan immediately called 911 (while she was still seizing) and a firetruck and ambulance arrived at our house within five minutes. When she came out of the seizure she immediately began crying and was very upset. While waiting for the EMTs to arrive, we stripped her down to her diaper to help cool her down. The EMTs checked her out and got the details of what had happened. I think her temperature was at 104 or so when they checked it at that time. They said we needed to take to the hospital to get her fever down and have her checked out. I dressed her in a bodysuit and gave her to Ryan so that I could change out of my pajamas. We wrapped her in a blanket, grapped her diaper bag, my wallet (for her insurance card) and some extra diapers, then ran out to the ambulance. The temperature outside had already dropped into the mid-teens so it was very cold out.

I held Keira in my lap on the stretcher while we were taken to the nearest hospital in the ambulance. Ryan was to meet us at the ER in our car. He was already there when Keira and I were rolled out of the ambulance on the stretcher. When we got to the ER, her fever was up to 104.9 and the nurses administered Motrin to bring the fever down. Keira was very upset and crying a lot and wanted me and only me to hold her. By 12:30 when the fever had dropped substantially, Keira was in much better spirits and no longer crying all the time, playing with Daddy and his cell phone. Her fever was down to 99.3 by about 1:00 am. Since the tests for flu and RSV came back negative and the two X rays taken of her chest did not show anything wrong, the seizure was diagnosed as a febrile seizure and we were sent home with instructions to give her Motrin and Tylenol alternately every four hours and to follow-up with the pediatrician the next day. I figured the fever might be due to the vaccinations that she had received on Monday afternoon, so the diagnosis made sense. When we got her in the car to go home, she was smiling and making happy noises and was very happy to be in her car seat and familiar surroundings. After stopping at a 24-hour pharmacy for more Motrin, we got home at about 1:30 and she went to sleep almost immediately.

Needless to say, Ryan and I didn't sleep much that night. The Tylenol and Motrin kept her fever down. When she woke up at 9:30 that morning, her fever was back up to 102.5 so we gave her the next dose of Motrin. We got to the pediatrician at about 10:15 that morning and were there for over two hours. At about 11 that morning, here fever was down to 101. The doctor did not think that the vaccinations would cause such a high fever, so some tests were run on Keira to try to determine the cause. A throat culture determined it was not Strep, and a blood count came back with Keira's white blood cell count elevated with anti-viral and anti-bacterial about equal. So it was thought that it was a viral infection. We were told that if she still has a fever on Saturday, that we should bring her into the office again.

Thursday afternoon when she woke up from her nap, her temperature was not elevated, but we gave her Motrin anyway. When we put her to bed at 8:00 pm, her temp was back up to 100.6 so we put her to bed knowing that we would need to wake her up at 9:30 to give her another dose of Motrin. At 9:15 she was very restless in her crib, so we woke her up, gave her the next dose of Motrin, and her temperature was up to 101.9. At 3:15 am Friday, we again woke her up to give her another dose of Motrin. When she woke up the next morning at 8:30, her temperature was down to 99.0 deg. I thought the fever had broken. However, at a little after 10 am, she was feeling a little warmer so I checked her temperature and it was back up to 101.0 so I gave her more Motrin. At 4:10, it was time for another dose, but her temp was 98.6 so I checked her again at 5:00, now it was only 99.6. So we waited until bedtime at 7:45 to check her temperature again. This time it was 101.3 so we gave her more Motrin and put her to bed for the night. We'll wake her again at 1:45 to give her another dose. It's looking pretty likely that we'll be making that trip to the pediatrician's office in the morning.

Throughout Thursday and Friday, Keira has been in good spirits, eating fairly well, and sleeping well albeit fitful. I am just so thankful that the seizure was not as bad as it could have been.

It turns out that febrile seizures are not uncommon and generally do not cause any long-term effects. However, there is now a higher chance that she may experience one again so we will have to be more aggressive in our treatment of fevers. Whereas previously the doctor didn't see a need for Motrin until the fever was 102 deg or higher, now it is recommended that we give her Motrin for fevers above 100.4 deg. Whereas previously, we could have given her Motrin once at bedtime, then only give another dosage if she woke up again during the night needing one, now it is recommended that we wake her up after six hours for the next dose.

I am just thankful that my beautiful baby girl is okay. I hope that she never experiences another seizure (for her sake and ours) like the one she had on Wednesday night, but I realize that there is a chance that she will. Hopefully tomorrow we will have more news as to why this fever has not yet broken. I will post an update tomorrow night.

15 Months Old and a checkup to prove it

Keira turned 15 months old yesterday! It seems like just yesterday I was in the hospital on bedrest, trying not to have her early, and then she came almost five weeks early anyway. Lucky for us, she was a healthy little thing with well developed lungs and a great appetite.

This afternoon, Keira had her 15 month checkup with the doctor. Since being born, she has grown so much:

.............Weight........Height
Birth......7 lb 1 oz.....19.50 in
2 mo....12 lb 13 oz...22.75 in
4 mo....14 lb............25.00 in
6 mo....18 lb 3 oz.....26.60 in
9 mo....21 lb 2 oz.....27.75 in
12 mo..23 lb 11 oz....30.00 in
15 mo..25 lb 3 oz......31.50 in

At birth, Keira was in the 25th percentile for weight and the 50th percentile for height. By 2 months, she was in the 90th percentile for weight, and by 4 months, the 75th percentile for height. Her weight and height percentiles have both converged into the low 80th percentile ranges and are now at 83% and 82%, respectively.

Of her close friends, she definitely has the biggest head. And her head circumference shows it! At 6 months, it topped the growth charts in the 93rd percentile. At 15 months, her head is in the 80th percentile. Hopefully it means there is lots of brain matter in there ready to absorb everything that her daddy and I have to teach her!

We were able to tell the doctor the following:

Walking: Keira can walk independently as far as 12 ft, but only walks about 20% of the time. The doctor said it is completely normal that she walks like a duck (Ryan's concern, not mine).

Talking: Keira says three words (Mama, Dada, tickle), maybe a fourth (kitty). However she does understand quite a few more words: she can sign 6 or 7 words, and can point to 7-9 body parts
The doctor said her verbal skills are about average right now, and should hopefully say about 10 words at 18 months. She did say that she would not expect a 15 month old to know as many body parts as she does so her verbal recognition is great. She said to just continue reading lots of books to Keira and that will help with the verbal skills.

Eating: Keira wants to eat all the time, but there are times that we have to cut her off. She really likes to drink her milk and eat fruit. We were concerned that we were feeding her too much!
The doctor said that cutting her off is fine, she should be drinking lots of water throughout the day when she is not drinking milk, and to give her lots of fruits and veggies at snack time rather than fill her up with crackers and goldfish (Keira is not going to be happy to hear that as she loves her goldfish!).

Head tilting: Since Keira was like 6 months old, she has gone through phases were she tilts her head to one side or another for about a week, then it goes back to normal for a month or so before happening again. Previously it was diagnosed by an ER doctor as torticollis. It happened again last week, so we mentioned this to the doctor.
The doctor said that this really doesn't sound like torticollis since it is not persistent and is not always on the same side. She suggested that we see an eye doctor to have Keira's vision checked just to make sure that something isn't wrong there for which she is compensating. If her vision is fine, it may just be a "thing" that she is doing. We'll cross our fingers that there is no vision issue.

With Keira being premature by about 4 1/2 weeks (she was born at 35 weeks 2 days for you other mommies), I always have to remind myself that she may be a little behind learning new things than other children born around the same time as her. It is hard to see your child sitting up later, crawling later, cruising later, and, currently, walking later than other babies who were born less than two weeks earlier than her. Foremost in my mind is that there is something wrong with her! But I try to keep the panic at bay most of the time and remember that being born a month early can be a big deal developmentally when your age is still being counted in months! I always feel better after the doctor's well visits to know that Keira is right on track and that nothing about her development has alarmed the doctor. Phew! I guess we are doing something right!