Defending the Boob

I'll start off right now by saying this post isn't for everyone.  It has boobs in it. 

Lactating ones.

I realize that half of you stopped reading after the last line, but to be fair, I've probably gained a few weird fetish dudes by now so I'm sure it all balances out somehow. 

In any event:  My name is Jen and I am an extended breastfeeding Mom.

As their biological mother, I chose to breastfeed all three of my kids.   I did this as I believe this is the best start that I can give them. I am not here to make you feel bad if you didn't;  we are fortunate enough to live in an area of the world that allows us options.   However, it's my blog and right now we are all about the boobies. 

It's sad in this day and age that you have to defend your choices as a mother, no matter what direction you take.   I am very lucky to have been able to breastfeed my twins up until now.  I struggled with my eldest for 6 months before giving up and switching him to formula. I wish I had known then what I know now (and had gotten a decent pump!)  The babies are now almost 14 months old and we are still going strong.   When Wyatt was born, I was open to any an all options for him in particular;  if it turned out that he needed to be tube or bottle fed pumped milk, then I would have done that.  We were very pleased when he was able to breast feed; not only would it provide the best dietary option and boost his immunity, but the increased resistance would give his oral-facial muscles a better start. 

As part of the 31 for 21 Blogging Challenge that I participated in last October, I put out this Factoid Friday:  7 Good Reasons to Breastfeed Your Baby with Down Syndrome.  Babies with Down Syndrome commonly have feeding problems;  I came across a study from Italy where 57% of babies with DS born in the four university hospitals were bottle fed (Pisacane, etc, 2003)  Depression and frustration were two of the most common cited reasons.  Feeding difficulties was the most common.  Only 30% of the children admitted to the NICU were breastfed.  I've run into similar studies from South America.  My advice to any new DS parent facing their options would be to do the research.  If you can do it, do it for the 7 Reasons that I've listed.

Now that the babies are 13+ months, I've now moved into very uncharted waters.  I'm now part of a new category:  the extended breastfeeder.  I have had (mostly well meaning) folks ask me "how long are you going to keep that up?" and the like.  (Also, "why are you still feeding both of them?", like I can pick one of them?) The stereotype, of course, is the "crunchy" mom who breastfeeds until the kid is in middle school... and yes, I have been asked that as well. Both Wyatt and Zoe are eating a variety of solid foods.  When I am at home, they continue to receive breast milk (they are supplemented with homogenized milk when I am working and there is not enough pumped milk in the fridge).  Why am I still doing this?

Really, it's more like: why the hell wouldn't I be?

There is no medical explanation as why I should cease breastfeeding my twins;  those 7 reasons still apply.  Between my insane work schedule and, well, life, any close, quiet snuggle time I get with the babies is important.  So what is the issue then, other than a vague societal idea that it is somehow weird and unnecessary?

To be honest, I did think about quitting.  It would be easier in some respects.  Pumping at work can be a drag, when all I want to do on my break is close my eyes for a few minutes or possibly eat something at a comfortable pace.  I might also want a glass of wine or two (or three) some evening at home. Then there is Zoe, who now has a mouthful of teeth.  Sharp, needle-like teeth.  I probably don't need to expound on that one. 

Ultimately, for me, it comes down to Wyatt.  Yes, he is eating solids, well above what is "expected" of a child with Down Syndrome at his age.  However, is solid food and cow's milk the best I can do for him and his special needs?

It is true that after 6 months, with any baby, supplementary feeding is recommended.  However, that does not mean that breast milk ceases to be of any nutritional value.  In fact, once you are over the year point, it is the exact opposite.  In 2005, Mandel determined that milk from mothers who had been breastfeeding for over a year showed "significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods."  To further expound on this, Dewey (2001) found that "Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins."  In fact, when analyzed, 448 ml of breast milk (in ages 12-23 months) provides (of the daily requirement):

• 29% of energy
• 43% of protein
• 36% of calcium
• 75% of vitamin A
• 76% of folate
• 94% of vitamin B12
• 60% of vitamin C

After the first year then, breast milk continues to be a valid form of nutrition for a toddler.  What else can it do?  Building on our previous 7 reasons:


"1)  Breastfeeding provides antibodies and protection from illness"

After the first year, breast milk continues to provide immunity and fight infection.  In fact, it has been shown that breast fed toddlers have less infections and a reduced severity of illness (Gulick, 1986). Also, breast milk has an increased amount of antibodies in the second year (Goldman, Goldblum, Garza, 1983) which increases even further at the time of weaning (Goldman, 1983).  It would seem that extended breastfeeding is a beneficial practice for the health of any child, especially one who is statistically prone to infection and illness due to his genetic make up.

"2)  Breastfeeding improves mouth and tongue co-ordination which will aid in speech and language development"
  
Breastfeeding provides a variety of "positive effects on the development of an infant's oral cavity, including improved shaping of the hard palate resulting in proper alignment of teeth and fewer problems with malocclusions." (Palmer, 1983). In terms of both motor skills and early language development, another study found "The proportion of infants who mastered the specific milestones increased consistently with increasing duration of breastfeeding." (Vestergaard, etc,1999).  Therefore, extended breastfeeding would only continue to enhance speech and language development.

"3)  Breastfeeding promotes increased brain growth due to DHA, a fatty acid that is not found in most formulas or cow's milk." 

Extensive research in this area has shown that there is a direct relationship between breastfeeding and cognitive ability.  Of particular note is a study from 2002, whereby "a significant positive association between duration of breastfeeding and intelligence was observed in 2 independent samples of young adults, assessed with 2 different intelligence tests." (Mortenson, etc, 2002).  Extended breastfeeding then, would further aid any child's cognitive development;  ostensibly providing a boost to one who was developmentally delayed.

"4)  Breastfeeding provides the opportunity for extra sensory stimulation as there is more skin to skin contact"

Many studies have shown that breastfeeding enhances motor skills and overall development.  In fact, "The psychomotor and social development of breast-fed babies clearly differs from that of bottle-fed ones and leads at the age of 12 months to significant developmental advantages of the psychomotor and social capabilities." (Baumgartner, 1984).  As the senses develop the more they are stimulated, it would be easy to infer that the more one is breastfed, the more developed the senses would become.  It is obvious how this would be helpful to a child with Down Syndrome.

"5)  Breastfeeding fosters closeness"
and
 "6)  Breastfeeding enhances mothering skills"

I think this quote says it best;

"A major reason for practicing sustained breastfeeding in industrialized countries in the face of social disapproval has been the belief that it provides a closer bond between mother and child. These children are often said to be more secure and more independent. They continue to remember this close bond and their mothers believe that it continues in some sense, even into adolescence, easing the difficulties in the mother-child relationship during this period." (Grenier, 1995)  

The strong bonds created with breastfeeding appear to last well into childhood, at least by our perceptions.  Ferguson found "significant associations between the duration of breastfeeding and maternal and teacher ratings of conduct disorder obtained at six, seven and eight years" (Ferguson, et al, 1987). 
 
"7)  Breastfeeding reduces the risk of Type 2 diabetes"

Breastfeeding your child reduces his or her chances of developing Type 2 diabetes.  What is not commonly known is that extended breastfeeding decreases the mother's chance of developing Type 2 DM as well.  According to the Journal of the American Medical Association:  "increased duration of breastfeeding was associated with reduced risk of type 2 diabetes".  In fact, for each year of lactation, a woman decreases her chances by 15%.  (Stuebe, etc, 2005).  With that in mind, if a woman has two children and breastfeeds them both for two years, she has reduced her chances of developing Type 2 diabetes by 60%.  Other diabetes related finds of note:  suppressed lactation actually increases the chances of diabetes. Also: "lactation was associated with improved glucose tolerance, fasting glucose, and total area under the glucose tolerance curve. In an analysis stratified by use of insulin during pregnancy, fasting glucose levels were significantly lower in the lactating group." (Stuebe, etc, 2005)

As it turns out there is also some evidence that extended breastfeeding reduces the mother's risk of certain cancers, rheumatoid arthritis, and osteoporosis.


Contrary to popular belief then, extended breastfeeding (past the first year) has valid benefits for both mother and baby. I must admit, although it can be tricky (mainly due to other people), it provides a quiet time that I can spend with both my babies at once.  They make eye contact with me, they make eye contact with each other.  Occasionally, one will poke at the other, but that is the story with any siblings.  It's also easy and free, which scores bonus points as well.  I won't know for sure if it will make the difference between Wyatt taking this course or another in high school.  I will know that when I do get a chance to cool it for a bit, I can rest easy knowing that I did my very best for him and his sister.  Which is all any of us aspire to do, really.

Long live the boobies.  To my twins at least, they're like no udder. 



---------------------------------
Baumgartner, C. Psychomotor and social development of breastfed and bottle-fed babies during their first year of life. Acta Paediatrica Hungarica 1984; 25(4):409-17. 

Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1).

Ferguson, D. M. et al. Breastfeeding and subsequent social adjustment in six- to eight-year-old children. J Child Psychology and Psychiatry 1987; 28:378-86.

Gulick EE. The effects of breastfeeding on toddler health. Pediatr Nurs. 1986 Jan-Feb;12(1):51-4.

Goldman AS et al. Immunologic components in human milk during weaning. Acta Paediatr Scand. 1983 Jan;72(1):133-4.

Goldman AS, Goldblum RM, Garza C. Immunologic components in human milk during the second year of lactation. Acta Paediatr Scand. 1983 May;72(3):461-2.


Mandel D, Lubetzky R, Dollberg S, Barak S, Mimouni FB. Fat and Energy Contents of Expressed Human Breast Milk in Prolonged Lactation. Pediatrics. 2005 Sept; 116(3):e432-e435.

Mortensen EL, Michaelsen KF, Sanders SA, Reinisch JM. The Association Between Duration of Breastfeeding and Adult Intelligence. JAMA. 2002;287:2365-2371.

Nursing Beyond One Year by Sally Kneidel, NEW BEGINNINGS, Vol. 6 No. 4, July-August 1990, pp. 99-103.

Palmer, B. The Influence of Breastfeeding on the Development of the Oral Cavity: A Commentary. Journal of Human Lactation. 1998;14(2):93-98

Pisacane A, Toscano E, Pirri I, Continisio P, Andria G, Zoli B, Strisciuglio P, Concolino D, Piccione M, Lo Giudice C, Vicari S.  Down syndrome and breastfeeding.  Acta Paediatr. 2003;Dec;92(12):1479-81.

Stuebe A., Rich-Edwards J., Willett W,  Manson J, Michels M, Duration of Lactation and Incidence of Type 2 Diabetes.  JAMA 2005;294(20):2601-2610.

Sustained breastfeeding, complementation, and care by Ted Greiner, Food and Nutrition Bulletin, 16(4):313-319, 1995

Vestergaard M, Obel C, Henriksen TB, Sorensen HT, Skajaa E, Ostergaard J. Duration of breastfeeding and developmental milestones during the latter half of infancy. Acta Paediatr. 1999 Dec;88(12):1327-32.

What is this "Normal" of Which You Speak?

Today is Saturday, a unique breed amongst the other days.  To many, it's the first day in their two days of respite from the rat race.  To me, a shiftworker, it's just another day.  Today, in fact, is day four of nine, where I am supposed to be cleaning the basement and the stairs.  Since my sciatica has been ranging from cripplingly painful to moderately bastardly in the last week, we can safely assume that isn't happening today.  Instead I will blog...

Today's entry is made possible by my shiny new 'puter which came about solely because my other "laptop" decided to wink out and not display anything any more.  I say "laptop", as any sort of illusion that this thing was in any way portable had long since died out.  In the six years that it had been in almost constant service, we had first witnessed the demise of the battery which forced it to be plugged in at all times.  My then three year old son decided to play with it one day and in the space of 2 seconds had managed to rip off the "S" key.  It then became permanently tethered to both the wall and a desk as we had to plug in an external keyboard.  It has been moved from the basement to the bedroom and finally to the living room with the advent of the twins.  Where it sat, for many months, wheezing along with an external drive in situ, which kindly did all its major remembering for it.  Now, *poof*. It is blind.  Unfortunately, I have a whole whack of things on there that I did not back up and need to get off there before we either relegate it to the recycle centre or rebuild it for our son.  Yes, the same one that ripped off the S key.  The irony is strong with that one.

Saturdays have taken on another meaning for me;  Special Saturdays.  Those familiar with Twitter lingo will recognize #CT (Charity Tuesday) #FF (Follow Friday) and the like.  The special need community has started another: #specialsaturday, in the hopes of raising awareness.  This week's topic is technology:  how much Team Logan relies on their technology was highlighted this week with the "laptop".  Not only is it a much needed source of respite and an outlet for me, but it is also the hub of the house.  (Thank goodness it is back...)

My bloggy friend Renata over at Just Bring the Chocolate has come up with what I think is a brilliant way to spend a Saturday.  Unlike your typical blog hop, where participants jump from one to another to get to know other bloggers, she's added a twist.  A challenge, if you will.  Instead of dumping my URL and running ... er... trying to put your best face forward or whatever it is that you do, this time, there's work involved.  Renata has challenged us to "redefine normal".  I love this concept.  Love it.  In her words:

"There is no such thing as the normal family, just varying degrees of weirdness. Just like the pile of things that sits hopefully at the bottom of the stairs waiting to be carried up day after day, after a while, we don't even see our own idiosyncrasies. Parents of special needs children, arguably, embrace this weirdness to a more impressive level than many other families, and, should you come across us, you shouldn't be surprised if some of it leaks out into everyday life."

Oh yeah.

We've always been a bit "off".  Even before children, my husband and I were geeks.  We are, what I like to refer to as "delightfully eccentric".  We read a lot.  We know a little about a lot of different topics.  I am creative without actually being an artist of any sort of description.  When our eldest was born, we just incorporated one more into our weird little herd.  Quinn, as it turns out, is really smart, funny, sensitive and really into arts and crafts.  If that kid ever figures out what he is really good at, he is going to be rich.

We amped up the oddity factor when I conceived our twins.  Rare in itself, having twins brings on its own set of unique problems and creative solutions.  We've adapted behaviours for survival.  When one of those twins turned out to have special needs, there was a whole other level of urgency added to "adapt or be destroyed".

To prove Renata's theory that we overlook our idiosyncracies, I had a really hard time coming up with one little thing that makes us unique (since we have adapted everything quite well into everyday life).
I have been very fortunate that other than one surgery thus far with my "typical" twin, we haven't had to do much extra with Wyatt's Down Syndrome medically, other than go to a ridiculous amount of appointments.  By "ridiculous" I mean "mind bogglingly insane amount" as both kids have their own issues that require attention.  As they were 6 weeks premature, Zoe is followed by the neonatal clinic at the hospital.  We have a couple of appointments a year there as they evaluate her development.  She also has a Family Doctor, a Pediatrician and a Surgeon (who repaired her hernia).  Wyatt, so far, has the following:  a family doctor, a cardiologist, a cardiac surgeon, a pediatrician, an ophthalmologist, an ENT, an audiologist, a speech therapist and OT/RT/PT.  My kids need an assistant, which has handily come in the form of their stay at home Dad, another unusual thing about our family, when you get right down to it.  But, I don't think of these things, I only consider ourselves as fortunate as there are no tubes and wires with Wyatt; we have been spared the onset of CHF with his AVSD so far.  There have been no medications to give (other than mineral oil in his ears).  We have been "lucky".

Furthering her concept along, I was wandering around the house doing this and that and trying to come up with what made us different;  as I was doing this, I kept having to rearrange, pick up or sort out piles of stuff.  In our house, "the pile of things that sits hopefully at the bottom of the stairs waiting to be carried up day after day" is literally just that.  Piles and piles of stuff.  We have piles and piles of extra things that parents of singletons, special needs or not, simply do not have to cope with.  For example, our main floor consists of a large eat-in kitchen and a combination living and dining room.  Since Wyatt and Zoe have come into our lives, I no longer have a living-dining room; rather I have an area with couches and a main floor nursery.  The table has been moved out, creating an open area for the kids to roll around and play in.  There is a play pen in there at all times, a ready "penalty box" or soft place to put sleepy little people.  In front of our antique sewing machine, there lives what I like to call our "therapy corner";  a collection of items used for Wyatt's daily PT that have either been adapted for the cause or brought for that purpose.

Our regular readers will recognize The Bean and The Speedbump.  Along with these are (left to right):  2 nursing pillows, a stack of pillows, two "banana" neck stabilizers, an infant anti-rolling brace thing, a rain stick, a blow up roller with balls inside, two Bumbos, two stuffed friends, a yellow happy face ball, a beaded wire toy that suctions to the floor, an infant head rest pillow, the safety mirror,  a tambourine, the gymini-jillikers, a spare bathtub and two Sleep Number bolster pillows.

Any or all toys can be commandeered for the cause at any time:  we have four baskets that are about 1 foot cubed, full of baby toys that are jammed under the coffee table.  Stuff.  We has it.

Team Logan is nothing if not adaptable.  It's "do or do not. There is no try".  Renata has brought a good point forward:  in all our trying to show inclusion, to show our "normalcy", we've started to overlook the little things that make us, us.  We've forgotten what it was to incorporate every adaptation into our routine and as a result, minimize the hard work that we do.  Along with inclusion, I think we have to celebrate that too.  We do work hard.  We don't want to lose sight of that, even if it is a labour of love.  We have our little quirks too.  So, time allowing, I will be participating in the "Define Normal" bloghop.  Once a week, we should have a time to reflect on our little peculiarities, to embrace our differences with a little whimsy.

...And lettin' our freak flag fly, baby.

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Don't forget to vote for Down Wit Dat as About.com's Reader's Choice for Special Needs Parenting Blog.   You can vote once a day, every day until March 21 using an email address or signing in through Facebook.  You can vote HERE.  -Jxox

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Bon Appétit!

We're on day four of The New World Order here at Team Logan and there have already been quite a few changes.  The kitchen is getting overhauled.  The laundry is no longer "Mount Logan" but rather resembles a large burial mound (hopefully not mine).  Everyone is a little more relaxed and Wyatt and Zoe are now eating solid food.

Last week I mentioned that I was leery of starting the babies on cereal;  I was concerned that Wyatt's head was still a little unstable.  My hope was to wait another two weeks to be well beyond the "six weeks corrected" grace period that each of their milestones is given.  That grand plan lasted until Saturday afternoon after observing both of them watching me eat.  After trying to take food away from me (not a wise move for anyone, even my own offspring) they sat there salivating as I ate my brunch.  Their little eyes bored into me, their jaws were moving in time to mine.  Their little pink tongues were darting out of their half open mouths over seemingly parched lips.  It was creepy.  It was time.  It was more than time.  These babies were hungry!

I hadn't dug out our high chair yet so they were each plunked into a Bumbo.  Wyatt still has trouble sitting up straight in the Bumbo for periods of time, so we were on the clock (I have since set up the high chair for him in the kitchen that works much better).  I mixed up a batch of runny rice cereal according to the directions for  "first feeding" and went to town.

Not surprising, my babies like to eat.

I love this and you Mom!

Rice?  More like awesomesauce!

I couldn't remember any of the first feeding guidelines so I had to consult 'the experts' beforehand.  According to a few places, a baby's first feed should be somewhere around a tablespoon or two.  These two polished off 1/4 cup (or more) each and were upset that I wouldn't give them more.

Please Mom... can I have some more?

I swear, I had to count my fingers afterwards as I was afraid that I had lost a few.  They were snapping at the spoons like little sharks.  According to the aforementioned 'experts', I was also supposed to keep food to once a day.  It was apparent by the end of day two that 2 "solid food" meals were going to be needed as they were starving (they still start out with a full breastfeeding session prior).  Can we say "growth spurt"?  Now they get BF 4 times a day, 4 hours apart and at lunch and dinner they get solid food and a "top up" bottle at bedtime.

I had been looking everywhere for first feeding instructions for DS kids and found little that was useful.  There's a reason for that;  the instructions are no different than any other baby.  The main concerns are still head/neck development and swallowing ability.  Although Wyatt pushes a little food out with his tongue at times (because he is actually giving me his patented "raspberry of approval", not because of his glossal co-ordination), he has still taken to food pretty well.  He requires a little more "shaving" than his sister, but that is typical of a boy.  They like to wear their food.

We also have a new secret weapon this time:  Sean brought home The Baby Bullet.   I was skeptical at first, in fact the first time I saw the ads I remember thinking "how superfluous is that stupid thing?" (I used to have a vocabulary BT or "Before Twins").  I have a blender... yes it was a wedding present and therefore almost 14 years old, but it's still practically new (right?).  Except for the cereals, I made all of Quinn's baby food with it.  I would cook huge batches of things that were pureed according to his texture tolerance and frozen in ice cube trays (which I would then empty into labeled freezer bags).  It was a good system, it was healthy, it was cheaper... and it was a helluva mess.  I think I finally threw out the last of it a year ago.  This time I can make up one thing at a time, quickly and efficiently.  What really sold me on it was the milling head.  It never occurred to me to make my own cereals.  So I did.  This afternoon, I started with 1/2 a cup of brown rice and ended up 20 minutes later with enough ready made rice cereal to last us a week (if they ate at every meal).  I filled four of those wee containers (2 oz each) for the fridge and filled our freezer container (which is half the size of the one shown) and froze it for later.  It is awesome.  I still have a box of baby oatmeal cereal to start them on in a couple of days, but after that we are totally making everything ourselves. 

I could only be happier if I were full of squished sweet potatoes

I even used it to make the banana puree this afternoon.  We'll give it another chance, but thus far the verdict is split:  Wyatt is of the mind that I should immediately switch to having it "on tap" instead, while after a few bites Zoe decided that it was worthy of her best yucky face.  I'll mix it with a little rice cereal and maybe a bit of what is currently on tap and see what she thinks then.

Overall, both twins are doing well.  At their doctor visit yesterday they weighted in at 13 lbs 9.5 oz for Zoe and 13 lbs even for Wyatt.  That differential can totally be attributed to Zoe's muscle mass which continues to astounds me.  She is faster, stronger and way more agile than full-term Quinn at this age.  Wyatt is much improved as he is much less "floppy" than he used to be.  In fact, when we lift him up high into the air he is not as ragdoll like and more like superman.  He will also stand on his legs when held in a standing position, something that Quinn was totally against for a very long time.  To quote one of my girlfriends, Quinn's take was "Legs?  What are they good for?"  Wyatt seems to have his own way about things which is very much a delight to watch.

There was a chill in the air this morning;  I can almost smell winter coming.  The babies will be 7 months old tomorrow and I go back to work a week later.   Time is marching on.  With each new thing I am reminded that they will not be babies forever and this special time will be over for us soon.  As bittersweet as that is, it also represents all the new things headed our way.  New things that will be done first one way, then repeated slightly slower and differently. Done differently, done in the Down Syndrome way.  Wyatt's little extra brings a whole new flavour to our family table. One that many, incuding us, have never experienced before but are enjoying immensely.

Bon appétit!

Milestones

Another week, another round of appointments.  I don't know if these appointments are getting easier or if I've just completely accepted that I will be doing a lot of this for the rest of my days.  Yes, getting to and from can sometimes [most of the time] be problematic with silly scenarios that I [have a knack for] seem to get into.  Lately I've been letting it all roll off me, which is made a lot easier as the news in these appointments has continued to be very encouraging. 

Monday morning was our follow up with the Neonatal clinic at the hospital.  Premature and underweight babies are at high risk for developmental delay so naturally Zoe was referred.  I initially thought the appointment was for both of them, but after an awkward few minutes at the desk I was informed that they don't follow Down Syndrome babies (they leave that up to Infant and Child Development).  Zoe had an appointment to herself for the first time since her surgery.  This was her official 4 month (corrected) visit.

The first little bit was typical:  weigh her in, measure and report.  According to the scale there, she weighed 13 lbs, 4 oz which I think is a bit more than she actually does (they left her dress on, so that could have added a few ounces).  Then it was meeting with the OT (Occupational Therapist) who laid her on the floor and checked out her development.

According to the Nippissing District Developmental Screening Tool, at four months of age a child should be able to do the following:

• Turn their head from side to side to follow a toy
• Glance from one object to another
• Turn [their] head towards a source of sound
• Make some sounds when looking at toys or people
• Brighten to sound, especially to people's voices
• Respond to you by making sounds and moving arms and legs
• Laugh and smile
• Finish each feeding within 45 minutes
• Lift [their] head and support self on forearms
• Bring both hands to chest and keep head in mid-line while lying on back
• Hold head steady when supported in a sitting position (ie:  in an infant chair or on your lap)
• Hold an object briefly when placed in their hand.

(© NDDS Intellectual Property Association, all rights reserved). 

Now, according to the OT, Zoe is scoring in the 50th percentile for her real age, not her corrected one; she can do this list and so much more (roll to her stomach, roll back to her back, hold objects in both hands, etc).  This is fabulous news... albeit not terribly surprising, given "The Princess" (as dubbed by the NICU nurses) has always been a superstar.

Yes, I can multitask.  I learned it from my Mommy...

The Neonatologist was simply enamored with her which also isn't too surprising as she is a real flirt when she is not screaming.  After a few physical checks (heart, lungs, eyes, ears, fontanel), he was done and so were we and we received our next appointment for late November.  We spent the rest of our time at the hospital visiting with Mommy's colleagues where both babies were held and snuggled by all.  Quinn didn't do too badly as well... he scored some Timbits and covered the office in original artwork.

...And on the way home I stopped traffic.  Yes, you read that right. What would a "doctor adventure" be without the "adventure" part?

When we had left in the morning it had just stopped raining;  it was quite possibly the first rain we'd had in a month.  The stroller was packed with rain gear: stroller cover, giant umbrella, a rain coat for Quinn.  At some point while we were inside the skies had cleared and the sun had decided to beat down once again.  I cursed myself for leaving my sunglasses at home and forayed out into the blinding light.  We were almost panting by the time we reached the bus stop and there was no shade to be found as the sun was almost directly overhead.  By the time the bus came we were already very hot and in need of something cold to drink.  I told myself that when we reached our connection if there was a wait we would go into a nearby store and get a drink, which we did, to cool off and kill a little time.  Once we left the store I started cursing as I realized that the curbs and sidewalks on all four corners of the street were torn up.  Our bus stop was missing in fact.  Damn and blast!  How were we supposed to get home?

I ignored the "use other sidewalk" signs as the bus I needed drove on this side of the street.  I deked up into a handy driveway to hopefully cut through... and found fences everywhere.  We were trapped.  I had two choices:  1) walk back to the "corner", cross the street, walk two blocks down the street, cross and walk back up to the nearest stop or 2) improvise.  I was also wearing strappy slip on sandals with a two inch heel that sounded like a good idea in the morning, but now were rubbing the skin off my feet as they swelled in the heat.  Vanity, thy name is pedicure.

We chose option #2.  Traffic had been reduced to one lane as there was an enormous digger currently gouging out the existing sidewalk and dumping the refuse into an equally enormous dump truck.  At a safe distance from these behemoths was a middle aged [read:  older than me] woman holding a slow/stop sign.  I chose to walk right up to her through a cordoned off area and ask her where the bus stop on this side of the street had gone (it was missing too).  She motioned and yelled something about a block ahead of where we were standing. I could barely hear her over the machines but eventually I made out that she was asking how old the twins were.  I let her know, she looked at each of them lovingly while Quinn stood, mouth agape watching the metal dinosaurs claw at the earth.  I had to interrupt her momentarily to ask her how I was going to get there and she smiled and answered "Well, I'm going to stop traffic for you".

So she did.  She stepped forward, expertly held out her hand and swung that sign around to "STOP" so that I could push the stroller (and Quinn) to the nearest bit of unmolested sidewalk.  On Main Street. In the middle of the afternoon.  It was crazy!  I sauntered down the middle of the road, the divider a foot or two to my left, past the giant machines (I have to admit I was a little spooked) and safely onto the sidewalk... a trip that had to take at least a full minute.  I could feel the traffic building up behind me and knew it had to be solid cars halfway to Orangeville.  I got to the sidewalk, flashed her a thumbs up and traffic started again.  I wasn't paying attention but I am sure I got more than one dirty look.  We opted to walk home from there;  it was a hot one broken only by a few shady spots which we took advantage of.  When Sean came home I regaled him with this story only to have him say "It's a good thing you had that giant umbrella with you for shade!"  Yeah.  Good thing.  (Dammit!)

Wednesday was a big day for both babies as we followed up with the pediatrician. Zoe weighed in (naked this time) at 12 lbs 14 oz and Wyatt a cool 12 lbs 9 oz.  Our mighty Micro-me has finally surpassed her moose of a brother (which is not surprising due to his hypotonia). They are exactly the same length,  58 cm (or almost 23') which is two centimeters more than Quinn was at birth.  (No wonder I needed that section!) According to the charts, Zoe started her life in the 5th percentile and has now moved up to the 25th. Wyatt remains in the 5th percentile.  At our last visit I asked how Wyatt was doing on the DS growth charts and was answered with "I wasn't aware there were such charts".  You'll permit me the mental high-five I gave myself when she added "...but he is at the 25th percentile on the Down Syndrome Chart" this time.  Score one for Advocate Mommy!

She was quite pleased at their progress over all.  Zoe was in a bit of a playful mood and when she tired of rolling to her side and scrabbling to get the box of wipes, she started going after the paper on the table.  Even as I was pulling her away she continued to frantically grab at it with both her chubby mitts and try to eat it.  It was hysterical.  I had to hold her for the rest of the appointment (which was fine as she is content looking around).  When I put her down to change her she rolled over and tried to crawl to the paper mess again.  Our pediatrician was amazed and remarked that it was very unusual in a preemie that age to be so mobile and it was a testimony to the amount of floor time and the kind of stimulation they got.  (Mental high-five number two!  Yay!) 

"Globally delayed"?  I didn't get THAT memo...

We also got the official go-ahead to stop the formula top-up (oh thank you!).  It isn't as easy as just cutting it out at this stage however;  I have to taper everything.  First will be a week of top up with formula in every other bottle, then a period of every other feed having EBM only top up and then taking it from there.  I'm still going to have to pump to make sure that the supply isn't impacted either.  I may never be able to stop pumping after a feed, but time will tell.

That particular trip home was easy as Sean picked us all up.  I got to tell him how awesome all the kids were, including Quinn who patiently sat through yet another appointment and carefully wrote down everyone's weight and measurements.  It was a stark contrast to the outburst he had before the appointment (where he threw a fit and refused to go).  He's growing up too...

I know not all of our appointments are going to end so well.  There will be a point in the future where Wyatt will have his AVSD operated on.  However, I hope that we will continue to have good news and be validated by their development and good health.  I am aware that we may be "honeymooning" with the twins right now and that is okay.  With my return to work date coming fast I feel that we deserve this time together.  That is okay too.  We are moving forward, all of us as a family and meeting our own various milestones.  Right now everything, dare I say it, seems to be all right. Wyatt is just Wyatt and his DS is just something he has, like his blue eyes.  It doesn't define him, or his sister.  Or us either.  It simply is.

That, ladies and gentleman, is a milestone unto itself.  At least for me.

So There Ought to Be

It has been a week of firsts with my family.  Some were better than others, some were simply fantastic.  With our twins, especially Wyatt, we have learned to see even the smallest milestones for what they are:  wondrous little victories.

We started out last Friday with our first big road trip with the babies.  As I have mentioned numerous times before, going anywhere with these babies is quite an undertaking.  With one baby, you have to pack up his or her room... with two babies, you have to pack up most of the house.  We tested the limits of our cargo space last weekend and I have to admit a begrudging acceptance of the Whaaambulance.  Two babies, three days.  Aside from our suitcase and Quinn's bag, bike and bag of toys we had the following:  two baby swings, two bouncy chairs, two bumbos, diapers for two (half a bag), wipes, two bags of blankets (one with receiving blanket/burp cloths/towels and one with heavy quilts),  a bag of baby toys, bottles, pump, nursing pillow, formula powder, sterilizer and a rolling carry-on full of baby clothes. I had a cooler full of bottles and a frozen stash of EBM.  I took my own bottle brush, drain tray and dish soap for the bottles.  I took my own laundry detergent in case I had to wash baby clothes.  It was nuts! Luckily they had a play pen there so that saved us another bulky item.  The only things that didn't get used were the bumbos, the dish soap (they didn't use antibacterial) and the laundry detergent (I washed everything when we got home).  Everything else was used at least once. 

Aside from the supply truck that you need with the twin road trip, there is also the set up and the implementation.  By now we have a pretty set routine around here;  where we keep the supplies, where we change and feed, where we do everything.  I have diaper stations and supplies on every floor of the house and set places that I keep things... now I had to figure that out somewhere else.  I tried to keep from descending on the in-laws like a swarm of locusts but some things could not be helped.  It is busy with twins;  there is always something that you have to be doing. Unlike at my house where I can and do leave dirty bottles in water in the sink for hours on end (to save time... I do the wash up once or twice a day), you can't do this elsewhere.  I was constantly washing and cleaning up something.  Plus I eat like a horse and drink copious amounts even when it is not hot... My five year old was running around wild as it was someplace new and hubby and I were snapping at each other as we couldn't find things.  The temperature soared, the babies didn't sleep very well and Zoe screamed a lot.  I'm sure we were the guests from hell.  Despite all of that, we did have a good time.

We also went to a family reunion where we had a great time.  I was so busy catching up and visiting that I didn't even think of getting out the camera until it was too late.  There was a group shot taken of everyone there so I look forward to seeing that.  It was very hot, but we visited with lots of good people and had a lot of good food.  Baby wrangling is a lot easier when others want to hold them.  :)

High maintanence?  Us?

We also received some handouts from Infant and Child Development to help Wyatt strengthen his muscles and develop.  They aren't as much exercises as positions to place him in to play.  Most are ways that we hold him to begin with, so that was a bit validating.  Each has a list of things to encourage, a list of what this particular position helps to do and play ideas for when you are doing each one. We've started consciously adding them into our day as much as possible.

Sizing up the O-pponent (before exercising with the O-Ball)

Our other firsts this week belong to Wyatt who can now roll over AND giggle.  I missed the very first roll as I found him on his tummy, but eventually I saw him do it.  Zoe is an old pro and lands in perfect position with her head up (not bad for two weeks practice),

Rolling Zoe

but Wyatt is still trying to steady his noggin. One day...

Keep on Rollin' Wyatt!

The first giggle totally caught me by surprise last night.  Sean was bathing Zoe and I was playing with Wyatt in the crib.  Since he is so flexible and we are encouraging him to grab his feet, I had his legs and was playing with his feet.  I tapped his nose with his big toes and he smiled.  I put one of his feet on either side of his face;  the smile got wider and there it was, the cutest "ahuh huh hee hee".  I squeaked and ran to tell Sean, tears in my eyes.  I guess I freaked him out as I couldn't get him to do it again, but I look forward to many more giggles with my little man.

Every new first with a baby is magical.  Every new first with twins is doubly so as you get to see it repeated at a later time and in a slightly different way.  We have the added little extra of seeing it repeated in the DS way.  I have always wanted a house filled with laughter and I believe we are well on our way of achieving that little victory as well.  After all, these are the things that matter most;  the little milestones that not only bring us closer to our goals, but also to each other in our journey.  Although each new little thing means my babies are growing up, our discovery of new things together brings us together with much wonderment and joy.  If that is not magic, I don't know what is.

"When the first baby laughed for the first time, the laugh broke into a thousand pieces and they all went skipping about, and that was the beginning of fairies. And now when every new baby is born its first laugh becomes a fairy. So there ought to be." -- James Matthew Barrie

The Upside of Down

It is only Thursday and I am pooped.  It has been a very busy week so far (and will continue to be so), but we have had a few nagging questions addressed. I am happy to report that these answers have brought a lot of relief and comfort.

As I mentioned previously,  Our worker from Infant and Child Development Services came Monday morning.  Their workers come from a variety of backgrounds including ECE, Psychology, OT, Nursing... ours comes from an ECE and Developmental Psychology background, which suited me fine. She came in, introduced herself... and spent over two hours chatting with me and playing with the babies on the floor.  It was great.  Quinn was in fine form as well;  when he heard that she had arrived, he hurried to get dressed.  Unfortunately, he missed the pile of clothes that I had left on his bed for him (shorts and a t shirt as it was going to be a very hot day).  Instead, he came down in brown track pants and a light coloured pullover with a collar on backwards.  He came right up to us on the floor and sweetly announced "Hi, I'm Quinn" while wearing what looked like a straitjacket. That's m'boy.  She didn't bat an eye... I guess she was too busy gazing into his.  I sent my little lunatic upstairs to change and we got on with the assessment which was only occasionally punctuated by an off the wall [to us] but perfectly pertinent [to him] statement or question.

The whole conversation, like my brain, was very tangential and informal. It totally centered around what the kids were doing.  Both babies were awake and alert and ready to show their stuff.

Listen... they're talking about us again...

Wyatt's head is getting a little more steady every day, which is very encouraging.  "A."  was happy that Zoe could push herself up on her forearms and showed me a little trick to help them master it.  Overall she was very pleased with Wyatt's development;  she remarked on a few things, including his vocalizations, his mouth shapes during these vocalizations and his ability to track by sound and sight.  He also reaches well for things.  A. continued by listing off a few things that I can do to help both of them improve and I was very happy to hear they were things that I was already doing.  Little things such as ankle/wrist rattles, using the dangling toys on the Gymini-jillikers (Gymini play mat), the simple toys I was using, talking to them, imitating their sounds, changing their environment, introducing texture, playing music for them, singing and so on.  We talked about their delivery, Wyatt's diagnosis, their stay in the NICU and how we managed that... even Zoe's surgery.  She was amazed that a) I managed to make it to Mother Goose at all and b) how I was "handling" everything.  Sometimes you have to have things pointed out to you and I am no exception.  I guess our story is a little incredible if you think about it.  A. made a point of relaying how well she thought Team Logan worked together and how well we have dealt with our roller coaster lives over the last two years or so.  I told her that all you can do is laugh sometimes, and cited the dishwasher (which died a horrible leaky death the night before).  What are you going to do?  That's life.

Many of our questions were finally answered.  Infant and Child Development Services sets you up with whatever extended services you might need, such as OT, speech therapists, etc.  Usually, speech therapy and the like start after 1 year of age.  The idea being that you assess where the child is with their speech, etc at that time and then intervene appropriately.  We talked about Wyatt's physical health and swimming was discussed.  I was surprised that they don't recommend exersaucers and jolly-jumpers and the like, but she went on to say that many parents leave their children in them for hours at a time where they are standing on their toes and that interferes with proper leg and foot development.  She did add that 10 or 15 mins here and there would be fine and would be helpful, but no more.  A. went on to say that the best place for them would be just as I had them, on the floor, where they could grow and stretch and build their muscles in a more natural way. 

ICDSP also has a ton of resources for us to utilize:  They have toy and book/video libraries, will and estate planning, evaluating eligibility for and setting up government funding, groups and programs tailored for your needs... and the list goes on.  They will also be involved before Wyatt starts school;  the spring before he starts JK, we (A, the OT, any other development specialists, the teacher, the principal and Sean and myself) will all meet and discuss exactly what his needs are and whether or not he will need additional support in the classroom.  I guess at the time we will also discuss whether our school separates twins or not, but that is another issue.  Even though I knew that he would be going to regular classes like a regular kid, for some reason hearing it from this woman made me relax a little.  I don't know why... perhaps, once again, a small amount of validation can go a long way.  She will be visiting us monthly for the first while to assess his continuing development, which I was also pleased to hear.  I found the whole experience to be extremely positive;  Wyatt's doing well, we are doing well and we are doing the right things for him.  I don't think it gets better than that.

That night we took them to our GP for their 4 month shots.  I'm not so sure of their scale to be honest, but according to it, Zoe weighs 12 lbs, 6 oz and Wyatt weighs 12 lbs.  Zoe has officially beaten her brother in the weight department (you can chalk that up to the muscle tone).  Our Family Doctor was pleased overall with their progress and gave them a shot in each thigh.  I had Sean hold them down... I couldn't bear to do that again.  They were reasonable that night, but were feverish yesterday...  light to no clothes and Tylenol seems to have taken care of that for us.

Tuesday we had a trip to the cardiologist and once again, the kids were on.  I really do like going there as everyone is so friendly and very helpful.  We didn't have to sedate Wyatt (which is always a relief) and it was such a pleasure to watch the babies interact with the staff.  There were a few awkward spots especially when Zoe started crying right when we were doing an echo on Wyatt, but one of the staff just walked over and got her to smile as if this happened every day.  Wyatt had his checkup and his echo and the Dr. is so pleased with his progress that we do not have to see him for another 6 months.  Fantastic! 

We had a happy little moment on the way out as well.  Quinn was playing with a new friend in the waiting room and when we were leaving, I was delighted to see that the (younger) boy he was playing with so easily had DS.  I introduced myself to the boy and his mother and talked to Quinn that his new friend had the same condition that Wyatt has.  "But, they don't look the same" was his reply, to which I responded that "G" looked like his family while Wyatt looks like ours.  I don't even think Quinn noticed that his new playmate was non-verbal... they totally "got" each other.  "G"'s mom was very pleased with the interaction and I was too...  as it was just a little heartwarming glimpse into the future.

It is always good to hear good things about your kids, it's even better to be given the reassurance that they are doing well and most importantly that you are doing the right things for them.  Although I think we are pretty good parents and we strive to be the best that we can for our kids, it is good to have that little extra bit of validation.  Armed with that, we can continue on knowing that Wyatt (and all our kids) will be the best that they can be.  We may not be able to predict Wyatt's journey, but his path will take him places... of that I am sure.

Wyatt intently listening to big brother Quinn

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You've Come a Long Way, Babies!

A lot can happen in four months.

Well, five really...  It's been five months since Wyatt's diagnosis. They were born four months ago yesterday.

Wow.

In that time, they've gone from tiny 5 lb bird-like creatures to big chubby babies that are (I think...) about 12 lbs now. 

Newborn Wyatt... so tiny.

Wyatt now. "What?  I wasn't gonna lick this..."

Newborn Zoe and a loonie...

Zoe now... a lot bigger and a lot goofier.

Both are developing nicely but we are starting to see the gulf widen between them a bit.  Zoe can hold her head up almost still now, while Wyatt has a way to go with that.  He can hold his head up, but it's a bit wobbly and he'll end up crashing into you with his giant noggin.  His babbling is more complex and multi syllabic while Zoe sticks to the classics:  the baby gurgle, the Gah! and her specialty, the blood curdling scream. She can smile and give a tiny giggle (a little "hee hee" that is adorable) yet he is just starting to learn how to smile.  When he does, he looks like an anime character as he uses his whole face.

You can rub my tummy for luck.

Unlike Quinn, who was pretty much textbook +1 (ie: exactly one month ahead) developmentally, these guys are all over the map (which is totally normal for premature twins born 6 weeks early).  I'm supposed to subtract 6 weeks from their age ("6 weeks adjusted") which would make them 2½ months old.  I've mentioned the head holding and the babbling; this generally occurs at the end of the second month (which would put them about right where they should be). They've both discovered their hands which usually happens (so they say) in the third month too.  So, as you can see, they are right where they should be for typical term singletons with some things and right where they should be for premature twins in other areas.  Confused yet?  Yeah, join the club.  I'm not worried about them at all as Zoe is as bright as a button and Wyatt is pretty bright too.  He'll do things in his own time, which as it stands now is keeping pretty much at par with his sister.

 

 How'd they get so big?

Our family is growing and changing as well.  Quinn is adjusting to his role as big brother although he has to be reminded constantly to be careful around them. He is a big help most days and we just have to be careful to make sure that his needs are met just as much as the babies are.  There are a lot of conversations spoken through gritted teeth around here;  usually he is waving something magnificent that he has just made for me in my face as I am trying to clean up the worst poop ever.  There was a lot of yelling initially as I was just too tired to think anything through...  it really hit home one day when Quinn remarked to his Dad that he was dressing up to disguise himself as someone else so that I wouldn't yell at him.  Ow.  Guilt, double plus ungood.

Things are settling down now that I am getting more sleep on average.  They are now going 4-5 hours between feeds and can go 6 hours at night.  Two or three nights this week they have gone 7 or so hours which has been fantastic. 5 hours sleep in a row?  Inconceivable!  Quinn still has an outburst once in a while, but that has thankfully decreased as well.  I still look hungrily to Friday nights as the weekend means Hubby's help for [a very short] two days.

I remember being settled into a routine by the end of the second month with Quinn (which corresponded to two weeks after I felt better post C-section).  I stopped about a week or so ago and admitted to myself that I felt that way again.  I didn't have that same overall sense of panic that I had the first time around, I just felt very very busy and a tad overwhelmed at times.  I'm happy to say that has subsided a bit so that now I can enjoy my family more.  We're still going to Mother Goose and I'm sure that has continued to help as well. 

Four months... it seems a lifetime (and for two little people, it has been just that).  I've come to terms with my son's condition and embraced his differences (I had already accepted him, make no mistake).  We've all made our own adjustments along the way and will continue to do so.  I've even started networking with other DS parents and getting out there to share our story and learn from others.  I've found support in surprising places and accepted the lack of it in the more obvious spots.   A friend remarked the other day that she would bet that I didn't think that I had it in me and that she was impressed and proud of me, even though I wasn't her own daughter.  I'm willing to bet she doesn't know how much that really meant to me, or how much I needed to hear that.  I'm proud of us too.  Anyway you look at it, I feel blessed... and confident that we will overcome and embrace what the next four months brings us.

My three little monkeys.  Who'da thunk it?