Kiera, Matteo, Oliver and Soren

Kiera, Matteo, Oliver and Soren

Monday, June 21, 2010

Nine-Month Wellness Check

Oliver had his nine-month wellness check today and like every appointment before this, he received a clean bill of health. I'm relieved to have a healthy baby, but also that I may have finally settled on a pediatrician. Oliver has seen a different doctor at every wellness check because I haven't found anyone I have liked. Despite the raving recommendation of a particular clinic a mere three minutes from our house by Chris's co-worker, I was disappointed with the three different doctors I saw and finally accepted that the hunch I had during my first visit that I was never really going to like the place wasn't going to change. A friend from a parents group recommended her son's pediatrician, and others in the group happened to go to the same practice, so I decided it was worth switching in the hopes that I could finally find someone I can envision sticking with throughout Oliver's childhood since I believe a relationship with a doctor is as important as his or her diagnosis at a particular appointment. Oliver has seen two different doctors, one at his six-month appointment and another today, and I like them both.

I feel like the wellness checks are not just assessing Oliver's health, but also affirming whether or not I'm doing a good job as a mom. We're all dealt with a deck of genetic cards that will determine most of our health, but as Oliver's primary caretaker, and especially as the one who provides Oliver is main sustenance, I feel the burden of his well-being. If he's not thriving and hitting his developmental milestones, I'd feel I am the cause since I'm the one who spends so much time with him, or if there were concerns about his weight, whether under or over, I wouldn't be able to help but feel it were my fault, like I hadn't fed him enough or fed him too much of the wrong kinds of foods. So when the doctor turns to me and says it's obvious he's a happy, healthy, well-fed baby, I feel both relief and pride.

Among those with similar-age babies in my moms group, we're starting to thinking about the next stage in car seats, the convertible. I was curious, therefore, to find out how much Oliver weighs, but at 17 pounds, 4 ounces, and 27 inches long, he's not in danger of outgrowing his infant car seat with its 22-pound, 29-inch-long size limits. In three months, he's gained about a pound and a half and less than an inch, which is on target. He's also dropped to the 10th percentile in height and the 7th percentile in weight. Since his percentiles seem to be going down every visit, I asked if that is a concern, but the doctor said his main concern is if the measurements take a steep drop or if he's, for example, in the 10th percentile for height, but 90th for weight (which might suggest I've been feeding him donuts instead of slices of sweet potato, toast and peaches). As for the lower percentiles, the doctor said between nine and 12 months, babies settle into their genetic path on the growth charts and follow it pretty consistently from there on out. Whether babies measure big or small in the first six or nine months isn't an indicator of future size, but it's where they level out at that nine-12-month mark. So when the doctor at Oliver's four-month appointment said that where he fell in the height percentiles indicated that he's gong to be six feet as an adult, my guffaw was not an inappropriate reaction. Given the genetic makeup of Oliver's parents, his current doctor is not surprised by bottom-of-the barrel measurements and expects to see similar measurements at the 12-month wellness check.

Besides taking measurements and doing a physical exam on the baby, the doctor at infant wellness checks runs through a list of milestones and today asked me if Oliver is doing things like grasping for objects, (yes) pulling himself up, (showing some interest, but no) responding to his name, (yes) clapping his hands (no, but he smacks his tray with his hands when he's run out of food) or rolling over (yes). I added that he's not crawling yet and only made his first (unsuccessful) movements towards crawling on Saturday. Chris's parents often tell the story that he nearly skipped crawling as a baby - crawled for maybe a week and then not to be outdone by the neighbor girl who was already walking, took to it. I was told that crawling is not considered a developmental milestone (except to us parents) and not something the doctors look for, because whether a baby crawls or not has no indication on whether he or she will walk. The doctor said that most babies crawl, but a small percentage never do.

I read more about crawling when I got home and learned that while we associate babies with crawling, there are actually many different ways that babies move from point A to point B, some of which are crawling, but not in the classical sense and some of which aren't crawling at all. What's important developmentally is whether babies can move horizontally across the floor to reach a desired object. Some will stay upright and scoot on their bottoms, some creep, some wiggle forward on their stomachs or pull themselves across the floor on their stomachs with their forearms, marine-crawling-under-barbed-wire-style. Some crab-crawl, moving backwards and some just roll. Remember, points aren't awarded for efficiency.

Thinking back to the last playgroup Oliver attended, where his group of baby friends had transformed from stationary babies to movers and shakers seemingly overnight, some of them crawled in the traditional sense, but the others used the exact same unique methods I just mentioned. Even Oliver is starting to at least roll. So Oliver may or may not crawl and whatever he does will be on his own time. I've just got to continue what I've been doing which is to give him plenty of floor time and let him work at it himself.

Sunday, June 20, 2010

Sleep Talk

Not surprisingly, sleep, or lack thereof, dominates conversations every time a group of parents with babies or young children congregates. So despite the real problems in our society - two seemingly endless wars, the worst oil spill in history and deficits at every level of government - all might still seem right with the world if our kids would just get some darn sleep. Or maybe us parents would have the energy to address these other problems if our babies were sleeping like, well babies. But with what little energy I did have, I was going to try to solve the sleep deficit one baby at a time. So I hosted a discussion on sleep training, Sleep Talk we called it, for the members of my moms group with the thought that if we got together and shared what we'd learned about sleep or experiences from our own kids, we'd all come a bit closer to making sense to something we had at one time assumed would come naturally.

I will admit that going into parenthood I was naive about sleep and babies, but given how little my husband and I knew about babies in general, (we thought we knew nothing before we had Oliver and then learned after he was born that we actually knew even less) the issue of sleep was just one of many topics we were just going to have to learn about on the go. So even though I knew babies wake up a lot during the night, I thought they otherwise just slept all the time and couldn't have told you in any more detail about the sleep patterns of newborns, let alone how and when those patterns change. I had no idea a baby could become overtired or that you need to help babies learn to fall asleep on their own, because I assumed that if they're tired, they'll sleep. That easy, right?

Chris and I got lucky with Oliver, because he figured out a lot of the sleep stuff by himself, and quickly, so we didn't have much time to inadvertently screw any of it up. Within the first few weeks of his life, we had figured out that rigorous rocking helped soothe him to sleep. He eventually grew too heavy for me to rock him for very long, let alone to rock him to sleep, and I'd put him down in his crib as soon as he settled down and he'd usually fall asleep. Only later did I learn that it's best to put babies to sleep "drowsy, but awake," because they're less likely to panic if they wake up in the same place and in the same condition they fell asleep. (So your arms and the rocking motion, even when done right next to the crib, are not going to be the same conditions as the still crib you set your now sleeping baby into.) This "drowsy, but awake" was what I ended up doing out of necessity, not with any deliberateness. Had I been a little stronger or had Oliver not been as obvious about how he didn't need the rocking anymore, I might have kept rocking him every night, well past the three or four month mark when babies grow out of needing motion to sleep, until he was fast asleep, and could have created one big sleep problem for him.

Oh, and that sleeping through the night that Oliver started doing around three months of age? That was totally him too. Chris and I were trying any supposedly magic sleep technique we had heard of - swaddling, white noise, bottle of formula before bed, socks on his feet so cold feet wouldn't wake him - and if any of those tricks contributed to Oliver's good night time sleeping, we'll never know.

The meltdowns (on Oliver's part)started to occur around four months, (my first occurred within hours of giving birth) and while exacerbating at first, because I couldn't figure out what could have gone so wrong for him so quickly, were also probably lucky, because when they happened in the evening and everything I did didn't comfort him, and then when I was out of options, I'd lay him down in his crib and voila, he went to sleep. I finally concluded he was tired. And over the weeks through his fourth and fifth month as his meltdowns occurred earlier and earlier, and I went from putting him to bed at 9:30 p.m. to eventually putting him to bed at 6:30 p.m., I realized only after the fact that he'd helped me set his bedtime. Had he been just manageable fussy, I might have mistaken his mood for teething, or typical "witching hour" type behavior, and not realized he actually needed to go to bed.

Only months later, after I finally read a sleep training book, did I learn that the moods of "happy" babies shift dramatically between the third and fourth months when the biology of sleep and their needs change, because their poor parents are often a few steps behind in understanding the development of sleep patterns, and the babies, therefore, aren't getting enough quality sleep. By that third or fourth month, the lack of sleep has added up and the baby is cranky...all the time.

Even though Chris and I ended up with a baby who slept through the night rather early on and goes to sleep and down for naps relatively easily, his "good sleeper" designation is relative. Even good sleepers go through developmental milestones that keep them up at times of night their parents had gotten used to them sleeping, or their naps or bedtime are thrown off by a change in their routine or they just mature and need to find a new sleep routine. Or they have parents who think they finally have it all figured out and are completely unaware that the sleep needs are in the process of changing.

While our exacerbation wasn't as dire as those with a baby who won't sleep, we still struggled with naps. Babies don't develop their sleep patterns overnight. It can take weeks or months as they first work on consolidating their night sleep, then their morning naps and later their afternoon naps. We noticed around the fourth month that Oliver consistently wanted to take a nap about an hour and half after he woke up for the day, but it was a months-long process to establish a pattern with his other two naps. And we went three days with some semblance of harmony with a predictable schedule for three naps a day when we realized we should be transitioning him to two naps. Sigh...

And all this lead up to the Sleep Talk. For us moms gathered at my house on that cool summer night to talk about sleep, there was nothing we could do about the mistakes we'd made in the past. We could only move forward, even if that meant correcting the sleep problems we may have created before bringing peaceful nights (and days) to our households. Since sleep is so vital to our emotional and physical well-being and ranks up their with food as necessary for human survival, I look back on the last nearly nine months of Oliver's life and the subject of sleep is one of the top "I wish I had known" subjects. I spent so much time worrying about what I needed for the baby, when I should have devoted some of that time to reading a book on sleep. But I do go easy on myself here, because I don't think I even knew there were books on "sleep training" and I didn't know it was something I needed to learn about.

For parents who've struggled with getting their babies to sleep and finally found some help from a particular author, they are often so thankful, they promote the methods from their particular book or the author like born-agains want you to come to Jesus. For some of us, the book was Dr. Marc Weissbluth's Healthy Sleep Habits, Happy Child. And for a parent who's gone months or even over a year without more than a couple hours of sleep at a time, being able to sleep for a full eight hours is like finding salvation.

I had wished some expecting parents had been able to attend Sleep Talk, because I'd want them to learn from all of our experiences and/or mistakes. So one of my top pieces of advice for expecting parents (and I know I have a lot, but really, pay attention to this one) is to read, or at least skim, a book on sleep training. Go to a bookstore and there will probably be a whole shelf full of books - it really is a much-written-about topic. Skim the books and look for an author whose philosophy jibes with yours, or what you think you'll be like as a parent, or whose recommendations will be realistic given your lifestyle. I'm a huge supporter of libraries and check out dozens of books, but this is one you should buy so you always have it for reference. Then actually read it, or again, at least skim it. If you're a first-time parent, you have a gift you won't have in any sizable quantity until you become an empty-nester - time. The catch-22, of course, is that you do have the time, but not the frame of reference. A lot of the book won't make sense until you actually have a baby and it's 3:00 a.m. and you're on hour number two of trying to soothe your baby to sleep. Until then, you may scoff at something you read and not believe it's necessary or that important, but at least you're giving your brain a chance to file nuggets of information away. And then when you're at wits end about what to do with a baby who won't sleep, that's when you have your "aha" moment and remember some tip some sleep expert had mentioned. Although a lot of parenting is learned by doing it yourself, at least you'll go into this parent thing with an understanding of the sleep needs of babies at different stages.

Every parent who's dangerously sleep-deprived and can't imagine another night with two-hour chunks of sleep looks for the magic bullet. There is none. It's possible to see progress overnight, but nothing will be completely solved. If what you're reading isn't working, it helps to talk to other parents who've read the same book (part of the reason behind hosting the sleep talk) and do some trouble-shooting. It's also a good time to reevaluate whether you're able to diligently follow the recommendations of a particular expert and if it's possible given your situation or parenting philosophy to follow his or her advice.

I laughed when one woman changed her R.S.V.P. to no for Sleep Talk because her five-month-old baby's sleep problems had been solved. Solved for that development phase in the baby's life, I thought. It's not just with sleep, but with every aspect of a baby's development, you think you have it figured out, and then it changes. Our sleep discussion was both an opportunity for trouble-shooting, to try to help each other solve specific problems in the current sleep development stages of our babies' lives, but also learn more about the biology of sleep and sleep development stages. It is with this latter knowledge that we'll be better prepared for future developments.

Thursday, June 17, 2010

I'm anxious when I have to leave Oliver with someone - not because I don't think he's in good hands, but because I feel bad for subjecting a crying baby to the kind soul who offered to babysit. Like many babies experience at one or more points in their first few years, Oliver has separation anxiety. While this emotional milestone is normal, anyone who's going to watch him has to have patience, thick skin (who hasn't held a screaming baby and wondered why the baby doesn't like you?) and an expectation that there will be tears.

I'd put off a dentist appointment for months - a much-needed cleaning after the hormones of pregnancy and breast-feeding had potentially littered my mouth with cavities, and continuing work on a crown, a process I began before I was married - but finally arranged with a couple from my babysitting coop to watch Oliver today. I'd warned them about what to expect and they weren't deterred - they have a ten-month-old and have seen it all themselves.

Despite my own anxieties of how Oliver would do, I felt like we were off to a good start because, by pure timing coincidence, Oliver had just been up from a nap and fed (aren't we all better prepared to take on life's challenges with sleep and food?) when I dropped him off and left him happily playing with the other couple's baby. Immediately after my appointment for the cleaning (no cavities!), I fished my phone out of my purse desperate to see how many missed calls and text messages I had with pleas for me to come rescue them from my crying son. Instead, just one text message - a picture of a happy Oliver and an "All is well!". What a relief!

With the other hour of my appointment postponed because the dentist had called in sick, and a baby who surprisingly wasn't missing mom, I was faced with freedom I haven't felt in awhile. For the next hour and a half, I could do whatever I wanted. Really? So I took my second run since Oliver was born and jogged down Summit Avenue and past the city's historic mansions and then relaxed in the sun in a park overlooking the Mississippi. My post-run lunch and shower at home were that much more enjoyable - in a way only another parent can understand - knowing that I was not going to be interrupted by the abrupt end of my baby's nap.

I returned to pick up Oliver and received the rundown of his time away from mommy and was amazed at how well he did. There were few tears, and in fact, two of the three times he cried was when either my friend or her husband left the room. Sure he still had separation anxiety, but I felt like it was progress that it wasn't just reserved for me.

I was excited to see my adorable little boy again, and he of course was more than happy to have me back. Holding him in my arms again, I realized those three hours away from my parenting responsibilities, even when one of them was spent at the dentist, had an amazing effect on my mood. I was happy and relaxed, as well as relieved that everything had gone well, even if just this once.

Wednesday, June 2, 2010

Oliver update: 8 months

Within just a week of his eight month birthday, Oliver revealed a string of subtle changes. He's gone from cooing to distinctive baby babbling. Right now he says a lot of ah ba, ba, ba....translation still inconclusive. I thought the cooing was cute, but I really enjoy listening to him "talk" more and need to set up the camcorder so I'll be ready when a talkative spell comes on, which is often when he's playing quietly with his toys. He's been able to giggle for awhile now, and has even "laughed" - a deep, bark-like laugh - but yesterday when he laughed, he sounded like a little boy. It was like I had gotten a glimpse into the future with his big boy laugh and I wanted to hear it again, but all I got was a big smile and a squeal.

Oliver now easily and routinely rolls over on his tummy, but just in his crib - when he's supposed to be sleeping. Only once, in the first day or two, did he roll and wedge himself against the side of the crib, oblivious to the fact that he could roll back the other way onto his back. He shrieked and I knew to get up to his room pronto. But every other time I've gone to his room to save him from distress, I've found him on his stomach in the middle of his crib, arms pushing him up - not an uncomfortable position - and crying. Not shrieking, just crying. And every other time I reach into his crib, he rolls over by himself. Frustrating! In the past two or three days, I've found him on his tummy smiling sometimes, but that first week, I routinely spent the first hour or so of his nap or bedtime in a pattern of letting him cry a little, going in to flip him back over, letting him cry a little, going in to flip him back over until he eventually finally fell asleep. His rolling onto his tummy and crying was frustrating and mind-boggling at the same time, but still left me feeling a little relieved that his new abilities are at least a precursor to crawling.

Because he is not crawling, nor is he showing any interest in crawling. Each week that we show up at our ECFE class, another baby is crawling. The Chesla side of the family has been saying that Oliver is going to take after his father by trying to skip crawling and go straight to walking. Sometimes I think he realizes that he's not mobile and that that's a problem for him. When he wants to reach a toy out of his reach, he leans as far forward as he can, supports himself with his hands planted on the floor in front of him and extends one hand out. I've tried giving him a lift, literally, by hoisting his bottom into the air to help him into a crawling position, but that only results in a face plant and a wail. I wait for him to cry out in frustration, but instead the look on his face just says, there's gotta be another way. Have you ever seen a cat fall, regain its footing and then proceed to intently groom itself, as if it were embarrassed it fell and is trying to divert attention away? Eventually Oliver gives up and scans for a closer toy and acts as if he never wanted to play with that other toy anyway.

The warm weather is finally here to stay. Even though it was a warm spring, any Minnesotan knows glorious weather any time through May can be snatched from you overnight. But summer is here for good and those winter days I wrote about in my post about seasonal amnesia really are a distant memory. But shorts and short-sleeve weather brings its own challenges I discovered. I don't know what is worse, bundling you kid up before heading outdoors or having to slather him in sunscreen. In the spring, Oliver wore pants, socks, long sleeves and sometimes a jacket with a hood and I didn't have to worry about much of his delicate baby skin being exposed to otherwise weak rays of spring sun. But applying sunscreen to a squirmy, snotty baby delays our departure time enough to cancel out the time gained by not having to put four layers of outwear on him. Despite the hassle of applying sunscreen, as fair-skinned as I am, I know it's important and meticulously applied as much as was needed for every outing. Then I started noticing the rashes. I thought I had let my son get burned and I was horrified at my irresponsibility. After learning about the difference between sunscreen and sunblock, and a process of elimination, I just recently concluded some (yet unidentified) chemical in sunscreen is the culprit and have resigned myself to buying an expensive sunblock that isn't causing an adverse reaction. I've also been careful about what I put on my own skin that could rub off on him. I've been searching for a good sunhat - one with a wide brim and a flat back so he can wear it in the stroller when his head is leaning against the back - so I can avoid application of the face area.

Wellness checks are now every three months instead of two, so we won't be back to the doctor's until the end of June for his nine-month check-up to learn how much Oliver has grown. I don't think he's in danger of growing out of his 22-lb.-limit infant car seat, but he feels heavier than the just-shy-of-16-pounds he weighed at his 6-month appointment. The pace of his weight gain seems to be outpacing the pace of my increased (I hope) muscle strength from lugging around a baby in my arms every day.

Everyone asks about sleep and I've finally stopped feeling guilty about reporting that he was and still is sleeping through the night. Unfortunately, it's from 6:30 p.m. - 6:30 a.m., which leaves little time for Chris to spend with Oliver in the evening and leaves me continually sleep-deprived even though I have a baby who is sleeping through the night.I believe I had more energy when Oliver was down to one night feeding, because then he'd sleep until 8:30 a.m. or 9:00 a.m. and I had a chance to sleep, and maybe even get a shower and eat breakfast before he woke. But a few weeks ago he his wake up time was creeping earlier and earlier and all the sleep advice I was getting was saying that it's impossible to get a baby to sleep later than his or her biological wake up time. Having already resigned myself to accepting that 6:30 a.m. was his natural wake up time, I was determined to make him stick to it and not 5:40 a.m. Maybe that period of the really early wake-up calls was just a fluke, or he was suddenly really sensitive to sound as Chris was getting ready for work, but eventually I managed to get him back to post-6:00 a.m. wakings.

But he is a good sleeper and I know I'm lucky. I attribute any minor sleep issues to his parents' cluelessness about babies rather than a problem on his part. We've had some struggles with naps and depending upon what week you catch me, I'll either have declared Oliver to be on a predictable nap schedule, or insisted I don't care anymore and am just going to let him sleep when he needs to despite what any book says about babies needing and liking routine and consistency. Since babies consolidate their nighttime sleep first and then their naps, starting with the morning nap, it was that late-afternoon nap, or lack thereof, that was leaving me almost as cranky as the baby every afternoon around 4:00 p.m. He was exhibiting the classic overtired symptoms and I simply couldn't get him to nap. I was exhausted myself by that point of the day, and often hungry and desperate to get dinner started. Oliver would cry, even when I held him, he was so tired and that was the happy family life Chris would arrive home just in time for. Thankfully it was warmer out and we went for a two-week period with no rain, so our saving grace became late-afternoon walks. I was persistent with giving him the opportunity to sleep in the late afternoon, even if he wouldn't let himself sleep, and eventually he was able to fall asleep. At eight months old, I think I can finally say that he does have a nap routine, even if he's not on a predictable schedule. I shoot for 7:30 a.m., 11:00 a.m. and 4:00 p.m., while trying to account for when he's tired and wants to nap earlier, or when where out on a walk or at a playdate, and a nap gets pushed back. He can easily get 4-5 hours worth of naps and day and I've concluded, like his dad, this kid needs to sleep a lot.

For those who read my post on baby-led weaning, you'll know that Oliver has started solids. We're letting him feed himself finger foods instead of spoon-feeding him purees and it wasn't until well into his seventh month when I felt like he "got it." Now that Oliver is taking an afternoon nap and we don't need a walk just to save our sanity and kill time before bedtime, Oliver now sits down with us for dinner. We also don't have to wait anymore for that small window of opportunity - when he's well-rested and has been nursed - to try and feed him solids. He now loves sitting in his booster seat and knows he's getting food. He'll try almost anything we put in front of him, even if one night he'll eat all the zucchini slices he can get his hands on, while the next night he cries as he eats it. (But with baby-led weaning, it's his choice whether to eat the zucchini or not, so we don't understand why he keeps trying to eat it if he's not happy with it.) I know he doesn't need solid food yet in his diet, but I do believe that he wants it and it is helping to fill him up even, whether or not he's made the connection yet between food and feeling full. He still makes a huge mess and the majority of his meal eventually ends up on the floor, but when you eat with him every day like I do, I can see how his dexterity has improved and he can do things like transfer a piece of food from one hand to the other so he can get a better grip or eat the other end of the stick of toast that had previously been covered by the fist of his other hand.