Oliver Update: 2 and a Half Years

At two and a half, Oliver can still be challenging - he's still a toddler - but he generally seems happier.  He's not teething, at least not for the time-being (four molars to go yet) and he's adjusted to having a little brother and being home with a nanny during the week.  If anything is distressing to him, it is that he doesn't understand weekdays and weekends and it must seem random to him that one day he wakes up and mommy and daddy go to work and Ashley comes and then he suddenly doesn't get to see Ashley and vice versa. 

Oliver loves his little brother, Soren.  Yup, I'm purposefully getting that in writing just in case he someday takes after his first-born parents and complains that his little brother is annoying, dorky, an embarrassment, or any combination thereof.  But at this innocent stage in his life, he likes to give Soren hugs and kisses and is respectful of his limitations as a playmate.  Okay, sometimes he snatches toys from Soren's chubby little hands and yells, "That's mine!" (even when it's not) but most of the time he'll bring Soren toys to play with.  Oliver is very attentive of Soren's needs and points out, just in case I hadn't myself noticed, that Soren has woken up, is crying, has spit up, needs his pacifier or is doing tummy time.  The funniest is when he projects his own feelings on Soren tells me what his non-verbal brother is thinking, such as that he misses Daddy or wants to play outside. 

Telling me what Soren is up to is just one part of Oliver's general routine of narrating everything he's doing or what's going on around him.  He chatters up a storm!  To put it in perspective, Chris says Oliver talks as much as his mom.  But don't all toddlers talk incessantly?

The only reason he doesn't talk more is that we think he can't yet talk as fast as he can think.  His pronunciation can still make it difficult sometimes for those who don't spend much time around him to understand him.  There have been times when I've looked at the nanny hoping that she had a translation. 

But you can hear those wheels of language development turning.  He's figured out verb conjugations, but hasn't quite gotten a hang of all of the exceptions to the rules, like saying, "The bird flied away." instead of "The bird flew away."  And he's trying to use logic to figure out new words. He and Chris went over to the park and watched some kids playing hockey.  When Chris asked Oliver what they were doing, he replied, "They're hockeying."  Or he'll say, "That dog is 'woofing' at me."

Oliver surprises us every day with the words he knows.  Some of them we just wonder where he learned, like when he announced to us that he wanted to go to a car wash.  We finally asked the nanny and sure enough, she had gotten her car washed the week before.  Or he'll pick up random phrases from books, but if we don't make the connection to the story, it's impossible to figure out what he's talking about.  His latest phrase is, "I need sumpin." (Translation, "I need something.")  We'd ask him repeatedly what he needed and offered up suggestions.  Then Chris was reading him an often-requested book about a boy getting a new baby brother and when he got to the part about the mom explaining that babies cry when they need something and then she rocked the baby and he settled down, it dawned on us that maybe that was Oliver's way of saying that he need to be hugged or cuddled too. 

Oliver is developing socially too.  We can tell there's a core group of people he always thinking about: his family, the little girl who lives next door, Ashley and her husband Matt, his friends Elsa and Noelle, and Noelle's mom, Dawn.  It used to be that he wanted to play with the girl next door because he just wanted to play with her toys, but he's matured to enjoying her companionship when they're running around outside together. 

While Oliver has a small group of family and friends he feels comfortable around, he's still socially cautious.  I've written before how he's not likely to immediately climb onto a play structure at the park if there are tons of kids on it.  He tends to hang back at first, as if he's figuring out how to read the scene and where he fits in with the group. 

Assessments were conducted on all the kids in Oliver's ECFE class and when the teacher noted that he didn't really play beside others or with others, but rather watched other children and played by himself, my first reaction was to need reassurance that these weren't signs that he's going to be a loner.  Not the slightest, she said.  He was happy and laughed a lot during the class and enjoys being around other children.

And I see this when he's with that group of kids and their parents he feels comfortable with.  It was adorable to watch him play with his friend Flora at the park.  They happily and quietly played in the sand and conducted their own conversation without any meddling from us parents.  Then the playground bully stole Flora's bucket and dumped sand on her head.  While Flora and the other girl tussled over the bucket, Oliver quietly picked up his bucket and shovel and moved away from the bully's orbit and continued to play.  So, yes, he's social in his own way, but clearly not confrontational. 



Oliver continues to have a variety of interests.  He still loves play dough, painting, drawing, watching YouTube videos of any sort of vehicles or music videos of such classics as "The Wheels on the Bus," books, riding his tricycle, playing in the sand with his buckets and shovels, playing in his rice box, kicking and throwing balls, and playing with his "choo choos," cars, trucks and puzzles.   

He still loves to draw, but his scribbles are actually starting to look like identifiable objects.  Not surprisingly, he likes to draw cars.  And even though he has tons of books, he seems to have them all memorized. You can stop reading a book and he can tell you the rest of the plot line.

Since we're going back to Philadelphia to see family for Easter, we sent Oliver in for a haircut.  Three's a charm, because other than some tears when he realized we were going to make him sit in that really high up chair, he sat mostly still and quietly for a haircut.  And each time he emerges from the hairdresser, he looks more and more grown up.  My little boy is getting older before my eyes. 

Through the Eyes of My Kids

Never before have I been so interested in garbage trucks, construction vehicles or really anything on wheels.  But I am, because Oliver is.  When we're out on walks or riding in the car, I've gotten so used to pointing out anything I think would be of interest to him that I find myself doing it when he's not with me. 

"Oh look, a bus!" I'll think to myself. 

And more than once I've excitedly pointed out a squirrel or a passing dog and then look down at Soren snoozing in his stroller and feel a little silly if a passerby heard me and didn't know that I also have a toddler at home and that this type of "sportscasting" is now just habit. 

Everywhere I go, I'm reminded of Oliver.  I cross two sets of train tracks to get to work and think about him every time and how excited he'd be to see the trains parked in the yard.  Or if I go grocery shopping by myself, I notice the kid-sized cart in the cart corral and think how happy Oliver would be to have snagged one of them.  I notice cars that look like mine, or Chris's, or the neighbor's, not just because it's natural to hone in something you're familiar with, but because Oliver can point out any car that looks like the car that someone he knows drives. 

Even though Soren's interests are still few at his young age, I still notice every ceiling fan.  The biggest ceiling fan I've ever seen is in the warehouse section of Ikea, and I never noticed it until after Oliver was born. 

And just when I think how silly it is that I get excited about driving past a construction site, because I look forward to telling Oliver about it, I'm reminded why co-parenting is so special.  Chris told me recently that he has similar reactions to seeing a line of school buses pulling away from a school-building.  This shouldn't have been a surprise to me that Chris is also noticing the world through the eyes of our kids.  He called me every day when he was in London and amidst the reports of how class was that day or whether he had time to do some sightseeing, he'd talk excitedly about the pictures he took for Oliver of London's "funny looking" garbage trucks or with the toy replica of the iconic double-decker bus in front of London's famous sites. 

Oliver's interests will undoubably change as he gets older, but I wonder how long it'll be before I lose the urge to say, "Oh, look what's coming," if I see a fire truck or a school bus driving down the street.

Institute of Child Development Study

Over the weekend Soren had his chance to contribute to the world of research.  Like I had done with Oliver, I enrolled Soren in the Participant Pool with the University of Minnesota's Institute of Child Development.  If your child fits the criteria for participants needed in a study, you're called to ask if you'd like him or her to participate.

Soren participated in a study for 5- to 7-month-olds.  There are four experiments being conducted as part of the study and Soren had the one where he looked at two objects on a computer screen and one object looked like it was on top of the other.  He was shown variations of the same groupings and then shots of the objects separated from each other.  The theory was that when the objects are separated, he'd look at the object that was "on top" first.  What this all means?  I guess I'll have to wait for the study to be published and read it.

I have no idea how much data they got from him though.  He sat on my lap in front of the computer screen and I wore sunglasses blackened out so I couldn't see what Soren was seeing and inadvertently influence him.  Before each image was displayed, the computer beeped to catch Soren's attention.  The beeping went on forever between each image, and then the researcher usually had to call Soren's name to cajole him into looking up.  She clearly wasn't having success at one point and I asked her what he was doing and she laughed and said, "He's looking at his shoes!"

I lifted my glasses a little to take a peek and there he was, looking ecstatic that he'd just discovered his feet.  He seemed more interested in trying to bend over as far as possible so he could stuff his feet in his mouth.  Since Soren likes standing, I stood him up on my lap to see if that would distract him from his feet.  Based on how slobbery his hands felt, I presumed he finished up the experiment with his fists stuffed in his mouth. I had signed a release allowing the tape recording of Soren's experiment to be used at conferences or anything else in conjunction with sharing the results of the study, but something tells me his video won't be used. The graduate student running the experiment had already worked with dozens of babies for this study before meeting Soren, so she knew how these kids just have minds of their own. 

Other than a few whimpers during the experiment, (I have no idea what he was crying about since I couldn't see) Soren enjoyed his time over at the U.  He liked looking around the lab and smiling at the graduate students.  He even let one of them hold him while I got us ready to go. 

As we walked back to the car, I thought about how despite how minor Soren's roll was in the study, he had helped out a bunch of students and their professor.  And so my kids remain enrolled in the Participant Pool with the hope that their names would be drawn again soon.

What's for Dinner?

Frozen pizza never tastes so good than when it's made by one of the members of our meal exchange.  After a busy day of weekend chores and time spent enjoying summer-like weather in March, Chris left this afternoon for softball practice before dinner and I was on my own with the kids until bedtime.  I hadn't even thought about what to do for dinner until that point, so thankfully, I had a stash of meal exchange meals in the freezer.  I pulled out a pizza, turned on the oven, and then headed upstairs to give the kids baths while our gourmet, made-from-scratch dinner baked. 

So many nights are like this.  Weekdays are of course the craziest.  It's fortunate that Chris and I are both home before 5:00 p.m., but that still doesn't allow us much more than time to feed the baby, set the table and either microwave or bake already-prepared food.  Maybe, just maybe, we'll have time to prepare a salad or other simple side dish.  Dinner prep was a little easier when I was home with the kids, but not by much, since taking care of little kids who couldn't entertain themselves for more than a minute left little time for much of anything.  Weekends end up being a blur of doing all the things we don't have time for during the week. 

When my friends and I, all of whom had young children, realized we were all experiencing similar levels of chaos at dinner time, the meal exchange was born.  For a year and a half now, we've undertaken the communal effort of feeding our families homemade meals.  The meal exchange has become a way of life and is something I'm grateful for, even in those months when I feel like I'm running out of time and am too overwhelmed to pull together such large quantities of food in one fell swoop.  But then when we all gather and I hear about the delicious meals everyone has made and I catch up with friends I haven't seen all month, I'm reminded how the committment to the meal exchange is worth it.

I've realized other benefits I hadn't anticipated.  I've lived abroad and have many friends from other countries and enjoy experiencing new cuisines.  It's easy to forget that even within my own culture there is such a variety of food traditions and it's been fun experiencing the food preferences and culinary styles of the other participating families.  Some people tended to cook comfort foods, while others brought dishes I had never heard of.  Over all these months, we've had multiple versions of lasagna, pizza, enchiladas, chili and Tator Tot Hotdish, yet they have reflected the cooking styles of the individual participants.  Some of these dishes have become part of my family's regular rotation. 


As much as we all rave about our meal exchange to our friends, we have experienced some growing pains along the way.  Our group almost split in two, as the vegetarian and vegans were no longer participating in the "anything goes" month and the meat-lovers were admitting they weren't as satisfied with the alternating vegetarian months.  A split would have been a disappointment, because while we all wanted meals we'd truly enjoy, the monthly exchanges are as much for socializing as they are for restocking our freezers.

We kept the group together by switching from an exchange format to a swap.  Instead of bringing enough meals for everyone participating, we bring a set number of meals, and then going in rounds, we choose what meals we want.  This format takes a little longer, but we realized it's workable if we have someone designated to manage the process and make sure everyone has chosen a meal before starting the next round.  It has also allowed us to include more people since the "subs," friends we had made in ECFE or a moms group, had become devoted partipants.

One thing has changed in the last year and a half.  Many of our families have gotten bigger!  Most of us met in a group for new parents at a local hospital when our first kids were born, and since then, many of us have added a second kid to the mix.  If we didn't think life could possibly get busier, it did.  Although the more meals for our freezer, the better, a few months ago, we finally started admitting to each other that making nine, four-serving meals every month was becoming too much.  So the other major change to our format is that we're only bringing six meals each month instead of nine.  Six sounds like a lot, but after making nine meals, six seems easy!

Thoughts on Pumping

When I decided to go back to work, one of the logistics of being a working mom I really was not looking forward to was pumping.  I told myself I'd give it a try and see how it went.  Unless I worked from home or had my own office with a locking door, I don't think my situation could be more conducive to pumping.  I have a private room reserved for nursing moms, a consistent work schedule, a pumping schedule I can decide for on my own and a boss who wrote her dissertation on the economics of breastfeeding.  And on the few occasions I'd forgotten to take my expressed milk home the night before, the nanny has dropped by my office on her way to take the kids somewhere.

Although pumping has gone really well, I do wonder if my work environment had been even slightly inconvenient for pumping, whether I would have stuck with it.  If I weren't able to take pumping breaks as needed, but instead had to divide my lunch break to be able to pump, I have to say that I'd probably pick socializing with co-workers at lunch or going to the gym and utilizing the precious limited time to do something parents so often have zero time to do: workout.  Or if I had to take a pay cut because I was only allowed unpaid time to pump or had to work an extra hour each day to make up for pumping breaks, I don't think I'd continue.  Since I'm breastfeeding when not at work, and am barely pumping enough to feed Soren the next day, two bottles of milk just wouldn't be worth the extra effort or inconveniences. I don't think I'm selfish for thinking this way, just lucky that I'm experiencing the type of work environment every nursing mom should have.

Soren update: 5 months

On the sheet handed out at Soren's four-month wellness visit, it stated, "This is considered one of the most social ages in infancy.  Enjoy introducing your baby to new people and watching that smile."

True to his age, Soren has been a social baby.  He loves smiling at people and it's easy to get him going by talking to him in excited baby talk and showing off an exaggerated smile.  Although Chris thinks he's shown the first signs of separation anxiety, he's otherwise been comfortable with others until this point and likes to be held. 

The one sure-fire way to get Soren to laugh is to tickle his belly.  He's really ticklish!  (Just like his mom!) When he went in for his appointment at four months, the pediatrician commented on how ticklish he is. 

At four months Soren had just started to roll over from stomach to back.  But by the end of the month he had abandoned that skill for rolling from his back to his stomach.  If you place him on his back on the floor, it doesn't take him long until he flips to his stomach, where he enjoys a better view of Oliver playing.  Unless distracted by Oliver, Soren acts as if landing in the tummy-time position had taken him by surprise and he cries, which is why I say he seems to have forgotten how to roll back onto his back, because otherwise, he should know how to get out of this predicament.  So while it's fun to watch Soren flip onto his tummy, his revelation of this new skill resulted in some bad sleep for a few days. 

Soren has pretty much outgrown his bouncy chair, but he can't sit up on his own yet and if we put him on his back on the floor to play, he rolls onto his stomach, which then leads to cries for help.  So for the time-being, we're stuck carrying him around or balancing him on our laps while trying to eat dinner.  He can sit up by himself unassisted for a few seconds with the support of the Boppy, and I know Oliver could sit in his booster seat by six months, so hopefully we're just a few weeks away from the next stage of physical development.

I have tons of pictures of my kids up in my office, so my co-workers know what they look like, but when I ran into one of them when I was out with Soren and pulled off his hat so he could get a better look, he exclaimed, "The kid's got no hair!"  Just like his parents and his brother as babies, Soren's a baldy, and I don't expect him to grow much hair for another year.  I have a friend whose baby was born ready for a haircut, but not so for any kids of mine. 

Everywhere I go with Soren, I still get tons of comments from strangers about what a beautiful/cute/darling baby he is.  Some even comment on his "big" eyes, although Oliver elicited many more of those observations.  And I still can't help but be proud, even though I had no say in what mix of genes he got.  Just like with Oliver, I feel sad that he'll one day no longer be "that cute little baby."

My validation for making Oliver brush his teeth

Yesterday's New York Times article "Preschoolers in Surgery for a Mouthful of Cavities" (reprinted below) was timely given that Oliver has recently been to the dentist.  I wasn't worried that he had a mouthful of cavities, (at least I hope not since we didn't get x-rays to double check) but given that instilling good oral hygiene habits in him has been a challenge, the article was a reminder to keep up the regimine.  And to keep after my husband, in-laws and the nanny to encourage the habits that protect teeth. 

New York Times

March 6, 2012

Preschoolers in Surgery for a Mouthful of Cavities

By CATHERINE SAINT LOUIS

SEATTLE — In the surgical wing of the Center for Pediatric Dentistry at Seattle Children’s Hospital, Devon Koester, 2 ½ years old, was resting last month in his mother’s arms as an anesthesiologist held a bubble-gum-scented mask over his face to put him under. The doctors then took X-rays, which showed that 11 of his 20 baby teeth had cavities. Then his pediatric dentist extracted two incisors, performed a root canal on a molar, and gave the rest fillings and crowns.

Devon’s mother, Melody Koester, a homemaker from Stanwood, Wash., and her husband, Matthew, an information technology manager, said they began worrying about brushing Devon’s teeth only after Mrs. Koester noticed they were discolored when he was 18 months old. “I had a lot on my mind, and brushing his teeth was an extra thing I didn’t think about at night,” she said.

The number of preschoolers requiring extensive dental work suggests that many other parents make the same mistake. The Centers for Disease Control and Prevention noted an increase, the first in 40 years, in the number of preschoolers with cavities in a study five years ago. But dentists nationwide say they are seeing more preschoolers at all income levels with 6 to 10 cavities or more. The level of decay, they added, is so severe that they often recommend using general anesthesia because young children are unlikely to sit through such extensive procedures while they are awake.

There is no central clearinghouse for data on the number of young children undergoing general anesthesia to treat multiple cavities, but interviews with 20 dentists and others in the field of dental surgery suggest that the problem is widespread.

“We have had a huge increase in kids going to the operating room,” said Dr. Jonathan Shenkin, a pediatric dentist in Augusta, Me., and a spokesman for the American Dental Association. “We’re treating more kids more aggressively earlier.”

But such operations are largely preventable, he said. “I have parents tell me all the time, ‘No one told us when to go to the dentist, when we should start using fluoride toothpaste’ — all this basic information to combat the No. 1 chronic disease in children.”

Dentists offer a number of reasons so many preschoolers suffer from such extensive dental decay. Though they are not necessarily new, they have combined to create a growing problem: endless snacking and juice or other sweet drinks at bedtime, parents who choose bottled water rather than fluoridated tap water for their children, and a lack of awareness that infants should, according to pediatric experts, visit a dentist by age 1 to be assessed for future cavity risk, even though they may have only a few teeth.

And because some toddlers dislike tooth-brushing, some parents do not enforce it. “Let’s say a child is 1 ½, and the child screams when they get their teeth cleaned,” said Dr. Jed Best, a pediatric dentist in Manhattan. “Some parents say, ‘I don’t want my little darling to be traumatized.’ The metaphor I give them is, ‘I’d much rather have a kid cry with a soft toothbrush than when I have to drill a cavity.’ ”

Dental decay often starts with a dull ache that may be mistaken for teething. That is why parents do not realize their child’s teeth are infected until they break or the pain becomes so acute that the child cannot sleep, said Dr. Joel Berg, director of the Center for Pediatric Dentistry, a joint venture since 2010 between the University of Washington and Seattle Children’s Hospital, which built a surgical wing because of the demand for oral surgery for preschoolers.

With a cooperative child, a cavity — or even many — can be treated in a dentist’s office with an injection of local anesthesia and an episode of “The Backyardigans” to distract patients.

But dentists routinely recommend general anesthesia for preschoolers with extensive problems, particularly if they will not even let X-rays be taken. The cost to parents for dental restoration under general anesthesia for a child ranges from $2,000 to $5,000 or more, depending on insurance coverage and the amount of work, several dentists said.

Dr. Megann Smiley, a dentist-anesthesiologist at Nationwide Children’s Hospital in Columbus, Ohio, is used to hearing parents question the need for general anesthesia to fix their children’s infected teeth. “It seems like putting a match out with a fire hydrant,” Dr. Smiley said. “But if any of us tried to get 12 teeth treated, we wouldn’t think that’s small.”       

The dental surgery center at Nationwide has three operating rooms, which staff members and local dentists used to treat roughly 2,525 children in 2011, 6 percent more than in 2010. The average age of patients is 4, and most have decay in six to eight teeth, she said.

“The most severe cases have 12 or 16, which is seen several times a week,” Dr. Smiley added.

Using general anesthesia on healthy children has risks, including vomiting and nausea, and, in very rare cases, brain damage or death. Using anti-anxiety drugs to relax a child coupled with local anesthesia for pain has risks, too, including an overdose that could suppress breathing.       

Hannah Schwartz of Brooklyn refused general anesthesia for her 3 ½-year-old daughter, Alice. By then, one of Alice’s eight cavities had already been treated in a dentist’s office using a papoose board to immobilize her from head to ankle with straps. Her daughter screamed, “Take it off me!” for the 20-minute procedure, said Ms. Schwartz, a nursing student.    

 

Afterward, “I left the room and burst into tears without Alice seeing,” she said, adding that she would try a third option, laughing gas.

Of course, the lack of money or insurance can be an issue, but several dentists in interviews nationwide attributed extensive cavities in part to lax parenting, at all income levels.

“It’s not just about kids in poverty, though kids of lower socioeconomic status tend to get more cavities,” said Dr. Rochelle Lindemeyer, director of the pediatric dentistry residency program at Children’s Hospital of Philadelphia and the University of Pennsylvania dental school. Affluent families may have nannies who “pacify kids by giving them a sippy cup all day,” Dr. Lindemeyer said.

Brushing teeth twice a day used to be nonnegotiable, she said, but not anymore. “Some parents say: ‘He doesn’t want his teeth brushed. We’ll wait until he’s more emotionally mature.’ It’s baffling,” she added.       

Dr. Man Wai Ng , the dentist in chief at Children’s Hospital Boston, said she heard parents, rich and poor, make similar rationalizations about their preschoolers’ snacking, like, “I can’t ever imagine Johnny being hungry, so I’m laying out a whole-wheat spread that’s always available.”

With a grant from the DentaQuest Institute, Dr. Ng started a disease-management program to alter the habits of parents of children with cavities so some could avoid the operating room. Her advice includes less frequent snacks, and only four ounces of juice a day. She does not forbid sweets, but suggests brushing afterward, and bacteria-killing Xylitol lollipops.       

Multiple studies have shown that even children who undergo general anesthesia to treat dental decay end up with cavities again. Janine Costantini, the ambulatory practice director at Children’s Hospital Colorado, said the staff treated a 3-year-old who was making his second visit to the operating room for dental work. The boy arrived with a bottle of Coca-Cola.