Daddy and Peter Share Tummy Time

I kind of think Mark is showing off.

Uncle Joe

As promised, dear reader, more in the Aunties and Uncles department. Here is Peter spending some quality time with his Uncle Joe (who is way, way too well-dressed for the occasion):

Putting Peter Down (Redux)

I thought, dear reader, that I would update you on the status of Operation Parental Sleep, lest you remain concerned about my health and that of dear husband. The bottom line is this: Peter now sleeps pretty much as I imagine all babies his (corrected ...) age do. That is, we do in fact put him down, in a bassinet (which resides in the play yard on loan from Auntie Amber - thank you!), and he does in fact drift off to sleep for a few hours at a time before waking up hungry. On a good night, he goes to bed just before we do (in the 9:30 - 10 p.m. range), wakes up once in the wee hours, and is fed up with being by himself by 6 or 7 a.m. (at which point he demands to be cuddled). On a bad night, of course, he wakes more frequently, and I will usually try to guilt Mark into getting up with him once or, if I'm feeling particularly lazy, twice (you see, dear reader, there's a very involved process that goes into feeding Peter these days, incorporating bottle-feeding and some quality time with ye olde double electric breast pump, but that is a matter for another post). Suffice to say that we are now in normal-new-parent territory, and out of holding-our-child-around-the-clock land (a place to which we hope never to return, cuddly as it may be). Weird thing is, though Peter seems perfectly content to sleep in his bassinet at night now, he staunchly refuses to nap there during the day. He prefers to do so in his infant seat (in other news, Peter seems genuinely to love sitting in the infant seat while awake, which is also a welcome development), which is all well and good but for the fact that, infant seats not being exactly SIDS-proof sleep locales, the arrangement requires my constant vigil. Here is Peter napping in his preferred venue:

Aunties and Uncles

In addition to the wide array of individuals to whom I refer as "Auntie This" and "Uncle That", Peter has an extensive selection of actual aunties and uncles with whom to spend his time. Here are just a few: Auntie Megg

Peter tells his Auntie Megg a story during a recent visit from Calgary.

Uncle Scott

Peter and his Uncle Scott do "Blue Steel".

Auntie Liane

Peter making eyes at his Auntie Liane. Liane is all set to go back to med school after spending a couple of weeks with us. We will miss her lots.

***

That's it for now, dear reader. Stay tuned for future posts, in which I will introduce you to Peter's Uncles Chris, Nick and Joe and his Aunties Esti and Meghan L ...

Windows

Better than television.

Face Time

When we met with Peter's developmental follow-up team at Sunnybrook, they gave us two homework assignments. One was Tummy Time, to which you've been introduced, dear reader, in another post. The second mission was what we call Face Time, which consists of making sustained eye contact with the Peanut. According to the follow-up team, eye contact is a critical skill that is essential to parent-infant attachment and forms the basis for social development and learning. The trick to Face Time is catching Peter during one of his Magic Baby Moments, during which he is suddenly calm, alert, bright, beautiful, and generally a pleasant little guy. During these moments, Peter will now look at us like we're people, and sometimes grace us with great big smiles, like this one:

Dr. Morty

I wanted to introduce you, dear reader, to Peter's wonderful Paediatrician (a.k.a. the Peteratrician), Dr. Morty. In addition to being an excellent Paediatrician (see his all-star ratings on ratemds.com), Dr. Morty is Esti's dad. You'll remember Esti, dear reader, as brother Joe's lovely and charming fiancee, to whom I introduced you in a previous post. Dr. Morty has been a lifesaver since Peter's discharge from the NICU by allowing us to bring him in for frequent weigh-ins, referring us to a wonderful lactation consultant, making adjustments to Peter's meds (sometimes late at night or on the weekend ...), and generally providing reassurance and top-quality health care. Additionally, Dr. Morty is lots of fun. He and his lovely and charming wife Elaine (a.k.a. Esti's mom) came to visit us at home a couple of weekends ago. To my delight, Peter was on his best behaviour. He sat in his chair and made eyes at everyone, then performed an all-star tummy session, ate, and promptly went to sleep. Also to my delight, Dr. Morty and Elaine brought Peter a Bumbo seat, which is on the list of recommended gear provided by the developmental follow-up team (not to be used until Peter is a little older and wiser, of course). Lest you tire of so much text sans illustration, dear reader, here are Dr. Morty and Esti (Peter is just off to the right, out of the frame):

The Other Other Shoe

As the parent of an extremely premature infant (or, I imagine, of any baby who's had a particularly rough start to life), you spend a lot of time waiting for the other shoe to drop. In my case, when I'm feeling particularly sorry for myself about the run of bad luck I've had in the childbearing department, I think of it as the "other other shoe". The other other shoe reared its ugly head on Friday, when Mark and I brought Peter to his follow-up appointment with his cardiologist, Dr. Ra Han, at St. Mike's. You see, dear reader, when Peter was in the NICU, he was identified as having a small patent ductus arteriosus (PDA). The ductus arteriosus is an artery involved in fetal blood circulation. Because a baby in the womb gets oxygenated blood from its mom, it doesn't need to oxygenate blood through its lungs (i.e., breathe). So, in fetal circulation, the ductus arteriosus diverts blood away from the lungs to the rest of the body. Once a baby is born, the ductus arteriosus begins to close. However, in some babies, and especially in premature babes, it remains open or partially open, called a "patent" ductus arteriosus, or PDA. Here is what a PDA looks like, compared to a normal heart (diagram is from the U.S. National Institutes of Health): The problem with a PDA is that some oxygenated blood gets mixed in with the deoxygenated blood in the pulmonary artery, where it is pumped to the lungs and, essentially, reoxygenated, rather than being pumped out to the rest of the body. In other words, to the extent of the diverted blood flow, the heart is doing double the work. This can put strain on the heart and lead to congestive heart failure. So, dear reader, as I was saying, when Peter was in the NICU, he was identified as having a small (about a mm) PDA. Since his PDA seemed to be asymptomatic (i.e., he had no signs of congestive heart failure), and since he did not respond to the use of drugs to help it close, Dr. Han decided that the best course of action was to do nothing and wait for it to close on its own (which it usually does). She scheduled a follow-up for three months from the time Peter was discharged from Sunnybrook to level 2 care, which then seemed a lifetime away. Until now, we had been hopeful that Peter's PDA had indeed closed on its own, and all of his doctors at St. Joe's had assured us that they thought it had. In fact, Dr. Han also assumed that was the case when she examined him on Friday, but performed an echocardiogram (which is an ultrasound picture of the heart) to be sure. As it turns out, the PDA is still there. This means that, for now, Peter still needs to be monitored. If he starts to show any signs of congestive heart failure (e.g., he has trouble eating or gaining weight), or if the duct doesn't close on its own in the next six months or so, then he will need to have a procedure to close it. The good news is that, now that Peter's a little bigger, that would not mean surgery. Rather, the PDA can be closed through a non-invasive procedure whereby a catheter is inserted up through the groin into the heart, as explained here, on the Sick Kids website. All of which is to say, dear reader, that it looks like this is not the other other shoe just yet. It's just that it stinks just a little bit to know that you have to watch your son for signs of something as scary-sounding as congestive heart failure. It also stinks to know that Peter's little heart is, to some extent, working twice as hard as it needs to. As if he didn't have enough to worry about.

The Ground Shifts (or, He Sleeps)

So, dear reader, you may be one of those who has expressed concern over young Peter's poor sleeping, or perhaps you've ventured a suggestion or two. Let me give you an update; so much has happened in the putting-Peter-down department that it's hard to know where to start.

Actually, that's not true: it all started a week ago Saturday. I was rocking a very fussy Peter in the nursery, covered in spit-up, as is my habit. Mark was taking longer than expected picking up some tiles for our bathroom reno, and we were late for a barbecue at my parents' place. To cut a long story short, dear reader, I was fed up. I decided to apply the classic, time-tested advice for such situations, and put Peter down in his crib for a moment whether he liked it or not, so that I could change my shirt, pee, and take a deep breath or three. Moments later, I found myself rushing back in to the nursery, certain that something was wrong: Peter had stopped crying. When I came in, I found him lying on his back, gazing contentedly at the black-and-white mobile that Mark and I had been sure was a complete dud, such was Peter's lack of interest in it. Mesmerized, Peter held that posture for the next twenty minutes or so, until Mark finally returned.

Then something else happened. Mark and I packed Master Peter into his car seat for the trip over to Mom and Dad's. Peter fell asleep during the trip over, as he is wont to do. As he is not wont to do, however, he stayed asleep for the next hour or so, while Mark and I had our dinner. Together. Without Peter in our arms. Here is the proof:

And here are Uncle Joe and Auntie Esti's reactions to Peter's behaviour (Esti, Joe's lovely and charming fiancee, is impressed but Joe, being a skeptic, is suspicious):

It didn't stop there. For one thing, Mark continued to be able to put Peter down in the Amby Bed for one 2-hour stretch or so at night (my strategy of using CBC talk radio podcasts as white noise was less successful, despite being scientifically justifiable). For another, last Monday, I was able to sit Peter down in the vibrating chair for an hour-long nap, with a bonus half-hour of contented quiet time:

And then, dear reader, something truly magical happened. Last Tuesday night, Peter slept in the Amby Bed, in our room, for 4.5 hours. In a row. I have never felt so refreshed (actually, I was initially mostly terrified, so sure was I that the young lad had stopped breathing, and I continued to feel a bit rattled for the rest of the night). I was full of hope that our sleep problems had been solved. Until, that is, the doom-and-gloom team at the developmental follow-up clinic stepped in. Not only did they pronounce the Amby Bed to be unsafe for a preemie (this, an interesting development, given that I had encountered the hammock in Dr. Sears's The Premature Baby Book, in which he specifically endorses it for such a babe), but they also made us feel like pretty much The Worst Parents In The World for not having gotten Peter into a Healthy Sleep Pattern. For those who are wondering, a Healthy Sleep Pattern involves placing your still-awake infant, unswaddled, flat on his back in a crib, with no blankets, pillows, or sleep positioners of any kind, in which position said infant, if properly parented, will promptly soothe himself to sleep (actual parents, or actual human beings who have ever tried to get yourselves to sleep, you can stop laughing now).

Since then, with hopes dashed and egos crushed, we have been doggedly trying to put Peter down to sleep at night in a play yard bassinet next to our bed. We have realized a couple of things. First, Peter doesn't actually have to be sleeping when we put him down, so long as he is sleepy. With his beloved pacifier in mouth (a rather high-maintenance prop, since he isn't awesome at keeping it there for prolonged periods), he very often does doze off on his own under the right circumstances. Second, the lad seems to be getting a little more comfortable in his own skin, and doesn't flail about and lose his mind when placed on his back in quite the same way as he did when we first brought him home. All of which is to say, Peter has in fact been sleeping, though sporadically, in his own bed for the last several days. Last night, he even managed to do so for a 3.5 hour stretch ... no, not quite continuously (I had to reach over and replace the pacifier a few times), but it's a good start.

Great Grandma and Poppa Visit

Some photos from Peter's first visit with his Great Grandma and Great Poppa, my paternal grandparents. Peter was initially on his best behaviour, even throwing my Grandma a couple of perhaps-smiles (Dr. Morty, whom you'll meet in another post, dear reader, assures us that we are not to expect smiles until 6-8 weeks corrected age, so we're probably imagining things):

Then, naturally, this happened:

Hilariously, my Poppa had Peter in his arms for all of 1.5 seconds before getting jittery and passing him back to Grandma:

And finally, my Grandma and Poppa with their first grandchild and first great-grandchild:

Play Date with Michelle and Jocelyn

While I'm catching up on posting, here are a couple of photos from Peter and my very first play date, with his Auntie Michelle and the very adorable Jocelyn (who is the prototypical Beautiful Baby). Michelle had a whole bag of toys for Jocelyn to play with but, to my amusement, she preferred the paper Wendy's bag and the plastic sterile pee bottle (Toys 'r Us, take note).

Stop ... Tummy Time

This week Mark and I carted Peter back to his birthplace for his first appointment at the Sunnybrook Neonatal Follow-up Clinic. It was a very exciting and emotionally-charged day, as we had not been back to our old stomping ground since Peter was still a long way from coming home. More importantly, it was our first meeting with Peter's initial follow-up team, which consists of a developmental paediatrician, a nurse practitioner, and a physical therapist. They will be monitoring Peter until he reaches school age so that, if he struggles with developmental challenges (common amongst extremely premature infants), they can intervene on a timely basis. Later on, there will be other health professionals involved to track things like speech-language development, but for now the focus is on growth and movement as well as very basic social development. So far, so good: Peter's weight, length and head circumference are within normal range for his corrected age (i.e., the age that he would be if he had been born on his due date instead of three months earlier), and, although he shows some abdominal weakness (typical for a premature infant), his variety of movement and ability to make eye contact are also appropriate. Both the appointment and the literature that they sent home with us were fabulous because they provided explanations for certain of the specific issues that Peter deals with (parents of premature babies, take note: grunting is typical and is caused by straining to poop because the abdominal muscles are weak - the solution is tummy time - see below) and also gave us concrete things that we can do to help him along. What was less fabulous was the fact that said literature, which in many instances refers to things you should start doing as soon as your baby is discharged from the hospital, was not provided to us until 6 weeks after Peter's homecoming. Naturally, we have been feeling guilty about all the things we could and should have been doing up until now, including much more tummy time. We've been making up for lost time: below, a video of a particularly successful tummy time session.

Tummy time does not usually go this well: about 80% of the time, Master Peter despises the prone position (unless he has his pacifier in his mouth, in which case he promptly dozes off, which sort of defeats the purpose). However, since we've been told that doing 6-8 daily sessions of tummy time is critical to developing abdominal strength and gross motor skills, we persist. You can thank us later, son.