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Thursday, May 2, 2013

Six Months

Half a year ago our world was changed. Six short months ago we welcomed baby cadence into this world. I can't believe time has flown by so quickly!

She is moving along great! The cranial helmet has not slowed her down at all- she doesn't mind wearing it. She hates putting it on and taking it off, but she same statement can be said for clothing so it's not isolated- she just doesn't like anything moving on/around her head. Particular!

Stats from her six month appointment:
weight: 15 lbs (50th %tile)
height: 26 in (50th %tile)
head: 98th percentile. Yep- still has a huge noggin!

Eating: She is doing fantastic with foods! Well most foods.... she has shared her aversion to carrots and zucchini (i.e. she SPITS them out on you). She has a pretty good schedule: wakes up around 6:30 and nurses. Goes to school around 7:30, receives breakfast food (either a fruit or oatmeal/rice cereal) and 3 breastmilk bottles at daycare, come home and has a snack of puffs (will explain those later), and a dinner of a vegetable/fruit mix, and nurses before bedtime.

*This morning, little lady decided to be brave. She bit mommy when she was done nursing. It hurt. Quite a lot. The first time it startled me, the second time I knew better. I pulled her back and firmly said "no, that hurts mommy". Poor pouty baby face commenced... with her bottom lip stuck out and quivering and the look of concern between her eyes. It broke my heart. But baby cannot be biting mommy, that is NOT cool. She did well with nursing tonight- no nibbles. We shall see how this story transpires... so far she only has two bottom teeth, but I have a feeling that she will soon be cutting upper teeth. :(

So cereal puffs, we started those last week. She started reaching for her food bowl and if her fingers got in the "dinner", she would then stick them in her mouth. So we got some puffs and laid them out in front of her (they are similar to cheerios, except they are made for younger babies and dissolve quickly once in their mouth, or a sweaty palm). The first time, she reached out and picked up all four puffs in one hand and couldn't figure out how to get them out of her sweaty palm. She has now mastered picking them up with the "three-finger pinch" and can effectively get them to her mouth 100% of the time, and in her mouth and eaten about 80% of the time. We usually find a few on the floor, or stuck to her pants. or her face. or her neck. or her helmet.....

Developmentally she is doing great. She can roll.... across the floor.... She can "belicopter", which is when she rolls over onto her belly and rotate around in a circle. She understands the concept of moving forward (she rocks to one side and trys to get a leg up underneath her), but she doesn't have the strength/coordination to propel herself forward. This is a source of frustration, and she will certainly let you know that she is frustrated. Quite loudly.
She can pick up things with both hands, but will usually reach with her right hand first. She has fed herself a few times with her left hand, but it's mostly her right.
She is almost sitting up. She can lean forward and put weight on her hands, but when she picks something up she loses her balance and will fall to the side.

She is resourceful. She was in her bouncy seat which has birds on a moblie above it. She really wanted to make the birds "fly", but she couldn't reach. So she picked up a rattle, and used it as a device to hit the bird and make it fly. Smart baby. She plays peek a boo well, and if you ask her "where's daddy", she will turn her head to look at places where daddy usually stands. She has said "da-da" a few times, and she likes to call "DADA" when she's upset and wants a cuddle. She is more talkative in the mornings, and likes to say "hey, hey, hey" on the way to school with nana. She does not like it if you don't talk back, so she will say "hey" softly once, and then "HEY" a little firmer to let you know that she wants you to say "hey" back. Sometimes it sounds like she says "yeah", and sometimes she will say "babdadabalababa". She giggles, and it is the cutest thing ever.

She has a boyfriend at school. Baby Josiah, every time they are placed next to each other they will hold hands and play together. His parents refer to Cadence as "his girlfriend", and we even have the teachers calling them boyfriend and girlfriend. It's cute. I think JR is a little concerned, but he's just being protective over his baby girl!

Sleep: oh wow this baby can sleep! She goes to bed around 8:30. Unless she's showing signs of being sleepy earlier. But usually it's around 8:00 - 8:30. And she sleeps until at least 6:30. If she wakes up, she will play with Lucy until I go in to get her in the morning around 6:30. She is such a happy baby in the morning- she smiles and reaches for me when I walk in the room. If she's sleeping and I have to wake her up, she may grumble for a minute, but then will smile and be ready to go.

Her hair is filling in... mid-tone blonde with a hint of red, especially when she's in a bright light or outside in the sun.

We are planning on having six month pictures taken outside this coming sunday- so hopefully the weather cooperates!


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Sunday, April 14, 2013

Heads up

Plagiocephaly/Brachycephaly

So Cadence wore the Pavlik harness (hip brace) for six weeks full time, and then six weeks at night- for a total of three months in the brace.  Three months that seemed like forever, but in the grand scheme of things were not that long and gave cadence the support she needed to have full hip healing.

During that time, she was not able to move around or roll from side to side, and placement was very limited (either she was being held or she was lying down).  She developed a little bit of a flat spot on one side of the back of her head, and the pediatrician noticed it at her four month appointment.  Since she had been out of the brace for a month, I was able to tell a difference in the significance of the flatness. We decided to watch it over the next two months to see if over time it would diminish. 

The shaping became more rounded out over the two months because she was able to start sitting in the bumbo and can spend more time on her tummy, but there is still an asymmetrical shape to the back of her head.  So I went ahead and called the pediatrician for a referral to an orthotist to be fit for a cranial band (cranial helmet).

I'm sure you have seen babies out in public with these helmets on.  It is not a big deal.  There is nothing neurologically wrong with cadence. She will not wear the helmet for a long time, it is not for "padding" of her skull.  It will simply round out the back of her skull.

So I figure a lot of people have questions.   Let me explain what the orthotist (a guy who makes braces and splints) found. 

He did a scan* of cadences head and found mild plagiocephaly and severe unilateral (one sided) brachycephaly.  Anatomical landmarks:  Looking down on the crown of her head, her right ear is more forward than the left.  Looking at the back of her head, her head appears to have a slight curve to the left.  Her left forehead is ever so slightly more pronounced than her right.

***(It was a digital scan.  The old school way of making braces involved a plaster cast, mold, and set cast and lots of adjustments afterwards.  It is now computerized and fabricated with more accuracy than the plaster molds)
He measured her head circumference and compared it to her birth and 4 month measures and set a plot to estimate her head growth amounts for the next six months.  In order to round out and be symmetrical, she needs 6mm of growth.  In line with her charts, he estimates this to take 2-3 months.


So here are some questions I anticipate people having:
1. How long does she have to wear the helmet?  For 2-3 months, or until results are seen and measurable.
2. Does she wear it all day every day? Initially she will have to build up to a full days wear.  But yes, she will wear it for 23 hours a day (like she did the hip brace).
3. Why now? We could wait a few more months to see if it rounds out on its own, but the longer we wait, the more difficult the process becomes.  As she ages, her skull is becoming closer to fusing (closing of the soft spot at the top and becoming less pliable/moldable).  As this is the case, the duration of the wear could have been extended. I don't feel like it will round out on it's own and I don't really want to risk the chance
4. Why is the head shape so important? Well there are little things - like her future image of herself if her head is misshapen.  Pigtails wouldn't be even, things may be uncomfortable.  For the larger things: sports and bicycle helmets may not fit correctly.  Glasses may not sit right on her head.  She could be at risk for TMJ or other jaw related problems.
5. How much does it cost? I have friends who have shared their stories of helmets and cranial bands with me, and there are a lot of variations here.  We have BCBS insurance, and they are covering 80% of the band cost.  Other insurance providers do not cover the band and it can cost upwards of $3000.
6. What is the difference in a cranial band and a helmet? There are a variety of cranial band fabricators.  The orthotist that we saw uses "kinder-bands", which look like helmets with a cut out on the top.  He explained that certain low profile bands (like the doc-band) uses pressure against the babys skull.  These low profile bands are a four to five step process, so the family would have to pay $3000 for each band made.  That adds up to a very expensive process, very very quickly.  The helmet is total contact, which does not "push" the skull, but rather facilitates growth in certain areas.  So her head is growing right now, so the helmet will help her skull grow in the areas that it needs to in order to round out.  She will only need one helmet.

So we were scanned on April 10th, and we will be fit in person for it on April 19th.  She will be evaluated in the office every 2-3 weeks to check growth and fit. 

I'm going to post pictures from my phone (it's so much easier than adding them to the computer etc). So they may not be in any particular order, but you will be able to see how she was scanned and what her head shape looks like now.

We did everything we could to try and prevent any issues, but life happens and we are going to do everything we can to take care of our sweet baby girl! :)



Otherwise, last week was pretty busy.  We have 2 teeth coming in, and she said "da-da".  :)
Sweet pea is growing like a weed!!!!

Monday, March 25, 2013

Four & Five

Okay so We have been a little busy.

So I lie. We have been super super busy.

Four months came and went - and then all of a sudden it's five months. What?!?

I'm going to try my best to remember four month stats...

Weight 13 lbs, 11 oz. 50%
25 inches long. 75%
Head circumference: 98%. WHOA!

She is tracking things left and right, reaching for them, and will hold objects given to her but quickly drops or loses interst. She can roll to her side to play with items, but still prefers her back for most positions. For play time, she can hold her head up and sit to play in the bumbo.

Started solid foods at four months- and that was a lot messy! Sweet potatoes everywhere.

In her fourth month we traveled up to the mountains to visit family and for her dedication!
Sunday March 10, 2013.

---------------

Five months. Last month really flew by, I need to stop the clock and spend some time with sweet pea!

Milestones: She can roll over to her belly quite frequently. Sometimes she filps onto her belly in her sleep, then gets mad- because flipping to her back is not quite as easy. Somehow her long arms get in her way! She mostly sleeps on her side though; as soon as i lay her down, she rolls onto her right side. Just like mommy. :)

She has started to giggle- and roll with the giggles. Last night, as I was giving her a bath, I sang "boom boom aint it great to be crazy", an old song from my childhood. She laughed and laughed and laughed.

Playtime is a lot of fun, because she will giggle, blow raspberries, drool and babble. She will pick items up and hold them out pondering "what in the world is this thing?" and then decide that it needs further investigation, i.e. putting it in her mouth. While on her belly she can push up on her arms, OR lift her butt in the air. Can't do both of those tasks simultaneously, but that will happen soon- and then we will be in trouble (i.e. she will be crawling soon). She LOVES her bouncy "office" (see picture below).


And lets talk about her hairdo. She must get this from her daddy. She has long "peach fuzz" type hair all over her head. That's fine with me. But what is this mohawk business? It's thicker on the top middle for some reason, and then she has this little rat tail on the back of her head at the top of her neck. Doesn't make sense to me, but she is still stinkin cute!



She loves the stroller and going for rides- she is big enough to fit in the stroller without the carseat attachment, but she prefers to look at what mommy is doing during our walks. Soon enough she will be interested in the birds and flowers and doggies, etc.

Clothes: She can still wear 3 month onesies pretty consistently. Carters 3 months still fit, but probably only for another week or so. Gymboree 3-6 onesies are a little too big. And this one brand called "Littles" something, well, they are too little. Pants- oh that's a different story. We are in 6-9 month pants, but we have to be careful because if they are too big she will scoot right out of them, or pull the pants off (she has gotten to be very successful at pulling socks off, and then eating them). Hats - to fit her huge melon? Not sure about that one.


My new endeavors:
- Just went to another consignment sale to get some random items that she didn't have. Let me tell you, this girl has PLENTY of clothes, but she is in a strange size. We had plenty of 3-6 month sleepers, and 6-12 month sleepers, but no 6-9 month sizes. So I got a few of those to fit for now (because if it's one piece it has to be the next size up for her length as of right now).

-Food! Oh gosh she is doing FANTASTIC with eating. She opens her mouth when the spoon is approaching and will "chew" and "swallow"the food. Sometimes food escapes, but it's usually because there was too much on the spoon or she wasn't prepared for the bite. It's gotten much, much "cleaner". At four months she was stripped down to a diaper and required a full bath afterwards because there were sweet potatoes everywhere. Wash behind your ears! But now, we are eating fully clothed and wearing a bib. :)
She has eaten Sweet Potatoes (yum), Green beans (meh, ok), Peaches (What!), Pears (ehk, shiver, yummy), apples (DELICIOUS!). She eats rice cereal in the morning at school, and then eats an entire container of the baby food mixed with a little bit of rice cereal to give it some texture.

I have decided to try making my own baby food- we will see how long this lasts/how she likes the food. Tonight I made zucchini, squash, and pears. The texture of the food I made is very similar to the gerber baby food + rice cereal she has been eating, so she should be fine. Hope it tastes okay. (PS: I had a pear for the first time. Baby is letting momma branch out!)

I made 13 bottles of baby food. Enough for almost 2 weeks. All of that came from one zucchini, two squash and two pears! I decided to give it a try for two reasons.

1. To save money. Baby food is expensive.
2. Fresh fruits and veggies are the best for everyone- and no preservatives or crazy ingredients. Who knows what gerber puts in their green beans, but it gives poor Cadence a rash :(


It's for that exact same reason that I am going to try and breastfeed as close to 1 year as possible. It's best for her and for me, and it also saves money!! (Baby formula is expensive!!!) I've got a pretty good freezer supply going, maybe about 3.5 gallon size bags full of breastmilk freezer bags. Pretty good amount I'd say, maybe enough for 3-4 weeks of bottles. Especially if she starts eating more "baby food" during the day.


Okay, I think that's all I can formulate tonight. It's late- but I wanted to get some stuff down before it became six months! :)

(P.S.: we are working to get a six month photo session scheduled, and will hopefully be able to have mommy & daddy both there that morning so we can have family pictures!)

Love to all. Happy almost easter!

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Sunday, January 27, 2013

Three months

Time flies. Seriously. Three months? And one week of work and daycare down!

First: baby info.

Favorite things: she loves talking (ok obviously not talking, but cooing and gah-ing). She enjoys smiling in the mornings, and loves lights.

Dislikes: does not like having gas or a too-full belly (i.e. when shee has to poo). Let me tell you, she can let it rip (she must get that from daddy). If she hasn't pooped in a while... Watch out, it may escape her diaper.

Milestones: has started to hit at things in front of her (see artwork below). She has rolled onto her belly a few times, and has rolled onto her back from her belly once.


Her first artwork. Of course digital on the ipad. :)

Daycare day one was tough, but we have gotten in the swing of things. Once I'm fully at wake forest location I think it will be easier. First week I was in Durham and wake forest 50/50. I am having to learn a lot of new tasks about home health (just a different kind of therapy, im not going out to peoples houses) on top of the new management piece. I can't wait to have full reighn and completely reorganize the space. :)

Cadence is doing well with daycare. I think she gets a lot of playtime because tuesday and wednesday she went to bed at 8, but was then up at 4am. She seems to enjoy her teachers and is never fussy when we pick her up.

Still spending quite a bit of time every night preparing her bottles. I have to make sure I have enough thawed milk in the fridge for her tomorrow. I have to put 4oz in 4 bottles for tomorrow, and I put those in her cooler in the fridge.. Making sure they have the date on them.. I have to put my three bottles of pumped milk into freezer bags, labeled with the date and amount. Then I have to wash todays pump equipment and bottles and her bottles and parts from daycare today. Finally, I make sure my pump bag and cooler is ready to go for tomorrow. I have to do this every night.

Last night in the brace! We dont have to wear it anymore!!!

First day at daycare.

Happy girl in her crib at school.


Tried to stimulate he with playtime, we see how well that went.

It was cold!



:)

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Monday, January 21, 2013

Mommy's first day

So today was the big day. First day at the Raleigh ISC office. First day back to work. First day Cadence had to go to school.

Preparing for a three month old to be away from mom for eight hours is an act of congress. It took forever (two and a half hours on Sunday night, plus some time on Saturday evening). I labeled all of her bottles with her specific color (orange), and put her name on them. Of course I ordered special labels for this task. You know that colored electrical tape and a sharpie would not suffice for me.

I prepared her pre-labeled bottles. 1. Make surre the date on the bottle is the date for daycare. 2. Make sure each bottle has the same amount of milk. I have a great freezer supply (three gallon size bags full of smaller frozen bags of milk). So I pulled out a few bags from November (frozen breastmilk is good for 6 months in a deep freezer) and had them de-thawed. On the first day, she received 4 bottles with 3-4 oz in each one. This was enough for her first day, a full 8 hours. 3. Make sure the bottles all have nipples and tops. 4. store them in the fridge until first thing in the morning, take them out and put them in a thermal bag to travel to school.
I also packed her first day bag for items for her "cubby" which included a change of clothes, 100 diapers, sensitive wipes, and two paci's. The daycare has enough toys, mats, music and a crib designated for each child.

Her bags were packed and ready to go. She woke me up smiling at 6:45 (talking and smiling the most in the mornings, she's related to her daddy for sure. I assure you, that did NOT come from mommy's gene pool). She had her morning milk and played in her rock-n-play while mommy showered. I swear the child looked at the baby monitor camera (which I was watching while in the bathroom), and grinned - then BLEW UP her diaper. She gets a kick out of the little things. :)

Finally got ready and got everything in the car and drove to daycare. I knew I wouldn't be able to drop her off and leave, so I picked Nana up to help! We carried in all of the goodies and headed to her clasroom. She had no trouble transitioning and didn't cry at all (she was ALL smiles). I had to tell myself it was alright and leave the room quietly. Fighting back the tears as we headed to the door of the daycare, and let them slowly, and quietly roll as I got into the car. Mom gave me a hug and said "she will be okay. you will be okay too". We dropped her off at 9am.

The work day drug on. foooooooorrrrrrrrrrever. Pumping in odd places (Conference room anyone?) I've pumped before, but in the comfort of my pajamas and at my own home. Pumping while in work clothes, in a strange and uncomfortable place is not so exciting. When 4:00 rolled around I was a ball of nerves. Ready to leave durham and pick up my baby. I couldn't get out the door fast enough, couldn't get the GPS set or the car started quickly enough, and I got stuck behind every slow person between durham and daycare. (If I had been in Greenville, this is where I would have gotten stuck at the train for 45 minutes. Diaster!

I finally left Durham at about 4:30 and picked up sweet pea at 5:00. She had enjoyed a stroller ride with her new boyfriend (the little boy that is "mommy's all star' with a football on his hiney, in the crib next to cadence). They were so cute. I called twice during the day, once at lunch and once as I was leaving work.

She was a perfect angel. Took bottles with no difficulty (except once, and it was because she had to belch. Teacher asked if I ever had issues with burping- Cadence doesn't burp easily after feedings, but will store them up and belch like a fraternity boy. I would say she gets that from her daddy, but unfortunately she comes by that honestly from mommy!). She has never slept flat in a crib- and didn't have any issues with that! She smiled and played and enjoyed some cuddle time with her teachers. It was a successful first day!

I am so proud of my little lady- she is growing and learning new things so quickly. It's an amazing miracle! I will post later this week about her upcoming 3 month birthday!


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Monday, January 14, 2013

What a.... poopy.... situation!

Baby girl has been very fussy lately. Here is evidence:

She has gone from pooping every time she eats to maybe only pooping once a day. And they are major blowouts, sometimes escaping the back of her diaper and creeping up between her shoulder blades. Graphic huh? Just be thankful I didn't take a picture.

I have found the best solution to take out these "poopy" stains. Oxyclean spray. I spray it on immdeiately, then rinse and rub out. Spray on again, let soak for a few minutes then pop in the wash. It gets every bit out. And I'vd had to do it a few times. She really likes to poop in the white outfits.

So I was snapping her picture tonight (horray iphone!) and I was able to get a progression of her poopy face. I was quite entertained. :)

"oh my, i think i might have to..."
"yep that's definitely a juicy poop!"
"squirt!!!"
"tee hee hee, and some for for ya"
"Oh yeah!"
"Have fun cleaning that one up!"

She was pretty pleased with herself. She enjoys giving those presents to mommy & daddy. And I must say, even though they are a little stinky, I appreciate the gesture. It's the only thing she is able to give to us so thoughtfully.

So even though I'm excited about going back to work, I'm in denial that I will have to leave her with strangers and 7 other babies on Monday. I am excited, however, about her bottle labels. Because there are 8 children in each class and the potential of 5 bottles per child, each child is assigned their own color. I may have talked about this already- I can't remember. If I have just smile and nod. So her color is orange. They said "just get orange electrical tape and then write her name on it, and put the date every day with garage stickers or masking tape with the date. Oh no no no no no no no. That will not suffice. I would have made my own lables, but they have to be dishwasher/bottle heater safe. So to the internet I roamed, and I found a really cool website: www.appliedlabels.com. You can order all sorts of organizing details.

I will upload some pictures once I have all of my bottles labeled. :)

Sending stinky love to all! :)

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Thursday, January 10, 2013

quick update...

So we went to the orthopedic yesterday. Cadence made a new friend in the lobby... Madison was 6 months and had extreme hip dyslpasia when she was born, and has been in the brace for 5 months. I'm so thankful they put Cadence in the brace early, even if she didn't have an extreme case- it got her healing on the road instead of "waiting to see how things went". So they called us back and we met Dr. Lark's PA and they assessed her hip. (Side note: he said she was the prettiest little girl he had ever seen. I'm sure he was fibbing just to make us smile, but Cadence had a huge gummy smile after that!)

He said that her hip felt really good. In order to make a final decision, he wanted a final ultrasound to compare to her previous one to look at the healing. So they made an appointment for us and we drove down the road to Raleigh Radiology to get the ultrasound. Cadence was such a good girl for the sonographer- she slept the whole time. Everyone in the office said she was such a sweetie. Of course!! The sonographer and the pediatric radiologist said the hips looked good. Because she was PASSED OUT and completely relaxed, both of her hips appeared to measure really "loose". She said babies normally scream during the ultrasound. Cadence is awesome and was a great baby. She always is :)

The orthopedic called me back today and said that we can continue the brace only at night, and we are DONE WITH THE BRACE after 2 more weeks. So before she turns 3 months old, we are DONE! No more brace after that. Not even at night. Lovely! :)

I can honestly say I am SO VERY THANKFUL! God has blessed us - we have an amazing sweet little baby, and she is very healthy.

We have worked out a daycare in Raleigh- she will be going to Rex's "Child development center". I have heard rave reviews of this center (Nana's coworkers, friends, and family members have used this daycare). I went last week and met the teachers, saw Cadence's new friends, and explored her new surroundings. I will be a mix of emotions on January 21 as I take her to daycare that first day, but I know she will be in good hands.

It's going to be an interesting transition. I'm definitely ready to go back to work- I like the schedule and consistency, and the feeling of accomplishment. For example, today we were up at 5:00, then napped from 7-10am. After I fed her, fed myself, showered, fed her, changed her (she had a major blowout), did some laundry, paid some bills, fed her and folded some laundry...... I really haven't accomplished much. I'm excited to be around adults, and get back into the swing of things. Assuming I haven't forgotten everything in 3 months and I still know how to be a Physical Therapist. I have to adjust to the new role of "rehab manager", and learn new things with the change in scenery. HOWEVER: I am going to miss my baby. Seeing her sweet face every hour, and I know everyone is going to miss pictures I can take and send immediately.

She surprised me the other morning. I had her on her playmat as I took a quick shower, and I popped my head out to check on her. She had rolled onto her side! WHOA baby! She loves to play with her hands in front of her face. If she doesn't have a paci in her mouth and she isn't "talking to daddy" (cooing or smiling her huge gummy smile), then she is trying to put her entire fist in her mouth. Not a thumb, not a finger, she sucks on her entire fist. Oh my little lady.

Some pictures to hold you over :)
This is how I feel about tummy time mommy!!!


I'm going to be a dancer. Look at those "jazz hands". :)

On my side when mommy was in the shower. Such a big girl And note where her hands are!

! Playing with my hands at midline. Such a proud PT momma. :)


Goodnight everyone! :)