December 25, 2011

Merry Christmas

December 23, 2011

We got a great picture of Peter holding his Happy Birthday, Grammy sign perfectly . . . however, this smile was just to cute to not share . . . so . . . Happy Birthday, Grammy . . . I am glad I get to celebrate with you today!

December 20, 2011

Greetings from sunny Florida! Sorry we have been incommunicado for awhile. We have been enjoying our time in Florida/Georgia with Brad's family . . . we got to stop briefly at Gruncle & Auntie B's house on the way down. We spent a couple days in Georgia and then headed to The Villages to see Grammy & GrampS' new villa. They even have a Peter Palm Tree (ok, it isn't really a Peter Palm Tree, but it is just his size!)

Grammy, sneaking Peter some B A N A N A S!!!

YUMMMMMM . . . 3 grain cereal . . . sounds so tasty, right?

Chillin' at the pool

Peter was worried that someone was going to feed him to the alligators so he had us park him under this sign!

Posing with Grammy & GrampS

December 11, 2011

Yesterday Sami came over for an afternoon visit . . . Peter and she had a fun time rolling around on the floor and hitting one another (because that's what babies who don't have complete control of their limbs do) . . . Peter showed off his eating skills and Sami showed off her rolling skills . . . and mommies and daddies had fun, too (Brad bought a Kinect system for our x-box . . . oh my goodness is it fun . . . and tiring)

December 9, 2011

Peter is dreaming of a winter wonderland . . .
Check out my new hat . . . Grammy made it for me (it matches the sweater she and Aunt Allison made for me) . . . I am sooo fashionable!

Peter had his developmental follow-up appointment at the NICU yesterday so I thought I would share some details from that exceedingly long appointment! Peter now weighs 14 pounds and is 25 3/4" tall. As I have previously mentioned, there is a Very Low Birth Weight growth chart that the doctors use to chart Peter's growth . . . he continues to be our long and lean little guy as his height is in the 95th+ percentile and his weight is in the 50th percentile. At this appointment, Peter was seen by Dr Thurin (our favorite neonatologist), Janelle (our favorite occupational therapist) and Judy (the dietitian). All gave him great reviews. He is physically doing very well. His lungs are clear and his growth is right on track. Janelle said most of his skills are far surpassing his gestational (and some his actual age). However, he does have a fair amount of tightness (due to an overdeveloped muscle) in his back. So, we are working on stretching him out at every possible opportunity. This is nothing to be concerned about, but we want to make sure it doesn't develop into anything serious. Judy is happy with his growth and is pleased with our food choices for him. She has given us the go ahead for meats and those yummy (or not so yummy to adults) crackers that kiddos like to gnaw on.

Now onto some pictures . . .

I am tired of peas, Daddy . . . please, no more . . .

Peter regularly falls asleep halfway through his evening meal . . . it is the strangest thing . . . it isn't like he nods of slowly . . . he's eating one minute and the next? He's out like a light . . . usually for about 15 minutes, then he wakes up, happily finishes his meal and eats a full bottle . . . he's a weird little dude!

This is what happens when Daddy decides that squash makes an excellent medium for face painting (to be clear, Peter is a very tidy eater!)

December 4, 2011

Do you like my new sweater? Aunt Allison made it for me . . . she's the best . . . Thanks Aunt Allison! Grammy made me a matching hat, but silly mommy forgot to put it on before she took this picture . . . I am embarassed to admit that I was a bit of a grumpy puss shortly after and unavailable for human consumption or photo ops . . . so, Mommy will post a picture with my hat tomorrow :)

December 3, 2011

I typed this post before Thanksgiving, but never got around to posting it . . . so, here it is . . .RSV . . . what it is . . . how to prevent it . . . what it means for us . . . there are pictures at the end . . . so, start reading!

Peter is on board with my plan to share a bit about RSV with you as he contracted his first cold right before Thanksgiving. Also, he started his regimen of incredibly painful shots and wants you to be aware of all he is doing to avoid RSV! So, here we go . . .
1.) What is RSV (Respiratory Syncytial Virus) RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children under 1 year of age in the United States. Each year, 75,000 to 125,000 children in this age group are hospitalized due to RSV infection. Almost all children are infected with the virus by their second birthday, but only a small percentage develop severe disease.
2.)Who is at risk for severe illness? Premature infants, children less than 2 years of age with congenital heart or chronic lung disease, and children with compromised (weakened) immune systems due to a medical condition or medical treatment are at highest risk for severe disease. Adults with compromised immune systems and those 65 and older are also at increased risk of severe disease. Peter was premature, he is less than 2 years old, he has chronic lung disease and, as a preemie he has a weak immune system.
3.)How is RSV transmitted? People infected with RSV are usually contagious for 3 to 8 days. However, some infants and people with weakened immune systems can be contagious for as long as 4 weeks. RSV is often introduced into the home by school-age children who are infected with RSV and have a mild upper respiratory tract infection, such as a cold. RSV can be rapidly transmitted to other members of the family, often infecting about 50% of other household members. RSV can be spread when droplets containing the virus are sneezed or coughed into the air by an infected person. Such droplets can linger briefly in the air, and if someone inhales the particles or the particles contact their nose, mouth or eye, they can become infected. Infection can also result from direct and indirect contact with nasal or oral secretions from infected persons. Direct contact with the virus can occur for example, by kissing the face of a child with RSV.
4.) Here's the important one . . . How can we prevent an RSV infection? Frequent handwashing and wiping of hard surfaces with soap and water or disinfectant may help stop infection and spread of RSV. Also, persons with RSV illness should not share cups or eating utensils with others.Ideally, persons with cold-like symptoms should not interact with high-risk children. If this is not possible, these persons should cover their mouth and nose when coughing or sneezing and then wash their hands before providing any care. They should also refrain from kissing high-risk children while they have cold-like symptoms. When possible, limiting the time that high-risk children spend in child-care centers or other potentially contagious settings may help prevent infection and spread of the virus during the RSV season.A drug called palivizumab (say "pah-lih-VIH-zu-mahb") is available to prevent severe RSV illness in certain infants and children who are at high risk. The drug can help prevent development of serious RSV disease, but it cannot help cure or treat children already suffering from serious RSV disease and it cannot prevent infection with RSV. Peter received his first palivizumab injection on November 15th . . . he will have one every month through May . . . the shot is very painful and due to his size, starting in December, he will get one in each leg. This shot is also very expensive (upwards of $3,000 per month if you were paying out of pocket) and very hard to qualify for . . . basically, if a baby qualifies they are in the highest risk group category for developing severe symptoms from an rsv infection.
The important thing to remember is that you don't know if you're sick or not . . . you may not show symptoms of RSV for 4-6 days after exposure . . . what does that mean? Here's an example:
Sunday - you are exposed to RSV at church (we aren't even allowed to take Peter, doctor's orders)
Monday - feeling fine
Tuesday - still feeling fine
Wednesday - still feeling great and thinking, I haven't met Peter yet . . . better stop by . . .
Thursday - still feeling good, drop by Brad & Kristin's to meet Peter . . . they cautiously let you "see" him after you have thoroughly washed your hands and confirmed that you haven't been to any public places that day (since germs could have landed on your clothes) . . . you don't get to hold him, but you are in the same room . . . you sneeze (you're sure it is just allergies)
Friday - still feeling ok, but have a little tickle and your throat and feeling a little sluggish
Saturday - you have a full blown cold
Later that week - Peter gets sick . . . he may just be miserable for a week or so . . . but, he may develop severe symptoms and end up back in the hospital on breathing assistance.
This is why we are so cautious about letting anyone (family, included) interact with Peter. We know he is cute and sweet and oh so cuddly . . . but, we already spent 52 days of his life in the hospital, we don't want to relive that experience for even one day.
So, as we approach the holidays, please know that we are going to do our best to keep Peter protected from germs. That may mean you don't get to see Peter . . . we're sorry if that's the case (because he is just the most wonderful little guy), but please know that we are trying to do what's best for him . . .
Oh, one more thing before I close . . . to be clear, we understand that kids need to be exposed to germs to further develop their immune systems. However, you learned in my previous post that most babies are born with an already functioning immune system. Peter was not. Most doctors agree that by the time a preemie is 2, their immune system will be up and functioning . . . so, until then, expect us to be overprotective of our little man . . .

Mommy, Daddy and I delivered our cookie trays today . . . so, I had to get a little festive

Did Mommy mention that I am eating peas as well as sweet potatoes?

Caught in the act . . . not sure what the act is, but I look guilty!

November 27, 2011

Peter's Excellent Adventure Continues . . . This is my happy family!


Naptime with Grandpa

YUMMMMM . . .Sweet potatoes, take two . . .

I swear, more of the potatoes went in my mouth than out!

Mommy says this is why she doesn't leave me with Daddy and Grandpa!

November 26, 2011

Day 4 of Peter's Excellent Adventure Peter & Mommy just hanging out in the old fire chute
Swinging is fun . . . but, a little scary

Grandma helped me down the slide

Swings for everyone

Mommy, can I try the sweet potatoes now?

I was a little unsure of the first bite, but it turns out, sweet potatoes are DELICIOUS!

My table manners are somewhat lacking

I like to hang out with Grandpa . . . he is a good cuddler

November 25, 2011

Day 2 of Peter's Excellent Adventure I think I like marshmallows . . .
Yes, I definitely like marshmallows . . . they're squishy!

4 Generations

I think Gruncle's glasses look better on him . . . what do you think? Ok, you're right . . . I'm super cute no matter what I am wearing!

I got to meet GG for the first time today . . . she was really excited to meet me . . .

Stay Tuned for tomorrow . . . Mommy & Daddy told me that I get to try solid food for the first time . . . AND, it is going to be sweet potatoes . . . do you think I can talk them into some marshmallows, too?

November 24, 2011

HAPPY THANKSGIVING from our favorite little pilgrim

November 23, 2011

Day 1 of Peter's Excellent AdventureA present, for me?!?
I wasn't sure how to open the present, but the wrapping paper sure is tasty!

No Doorway Required? What could this be?

Hurry Up, Daddy . . . put it together!

This ROCKS!!

Piano Time with Grandma

Hanging Out with Grandpa . . .

Gotta Go . . . Auntie B and Gruncle just arrived!

November 22, 2011

Happy 1/2 Birthday to Peter!

Peter had his 6 month checkup yesterday and the doctor said (and I quote) . . . "he's just perfect" We, of course, agree . . . but, it is nice to get validation from a medical professional :) Peter now weighs 13 lbs, 6 oz and is 24 1/2" tall. He is still not quite on the growth charts for his actual age, except for head circumference (yay for the 2nd percentile!). What can I say? The kid has a big noggin! On the preemie growth chart (which he will be assessed on until he is 2) he is in the 55th percentile for weight, 95th percentile for length and 98th percentile for head circumference. Peter also had his follow-up appointment with Early On this past week. For the most part he is meeting milestones that a 7 month old should be attaining (except for rolling over - which he can do, he just won't . . . . we know this because we put him down for a nap on his back/tummy and return to find him on the opposite side . . . . he's just stubborn!) OK, that's enough rambling about our magnificent little man . . .

We woke up early this morning to make our first road trip with Peter . . . we drove to Watseka (Mommy's hometown). We'll be here for the Thanksgiving holiday . . . we surprised Grandma & Grandpa a day early . . . needless to say, they were pleased . . . more pictures from Peter's first adventure later this week!

Peter LOVES to stand up . . . he can stand while just holding our fingers . . . and, he is starting to figure out the motion of walking . . .

Fun Times!

November 16, 2011

Did you know that November is Prematurity Awareness Month? Me neither! However, in honor of our sweet little Peter, I thought I would share some interesting statistics related to prematurity

1) 1 in 8 babies in the US are born premature (before 37 weeks of completed gestation); that’s 543,000 babies per year.

2) At 25%, premature birth is the number one cause of neonatal mortality in the US.

3) The rate of premature birth increased by more than 20 percent between 1990 and 2006. This increase is directly related to increased use of invasive fertility treatments.

4) The average first-year medical costs, including both inpatient and outpatient care, are about 10 times greater for preterm infants than for full-term infants.

5) Although we have identified many risk factors associated with premature births, nearly 40 percent of these births have no known cause.

6) Risk factors for premature birth include maternal hormone imbalance, structural abnormality of the uterus, chronic illness, infection, and unhealthy lifestyle choices. Preterm delivery is also more likely when a woman is over age 35, under age 19, or is carrying multiple fetuses. In my case, Peter’s early arrival was due to pre-eclampsia and a blood clot on my barely functioning placenta.

7) Half of all neurological disabilities in children are related to premature birth.

8. Due to many recent advances, more than 90% of premature babies who weigh 800 grams or more (a little less than 2 pounds) survive. Those who weigh more than 500 grams (a little more than 1 pound) have a 40% to 50% chance of survival, although their chances of complications are greater. Peter weighed 1188 grams or 2 lbs, 9 oz.

9) The earliest preemie to ever survive was born at 21 weeks, 6 days gestation. The smallest preemie to ever survive was born weighing 9.1 oz.

10) Famous preemies include Albert Einstein, Mark Twain, Sir Winston Churchill, Victor Hugo, Napoleon Bonaparte, and Isaac Newton.

11) Patent ductus arteriosus (PDA): A heart problem that is common in premature babies. Untreated, it can lead to heart failure. Basically, there is an opening between valves that allows for nutrition to reach the baby. The valve needs to close shortly after birth and normally does. However, in some babies, the valve stays open. This was Peter's case. Luckily, he was treated with a drug that helped the valve to close. There are no long term effects of PDA.

12) Low blood pressure is a relatively common complication that may occur shortly after birth. It can be due to infection, blood loss, fluid loss, or medications given to the mother before delivery. Low blood pressure is treated by increasing fluid intake or prescribing medications. Peter received one blood transfusion when he was less than a week old to treat his low blood pressure.

13) Intraventricular hemmorhage (IVH): Bleeding into the brain’s ventricular system. This type of hemorrhage that is particularly common in premature and very low birth weight infants and can cause pressure in the brain and brain damage. We were so thankful the day we found out that Peter's head ultrasound came back clear, no bleeding in the brain.

14) Retinopathy of prematurity (ROP): Abnormal blood vessel development in the retina of the eye in a premature infant. In severe cases, such as that of Stevie Wonder, scarring and retina detachment cause vision loss. Peter had multiple eye exams while in the NICU, all resulting in a diagnosis of "Immature" . . . as he was not yet supposed to be in this world, immature was the diagnosis we were looking for. He has no eye issues.

15) A baby’s suck reflex does not begin until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability because of this. Therefore, infants born earlier than 34 weeks gestation usually require a feeding tube to meet their nutritional requirements. Peter was not introduced to breast or bottle until he was 5 weeks old.

16) The transfer of maternal IgG antibodies to the fetus predominantly occurs after the 30th week of pregnancy. Premature birth interrupts this transfer, leading to lower levels of maternally-transmitted antibody at birth. Peter was born in the 30th week of pregnancy and is therefore much more susceptible to infections than full-term newborns. He had a yeast infection while in the hospital.

17) Infant respiratory distress syndrome (RDS): Caused by developmental insufficiency of surfactant production and structural immaturity in the lungs, RDS is the most common single cause of death in the first month of life of the developed world. I was given glucocorticoids 48 hours before Peter’s birth to help speed his production of surfactant. Peter was given an exogenous surfactant through a breathing tube into his lungs shortly after birth and again 3 days later to mitigate his RDS.

18) Bronchopulmonary dysplasia (BPD) or Chronic Lung Disease (CLD): Characterized by inflammation and scarring in the lungs, BPD is a chronic lung disorder that is most common among children who were born prematurely with low birth weights and who received prolonged mechanical ventilation to treat RDS. Peter developed BPD as he required oxygen assistance well past his due date. This puts him at a significantly increased risk of respiratory challenges. A common cold for a term, health baby his age could put him in the hospital and back on breathing support.

19) Necrotizing enterocolitis (NEC): The death of intestinal tissue. NEC primarily affects premature infants or sick newborns and has a 20-30% mortality rate. Babies born at Peter’s gestation have roughly a 5-10% chance of developing NEC. Peter did not develop NEC.

20) Neonatal hyperbilirubinemia: Newborn jaundice is a condition marked by high levels of bilirubin in the blood. The increased bilirubin cause the infant’s skin and whites of the eyes (sclera) to look yellow. Severe cases can result in brain damage. Peter required a week of phototherapy to treat his jaundice.

21) Because of their large skin surface area relative to their weight, premature babies usually must weigh at least 4 pounds in order to efficiently maintain their body temperature. Peter spent 45 days in an incubator before he was big enough to sleep in a bassinet.

22) Apnea of prematurity: Cessation of breathing by a premature infant that lasts for more than 15 seconds and/or is accompanied by hypoxia (oxygen deprivation) or bradycardia (a heart rate of less than 100 bpm). It occurs in at least 85 percent of infants who are born at less than 34 weeks of gestation. Peter had one apnea episode on his first day of life. He never had a bradycardia episode. This is highly unusual for a baby that required oxygen support as long as he did.

23) Umbilical and inguinal hernias occur more often in premature infants. Inguinal hernias require hernia repair surgery. Umbilical hernias are usually self-resolving.

24) Cerebral palsy (CP): A broad term used to describe a group of chronic “palsies” — disorders that impair control of movement — due to damage to the developing brain. Premature babies are 8 times more likely to develop CP than full-term babies because their immature lungs may be unable to provide sufficient oxygen to the brain.

25) 25-27 weekers spend on average 71 days in the hospital prior to discharge. 28-30 weekers on average spend 39 days. 31-34 weekers, 12 days. 35-38 weekers, 4 days. 39-42 weekers, 3 days. Peter spent 52 days in the NICU, costing our insurance roughly $470,000.

26) More than 70% of premature babies are born between 34 and 36 weeks of gestation. Twelve percent are born between 32-33 weeks, 10% are born between 28-31 weeks, and 6% are born at less than 28 weeks.

27) The average birth weight of singletons is 7 lbs. 5 oz., of twins is 5 lbs. 3 oz., and of triplets is 3 lbs. 11 oz. Peter weighed 2 lbs, 9 oz.

28) Preeclampsia is a pregnancy condition in which hypertension arises in association with protein in the urine. The only known cure is delivery of the placenta. Preeclampsia affects 5-8% of women and 0.42% of all pregnant women need to deliver before 34 weeks because of severe preeclampsia – that’s about 16,800 babies each year in the U.S. Peter was delivered at 30 weeks due, in part to me developing pre-eclampsia.

29) Premature labor can be managed with hydration, bedrest, medications to stop labor (e.g., magnesium sulfate, nifedipine, terbutaline), and medications to help prevent infection (especially in instances of premature preterm rupture of membranes).

30) The body of a mother who delivers early will automatically produce milk that’s specially designed to nourish her premature baby, with extra minerals, fat, and protein. The leukocytes and antibodies in breast milk protect babies from infection.

So, there you are . . . more information than you really wanted? It is for me, too . . . Stay Tuned for an exciting monologue on RSV, its prevention and what that means for our household (I know, your just full of anticipation!

November 14, 2011

Fun Cousins