Elva at 18 months – what we’re playing with.

I’ve not had a lot of motivation or inspiration to write much at all for a long time now, though I do actually like blogging.  When I have the flow going I find it very enjoyable and rewarding, and I’ve also had lots of feedback that people like to read about our experiences and how we do things. So I thought I would try something different and write about what we are currently doing, playing with, eating, etc.  Possibly boring – but I guess we’ll see!

Elva is now 18 months and is highly motivated by toys and play.  She’s pulling to stand, beginning to cruise, and starting to really develop her fine motor skills.  She’s interacting and engaging in play with others, and learning to communicate her wants and needs.  Its a really beautiful and fun stage! At the moment Elva sees her physio once a month, and her key worker comes once a fortnight.  Her key worker is an OT, but she doesn’t really do any work with Elva.  She observes and interacts with her, and then gives suggestions of what we could do to help aid her development toward goals that we have chosen.  Consequently, a large part of Elva’s therapy is designed and implemented by us.  Had you told me this earlier on I would have felt quite stressed at that level of responsibility, but I’ve discovered that it’s actually quite fun!

We have found a few toys recently that have been particularly well loved, and all of them can be picked up at Kmart!  Even better, 2 of them were just $5 each!

Bright Starts ‘spin n’ slide ball popper’.
$39 from Kmart.

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WHAT IS IT?
A ball popper is set up like a water park for plastic balls.  There are 2 slides that lead down to the blue ‘pool’ turntable.  The turntable spins the balls out to the chute and down to the popper, which pops them up to the top of the red slide. And repeat.

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HOW WE USE IT.
The popper is frequently over zealous in its popping, and so balls often end up on the floor instead of down the slide.  We sit it on a box that is a good height for Elva to pull up on, tall enough that she needs to bend down to get the balls on the floor but low enough that she can reach all parts of the toy when she’s standing.  And Elva loves it! The up, down action required for retrieving and and returning the balls is fabulous for her core strength and movement, and picking up and placing the balls back onto or into the toy utilises her fine motor skills.

PROS
As its electronic and the popper feeds itself it doesn’t require intense parental involvement for play.  It’s good to have a couple of these options up your sleeve for when you need to run off to the toilet on a particularly needy day!  It’s attention grabbing and quickly rewarding which encourages the child to keep returning for more.  Elva finds it really exciting.

CONS
This toy is noisy.  It is so obnoxiously noisy that big sister Rory often begs to turn it off.  Imagine a plastic ball popper rave.  It’s that noisy.  I tend to avoid noisy plastic toys, but this one has been so successful in encouraging both fine and gross motor skills that its getting a pass.

Milestone Animals.
$5 per pack from Kmart.

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WHAT IS IT?
13 different wooden animal shapes in a square plastic tube. They are small and brightly coloured.

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HOW WE USE IT.
Elva’s most favourite game with these she actually made up herself.  We had been playing with them very basically, she would pick one up and I would name the animal and the colour of the block. As I was packing them away into the tube, Elva started helping.  I hadn’t expected her to have the fine motor skills necessary to put the animals into a less than 3cm by 3cm square hole, but she clearly does!  Her intense concentration as she works at packing them all away is a wonderful thing.

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After seeing how well the first pack was received I started thinking that the animals were a perfect size for matching games, so I bought a second pack.  I had assumed that matching games were far and above what Elva was capable of, but I figured that I could introduce the concept for now and it would start the process for games later on down the track.  As it turns out, I was underestimating my girl again.  I tipped out both packs of animals and then started showing her the pairs.  I picked up a single pair and said “the same”, and put them down together away from the rest.  Elva picked up 2 different animals and I said “different”.  She threw one behind her and I looked down to pick up the next pair.  When I looked back at her she was holding the matching pair!  I showered her with praise, but wondered whether it was a fluke. She had trouble picking out further pairs unassisted, until I realised that I was expecting an awful lot of her and that I should narrow down the options considerably.  So I cut right back and offered her 4 tiles to make 2 pairs, and she got it immediately.

PROS
I picked these animals up on a whim.  As it turns out, these have been one of the most enjoyed and versatile toys I have bought Elva to date.  They are perfect for her now, but equally hold the attention of her 4 year old sister.  Both girls have created their own games with them.  As they are small and come in their own carry case they are also easily portable. And they cost just $5!

CONS
You have to purchase 2 packs in order to get pairs. I am struggling for a negative for these!

Chunky Safari Puzzle.
$5 from Kmart.

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WHAT IS IT?
Wooden animal puzzle depicting a stylised ‘safari’ scene.  The animal pieces can stand alone outside of the puzzle board for different play opportunities.

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HOW WE USE IT.
The girls play together beautifully with this one.  As the animal pieces are bigger and more detailed Rory encourages Elva to pick them up, talks to her about the animals, the colours etc and makes up stories.  They ‘chat’ about them, and Rory puts the pieces back into the puzzle board and Elva gets them out again.  I plan to start using this one for animal recognition, asking Elva to ‘find the lion’ for example.

PROS
Big, easily distinguishable pieces that are eye catching and fun.  Versatile. Aside from being a puzzle suitable for 2-3 year olds the pieces are big enough to be suitable for younger babies, but also stand alone allowing for older children to play more complex games.

CONS
Not easy to pack away or transport, but at $5 you can’t really go too far wrong!

So how do we feel about posts like this? Post your feedback below!
K

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Teaching Elva to demand feed.

So far this World Breastfeeding Week I have posted about establishing breastfeeding in the NICU, and in it my final guideline was to aim for demand feeding. Demand feeding in hospital is virtually impossible, and after 3 weeks with an empty stomach Elva had no concept of eating to satiate hunger.  Prior to her birth I had looked for resources online for addressing this and found literally nothing, so I wanted to elaborate further on how we went about teaching Elva to recognise hunger and demand feed.

When we were arranging rooming in the nurse stated that they would push Elva out to 4 hourly feeds in preparation for going home.  As she wasn’t even at full term and was 3 full weeks off her due date I was shocked that this would even be considered.  I said as much, and the nurse laughed and said ‘oh but its so much more convenient for you as the parent’.  I didn’t want convenience.  If I had wanted convince I would have bought a fish, not had a baby!  Scheduled feeds may work for a few, but for most mother and baby dyads they negatively impact supply.  I told the nurse that when we got home I would be setting alarms every 2 hours round the clock in the hopes of teaching her to demand feed.  She looked completely shocked, and then told me that this was ‘one of the perks’ of having a premmie baby – that they could ’teach her good sleep habits’ before she came home.  This is hugely problematic.  We have this expectation of tiny babies that they should sleep and sleep and sleep, especially at night.  That that is what makes them ‘good’.  If they don’t we have plenty of ‘baby gurus’ and ’sleep trainers’ out there who will tell you exactly how to make that pesky baby comply, usually through some form of ignoring the infant until they do as desired. Unfortunately this sleep obsession has negative impacts on more than just the way we view our baby’s sleep habits.  Did you know that the most important time to feed or pump when establishing and maintaining supply is in the early hours of the morning?  Night feeds are important for multiple reasons, and for much longer than the ‘baby gurus’ will have you believe.

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Rooming in.  Photo by Aurora!

At my insistence Elva was kept on 3 hourly feeds, and that weekend when we roomed in I set my alarm to go off every 2 hours.  It was exhausting and overwhelming, but I was determined to teach my tiny baby that hungry wasn’t normal, and so I pushed through.  After the first night the neonatologist decided that he was unhappy with Elva’s weight gain and advised us that if she did not gain sufficiently the following day that she would not be going home.  After 4 weeks and with going home slipping through my fingers, I panicked and agreed to the dreaded top ups. They came back to me and said that I needed to give 30mls after each feed.  Given that her measured feed volumes were only just over 50mls, 30mls after a full breastfeed was ludicrous.  But I was so desperate to take her home that I just nodded my head, and after her next feed I dutifully put 30mls in the bottle.  I warmed it in the bottle warmer and then pushed the plastic nipple into her mouth.  And she turned her head, pushed it out, spat it out, choked on it and cried.  I cried.  After trying for an excruciating few minutes, I gave up.  I tried for the next few feeds, but nothing worked.  She could not use the bottle.  That night I had an idea, I got out a breastmilk storage syringe  and took a cold bottle out of the fridge, suctioning up the cream that had separated to the top.  I syringed it into Elva’s mouth, up the back of her tongue more like she was used to with the breast, and though she spluttered a bit she managed to swallow it.  It was only a few mls, but it was something!  I felt relieved for a few minutes, until she vomited up far more than that tiny top up.  She wasn’t a vomity baby, in fact the only time I had ever seen her vomit was after she was given some medicine in between her 2 surgeries and she brought up brown bile, and so I knew that this had to be directly linked to the top ups.  She had the same reaction after the next 2 feeds with only an extra 2-5mls being syringed in, so I called the NICU and a nurse come down to speak with me.  She agreed with me that Elva was clearly drinking her fill from the breast and that the top ups were just causing problems, and so she went and spoke to the Nursing Unit Manager.  The NUM called me and said to cease the top ups immediately, that it was obvious that they were unnecessary and that if we continued with those orders it would only lead to lost weight rather than the intended gain.  She put a note on Elva’s file for the Doctor the next morning to take into account the vomiting up of feeds caused by the top ups when weighing her the next day and determining whether she could go home, and in doing so secured her ‘release’.  The next morning we had the green light and she was discharged!

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What do you spy on the table behind us?  A quiet moment captured by the lovely ladies at Shot From The Heart Photography.

Discharge was an incredibly surreal experience. To be able to take your baby home and just exist with them in everyday normal life is something that is taken for granted for the most part, and with good reason!  For us it felt as though life could finally recommence, as we were no longer tearing ourselves into pieces trying to be everywhere at once and always letting someone down.  Sitting on my couch with my baby in my arms and my older daughter snuggled up by my side was complete bliss!

It took 2 full months after discharge to teach Elva to demand feed.  I set 2 hourly alarms around the clock for about 2 weeks, and then pushed it out and gave myself a 4 hour gap in the night as i found myself so tired that I was sleeping through the alarms.  After a further 2 weeks like that we moved to 3 hours during the day, and at night I would feed Elva off to sleep around 8-9pm, then set the alarm for just once during the night.  We continued with this for another month, slowly stopping the alarms as she began to demand more and more.  Eventually there was no need for alarms as she was demanding all her feeds!  I would (and still do at 17 months) have to offer on occasion if I realised that she had gone a significant period without a feed, but from that point forward she was demand fed.  We had a slight wobble at 4 months when she was hospitalised with Bronchiolitis and had the NG tube put back in, but that was quickly recovered from and she has gone from strength to strength since.

If breastfeeding your child is a road trip, then we started on a pushbike and when we finally got to the car it had a flat tyre, no map and no petrol.  Yet we got there in the end!  If you are in need of some breastfeeding support I would recommend joining one (or more) of these Facebook groups – Breastfeeding Younger Babies and Beyond, Breastfeeders in AustraliaUK Breastfeeding and Parenting Support or Breastfeeding Children with Down syndrome and/or Special Needs – don’t worry if the group isn’t specific to your area, these groups are all great for support regardless of where you live.  Please also feel free to send me a message on the blog’s Facebook page if you have any breastfedding questions that you need answered.

Kxx

Establishing Breastfeeding in the NICU.

A year ago for World Breastfeeding Week 2015 I posted the first instalment of Elva’s breastfeeding journey. At the end we had reached Elva’s very first feed, and I said to stay tuned for a follow up post detailing the ins and outs of establishing breastfeeding in NICU. A year later, and here we are. Better late than never right! Oops.

For context – the previous post can be found here.

To summarise: on the day that the surgical team gave the go ahead for breastfeeding the negative neonatalogist was off sick, and instead we had a sympathetic registrar in charge.  Elva was 3 weeks old/36 weeks adjusted age and with a little manoeuvring we were able to get her latched and she had a good feed.  She tolerated the feed well, and thanks to our wonderful nurse Amy we were able to update her feeding information to state that all of her day feeds would be breastfed.  Her feed times were adjusted to accommodate the times I could be at the hospital, and from that feed on Elva was solely breastfed while I was at the hospital.  It sounds easy doesn’t it.  I popped her on and off we went.  But it wasn’t nearly as simple as that.

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First feed. Beautiful.

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About 27 babies that died, and 1 that didn’t.

Australia, we need to talk.

Last year, in 2015, 27 babies aged 5 months gestation or more survived late-term abortions in Queensland hospitals.  This is the highest number of survivals followings attempted terminations in the state in 10 years. I am not up for an abortion debate.  This is not about a woman’s right to chose what happens to her body.  These babies were all independent of their mothers and still alive, and yet each of these 27 babies were denied medical care and left to die.

I want you to understand that these babies were more than just terminated pregnancies.  I want to take these figures from abstract numbers and I want you to understand that each of these babies had faces.  That each was their own person, and that they almost certainly had anguished parents who believed they were making a kind and merciful choice.  More than that – I want you to understand that with just a few words Elva could have been one of them.  That this was the medically accepted, suggested, recommended, preferred option.  I want to hammer home the horror of this by showing you the face of a child just like those 27.  Born in the same year, in the same country, pre-term, with 2 separate diagnoses that made her a candidate for this treatment.  I want you to look at her and see the 27.  I want you to look at her, into her eyes, and imagine her without the medical interventions, left alone in a cold room to die. This is my Elva.
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Just a few hours old, I was able to see her face properly for the first time as the nurse took the CPAP mask off her for a few moments.

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