Welcome to Cold/Flu/RSV season!

It’s October, and you know what that means! Cooler temps, pumpkin spice everything, and the onset of cold/flu/RSV season! If you haven’t scheduled your yearly flu shot, you really should, especially if you have contact with young children or the elderly. Herd immunity is so important to protect our most vulnerable populations. As you should know if you are a reader of this blog, preemies in particular are incredibly susceptible to illness, but especially RSV. Most babies get RSV by the time they are two years old and it manifests as a bad cold. Not so for preemies. RSV can cause pneumonia, bronchiolitis, even death. 

This year will be Little Miss Minion’s second Cold/flu/RSV season, and her first without the monthly Synagis shots. In case you’ve forgotten, Synagis is a shot of antibodies given to the most vulnerable preemies to try and boost their immune systems to fight off RSV. LMM doesn’t qualify for the shots anymore, so she will be facing this season on her own. That means that the Minion household will be extra vigilant about germs–not that we aren’t already. 

This concludes my annual plea to get yourself and your family a flu shot this year. Help protect babies like Little Miss Minion, who can get severely ill from something as simple as the flu. Stay home if you are sick. Wash your hands. Cover your mouth when you cough. Keep your germs to yourself!

7 months adjusted

Little Miss Minion got her (probably) last synagis shot the other day. It’s a bad season for rsv so they aren’t sure if there will be one more shot this year. We got a new weight for her too: 15 pounds,  1.2 ounces! That’s a little over 8 times her birth weight, in case you were wondering.

She’s got the tiniest little spot of a tooth coming in on the top. It seems to be taking its time to come in, but it’s not bothering her.

She’s a rolling champion and a really good sitter. She sits mostly by herself now, for about 10 minutes at a time. She loves playing with her stackable cups and dolls. She loves to “talk” with us, making noises and then we talk back to her.

She’s so so close to crawling. She can pivot using her hands and arms, but she can’t move forward just yet. Soon…and then she’ll really be mobile and we’ll have to baby proof!

6 Months Adjusted

Little Miss Minion is 6 months adjusted today! 

Weight today was 14 pounds, 6.8 ounces. Weight at birth was 1 pound 14 ounces. Length today was 24.5 inches. Length at birth was 13 inches. 

Her favorite things to do include eating baby food, screeching, standing with stabilization, and rolling from her stomach to her back to her stomach across the floor. 

Agenda for the week includes another Synagis shot, an MRI, and a neurosurgeon appointment. This will be her first official follow up, because she’s always had a shunt issue that brought us to the ER way before her scheduled follow ups. 

We bumped her up to level three bottle nipples and she is chowing down. We also got her a sippy cup, but she’s not too interested in that yet. 

Attention: Milestones ahead

This has been a good week so far for milestones. Little Miss Minion rolled from stomach and back over her left arm the other day, and tonight she rolled from her back to her stomach! Theoretically, she could roll around the house now, if she wanted to. She’s also gotten really fussy with her bottles in the last couple of days, and since her fontanel feels fine, we are thinking that she needs the next size up in bottle nipples. The pediatrician told us in December that we could start her with a sippy cup, but she hasn’t really been ready for it until now. So this weekend, I’ll be buying size 3 bottle nipples and some sippy cups!

We’re still working with her on consonants. I sing the Star Wars theme to her with all B sounds, and she likes to hear it but she won’t repeat it yet. 

It is Appointment Central over here. She has an MRI and neurosurgeon follow up (the first one we will have made it to, since she kept having shunt issues). She has her Synagis shot. She’s got her six month follow up NICU visit. She gets physical therapy once a week. Sometime soon, she needs to see her pediatric opthomologist, an audiologist, her pediatric neurologist (different from her neurosurgeon), and she’s got another pediatrician check up in there somewhere. 

It’s a good thing I have such a good memory. 🙂 

Seven months!

Today is Little Miss Minion’s seven month birthday! She also had a pediatrician check up this morning, so I have lots of fun new stats for you. She is 23 inches long, and a whopping 12 pounds, 10 ounces! Her percentiles are: 50th percentile among very low birthweight girls, 25th percentile among low birthweight girls, and 3.77th percentile of full term babies, unadjusted for prematurity. That last one sounds bad, but she hasn’t ever really been “on the chart” before, so this is fantastic. Her head circumference is perfect, which is an important thing to look at with her hydrocephalus. Overall, it was a very good visit. 

She’s rolled over a couple more times this week. She has started spinning a toy on her bouncer, which shows that she’s starting to understand cause and effect. She likes it when I play peekaboo with her and she loves kisses and smiles. So far, she’s eaten rice cereal, oatmeal, sweet potatoes, apples, pears, and peas. She was holding a spoon while we fed her the other day and she shoved it in her mouth. She gets oatmeal in the morning, half a container of food at lunch, and a full one (if we’re sure she won’t have a reaction) for dinner. She’s also eating 4 ounces of breastmilk every couple hours still, since that is where most of the calories should come from for several more months. 

She likes to chat with us, especially in the mornings. She coos, we talk back to her, she coos again. Sometimes she gets really excited and squeals and screams. Her pediatrician and her physical therapist both say that she’s very social and a very happy baby. 

Synagis shot #2 is tomorrow. This is the RSV antibody injection that she will get once a month during RSV season. A new study I read about said that by the age of three, something like 95% of all babies will have gotten RSV. For full term babies, it usually presents as a cold, possibly requiring the use of a nebulizer–picture an oxygen mask with aerosoled medicine. For preemies, it usually presents as difficulty breathing, extreme lethargy, high fever, and blue-tinted lips and nails due to oxygen deprivation. Obviously, RSV is a big deal for preemies. Treatment involves admission to the hospital, being given oxygen, being put on a ventilator if the lungs are too weakened to work properly, and medication for inflamed and irritated airways and lungs. Secondary infections can include bronchiolitis and pneumonia, both of which are very bad news for a preemie with already-weakened lung function like LMM. 

The upshot of this: isolation is good. No people, no germs, no illness, and no hospital admissions. 

Looking Good

Little Miss Minion had a follow up MRI this morning to make sure that the old shunt is working, the ETV is working, the new shunt is working, and that there aren’t any pockets that aren’t being drained by the aforementioned methods. And the verdict is….Cleared until February 2016! The neurosurgeon was “ecstatic” and “very happy” with how her MRI looked, so hopefully we are in the sweet spot where everything is in balance.

Her physical therapist is pretty happy with her lack of regression over the past month. We’ve had to cancel 2 sessions because she was either in the hospital or still recovering. Usually, babies regress much more after surgery and she had two in two weeks.

She’s started playing with her toys more. She grabs them and actually grips things. After her bottles and 20 minutes of upright reflux rest, we usually lay her down on her mat and let her play with her toys. They hang from a support so she can bat at them and grab them. Her favorite is a zebra that Mr Minion named Paul, because “why not?” Next is a fish that I named Joe after Joe Pesci, whose real name is Joey Fisher. Then we realized that we had Joey and Pauly, the Goodfellas gangsters, so we named a doll that she loves Marie, since all the guys were married to girls named Marie in the movie.

She holds rattles, sucks her thumb, puts everything in her mouth, sucks on clothes, her hands, toys. She smiles and laughs all the time. She’s really nailed rolling onto her side, but she can’t quite make it all the way over consistently yet.  Her abs are not as strong since they added the second shunt and catheter, but she’s bouncing back really well.

She got her first RSV shot this week. She’ll get one per month for 5 months to help boost her immune system’s response to rsv. Most recent weight: 11 pounds,  9.3 ounces.

Big Girl

Yesterday, Little Miss Minion held and shook a rattle. According to several sources, this usually happens around 4 months. LMM is 2 months adjusted, so this is fantastic. She smiles at Mr Minion and I all the time and tracks us as we move around. I think I’ve said before, but I’m sure her eyesight is better than mine.

Today, we ventured out for a walk. It was a little cool, so I bundled her up in two outfits, socks, and a hat, plus her blanket. She likes to be pushed in the stroller and fell asleep almost immediately. Mr Minion and I don’t get out much, so it was nice to get some fresh air.

She’s awake for longer stretches after her feedings, so we’ve started doing play mat after the wait for her reflux. She bats her toys and grabs them, which is a great thing, developmentally. She’s also started grasping my fingers or the bottle while she eats.

This week’s excitement is a pediatrician appointment on Monday and the scheduling of her follow up MRI in a couple weeks. She will also get her synagis shot sometime this month, which I am greatly looking forward to. I think she’ll get more shots Monday too. I’m probably the only mom who is excited about more shots.

PSA: If you haven’t gotten your flu shot yet, you should. Help prevent the spread to babies and other immune compromised people.

2 Months Adjusted

Today marks two months after my original due date, August 6. Little Miss Minion is 2 months adjusted today, and she has learned so many new things since 1 month adjusted. She smiles on her own at Mr Minion and I. She smiles when we smile at her. She grasps toys, bats at the hanging toys on her play gym, and laughs. She rolled over twice yesterday–very impressive. And she will sit almost unsupported, just with light support around her waist. She weighed 9 pounds 7 ounces a couple of weeks ago at her last pediatrician appointment, so I am sure that she is into double digits by now. She’s outgrowing some of her newborn outfits (mostly onesies), and is into 0-3 months now. She’s still taking about the same amount of milk-right around 100-110 mls, which is 3 1/2 to 3 3/4 ounces. She’s starting to finish them completely, so we’ll probably bump her up to 120 mls, or 4 ounces, in the next couple of weeks.

Our other big milestone this month (besides her 5 month birthday on the 14th) is her first Synagis injection. Synagis is a shot that is given to at-risk babies to help reduce the severity of RSV, should they acquire it. You can read more about it HERE. She qualifies based on her birth weight and will get one shot every month for five months. What’s the big deal, you might ask. All babies get sick, after all. How else will they build their immune systems? The reason is simple. Preemies didn’t get the chance to build their immune systems in utero and therefore are much more likely to get sick than full term babies. Preemies (or any baby born before about 37 weeks) will have underdeveloped lungs. A baby born at 40 weeks had 3 full months of extra time to soak up antibodies than Little Miss Minion did. It is of vital importance that she gets the chance to build her immune system without the challange of being sick. Below are some images that might help you to picture the differences.

Keep in mind with the Lung Capacity image that the smaller set of lungs is representative of a baby born at 34 weeks. This is 6 weeks older than Little Miss Minion was at her birth. Preemies who get sick with RSV can end up in the hospital and can require ventilators, or breathing machines. Their airways are too narrow, and with the inflammation of something like the cold, flu, or RSV, they quickly become unable to breathe on their own. I’ve seen Little Miss Minion on a ventilator and it is not something I care to experience again.

My final word on isolation (for today, at least) is this letter, written by the parents of a 23-weeker. I’ve copied the first part of the text below, but http://anearlystartblog.com/2014/01/07/isolation-isnt-about-you/ is the link to the full version of the original letter and website. Many, many thanks to Andrea M for allowing me to link it here.

Dear Extended Family,

Isolation isn’t about you. Let me explain…

Babies who are born prematurely are different than full-term babies. First, premature babies have under-developed lungs and often require life-support and breathing tubes for days, weeks and even months. An important goal for every premature baby is to breathe on their own. Unfortunately for some preemies this doesn’t happen. Some preemies come home on oxygen support or on a ventilator. Their tiny lungs are not capable of keeping them alive without the help of a machine.