Under cover Wednesday.

Max vs. Nature - Part II

It was a beautiful day in Winnipeg today. The sun was shining, there was a light breeze and it was a balmy 15 degrees (Celsius of course). It seemed like the perfect day for round two of "Max vs Nature." If you recall, back in mid February the mercury swung into the plus digits and we thought it might be a good opportunity to introduce Max to the great outdoors. Frankly, he didn't know what he was missing, but his Mum was desperate to get out of the house. The excursion proved to be a little premature. Max hated every second. Today though, today was the day.

I dressed Max in fleece pants and hoodie, wrapped him in the carrier and off we went (much simpler than the countless layers we donned in February.) We stepped outdoors and the sun hit his face - he squinted, turned his head quickly and realized he was out in the world that he usually watches go by from the car window. He was instantly hooked. We walked around our neighbourhood for 15 minutes and Max took in the sights. He was captivated by everything, and quietly turned his head from side to side making note of the soggy brown grass, the bare trees, the dirty cars, the mud puddles. I only wonder what it all must look like through his eyes. We ended our excursion in the VitaHealth market down the street from our apartment where we bought a few things for dinner. This was Max's first trip to a store of any variety. Actually, the first place he's been aside from Dr. appointments and Vovo's house. He eyed the shelves of coloured boxes, watched Dad bag some vegetables and watched very intently as the lady at the counter bagged our things and made small talk. I counted three other shoppers while we made our purchases so it wasn't a bold introduction to the general public, but it was nice to get out and share a simple shopping experience as a family.

It seems silly, but we often lamented how we couldn't just escape the house this winter and roam around the mall like people with "regular" babies. This quarantine has been fairly isolating. We're really used to getting out together - running errands, grabbing a bite to eat, going for coffee - so it's been hard to not go out together as a family. We've been spending the winter taking turns getting out of the house while the other stays home with Max. But spring is here and in May we can start taking cautious trips into public and finally showing Max off to family, more than two at a time. Just in time for his birthday!

(Mostly) Wordless Wednesday.

Yeah, I'm adorable.

I may be a little wobbly, but I can stand all by myself!

No, no, I don't want to eat with the spoon - I just want to bang it on my chair.

I can do it!

Check out my new chompers!

Busy bee.

It's been a busy week around here - somehow we managed to have three doctor appointments all in the same week. Max is officially tired and so are we.

Our first appointment was with the feeding and nutrition clinic. We were able to demonstrate Max's eating skills, which are still (very slowly) developing. It's clear that while Max isn't entirely sure about the whole eating thing, he is swallowing what little food he's able to tolerate in his mouth, so it's a positive step. The feeding doctor was quite positive about Max's progress and seemed fairly confident that we need not stockpile lots of g-tube supplies. We have been offering Max food by mouth once a day since we began and we've now been instructed to up the ante. 24 hours is a long time in the world of a baby and we need to get in as many food experiences as possible every day to get him used to eating. So we're now feeding him 3-4 times a day and we've been trying new flavours - banana, avocado, carrots, sweet potatoes, pears. The degree to which he tolerates the tastes varies with his mood, but so far, the increased frequency of feeding seems to be going well. We've also slowly transitioned one of his liquid  meals to a blended food meal, so each time he eats his blended bananas by mouth, he's also getting some through his g-tube. The hope here is that having some solids in his belly not only gives him a full-feeling reward to his oral feeding, but also helps keep his reflux to a minimum. It feels like much of our day revolves around eating, but currently it's our only developmental battle.

Later in the week we met with the Newborn Follow Up Program. This program follows the growth and development of sick and premature babies once they leave the hospital. If Max experiences any problems or delays with his development in any way it will be identified early and services will be set up for him. So far he's doing great and no issues were identified. He's still well within "normal" for his adjusted age. We're super proud of him!

Our third appointment was for Max's monthly synagis injection that protects him against RSV. Unless something changes, this should be the last RSV shot he'll receive this year and RSV season should come to a close in the next month or so. We're very excited to start venturing out into the world once we get the word that the general population is less germy and infected. We're still not going to be rushing out to crowded places, and gatherings with lots of kids or potentially sick people will still be off limits for us, but a walk to the local coffee shop and strolls around the neighbourhood are highly anticipated around here.

In non-medical news, Max has finally cut his first two teeth. His bottom teeth finally made an appearance and his gummy grin now has two pearly whites. He's still gnawing on his fists like they're made of sugar, so we're not sure if the top two are on the heels of the bottom ones or if he's just enjoying the new chewing sensation. Either way, his new smile is adorable and we'll have to snap some new pictures soon.

On Monday Max will be 10 months old (or nearing 7 months corrected). It's hard to believe that his birthday is nearing. He's getting to be such a big boy (but not really), and his 13lbs 2oz is nearly 8 times bigger than his birth weight and he's nearly twice the length he was when he was born. He's still a peanut, but he's huge to us! It's hard to balance wanting him to grow without wanting him to grow up too fast. We're trying our best to enjoy every minute.

Happy "excuse to wear green" Day!

 

And then there were two.

Something new seems to happen every day when you have a baby. It must be amazing to be learning so many things all at once. It really is true what everyone tells you, "Don't blink, or you'll miss something!" It really feels like we've been making up for lost time these last three months. Max was essentially a 3 month old when we brought him home and it really felt like, in a lot of ways, that we had missed that newborn stage with him. Sure we spent time with him, but it's hard to fathom how difficult it is to feel like a parent when your child has never left the hospital unless you've tried to do it. Now that we're home we appreciate every moment a little bit more.

Had Max been born on his original due date he would be 6 months old today. It's hard to believe. It seemed to us that Max was fairly on-track developmentally for his corrected age. We had an appointment with occupational therapy last week that confirmed our suspicions, and it was nice to have the professional nod of approval. There's a fairly wide range of "normal" when it comes to developmental milestones for babies, but Max is well within that range. It's amazing considering where he started. Max is tolerating, and even sometimes enjoying tummy time; pushing up on his arms, rolling over, and trying really hard to get onto his knees. He's very close to sitting on his own and still loves standing - he's taking all his weight on his legs, and just needs help balancing. He's grabbing at toys, making lots of noise during play time, and recognizes his name. We're beginning to wish that a couple of teeth would make an appearance, as Max is a drooling, gnawing, ornery little boy lately - soon, perhaps!

On the eating front, Max has been doing very well. We've been offering him rice cereal once a day and he's doing really great. He seems to love the taste and gets very excited about the whole experience. He still doesn't seem to really understand the mechanics of eating, but ends up inadvertently swallowing some anyway. We're more concerned with building positive associations with his mouth and eating right now and the mechanics can follow. We even tried some pureed pears today, and while he wasn't too sure about the taste and texture he was eventually opening his mouth for more tastes. Certainly a bold effort - we're very proud.

In other health news, the dreaded cold has found our house. For a home with a preemie it might as well be the plague. On the plus side it is Rafael that is sick, and not Max, but we're pretty nervous about having him in such close quarters with cold germs. Rafael has been camping out in the living room and sleeping on the couch and Max and I have been sequestered to our bedrooms. We occasionally wave at each other if I'm in the kitchen, but that's been the extent of our contact. It's been a little rough not having an extra set of hands occasionally throughout the day, and Rafael misses Max terribly, but we're hoping to get through this unscathed. I'm hoping that Max being breastfed makes a difference and will protect him from any wayward germs as we all cross paths throughout our apartment.

We're becoming desperate for winter to be over. Hurry up spring!

The difference of 77 days.

"Is Max eating anything yet?"

We've heard this a lot over the last few months. It was the hot topic before we left the NICU and it's become of even more interest since we've been home. Really, no one wants Max to eat more than we do. The g-tube affords us the luxury of having Max home with us, but it is no walk in the park and comes with its own set of complications. We want him to eat as soon as he is able.

We knew he wasn't ready when we brought him home though - that's why he had the g-tube placed, after all. We've spent a lot of time working with him to overcome his oral aversion, mostly in the way of desensitizing his mouth and getting him used to the sensation of having non-painful things happen in and around his mouth. Our efforts, combined with his own (Max is currently incapable of holding anything in his hands without trying to shove it in his mouth) have been making great strides.

We were told it was likely that Max would skip the bottle stage altogether and move onto a spoon and cup when he was ready for oral feeds. Back in December when we first came home we were encouraged to try some rice cereal to see if a substance thicker than milk might make it easier for him to control, and thereby panic less. It didn't go so well, and it was pretty clear he wasn't developmentally ready for that step - after all he was only three months corrected at that time, which is three months earlier than they generally recommend introduction of solids. We decided to let it rest and concentrate on positive experiences until we felt he was ready again.

Recently Max has been showing signs that he might be capable of trying food again. On a whim I decided to offer Max 2 mLs of breast milk in a syringe. One drop at a time, he swallowed it down, waving his arms and grabbing for the syringe, sticking out his tongue. It took about 5 minutes to finish, but he swallowed it all, didn't panic, and didn't throw up. This might not seem like a big deal, but around here, it's a major win. We decided to throw caution to the wind and pick up another bag of whole grain rice cereal. We set out cautiously, but with high hopes. We were pretty thrilled with how Max took to it. He swallowed several spoons of cereal, without much fuss. No lies here, we were both holding back a few tears. A baby's first bite of solids is always a milestone to remember, but for us, it's a blinding ray of hope. We came home not knowing how long it might take to get Max to this point. Now, we're no fools - you don't make it through 6 months in the NICU without knowing a thing or two about how tiny the steps foward can be at times - but this is such a huge victory we can't help but celebrate.


Compare Max's first attempt at solids, with his second attempt, 77 days later!
Make sure you watch the first video until the end. It's a doozy.