Fight For Preemies

I have two children. They were born born too soon and too small. Their combined birth weight is less than 3 pounds. And I am not alone. Today, 1 out of 8 babies are born prematurely. That's scary. We need to find out why and we need to find out how we can prevent premature birth.

Like so many other women, I did everything I was supposed to do. I took my vitamins, I ate what I was supposed to eat, went to the doctor for every check-up, asked many (many) questions and still, I had babies who came early.

To find out more about our experience with having babies born prematurely - check out our video that was made by the March of Dimes. http://www.fifieldproductions.com/_flash_ambassador_family_08.aspx

Beyond sharing the story of our children's premature birth (in the video above), I want to talk more about what prematurity can mean long term. Dealing with prematurity goes far beyond the NICU stay. Many preemies come home with long term medical issues - our daughter came home oxygen and feeding tube dependent. As parents we have to quickly learn often complex medical issues and how best to navigate the complicated and confusing world of doctors, insurance and medicine.

In addition to medical issues, most preemies need additional support for development including gross motor, fine motor, speech, etc. My kids have both had PT, OT, developmental therapy, speech therapy, and more. Six years into this prematurity journey and I'm still amazed how parents of full term babies don't worry about most of that because their kids naturally develop those skills.

Most of the stories we see in the news are about miracle babies that are now "perfectly" healthy. And I'm happy for those babies. Ecstatic really. But I think sometimes in our want for happy endings we end up avoiding the larger issue. Many preemies (especially those that are born weighing less than 2 pounds but even some that are bigger) end up with long term problems including eating issues, CP, developmental delays that extend long past the "catch up" age of two, and more.

Thankfully my son was able to catch up developmentally by age three. Time will tell if any other issues crop up. Although my daughter is still feeding tube dependent and has some developmental and speech delays, I still consider her one of the lucky ones. Things could have been much worse.

I'm grateful for both of my children. They have taught me more than I can imagine about what true strength means. Both of them had to fight just to survive. They fight every day to learn new things.

Let's all join the fight for preemies so that one day all babies can be born healthy.

Calling All Bloggers

Hi fellow preemie moms and dads.

As many of you probably know, November is Prematurity Awareness Month. I invite all of you to come join me at Bloggers Unite. They are partnering with the March of Dimes in support of Fight For Preemies. The goal is to have 500 bloggers posting on and before Prematurity Awareness day - November 17th.

So consider this your official invitation. Please post a special story about your own preemie miracle. We want everyone to learn why it is SO important to support the ongoing need for prematurity research funding.

You can also grab a badge or banner for your blog. Now get posting!

A Little Blog Vacation

Life has been hectic in the Preemie Parent household lately.

Colds, my son starting Kindergarten (where we have jumped into activities with a full body cannonball - no toe dipping here), new schedules and a pretty bossy two year-old have all combined to take over my schedule.

So I'm officially calling a vacation through next week. By then I plan to have my new schedule set so that I can get a bunch of blog posts up that have been patiently waiting. Like all of you.

Stay well everyone!!

BTW - I found this great section on the March of Dimes website about when to call the doctor: http://www.marchofdimes.com/pnhec/298_1449.asp. For some reason it's not letting me format correctly so I apologize for the full link in the text). There is some good basic information that's highly useful when you're at home not knowing what to do.

Favorite Product: Crayons

Who doesn't love a box of crayons? I've seen people old and young alike sit down and instantly start coloring. They are one of the most basic items because they are great - you can nurture creativity and work on fine motor skills while having fun.

Here are some ways to use crayons to help encourage your preemie's development:

1) Start early - as soon as your preemie can hold an object, give him/her a crayon. Place a piece of paper in front of your preemie and help him/her make a mark on the page. Any effort should be praised. In the beginning your preemie will probably just make light, random marks or dots. And that' great!

2) Drawing lines - once your preemie can hold the crayon somewhat effectively, encourage him/her to draw a line across the page. And then down or up. It helps to draw dotted lines to follow or at least show a start and stop point.

3) Learning colors - since crayons come in pretty much every color, they are a great way to help your preemie learn colors. You can ask for crayons of a certain color or request that he/she colors with a certain color. Older preemies can practice putting colors in order from lightest to darkest.

4) Scribbles are important! Don't worry if your preemie has absolutely no concept of how to color an object. That will come with time. Praise all efforts at coloring across an area. Make it fun!

Happy coloring!

It's cold and flu season already

As we are battling colds #2 and #3 in our house (for the last 4 weeks) I wanted to remind everyone that even though it's not officialy winter, cold and flu season is already here.

Check out the Staying Healthy section for posts about getting kids to wash their hands and tips for going out in public. You know - that place with all the germs.

Please send get healthy thoughts our way. We sure could use them.

Learning Colors Activity: Color Jump

We have been working on naming and correctly identifying colors in our house lately so I thought I would share some of the activities that we have come up. This seems to be an area that my daughter is having trouble with so we are trying a lot of different games and projects to keep her interested and learning.

This first activity is called the color jump (she is really into jumping). For those who are less mobile (or less obsessed with jumping), this activity can be touch the color, stand or sit on the color, etc. Anything that will work for your little one.

Here is a picture of the "game board." Please excuse the fast tape work on the ground. My little one saw what I was doing and quickly came over to "help" so I had to be fast.

I started with five colors however you could start with more or less depending on your child's level.

1. First I showed my daughter each square and told her what color it was. Than I had her stand to one side. As I called out a color I told her to go and jump on that color.
2. I started with yellow since she knows that color best. She was very happy to go over and jump on the square.
3. While playing I would first wait to see if she went to the right color and then help her if she needed it.
4. We've played several times and it keeps her interest longer than looking at a color book or sorting bears.

In my inbox this week

I found two great preemie related things in my inbox this week:

1) The Toys R’ Us Catalog for Differently-Abled Kids. I LOVE that Toys R' Us makes this catalog. They take their toys and divide them into appropriate developmental categories including sensory, gross motor, fine motor, etc. As parents of preemies, we quickly start to train ourselves to view products for more than just the pretty packaging. We constantly ask "What will my child learn/get out of this product?" I think it's great that Toys R' Us takes the time to create this catalog and give parents a head start for choosing products that will be helpful to our kiddos.

2) The NY Times article: For Parents on NICU, Trauma May Last I know this article has been passed around quite a bit this week but I wanted to post it just in case some of you hadn't seen it. So many times the stories about preemies focus solely on the babies. And more specifically the babies who are doing quite well. And while I love a good success story as much as the next person, I think people need to read that the NICU experience extends far beyond the actual experience. It becomes that much harder to survive the experience and get beyond it when no one around you understands what you went through. And they start to get bored hearing about it. I hope that more and more reporters will begin to seek out these stories. They need to be told. They deserve to be told. So thank you Laurie Tarkan for taking the opportunity.

Back to School Time

We are FINALLY (I hope) over the horrible cold that took over our house for two weeks.

With September just around the corner and school starting - it's time for a back to school post. We have a kindergartner in our house so we are all pretty excited (and a little nervous) about school starting this year.

Here are some tips to help make things easier for preemie's that are going to school or daycare.

The more they know
If your preemie has any medical issues and/or is taking medicine, be sure to talk with his/her teacher at the beginning of the school year.

1. Let teachers and administrators know basic information about any conditions or issues that your preemie has. Some examples are: asthma, CLD, GERD, delays, etc.
2. Siblings - If you have older children, let their teacher know a brief summary of your preemie's issues just in case a problem arises. We will be telling our son's teacher about my daughter's oxygen and feeding issues. That way if our son makes reference to it or other kids ask - the teacher will have a basic idea of the issue which will hopefully avoid any confusion.
3. Services - If your preemie is receiving EI services that will take place during school hours - make sure you let the teacher know so proper arrangements (and expectations) can be made.

Medicine

1. If your preemie is taking medicine that must be administered at school, find out who will be giving the medicine and speak to them about proper dosage, how to give it, reactions, etc.
2. Put a Personal Medication Card in your preemie's backpack. I highly recommend having the card for your preemie and carrying it in your purse, in the diaper bag, etc. The link I've provided is to the card that Standford Hospital hands out. If you want to make your own be sure to list the conditions your preemie is being treated for, known allergies, and medicines he/she is taking including dosage.

Social/Sensory/Specific Issues

1. Social - if your child has any issues with peer (or adult) interaction - make sure your preemie's teacher is aware. Be as specific as possible - what triggers the problem, how to help calm your preemie down, etc.
2. Sensory - if your preemie has any specific sensory sensitivities - tell the teacher. Again, be specific. Let them know exactly what causes the problem and how your preemie calms down. If the teacher knows in advance they can help prevent issues before they happen.
3. Specific - Let your preemie's teacher if there is something specific that you want him/her to do or not do. Or on the flip side - if there is something specific that your preemie needs to do each day to ensure a smooth time.

Most importantly: Embrace the new beginning and opportunities for your preemie to learn new things!!

Developmental Milestones: 16-19 months

This week's developmental post is focused on the developmental milestones of preemies who are 16-19 months old. Previously I have done posts for 12-15 months, 9-11 months, 6-8 months old, 3-5 months old and 0-2 months old.

Gross Motor

• Walks up stairs with one hand held
• Creeps backward down stairs
• Climbs into an adult-sized chair

Small/Fine Motor

• Puts a round shape in a shape sorter
• Makes marks with a crayon or pencil
• Stacks 3 blocks

Social/Play Skills

• Plays with the same toy in different ways
• Plays with one other child; each doing separate activities
• Brings an object/toy to an adult to encourage adult to play

Communication

• Names objects or pictures on request
• Uses approx. 5-10 specific words by him/herself (not in imitation of someone else)
• Will get 2-3 familiar objects when asked (one at a time)
• Points to at least 3 body parts on him/herself or a doll

Ways to encourage development:

• Continue to practice conversations - let your preemie say something and then say something back. Make sure you pause in between comments so that your preemie has a chance to respond.
• Play ball - practice throwing and kicking. Use a large ball for kicking so your preemie can more easily make contact with the ball. For throwing, use a small ball that he/she can easily hold onto. You can practice throwing the ball back and forth or into a container.
• Blocks - offer blocks as a toy. Practice stacking (and then knocking them down - the fun part). Build things.
• Continue to read books with your preemie. Point out specific things on each page. "Look at the cow" "The cow is eating"
• Encourage self-care - let your preemie try to feed him/herself more, take on and take off clothes and wash him/herself in the bath.
  

Be back soon

Sorry for the lack of recent postings - We have been in major cold city this week. My son managed to get through it pretty quickly but me? Not so lucky. I don't remember a cold this bad in a long time (I guess there is a definite plus side to staying away from sick people). Let's hope my daughter doesn't get any worse.

Be back this weekend with new posts!!

Thank You

I was recently informed that my blog was included on a list of the 50 Best Blogs for Neonatal Nurses.

Beyond wanting to send out a public thank you for the inclusion, I wanted to pass along the link to everyone because there are a lot of great blogs that could be useful to parents.

So thank you and happy reading!

When Pretend Feels More Real Than It Should

Like many girls (and boys) we have a play kitchen in our house. It's stocked with all sorts of pretend food, utensils, pots, pans and other necessary objects for a kitchen. With help my daughter will happily stir food and pretend to eat it. She very dutifully answers yes or no about the "taste" of the pretend food. Sounds like a great moment, right?

Not exactly.

The thing of it is that all our daughter does is "pretend" to eat food. She will happily ask for food and put it in her mouth. After a few moments or minutes the food comes right back out again. You can imagine how great our floors look sometimes. At this point it has pretty much become a part of our world. I've bought and tried every food possible - spicy soup, bright green pudding, ice cream, Fruit Loops, pickles, mango, the list goes on and on. So far nothing has worked. Since we know she can swallow we hope that she will soon figure out that it is okay to swallow.

As many parents of non-eaters know, it can be tremendously hard to have a baby who doesn't eat. On so many levels. One of the hardest areas is socially. Eating is so.....normal. People just can't grasp the idea that someone willingly will not eat. I've had family, friends, strangers, doctors, etc. tell me to try all sorts of things. And I do. I have. I will. But so far none have worked. Most people are well meaning. They truly want to help.

Then there is the flip side. Some think that we just aren't "doing it right." If only that were the reason. If only it was a matter of me being retrained because let me tell you - I would sign-up for that course in a heart beat. And I'm positive I wouldn't be the only one there. But alas. That's not quite it. It isn't a matter of buying the right food or feeding it to her in a certain way.

I know in time it will happen. It will. Until then I smile and try not to laugh (or sometimes cry) when I ask my daughter if that bite of air was indeed delicious.

It usually is.

Of course.

Imitating Movements

One of first ways that children learn how to speak and communicate is to copy or imitate movements that they see.

By helping and encouraging your preemie to imitate movements, your can improve eye contact, interaction and communication. Find various times throughout the day to encourage your preemie to imitate various movements. Start by doing the movement yourself a few times and then encourage him/her to do the same movement. Make sure you praise any attempt at imitation.

Here are some activities and movements to get you and your preemie started:

• Clapping
• Waving
• Blowing a kiss
• Brushing hair
• Knocking down blocks
• Stirring with a spoon
• Brushing teeth
• Blowing bubbles
• Pushing a car
• Banging blocks or other objects together
• Pushing buttons
• Throwing a ball
• Putting a hat on

Make and Take: Basic Foam Puzzle

I just posted a tutorial on Entertaining Kids on the Go about making a Basic Foam Puzzle. For preemies who are learning about puzzles and shapes, a basic 2 or 4 piece puzzle is a great place to start.

Encouraging Imaginative Play

Teaching your preemie how to use his/her imagination can be one of the most frustrating and fun things to do. Imagination doesn't come easily at first. My daughter in particular is a very linear thinker - if something does a specific thing than she will do it. Getting her to interact with a toy without any rules or prompts is much more difficult. So we start slow and continue to work on it. Here is a look at one of her new favorite games along with specific examples how we use it to encourage imaginative play as well as speech and fine motor skills.

Here is a picture of our pretend zoo:

As you can see, we subscribe to an open floor plan. Our animals are free to roam about when they need exercise. We also like to give them plenty of changes to their living areas so we occasionally build tall towers are extra tall wall pieces when necessary.

1) Fine Motor - Using large building blocks is a great way to built a preemie's fine motor and planning skills. Encourage your preemie to put the pieces together however he/she wants. There is no perfect building or zoo cage for that matter.

2) Imagination - Talk about what you think the animals want to do. In the beginning you can help guide the activity. Are the animals thirsty? I give my daughter a mega blocks piece and encourage her to give the animals some water. Do they want to play? Maybe they want to jump. Then my daughter will help each animal jump. Sometimes they jump on the ground and other times they like to jump on the blocks.

3) Speech/Communication - Talk about each of the animals in the zoo. Name them and talk about what sound they make. Work on action words like sleeping, eating, or drinking by having your preemie help the animals do each thing. As he/she makes the animal jump say "look the animal is jumping. He is jumping very high." This will help your preemie make the connection between the word and the action.

Documenting my preemie birth experience

I'm glad that people are finding the 20 questions useful. As promised, here are my responses to the questions. I used my son's birth for this one. I took out all of the NICU related questions because I think I'll do those as a separate set of answered questions.

1. What are the facts?
   a. Weight/height/gestation info.
   Dominic was born weighing 1 lb. 15 ozs., he was 14 1/2 inches long and was exactly 31 weeks.
   b. Birth info – why did you have to deliver early?
   I had to deliver because I had HELLP Syndrome. My blood pressure was skyrocketing, my kidneys were beginning to fail and Dominic wasn't moving as much as he should have.
   
2. What are some of the firsts you remember most?
   a. First seeing him/her
   I got to see Dominic for the first time as they wheeled me from recovery to a regular room. I remember being amazed at how tiny he was and yet he was still able to hold my hand for a moment.
   
3. Beyond your significant other, who was the first person you told about what did or was going to happen? Why?
   The first person we called was my sister. She was going to college at the time and living with us. She came right over and stayed with my husband which was great.
   
4. What was the scariest moment?
   One of the scariest moments for me was when I realized that I was going to have surgery. I had never had surgery before and the only thing I could think about was those Reader's Digest stories where the pain medicine doesn't work. In a way I'm glad that those thoughts were there because they quite honestly made me focus on something other than the fact that I was delivering our baby so soon.
   
5. What was the happiest moment?
   Getting wheeled into the NICU and seeing my son. It was also scary but seeing him there looking like a real baby (I seriously had no idea what to expect) made me happy. And hopeful.
   
6. When you look back, what makes you laugh?
   I will never forget this particular moment. The doctor had just told us that they needed to deliver right away. In my head I'm thinking "Okay. Well, I haven't had Lamaze classes yet so this will be hard. But women did it without classes for years so I'm sure I can do it." My thoughts must have been apparent somehow because suddenly the doctor looks at me and says "This will be an emergency c-section." Of course I looked straight back at him and said "Right. I figured that was the case."
   
   The other funny thing I remember is not being able to stay awake during the first 24 hours after surgery. They had to give me magnesium sulfate and that stuff knocks you out (esp. when they give you a really high dose). I would fall asleep in the middle of conversations. At one point they had brought me a Popsicle and I distinctly remember my brother-in-law sitting there and having to tell me over and over again "Debbie. Don't fall asleep. You have a Popsicle."
   
7. What was the hardest part?
   I had to be put under for the surgery because my platelet levels were so low. Waking up in recovery I had no idea if my baby had made it, how he was doing or anything. My husband came in pretty quickly to tell me we had a boy and how much he weighed. The nurses promised to bring in a photo however it seemed to take forever. I felt like I was in that room for hours (turns out it was only about an hour and a half) and just knowing that my son was in the NICU somewhere and I couldn't go see him was really hard. I did finally get two Polaroid pictures to look at and I will always treasure them.
   
8. What surprised you the most?
   I was really surprised by how hard it was to recover from the initial surgery. In some ways I'm thankful that my first 24 hours were foggy because I didn't focus on the fact that I couldn't see my son. The next day I thought that I was doing much better and started to grumble to the nurses that I was FINE despite what they said. So the nurse had me get up and sit somewhere while they changed the sheets on the bed. Not more than 30 seconds into it I thought I was going to throw up. Hmmm. Perhaps the nurse did know what she was talking about.
   
9. Who was there? Who helped you the most?
   Many of our family and friends came out to support us which was great. My parents, my husband's parents and my sister (and her husband) were there quite a bit and that helped a lot.
   
10. What are you most grateful for?
    I'm grateful for the anesthesiologist in the operating room. Just as she was putting the mask on to put me under she said "You are going to be fine and your baby is going to be fine." That helped me relax so much and I will always remember that moment.
    
11. What sounds or smells do you remember?
    Hmmm. I don't really remember anything right now.
    
12. If you could capture one moment in time and take a picture of it – what would it be? Why?
    I think it would have to be the moment they wheeled me into the NICU and I got to see my son for the first time. It was scary but also so wonderful. Even though we remained worried about him and his survival for the first few weeks, I think in that moment I knew he would make it.
    
13. What would you change about the way you did things or a decision you made?
    I had known that things weren't quite right for the last couple of months (I was really small) and I wish I had pushed harder for them to check on the baby. Since he was my first I didn't really know what the expect so I wasn't sure if I was right or just being paranoid.
    
14. What have you learned from the experience?
    I definitely learned to trust my instincts more. If something feels wrong (or right) than I try to listen to what that inner voice is saying and go with that. I've also learned that sometimes the most important things are taken out of your hands (the care of my son) and that has to be okay in order to get to the next step (taking him home).
    
15. Have you changed from the experience?
    I think so - I hope so. Among other things, I've become much more assertive with medical personnel. This is my body (or my child's body) and I will always have a say in what is done and why.
    
16. How did it make you a better person?
    I think that the whole experience has made me much more thankful for what I do have. It has also made me realize that things happen that we didn't want or have any control over but we have to make the best of it. Whatever that might be or mean.
    
17. What would you tell other people who are going through the same thing?
    Trust your gut. Doctors are often too quick to disregard a potential problem. Friends may tell you - "oh it's nothing. Don't worry about it" And they might be right. But what if they aren't? If you really feel like something is off or not right, ask to be checked. The best/worst that can happen is that they tell you everything is fine.
    
18. Would you/could you do it again if you had to?
    Absolutely! And I did (with far more issues the second time - lucky me).
    
19. How did it feel when you knew you were going to be taking your baby home?
    Exciting and a little bit terrifying at the same time.
    
20. Five words that describe the experience
    Scary. Amazing. Terrifying. Humbling. Incredible.

Documenting the Experience: 20 Questions

Many preemie parents that I talk to have a hard time thinking, talking, or writing about their preemie’s birth experience and time in the NICU. Unlike healthy pregnancies, a preemie birth is far from a joyous, happy experience. Instead it is filled with fear, sadness and missed opportunities. Although it wasn’t the perfect experience, I feel that it is important (perhaps essential) to document the experience. Think of what it will mean to your kids as they get older. Whether you scrapbooking, blog or simply write in a notebook, capturing this experience can be a wonderful way to remember those beginning moments in your preemie’s life.

Ali Edwards has been a huge inspiration for me over the years. She has always made a point to focus on documenting the story. Using words and photos you can remember the memories of your little ones start in the world. She did a great series on using words and photos that I think is fantastic.

I think sometimes part of the problem that preemie parents have is that as they tell the story, the emotion of the whole experience comes flooding in. Most of us can quickly dissolve into a puddle of tears as we remember how we felt and what our babies went through. And that’s okay. I think that if you can concentrate on small parts of the story than you can really capture the whole experience. And hopefully by isolating specific moments, you won’t be so overwhelmed.

I have created 20 questions that I think will give any preemie parent a chance to write down and record their preemie’s experience and hopefully get through it. They might even help you remember things that you forget when faced with the whole experience. You can use the questions to write about their birth, the NICU experience, first year or all of them. In the next few days I will post my answers to the questions.

So take a deep breath. Dive in. Remember the moments. Enjoy the process.

1. What are the facts?
   a. Weight/height/gestation info.
   b. Birth info – why did you have to deliver early?
2. What are some of the firsts you remember most?
   a. First seeing him/her
   b. Holding him/her for the first time
   c. First bath
   d. First time on room air
   e. Feeding – first time breastfeeding, first time with a bottle, full feeds
3. Beyond your significant other, who was the first person you told about what did or was going to happen? Why?
4. What was the scariest moment?
5. What was the happiest moment?
6. When you look back, what makes you laugh?
7. What was the hardest part?
8. What surprised you the most?
9. Who was there? Who helped you the most?
10. What are you most grateful for?
11. What sounds or smells do you remember?
12. If you could capture one moment in time and take a picture of it – what would it be? Why?
13. What would you change about the way you did things or a decision you made?
14. What have you learned from the experience?
15. Have you changed from the experience?
16. How did it make you a better person?
17. What would you tell other people who are going through the same thing?
18. Would you/could you do it again if you had to?
19. How did it feel when you knew you were going to be taking your baby home?
20. Five words that describe the experience

Favorite Product: Teddy Bear Counters

We are currently working on sorting and naming colors right now so Teddy Bear Counters are a current favorite toy in our house.

I like these little bears because they offer a lot of color options and kids can enjoy the fun shapes and feel to them. Our daughter is much more interested in sorting the bears than she is flat shapes or paper. Here are some fun ways to use these bears (or similar products) to encourage your preemie to sort colors.

1) Start with only 2 or 3 colors. Too many colors is confusing and difficult for your preemie to master. I like to start with yellow, red and blue because each color is very distinct and easy to tell the difference (as opposed to orange and red since they are very similar).

2) Use cups or a divided tray to help your preemie realize that the bears are to be separated rather than piled together. For my daughter I have found that a divided tray works best because she can't move it. With cups she often gets distracted because they can be knocked over or moved.

3) Place one bear of each color into the cup or tray section. Start out by doing the activity yourself. Pick up a yellow bear and say "yellow." Then point to the bear on the tray and the bear in your hand and say "see- same, same." You want your preemie to start understanding that some things are the same and some are different. This will help him/her figure out how to sort. Do one or two of each color yourself and then encourage your preemie to put the next bear in. If he/she does it right than do a lot of praise. If he/she gets it wrong just say - "No. Those aren't the same." and then help him/her put the bear in the correct spot.

4) Add more colors over time. As your preemie starts to master the basic idea of sorting, add more colors so that he/she can continue to build on the skill.

5) Be patient. Like with anything else, if your preemie isn't interested in the activity than put it away and save it for another time.

Keeping Your Preemie Safe

One of the big areas that new parents often hear a lot about is baby safety. There are a ton of great safety products out there for keeping your home baby proofed and safe from exploring little people. However preemie parents need to think beyond normal baby proofing and consider baby products and how safe they are for their babies.

The March of Dimes has a great page on Baby Safety. Here are some additional tips for keeping your preemie safe in baby gear or with toys that may not be designed for them.

1) Weight - Many preemies come home weighing less than 5 pounds so car seats can be a big issue. Make sure you check the weight requirements and belt position before buying one. Check my list of car seats for ones that are ideal for preemies. This is also true for other products like Baby Bjorn and some toys. While it may not seem that important - often the weight/size requirement is there to ensure proper positioning during use.

2) Actual/Adjusted age - Remember to use products that are appropriate to your preemie's adjusted age. Your preemie won't get the maximum benefit (and may not be developmentaly or physically ready) for a toy that is made for someone older.

3) Physical abilities - if your preemie has some physical issues or limitations than make sure you choose toys or equipment that will fully support them and enable them to use the item. This is important for equipment such as infant baths. My daughter has low muscle tone so we had to use a bath that allowed her to lay back with support but was also big enough to accommodate her. I like to choose toys that transition through phases such as tummy time, sitting and then standing. This allows you (and your preemie) to get the most use out of the product.

4) Small parts - some preemies tend to be mouth objects a lot longer than full term babies. Make sure that any toy you give your preemie doesn't have small parts (this goes back to the issue of choosing toys that fit their developmental abilities vs. actual age).

To check out potential products and toys for your preemie, here are some of my favorite
preemie products.

Favorite Product: Bubbles

This week's favorite product is Miracle Bubbles!

Bubbles are such a great, inexpensive toy that pretty much any kid will enjoy. There are a ton of choices out there but at the end of the day - any set of bubbles will do. Here are some ways to use bubbles to encourage your preemie's development.

1) Blow some bubbles - encourage your preemie to watch the bubbles fly away. Once they get the idea of tracking the bubbles, show them how to pop the bubbles. If your preemie isn't yet mobile than I would first try bubbles in the house or in the bathtub. That way he/she has more of a chance to actually pop one. You can also blow some and then use the blower to hold one of the bubbles so your preemie can see it and you can help him/her pop it.

2) Asking for more - bubbles are a great activity to do when you are trying to teach your preemie to tell you that he/she wants more of something. Whether you are using sign or words, blow some bubbles and then wait. Then ask "Do you want more?" Show me/Tell me. And then blow more after he/she indicates more.

3) Gross Motor encouragement - bubbles can help encourage your preemie to crawl/cruise/walk/run. Blow some bubbles in one direction and then encourage your preemie to go get them. This is another time when blowing bubbles inside might help because they don't go as far away.

Let's Hear It For The Dads

With Father's Day just a few days away, I wanted to devote a couple of posts to dads.

Did you know that the March of Dimes has create a site with information geared just for dads? Check it out: March of Dimes site just for dads. There is a lot of great stuff there. I love that they made a separate section. I think too much of the time all of the pregnancy/new baby information is only talking to the moms so dad's tend not to read it. They miss out on some good information.

Here are some things that I have noticed/learned/discovered as the parent of two preemies:

1) Ask him too - With both of our kids I've heard many people ask "how are you doing?" or say "this must be so hard on you." And while I greatly appreciate the concern, I realize that many people don't/didn't ask my husband how he was doing. It's his baby in the NICU too. So take a moment and ask the new dad how he's holding up.

2) Guys are different - Although there are thousands of articles and talk show segments devoted to the fact that guys react and think differently than women, in the stress of the moment we often forget. We maybe in the corner crying our eyes out and look over at our husband/partner and see him zoning out watching a ballgame. Your first instinct maybe to yell "What is wrong with you?" but before you do that - take a moment (or two). Guys often internalize a lot of stuff - just because he isn't sitting next to you crying doesn't mean he isn't just as upset. Now if he normally cries at stuff and suddenly he has the emotional depth of a doorknob than maybe you should talk about it. Make sure he isn't burying those feelings too deep. I still remember the day that the social worker came to see us after our son had been born. He was born very early Saturday morning and she didn't see us until late Monday afternoon. Now, if I can help it I try not to cry in front of random strangers. We had already talked and cried with so many people that I was able to hold it in. So, it bothered me SO much when after talking with us she said "I'm a little concerned that you guys aren't more upset. You know, crying more." Remember that outward appeareances often hide what's going on inside.

3) Dads need to take care of the baby too - I know how hard it is to watch your baby in the NICU and see the nurses doing all of the day to day care. You just want to jump in there and say "that's my baby. I want to do that." So I also know how exciting it is to change a diaper and take a temperature. Finally - mom gets to do something. And while that is very important and a huge bonding moment, don't forget about dad. Let him (even encourage him) to get in there too and change the diaper every once in awhile.

4) Dad may not want to be at the hospital for as long as you do - this goes back to the whole concept of guys are different. You may be content to see at your baby's bedside for hours at a time. Your husband may be good with a 10 minute visit. Or vice versa. One is not wrong or better. Try not to get upset with your husband. Talk about it and just accept that he is doing what he needs to do and you get to do the same.

More later this week...

Sign Language: Play

This sign language post is devoted to the sign for "play." Obviously kids love to play so this is a great sign to teach but it's also another nice way for your preemie to indicate an activity vs. a need.

Go here for an explanation and video on how to do the sign. For beginning tips on introducing sign language to your preemie, click here.

How to incorporate the sign:
- Start using this sign every time you want your preemie to "play" with you. Start by using the word and the sign together. After your preemie has watched you a few times, help him/her do the sign him/herself. *TIP* Depending on how old your preemie is, play can be a difficult sign to figure out. My daughter had a hard time making a distinction between play and all done because they both involve moving your hands around. We changed the sign by having her just use a closed fist and then moving them. If you do make any sign modifications - make sure any caregivers, therapists, family members, etc. know what the modified sign is indicating.
- Every time you change activities during play time, use the sign and word together. For example: Do you want to "play" with the blocks? That was fun. Now let's "play" with the puzzle. Anything that helps your preemie realize that if he/she uses the sign, he/she will get to do what they asked to do.
- If your preemie brings you a toy, use the sign or encourage him/her to use the sign before playing. You can take the toy and say "do you want mommy to play blocks with you?" and use the sign.

Remember to try and honor your preemie's request to play if he/she uses the sign. Even if you only have a couple of minutes, that will still help your preemie make that important communication connection (ask and you will (usually) receive).

Development: Learning Joint Attention

"Joint attention" means the active sharing of an experience with your preemie. When both of you are actively looking at an object or event - sharing in the moment. This can be a very difficult skill for some preemies to learn but it is really important for learning speech and social skills.

Here are some ways for you to help your preemie develop this skill:

"Look at me" - While your preemie is sitting near you, tell him/her to "look at me" and wait for him/her to look. If he/she doesn't than say it again but gently tap his/her face and then your own face. Again, wait for your preemie to look.

"Look" Part 1 - Hold up a toy and say "look." Wait for your preemie to look at the toy. When he/she looks, give him/her the toy as a reward. You can also point to a toy and say "look." Once your preemie has looked at the toy than give it to him/her to play with.

"Look" Part 2 - Blow bubbles and say "look." When your preemie looks at you, blow more bubbles and then say "look" again while you point at the bubbles.

"Look" Part 3 - Reading books is a great way to help encourage your preemie to grasp the "look" concept. As you read a book, point to the picture and say "look." You want your preemie to look at you and then look at the picture.

You can practice this concept anywhere or with anything that your preemie might be interested in. A balloon, family member, trees, anything that will attract your preemies attention and get him/her to share the experience with you.

New Blog

I've started a new blog - sort of an extension of this one. It's called Entertaining Kids on the Go. After having to take my kids to weekly appointments and being forced to come up with some fast ways to keep them entertained and quiet - I decided to start a blog that shares those ideas for other moms and dads.

Enjoy!

So Excited

I am very excited to announce that I am now an official March of Dimes Mom. They should have my picture and bio up soon. My husband and I have gotten so much out of the amazing March of Dimes community so I am delighted to be able to give something back. Being able to read information from a trusted source in addition to stories from other families who “have been there” was (and is) very helpful to us. I’ll be blogging about topics related to prematurity (like I do now) but as an added bonus, I’ll be linking to some great information from the March of Dimes.

Keep Talking: Part 2

This is part 2 of the Keep Talking series. This series provides suggestions for ways to talk to your preemie even though he/she isn't talking back. Today's post will give you more ideas to keep the conversation going. Keep Talking: Part 1 has some additional ideas for you.

1) Action - when you talk to your preemie and narrate what you or he/she is doing, use action words like jump, run, sit, sleep, etc. This is a great thing to do with a stuffed animal. Make the doggie jump high or lay down. Give a stuffed animal to your preemie so that he/she can do it with you. Try to repeat the word and action as many times as possible in a row so your preemie really starts to process the word and the meaning. If you go for a walk you can say "look we are walking. Let's walk. Look we are walking together. Wow. You are so fast. Maybe tomorrow we can walk again." This is also a great activity to do with siblings. Narrate what they are doing or get them to play Simon says so that you can repeat an action several times.

2) Description - Help your preemie understand more about what is going on around them by using descriptive words. Try it right now - grab the closest object to you. What words can you use to describe it? For example, I have a little rubber ducky next to me (courtesy of my daughter). I can say that the ducky is yellow. The duck has an orange beak. The duck has a purple crown on her head. The crown is very pretty. The duck has a purple star too. This duck is small. You can squish the duck to make a squeaky sound." And on and on you can go. To start, try picking a single descriptive word and use it as many times as you can. Put your creative hat on and just start talking. Make it a game. Get siblings involved. If you have trouble thinking of things - talk about the shape, size, color, weight, location, noise, size, etc.

3) Keep it simple - Sometimes preemies have a hard time processing all of the words that we say. Especially when we are trying to tell them to do something specific. I've found that if I keep the request down to 2-3 words my daughter has a much easier time understanding me. It may sound weird to a stranger but trust me - it works. Some examples are: if I want my daughter to put a toy in a bin, I simply point to the toy and then the bin while I say "put in." As she gets older and understands more I will expand that to "put car in" and then "put car in bin," etc. Start simple and see how your preemie reacts. Chances are he/she will have a much easier time following your direction.

It may seem hard to do these things but trust me, once you get started it will quickly become a regular part of your day/routine. Just like anything else, start small. Pick one time of a day where you will narrate everything you are doing. Or choose bath time to describe the toys your preemie is playing with. Choose one activity where you simplify your language.

Happy talking!

Drawing a line

As your preemie starts to develop his/her fine motor skills - encourage him/her to "color." At first just have your preemie hold the crayon and touch a piece of paper. Make sure you point out the color marks that appear on the paper. Take a crayon and color with your preemie.

Once your preemie gets the idea, he/she will start to dot the paper and then draw random lines across the page. There won't be any rhyme or reason to the drawing and that is fine. In fact - feel free to cheer your little one as if they have just completed a masterpiece on par with DiVinci or Van Gogh. Normally kids do horizontal lines first. As your preemie masters the art of a horizontal line, you can start to encourage him/her to draw a vertical line. This can be a difficult concept to understand so here are two ideas to try. The ideas come from my daughter's awesome developmental therapist.

1) Go/stop. Draw a circle at the top and bottom of the page (vertically). Connect the circles with a green dotted line. Color the top circle green and the bottom circle red. I would suggest starting out with about 5 of these lines. Put your crayon on the green circle and then draw a line to the red circle (you have now made a vertical line). As your draw the line say "go" and then say "stop" at the bottom. Do the first two lines yourself and then encourage your preemie to do the same. Continue saying go/stop as each line is drawn.

2) Vroom. This is basically the same concept as go/stop but instead of saying go/stop - you say vroom while the line is drawn. This is an especially good thing to use if you have a little boy who likes cars.

Having a sound associated with a specific movement or activity is very useful for getting kids to try and then remember it. I had tried to get Olivia to draw a vertical line with zero successes. Seriously. We talked about. I showed her how to do it. She was very excited - yes was heard several times when asked if she wanted to try it. And so the crayon was handed over. And then she promptly made horizontal lines over and over again. After our developmental therapist told me about the go/stop trick I tried it out and in one try Olivia was making vertical lines.

The funny part is that she continues to say go/stop when she draws the lines (even without the circles).

Happy coloring!

Favorite Products #33

A current favorite product in our house is the Doodle Pro.

Recently my daughter has become nothing less than obsessed with the Doodle Pro. She excitedly points at it and says "draw, draw." I have always loved Doodle Pro type products because it provides endless amounts of possibilities - don't like your drawing? Erase and start over. Do you want to practice drawing circles or other shapes? Go for it. This is a great product for kids because you can take it anywhere, it doesn't make a mess and kids of pretty much any age can have fun with it.

Here are some ways to encourage your preemie's development:

1) Fine motor - This is obviously a great product to help your preemie work on fine motor skills. Holding the pen and then drawing with it takes hand strength and coordination. If your preemie has trouble at first, help him/her hold the pen and draw. Some of the Doodle Pro products now come with magnetic shapes that can be "stamped" across the board. This is another great activity for fine motor work. You can have your preemie work on lines (horizontal first) and then circle drawings. My daughter loves to trace her (or my) hand too.

2) Cause and Effect - a great way to demonstrate this is by drawing a picture and then sliding the eraser bar so that it disappears. Tip: make sure you demonstrate the erasing part with your OWN drawing first. Some kiddos don't want to erase a masterpiece right away.

3) Shapes, counting, etc. - as your preemie gets older you can use the Doodle Pro to practice naming shapes or count how many of something you have drawn.

The Proof is in the Pudding

Or yogurt as the case may be. I would like to present my latest adventures in the world of feeding/weight gain issues. Otherwise known as "how to tell that your life is slightly left of normal."

Proof #1: Last night I was at the grocery store (THE happening spot on a Friday night). I was cruising through the yogurt section and stopped to buy some Danables Crush Cups. For those of you unfamiliar with this item, it is yogurt in a cup that you squeeze in order to slurp the yogurt out. I see it as a personal testament to how much I love my son that I let him eat these things - I hate the sound of slurping. Anyway, lately he has been eating two of them each day during his snack times. As I went to pick up more of them last night I did a happy dance. Not because they were on sale (that dance came later) instead it was because they are 100 calories each. That meant an extra 200 calories each day! Exciting stuff for a mom whose son needs to gain weight and doesn't seem to be able to.

Proof #2: At the checkout I was unloading the baby food I had bought for my daughter. She still isn't eating orally - we are putting it down her tube. Anyway, as I was doing that I was hoping with my whole being that the checker would not ask how old my baby was. Because my baby isn't really a baby anymore. She's two. I wasn't really prepared to explain the whole reason why my two year-old is eating stage 2 fruits and vegetables. And not really eating them at that. So instead I was fully prepared to take complete ownership and parental claims of my nephew. My sister's beautiful, healthy eight month-old who does eat stage 2 baby food. I'm sure she will understand. With his adorable cheeks he never stood a chance against me taking ownership anyway.

Songs to encourage communication #2

As I posted before, singing to and with your preemie is a great way to enhance his/her communication skills. Last time I posted about Wheels on the Bus. This post is dedicated to the classic song "Old McDonald Had a Farm."

Here are some ways to help your preemie participate in the song.

1) Animal sounds - This song is great for teaching and working on animal sounds. If your preemie is just learning animal sounds than make sure you really focus on the animal sound part of the song. As your preemie learns new animal sounds you can add more verses to the song.

2) Use pictures or toys - If you have a book with animals or actual animal toys than bring those out for singing the song. This will help your preemie make the connection between the animal and the sound. As you sing the song, hold up the animal or picture that you are singing about. You can let your preemie hold the animals and play with them during the song.

3) Pause - During the song, try to pause during each part (esp. the animal sounds part) in order to give your preemie a chance to "sing" along. Any sound or attempt at sound that your preemie makes should be celebrated and encouraged. It doesn't matter if he/she sings in tune with the song. Taking turns helps your preemie learn how to talk and communicate.

3) Add animals - Does your preemie know more jungle animals than farm animals? No problem. Your farm can have any animal on it that you want. Lions, elephants and pigs can all hang out and play on your farm. We have also added in a farmer (who says hello) and a tractor (who makes car sounds that only my son can do).

Life in our preemie world: Stares

8 minutes and 12 seconds.

That is the longest amount of time that someone has full on stared at my daughter (that I noticed and timed out of pure curiosity). Granted it was a ten year-old boy but still. Awkward. When we go out places we often attract first, second, and sometimes even third looks from people. We went to Disneyland last year and two different people walked into something because they were looking at her and not the big huge bush in front of them.

For the most part I don't mind the extra looks. A two-year-old with oxygen is an unusual site indeed. Add her feeding pump and that makes for even more attention worthy notice.

I usually just smile at the kids that stare and then ask their mom or dad half whispered questions about "the thing in her nose." The 8 minute stare came from a boy who walked over and just stood directly in front of us while we were watching my son ice skate. I tried to get his attention to see if he had a question but nope - just kept staring.

My husband and I actually don't mind when people ask questions about our daughter. We want to spread the word about prematurity. Personally I do get a bit frustrated when people just stare without saying anything or ask "what's wrong with her?"

I know I'm not alone. I've talked to other preemie moms and dads that have had people stare at their child, ask ridiculous questions or compare how their kid is doing to yours. So I've decided we should fight back. Let's stare at all those weird full term babies who hit their milestones on time, are average size and basically "normal." Let's ask silly questions. Here are some completely tongue-in-cheek, just for fun suggestions to get you started:

1) How old is he/she? When they give their perfectly normal answer that matches the size of their kid than you ask - "Isn't it boring to have a child whose size is so...predictable?"

2) When they talk about how they only go to the pediatrician for immunizations/well baby/sick visits, than you say "So, you only have one doctor for your kid? I have 7!" We may not be able to beat them at some things but doctors - we win every time.

3) When they talk about how their kid did xyz at whatever age than you just stare for a few seconds and say "interesting." That will throw them off. Or you can say "doesn't that get boring?"

Do you have any strategies or thoughts about dealing with the curious people of the world? Please share!

Where O Where

Many apologies for my blogging absence of late. Between birthdays, appointments and a fully mobile two year-old to go with my energetic five year-old, things have been crazy.

But I'm back! With many new posts in the days, weeks to come. If I don't melt in all this heat first.

New Preemie Parent?

Are you a new preemie parent? Is your baby in the NICU or getting ready to come home. Make sure and check out all of the entries in the NICU section for helpful information to get you through a very tough roller coaster ride.

Focus: Single Activity Work

My daughter often has trouble sitting down and working on a single task. If she isn't interested than she wants almost nothing to do with it. Now that she is fully walking, working on specific developmental areas can be difficult. Recently I've started reading a number of blogs focused on the Montessori approach to teaching and learning. I like many things about the Montessori approach and I've been slowly trying to integrate that style of learning into what I do with my kids each day.

One blog that I love has some great activities that she does with her 15 month old. One of them was introducing the concept of pouring. Here is the post: The Wonder Years. She used a large container and put plastic Easter eggs inside that were poured onto a tray. My computer is broken (again) so please click on the link to see the pictures that she has. For Olivia I had her pour the eggs into a bowl.

This is a great task for working on several developmental areas:

1) Fine motor - after pouring the eggs into the bowl, I had her put the eggs back into the large can so she could pour again.

2) Waiting - Olivia had to make sure all the eggs were inside the can before pouring again. This is an important skill to work on with kids

3) Visual perception - by having Olivia pour the eggs into the bowl, she had to figure out where to place the can so that the eggs would end up inside the bowl.

The best part? Olivia loved it! She asked to do it at least 5-6 times for several days in a row. I'm planning on introducing more activities like these and I will post them here for you to try as well.

Favorite Products #32

Lately one of the favorite products in our house is the Fisher Price Little People: Animal Sounds Farm.


Olivia got this as a Christmas gift and she really enjoys it. She hasn't quite gotten to the point of doing any imaginary play but she does like to make animal sounds and move each animal around the farm.

Here are some ways that you can encourage your preemie's development with this toy:

1) Animal Sounds - encourage your preemie to imitate the animal sounds for each animal. The toy does make sounds however it's often easier to just make sounds yourself. Start with one animal and then add in more as he/she masters them.

2) Turn taking - help your preemie learn how to take turns. Drop one toy through the "silo" area and then let your preemie do the same. Turn taking is an important part of language and social development.

3) Fine motor - show your preemie how to open the little doors or operate other parts of the farm.

4) Imaginary play - have the animals talk to each other. Maybe they all want to go for a walk around the farm. Any type of role-playing/imaginary play is great.


Happy farming!

Fine Motor Skills in the Highchair

As kids get more mobile it becomes harder to work on fine motor skills. What preemie on the go wants to sit still? One of the best ways to help your preemie focus on fine motor skills is to do it while he/she is in the highchair. With some planning and enthusiasm you can really make some great progress. Here are some games and activities to try that I posted on a message board recently.

Cheerio Drop and Dump - Get about 10-15 cheerios and put them on the highchair tray (eating the cheerios is always okay and encouraged). Put a small bowl on the try next to the cheerios. Encourage your little one to drop the cheerios into the bowl one at a time. Try and get him/her to use a pincer grasp (thumb and first finger) to pick up the cheerios and drop them in. Once all of the cheerios are in the bowl - let him/her dump it out and do it again. Once he/she has dumped them out once he/she may only want to put a couple in before dumping but that's okay :)

Raisin Drop and Dump - same as above but with raisins - smaller and harder to do.

Stickers - Get a bunch of stickers - bigger ones to start. Start by taking a sticker and putting it on your little one's hand. Encourage him/her to take the sticker off and put it somewhere else. Use smaller stickers as he/she gets good at it. Once he/she gets the hang of it, let him/her peel off a sticker (will probably need you to start it) and then let him/her put it on a paper.

Coloring - tape a piece of paper to the highchair tray. Give your little one a crayon and encourage them to color on the paper. take a crayon yourself and draw some lines on the paper. At first they will probably just make dots and then tentative lines. Once they master a straight line, encourage them to draw a circle and make a cross. Some kids like to hold a crayon in their fist at first so you may want to break a crayon in half or buy the little beginnings crayons.

Popsicle Sticks - Get a travel coffee mug that has a slot at the top. Take some small popsicle sticks and have your little one drop them into the cup through the slot. Once they put them in, open the lid and let them dump them out. Repeat.

Playdough - this is a tough one because kids may try and eat the playdough. You have to be really careful. Take some playdough and just let your little one touch it, squish, roll it, etc. Encourage them to roll small pieces of the dough in between their thumb and first finger. Make snakes by rolling pieces with their whole hand.

Toy suggestion - Right now Target has a great little mini-barn and small plastic animals in the $1 section. They are great (slightly larger) items that can kids can play with and practice picking up, etc.

For drawing - you can get one of those portable drawing boards that erase (Doodle boards) or the Aqua Doodles - uses water to color and then dries so you can do it again.

Songs to encourage communication

Babies love singing. Singing is a great way to entertain, calm and even teach your preemie. It's also a great way to help your preemie learn communication skills.

A great song to start with is "The Wheels On The Bus" Here are some ways to help your preemie participate in the song.

1) Hand gestures - Try to use a hand gesture for each verse of the song. Encourage your preemie to copy you. If you don't know the "typical" hand gesture - make one up. You can tailor it to your preemie's abilities. As my daughter started signing she was much more interested in this song because of the hand gestures she could make.

2) Pause - During the song, try to pause during each verse in order to give your preemie a chance to "sing" along. Any sound or attempt at sound that your preemie makes should be celebrated and encouraged. Taking turns helps your preemie learn how to talk and communicate.

3) Add verses - there is nothing to say that your bus can't have additional people (or animals on it) to make the song longer and/or more interesting for your preemie. If you preemie has some favorite animal sounds or people - put them on the bus too. Here are some verses I add to our bus song here at home:
"The Aunties on the bus say give us a kiss"
" The Grandmas on the bus say we need a hug"
" The Uncles on the bus say give us a high five"
" The doggies on the bus say woof woof woof"
" The kitties on the bus say meow, meow, meow"

Happy Singing!

Focus on sign language: Book

This sign language post is devoted to the sign for "book." Since most kids like having books read to them, this is a great sign to start teaching your preemie how to ask for specific items .Go here for an explanation and pictures on how to do the sign.

For beginning tips on introducing sign language to your preemie, click here.


How to incorporate the sign:

• Start introducing the sign each time you read a book to your preemie. Start by using the word and the sign together. After your preemie has watched you a few times, help him/her do the sign him/herself.
• Use the sign and word in a question. Do you want a book? What do you want? A book? Anything that helps your preemie realize that if he/she uses the sign, you will get him/her what they asked for.
• If your preemie brings you a book to read, use the sign or encourage him/her to use the sign before reading the book. You can take the book and say "do you want mommy to read the book?" and use the sign.
• Each time you read a book, use the sign as you talk about it. Look - we are reading a book (use the sign) about Bob the Builder.
• Remember to read a book if your preemie uses the sign (as appropriate).

Keep Talking: Part 1

When babies are small or have a delay in speaking it is often hard to keep up a conversation with them - who wants to talk to themselves? As hard as it may be - talking with your preemie is essential for language development.

Here are some tips to help get you talking:

1) Toys - talk about the toys or other things that your preemie is interested in. Name the toy and narrate what you and your preemie are doing with it. Look this is a farm. The sheep says "baaa." The sheep is going to go and eat. And look, here is the pig. He says oink, oink. And on and on.

2) Routines - narrate the routines in your preemie's life. As you get him/her dressed, change a diaper or play together talk about what is happening.

3) Repeat, repeat - studies have shown that when kids hear the same word over and over again, they are better able to learn and speak the words. So try saying a word as many times as possible over the course of a few minutes. For example: look at that red car. The car is going fast. Cars say vroom, vroom. Our car is blue. A car has a horn, etc."

4) Slow down - when you speak to your preemie try and slow down. Adults often talk very fast and that can be hard for a preemie to understand. I've been focusing on action words for my daughter (i.e. down, up, in, out, etc). When I ask Olivia something I say "Can we put that in?" with special emphasis on in. It's really helped her to understand and sometimes imitate those words

Favorite Product #32

This week's favorite product is for all the preemie moms and dads out there who are looking for ways to boost the amount of calories they give to their little ones.

The product is called ScandiCal.

According to the Axcan Pharma website - SCANDICAL® Calorie Booster is a taste-free powder that quickly and easily adds 35 calories per tablespoon to your meals, without changing the taste of the foods you love. SCANDICAL® comes in a portable, 8 ounce, shaker-top dispenser can, conveniently allowing you to add calories to individual servings and eliminating the need to prepare separate, high-calorie meals.

I got ScandiCal for our son. He has always been on the really skinny side and I'm trying to add a few pounds on him before Kindergarton this fall. Beyond being an active five year-old, my son doesn't eat a lot at one time. I've tried adding butter to food and make him Pediasure Hot Chocolate each night but to no avail - not enough volume at one time to make an impact. I found ScandiCal and I LOVE it already. It looks a lot like Parmasean Cheese. You can easily mix it into pretty much anything. I haven't said anything and niether has he. I mix it with his peanut butter on sandwiches, in his apple sauce and other foods. So far so good. I think we have even seen a slight weight increase after only a week of use (I can't be entirely sure because I want to get another weight check to be sure it is accurate)

SCANDICAL® is gluten-free and certified as kosher.

Interested in trying it out? The Axcan Pharma website says that you can call for a free sample at (800) 4-Scandi (800-472-2634).

Dance Baby Dance

Babies love movement. Movement can be soothing, fun, and distracting. It can help your preemie learn how to use his/her body and it's a great way to connect with your preemie. You can dance with your preemie at any age. Don't worry - you need to be good at it. Your preemie will just enjoy the time spent with you. And dancing is fun and good exercise - a win, win.

Here are some suggestions to get you started:

1) For very young preemies - start with music that is soft and mellow. Even lullabies work. Hold your preemie in close and gently rock back and forth with the music. Your preemie will start to associate the movement with the music which is an important connection.

2) Once your preemie is strong enough to support his/her own head - make your movements bigger and more purposeful. You can start to choose music that has more of a beat. If your preemie likes it - spin around in circles. Jump up and down (lightly) and really get those hips moving. Anything that allows your little one to really feel the movement.

3) Encourage your preemie's own dancing. Help your preemie move his/her own body to the music. Our daughter started "rockin' out" as soon as she could sit up. Personally I think she was born in the wrong era as her head banging skills are quite good. As soon as she hears music her eyes light up and she starts swaying. I love watching her.

Some Dancing Tips (of the non-technique variety):
- When you introduce music to your little ones, be sure to pick songs that you can stand listening to over and over again. Over and Over. My daughter will only dance to certain songs. If I try and get her to dance to something new she wants nothing to do with it. Currently her favorites are songs from High School Musical. I have only myself to blame as I'm the one who let my son watch the movies with me (much to my husband's chagrin) and then put some of the songs on my iPod.
- Looking for some lullabies that don't make you cringe? Try RockABye Baby! Records They sell lullaby versions of songs from popular bands including the Beatles, Bob Marley, No Doubt, Green Day, etc. I really like them.
- Sing along. Singing with your preemie is also a great way to encourage language development. Sing with the songs and encourage your preemie to "sing" too.
- Feeling stressed? Tired? Cranky? Put on some music and dance (with or without your preemie). We have been stuck inside due to the rain and the late afternoon often brings the cabin fever blues so we have been dancing quite a bit this week.
- If your preemie loves music and/or dancing - use it as an opportunity to teach him/her the sign for music. I'll do a post on the sign later this week.

Happy Dancing!!

Valentine's Day Craft

If you are looking for a great Valentine's Day decoration craft to do with your preemies - I posted one at http://www.giftsbyhand.blogspot.com/

I think I'm going to add new hearts each year to show how much bigger my little ones are getting.

Have fun!

Siblings and Doctor Visits

Depending on the level of issues/needs that your preemie has, you may end up going to a lot of doctor's appointments. If you have other children who are not in school or with a babysitter, that can usually mean that they are dragged along as well. In my case, I have to take our son to most of my daughter's appointments. Here are some things I have learned to make it easier on everyone.

1) Entertainment - when you pack the diaper bag, be sure to pack things for your other kid(s) too. Books, coloring books, small toys, stickers - whatever will keep them entertained and at least marginally quiet for awhile. For my son I always carry around a few cars, this race track, a small pad of paper, some crayons and one toy of his choice. This ensures that he has several options to keep him occupied.

2) Snacks - little ones (and big ones) get hungry. And they often get hungry at the exact moment that your doctor is outlining a new plan of care for your preemie. I always bring an assortment of fruit snacks or other non-perishable items that can be quickly handed over to my son during those moments.

3) Set expectations - let your kids know where you are going and what is going to happen. They need to know what it means to "be good" during the appointment - stay quiet, let mommy/daddy talk to the doctor without interruptions, etc. For our son he knows that going to PT means he gets to play without taking toys from his sister, the pediatrician means he gets to see the trains when we are done, etc. Setting a routine helps to make the trips a lot easier.

4) Rewards - try and find small rewards that can be given to siblings who have to tag along. Many doctor's offices now have train sets or fish tanks to look at - let your kids look at the trains/fish tank before and after the appointment. Spending a couple of extra minutes after an appointment letting them look at the trains can go a long way towards making them feel better about going somewhere they don't want to go. A lot of doctors have stickers and/or lollipops. My son always gets to choose one of each (and our pediatrician is great about handing him the box of stickers so he can stay occupied for several minutes picking one out).

5) Come prepared - if you know the doctor is going to need some specific information, try and have it ready before you get to the appointment. It makes it much easier to balance your kids and listen to the doctor if you aren't also looking for paperwork, etc.

With a little extra planning, bring a sibling to a doctor's appointment can be far less painful and distracting.

Favorite Product #31

This week's favorite product is the 100 First Words Bright Baby board book.

**For some reason I am having trouble with the pictures so I will try and post it later**

While parents may find the Bright Baby (or other similar books) mind numbingly boring, kids love these books. The simplicity, bright pictures and clearly defined items are easy for them to understand. And learn. These books are great for preemies who are working on language development and fine motor skills (including pointing and turning pages). There are many different versions of these books - right now this one is Olivia's favorite. I think she likes the larger size of the pages.

Here are some ways to use this book to encourage your preemie's development:

1) Read the book - this is a great book to read to a preemie who isn't yet ready to "follow" a story and/or has a short attention span. You can get through each page quickly and yet still give your preemie the beginning love of reading.
2) Fine motor - turning the page. Encourage your preemie to turn each page when you are done. At first you may need to lift the page a little bit to get your preemie started but overtime he/she will get the idea.
3) Fine motor - pointing. As you read the book, start pointing at some of the pictures. Choose 2-3 on each page and point directly at the picture as you say the word. Encourage your preemie to do the same. At first your preemie may just randomly point to the page - and that's okay. Over time encourage your preemie to point at specific pictures. This not only helps refine her pointing skills, he/she is also learning to identify objects.
4) Language - As you read the book, clearly say each word. For objects that your preemie might be familiar with - point to the picture and say the word. Draw his/her attention to it "see, here is the ball." This will get your preemie to start identifying the word and the object together. As your preemie becomes more interested and starts building more words, you can increase the pictures that you point too.

Like with anything else, follow your preemies lead. He/she may only be interested in looking at certain pictures or just turning the page. And that's okay. It's all a part of the process.

Focus on sign language: Sleep

This sign language post is devoted to the sign for "sleep/tired/bed." This can be a good sign to teach your preemie so that he/she can tell you when he/she is ready for bed or tired. Once they understand the sign, it is also a useful tool to help your preemie transition to bedtime.Go here for an explanation and pictures on how to do the sign.

For beginning tips on introducing sign language to your preemie, click here.

How to incorporate the sign:

• Start introducing the sleep sign before naps and bedtime. You can say “time to go to sleep” and then use the sign. Make sure that once you make the sign, you put your preemie into bed. If you use a different name for sleep or bed than use that word in order to help your preemie understand.
• When you see your preemie looking tired, ask him/her “do you want to go to sleep?” and then make the sign.
• If you see your preemie making the sign for sleep, honor his/her request and put your preemie to bed. If it’s during a non-nap or bedtime that is okay. Sometimes your little one may want to experiment with signs and the power it gives him/her to communicate. Even if he/she only goes down for a minute, the important lesson is that he/she learns what the sign means.

General signing tip: Create a chart of the signs that you have taught your preemie so that you (and everyone else) can easily tell what signs your preemie knows and/or is working on.

Clothes matter

Don't worry. This isn't a post about the best in children's fashion or a lecture about how to dress your kid more like Suri Cruise. Considering the fact that last week I took my daughter out in pants with fruit snack stains on them (mortified doesn't begin to describe it)- I don't think I'm qualified for that kind of post. Instead this post is about paying attention to clothes as it relates to helping your preemie with their fine/gross motor skills.

1) Shoes - as soon as your preemie starts to work on standing, cruising, etc. they should be in some sort of shoe. Preferably one with a tennis shoe like bottom for the best possible grip. These days you can find shoes with a good sole in almost any style. Socks are far too slippery - imagine trying to learn how to stand or walk on ice. Bare feet are good too because your preemie can use his/her toes to better grip the floor.

2) Pants length - No matter how cute those baby jeans may look on your little one, if they are too long than they will interfere with your preemies movement. I constantly roll up the bottom of my daughter's pants to ensure that she won't trip or slide on the bottom of her pants. Just remember to unroll them when you are going out.

3) Sleeve length - The same rules apply to shirts. If your preemie can't see his/her hands than he/she won't be using them correctly. Make sure your preemie's shirts don't have sleeves that are too long or loose. Also, when working on self feeding or any other messy activity - remember to roll up the sleeves. It will be easier on them and you will feel less stressed about possibly cleaning yet another shirt (and less stress makes for happier mealtimes).

Favorite Product #30

Today's favorite product is a wooden Pop Up Toy.

I absolutely love this toy for its simplicity. There are four cylinders that have hidden springs on the bottom so your preemie can push each one down and then watch it pop back up again. I was amazed at how much time my son spent playing with this toy. Beyond the concept of cause and effect, it is also a great toy for teaching colors.

Ways to encourage development with this toy:

1) Cause and Effect - show your preemie how to push the cylinder down and then have him/her watch as it pops back up again. Help your preemie the first few times and then let him/her do it on his/her own once the concept is understood.

2) Fine motor skills - Once your preemie has figured out how to push the cylinder down, encourage him/her to use just one finger to push the cylinder. This will help him/her learn how to point and to isolate one finger to do something.

3) Colors - As your preemie gets older and starts to notice colors, this can be a great first toy for teaching different colors. Point out and talk about each color. Say a color and then push down the matching cylinder. As your preemie starts to get the concept you can ask him/her to do the same.

Developmental Post #24

This week's developmental post is focused on the developmental milestones of preemies who are 12-15 months old. Previously I have done posts for 9-11 months, 6-8 months old, 3-5 months old and 0-2 months old.

Large/Gross Motor:

• Can walk alone
• Creeps up stairs
• Squats when playing and then resumes standing

Small/Fine Motor:

• Turns pages of a board book
• Stacks things
• Takes the lid off a container (box, tub)

Social/Play Skills

• Combines related objects in play (spoon in cup, man on truck, doll on bed)
• Initiates ball play or other social game
• Imitates adult in simple task (wipes table, dusts, sweeps, etc.)

Communication

• Child's babbling sounds like a sentence of real words intonation
• Uses two single words meaningfully
• Follows a simple direction
• Points to a body part or familiar toy on request

Ways to encourage development:

• When reading a book - encourage your preemie to turn the page
• Put items inside a clear container with a lid and encourage your preemie to take the lid off to get the toy
• Encourage pretend play with items that go together - when "feeding the doll" stir the food in the cup and then feed the baby, put a driver in the truck before it drives away, etc.
• Let your preemie "help" with household tasks like dusting, cleaning tables/cabinets, putting things away, etc.

Advocate Series: Doctors

When it comes to being an advocate for your preemie one of the best (and often frustrating) resources you will have is doctors. You will often have various specialists involved in your preemies care. Every doctor has an opinion or a way of doing things. The key is to find out how to work with all of them in order to get the best care possible for your preemie. So this part of the advocate series is devoted to doctors. There will be three parts including general tips, practical advice and specific ways to get the most out of your team of doctors.

General:

Ask Questions. It is your right and your responsibility to ask your doctor questions about any procedure, medicine, test that they want (or don’t want) to do on your preemie. Make sure to ask the “who, what, why, where and how” questions. This will give you a better idea of what they want to do so that you can make a more informed decision.

Do research but use it appropriately. The internet and message boards can be a great tool for giving you as much information as possible when it comes to various issues your preemie may face. If can be helpful to better understand what your doctor is talking about or to find new options. But a word of caution – spending 5 hours on Google does not take the place of an medical degree. Use your research wisely. It can help you suggest something new or understand why they want to do something. If you read something that indicates your doctor isn’t doing what other doctors have done for other preemies than ask.

Ask for time. If you are being faced with making a decision about a procedure, surgery, medicine, etc and you aren’t sure about it, ask for time to discuss it and decide. There may be times when this isn’t possible however a doctor can usually give you some time to really be comfortable with a decision before moving forward.

Follow up/follow through. I’m sure you have heard the old adage “the squeaky wheel gets the grease.” This can be very true with doctors – especially in the NICU. If you have more questions or if you feel like something isn’t being done than ask. And ask again. On the flip side – do it appropriately. We were told that line in the NICU for our son so we would ask to see the doctor every time we came in but we quickly realized that the doctors didn’t really have an important update and we were more annoying than anything else. Also, if it is something small that you are worried about than bring it up but then give them time to fix the issue. Don’t expect an instant response to everything.

The Ultimate Goal. For preemies there are often many specific goals they need to attain such as eating orally, weight gain, getting off oxygen, going home, etc. Sometimes it can appear like nothing is being done to accomplish those goals or the amount of time/steps it would take to get there is too much. So find out what the ultimate goals are for your preemie and more importantly, have your doctor outline the steps that it will take to get there. Sometimes when you know “the plan,” it is easier to see when and why things are being done. For example, some preemies that go home on oxygen end up getting the rate increased at first rather than decreased. This can be frustrating for parents because it seems like an unnecessary step backwards. Often times it is actually paving the way towards weaning off oxygen. For weight gain – find out exactly how much weight they want your preemie to gain and what they are doing to get your preemie there. Or what you should do to get your preemie there.

Focus on sign language: All Done

This sign language post is devoted to the sign for "all done." This is a great sign to teach preemies because being able to indicate that you are done eating/playing/doing something is very important. It gives your preemie a sense of control over the situation which can help ease potential meltdowns.

Go here for an explanation and pictures on how to do the sign.

For beginning tips on introducing sign language to your preemie, click here.

How to incorporate the sign:

• Start by using the sign in specific situations where you know that your preemie is "all done" such as at the end of a bath, at the end of a meal/feeding time or when you are done with an activity that has a specific end to it (time at the park, playing a game, reading a book, etc). Tell your preemie "bath all done" and make the sign for all done as you say "all done." Repeat this over numerous occasions. The key is to let your preemie be all done when you do the sign. He/she needs to know exactly what all done (and the sign) means.
• Use meal time or playtime to ask your preemie if he/she is all done. Are you "all done?" and then point to whatever it is you are doing. Encourage your preemie to do the sign. Honor any small motion that indicates the all done sign.
• When your preemie makes the "all done" sign, encourage him/her to tell you what he/she is all done with. For example, if you are reading a book and your preemie makes the all done sign, ask him/her - Are you all done with the book and touch the book. This will encourage your preemie to start telling you (by touch or later verbally) what he/she is all done with. This is an important part of extending the communication process and understanding for your preemie.
• Word to the wise - your preemie may start using the all done sign during times when you don't want him/her to be all done. My daughter will say she is all done before we are done with a specific therapy activity or meal. Acknowledge that he/she has said all done but let him/her know that the activity isn't done quite yet. This may take some time to work out but as long as you honor him/her being all done as much as you can it should be just fine.
  

General signing tip: Make sure that you teach your spouse, other children and other caretakers the signs that you are teaching your preemie. This will help your preemie use the signs more often and they will be able to understand what your preemie is saying. It can also be a helpful part of the learning process - when your spouse or other children make the sign be sure to offer lots of praise just like you would if your preemie did the sign.