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.