Life In Our Preemie World

Life in our preemie world has been quite busy of late. A flurry of activities (both planned and unplanned) have kept us busy, busy. One of the things that we have been started planning in our house is Halloween costumes. I know it's not quite October however we LOVE Halloween. And I normally try to make costumes myself which requires some advance planning to get it done in time. This is Olivia's second Halloween. Hopefully she will be able to see at least a few people in this year before the official winter "lockdown" commences. Last year she and I spent it at home while my son went trick-or-treating with dad and friends.

This year she is going to be:

Because seriously, what preemie isn't a Wonder Woman or Superman?

Our son was Superman for his second Halloween (the first was spent in the NICU while wearing a festive bib). We decided it was only fitting for Olivia to follow suit in a smaller version of the costume above.

Do you have a great preemie costume idea? Leave a comment and let us know.

Developmental Post #21

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

Here are some developmental milestones you may see when your preemie is 9-11 months old.

Gross/Large Motor

• crawls on all fours
• pulls to stand & lowers self to floor (changing position without falling)
• cruises by holding onto furniture
• stands alone

Fine/Small Motor

• pokes at objects or pictures with an isolated finger
• drops toys on purpose
• picks up small items with index finger and thumb
• plays with two toys at the same time

Social/Play Skills

• finds a toy that has been hidden under a blanket, cup, etc
• imitates facial movements (pucker lips, tongue out, etc)
• participates in social games (peek-a-book & pat-a-cake)
• indicates when he/she wants something

Communication

• turns when name is called
• imitates non-speech sound (tongue click, cough)
• looks at familiar person when named
• plays with toys while making appropriate sounds or words (car sound, "boom" for falling objects)
• stops activity momentarily when adult says "no"

Ways to optimize your preemie's development

• play social games with your preemie as much as possible
• name objects to encourage vocabulary development (do you want the ball vs. do you want this or Look, here is the cow/horse/dog/etc)
• Put your preemie on the floor with several different toys to play with
• Offer choices - hold out two toys and ask (example: do you want the ball or the block?)

Favorite Product #26

This favorite product post is dedicated to the Fisher Price Brilliant Basics Shape Sorter.

Shape sorters are always fun. They teach some great skills and can last for a long time even as your preemie learns new things. I like the Fisher Price shape sorter (although I have the slightly smaller version) for several reasons. Simplicity - the container itself is very simple so that kids can more easily concentrate on putting the shape blocks inside. Removable lid - you can use this product to teach your preemie about putting items in or taking items out before he/she can shape the blocks which makes it a long lasting toy.

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

1) Put in/Take out - put all the blocks into the container and then take off the lid. Encourage your preemie to take the blocks out of the container. You may need to add additional items to the container so that they are closer to the top and easier to reach. Once your preemie has mastered this skill, encourage him/her to put the items back in.

2) Shape sorting - start with just one shape. Offer your preemie one block and then encourage your preemie to put it into the container. Use your hands to cover up all of the shaped holes so that it is easy for your preemie to put it into the correct spot. Offer new shapes and more options as your preemie masters the skill.

3) Same - Use the blocks to encourage your preemie to sort the blocks into the same color/shape piles. Show your preemie how two of the blocks are the same and then try and get him/her to do the same.

Insurance Tip: Managing Managed Care

Managing your insurance company can be a huge hassle. Multiple doctor visits, various procedures, changes in equipment, etc can make it difficult to ensure proper payment and coverage for your preemie. Here are some tips to help manage your "managed care."

Authorizations:

• Make sure you know what doctor, procedures, etc. need authorization prior to the visit. If you have an HMO, the restrictions can be quite specific so check in advance of having anything done.
• Once you know when authorizations are required, make sure you get one! And make sure it is in writing. Our pediatrician is part of a larger HMO group so anytime we see someone outside of the practice we have to get authorization. I keep a copy of all authorizations with me so that I have it available if needed.
• Don't go to an appointment without one! Some specialists may not realize you need an authorization. Insist that the authorization be in place before going to an appointment or you may be responsible for the full payment of the visit or procedure. Don't back down!

Check your statements:

• Keep a notebook or file folder with all claims and benefits information/statements. File by provider so you can easily check records for exact payments made or issues involved.
• If there is a note about non-payment, check to make sure there isn't something you need to do to get the process moving. Sometimes insurance companies request additional information from a doctor and they may not get it in time. Find out the cause and be proactive - call your doctor and remind them to send the files/information.

Procedures, Lab Work

• Some lab work or x-rays have to be done at certain locations in order to be fully covered. Always follow the "know before you go" rule.
• Unless it is an emergency, always go to the required lab/location for work to be done. A specialist may not realize you have this requirement so be assertive if necessary and let them know where you need to get work done. You don't want to be stuck with the bill later so a little extra leg work on your part is well worth it in the end.

The insurance category has more posts with insurance tips and advice, so make sure to read it!

And if you have a tip or advice to share, please leave a comment.

Updates Coming

My apologies for the recent lack of regular postings - things have gotten a bit crazy around here. The good news is that even if my hands can't do the typing, my brain does the thinking. Lots of new postings will be coming in the next few weeks including: week long features on dealing with emotions, the issues of having a preemie, siblings, etc., as well as new favorite products, sorting through insurance issues, more peeks into my preemie world, more NICU articles, and much more.

I'm looking forward to it and I hope you are too!

Life in our preemie world

This picture is one of the stories of our life right now. This blurry shot perfectly captures Olivia right now. Because we have a crawler on our hands. Ever since little girl finally got her whole body to figure out how to crawl she has been a blur of motion ever since. Occasionally she gets stopped by her oxygen cord (or her brother) but not for long. Off to find new things to get into, new drawers or doors to open, new books to pull off the shelf. She is so unlike her brother who was a model child in this area - he rarely opened cabinets or drawers unless they had his toys in them.

And so we adjust. We find new places to put things and new locks for the drawers. And our son learns that his cars can't always stay EXACTLY where he wants them to because his sister may have another idea about that. Like seeing how far she can throw them before someone notices :)
It's a challenge but a super fun one to watch because every moment is like a new discovery for her. And us.

What new skill has your preemie learned how to do recently?

Playing with Dolls

Having your preemie play with a doll or teddy bear is a great way to encourage language and communication skills. Therapists often call it symbolic play. Here are some tips for encouraging your little one to play and how to make a great "play box" for your preemie and his/her doll.

Finding a doll - for this type of play any doll or stuffed animal will do. Make sure it is one that has an obvious mouth (if you aren't using a doll). It should be big enough that your preemie can easily give the doll/stuffed animal a hug. The doll doesn't need to do anything fancy. Depending on the age or interest of your preemie, it may be helpful to name the doll or stuffed animal.

Play time - A doll is a great way to encourage symbolic play. Things such as giving the doll a hug/kiss, feeding the doll, putting the doll to bed, brushing the doll's hair are all good ways to encourage language and communication. You can also use the doll to help learn body parts. Our daughter likes to touch the feet on the doll and then touch her own feet. In the beginning you can show your preemie the doll and let him/her play or examine it (or in the case of my kids - drop it or poke it in the eye). Try one activity at a time - "Let's give the doll a hug." First you hug the doll and then encourage your preemie to do the same. Depending on your preemies interest, build in other activities slowly.

Play Box - You can easily create your own play box for the doll. Here is a picture of our play box along with a list of items that you need to create your own quickly and cheaply:

• plastic box with an easy to open lid
• blanket - I used one of my son's old receiving blankets that he didn't need anymore
• spoon
• small container for pretend food
• hairbrush
• toothbrush
• Optional: bottle or sippy cup. The doll for my daughter came with a small baby-sized bottle but you can certainly use a regular one.

Happy playing!!