Early Childhood Assessment

ADJUSTED AGE: 8 WEEKS

Truman had his first developmental assessment by Early Childhood Intervention on Monday and was pronounced as being on track for his adjusted age. It was determined that he was right on track regarding motor skills and that his verbal and social skills were evolving toward where they needed to be. At this time, he will not be receiving any therapies from ECI to help catch him up. Because his pediatrician and therapists through Baylor are working on his feeding and nutrition issues, those were not assessed. His ECI case worker will continue to check in on him every month to make sure he remains on track.

We felt going into the assessment that Truman is just about where he needs to be for a two-month-old baby. However, we wanted confirmation of that and to make sure that he continues to be tracked due to the intraventricular hemorrhages he suffered in his early weeks. Although no brain damage appears to have ocurred at this point, the blood is still there and could cause damage in the future. He is still at elevated risks for such complications as cerebral palsy, so it's important that developmental specialists keep an eye on him.

Truman had a follow-up opthamologist appointment yesterday as well. The retinas of his eyes have moved into zone III (the final zone of development) and appear to be progressing. The ridge remains on his left eye, but it has moved out, allowing the vessels to move into zone III. So, another good report.

Developmentally, we heard what sounded like Truman's first official "coo" on Monday morning. It was a very cute squeal. I also noticed yesterday that in addition to tracking, he has started to move his gaze between objects. There is a stationary mobile on his changing table, and he was looking from one bear to another and back again.

Again, we have so much to be thankful for that considering the horrible start our little had in life, things are really going quite well for him.

--Kara

Smiling

CURRENT WEIGHT: 7 LBS, 5.1 OUNCES
ADJUSTED AGE: 7.5 WEEKS

Truman had his first very clear smile at me yesterday. It was great! He smiles a lot out of contentment, but this was the first clearly directed at someone. We can't wait for more.

--Kara

Update: January 25, 2007

CURRENT WEIGHT: 7 LBS, 5.1 OUNCES
ADJUSTED AGE: 7.5 WEEKS

Truman had another pediatrician appointment yesterday. The pediatrician is happy overall with his health and developmental progress, but is concerned about the fact that we have seem to have increasing eating issues. That prompted the doctor to refer us to a feeding clinic for weekly sessions.

In recent weeks, Truman has returned to his earlier ways of screaming through bottle feedings and trying to refuse bottles altogether. And, he has become a lazy breastfeeder. Although he is always eager to breastfeed, he seems only to get satisfied overnight and early in the day when the supply is greater and nursing is easier. So, trying to keep him happy and full has become quite a struggle. I was so glad to hear that there may be special help to ease these issues, particularly considering that I am returning to work full time in about five weeks because we won't be able to cut bad bottle sessions short and offer breastfeeding as an alternative while I am at work.

Developmentally, Truman hit another milestone this week. He began tracking moving objects with his eyes and head. We noticed it on Sunday. He was very obviously following Ben's hands with his eyes and whole head. I've noticed in the last couple of days that when I put him down in his bouncy seat, he watches me walk away from him.

--Kara

Getting longer!

CURRENT WEIGHT: 6LBS, 9.6 OUNCES
CURRENT LENTH: 19.25 INCHES
ADJUSTED AGE: 5.5 WEEKS

Truman had another good doctor visit on Wednesday. They did a full check-up with more assessments than usual. His pediatrician was happy with his muscle tone and overall physical health. He's still very small, but growing at an average of 2/3 of an ounce a day. He is really starting to look bigger and is outgrowing his clothes. He is still in preemie clothes, but he's wearing the larger brands now. His ECI case worker came to visit last week, and I think we are really going to like her. His developmental assessment with the occupational therapist will be next week.

His nasty diaper rash is almost completely gone. I think the greatest factor has been a maturing GI tract. Instead of having small stools 20-30 times per day, he is now having about two large ones each day instead.

Truman is getting better about sleeping at night -- at least the first part of the night. He still wakes every two to three hours to eat, but will go back down after eating, that is until about 4:30 or 5 a.m. He is currently shaping up to be a super early riser! For any of you who know his dad, yikes! The only thing that will get him back to sleep after that is cuddling with Mom.

He appears to have made it through his first minor illness at home with flying colors. Yesterday, he was acting lethargic and clearly having more gas pain than usual, as it was causing him to squeal in pain. He also had a little diarrhea and was spitting up what little he was eating. A phone call to the nurse practitioner diagnosed it most likely as a GI bug of some kind. We pumped him full of Pedialyte and he was fine by this morning. We are still holding off on the fortified milk for another day or so and giving him straight breast milk, which he is handling just fine today.

We are still doing okay with the isolation. Truman has had a couple of healthy visitors and we get out about once a week for a doctor's appointment of some kind. We also try to go out in the stroller or into the yard some on nice days. And, I try to run errands on the weekends to get out some when Ben is home. The hardest part has been the logistics of it all. For example, there are no drive-through pharmacies in Dallas that will compound the liquid Prilosec that Truman needs, so I had to find the one in town that compounds and is open after hours so that one of us can go and stand in line while the other parent can be home with Truman. And, even the weekend errands have to be well-coordinated to make sure they all get done because making it out on a weeknight is virtually impossible by the time Ben gets home from work and we've had dinner and such. Also, errands have to fit in around pumping. And pumping while caring for a very demanding baby (he doesn't like to ever be put down) is a whole other story for its own day. Even with the hard work and early mornings, we wouldn't trade him for a million other babies.

--Kara

Update: January 3, 2007

ADJUSTED AGE: 4 WEEKS, 1 DAY

Truman's diaper rash finally appears to be getting better. Perhaps the paste we mixed of Calmoseptine (calomine and zinc oxide) and stoma adhesive powder created enough of a waterproof barrier to do the trick or it could be the blowdrying of his little bum after all diaper cleanings. Blowdryers aren't usually a changing table accessory, but it seems to work, and he seems to really like it.

He had another appointment with the pediatric opthamologist on Monday. He eyes still appear to be progressing even though the Retinopathy of Prematurity (ROP) is still present at this point. There is a ridge on his left eye where the vessels will have trouble growing past, but the opthamologist thinks that his vessels will ultimately grow past the ridge and that he will likely have normal vision. ROP is something almost all preemies, particularly micropreemies, suffer from because the retina does not develop until later in gestation. Basically, the blood vessels of the eye grow out from the center and must reach the edges of the eye to ensure full peripheral vision. It just takes longer for a preemie because the vessels do not grow well exposed to light, oxygen, and other external factors. Truman goes back in a month for another exam.

On the feeding front, it turns out that the special formula that was prescribed is available only to hospitals as of this past October. Even the pediatric clinic can't order it other than as samples. So, Truman's nutritionist team (he has three nutritionists) has recommended adding Human Milk Fortifier to his breast milk bottles. So, it turns out that he will be exclusively on breastmilk after all. We are just going a different route to beef it up to make sure it has all the ingredients he needs.

In addition to rolling over, Truman has started actually hitting some of the things he swings at on his playmat. His case worker from Early Childhood Intervention is making her first visit on Friday. Once that evaluation process begins, we will have a better idea of where Truman is developmentally and where he will need additional help.

--Kara