Tag Archives: preemies

Parenting Petite Kids

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I’m short. People use all sorts of nice euphemisms: petite, vertically challenged, little. At 5’0″ (152 cm), my legs are just long enough to reach the floor when I’m standing. I have to perch on the front edge of your average chair to rest my feet on the ground. If I sit back, my legs swing in a very unprofessional way. I often find myself tucking one or both legs under me at work. As my daughters put it, I’m “a very small mommy.”

My 6-year-olds are very small girls themselves. Their first-grade classmates revel in picking them up and twirling them around. They don’t seem to mind much, instead enjoying being the “cute little ones” of their classes. M just made it out of the 1st percentile on the growth chart, weighing in at 38 lbs (17.2 kg) at age 6 years, 9 months. That’s 3rd percentile, people! She’s a giant! J’s 41 lbs (18.6 kg) puts her in the 10th percentile. She’s come a long way since her 3 lbs 6 oz (1.5 kg) birth weight .

My daughters’ current small stature likely has very little to do with their prematurity. Birth at 33 weeks gestation explains the girls’ low birth weight, but most premature infants catch up with their birth age peers in height and weight by the age of 1 or 2. If you think about it, it makes sense. My girls are 2 months “younger,” measured from conception, than other kids born in May 2006. When they were -2 months old, it was a big deal. At 4 months old, it was still a pretty big deal. At 6 months, J weighed 12 lbs 12 oz, and M weighed 11 lbs 12 oz, and they were on track. At the age 6 years, 2 months doesn’t make all that much of a difference. You can just blame me for their lack of stature.

I suspect it’s much easier to be a short girl than to be a short boy, but society’s gender attitudes is a topic I won’t touch just now. I’ll just say that I don’t perceive myself or my daughters to have any hang-ups about being short.

Being especially small comes with challenges all its own. The world is built for average-sized people, so we make adjustments. We have stools in every room of the house so that we can reach the things we need. I learned what products could be tweaked to accommodate the realities of raising short babies, toddlers, and young children.

Car seats

It takes a lot of blankets to secure a baby of less than 5 lbs in a carseat.The first time I dealt with the unique experience of having a super-small child was coming home from the hospital. Our Graco Snugride infant seat was technically okay for a 5-pounder, but how were we to keep the babies from rolling around? The size of the infant head support it came with was laughable in comparison to my littles. The NICU nurses came to the rescue, once again. They showed me how to roll up receiving blankets and layer them around the baby to keep her in place on her first hundred or so car rides.

In the US, we’re taught that children should ride in rear-facing car seats until they are both at least 1 year old and weigh 20 lbs, and recent recommendations encourage waiting until they’re 2 years old. As I understand it, the weight limit is a matter of having enough mass to resist being thrown in the air in the event of a crash. The age limit has something to do with the length of the spinal cord in comparison to the spine. As my pediatrician put it when I raised a concern about the girls’ legs eventually getting cramped, “Better broken legs than a broken neck.” My girls were well past age 2 before we turned their Britax Marathons forward-facing.

Now that they’re 6, J and M continue to wear 5-point harnesses in their Diono (formerly Sunshine Kids) Radians. Their classmates are all in booster seats, but M doesn’t meet the 40-lb weight minimum, and I’m in no hurry to reduce the girls’ level of containment in the car. Again, it doesn’t seem to bother them too much, although I occasionally get nasty looks at how long we spend getting the girls situated getting in and out of the car at the school pickup drive through. They can buckle and unbuckle themselves, but two buckles each necessarily take longer than one a piece.

Shoes

M and J started walking at 12 and 11 months, respectively. They both wore infant size 2 shoes at the time. There are very few walking shoes that come in a size 2. I certainly couldn’t find any. I ended up resorting to custom shoes ordered from Preschoolians in their “Walkers” line. They weren’t cheap, but they did allow us to go to the park without fear of stones and splinters in the girls’ feet. It wasn’t long before J and M were walking into daycare in the morning instead of me carrying them.

M tends to end up in light up shoes even at age 6; it’s hard to find sturdy, comfortable, school-appropriate shoes in a kid size 9.5. J’s a size bigger, and there are many more options open to her.

Clothes

Clothes weren’t quite the same challenge as shoes. Preemie clothes were gargantuan on the girls the first few months, but once they fit newborn sizes, it was easy–and so much fun–to shop for them.

J and M will be 7 in a few months. I just gave away the last of their size 4T clothes on Freecycle, because they’re fitting comfortably in 5Ts in most brands. When it comes to clothes that can fit loosely, such as sweatshirts and T-shirts, I can shop all the way to an XXS. The nice thing about being little is that M and J get a lot of hand-me-downs, and some hand-me-ups, from friends.

The girls have been wearing the same 4-6 sized tights for 3 winters in a row now, and they’re starting to fall apart. I’m not complaining. I remember how expensive it used to be to dress two kids when they were growing into new sizes every 3-5 months.

J and M’s first public school in El Paso had a uniform. We had trouble finding uniform shirts to fit them, so they just ended up wearing their XXS shirts baggy. I couldn’t get khaki bottoms that wouldn’t fall down at the store recommended by the school, but ended up finding good options online at French Toast.

Shopping carts/high chairs

For a long time, I’d go to the grocery store with one baby in a front carrier and the other in an infant seat placed in the cart. However, even though this continued to be practical weight-wise, by the time the girls were one, they wanted to sit in the cart and look around. The first time I tried, they flopped all over the place, and I gave up. M and J regaled nearby shoppers with wails and demands to “Sit cart! Sit cart!” as I pulled out the double stroller to try Plan B.

Ikea came to the rescue. They had an inflatable cushion that I could place around the girls to keep them propped up and contained. Unfortunately, they no longer sell it in the US. It was genius! I also used this cushion in restaurant high chairs to great effect.

How do your kids compare to others in size? Do you have any product recommendations to help kids on the smaller end of the size spectrum?

Sadia is the single mother of 6-year-old identical twins, M and J. They live in the Austin, TX area, where Sadia works in higher education information technology.

A preterm MoM intro

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With the new year upon us I thought I’d take on a new blogging opportunity. Let me introduce myself. My name is Carolyn and I am a mom to fraternal b/b twins, living, parenting and working in Ontario, Canada.

My twins are 2.5 years old and are spunky little men, with great personalities of their own. My guys are little for their age due to arriving at 27 weeks and challenging their parents from day one! They are amazing fighters and have come so far!

Canada offers mothers maternity and parental leave if they’ve been working enough hours leading up to the arrival of their child (ren.) I was lucky to be one of those people. I actually took 16 months off to be with my babies. The times were tough, but we made it through. There was definitely a lot of frustration and tears for everyone involved, but these little men taught us much about perseverance and developed our ability to kick adversity in the b-u-t-t time and time again.

I have been writing a personal blog coming up on 2 years about the ups and downs of my family. You can find my blog at http://twintrospectives.blogspot.ca. We also have an older boy, born at 31 weeks, who the twins love and learn so much from. These 3 boys have been our family’s inspiration.

I usually blog on the topic of prematurity and what might come afterward for others and what has evolved for my family in particular. The experience of preterm birth has given me a positive outlook on life, which might sound weird, given the fact preterm birth is the scariest thing most who go through it will ever experience. I figure if I can get through such an uncertain time, along with my family members, then there isn’t really anything else we can’t figure out. This is what I hope to be able to teach my children as I mother them and watch them grow during their childhood.

Aside from helping my own children along the way, my greatest passion is assisting new families going through the preterm birth experience, one step at a time. I have found my way into my local Multiple Births Canada (MBC) chapter, now working as a peer health worker (outreach worker,) as well as I’ve  just taken on a co-chair role in the development of MBC’s Preterm Birth Support Network.

In 4 short years my amazing little preemie men have taught me so much about life and I hope to be able to share some of what they have been teaching me with the How Do You Do It community.

Reunited

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I got the best news in a long time today. A college friend’s twin boys were reunited at 2 months old. Her second NICU baby got to come home from the hospital, 7 weeks after his brother.

In the middle of the joy I felt for my friend, though, I felt an upwelling of the sadness, anger and helplessness that tainted the joy of my own babies’ release from the hospital, over 5 years ago. Homecoming is one of the ways that the NICU experience can differ for parents of premature multiples in comparison to preemie singletons. Many twins and triplets are released from the hospital simultaneously, but many are not.

Our daughters were born 7 weeks early, but had few problems apart from their small size. J had a hole in her heart, which eventually resolved itself, and M had a facial cleft that turned out not even to require surgery. Neither of these conditions required hospitalization, so they were textbook “feeder growers,” newborns who were hospitalized until they had fattened up enough to maintain their own body temperature and had the strength to suck enough nutrition to keep them healthy.

Our girls didn’t need any assistance breathing; they’ve been verbal and long-winded since the start. They were keep in warm isolettes, and fed a mixture of high calorie formula and my breast milk through feeding tubes inserted through their noses and threaded into their stomachs. Every three hours came a diaper change, weighing, blood sugar measurement, temperature measurement and feeding. We watched every number as they rose and fell, and I promised myself I would take notes when they got home so as not to double feed one baby and starve the other. J and M were cared for by the same nurse, so their schedules were offset by 15 minutes. One benefit to having NICU babies was that they were on a clockwork schedule by the time they came home.

There were 3 criteria to be met, we were told, before the girls could come home. They had to weigh 5 lbs (2.25 kg), be able to maintain their own body temperature, and take 8 meals in a row by mouth, drinking at least 31 mls of formula/breast milk each time. Every now and then, when J asks for her “warmed up milk, please,” at breakfast or dinner, I wonder at the way she guzzles 8 oz of milk down and think back to the days I tried to get her drink 1 oz by force of will alone.

We wanted all the girls’ energy to go to growing at first. Somewhere in the first week, I think, they were introduced to doll-sized bottles. It took a few tries to get them to suck, first 1 ml, then 3, more and more each meal. They finally made it up to 31 mls at a time, but couldn’t keep it up two meals in a row. It was just too much work.

M couldn’t finish her bottle at every feeding, but she made an effort. Once, I was even allowed to let her suckle at my breast, although the nurses took her away before she exhausted herself. J was less predictable. She’d suck like a champ and then suddenly get distracted, seemingly more interested in playing with the bottle than drinking from it. Two weeks in, she broke our hearts by refusing two meals in a row and being put back on her feeding tube. It was the only time I saw my husband so upset that he couldn’t stay in the NICU to monitor every last detail of our babies’ care. A friend took him out for a beer.

When our girls were 2 weeks old, the hospital staff pronounced them to be the healthiest babies in the NICU. They could afford to be downgraded to a less fancy-schmancy NICU within the same hospital network. We talked it through and agreed to free up their beds. However, when the paperwork arrived, we were asked to sign a waiver releasing both the hospitals and the ambulance service of responsibility for the babies during their transport. There was no way we were signing that, so the girls stayed put.

Two days later, M was ready to come home. She hadn’t quite made the weight cutoff, but they couldn’t see any reason she wouldn’t be just fine at home. She passed the carseat test, and home we went.

It takes a lot of blankets to secure a baby of less than 5 lbs in a carseat.

J was still on her feeding tube. I felt more torn as a mother of twins in that moment than I ever did before or since. I was celebrating the health of one of my daughters, but leaving the other alone at the hospital, without even her sister with her. My husband was away for an army training exercise, and I was still recovering from my C-section. Fortunately, my father-in-law was able to stay for 3 weeks, and drove us the 30 miles to the hospital every day so that I could deliver breast milk and steal a few moments with J. I couldn’t stay too long, though, since M was in her carseat in the hospital parking garage with Grampy.

After 5 long, agonizing days, J was ready to come home. It finally felt like my life as a parent could start. My friend just ended 48 days of that waiting, and I hope that her heart can finally begin to heal.

Did you get to bring your babies home at the same time?

Sadia’s daughters, M and J, are still short for their nearly 6 years, but Sadia is short for her nearly 33, so it works out nicely. They guzzle milk, grow, and keep each other busy in El Paso, TX.

Medium and Happy

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(Leila and Rahul are turning 2 in a few days. They are doing very well, happy and healthy, other than a cold they have been fighting for the last week.  I would like to share something I wrote when they turned one-and-a-half.)

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Rahul and Leila have come a long way since their birth at 31 weeks gestation. At 18 months they have caught up with other children their age physically, emotionally and developmentally.

Leila recently jumped from the 5th to the 10th percentile in weight, and Rahul is steady at the 10th.  In height they are both at the 50th percentile. All in all, according to the charts (which might be slightly different that the US standard ones?), they are light weight children of average height. Not that it means much anymore. Last month I met a five month old baby who weighed as much as Leila. At their NICU there was a baby born at 24 weeks, much tinier than them. Now however, when I see them play amongst toddlers their own age, they merge right in, size-wise as well as ability-wise.

Since they were born a couple of months early it was normal, even necessary to closely monitor their weight gain. Thankfully we have had no serious problems since they left the NICU. They are both running, playing, and talking a lot. They are full of energy.

It’s time for me to let go of the obsessive monitoring. They need a break from being scrutinized and compared. They inevitably get a lot of it just for being twins. They don’t need any more, and especially not from me. In the big picture a little delay here or there is not a big deal. I have noticed that they are eating a little more than before, sleeping a little bit better, and enjoying each other.

I have found that comparing healthy babies growth and development is useless, and even silly. We all do it though. It’s natural. Parents often compare how soon their babies sit up, crawl, start sprouting teeth, walk, and talk in relation to others. Discussing these things with other mums and dads is important, especially for first time parents. It is necessary to follow-up on certain milestone achievements. If a real problem is caught soon enough it could be addressed more effectively.

There is a wide range of normal. I can see that just by having two babies. Leila crawled by 7 months, Rahul started after 9. They both had issues with digestion in the NICU. They digest differently. R has a strong reflux, Leila a poor appetite. Now L eats all the time and R eats only when he can feed himself! They both got their first teeth around the same time. According to Dr. Sear’s “The Baby Book”, when teeth come out is a genetic trait. Speech seems to be a big “issue”, and especially when there is more than one language spoken. We have 3 languages around us, and so far they are both saying words in all.

My brother didn’t speak until he was 2. My grandmother forced my parents to see doctors about this. Neither did he eat. What a catastrophe. My parents were easy-going enough to let him be. When he was ready he spoke and when he was hungry he ate. Now he talks a lot, and eats a lot. He is a professional sportsman, and a big guy. My brother-in-law spoke “late”, but apparently when he did it was in full grammatically correct sentences!

When asked, I usually responded to questions about my children’s age, weight, birth order etc. And then I asked similar questions back. Sometimes I even initiated such dialogues. I knew it was silly, but I needed to hear that Leila and Rahul are smaller than others to validate their experience of early birth, as well as mine being their primary care-giver. It has not been easy with their tiny milk feeds. After birth they wouldn’t drink more than 1 to 3 ml of milk at a time. By 1 year R could take 120ml. But because of his reflux he had to stop and burp every 30 ml. Each feed was drink, burp, drink, burp…  Leila woke up every 2 to 3 hours to drink at night, and still does. Most babies around us sleep through the night and eat comfortably. I couldn’t help comparing.

I was listening to a studio talk by Richard Freeman, an inspiring senior Ashtanga teacher the other day. I am paraphrasing what I understood from it. He said as soon as we realise that our Asana posture is medium, that it could look better, and it could also look worse, there is a release. The pressure dissolves and the breathing starts. It is no longer about having the perfect posture. It is more intrinsic and personal. That’s when the suffering stops and the practice can deepen.

The same goes for size. As soon as we can acknowledge that we are medium, that we could be taller or shorter, fatter or thinner, there is a release. We can move on and think about other things. I once told a close friend that her son was tall. “No” she responded, “he is average height.” Her honesty struck me.

Rahul and Leila are changing all the time, as I am. When I am around them I want to be actually present. I want to encourage them to have fun, and to laugh. They have enough time to follow curriculae and perform in the future. We can all stack 4 blocks and order rings according to size. It makes no difference to me if they can do it now, or in a few months. They are full of love and energy and that is what really matters. I want them to be Medium and Happy.

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Natasha lives in Chengdu, China with her husband Maher. She is mum of  twins Leila and Rahul, and was an Ashtanga Yoga teacher until her little yogis became the teachers. You can find more of her thoughts and stories at Our Little Yogis.

 

Let the speculation begin

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There are conflicting reports out there, one saying that Angelina Jolie has given birth to two girls, one saying it’s not true and she’s resting at her fabulous new home in France.  According to what I’d heard, her due date was August 19, which would make her 28 weeks… so I’m really, really hoping the reports are not, in fact, true.

I guess even celebrities aren’t immune from the preemie risk.  Fingers crossed for all the pregnant ladies out there…