Four months!

Zoë is four months old today!  Woo hoo!

Yesterday Zoë did something really cool.  She grabbed onto a toy and shook it!  Yes, it was attached to her play mat, so she was really just wiggling her arms like usual, but I swear that she was moving her left arm (the one with the toy) more than her right.  It was pretty cute.  I'm sure she's FAR from actually grabbing toys and playing with them, but she hadn't done it before.  Even if it was a fluke, it was fun to celebrate.

Last weekend Chris' Grandma Carol and Ralph came up to visit.  I think it's fair to say she was smitten with Zoë and we loved having her visit and see our house, too.  They took us out to a lovely lunch and brought us a rose bush for Zoë that we've planted in a special place in our yard.  Since we've done so much work around the yard these past few months it's nice to have plants that hold some meaning back there.

Great-grandma Carol and Zoë

That's all for now, we just can't believe how much FUN our little girl is becoming.  Each coo and smile makes our hearts swell even BIGGER.

Just another medical procedure...

Snuggles with Mom.

Zoë went in for her swallow study yesterday in the radiology department at Valley Medical Center.  Just in case you don't remember (I referenced it way back here), the feeding specialist was concerned that she might be aspirating part of her feeds (meaning part of it was going into her airway instead of straight to her esophagus) and wanted to rule it out, because it can be really uncomfortable and, more frightening, unsafe if that were to be the case.

Sleeping on Dad.

We arrived at the hospital and decided we should visit the NICU, since we were nearly next door.  It was the best feeling to have the nurses come running when they saw us standing at the entranceway.  Zoë received a lot of hugs and snuggles and "oh she's getting so big!"s.  I felt like we were visiting family we hadn't seen in over two months, they were fantastic.  They told me what a fabulous job I'm doing and said they missed us.  Wow, when I'm having a bad day I'm just going to go back there for a little pick-me-up.





When it was time for our radiology appointment, we went and met with Amy, the therapist we met with while Zoë was in the hospital, and found out she was going to do the study for us.  We went back to a room and plopped Zoë into an upright chair (after Amy got her own snuggles in) and all of us donned the really fashionable lead aprons (except for Zoë...hmmm, don't you think they could have a really small one to drape over her body?  I guess not.).  The first thing we fed her was a thin mixture of Barium (barium is what shows up on the x-ray!) and they took x-ray video of Zoë eating.  Amy could see immediately that she was partially aspirating the barium, so the next step was to try a more viscous barium mixture (after a palate cleanser of regular formula).  This time, Zoë didn't aspirate anything at all.  The difference was amazing.

After the study, Amy went back through the video with me and described everything we were seeing.  First of all, x-ray videos are awesome.  It was REALLY cool to see Zoë eating (AND I could see her reflux, too...cool).  Secondly, I feel like I learned way more medical terms about how we eat and swallow and why Zoë's been having problems. Her diagnosis is pharyngeal phase dysphagia which means that she had "deep penetration into the laryngeal vestibule on thin liquids".  In other words, part of her feed is going into her airway.  Amy said it wasn't REALLY deep (although, deep penetration describes otherwise, in my head), but she suspects that if we kept feeding her the thin liquid it would have gotten worse as Zoë got more fatigued.  Apparently this is a not so out of the ordinary considering her prematurity.  We've got a prescription for an artificial thickener to add to her formula to mimic the thicker Barium test.  I can already tell the difference from three feeds today.

Zoë should grow out of this issue as her jaw and esophagus matures.  The only concern is that maybe she might have a laryngeal cleft (similar to a cleft palate...something didn't fuse completely) and we'll have to determine if that's the case when we go back for another x-ray after a while to monitor her progress.  Amy was pretty certain she's cleft-free, though, so we'll hope that's the case.

In other news, she's now into her 3 month clothes, although they are a little big on her.  She definitely outgrew the newborn ones though.  I do her laundry every 2-3 days and it seemed like from one laundry day to the next she had outgrown them.  And I'm not talking, "Oh, they're a little bit too snug this time" I'm talking "girl, you're going to pop those buttons right off" tight.  I thought I would be excited to put her newborn clothes away and dive into the new wardrobe but I found myself getting a little teary-eyed as I was folding her clothes and putting them away.  :(

Zoë loves her black and white books.

Captive audience for story-time.

We've started to have daily story-time and she seems really engaged when we're reading.  It's fun to have her sit up and look at the pictures (her favorites are still the black and white books).  We're still working on tummy time.  Chris propped her up on the Boppy today which lead to a few minutes of good tummy time, we'll have to see if it lengthens as she gets older.

Tummy Time with Dad

We now have a week and a half break until her next doctor's appointment where she'll get her 4 month vaccinations.  Four months already!  Sheesh!  Shouldn't she be walking by now?  ;)

Happy Mother's Day!

As a very special treat to Chris and myself, Zoë has now slept for SEVEN hours the last two nights straight.  WHAT?!  From about ten until five am she's been a total sleeping angel (even in the heat that we've had...maybe that's helped?).  Chris is convinced we can't let her sleep that long and swore he would wake her up earlier than that this morning...uh, no he didn't.  :)  Which is just fine!  I weighed her last night before her bath and she weighs 9 pounds 4 ounces by our scale.  Which means she's gained 0.8 pounds in a week.  That's great weight gain and helps us feel better about letting her sleep.  She started her reflux medicine this week and it's a freaking miracle.  She doesn't grunt or groan while eating and hasn't projectile vomited ONCE since she started (she was doing it once a day before).  She seems a lot more comfortable while eating and is eating more regularly and more volume.  She has her swallow study x-ray on Thursday, so we'll see what that tells us.  And the home visiting nurse is coming Friday, so we'll get an official weight then.

Yummy Mother's Day breakfast!

This morning Chris made a delicious breakfast of stuffed French Toast (uh, it was amazing), let me sleep until 8!, and treated me like a queen.  :)  I told him he has set a high standard for future Mother's Days...bummer for him and Zoë.  :)

That's all for now!  Oh, and this:

Eating, sleeping and smiling, oh my!

We are getting regular smiles now!  Zoë has to be in the right mindset, but she will definitely give you a big smile or two when you talk to her or make faces at her, and they're becoming more regular, too.  My favorite place to get good face time in is when she's on her changing table.  For some reason, she's usually in a good mood (after the diaper gets changed, of course).  She's also making a lot more sounds, cooing, etc.  It's adorable and heart-melting and makes the toughest days better.

Changing table fun

Mom, I hate shots!

I have reflux and eating hurts!

We're still struggling in the eating department.  We went to the pediatrician's office on Friday for her last synagis shot (until the fall, that is) and talked about how her reflux doesn't seem to be getting any better.  We tried the rice cereal as recommended by the doctor, which seemed like it worked at first but then she started seeming just as uncomfortable while she was eating as she was initially.  She suggested we add even more rice cereal to see if it helped, but then if it doesn't get better in a week we can call back and get a prescription filled for some medicine.  This weekend hasn'tbeen easy...she eats about 40-50 ml (for her weight-8 pounds 6 ounces- she should be eating 77ml eight times a day) and then won't eat anymore.  The doctor mentioned that she might not eat AS much because there are more calories she's getting with the rice cereal (we're up to 27 calories per feed now!), but that seems like it's not enough.  The formula is SO thick with the supplement and we think it's harder for Zoë to get it out of the bottle (she's still using the preemie nipple, as demanded by the feeding specialist).  We think with the combination of more calories and the amount of effort she's putting into thefeeding that she's just not eating enough.  We gave her a bottle of straight formula last night and she guzzled it happily (and noisily, because despite the rice cereal being more difficult to eat, it does seem to help with the reflux).  And then promptly threw it ALL up on Chris (seriously, it was pooling in his t-shirt) ten minutes later.  :)


Clearly, we have an infant who is having no problem gaining weight, but does seem to be uncomfortable while eating, which we don't want to turn into an eating aversion in the future.  I'll be calling the doctor's office on Friday to fill that prescription, I think...

She looks a little like Scarlett O'Hara...

In the sleeping department, she's doing pretty well at night.  We were not given the go-ahead by the doctor to let her sleep as long as she can...she'd still like us to feed her every three hours, even through the night.  Uh, I'm done with that.  I'm pretty sure with as well as she's gaining weight (and especially with more calories in her diet), we can let her sleep as long as she will (sometimes she'll sleep for FOUR hours straight, like she did last night!).  I'm ok with going off-book for this one.  Since I'm no longer pumping (Halle-frickin-lujah!) this past weekend was the first weekend I slept through the night since January.  Chris took all of the feeding shifts and it. was. glorious.  So, I'm definitely going to let Zoë drive the bus at night.  If she gets up every three hours to eat, fine for now.  But if she wants to sleep an extra hour or two?  Even better.

Walks are good for EVERYONE.

Chris and I had a date night this past weekend and went to Thai food and rode The Great Wheel in Seattle (all his idea!).  It was really fun, really really fun!  We celebrated my birthday all week (maybe dropping it down from a month to a week is more reasonable, after all...) and hey, Mother's Day is coming right up!  :)

Love date night!

Naptime with Dad is always good.