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the eric update - day 254: yet another ( and, we learn, not his last ) developmental assessment.

it's hard to believe that it has already been almost two months since odin's last developmental assessment and despite his passing that test with flying colors, it was hard not to get a little nervous today as we prepared to meet the developmental specialists associated with the neonatal intensive care unit. his first assessment was conducted by a nurse from a county support program and it's not impossible for the two sets of specialists to come to different conclusions. and they immediately gave credence to our suspicion that they might possibly come to a different conclusion by letting us know that they didn't agree with the county's recommendation that odin was doing so wonderfully that he didn't need any more active monitoring by specialists. the specialist's opinion was based not so much on any specific behavior she did or didn't see in odin, but rather she reassured us that is was simply a matter of statistics.

since he's a "25 weeker" her experience tells her that it's likely ( although not a certainty )that some sort of developmental delay will appear over the next year or so and it's best to have a conservative monitoring program to help ensure that you can catch issues early.

but after that gentle reminder that we should never lose sight of the fact that for years to come odin will require close monitoring, she seemed to agree with the county's conclusion that he did not yet show any of the "normal" delays that one might expect from a baby born 15 weeks early.

except for this moment, when she's noting that he has "poor" shoulder strength and "mild decreased central tone", which means that even though he's been sitting up unassisted for quite some time, he's showing signs of of having underdeveloped muscles in his torso and upper body which could potentially delay crawling.

the prescription for "mild decreased central tone" is more frequent "tummy time" exercises, which - photographic evidence notwithstanding - odin will happily tolerate for only very short periods of time. nonetheless we'll have to be a little more disciplined about getting him to workout at gym.

additionally, the developmental specialist expressed some concern that he apparently hasn't gained any weight since his last pediatrician's visit. while he's shown relatively normal diminished weight gains over the past few months , not gaining an ounce is possibly a sign that something is amiss. or not, depending.

the specialist would like to see him gaining about 20 ounces each month, so if he doesn't start packing on the pounds i suspect we'll be weighing ( ha! pun intended. ) the merits of a variety of recommendations for helping him to gain weight.

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3/15/2005 11:25:00 PM 8 comments

8 Comments:

Some questions to ask yourself: Was it the same scale that he was weighed on initially? Was it the same time of day? Was he with or without a diaper each time? How wet was the diaper? There are many factors that can throw off the weight by as much as 10 oz. - especially weighing him on different scales which might be calibrated differently.

I won't give you any recommendations on gaining weight because I don't think you need any other than to continue to nurse on cue (I hate the "demand" word, a child shouldn't have to "demand" to be fed) You mentioned delaying his feedings at night, but as long as you're not denying him a feeding when he's actually hungry, I don't think that would be a factor in lack of weight gain. I think more likely it's the scale or something, but the occasional plateau is normal too, when the body might be growing lengthwise instead of weightwise. Just wait until he hits toddlerhood and takes 6 months to gain 20 oz.

By Blogger Candy, at 8:29 AM  

Has he grown in length at all?

By Blogger pumpkinhead, at 12:07 PM  

My friend Rachael is a developmental dance and movement teacher, and she has a website with a bunch of articles and resources for making tummy time more fun (or at least palatable). The URL is http://www.sparkplugdance.org

It sounds like he's doing really well not to be showing any signs of delay. Must be your superior genes once again.

By Blogger Moxie, at 12:07 PM  

candy: Some questions to ask yourself: Was it the same scale that he was weighed on initially? Was it the same time of day? Was he with or without a diaper each time? How wet was the diaper? There are many factors that can throw off the weight by as much as 10 oz.pretty much everything you could make different was different. different time of day, no diaper and different scale, which is why we're just making a cautious "mental note" and putting off any conclusions for another couple of weeks when we'll get the results of his next rsv weigh-in.

nope, no denying feeding :-) and he does seem to be doing a good job making up for "lost" night feedings by feeding longer when he does wake up ( instead of 5 minute feedings every hour or two, it's more like 10-20 minute feedings every 5 hours ).

By Blogger e3, at 1:01 PM  

pumpkinhead: Has he grown in length at all? |

hmmm. now that you mention it, he has grown about 2 inches in length ( or is it height? ) in the past few months ( for the record, he's now 25 inches long/tall ). /scratches chin/ i wonder if that could have anything to do with it :-)

i think the developmental specialist was implying that she'd still like to see 20 ounces a month in weight gain for a 5 month adjusted infant, gains in length or not. but she did also acknowledge that it could be a normal plateau. or maybe not. and odin's not telling us what he'd like, so i think we're going to switch him to formula and caloric fortifiers so we can get him bulked out.

just kidding.

By Blogger e3, at 1:10 PM  

I've been trying to comment for days but blogger wouldn't let me. PLEASE don't stop the Odin Updates! They give me hope that our 24 weekers will be just fine!

By Anonymous Anonymous, at 2:02 PM  

I've been trying to comment for days but blogger wouldn't let me. PLEASE don't stop the Odin Updates! They give me hope that our 24 weekers will be just fine!garrrggh. i've become increasingly aware that blogger's comment function stinks and it's flakiness often prevents people from commenting. thanks for being persistent. and very best wishes and prayers from us that your nicu rollercoaster ride will be as uneventful as possible. feel free to send us photos or point us to a website for updates :-)

By Blogger e3, at 2:11 PM  

Formula and caloric fortifiers? Please. Parents who are truly concerned with bulking their kid up will just go straight to injectible steroids. Jose Canseco gives them two thumbs up.

By Blogger Moxie, at 9:57 AM  

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[ rhetoric ]

"it is hard to be brave," said piglet, sniffing slightly, "when you're only a Very Small Animal." rabbit, who had begun to write very busily, looked up and said: "it is because you are a very small animal that you will be Useful in the adventure before us."

the complete tales & poems of winnie the pooh

[ about ]

this site chronicles the continuing adventures of my son, odin, who was unexpectedly born on the fourth of july at 25 weeks gestation, weighing 1 pound 7 ounces.

he's quite a fighter and you can always send him a postcard to the most current address listed here if you're inspired by his adventures. see the postcard project/google maps mashup to see a map of the postcards.

if you're new, you can browse the archives to catch up. and don't forget to watch a few movies that i made while we were in the neonatal intensive care unit. or if you want the abridged version and you can find a copy, you can read about his adventures in the november 2005 issue of parents magazine.



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