Row, Row, Row Your Boat

058SOZO058.jpgThis is still the girls’ favorite book (thanks, Margie).  Luckily, there are several readers in their lives who can take a turn since Sophia gives me funny looks when I just say the lines without turning the pages!  Zoe recognizes the tune now and surprised me by “roaring” when she heard the melody on a toy.  She also roars and rocks when we get to that song in another book.  I watched Sophia one morning “reading” it to herself.  She was turning the pages with her chubby little hands and when she got to the crocodile line, she clapped her hands (like the jaws) and threw her hands up for the scream.  It was really sweet.

Sophia has also started tickling herself for the line in “Love Bug” that goes:  “and what he most likes to do is tickle, tickle, tickle…you!”  She has been mimicking the “mama” sign, but not using it yet, as far as I can tell. We didn’t really focus on the Papa and Mama signs so much since we thought she’d be able to say them first, but signs might be easier at this point.

The croup appears to be gone, thank goodness, but we still haven’t figured out the right rate and dose to feed Sophia on the pump in the morning without spitting up.  I think we have to go back to our original plan and work more on creating hunger when her reflux is better.

Poor little Zoe has replaced her cough with teething discomfort.  She had seemed to be taking it really well, but had a rough weekend.  She’s had a fever, which makes her uncomfortable, restless, and not very hungry.  There is sort of a dispute in the medical community about whether teething actually causes fevers or not, but I sure hope that is all it is.  Zoe spent most of the weekend days too tired to eat and too hungry to sleep.  She’s been sleeping at night, but wakes a lot.  Needless to say, the girls are still sleeping in separate rooms.  We sure have bad timing for trying the switch.

We started giving Zoe Tylenol for her fever, but she spits it out.  It is so strange to have to try to figure out how to get her to ingest it.  We are so used to just putting all that stuff in Sophia’s tube, even while she’s sleeping.  With Zoe, we have to wait until she wakes up in pain to give her the medicine she doesn’t like and then wait for it to work!  I finally started laying her down on her back while I give her small amounts from the syringe; that way when she tries to spit it out, it goes right back in her mouth.  I also tried Ibuprofen thinking she might like the taste of that better, and it lasts longer, and it always worked better for Sophia’s fevers.  That was no better in her mind.  In the course of determining how much we could give her, I realized we’d been giving Sophia .5 mLs less than she could have been getting since she was 20 pounds (quite awhile ago).  I don’t have any idea how we overlooked this.  I imagine I thought the cut offs were similar to those for Tylenol or something, but I felt really bad.  I think the croup was the only time we’ve really treated a fever lately; otherwise, it’s primarily been teething, but we might not have had to give her Tylenol in between times if I’d had the right dose for her weight–ugh!

During OT, Margie reminded us that it would be easier for Zoe to crawl if her knees were bare (thus, the outfit above).  How quickly we forgot that that was what worked for Sophia!

Sophia decided that this week would be her week of self-directed OT.  Both John and I on separate mornings left Zoe’s peas too close to the edge of the table when we stepped away and when we got back to finish feeding her found Sophia on the floor with peas all over her mouth, her clothes, her hair, the chair, everywhere!  Maybe the trick to getting her to eat will be to “leave” food just within her reach.  On another morning, she figured out how to open the jar of Vaseline I was using for her cracked lip.  She dug her fingers right in it and smeared it all over the books that were within reach.  Good sensory practice, but not fun clean up!

On a sort of embarrassing note, I did call our nurses to check about the Vaseline, because I wasn’t sure it was okay for her to ingest it.  After learning I shouldn’t give her vitamin C, I figured I’d better check on the Vaseline, too.  I’m sure they have pages of my inquiries.  I didn’t realize they recorded these things until I had Zoe and the nurse told me it would be okay to take her home that day because they “knew I’d call if I had any concerns.”  My mom said they knew this because they kept records of all the calls I made for Sophia!

Sophia also worked hard on napping this weekend.  Unfortunately, her Papa and I had a miscommunication about the nap routine and I was putting her down awake for the last two weekends, and he was rocking her to sleep during the week.  So, by this weekend, Sophia was not at all happy to be put in her crib awake.  I followed the “book” suggestion on Saturday–letting her try for 70 minutes, getting her up for 30 and letting her try for another 70–guaranteed to work by then, yeah right!  No nap that day.  Today, I decided that she really needed to try until she fell asleep, even though it was just naptime and not night time.  I think she learns that you’ll get her up after an hour, so she just won’t sleep.  Of course it was traumatic and stressful, but I let her try (mostly hollering w/o crying, with a few bouts of kicking the mattress) until she fell asleep (2 1/2 hours–ugh! again)  I know it sounds awful, but she has gone 3 hours at night before falling asleep, so she is not the standard kid they talk about in the books that will certainly fall asleep after an hour.  That strategy worked at night, so I’m hopeful this will be a good napping week, but I’m sure it won’t be easy.  The tricky thing about nap time is that she is so much more wild than at night.  I think she probably sits up in her sling while she hollers.  Both days she disconnected her pump so the bed was soaked when I got her up.  Luckily, we had time to get the bedding and sling washed and dried before her bedtime.  The first day, she must have just kicked enough that the med port came open in the extension that goes between her MIC-KEY button and the disposable feeding bag.  That meant that the food being pumped in went out the open port and I think the food that was already in her stomach leaked out as well.  She sleeps inclined and I think the gravity causes the stomach to empty out through the tube.  I fixed the med port issue when I went in to check on her after she coughed, but sometime after that she got the whole extension out of her MIC-KEY.  I’m sure it must just have been her tossing and turning because she had a onesie on over it and couldn’t have disconnected it intentionally.  Today, I went in with the pump was beeping “no flow” because she was laying on the tube.  Sometime after that, she disconnected the extension from the disposable part of the tubing, and again the new milk was pumped into the bed and I’m sure her stomach emptied out as well.  I don’t think we are going to have very good results when she gets weighed before her Synegis (anti-RSV) shot tomorrow.  We don’t have enough time over night to make up all of that food.  I think we are going to have to stop using the pump during her nap and just feed her what we can before she gets sleepy.

It was a good chance to see whether or not Sophia would eat better if she was theoretically hungry.  She actually did okay, taking 5 or 6 bites of cereal and fruit and a few squirts of water from a syringe.  I don’t think she actually felt very hungry as she wasn’t irritable at all, so I’m not sure how well this eating training is going to go.  For right now, we’ll focus on trying to make sure we can keep the food in her tummy,  and then work on getting her to get food into her tummy herself.   With Zoe we have to work on her feeding herself and not Mukwa.  She loves to give Mukwa anything she can drop over her high chair tray (including her hands to be licked).  This morning she was looking around for Mukwa, leaned over to that side, dropped the Cheerio down to the floor, raised her eyebrows at Mukwa (“Hey, look what I got you!), and turned back to me and squealed–our little stinker!