Aubrey is on the left, Paige on the right. They were candy corns for Halloween. Here's a picture of Aubrey and then Paige at the pumpkin patch.
We probably won't be able to put them in the same costumes again because they'll be old enough to have a say in it next year, haha.
The girls have been doing really well over the past month. Andrea and I continue to be amazed at their growth and mini-milestones.
About a month ago we had an appointment with the NICU high risk follow up clinic. We met with one of the NICU doctors and an occupational therapist. According to their assessment, the girls were almost developmentally on track with their adjusted age. They were a little behind on tummy-time stuff, meaning they absolutely hated tummy time and they didn't support their upper bodies with their arms like they should have been doing. After the clinic visit, we went upstairs to the NICU and got to see most of the doctors and dayshift nurses that took care of the girls. It was really neat seeing them all again and for them to be able to see the girls as regular babies without all the cords and tubes hanging from their bodies. The girls loved all the attention that they got and were all smiles.
We've been working on tummy time a lot since then. The girls have gone from screaming within a couple of minutes after being placed on their tummies a month ago, to tolerating it very well and actually playing a little bit for up to 20 minutes at a time now. The girls still aren't rolling over on purpose yet, but occasionally during tummy time they'll get way up on their hands and roll over accidentally. They always have a surprised look on their face anytime this happens - "whoa, what just happened?" - so it's pretty funny to see.
We're currently feeding the girls solid foods twice each day now, and they're both doing a good job eating. Aubrey typically eats more than Paige and is a lot easier to feed, but Paige is catching on quickly. We've fed them all sorts of pureed vegetables and fruits. Their favorite foods so far are bananas, pears, carrots, and peas. They weren't too fond of spinach, and aren't very interested in apple sauce. They really like eating banana flavored Baby Mum-Mums, which are thin rice crackers. We usually feed the girls in their bouncers, and our dog does a very thorough cleaning of the bouncers after feeding time is done. Here's the dog getting comfy in one of the bouncers.
Here are two videos of the girls we recorded about a month ago. Sorry about the hair, I tried giving them both mohawks, but they wouldn't hold still enough for me to do a good job. Aubrey is in peach, Paige in yellow.
The girls are starting to interact and play with each other. When we lay them down next to each other, they touch each other's faces and giggle (until one gets ahold of an ear or a handful of hair, then half the giggles stop). Paige gets really excited whenever she sees Aubrey. Aubrey is a little interested in her sister, but doesn't get as excited as Paige does.
Both girls are getting very good at grabbing toys and bringing them to their mouths to knaw on. Despite all the fun toys Andrea and I and other people have gotten the girls, their favorite thing to play with is still plain old paper. Here's Paige chewing on a paper bag, despite having the much better option of chewing on the apple slices in front of her.
Both girls are sleeping through the night and we have stopped doing late-night feeds. They usually fall asleep around 7 or 8, we change their diapers and feed them again around 9 or 10, and then they sleep until about 6:30. Occasionally one of the girls will have trouble falling asleep, but they never wake up in the middle of night (yet). Napping, on the other hand, has been somewhat of an issue. They both hate being put down for naps, even when they're so tired they can barely stay awake. I guess we should be grateful that they're at least good sleepers.
With the exception of Paige still taking a breathing treatment called Pulmicort, both girls are off all of their medications! This had made feeding routines much easier. Paige got the OK to stop oxygen about a month ago, so we don't have to deal with that at night anymore, either.
Here's a fun one of Aubrey just as mommy was finishing giving her a bath.
Both girls have had a couple of follow up appointments over the past month. Paige was seen by the same pediatric pulmonologist who did a consult for her while she was in the NICU (see post from April 6, 2013 for what happened then). He was happy with how her lungs have improved, and we have a follow up appointment with him in 3 months just to make sure everything is still going OK. Just as we learned in the NICU, he reiterated that the best treatment for chronic lung disease is growth and weight gain. He said that Paige will probably have to continue taking the Pulmicort breathing treatment for many more months, and that the best indicator of whether or not it's still needed will be how she does when she gets sick. If getting sick puts her in the hospital or she has to be treated by a medical professional, she still needs Pulmicort. If she does fine with just mommy and daddy's help, she can start to be weaned off of it. We also discussed life-long consequences of chronic lung disease. He said that the most noticeable difference would probably be how well she can handle high altitude. She will most likely huff and puff a lot more than you and I if she were high up in the Sierras. We also determined that she would most likely not have the lung capacity to be an Olympic swimmer.
Paige also had a plastic surgery appointment in order to assess her head shape. She has a noticeable flat area on the back right part of her head. Two things have caused this. First, she was intubated for a very long time after she was born. While intubated, babies have to lie on the side of their heads. Despite nurses' best efforts to rotate sides, one side usually gets a disproportionate amount of "down" time due to either medical necessity or nurse oversight (flat head worries are not a primary concern when you are worried about keeping a baby alive). Also, Paige has a slight case of torticollis that causes her to favor turning her head to the right while she sleeps. The torticollis has nothing to do with being a preemie, but is more common with twins due to space constraints while they are in mommy's tummy.
The plastic surgeon did some measurements and determined that Paige's head symmetry is off by 4.6%. If a baby's head symmetry is off by 6% or more, they recommend one of the head helmets. She doesn't meet the 6% threshold, so she doesn't need a helmet for now. Head helmets are only effective if started by 8 months of age. Paige's adjusted age is 6 months, so the plastic surgeon wants to see her again at 7 1/2 months adjusted age just to make sure she doesn't need a helmet. The plastic surgeon also gave us a referral to physical therapy so that we can get some tips and strategies for better head positioning for Paige.
Aubrey had an appointment with a hematologist. She had 3 unusual bleeding events while in the NICU, so the NICU referred us to the hematologist. Some of my side of the family (Josh writes this blog, in case you didn't know) has a bleeding disorder called Von Willebrand Disease that gets passed down to half of the kids born to a parent who has it. I was unlucky during the baby-making chromosomal lottery and got stuck with it thanks to my dad. Aubrey probably got unlucky during the baby-making chromosomal lottery and got stuck with it thanks to her dad (me). (In case you're wondering about Paige, she was also unlucky during the baby-making chromosomal lottery because she got stuck with me as a dad, haha). Laboratory tests for Von Willebrand Disease require lots of blood. Aubrey is pretty small so the hematologist, Andrea, and I thought it best to hold off on having her tested until she was a little bigger and had more blood in that body of hers. We'll have her tested sometime in mid- to late-2014. As I write this, I realize most of you don't know what Von Willebrand disease is. In a nut shell, the disease makes it makes it hard for your blood to form clots, which results in easy bruising, lots of bloody noses in elementary and middle school, and (for girls) abnormally heavy periods. There are various medications that can reduce the severity of the bruising and bleeding.
We also had a follow up hearing screening with the audiology department, something that is automatically done with preemies even if they pass the newborn screening like our girls did. Our girls were not quite developmentally mature enough for the screening, so we're going to repeat it in a couple months. The screening test consisted of playing quiet sounds from different speakers in a soundproof room while Andrea or I held one of the girls. After the quiet sounds, Disney characters would light up and "dance" above the speaker that played the noise for a few seconds as a positive reward for finding the sound. (I passed the test with flying colors, despite Andrea's persistent concerns that I'm deaf and never hear anything she says). The girls got bored with dancing Minnie Mouse after about 3 dances, and started playing with their own feet. The audiologists then did a passive measurement of the girls' hearing, which they both passed. We're going to re-do the dancing Minnie Mouse show in about 2 months.
Both girls will be getting Synagis shots once a month to help protect them against RSV (respiratory syncytial virus) during the cold and flu season. They get their first shot this week. Babies born before 28 weeks are supposed to get these shots during their first and possibly second winter. RSV usually sends preemies to the hospital for a few weeks and puts them on ventilators, so if Aubrey and Paige are hard to find this winter, it's because they're trying to avoid getting RSV.
That's enough medical stuff. Here are two pictures. The first is a picture of Paige's foot 5 minutes after she was born. The second is that same foot 9 months later.
Both girls are getting very good at grabbing toys and bringing them to their mouths to knaw on. Despite all the fun toys Andrea and I and other people have gotten the girls, their favorite thing to play with is still plain old paper. Here's Paige chewing on a paper bag, despite having the much better option of chewing on the apple slices in front of her.
Both girls are sleeping through the night and we have stopped doing late-night feeds. They usually fall asleep around 7 or 8, we change their diapers and feed them again around 9 or 10, and then they sleep until about 6:30. Occasionally one of the girls will have trouble falling asleep, but they never wake up in the middle of night (yet). Napping, on the other hand, has been somewhat of an issue. They both hate being put down for naps, even when they're so tired they can barely stay awake. I guess we should be grateful that they're at least good sleepers.
With the exception of Paige still taking a breathing treatment called Pulmicort, both girls are off all of their medications! This had made feeding routines much easier. Paige got the OK to stop oxygen about a month ago, so we don't have to deal with that at night anymore, either.
Here's a fun one of Aubrey just as mommy was finishing giving her a bath.
Both girls have had a couple of follow up appointments over the past month. Paige was seen by the same pediatric pulmonologist who did a consult for her while she was in the NICU (see post from April 6, 2013 for what happened then). He was happy with how her lungs have improved, and we have a follow up appointment with him in 3 months just to make sure everything is still going OK. Just as we learned in the NICU, he reiterated that the best treatment for chronic lung disease is growth and weight gain. He said that Paige will probably have to continue taking the Pulmicort breathing treatment for many more months, and that the best indicator of whether or not it's still needed will be how she does when she gets sick. If getting sick puts her in the hospital or she has to be treated by a medical professional, she still needs Pulmicort. If she does fine with just mommy and daddy's help, she can start to be weaned off of it. We also discussed life-long consequences of chronic lung disease. He said that the most noticeable difference would probably be how well she can handle high altitude. She will most likely huff and puff a lot more than you and I if she were high up in the Sierras. We also determined that she would most likely not have the lung capacity to be an Olympic swimmer.
Paige also had a plastic surgery appointment in order to assess her head shape. She has a noticeable flat area on the back right part of her head. Two things have caused this. First, she was intubated for a very long time after she was born. While intubated, babies have to lie on the side of their heads. Despite nurses' best efforts to rotate sides, one side usually gets a disproportionate amount of "down" time due to either medical necessity or nurse oversight (flat head worries are not a primary concern when you are worried about keeping a baby alive). Also, Paige has a slight case of torticollis that causes her to favor turning her head to the right while she sleeps. The torticollis has nothing to do with being a preemie, but is more common with twins due to space constraints while they are in mommy's tummy.
The plastic surgeon did some measurements and determined that Paige's head symmetry is off by 4.6%. If a baby's head symmetry is off by 6% or more, they recommend one of the head helmets. She doesn't meet the 6% threshold, so she doesn't need a helmet for now. Head helmets are only effective if started by 8 months of age. Paige's adjusted age is 6 months, so the plastic surgeon wants to see her again at 7 1/2 months adjusted age just to make sure she doesn't need a helmet. The plastic surgeon also gave us a referral to physical therapy so that we can get some tips and strategies for better head positioning for Paige.
Aubrey had an appointment with a hematologist. She had 3 unusual bleeding events while in the NICU, so the NICU referred us to the hematologist. Some of my side of the family (Josh writes this blog, in case you didn't know) has a bleeding disorder called Von Willebrand Disease that gets passed down to half of the kids born to a parent who has it. I was unlucky during the baby-making chromosomal lottery and got stuck with it thanks to my dad. Aubrey probably got unlucky during the baby-making chromosomal lottery and got stuck with it thanks to her dad (me). (In case you're wondering about Paige, she was also unlucky during the baby-making chromosomal lottery because she got stuck with me as a dad, haha). Laboratory tests for Von Willebrand Disease require lots of blood. Aubrey is pretty small so the hematologist, Andrea, and I thought it best to hold off on having her tested until she was a little bigger and had more blood in that body of hers. We'll have her tested sometime in mid- to late-2014. As I write this, I realize most of you don't know what Von Willebrand disease is. In a nut shell, the disease makes it makes it hard for your blood to form clots, which results in easy bruising, lots of bloody noses in elementary and middle school, and (for girls) abnormally heavy periods. There are various medications that can reduce the severity of the bruising and bleeding.
We also had a follow up hearing screening with the audiology department, something that is automatically done with preemies even if they pass the newborn screening like our girls did. Our girls were not quite developmentally mature enough for the screening, so we're going to repeat it in a couple months. The screening test consisted of playing quiet sounds from different speakers in a soundproof room while Andrea or I held one of the girls. After the quiet sounds, Disney characters would light up and "dance" above the speaker that played the noise for a few seconds as a positive reward for finding the sound. (I passed the test with flying colors, despite Andrea's persistent concerns that I'm deaf and never hear anything she says). The girls got bored with dancing Minnie Mouse after about 3 dances, and started playing with their own feet. The audiologists then did a passive measurement of the girls' hearing, which they both passed. We're going to re-do the dancing Minnie Mouse show in about 2 months.
Both girls will be getting Synagis shots once a month to help protect them against RSV (respiratory syncytial virus) during the cold and flu season. They get their first shot this week. Babies born before 28 weeks are supposed to get these shots during their first and possibly second winter. RSV usually sends preemies to the hospital for a few weeks and puts them on ventilators, so if Aubrey and Paige are hard to find this winter, it's because they're trying to avoid getting RSV.
That's enough medical stuff. Here are two pictures. The first is a picture of Paige's foot 5 minutes after she was born. The second is that same foot 9 months later.
We did some family photos at Old Poway Park a couple weeks ago. Here are some highlights. Aubrey is with Mommy and Paige is with Daddy in all photos except the last one.
Height and weight time! The girls are catching up on the growth chart, but still not on it. They are almost at the 3rd percentile for height. One of these days I'll post the actual growth chart that I use to track them.
Aubrey:
Day 1 - 2 lbs 2 oz 14 inchesDay 8 - 2 lbs 7 oz
Day 17 - 2 lbs 11 oz
Day 27 - 3 lbs 1 oz
(1 month)
Day 36 - 3 lbs 4 oz
Day 46 - 3 lbs 7 oz 16 inches
Day 56 - 4 lbs 0 oz
(2 months)
Day 62 - 4 lbs 9 oz 16 1/2 inches
Day 72 - 4 lbs 14 oz 17 1/2 inches
Day 80 - 5 lbs 5 oz
Day 88 - 5 lbs 14 oz 18 inches
(3 months)
Day 102 - 6 lbs 6 oz
Day 110 - 6 lbs 15 oz
Day 118 - 7 lbs 6 oz 19 1/2 inches
(4 months)
Day 126 - 7 lbs 8 oz
Day 134 - 8 lbs 0 oz 20 1/4 inches
5 months - 9 lbs 2 oz
6 months - 10 lbs 6 oz 21 1/4 inches
8 months ~12 lbs 12 oz (bathroom scale method)
9 months - 13 lbs 14 oz 25 1/2 inches
Paige:
Day 1 - 1 lbs 13 oz 14 1/2 inches
Day 8 - 1 lbs 12 oz
Day 17 - 2 lbs 2 oz
Day 27 - 2 lbs 10 oz
(1 month)
Day 36 - 2 lbs 13 oz
Day 46 - 3 lbs 5 oz 16 1/2 inches
Day 56 - 3 lbs 10 oz
(2 months)
Day 62 - 4 lbs 1 oz 17 1/2 inches
Day 72 - 4 lbs 4 oz 18 inches
Day 80 - 4 lbs 14 oz
Day 88 - 5 lbs 0 oz 18 inches
(3 months)
Day 102 - 6 lbs 2 oz
Day 110 - 6 lbs 7 oz
Day 118 - 6 lbs 12 oz 19 inches
(4 months)
Day 126 - 7 lbs 1 oz
Day 134 - 7 lbs 4 oz 19 3/4 inches
5 months - 7 lbs 14 oz
6 months - 9 lbs 1 oz 21 1/2 inches
8 months ~11 lbs 3 oz (bathroom scale method)
9 months - 12 lbs 9 oz 25 1/2 inches
Oh, and should anyone care, I went through all the posts, standardized the size of all pictures, and upgraded significantly the quality of the videos I posted the first 6 months (and made sure that they all work now).
