Monday, March 24, 2014

Motor Monday: Rollin' rollin' rollin'

One of the most interesting things for me as a mom of triplets and pediatric PT is watching our three babies develop motor skills on their own timeline.  It is also probably the most aggravating thing, at times, because sometimes it feels like nothing I do is helping Avery get this rolling thing down!  Isaiah and Ellie have both been rolling from belly to back for a long time now. Avery HAS rolled, but only a few times in front of me (& a handful of times when we weren't looking) and she really doesn't seem interested in trying even when I let her get really frustrated.  I figure she's just trying to teach me patience and make me a better therapist. :)

What's also interesting is that Isaiah and Ellie roll in completely different ways. Occasionally each of them will use the other method for rolling, but I'd say at least 90% of the time they stick with their go-to pattern. Isaiah uses his big noggin' to lead the charge in his roll, shifting his weight over one shoulder, as you can see in this video. (you also get to hear his happy squeals!)

Ellie on the other hand uses her legs to do the heavy lifting and leads the roll with her bum. She puts her head down and gets mobility from her hips rather than her shoulders.  When Ellie first started rolling she did it the same way as Isaiah but since she's learned to lead with her hips that's the way she does it pretty much every time.

And here's Avery during two of her rare moments of glory. On the first one, leading with her head, I positioned her on her elbows with them tucked in tight. In the second it was all her and I just barely caught it as you can see. That day she rolled three times in a row and then despite trying over and over she couldn't get it again.

We made a new friend last week and their daughter, who is a month older than Avery, is stubborn about rolling too. She did it for a week or so and then hasn't done it since, but is sitting by herself and looks great on her tummy. So, we'll see. I'm not giving up though! To practice rolling, both belly to back and back to belly I like to have the babies act out the song Ten in the Bed minus actually falling out of bed part!  We play it on the floor and I help them initiate the roll from their shoulders or hips and then let them finish it. I roll one baby each time I sing "roll over." Because it's to a song they all seem to enjoy this game and it's a great way to get a lot of rolling practice in. 

Sunday, March 23, 2014

First step toward becoming foodies

Over the past month or so the babies have begun showing interest in food, watching us like hawks when we eat. So for the past few weeks we've been giving them tastes of our food off our fingers.  We've also been reading up on different approaches to starting solids and have decided to primarily go with what's called baby led weaning. In baby led weaning the focus is on the babies feeding themselves right from the start.  Like with most things, we aren't going to be hard core about this and plan to do some purées as well. We have given them a few hard fruits and veggies just to taste and/or gnaw on with their gums a few times over the past couple of weeks, but today was the first time we tried something they could actually, in theory anyways, swallow.  First up banana and avocado.  Here's how it went:

Everyone was pretty interested in the prep, wondering what the naked babies in the bumbos was all about...
Oh the anticipation!

"You want me to do what with these things exactly?!"

"Um, can I start yet?"

"I don't know about this Mom!"
They started out a little bit tentative, but everyone did initiate grabbing the food and bringing it towards their mouths.  Holding the slippery pieces proved pretty darn tricky though.  I read a suggestion for that somewhere about coating the pieces with baby cereal or something...I'll have to look that up again...

Ellie going for it with the banana

Avery with a good grip on her avocado spear

My hands are pretty tasty.  Does that count?
When they seemed to be getting frustrated with not being able to pick it up/hold onto it long enough, I helped them out a bit.  It's cute how they all grabbed for my hand holding the food and brought it toward their mouths.  Isaiah was the least interested in the whole idea today.
"Okay, I'll try long as you think it's okay Mom"

"Yeah, Mom, give it to me!  Just bring it right to my mouth!"

"Oooh, such a pretty green color!"
Sometimes they seemed to like it...
And sometimes they didn't...
"Eww...this feels funny in my mouth"

Avey spitting out the piece of banana she'd gummed off.
But even when they made these hilarious "yuck" faces, they kept picking up more or pulling my hand back toward them, so they must not have minded too much.  The girls were especially into it today.  And no matter what, everyone got a good messy sensory experience out of it!  We got six slimy hands, a couple of green bellies, and some sticky eyebrows out of the deal.
avocado tummy

Messy babies & bumbos

All in all, it was pretty fun and cute.  I don't know that we're quite ready to commit to this being an every day activity, but it was a nice afternoon waketime activity and we'll start building it into their days more often.  I installed their high chairs on the table today, but we thought since we wanted them to at least try to pick up the food themselves that having a little more support would be helpful, thus the bumbos.

Water babies

We took the babies to the pool this weekend for the first time.  Our new friends and their seven month old daughter joined us so we could have a 1:1 adult to baby ratio, which was super and definitely made things easier!  The babies all LOVED the water!  We got lots of big smiles from everyone and heard lots of talking.  Avery particularly like being lifted high in the sky and then splashing down in the water and didn't really seem to mind when her face got splashed.  Ellie seemed to like it when I laid back in the water a bit so she could prop on her elbows on my chest.  And Isaiah was the king of floating on his back!  He just loved it and seemed so relaxed with his head fully back so both his ears were in the water.  They all got a mouthful or two of water at various points, most often of their own doing, though occasionally it was definitely our fault!  We passed the babies around a lot so we would get one on one time with each of them.  

We picked up cute suits for the girls for a couple bucks from a consignment sale this week, which was great timing.  We didn't have a suit for Isaiah, but Michelle's mom had picked up a 12mo suit for later in the summer and we decided to just try it.  It was WAY too big for him, but it stayed on well enough.  We'll have to check the local kids resale store to see if we can find a smaller one for him.  I thought we had other suits, but couldn't find them this morning in a quick search.
all our little water babies

No one was a big fan of the after-pool process of rinsing off in the shower, getting lubed up with coconut oil, and changing out of wet suits and into dry clothes, but they survived.  And really, the crying was fairly minimal considering how chilly that whole process is for everyone, including the adults!  It was sooooo helpful to have Deirdre there to help!  I think we could do it by ourselves but there would definitely be more crying!  Once everyone was dressed we fed them in the lobby and all three fell asleep.  

We decided to take advantage of three sleepy babies to get groceries so Michelle drove laps around the Trader Joes parking lot while I shopped. Then I lapped the Giant lot while she popped in for the last few things on our list.  All three were still sleeping when we got home and actually stayed asleep in their car seats in the house for a while. The girls each slept for an hour and a half and Isaiah napped for two hours! If we can get super long naps like that every time we'll be swimming a lot more often!! :)
Here's a quick video Deirdre took for us of everyone in the pool.

Wednesday, March 19, 2014

Some well-deserved ME time!

Woohoo!  I'm feeling so accomplished tonight!  I just successfully did bedtime all by myself! Michelle has class on Wednesday nights and usually Hope is here to help me, but she just got back from spring break and the rugby team just started outdoor practices and I completely forgot to check in to make sure she would be here to help tonight.  When I realized I was on my own for the last two feedings of the day and bedtime routine I decided that, rather than panic (which was my first thought), I would embrace it and have an over the top positive attitude to see if it would rub off on the babies. =)  Whether it was my positive attitude or sheer luck I'm happy to report that this evening was a rousing success!

I got all three babies changed and into their giant overnight diapers and got them all their zantac and vitamin D.  While I changed each baby the other two played contentedly in the play gym in their bedroom, probably because of the chipper little ditty that I made up on the spot and sang the whole time. =)  My little ditty went something like this "We'll all have a happy bedtime, we'll all have a happy bedtime, we'll all have a happy bedtime for Mommy tonight!" They must have been paying close attention to the lyrics because bedtime the past few nights has been tough and they rocked it tonight.  No one even cried when I swaddled them. (Okay, Avery cried a little after being swaddled before she got her bottle, but nothing major!)
My set up.  When not taking this selfie I used my
right hand to hold the bottle and left to support Ellie's head

Some bedtime sibling love
Everyone ate well with minimal fussing and everyone was pretty content when they were finished.  Then I read everyone two books and Ellie nodded off during the first book.  And I put them to bed one by one singing our goodnight song and everyone went down by 6:45 with no more than a single peep.  It was AMAZING!!
(Clearly Ellie is enthralled!)
So I decided that I should celebrate my successful solo bedtime with a little me time.  I didn't feel like leftovers so I whipped up a quick kale rice bowl in a peanut sauce and made myself a pomegranate margarita and plunked myself down to blog a bit.  I am going to finish off my "me time" enjoying a homemade gluten free fortune cookie given to me by my friend Heather! Eventually I'll get to cleaning up the messes in the kitchen and living room, but first some well-deserved me time!  Ahhhh, this margarita tastes fantastic! =)
My "me time" set up
(I'm also ignoring the work I need to do on the other computer!)
the kitchen mess I'm ignoring
the living room mess I'm ignoring

Tuesday, March 18, 2014

A few pics from the past couple weeks

Here are some cute pics from the last couple of weeks...
Auntie Jess came for her fourth visit since the triplets arrived. 
It's getting harder to hold all three!
Auntie Jess & Avery having a chat 
before bed

Jess and her girls

Me chillin with my crew
And the sharing (or fighting over) toys 

Ellie looking cute before a walk

Sweetest little guy snoozin' on the boob

Don't I look handsome in my plaid shirt and 

Ellie showing off her awesome huge 
gummy smile

Avery muggin' for the camera

We all LOVE these balls...we just wish we could 
get them in our mouths!

Thanks Auntie Carrie for the adorable 
"cutest baby" onesies!
looks like Avery is going to be able to 
curl her tongue!

Big smiles from E & I while A practices her 
Two of three are amused by Mama 
but Ellie looks unsure

Monday, March 17, 2014

Motor Monday: Baby Sit-ups

Tonight's post is going to be quick and "off the cuff" because I had another post written and then realized I was missing a key video!  So I'm whipping this up before heading to bed.  Just like us, babies should be doing sit ups as part of their regular exercise routine.  Baby sit ups are a great way to work on head control and abdominal strength.  Here's a video of Avery doing baby sit-ups, or pull to sit, at about three and a half months.

In this second video, she has already done 3 or 4 reps of baby sit ups and you can see the muscle fatigue set in.  One tip for doing baby sit ups is to try to get your baby to look at your face before you start (making silly faces, talking, and singing can help).  Most babies will be motivated to keep that eye contact and will work harder to lift their head so they can keep seeing mom or dad.  Avery wasn't cooperating with that for this video.  She was too busy looking around which didn't help with her head control!

If your baby isn't ready for this version of baby sit ups, you can start with a modified version where you support your baby behind her shoulders rather than grasping her hands/arms.  If your baby's head is dropping back like Avery's in the second video right from the start, try the modified version.  If it seems like your baby is having trouble getting started, you can start at the top and slowly lower baby down to the floor/bed/changing table.  Just like grown up sit ups, babies are working both on the way up and on the way down so take your time both directions. You may notice that at first the baby will be able to hold her head until just before reaching the bed and then it will flop back.  You can keep your fingers positioned just an inch or two behind baby's head when doing this so you can "catch" her head if it flops.  A more advanced version is to hold just the baby's hands rather than her whole forearm as I do in this video.

Baby sit ups are super easy to integrate into daily routines, which is one thing I love about them.  Our babies do them almost every time they get up from the changing table or floor.  You can also do the reverse sit up every time you put them on the changing table for a diaper change for double duty.  Just doing these at diaper changes means they're doing a minimum of eight sit ups over the course of a day, and as we can attest, often many more times than that!  If you want to work on endurance you can do multiple sit ups in a row until your baby shows signs of fatigue.

Did you know that a study was published in 2012 showing an association between head lag (where the babies head lolls backward) during pull to sit and autism spectrum disorders in high risk infants (siblings of children with ASD)?  They showed an association, which is very different than causality, so this does NOT mean that all infants with head lag at 6 months will have autism, but head lag at 6 months may be indicative of some type of neurodevelopmental problem.  Pull to sit is only one indication of the development of postural control, but if your baby is struggling with it at 6 months of age, it is worth bringing up with your pediatrician!  

Thursday, March 13, 2014

"Guest" post: The points system: When you can't do it all. Learning to breastfeed triplets, part 1

For "Throwback Thursday" this week we have a special guest post by Michelle, reflecting back on the most helpful advice she got from a lactation consultant while trying to "do it all" surviving the first week of breastfeeding triplets.  Here's Michelle!

I initially set out to write a product review and realized that I really wanted to talk about what I've learned about breastfeeding and then do the product review of Rumina's pump&nurse products. (stayed tuned for this in pt. 2)

I really knew very little about breastfeeding before the trio were born.  I had seen others do it of course and I knew from friends that it was not going to be super easy or awesome at first.  Mari had been pumping for months, so I'd seen her do that, but I really didn't know the mechanics of pumping either.  We had visited a lactation consultant (LC) before the babies were born and while she was enthusiastic and supportive, she didn't get into "how to's" at all.

When the babies were born (via c-section at 34 wks), I was told to pump within 2 hours, but was still in "recovery" and Mari was in the NICU with the babies, so I wasn't sure how to begin! Thankfully a LC visited to walk me through that first dairy cow-like experience of hooking my udders, er breasts, up to the pump.  I don't remember too many details from the first week of nursing because the combination of pain meds, sleep deprivation, and the stress of having three babies in the NICU leads to memory loss, literally! But I do remember that it felt very stressful and exhausting. I know I sought out help from the LCs at the hospital often and remember it feeling rather unhelpful with one exception: a very seasoned and practical LC who taught me a valuable lesson that I wanted to share with new nursing moms!

Because we had three babies to feed, we had to work hard to establish a good milk supply. While the babies were in the NICU we were told to pump every 2 hrs during the day and at least every 4 hours at night and to definitely get 8 times in 24 hours.  This is in addition to attempting to nurse the babies so they could learn to nurse and recovering from major surgery! (Not to mention visiting with a million doctors coming to check on me and/or the babies).  While I don't remember details, I clearly remember feeling completely overwhelmed with trying to fit so many things into a 24 hr period! Oh, and of course, I was also being told to rest (sleep is important for milk supply) and eat (a healthy diet, also important for milk supply).  I literally could NOT follow all the advice! 

I was feeling stressed about getting enough nursing and pumping in during each 24 hr period and am so thankful for the advice of the seasoned LC who taught me a system that helped me find some balance.  She told me to think of "things good for milk supply" as a whole and to give myself points for everything that met the definition. If I took a nap, I got points! If I tried nursing babies, more points! Kangaroo care? Points! Pumping? Points. She made me feel like I didn't have to, and really couldn't, do it all and that was okay.   If I couldn't nurse them, then pump. If I couldn't pump, eat a good lunch and cuddle with a baby.  It all counted!

This was such a relief to me.  I still tried to pump and nurse as often as possible, but I stopped being rigid about doing it all so many times per day!  Letting go of that let me focus more on enjoying our three precious babies.
cuddle time with Avery? Points...

Kangaroo care with Ellie? Points...

taking a nap? Points...
(no I didn't REALLY nap with all 3 in bed covered in a sheet, but it did make a cute pic!)

Part 2...what happens when three babies and two nursing moms leave the hospital? Coming soon...

Monday, March 10, 2014

Earning my mommy badges

I think the fact that, as of yesterday, I can tell you that regurgitated breastmilk is surprisingly sweet means I have indeed earned a new mommy badge. It may not be a coveted mommy badge, but certainly one I'll remember! Yesterday afternoon we were getting the kiddos ready to go for a walk to enjoy the sunshine and glimpse of spring. Two out of three were fed and I was taking Isaiah back for a diaper change. He was a little fussy so I picked him up overhead which usually makes him smile but about halfway up I discovered why he was fussing! A fountain of spit up flew out of his mouth and directly into my open smiling mouth! Ewww! I'm amazed I didn't drop him out of pure shock! What I did do is start laughing really hard and for those who know me well, me laughing hard with a full bladder is, well, a recipe for disaster! In less than a minute I'd gotten spit up in my mouth and peed my pants (a teeny bit)!  Pretty impressive I'd say!  

I think the "puke in the mouth" badge is probably up there with the "pee in the face" badge. Which I thankfully have yet to earn!  Michelle and both have our "catch puke on your hand" and "get peed and pooped on in the same day" badges already. I'm a pretty competitive person, but It doesn't extend to this area of my life! One mommy badge I hope never to earn that not one, but two, of our friends have posted about recently is the "puking while breastfeeding" badge!  I'd also love to skip the "breastfeeding through mastitis" badge that my sister and other friends have endured.  What other mommy badges have you earned that you could've done without?! Any funny stories you care to share?!

       "Uh, sorry about that Mommy!"

Motor Monday: Look Both Ways

If you read my first Motor Monday post you might remember me talking about how one issue for babies in the NICU is that they often turn their heads to the right?  Well side preferences don't just happen with preemies and in fact I just got a question today from a friend with a newborn who prefers to look to the left.  She said "He pretty much is always looking that way.  We have tried noise and visual stimulus to get him to turn and stay on the non-preferred side.  Do you have any more suggestions?"

So although I had another post started, I figured this was a perfect Motor Monday topic and wanted to get suggestions to my friends sooner rather than later!  At my request they sent me pictures of the back and top of his head and said I could share them here.

In the picture from the top you can see a VERY mild flattening on the left side (really, the right just looks a little rounder/fuller in the back).  On the picture of the back can you see how his right ear is tilted down towards his right shoulder?  Having never met this little guy I certainly can't and would never diagnose him, but I wouldn't be at all surprised, based on the pictures and his moms' descriptions of him, if he had a mild torticollis, or tight neck muscle on the right side of his neck.  When this happens, kiddos prefer to look to the left and tilt their head to the right.  So, what can his moms do to help him?  Here are a few tips for any parents who notice that their baby has a favorite side.  I'm going to write this for our friends' kiddo who looks left, but if your kiddo prefers to look right, just flip the sides!

1. Everything interesting is on his right!  This little guy is only a couple weeks old so his moms are probably the most interesting thing to him right now but lights, noise, other people might also work.  The big thing is just to be mindful of his positioning throughout his day.  Place him in the crib so that he would have to look to the right to see you when you come to pick him up after naptime.  This goes for the changing table too.  It might feel awkward for you to have to switch to using the other side but do it for your baby!  Same thing applies to being on the floor or in a bouncy seat...everything cool is to the right.  It's even better if you or the toys can be just a bit behind to encourage the baby to look up and right because that stretches out the tight neck muscle even more.

2. The side carry stretch.  This was apparently the best way to calm me down as an infant and it works like a charm for our little hothead Avery too.  Have the baby face away from you on his side with his right ear on your right arm.  Place your left arm between the baby's legs to support his body.  The idea here is to gently stretch his right ear away from his right shoulder. (i.e. moving his left ear closer to his left shoulder)
Here's an example of a version of the side carry with Avery

3. Tummy time.  Our friends are already working on this (I know this because I've seen adorable pics on Facebook!) but their little man, who keep in mind is only two week old, manages to turn his head back to his favorite left side when they put him down facing right. In this case, You could try tummy time on mom's chest with his head gently blocked from turning left by mom's head or hand.
I could move my hand up to his head if he started to turn
his head the other way.

4. Sidelying with a boppy. This is the same idea as the side carry, getting the right ear away from the right shoulder. Just like with the side carry, the focus for this stretch is on the tilt part versus the turn.  So you are stretching the right side of his neck by increasing the distance between his right shoulder and right ear. Here's a picture of Isaiah in this position.
Right shoulder away from right ear for a kiddo who prefers to turn left

5. Body Block!  Use your body to block the baby from turning his head to his favorite side.  You can do this having the baby's body facing you and head looking up when held in a cradle position or use your hand or head to block the preferred side when held at your shoulder.  Here's Michelle with Isaiah using her arm to block him from turning to the right.

I hope these tips are helpful for our friends and other babies who are favoring one side. Once babies start turning their heads both ways equally and moving more, their heads will gradually even out in most cases.  In the meantime, while he is awake I would hold him and wear him as much as possible and do lots of tummy time to avoid more time with pressure on the same spot on the head.  Your baby will be spending a lot of time on his back already just while he's sleeping so minimize time in equipment like the carseat, swing, etc and laying on his back on the floor.  When he is sleeping, if you have a sound sleeper, I'd recommend turning his head to the non-preferred side once he is asleep!  (That said, Isaiah used to consistently sleep with his head to one side and I was rarely willing to risk waking him up by turning his head so I understand the value of sleep!!)

Big thanks to our new mom friends in Boston for their question!  Do you have any motor development questions (about a certain age or disability) that have been rattling around in your brain?  If so, leave it in the comments and I'll add it to my list!

Monday, March 3, 2014

Motor Monday- What time is it?! Tummy time!!

As an early intervention therapist, one of my standard first visit questions for parents of babies is to ask about daily routines including how much time the baby spends on his or her tummy. So when we'd been home with the triplets for a couple weeks and settling into some routines I was appalled to realize how little tummy time our babies were getting. I know, I know, they were only a couple weeks old and you know, we were first time moms with TRIPLETS so I should cut us a little slack.  But I resolved to "walk the walk" when it came to tummy time and started introducing Michelle to a bunch of different ways we could sneak in tummy time. So for today's Motor Monday post I'd just show you the "many shades of tummy time" in the Therrien house.  Here are a bunch of the ways we've incorporated tummy time and pseudo tummy time activities into the lives of our little trio over the past five months.  Tummy time is good for all sorts of things!

Like regulating your breathing in the NICU...
or bonding with mommy at home.

Early on tummy time was just good for a snooze...
any which way you happen to land...

especially with your best buds.
Tummy time is also good for showing off your ruffle butt...
or your monkey & froggy butts...
or your festive Santa butt!

Tummy time is great when you want to stare adoringly at your mommy...
or that adorable, if slightly distorted, baby in the mirror!

Tummy time is good for spending quality time with your sibling...
but it gets pretty boring if he falls asleep!

Tummy time is good for waiting to eat...
eating your brother's finger...
or knawing on your sister's head!
Tummy time makes for a cute brotherly photo shoot...
until your brother starts sniffing your butt that is!
Tummy time is good for showing little friends what to do...
or "one upping" your sister!

Tummy time is good for watching your siblings...
reading a book...
or watching the Olympics!

Tummy time is good for playing by yourself...
or with Mama
which is really soooo fun!
But let's be honest...tummy time can bring out a range of emotions...
and especially frustration!
Tummy time looks a little different month by month and day by day...
and we all do it a little differently.
But even though it is hard work (note the drool!)...
 it always helps make us stronger...
and, well, let's be's not like we have a choice when our mom is a PT!!