My nighttime "logic"

Another middle of the night blog post coming your way because I want to jot this down before I forget. So tonight we got the babies down around 7:15. Then we had a super fancy dinner courtesy of our freezer. I know it sounds like I'm probably being sarcastic, but seriously, it was fancy! We had perfectly cooked filet mignon with a potato, mushroom, haricoverts veggie mix from Trader Joes and a glass of red wine.  We chatted with  Hope, hung up our pull up bar (more about our "get fit" plans later), and competed in a game of Dance Central 2 on Kinect. We haven't played Kinect in over a year so it was fun to bust that game out again!  And it gave us all a good laugh. I'm loving this earlier bedtime for the babies because I actually feel like I see glimpses of our former selves in that extra hour we get before we go to bed too!  But I digress from the point of this post!

So Michelle and I head to bed around nine and go to sleep around 9:30/9:45 (our typical bedtime these days).  Pretty much right at midnight I-man starts crying. Now, this next part I'm telling you is courtesy of a re-telling by Michelle because I don't actually remember this conversation, but it went something like this:

Michelle: "Should we get him (to feed him) or just give him the pacifier (to try soothing him)?"

Mari: "I thought we weren't doing the pacifier." 

Michelle: (very confused about this as we haven't discussed weaning from the pacifier yet) "Why?"

Mari: "Cuz they're not ready... We said they're not ready for solid foods..."

What?!? And when Michelle challenged me on this completely unrelated and ridiculous thing to say I got defensive, even mad!

About five minutes into nursing the babies (Michelle had him & I'd gotten Avery to eat), Michelle says to me "What's your mental capacity right now?"  When I respond with "Um fine??" In a questioning tone she goes on to tell me about the above conversation. Bits and pieces sound vaguely familiar but more clear than the actual conversation is the memory of a feeling. It's like I remember feeling like I was underwater and struggling to reach the surface. Like my brain knew that it wasn't working at full capacity and so at the same time as I was arguing with Michelle I was working incredibly hard to figure out if what I was saying actually made any sense, which clearly, as you can see, it did not! And as I was swimming back to the surface of full awareness I was struggling to remember what I'd just said, making it very hard to construct a logical argument.

As Michelle retold this conversation I just laughed and laughed and then apologized over and over because I was getting frustrated with her and not being my best kind living self as I worked my way back to full consciousness! I wonder now, is that maybe what it feels like for people with dementia? In the early stages do they know that what they're not quite making sense? Does it feel like they're always struggling to make sense? If so, I can imagine that it's very frustrating!  But enough of the serious middle of the night reflection. Conversations like this are why Michelle and I have to make a game plan for the night together before we go to sleep because I'm often useless when it comes to making decisions at night, at least for the first few minutes!  Here's hoping that this blog post makes more sense than my argument and that the babies start sleeping longer stretches soon!  I think Isaiah will be wearing this tomorrow!

Grandma is one funny lady!

Grandma Stephen came for a visit last week and the kiddos and mommies all agree that five days felt too short. Denise was, as always, a big help.  It was great timing for the arrival of another set of hands because our little ones have been struggling with sleep again lately.  (More on that in another post). But having an extra person when we're feeling particularly sleep deprived is very helpful! Denise made some yummy dinners, kept the laundry moving, and, of course, gave the babies lots and lots of love.

Grandma & Ellie in their coordinating colors

Apparently Grandma is funnier than she knew because she got a ton of good laughs from all the babies. Denise is great at exaggerating her facial expressions and the babies were really responsive to that.  Ellie was particularly enamored with Grandma this trip and just laughed and laughed with (or at!) her! Denise sang them lots of songs, but the crowd favorite was Wheels on the Bus!  They especially liked Grandma's action packed version that gave Denise a good arm workout each time.  Making ten pound babies go "round & round" and "swish swish swish" is tiring! Check out this adorable video of Ellie & Grandma.

On Saturday Denise and I took the trio out on a little shopping trip. Denise is a member of Sam's club and we like to take advantage of that to stock up on a couple of things when she's in town. My favorite purchase was a "handy hauler" for gardening since this summer I won't be able to use the kiddos' wagon as my wheelbarrow like I did last summer!  The babies were very good and all three took little snoozes while we were shopping.  All in all, a successful outing!

Grandma can still hold all three

Motor Monday-Primitive Reflexes Part Two

Here's the promised part two of primitive reflexes and why they matter. This is a short one because we haven't been getting much sleep around here lately and I'm not functioning at the top of my game cognitively!  Like I said last week, we still don't fully understand the role of primitive reflexes and their relationship to motor development though I talked a bit about how primitive reflexes are hypothesized to help with motor development.  Primitive reflexes are controlled by the brainstem and as the higher level parts of a baby's brain develop they learn movement patterns that are more complex that take over for the reflex patterns.

The important thing to know about primitive reflexes is that they aren't normally "obligatory" in that they don't happen to the extreme every time the stimulus happens. Sure, most of the time if you touch a baby's cheek they will turn toward the touch because of the rooting reflex, but it doesn't happen every time.  Obligatory reflexes where the baby or older child can't NOT do the movement is a red flag that there is something atypical going on with the nervous system.  Cerebral palsy is a good example of a diagnosis that might involve primitive reflexes that are obligatory.  Another red flag is when reflexes don't fade away as much as they should or when they should, known as persistent reflex patterns.  One study of very low birthweight infants (i.e. tiny preemies) found a clear association between the strength of primitive reflexes and motor delays (i.e. infants with very strong reflexes at 4 months were more likely to have motor delays), while another found no association between primitive reflexes and motor skills in term babies.  Persistent reflexes may also be associated with delays in other areas like reading skills.

Last week I included a picture of Isaiah in ATNR or fencer's pose. Can you picture how ATNR could seriously get in the way of rolling back to belly?  Baby looks to the left and tries to roll that way to get to mom but that darn left arm is sticking out to the side like a kickstand?!  ATNR typically fades by 4-6 months, which happens to be just when babies are learning to roll from back to belly.  A persistent ATNR could also interfere with crawling.  Picture the infant below who turns his head to the left to see his dad.  If he has persistent ATNR (which you'll remember should be integrated by 6 months), his right elbow would bend or buckle, which would be pretty inconvenient and might mean a good head bonk for baby. 

When crawling we need to be able to look side to side without
our support arm collapsing

One other interesting thing to note about primitive reflexes before I sign off on this post is that they sometimes show up again in older adults, particularly those with severe dementia or Alzheimers.  I think this is fascinating! Okay, time to try to get some sleep before the babies wake up again!

Motor Monday-Primitive Reflexes Part One

Are you calling my baby primitive?!  Do you think we are cavemen or something?  Nope, no name calling here, but when babies are first born their nervous systems are not fully developed and most of their movement is controlled by a more primitive part of the brain called the midbrain.  These movements are reflexive, in that they are in direct response to a stimulus.  You are probably familiar with some of the primitive reflexes like rooting and sucking. To me, these reflexes make sense because they are true survival instincts that help infants find and take in food.  Similarly the gag and coughing reflexes are important for survival, clearing the airway.  Some of the other primitive reflexes are not as clearly linked to survival now, but you can see how they might have been at one time. (It's already late and I need to get to bed, so I'm only going to touch on a couple of examples of other reflexes tonight!)

The Moro (or startle) reflex is a good example of a reflex that you can see being useful some time in human evolution. When you watch the video, watch how Avery's arms initially flare out to her sides and then pull back in to hug her body.  This is the baby's response to a threat, in this case being "dropped."  This reflex may have helped a baby cling to his mother if she began to fall.

Other reflexes are harder to see the "survival" value in.  If you have kiddos, or have spent a lot of time around babies, this pose probably looks pretty familiar to you.

This is classic ATNR (assymmetrical tonic neck reflex) where the babies head is turned and the arm and leg on the face side straighten and then bend on the skull side.  It's a little harder to see how this type of reflex could be survival based unless the baby can hold a sword and shout "on guard!"  (This position is often referred to as the fencer position.)  As babies get older, these reflexes get integrated into more purposeful movements or are inihibited and essentially disappear.  We still don't fully understand the purpose of these reflexes, but they are hypothesized to play a role in motor development.  ATNR, for example, may help babies see their hands and recognize that their hands are in fact theirs and may turn out to be pretty useful.  

Did you know that tiny babies can walk if you support them in standing and tip them forward a bit?!  This reflex is aptly named the stepping reflex, which may set the foundation for the general patten of walking and even for kicking that helps build the muscle strength needed to walk.  I am sooooo sad to say that I don't have a video of the stepping reflex to show you.  I had a great one of Avery when she was about a month old, thought I uploaded it to YouTube, and deleted it from my phone only to realize I'd uploaded a different video. =(  By the time I realized it, all their stepping reflexes were pretty hard to elicit.  So if any of our readers have a newborn and want to send me a video of them "walking" I would be so grateful!  

In Primitive Reflexes Part Two I'll talk a little more about what can happen if these reflexes don't integrate properly or are what we might call "obligatory" and the baby or child can't override the reflexive response.  Are there any other reflexes you've heard about and want to know more about?  If so let me know and I'll add that into part two!

A day in the life...with 3-4 month old triplets

I've been meaning to write an updated version of our "day in the life" post for weeks now and just haven't managed to get started. By the time you finish reading this post I think you'll understand why. Here's an average day these days: (we've essentially been on the same schedule since two and a half or three months)

7ish- Wake up & eat (most days Isaiah is our alarm clock). We each nurse one baby in our room while, hopefully, baby #3 is still sleeping. Feedings are generally taking about 20-25 min most times. We keep hearing this shoud be getting faster & it is, but not as quickly as we'd like. They are sometimes finishing in 15 minutes though.  Hopefully that is a trend!

7:30- Michelle feeds #3 & I change stinky overnight diapers, most often poopy. All babies get Zantac for reflux.

7:45-Playtime-Usually in the activity gym in our bedroom (Some days this is about when I leave for a work visit, leaving Michelle to get everyone down). Baby 3 gets changed.

8:30ish- Babies 1 & 2 start getting sleepy and get put down for a nap.   Nap time routine is a song or two and then down in their cribs. (Some days they're back down as early as 8/8:15 if they seem really sleepy). If we're both home one of us might get a shower while there's only one baby awake or go make breakfast.

9ish-Baby #3 goes down & moms eat breakfast if we haven't already squeezed it in cuz we were starving.  Usually enough time to get dressed, brush teeth, etc too.

9:30-Babies 1 & 2 wake up and eat...feeding party has moved to the living room now.

10-Two diapers & playtime in activity gym, bumbo, tummy time, etc.  Baby 3 up to eat (This is another time I might head out for work visit & be back by 12 or after baby 3 eats I send Michelle to the bedroom to do homework while I handle the babies.)

10:30-Diaper time for baby #3 who then joins playtime in the living room.

11ish-Babies 1 & 2 go down There's always about a 15 min leeway on either side for naps that vary between 45 min to a little over an hour. So if they seem like they're getting sleepy earlier, down they go.  If one baby wakes up early, lately they've been content to have some quiet time in the swing until baby 2 wakes up to eat..usually no more than ~15 min.

11:15/30- Baby 3 down for nap & moms get laundry moving, eat lunch, or maybe Michelle tries to do a quick homework task or make a meal plan. (Note the OR in the above statement! There's typically time for one task...especially when one of the first two down wakes up early or baby #3 has a hard time going down.)

12- Babies up to eat (As before baby 3 is 15-30 behind 1 & 2)

Repeat feeding-diaper-playtime-nap cycles with feedings around 2:30 & 5. Difference being that as the day progresses naps get harder and less consistent, often needing more intervention to get them to sleep, which means we get less done.

7:30-Start bedtime routine. For this cycle we do diaper changes first, getting them in their overnight diapers. Then we swaddle them, nurse them, read a couple books, sing our goodnight version of Frere Jaques and lay them in their crib, drowsy but awake. Typically, they all go down pretty easily with minimal fighting. If they do fight it, we set a 5min timer before going in to soothe. That's usually all it takes before they are off to dreamland.  This is the longest stretch of sleep, typically from about 8:30/9 to between 1 & 2. Some nights we have an early wake up but they usually soothe themselves back to sleep. On really lucky nights they might sleep until 2:30.

9-9:30-We get ourselves ready for bed, prep nighttime snacks, and pump right before bed. We are typically in bed by 9:15/9:30.

1 or 2a.m.-First night feeding. These night feedings are all business. Everyone stays swaddled, eats in the dark in our bedroom, and right back down. Usually no problems going back down though a few times lately Avery has gotten upset when we lay her back down. We do a quick pump after this feeding too because even though it means less sleep, it's a lot easier to pump at night than it is during the day now. The babies are just too busy for us to pump during the day now. Hopefully our milk supplies will keep up. So far so good. Our snack for this feeding is almost always an apple cut into thin slices.

4/5a.m.- 2nd night feeding. Same as the first only we don't pump after this one since by the time they're all back in bed we usually only have an hour or two left to sleep. Some days, like when I have an 8am visit or Michelle is feeling particularly stressed about school we just stay up after this feeding. It's a hard choice to make, but we usually get a lot done when we do it. As you can see from the schedule above, the longest window we have to accomplish any task is about 30 minutes and if we stay up after this feeding we might have almost 90 minutes of continuous time to work, which feels like an eternity. But, when we do stay up, we've generally gotten about 6 hours of sleep so we can't do this all the time or we get worn down.

And then we start it all over again around 7a.m.!  We keep waiting for their cycles to stretch out a bit, but they're just not ready yet, I guess. They are pretty good at letting us know when they need to sleep and are very clear about when they need to eat!!

And that's our life these days! Whew, anyone else feel tired just reading this?!

Lots of sleepy babies

Visitors make February more palatable

February is the worst month. Everyone knows that right? I know it's short, but it usually feels like it lasts forever and winter will never go away!  Fortunately, we have lots of visitors this February to help brighten this dastardly month. Look at all this snow!!

about a foot out there I'd say

We rang in February with a visit from Auntie Marty, one of our best friends from Seattle.  Marty came bearing Seahawks gear so we could represent properly during the Super Bowl party we went to.  It was great to see Marty and so helpful to have her here for two weeks. Marty is a quick study and picked up in routines quickly. Auntie Marty was a true spit up magnet, often having a competition with Isaiah to see who could change more times by noon!  

I-man (as Marty likes to call him) snuggling in

Isaiah got 'er good!

Having Marty here was like having a personal chef! She came with a stack of recipes she wanted to make and they were all delicious!  She made us a Hunter's Stew with chicken thighs and pancetta, a delicious brazilian dish, and a yummy butternut squash, quinoa, and chicken stew. Marty also did a lot of grocery shopping for us and played outside in the snow with Humphrey. Marty was actually excited about the snow unlike us!

bedtime story

Marty & the trio

Marty left on Saturday and my great aunt Nancy arrived on Sunday afternoon and is here for the week. Nancy arrived in grand fashion with her little car getting stuck partway up our driveway after a long drive in the snow!  Hope and I tried to push it up but had no luck. Nancy said "I came to help and here I've just brought trouble!"  Eventually, after our driveway was plowed and a good deal of persistence Nancy finally managed to drive her car all the way up!  Nancy has jumped right in to help, changing cloth diapers and making sure the laundry is always moving, cleaning the kitchen and walking babies in endless laps around the living room.  She is a loyal blog reader so Nancy knows and remember so much about them, you'd swear she's visited before! 

Nancy read them lots of books

And did lots of laps

And got lots of good smiles

Nancy leaves tomorrow and then Michelle's mom arrives Tuesday evening. Denise is flying this trip and we're all excited because United recently started direct flights between State College and Chicago! Before this change, flying to Chicago meant a stop in Detroit, Philly, or D.C. (the only places any airlines flew from State College). I don't know how often we'll be able to fly there, but it's nice to know that it is an option now.  It's only been a month and a half or so since Denise has seen her grandbabies, but I'm sure she'll be surprised how much more they are doing!  We are so thankful for our February visitors!  They are letting us take our time finding the right person to be our mother's helper and it really is easier with an extra person around here!  Anyone want to sign up to come visit in March?!?

Ellie finds her voice!

My oh my! Little Miss Ellie has found her voice in a big way in the past week or so! This little girl has been cracking us up left and right! She has turned into quite the chatterbox and she is LOUD! Ellie and I had a ten minute "conversation" yesterday talking and laughing back and forth, she's a very good turn taker and she just loves to see your reactions to her talking. Here's a snippet of our chat. I love how she puts her whole body into it and makes some goofy faces along the way!

She also likes talking to her reflection in the play gym mirror!  This little video of her in the play gym gives a better sense of how loud she is!

We LOVE her big girl voice and look forward to many more laughs from Ellie and the other two when they get there!  I can't wait til they're all chatting with each other!

"Well, hello there!"

Motor Monday- Let's start at the very beginning

I wasn't sure what my first topic should be for Motor Monday, but then we got an email from someone at Geisinger asking us to answer some questions about our experience there in labor and delivery and the NICU. Answering those questions had us reflecting on our experience and me thinking about the NICU from a motor standpoint. I thought maybe we should "start from the very beginning" and talk a bit about the NICU and what the big deal is about being a preemie. (My apologies if you have the entire Sound of Music soundtrack stuck in your head now! I know I do!)  When we were in the NICU I was way too busy falling head over heels in love with our little trio and being nervous about their health (especially nutrition & breathing) to spend much time thinking or blogging about the NICU from a motor standpoint, so I might as well do it now.

Since most of you reading this blog probably aren't pediatric therapists or NICU nurses, I'll start with the basics.  What is the difference between preemies and term babies other than the obvious size difference? The general problem is that these tiny babies were born too early into a world they weren't quite ready for! Their nervous systems are not fully developed and for the most part they're so small that they haven't been squished in the uterus yet.  Because of this preemies look very different from term babies when they're laid down, either on their backs or their tummies.

Premature babies generally have low muscle tone, which means that they have less resting tension in their muscles and it takes more effort to essentially turn their muscles on.  I find that muscle tone is a challenging concept to explain to people.  In person, during my early intervention visits, I use my hands to explain the crossover of muscle fibers, but that's tricky to do in blog form, so let's try this metaphor.  First, imagine yourself sitting on a kitchen chair and think about the effort  required to stand up and start walking.  This is like "normal" muscle tone.  Now imagine yourself in lounge lizard or couch potato mode, sunken into a deep cushy La-Z-Boy recliner and the monumental effort it would require to walk to the kitchen for a beverage.  The second image is akin to having low muscle tone, or hypotonia.  It just takes more effort to get started because the muscles are starting out in a more "rested" state.  Babies with low tone are often described as "floppy babies" and feel squishier than babies with normal tone.  As they get older when you pick them up, it might feel like they're going to slip right through your hands and they may feel heavier than you expect because they don't hold their own weight.  People with low muscle tone also tend to be more flexible (hypermobile) and fatigue sooner (lower endurance).  I often have parents ask "can muscle tone change?" and generally my answer is no, but preemies can be an exception to that because their nervous system is still maturing similar to how it would in utero.  In my experience, not all preemies who are born with low tone present with hypotonia as kids.

Babies born full term are usually so big and so squished in mom's uterus for the last few months that when they are newborns they tend to rest in the aptly named "fetal position" with their hips and knees flexed (bent) and their arms in tight to their bodies, elbows flexed. In PT terms this is known as "physiological flexion."  Premature babies are born before they get big enough to be super squished for very long, if at all. As a result of this and their low muscle tone preemies don't naturally "ball up" like term babies and instead lie fairly flat. The classic preemie position is to have their legs in a frogged position out to the side and their arms flat out to their sides, often making the shape of a W. 

You can see how our babies are kind of "flattened out" when lying on their backs in their warming beds. And because they were triplets and a little more squished in there than single babies born at 34 weeks they're actually a little more flexed than some preemies.

"Gravity is rough guys!!!"

Ellie showing off the "W" arms I talked about--though fairly close
to her little body

even our "big boy" is struggling with the whole gravity thing

For comparison...here's wikipedia's example pic of a newborn
one hour after birth.  Notice how flexed the hips are and how
arms are in by the chest

Ideally, we don't let babies stay in this position for long, but instead try to mimic the "everything pulled in tight" positioning of term babies. The normal fetal position is calming for babies, which is super important for preemies in the NICU being bombarded with monitor noise, heel sticks, IVs, and other medical procedures.  It's also important to be mindful of positioning to support preemies' motor development.  If they aren't positioned well the typical preemie postures can lead to delays in meeting milestones like rolling and sitting.

an example of ineffective attempts at positioning...the rolls are there
but they aren't really doing much to support her

ah...peaceful, calm baby all tucked in tight
knees flexed up under her belly and arms in tight to her body

Ellie in a nice sidelying position. Snug as a bug
(all my positioning pics seem to be of Ellie!)

Isaiah all swaddled up to help keep his limbs in tight
(he was the first one in clothes and a swaddle because he was maintaing his temp)

An example of a much smaller baby being positioned in NICU
(granted I wish her legs were flexed more!)

      nice "hands together" positioning here  
(Thanks Heather for sharing the pics!)

One other NICU thing parents need to be aware of is that the way the workstations are set up, the babies are almost always approached from the right. This sets them up to get torticollis, or a tightening of the neck muscles on one side that can make it hard to turn all the way to the left. This is one thing I actually talked to the NICU docs about while we were there because I have had more than one kiddo on my caseload from that NICU with this issue.  (See, even in the midst of semi-crisis I can't totally turn off my PT brain!) Also, because gravity is a beast, preemies' heads often fall to one side or the other and they rarely face up.  Even if they aren't always turned to the right, this can cause a form of plagiocephaly (or flattened head), called scaphocephaly, where the babies' head is flattened on the sides and longer in the back like the sketch below from Hanger Orthotics.  This was already starting to happen to Ellie from her time in the NICU I think.  Her forehead was more prominent and her head was pretty narrow at first. (though not to this extreme)

Or if the baby's head is partially turned a lot of the time to the same side it can result in a flat spot just on the back corner leading to a head shape like this one.

you an see how the eyes and ears can
become assymetrical when this happens

The take home message is the NICU nurses and therapists play an important role in helping premature infants start from a better place when it comes to motor development!  The goal is to mimic typical newborn postures and to be very conscientious about the position of the babies' heads during their stay in the NICU.  Understandably, there are a lot of other things for nurses to pay attention to, but if parents are also aware of these vulnerabilities then they can be advocates for their babies!  Okay, time to wrap up the inaugural Motor Monday post that I am just sneaking in before heading to bed.  I need to work on getting these written up over the weekend so I can post them first thing, but, well, I have triplets you know, so that might not happen!  Let me know what you think about Motor Monday and if you have any topic suggestions!

Double Trouble

We had our 4 month well baby visit Tuesday and both of the girls have doubled their birthweight! Isaiah isn't quite there yet but he's still trucking up his growth curve so no worries.  Here are their stats from Tuesday at 4 months and 2 days:

Isaiah

10lbs 8oz

24 inches long
41.5cm head circumference

Avery

10lbs 2oz

23 inches long
39cm head

Ellie

10lbs 4oz

23.5 inches long
39.5cm head

Dr. Brink is very pleased with their growth and development so far. She said asked if we had concerns and we mentioned how Avery has had bouts of extreme fussiness without an obvious cause and Dr. Brink said it might be reflux so recommended that we start her on the Zantac too.  So hopefully that will help our poor hysterical baby feel better.  Still no luck on the Synagis, but Dr. Brink seemed hopeful we'd get it by the end if the week or so and then we could come in for a nurse visit.

The shots they did get (DTaP, HIB, & Pneumococcal I think) were pretty brutal as usual.  Ellie had the hardest time this round.  It was great to have Marty along for the visit so it was one on one.  The past couple of days have been rough too.  They've all be running low grade fevers, especially the girls, and have all been fussier than usual.  It's been tough to put anyone down to play on the floor without them getting crabby.  And last night was an awful night of sleep, with Avery having a meltdown from about 11:30-1 and Isaiah from 4:30-6.  Ugh.  Here's hoping they sleep better tonight and take decent naps today!

Auntie Jess took their one month pics and put them next to their four month pics so we could really see their growth over the past few months.  Kind of crazy to see the how much smaller the frog looks in comparison now!

Expanding the blog...

For a few years now I've been thinking about starting a blog about pediatric physical therapy and all the super fun ways I've found to help kiddos develop their gross motor skills.  But I just never got started. Since the babies have been born I've been taking lots of videos of them, specifically trying to capture all the little stages of their gross motor development. I'm a total PT mom geek, I know! I was also thinking that some day I'd love to be an adjunct instructor at the university level and teach a class on motor development. If that ever happens, I'd love to have videos of the kiddos to use.

Also since the babies were born, I've been watching their development like a hawk and have tried to incorporate lots of motor development activities into our daily routines. As an early intervention therapist that's what I try to help families do so I figured I'd better be able to walk the walk and not just talk the talk!  

So the other day I thought, "Hey, why not add all of this info to the blog?"  That way  I can actually use all the videos I've been taking and potentially provide a useful educational tool for other families with infants, whether preemies or not, since the activities are the same. And I figure, if we can do these things with triplets, then they must be pretty do-able!  The other great thing is that we have three babies who are all doing things on their own schedule and in their own way, so we'll get to see some of the wonderful variation that exists within typical motor development, albeit on the preemie schedule.  So I'm going to start doing Motor Mondays and post about motor development every Monday.  I was asking Michelle, Hope and Marty which day I should do for the theme posts and Marty suggested that I do "Torture Tuesdays!"  She's basing this on the fact that every day I get the kiddos on their tummies and they don't always love it. =)  If you have suggestions for topics or motor development or questions you have wondered about feel free to comment or send me an email on my personal email or at TherrienTripleThreat<at>gmail.com!

I've recently started adding labels or tags with key word to the posts to help people find the posts that interest them so if this isn't your thing you can skip them and not miss out in the posts loaded with smiley baby pics. I'm still learning about this whole blogging thing but my goal is to have pages that categorize posts by topic so posts to highlight ones that might be of particular interest to other MoMs (Mothers of Multiples) or ones related to motor development.  I've recruited my brother's girldfriend Vicky, who just finished a graphic design program, to help me redesign the blog too.  I'm looking forward to all these changes!

Last week I found a group online called "How Do You Do It?"  for and by MoMs that shares "day-to-day realities, joys and challenges of raising trins, triplets and more." I emailed the organizer to add our blog to the blogroll and she read our blog and invited me to be a regular contributor to the blog!  Another fun "outreach" thing from this week is that I saw a post on Facebook from a lactation consultant who was looking for LGBTQ families to share their stories.  She is doing a presentation on LGBTQ issues at a national conference to help LCs do a better job of serving our community.  So I emailed her and she is very excited to include us in her presentation and wants to share the blog and some pictures from the blog in her presentation.  We think this is pretty great and are happy to be able to help other families like, even if it is indirectly!  Like our welcome message on the blog says, the primary reasons for starting the blog was to share information with friends and families and document our story for the kiddos, but also to help other expecting triplet families and I think these connections will help make that third purpose more likely by getting more people checking out the blog.  If you have other ideas for me on spreading the word please shoot me an email, I'd love to hear them!  Keep your eyes peeled for some of these changes in the coming weeks!

Oh, and here are some cute baby picture just for fun!

Chillin' in Isaiah's crib waiting for a diaper change

"We should party in your crib more often bro!"

Ellie enjoying her fingers (on her left hand of course)

All 3 kiddos are partial to this "left hand in the mouth, right
hand by the ear" pose

Happy 4 month birthday babies!

Our babies are one third of a year old!!  It's hard to believe!  The four month photo shoot was much more pleasant than the past couple because we had no criers!  It's funny because I think in some ways the babies are starting to look more alike but they are also developing their own individual personalities and idiosyncracies.

Isaiah tends to be our fussiest baby, but man oh man, when he is happy he's a major charmer.  He wakes up super duper crabby but after he eats is happy as a clam.  He is back to rolling more now and has been happier on his tummy.  He continues to spit up like crazy and is the source of LOTS of extra laundry around here.  It's a bummer because sometimes it seems like his tummy is the reason he's fussy because he'll get fussy and then within five minutes we get a big dose of chunky spit up.  He laughed for the first time last week and apparently he thinks Michelle's singing voice is hilarious because that was what did it.  We have yet to catch his laugh on video but we'll keep trying because, of course, it's super cute.  Isaiah is a fan of his left thumb and can go to town on it, but as you can see in the picture below he's been clasping his hands a lot and bringing both of them to his mouth.

Isaiah hamming it up for the camera

Future rugger

Avery is like a race car who goes 0 to 60 in 5 seconds flat.  Lately she has been our most chill baby a lot of the time, but oof when she gets mad look out!  This little girl can go into hysterics like no other and has a hard time being settled when she does.  Avery rolled over from her tummy to her back once or twice when we put her in a good position, but she hasn't done it completely on her own.  She does the best in the bumbo seat and seems to like it more than her siblings.  The swing is like magic for Avery most of the time.  Avery gives some of the best smiles and is probably the easiest to get smiles from.  She likes to chat though we have yet to capture a good conversation on video yet.  But you should know that when you're chatting if she says "Ghee" she is not asking for clarified butter, but rather about to lose her sh*t! =)  Avery is a big fan of her left fist/fingers and does a nice job calming herself with it when she hasn't gone into hysterics.  She's also a drool monkey who can soak your shirt in two seconds flat!

Avery showing off her beautiful smile

She's sooo close to laughing but hasn't yet

Ellie is our most even-keeled little baby.  She doesn't cry out of the blue, you can almost always see it coming.  Ellie has made great strides in her development this month!  She is rolling over belly to back fairly consistently and has made great progress with her head control overall.  Ellie has really found her voice in the past week and she's LOUD! She's become a serious chatterbox, but sometimes you have to see her face to know if she's "happy talking" or "mad talking!"  She's been cracking us up with her loud talking this week.  Apparently the feeling is mutual because Ellie laughed for the first time this weekend! We managed to catch a little laugh on video today so look for that in an upcoming post!  Ellie also likes to suck on her left hand, but she hasn't decided whether her thumb or fingers are the tastiest just yet.

Big gummy smile!

waving to the camera

Our "Triple(t) Threat" moniker is appropriate for our little trio.  They can get ya' with their big smiles and sweet personalities or they can turn on you and come at you from every direction with three screaming, crying babies!  They sure keep us on our toes, but we love them with every ounce of our beings!

The best of a zillion...these group shots tempt me to photo
shop the best pic of each baby...if only I had the time! =)

Their 4 month/Super Bowl shot was one of the other decent group shots

Congratulations Seahawks!!!

The babies were rooting for the Seahawks at their very first Super Bowl and are pleased they picked a winner!  Here they are in their green & white diaper covers & "go hawks" socks this afternoon...

Tonight was our first evening adventure with the babies, which meant not being home for our usual 7pm bedtime feeding! We went to our friends' house for a super bowl party tonight, arriving around 5 and leaving after 10pm.  The babies were all dressed in green, blue & white sleepers so everyone would know who they were cheering for!  And their moms were in Seahawks shirts thanks to Auntie Mary!  All in all the babies did very well with really only one little meltdown from being over tired (Isaiah, that's you I'm talking about!).  They handled being passed around and got to see the "big kids" playing wih all sorts of toys.  They also did pretty well nursing there, but you can tell they were more distracted, eating for a minute, then coming off, etc.  Anyway, it wasn't much of a game, but the Seahawks won which, if I can't cheer for my Packers, then at least the "hometown" team won!  Congrats on your first Super Bowl win Seahawks!  Now we'll see how this schedule change impacts all of us!  Here's hoping for decent sleep!

Date night! (well, afternoon)

Yesterday was our second ever time where both Michelle and I left the babies.  The first time, you might recall, was to go to lunch and Happy Feet for a massage as part of our Christmas present from Michelle's mom.  Yesterday's date was part of my birthday present from Michelle.  One of our best friends from Seattle, Marty, is visiting (pics to come later) and she and Hope watched the babies for us.  We went to lunch at a new microbrewery in town and then to see the movie Her.  It was lovely to have that little bit of time away and we did a remarkably good job of having adult conversations that did not revolve around babies!  The food at the microbrewery was some of the best we've had in State College so that was nice.  And we saw the movie Her, which was pretty interesting.  The most impressive thing, I think, is that neither of us fell asleep in the movie!!!

Lots of photos from the past few weeks

I realized I've taken a ton of cute pics over the past few weeks and haven't shared them with all of you yet!  I actually have more than this, but figured I'd split them into two posts so it wouldn't be quite as long!

this grabbing toys thing takes serious concentration!

but it's pretty fun!

Hi Mama!!

love this one!

happy chatty baby!

another happy chatty baby!

"I love you Mommy!"

Avery's new "left hand in mouth, right hand by her ear" pose

cute boy in stripes

happy girl in neon (Thanks Auntie Tracy!)

Love this sweater and hat on him!  Such a cheeseball!

Our little bear (to keep him warm on an outing)

turns out Ellie was wearing a sweatshirt with ears too!

so of course I had to go to the closet & put Avery in another
little bear outfit!  She was thrilled with that idea!

Our Three Little Bears!  (Avery's still not so sure...)

Our Three Little Bears part deux! 

"Okay, Mommy!  I guess I do look pretty cute!"