Thursday, July 30, 2009

Four-month Well Visit

Yesterday was Harper's four-month checkup, and I can't believe four months have already passed since she was born. Well, in a way I can, because I'm getting to the point now where I really can't remember what life was like not to have her here with us, but I remember the day I had her so vividly (at least up to the point of my surgery!) that it hardly seems like that could have been four months ago.

Here are her stats:

Weight: 11 lbs. 9 oz.
Length: 23.125 ins.
Head circumference: 15.625 ins.

Jeff & I were surprised because we both expected her to weigh more than that (after all, she has recently earned the nickname "Harper the Hutt"—as in "Jabba the Hutt"—from some of our friends due to her rolls!), but she's following a normal growth pattern and everything, so she's on the right track. For a four-month-old baby, she is in the 6th percentile for weight, the 7th percentile for length, and the 9th percentile for head circumference. However, if these numbers are plugged into her adjusted age—nine weeks, the age she's supposed to be and would be had she born at term—then she is in the 51st percentile for weight, the 60th percentile for length, and the 59th percentile for head circumference. So basically she is right where she needs to be.

What else? Her umbilical hernia is almost fully healed. I don't know if I ever even mentioned that, but Harper had a very small umbilical hernia as a result of her prematurity. It's a very common thing for preemies; they are born with such a small amount of core muscle that part of their intestine protrudes through a "weak spot" in their abdominal wall (aka: their belly button). This causes their navel to slightly poke out whenever they strain (e.g., cry, poop, etc.). Basically, whenever she strains, Harper's belly button becomes an "outtie." We first noticed it in the NICU, and it was later diagnosed as an umbilical hernia. The good news is that it's getting better. The doctor can no longer feel the hernia, which means it has decreased in size, and he assured us that Harper will not need to have it surgically repaired. Dr. B thinks it will go away on its own within the next few months and told me not to worry, that she would eventually have a perfect "innie" bikini belly button.

The fact that he mentioned bikinis is hilarious, because it's been a hot topic of discussion since before Harper was even born. For some strange reason that I don't understand, Jeff has this issue with Harper wearing a bikini. It started about six weeks before my C-section, when I was shopping online for Harper's first swimsuit…

I showed Jeff this adorable giraffe-print bikini from Baby GAP and said, "Isn't this darling?"

His response was, "I don't think she needs a bikini."

Puzzled, I asked, "OK… But what's wrong with a bikini? What's your deal?"

"I just don't want her wearing one. No bikinis. She doesn't need to be running around with an exposed tummy."

"But she's a BABY!"

"OK, fine. She can wear a bikini before she turns one. But between one and eighteen, no bikinis."

A few weeks later, we had a bunch of our friends over and I brought up the bikini subject, thinking all of them would say that Jeff was completely overreacting. To my surprise, every single one of the guys agreed with Jeff. (All of the girls, however, sided with Mommy.) I actually ended up buying Harper a one-piece for this summer, but I guarantee next summer the bikini issue will come up again.

However, I will eventually win this one. And here's why:

(1) I honestly don't understand what is wrong with wearing a bikini. Americans have been wearing them since the '40s. I have pictures of my mom and her friends as eight-year-olds running through sprinklers in theirs.
(2) Since I will be picking out all of my daughter's clothes for AT LEAST the next decade, I think my husband can trust my decisions on this. Obviously I am not going to pick out a skanky-looking swimsuit for our precious, innocent little child.
(3) I don't want my daughter to grow up feeling ashamed of her body or how she looks.
(4) I'm not a fan of creating problems out of non-issues. To me, that is how you create much bigger problems. If Jeff makes this a big issue, it will bite us both in the you-know-what later when Harper is a teenager. If he acts like it's no big deal, Harper won't think it's a big deal either. My parents never forbid me from wearing a bikini—or anything, for that matter—and consequently, I never pushed the limits on that subject at all. I never owned a bathing suit that was too provocative or a skirt too short or a shirt too low-cut. It never would've even occurred to me to buy one. However, had my dad been all, "Young lady, one-pieces only until you go to college!" it probably would've been a different story.

Anyway, that's the bikini issue. Back to Harper's appointment…

I jokingly mentioned to my pediatrician that my husband had already decided to put his foot down when it comes to two-piece bathing suits: "Yeah, no bikinis until she's 18, he says."

Dr. B, who has two grown daughters of his own, continued examining Harper and laughed, "Is that right? Well—HA!—you tell your husband I wish him a whole hell of a lot of luck with that one. HA!"

I, of course, made sure to repeat Dr. B's comment to my dear husband later that day. He couldn't help but laugh.

Anyway, normally babies start eating rice cereal and stuff like that at about four months old, but because Harper is a preemie, Dr. B thinks we should wait until she has an adjusted age of four months old before we introduce her to any type of solid foods. I'm a little disappointed, because I think Jeff & I are both looking forward to feeding her something else besides bottles, andI won't liebecause I've heard that babies do a MUCH better job of sleeping through the night once they get on rice cereal. But that's OK. September will be solids month!

And I really shouldn't be complaining at all, because after switching six times, we have FINALLY solved our formula crisis. Per an old high school Facebook friend's suggestion, we tried Good Start's Soy Plus formula last month, and we have been on it ever since. Harper is generally a good eater, although I've been concerned lately that she isn't eating enough. The rule of thumb is that you take your baby's current weight and divide it in half; whatever you get is the maximum number of ounces she should eat per feeding. In Harper's case, that means she should be eating about five-and-a-half ounces at each feeding, and her problem is one of inconsistency. She'll down a five-ounce bottle at one feeding and refuse to eat more than three-and-a-half ounces at the next one. I asked Dr. B about it, and he said that anything within two ounces of the maximum number of ounces she should eat is OK. So, as long as she eats at least three-and-a-half ounces of formula at each feeding, we're in the clear. She's been doing that—and sometimes much more—so I guess we're on the right track.

The best part is that Harper's gas is sooo much better; her tummy aches are practically gone; and her system eventually regulated itself so she doesn't have any more constipation issues. This is a huuuge relief to her parents, who were starting to worry themselves sick about her. She is also taking a small dose of a very mild antacid every day, so I'm sure this is helping with the digestion and tummy issues she had while on previous formulas.

Harper also had to have her four-month vaccinations, which was, of course, traumatic for us both. She did much better this time, though, and didn't cry nearly as much as she did as a two-month-old, so Mommy was incredibly proud of her. I also had the Infant Tylenol with me in my diaper bag this time and gave her a little bit in the waiting room, so that helped tremendously. After we got home, she slept almost the rest of the day. That's REALLY unusual for her, so I know she had to feel pretty crummy because of the shots. My poor baby.

She seems much better today, but I am trying to be extra careful when handling her. I remember how badly that DTaP shot hurt when I had to have it—as a 15-year-old, I couldn't even lift my left arm to shoot a basketball at practice—so the idea of bumping her or touching her little leg when she's sore makes me cringe. She seems back to her regular, inquisitive self, though. I'm so glad to see that she's feeling better, although I'm already dreading her six-month vaccinations. Then I know we'll have another round at nine months and again at a year! And those are just boosters… That's not counting our monthly dose of Synagis—a shot given to preemies to prevent them from catching RSV, a type of respiratory virus that can seriously affect babies with underdeveloped lungs, during the flu season—assuming we're approved. (One shot of Synagis costs $1,000, and babies need the shot on a monthly basis during flu season, so it can quickly add up. As a result, you have to be "approved" for Synagis, which means that your insurance company has to evaluate your baby's likelihood of contracting RSV based on a number of factors—the degree of his/her prematurity, whether he/she will be exposed to other children during the flu season, whether he/she will be in day care, etc. It's basically insurance companies' way of figuring out which will cost less: paying for your child to have the shot or paying for your child's hospital bill should he/she contract RSV. Harper hasn't been approved yet, but Dr. B seems to think it won't be a problem, given that she was born eight weeks premature. We will find out the verdict in September, so I'll keep you posted.)

She is waking up from her nice long nap, so I will have to finish writing about all that's gone on over the past few weeks next time. Until then…

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