Problems With Doing Things Too Early

On Friday afternoon, we were visited by Marsha, an OT who is nationally and internationally known for her work in the area of feeding behaviors in children. She visited our house to see Baby A. Henry had been a patient at her clinic (via early intervention) but was seen by one of her colleagues. The reason for the visit was that I felt that Baby A's sucking wasn't quite adequate. While she has gained weight (not setting any records but is slowly gaining), I have been concerned that if her suck continued to be "lazy," we'd run into problems in a couple months when she'll be expected to consume more. As it is, she is only taking 4-5 ozs at best in a sitting.

Marsha pretty much pegged the problem within 30 seconds of watching her eat. I could tell that she'd figured it out, but she let me talk about Baby A's history and our observations. I told her how it seemed like Baby A was ahead on several gross motor skills, but I thought that her trunk wasn't particularly strong, which is interesting because most skills develop from the trunk.

When Henry was 2 months adjusted, he "rolled over" and we thought we had a gross motor skills genius on our hands. As it turned out, his neonatalogist at the development clinic wasn't pleased because the way he rolled was by stiffening his legs and not by turning himself from the hips. Lesson: It isn't just reaching a milestone that matters but how that milestone was accomplished.

Fast forward nearly 3 years later, we thought that we had another gross motor genius on our hands. Baby A was doing tummy time like a pro before 2 months [Henry hated tummy time until AFTER he learned to crawl at 8 months adjusted]. Around 2.5 months, she could lift her head high while on her tummy for a good 5 minutes + and roll from back to tummy. It looked OK to us b/c she wasn't stiffening her body to do the roll as our son had done. Before 3 months, she was doing 180s on her tummy [Henry did his first 180 at about 7 months adjusted]. At 4 months, she was rolling back to tummy. Although she has a desire to sit up lately and has had pretty awesome head control since she came to use at 2 days, I've noticed that her trunk seemed kind of shaky.

During the bottle feeding, Baby A extended her back a bit, which Marsha noticed right away. Marsha suspects that the sucking issues are a result of Baby A having overdeveloped back muscles but underdeveloped tummy muscles. She says that when babies extend back, it affects their swallowing skills. One doesn't swallow optimally when in a extended position.

The good news for Baby A is that we've had her on reflux medication for a couple weeks now, which will hopefully minimize her need to extend backward to alleviate the reflux pain. Marsha has given us some excellent tips for encouraging the tucked position. She thinks that if we encourage more tucked positioning and a bit less back extending, the swallowing will come more naturally in the next month or so.

One observation that she has about child development is that when kids do things "early," it is usually because they are overcompensating with another muscle group. In Baby A's case, she has overdeveloped back muscles, which are allowing to her to do these skills, but not optimally. And that matters because if she doesn't have the balanced tummy muscles that could potentially impede skills down the road. Marsha said that if a kid ever seems like they are a month or two "ahead" on a skill, it gives a therapist pause. Optimal development tends to follow a set pattern. So while some kids may be a couple weeks ahead of another kid generally, when the gap is really huge, there's probably an underlying reason.

Marsha talked with Cuyler, Henry's former OT, before visiting. She didn't do an evaluation on Henry, but said that if we wanted one, we could set up an appointment later. We think that Henry's doing well on the fine motor and eating front. She did give us some great tips for feeding toddlers. Her approach for feeding kids 2.5-4 years old is: Dippers, Dips, and Crumbs. She said that kids like doing things, so the act of dipping foods makes a boring meal more fun. Dippers can be carrots, pretzels, dried fruit, whatever. Dips can be hummus, yogurt, guacamole, etc. And crumbs make the food extra exciting. For example, one could use dried apples to dip in yogurt and then dip in crumbs of graham crackers. That helps incorporate a couple food groups while make the act of eating fun. I mentioned to Marsha that Henry tested out of early intervention but I thought the DAYC test was for lack of a better term "lame." She had a smile on her face when I said that. She said that I should feel comfortable telling them that I wanted him retested if I thought the test wasn't appropriate. It's tempting.

It was Friday. She was about ready to go home when Henry rudely said, "You are going to go home now." He basically tried to usher her out the door because it was interfering with his plans to watch Toy Story 2. I told him that he was being rude. I'm sure it sunk in and that he learned a lot from the admonishment.

I took the dogs for a walk. Jeff made dinner. The kids watched Toy Story 2. Baby A slept.

The kids ate very well at dinner. Two kinds of french fries, meat balls, corn, grapes, and chocolate pudding. We didn't have to nag. That was so nice!

After dinner, Jeff took the kids up to Yvonne's house to see her sunflower. He took the dogs too, so they got two walks in the evening. Baby A woke up while they were out. She polished off a 5 ozs bottle within a couple minutes. I made sure that she didn't extend her body. Jeff brushed the kids' teeth. I read them their evening books. Henry did somersaults on his bed. I asked him if that was good idea. He said, "Yes!" Sigh. He managed to bonk his head against the wall and headboard but persisted in telling me that his stunts were good ideas.

On Saturday, we went to Joel’s in the morning for breakfast. Henry ran around the courtyard. He climbed on a ledge that was about three feet high. I said, “Henry, jumping from there is not a good idea.” So he jumped anyway and fell on his backside and said “Ow” under his breath. Occasionally mother does know best. We visited the turtle pond after that. It was hot and Henry looked exhausted from the heat. Jeff took Baby A to get the car. While we waited, Henry announced he had to go poop. Of course. I asked him to hold it for 5 minutes. I had my office keys in the car and hoped to run Henry over to my office, which was only a block away. Henry, however, hid behind a tree and things happened before we made it to the bathroom. Fortunately, it wasn’t a big mess. And the silver lining is that he definitely knows when he needs to go to the bathroom. He just needs some work on anticipating those needs a couple minutes before he hits crisis stage. I stayed at school and worked. Jeff took the kids to my parents for awhile and then took them home. They didn’t nap.

On Saturday night, we went to the Desert Museum with our friends Carolyn, Zak, Adelyn, and Spencer. The kids were relatively well-behaved, and Henry was excited to see Adelyn. Henry asked questions of one of the docents doing a station on owls. “What’s that?” was asked as he pointed at various objects on her table. We got to another station with a person holding an owl. Henry made his way through the crowd so it was hard for me to get to him as he tried to climb up on the table in front of the owl. He enjoyed the cave. I took him and Miss R up the top part of it, which I loved as a child. Miss R wasn’t thrilled with that part and wanted me to hold her, but the ceiling was too low and side walls too narrow. She and Henry really liked playing in the sand. The animal highlights included seeing the mountain lions walk around and watching the beaver swim. When visiting the museum during the day, the mountain lions and beaver are often asleep, so it was a treat.

On Sunday, I dropped off Baby A with my parents and took The Twins to see Toy Story 3 in 3D with Aunt Carolyn. The kids were well-behaved. Before the movie, we went to the play area in the mall. Aunt Carolyn gave the kids quarters to ride some play things. At the movie, Miss R sat in a seat by herself for the entire movie, which is a first. After the movie, we stopped by Party City. I bought the kids costumes. Henry picked out a Woody outfit. Miss R had a choice between Cinderella, Tinkerbell, Snow White, and Ariel outfits. She picked out an Ariel dress. I knew that Jeff wouldn’t be thrilled with the choice as Ariel is his least favorite Disney heroine, but I’ve heard that you are supposed to give kids choices. When we got to my parents, I let them put on their costumes. They looked as cute as could be.

I took Baby A back home with me and got some work done. We went back to my parents around 7PM for dinner. Aunt Gloria, Aunt Erin, and Uncle Brian also came to dinner. When we arrived, Henry was sound asleep. He started napping at 6PM. Miss R didn't nap at all. She got very silly toward the end of the evening as she often does when she is tired. Henry played with Aunt Erin afternoon dinner. They were in Erin's old room playing with toys that my mom had put back there since Henry hadn't played with them in awhile. He enjoyed that.