Eating progress

Jac's eating has definitely improved. He makes it through most days without a significant spit-up or throw up. Although he still has those occasionally, it seems like the combination of Alilmentum and Fiji water mostly agrees with him.

Good things are happening -- his weight gain is picking up again, and he doesn't shrink away from the bottle. In fact, when he gets hungry and we bring the bottle to him, he has a cute "Oh! Bottle! Gimme!" expression as he reaches out to guide the nipple to his mouth!

Since his eating has been going so well, we have decided to stop logging his feed volumes. We now keep making enough formula to stay ahead of him, and let him drink all that he wants.

Starting to feel older

Recently, Jac's started to look more definitely older. His hair is starting to grow, his face is more chubby, and his movements have gotten much more controlled.

Until recently, I think it would have been easy to pass him off as just a newborn baby. But now, it's more clear that he's not a newborn, but an older (yet small) baby.

It is fun to watch him develop! His "stand" (with balancing assistance from us) has gotten much better. He hasn't even crawled yet; but I get the feeling once he crawls, it'll be a fast transition to walking!

No.2's first ultrasound and estimated due date - Oct. 7, 2008

So it is official. I have a small entity growing in my belly! LOL! Hopefully it is a baby - it looked like one on the ultrasound! No. 2 was moving around quite a bit and we could see all of his limbs and his head and his heart! Cool!

Joseph, and Jac and I visited the OB/GYN this morning and were given the great news that No. 2 is 12.5 weeks along! Whoa! I am so bad at date math but I got the conception date spot on! Unfortunately when I did the date math for a conception date of Jan. 28 I ended up with No. 2 being born around Thanksgiving! Man was I wrong. The doctor thinks conception was Jan. 26th and No. 2 is due Oct. 7th! Oh man! That is 15 months separation from No. 1 (Mr. Jac). Whoa! Almost Irish twins (I guess that is only fair since my Mother's father was Irish).

No. 2 seems so much more real now that we have seen him moving around. Sometimes I still find it a little hard to believe that there is a small human growing in my belly and at 12.5 weeks along he has arms and legs and a head and is moving! (BTW, I am convinced that No. 2 is another little boy, I don't know why, I just am!)

(We forgot to ask for the ultrasound pictures that the doctor took of No. 2 but I will try to get them and post them up!)

I now have an appointment scheduled with the perinatologist in Denver for a First Trimester screening where they look for chromosomal disorders such as Down Syndrome and Trisomy-18 (the appoin. is this coming Wednesday). They can also detect some other defects such as heart defects. This is a standard set of testing that is done but our OB does not do it - they have the perinatologists do it. That is good for me since it will give me a chance to talk to another perinaologist and get their opinion of the MTHFR mutation and chances for another IUGR baby with No.2.

After the appointment on Wednesday we may have a new estimated due date - we shall see! Stay tuned!

Inherent risks for No. 2

In a post about 2 weeks ago I talked about the blood tests that I had to look for an explanation for Jac's IUGR. The results of the tests are back. All but one of the tests came back with a normal result.

The one test that did not was a genetic test for the gene MTHFR. I was found to be a Compound Heterozygous for this gene. This means that I have two slightly broken copies of the gene, one from my Mom and one from my Dad, but that each copy has a different genetic mutation. One copy has the C677T mutation and one has the A1298C mutation. This is better than having two copies of the C677T mutation.

I have read a lot of literature now on this and I am still confused but here is what I have figured out (If anyone reading this blog disagrees or has more information please send me an email or leave a comment.)

The MTHFR gene codes for an enzyme that is involved in folate metabolism and defects in this gene can lead to high levels of the amino acid homocysteine that the slightly broken enzyme is not as efficient at breaking down. High levels of homocysteine in the blood can cause a variety of long-term problems but the science seems to still be out on what they all are.

When doctors find a patient with that is Compound Heterozygous for MTHFR they look at her homocysteine level. If this is normal (below 6 during pregnancy - mine was 5.5) they do not consider the MTHFR gene to be causing an increased risk for the pregnancy.

Patients that are Compound Homozygous for the MTHFR gene with the C677T mutation are at increased risk for miscarriage and preeclampsia.

There do seem to be some additional risks for neural tube defects in the baby (e.g. spina bifida) with a Compound Heterozygous MTHFR but the extent to which the risks for these defects is ameliorated by the diet of the mother is not clear to me from the research I have been able to find.

The only recommendation for "treatment" for a Compound Heterozygous MTHFR pregnant woman (such as myself) is an additional Folic Acid, B-6, B-12 pill daily to ensure that homocysteine levels in the blood don't rise. This is not a universal recommendation and seems to be a bit controversial. It was not recommended by the perinatologist that ordered my labs but Father's cousin who is a doctor does recommend it. This is a prescription supplement. It can't hurt and it might help is the thinking with this supplement.

My Dad's cousin says our risk of another IUGR with no diagnosis of the cause of the previous IUGR is 50%, the perinatologist says 10%. Those are so different my head is spinning. My Dad's cousin says no way I can go to Italy and the perinatologist says go for it unless we find a problem before then. Augh!

The only other "treatment" recommendation is to take a baby aspirin every day along with my prenatal vitamins.

Jac's new "talking"

Jac has a new "talking" voice. He has gotten much louder and more vocal in the last few days. He "says" all sorts of things - most of which we are at a loss to interpret. Fortunately his needs are still fairly simple! I can't wait until he learns a few signs so we can really start communicating.



This is for you Grandma!

Jac in his Bumbo seat

I have seen Bumbo seats many times - and thought for sure that an OT would say they were a terrible idea - letting kids sit up before they are ready - but she told me to get one! Who knew! Jac likes it - for short periods of time - and he can play with toys while sitting up this way. Pretty fun! I will get some better pictures of him in it this week! And maybe a video if he will let me!

The idea of the Bumbo seat is that it uses a baby's weight to allow them to sit up - before they are able to do it. As long as the baby has head control (which Jac does) they can sit up without help. Kinds cool. For short periods of time of course.

Daddy and Jacie

While we were taking our family pictures today our friend took this great picture of Daddy and Jacie! I love it!

Family picture

We asked a friend of ours to take a family picture today. We only have one family picture prior to these - on the day Jac was born - and I am in a stretcher and Jac is in an isolette. Hmm... But now we have some nice ones!

Jac has truly discovered his feet

Jac discovered his feet for the first time at the end of January - you can see the post here.

But now he really gets it. I think the thing that helped him really "get it" are these cool little sock things that have a cow on one foot and a sheep on the other and make sounds when he moves his feet. When I first saw them at Target I thought they were a little silly - but man does Jac like them! He really began to play with his feet when I put them on (it took a few times before he really got into it) and now he is playing with his feet all of the time.



Today he was playing with his feet while he was in his car seat! Wouldn't it be great if that would make riding in the car seat easier for him!

He also likes to play with his feet while he is on his changing table (really one of his favorite places!). I have helped him get his toe in his mouth while he is on the table but that is a pretty advanced move!

Help for Mommy

With the new pregnancy I have been feeling a bot overwhelmed. It is hard to be here in Colorado, away from family, and the familiar, and in the snow and a real winter.

I have been looking for ways to help relieve some of the pressure I have been feeling and I have found a few outlets.

I have hired a new girl to help 4 days a week. Her name is Adri and she and Jac get along well. I am not ready to leave Jac with her yet but I hope we will get there eventually. For now, she is helping around the house. To hold Jac so I can have two hands, or come with me to the chiropractor like she did today.

I have started seeing a psychologist. She seems nice and we shall see how it goes. Our insurance company will pay for 20 visits so we shall see if some talk therapy can help me sort through the complex feelings I am having as a new Mom and soon to be mother of two.

I have joined a Post-Partum Depression (PPD) group at The Kempe Center in Denver. I don't have classic PPD but I am feeling overwhelmed, especially at the prospects of another potential IUGR baby on the way. I had a 4 hour long interview with the doctors that run the program and it felt so good to talk. I literally got to talk to for 4 hours. They had lots of questions that I really had to sort through in my mind to answer. It felt so good to talk about how hard the last 8 months have been (and really before that as we moved but that feels like a million years ago!). They want to meet Joseph (they have already met Jac) so we are all going down there in two weeks for another interview. I don't know that Joseph is going to enjoy the talking as much as I did but he only needs to come the once. The group is going to be a group of Mom's, with a leader from PPD group, that will meet every week for about 3 months. Each week we will discuss a different topic. I am really looking forward to it. I really don't have PPD - just an overwhelmed Momma so please don't worry!

Another cold day

Brrr... It snowed a ton last night! I've been told that March is the wettest/snowiest time around Boulder.

Taj took Jac out to the Apple Store today (her Mac is being sent in for repairs!) -- realizing that Jac's hat was missing, she improvised and covered his head with a blanket:



Now, that's quite the face!

While Taj, Jac and I shied away from the cold, Knutson had a grand day playing in the snow!

We have an over 9 pound baby

Little Jacie weighed in tonight on our home scale (Thanks Matt and Ali!) at 4.11 kg or 9 pounds and 1 ounce (9.06 pounds)!

OMG! This means that in 10 days (we last weighed him 3/4) he has gained .42 pounds or 6.7 ounces! Yeah!

Go Jac! You have broken 9 pounds!

Denver Downtown Aquarium

Jac liked the fish at the Japanese restaurant so much that we decided to take him to the Downtown Aquarium in Denver. Jac really liked it. There were a lot of families there. Lots! The aquarium was surprisingly good. Lots of displays, well laid out, with lots! of fish! They had some nice large aquariums with some big turtles and sharks, and other larger fish. There was one grouper that looked like it could swallow Jac without noticing!

We all had a good time and I am sure we will go back!

As some of you may know, I am not a huge fan of strollers, I think it is better for infants (and children) to be carried when they can't or don't want to walk. For some reason when we went to the Aquarium we decided to bring the stroller. This was the exact wrong time to bring the stroller and truly proved by babywearing is an easier alternative. The place was jam packed, and it was hard to maneuver the stroller. It was hard to find a place to park it when we stopped so it was not in traffic. Also, the floor was uneven so it was hard to roll it! We carried Jac and pushed the stroller. Too funny!

Thump, thump

Jac loves to be changed. We have a routine way of doing it, and he loves it. He particularly likes to thump the changing table. His changing table is a dresser, so it is hollow beneath the changing table. This means that when you thump the changing pad you get a nice thumping sound from the table. So fun! He loves it.

It is pretty clear that he knows what "Thump, thump" means. If you say it to him, anytime he is laying down, he will start banging his feet against whatever he is laying on, especially if he is being changed. He will thump even if you don't encourage him, but if you encourage him he really goes to town.

What a sleeper

Jac slept from 11 pm to 6:30 am - woke up and ate - and then slept on me on the couch until 10:15 am! That is 11.25 hours! Amazing!

Yeah for cold formula

So - Jac had not been taking Alimentum very well. I had mentioned the stress that this causing all of us. On Monday we ran out of MM without dairy in it. Now what!

The water here in Boulder that comes out of the faucet does not taste, or smell very good. We double filter it and it still smells a bit suspect, particularly when it is room temperature, or warmer.

It occurred to me, that this phenomenon could be affecting Jac's formula also. The combination of the water (which I believe is safe but still smells a bit suspect) and that all things are more pungent when warmed up. If the problem with the formula was that it was too smelly, then what if Jac ate it when it was cold!

Yeah! Cold formula it is. Straight out of the fridge, or made with a cold bottle of Fiji water (we all have to have our standards!).

Jac takes this cold formula like nobody's business! I have been giving him straight formula all day, nice and cold, and he has been taking it like a champ!

Blood tests for Momma

As soon as I realized that I was pregnant with #2, the urgency to get blood tests to try to figure out why Jac was IUGR and if #2 had a high likelihood for being IUGR, increased exponentially. I had had, had figuring out what blood tests to get on my list since Jac was born but my research had borne limited fruit and I had not made much progress.

So, as usual, my Mom helped me figure out what to do. I contacted my father's cousin's husband, who is an OB, and he helped immensely. He gave me a list of tests to get and helped me figure out who to contact next.

I found a perinatologist (these are special doctors for high risk maternal fetal medicine) group in Denver and got the test ordered. And then I went and opened my veins this past Saturday. Literally. They took blood from both arms - and I think they took around 14 or 15 vials of blood.

You have to realize when I tell you this, that when I was 13 years old I ran out of Kaiser Permanente because they wanted to give me a shot - 1 shot! The things you do for your kids!

I think the thing that made the bigest difference in me getting over some of my fears of needles was all of the tests I had done while trying to get pregnant with Jac. Also, how can I be a big baby after watching what Jac went through in the hospital. Seriously.

Here is the list of tests they did:

Beta-2 Glycoprotein 1 Ig, Ig M
Lipoprotein (a)
ANA w/ reflex
Anti-cardiolipin Ab,IgG/IgM
Factor II, DNA Analysis
Factor V, Leiden Mutation
MTHFR
PTT-LA
dRVVT
Lupus anticoagulant reflex
Protein C-Functional
Protein S-Functional
Hexagonal Phase Phospholipid
Antithrombin III
Homocysteine

HUTH

I have decided to hang up the horns. The combination of Jac getting older and more active and being pregnant is just wearing me out. I am pretty much at the end of my rope in terms of energy and I have decided I will be a better mother to Jac and #2 if I stop. I am pumping right now just to relieve the pressure - but I am going to pump just for comfort until my milk dries up. I am ineffably sad about this decision but I believe it is the right one for our family.

Jac will be 8 months old tomorrow - so I made it to one day short of 8 months!

Fascinated by the fish

Joseph and I took Jac and went to dinner at a Japanese restaurant in Arvada. The restaurant had a bunch of fish tanks. We were seated next to a very large one with about 7 very large salt water fish. Jac loved it! We never took him out of his car seat! He sat the entire dinner watching the fish swim around! We are going to have to take him to an aquarium soon!

Jac's first "real" food

Joseph and I went to lunch today at a mediterranean restaurant. I had hummus as part of my lunch. Jac has been watching us eat and looking longingly at our food for a couple of weeks now. We decided to offer him a bit of hummus as it seemed like a texture that he ought to be able to handle. I put some on the tip of my finger and offered it to him. I don't think he swallowed any but he got it all over himself and me and had a grand old time!

Teething - for real this time

Jac started teething while we were in Los Angeles. It does not seem to be making him too much fussier than usual - perhaps a bit when it is clearly getting to him and it may be making going to sleep a bit harder.

It is very cute to watch him put EVERYTHING into his mouth. Whatever he gets his hands on goes into his mouth. I took videos of him today "eating" his tubing and the strings from Daddy's sweatshirt. Cute!

Adding formula to breast milk

We are now fortifying my EBM with full fledged, mixed formula - at an almost half and half ratio. So 40 ml of breast milk with 40 ml of Alimentum (that has been mixed at the manufacturer's recommended water to formula ratio).

He takes this combination well sometimes, and not so well at other times. When he is hungry he will take a bunch, but as his hunger tapers off a bit, but he still wants some more food, he won't take the combination very well. It also seems as if the combination does not "age" well. Breast milk can sit out for quite a while and Jac will take it without objection, but EBM + Alimentum that has been sitting for 30 min. he won't take. It usually sits when he starts out eating strong, and then rests, and wants to eat more. We tried heating the combination back up tonight, to see if he just doesn't like it cold, but that didn't seem to work. We will have to experiment more to see if we can find a way to help him take it more easily.

HUTH - During the day

On Wednesday I made the decision to HUTH, during the day. One of my biggest stressors is trying to pump when I don't have any help. When Jac was smaller I could pump while he was sleeping by holding him up on my shoulder while he slept. He has gotten too big for this now - and too active. So I have decided not to pump while Joseph is at work, unless it is easy. So if Jac goes down for a nap easily, and I am not too tired, I will pump while he sleeps. Otherwise, I will wait for Joseph to come home. This is not easy. My boobs hurt and I am not making as much milk, but for my now pregnant bodies sanity I have to do it. We shall see what happens to my milk supply. I have been told that it is going to dry up with the pregnancy anyway - we shall see.

Fifth Synagis injection

Jac had his fifth Synagis injection today. It went fairly well. He cried for the injection and for a minute or so after but he calmed down pretty quickly. We should have one more shot to go for this season and then we are done until next year. We won't know until next year if his pediatrician will order Synagis and if the insurance company will approve it. We paid for the fourth injection (as part of our deductible) and it was $1840 so I can imagine why the insurance company evaluates the requests carefully!

Request for impressions - 7 months old

Hi All - A bunch of you have seen Jac in person during this trip. I would like to request that you make a comment on the blog, and tell us what you saw and heard from little Jac. I think this would make a cool little section for Jac to read someday to hear how people other than his parents saw him when he was 7 months old. If you don't know how to do a comment email me and I will help you with how to do it.

And then there were four

I am pregnant. I am probably about a month along but we don't know for sure. Hmmm... Why am I revealing this so early on in the pregnancy? Well - frankly because I feel sick as a dog, I am tired, and I want to write about it and share it. So - welcome to the ride.

If I am right about how far along I am, then Jac and #2 will be about 16 months apart. Whoa! Joseph and I made an active decision when Jac was born that we would not make any efforts to prevent my getting pregnant a second time. It was difficult to get pregnant with Jac and we decided to let nature run it's course this time. And man did it ever.

I became convinced I was pregnant when I started to feel nauseous. I had been feeling pretty badly, tired etc. but it was the nausea that convinced me. I did two stick tests which were positive and then blood test that was also positive.

And I have been feeling nauseous, on and off, ever since. I just remembered the feeling so clearly from the beginning of my pregnancy with Jac. With Jac, I was nauseous and tired for about 4 months. Augh! That is going to be a much tougher road with an infant to care for. Last time I took to my bed when things got bad. That is going to be much less of an option this time.

Today, I was feeling so sick during the day. It was very hard to hold things together, trapped in the house with the cold wind outside, trapped by his dislike of the car seat. Trapped and tired and nauseous. Augh. Not a good combination.

And then there is the pumping. I am getting much less milk now. This trip was not kind to my milk supply. I was too tired for most of the trip to pump in the middle of the night and feed him. So I fed him and did not pump. Not good. My supply is now less than he needs each day. We have started defrosting milk from the freezer stash. The stash is big, but the portion that he can use, that does not have dairy in my diet is small. At this point I have only needed one frozen bag a day.

During the trip I really pushed using formula. I added it to almost all of his feeds. He did well taking it. And then we traveled home. I discovered how much he does not like MM (Mother's Milk) combined with formula that has been sitting at all. MM can sit for up to 10 hours after it has been pumped (I never let it sit that long but sometimes it will sit 2 hours between feeds and he is fine with it). The combination of formula and MM just doesn't last very long. He really doesn't like it. Problem. After the trip home he did not want to take formula at all. We have taken him off the formula all day today and will try to start it again.

I really need him to start taking the formula. At this point my pumping future is short. Feeding three is more than I can handle for a long period of time. I think it would be different if I were breastfeeding, but pumping is just too draining (physically and emotionally). It is a very hard thing to imagine stopping, but I need to, for everyone's sake. I just hope that Jac's health will be ok without it. Perhaps he will start growing better on the more caloric formula.

We weighed him last night, he was 3.92 kg - 8.64 pounds. This means that he only gained 100 grams - or 3 ounces in 1 month. It is something, but not much. We were hoping that all of the formula that we have been feeding him would make a difference. Maybe it will soon.

Trip to Las Vegas

Jac and I spent Friday to Sunday in Las Vegas with the grandparents. We went there to celebrate my Aunt Judy's birthday. We did so in fine style at Andre's at the Monte Carlo hotel and casino on Saturday night.

Jac had a chance to meet two more of his Aunt's and Uncle's and some of his cousins. My Aunt Judy and Uncle Fred (my Mom's middle sister) and my Aunt Patricia (my Mom's oldest sister) and her husband Sam. Jac also got to meet his cousin (my cousin) Kelly, Aunt Patricia's daughter, and two of Kelly's son's and her husband. It was great for Jac to have a chance to meet more of his family and for them to get to see him at his tender young age.

He was very popular as usual and everyone commented on how cute and socially interactive he is.

The car ride to Vegas went pretty well. It is normally a 4 hour ride, but it took us a bit longer as Jac requested a few extra stops. He did fairly well in the car, but I would have to say that it is definitely not his favorite place.

The most remarkable thing that happened while we were in Vegas was how Jac slept on Saturday night. After we got back from the party, I was very tired, as was he, and as usual I needed to pump. He slept in the car on the way back to my Aunt's (he had fallen asleep at the end of the party). He then stayed asleep in his car sleep while I pumped, and then all night. Amazing. He woke up at 6:30 am - happy as a little clam. I was awake, lying next to him. I could hear him but not see his face. I started to hear some sounds and knew he was waking up a bit. And then I heard him scratching the car seat with his fingernails (a new trick he figured out during this trip) and I realized he was fully awake. I sat up and looked at him and he gave me a big smile, and kept on smiling. Amazing. Generally he wakes up crying!



We flew back from Las Vegas on United and it was a mess. When we checked in the stewardess kindly upgraded us to Economy Plus - in seat 1A. Little did she know that a giant was to be seated next to us. Literally. This guy had to have been at least 6'4" and 350 pounds. He was so large that he intruded into our seat (a lot!) and I was unable to get the tray table out of the arm rest because he hung over the arm rest and it could not be opened. Not a good situation. Jac was not a happy camper on the flight and trapped as we were it was very hard to help him be happier. I couldn't figure out if the pressure changes were the problem or what. A very trying flight for us, and for anyone seated within a few rows of us. Fortunately it was only an hour and a half flight from Vegas to Denver.

Sleeping Beauty and Sleepy.

I came home for lunch yesterday... When I walked in, I only got responses from the dogs. I found Taj and Jac asleep in the nursery... And despite my being not very quiet, they never woke up the entire time I was home.

My, he's grown!

Taj and Jac came home last night. It's been a week since I last saw them, and they've both changed on me in that time! Not only did Taj cut her hair (which I knew about), she also changed her hair color -- it took me a while to spot her at the airport because of that!

Jac has definitely grown. It'll be interesting to see how much he weighs now. He's also developed a full control of his head. His head doesn't "flop" at all now. His crying voice has changed some, too. And, most importantly, his motions are clearly more purposeful than ever.

It's amazing how even a few days makes a big difference!