What's with the weight updates? Aren't they pretty much in the clear in that department?

Well, yes.  Even the doctor isn't asking for weekly weight checks anymore.  We're not doing them at a doctor's office.  Instead, we're doing weekly weigh-ins at the lactation consultant's office in Burlingame.

The reason why is that our pediatrician said that if the weight gain was consistent we could gradually replace formula bottles with nursing sessions.  We have done this with considerable success, but also with caution.  An example would be last week's weigh-in, at which Anna had gained only three ounces in a week.  This is sub-par at best -- the doctor is looking for something more like six ounces per week (which, you will note, is what we got this week).  If the weight gain fluctuates too much, we'll need to make sure a greater proportion of their feedings are measurable by volume, and that means bottles.  Meanwhile, 100% nursing is still our goal, but we won't do it at the expense of consistent weight gain.

The other problem is iron.  Anna is on the good side of borderline anemic, while Evelyn is slightly below that borderline.  Our pediatrician wants them to get a measurable dose of iron.  One source is Poly-Vi-Sol, a multivitamin that can be added to a bottle -- Anna gets half a milliliter per day, while Evelyn gets a full milliliter of the same stuff.  However, the formula is also fortified with iron and is therefore another source.  As the formula feedings are phased out, their iron intake may also fall off, potentially requiring a larger dose of Poly-Vi-Sol in their morning bottle.  And when the morning bottle also goes away, we're looking at injecting the Poly-Vi-Sol orally, which many parents can tell you is no fun for the baby.  Still, we know that while it may be unpleasant, it's what success looks like.

Last bit of medical news -- the girls were considered for an experimental course of prophylactic treatment for respiratory syncytial virus (RSV), an extremely common lung infection.   Everyone contracts an RSV infection eventually, but it is more likely to cause severe respiratory illness in infants born prematurely.  The prophylactic treatment is recommended for these high-risk infants.  It's a drug called Palivizumab, which sounds more like a name C.S. Lewis would have given to one of the crypto-Arab villains in the Narnia books.  However, you can only qualify if you were either (1) born before 32 weeks or (2) born after 32 weeks and now present two risk factors.  The risk factors included school-age children in the household (ding!) but we didn't have a second risk factor.  I'm told that if our primary source of heat was a wood-burning stove, we would have been in like Flynn, but no such luck.  I think our pediatrician was a little disappointed that we didn't qualify.  Not presenting a second risk factor is sort of a left-handed compliment here, but we're generally very trusting of our pediatrician and grateful that he resisted the temptation to qualify the girls for the treatment by exaggerating the risk factors.

Non-medical news:  The girls have definitely discovered that it's better to be held than to be put down.  Rats.