Wednesday, October 22, 2008

Mouse in a bouncer.

Patrick and Kitten.

So what's it like having twins in the house? (Update.)

In First Amendment law there is a problem called "the heckler's veto."  It goes like this:  People have a right to give speeches.  Sometimes a controversial speech causes a disturbance amongst its audience -- say, the people who oppose the speaker's ideas begin throwing tomatoes at the speaker and her supporters in the crowd.  The speech is legal; the disturbance caused by the speech is illegal.  Assume the police cannot practically single out the criminal element in the crowd.  Should the civil authorities stop the speech in order to quell the disturbance?  Failing to do so will cause criminal conduct to continue, and someone could get hurt.  But doing so allows a small group of opponents of the speech -- even a single threatening individual -- to game the system by inducing the authorities to stop the speech, which they otherwise could not do in the absence of the threat of impending violence.  Hence, the heckler has, by being a hooligan, tricked the authorities into censoring the speech.  The heckler, though in the minority, has exercised a "veto" over the speech.

This is a lot like having two babies and two boys in a household.  Even if everyone is being cooperative, all it takes is one uncooperative person, acting unilaterally, to exercise veto power over what the group wanted to do.  Like eat dinner.  Or be on time.  Or sleep.

Although maybe you would be surprised at the frequency at which the heckler, acting unilaterally, is quickly joined by a co-conspirator.

Thursday, October 16, 2008

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.

Weight update.

Anna
  • 10/15:  8 lbs 8.5 oz (up 6.5 oz in a week)
Evelyn
  • 10/15:  10 lbs 2 oz (up 7 oz)

Wednesday, October 8, 2008

How are they doing?

At first they were easy. Wake 'em up, change the diaper, feed a bottle, put 'em down. When you put 'em down, they stayed down. We thought this meant that life in the NICU had conveniently sleep-trained them on a strict three-hour cycle, which translated into "Everything will be easy and will remain so."

Then our lactation consultant hinted that this behavior was really developmental in nature, and that they were still in utero as far as their brains were concerned all the way up until their term date. We were told to expect therefore that they would behave like normal newborns upon the arrival of their term date.

I ruefully report that this has turned out to be completely true. They are 10 weeks old measured from their birthdate, but only about 3 weeks measured from their term date. The middle-of-the-night alertness and desire constantly to be held has most certainly begun, right on time.

On the upside, Anna is showing a smile now and then. Which is nice, because it takes the edge off of being awakened at 3 a.m. and dealing with a baby that is fussy and needy despite a full meal. Evelyn has yet to grace us with a smile, but we assume she is smiling on the inside.

Weight update.

Anna
  • 10/8: 8 lbs 2 oz (up only 3 oz in one week -- back on the sauce for her)

Evelyn

  • 10/8: 9 lbs 11 oz (up 6 oz)