Wednesday, May 9, 2012

Car Seats: New AAP guidelines

[sleepy little boy]

Within the last month, the American Academy of Pediatrics has updated their recommendations on car seats, and I wanted to share them with you! Rear facing and forward facing is a debate among many, but there are so many safety factors to keeping your babies rear facing longer. We'll touch on that in a minute!

The MINIMUM requirements were to rear face your child in their car seat until they were 20lbs AND one year old, but many parents interpreted that as the best time to make the switch. The minimum requirement still remains, but the the recommendations have been clarified/changed: they are are to keep your child rear facing until they are 2 years old, or until they reach the maximum height and weight restriction for rear facing.

A 2007 study in the journal Injury Prevention found that children under age 2 are 75 percent less likely to die or to be severely injured in a crash if they are rear-facing. Another study found riding rear-facing to be five times safer than forward-facing. 

A rear-facing child safety seat does a better job of supporting the head, neck and spine of infants and toddlers in a crash, because it distributes the force of the collision over the entire body," said Dennis Durbin, M.D., F.A.A.P., a pediatric emergency physician and co-scientific director of the Center for Injury Research and Prevention at The Children's Hospital of Philadelphia and lead author of the policy statement and accompanying technical report.

A lot of parents decide to switch their kids over at the minimum requirements because "it's easier," "the kids aren't as bored," "their legs aren't squished," etc. But I think as parents we should think about the potential consequences of turning our babies around too early... the consequences could be deadly.

"It's easier" and "the kids aren't as bored:" Sure, it's probably easier to get your child in and out of their car seat when they are forward facing. It's easier to talk to your child and keep them entertained, and give them things. But is the protection of our kids not greater than convenience?

"Their legs aren't squished:" I googled images of "kids sitting," and this is what I found:

Basically, most of the images that I saw were children sitting comfortably, with their legs crossed. It's their choice of position to be comfortable in the majority of cases. When you see kids sitting on a chair or a couch, most of the time, they have their legs pulled up because it's more comfortable that way. Most kids, when they are in car seats, cross their legs, and don't sit with legs straight out. As they get older and their legs grow longer, it might be a little more uncomfortable for them as they are unable to stretch as much, especially on longer car trips. As parents, we are not necessarily supposed to make our children comfortable for the sake of safety. Would you let your children do other dangerous things, like play with knives or fire or in the street because the kids want to? Obviously not. As a parent you need to choose what is best for your child.

[disclaimer: this picture was taken last July; Ryan was 5 months old. I've become a lot more "safe" when it comes to car seats since doing as much research as I have; in this picture, the chest clip is way too low on Ryan and should be up higher, about armpit level. Just wanted to make that clear! Chest clips are meant for the upper chest... and unless the strap covers come with the car seat, they are not meant to be used. These did not come with that particular car seat so I really should not have used them. I didn't know at the time, though.]

[Rear facing is still fun! Here is Ryan and my sister, Erin]

[13 months]

[his straw cup looks so huge, hehe!]

Another reason I've heard parents may give for forward facing their kids: "If they get in a car accident rear facing, they're going to break their legs." I don't know about you (and Lord willing this will never happen!), but I would much prefer my child to potentially break a leg in an accident than have his neck be snapped off internally. When your child is rear facing, and you are hit from the front, most of the impact is taken by the car seat. When your child is forward facing, your child takes the brunt of the force and is much more likely to be severely injured. Also, rear end crashes (which are the kind that "could" potentially cause damage to your children's legs) are much less common and don't usually happen with the force that head on or side collisions do. This is not to say that rear facing your kids in the car seat is 100% injury free. No, injuries CAN still happen. But they aren't as likely to be nearly as severe, nor are they as common to happen. This, to me, is reason enough to keep Ryan rear facing as absolutely long as possible.

With all that being said... we wouldn't be able to forward face Ryan right now anyways, even if we wanted to. Yes, he is 15 months old, but he only weighs 18lbs so he doesn't even come close to meeting the minimum standard for forward facing. And we do plan on keeping him rear facing for as long as we can. Watching videos and reading studies on this topic have made this something we feel very strongly about. This post isn't to get you to "agree with me." I'm just simply laying out the facts and recommendations for those who do not know them, and sharing our opinion. I would ask that you please do research, watch videos, read through some statistics, and then make an educated decision before you front face your precious one. And if you've already made the switch, there's no reason why you can't go back, should you decide to. It will take some adjustment, but it's very likely to be worth it.

Here's Joel's story. He was 18 months old at the time he was in a car accident with his mom. They were in a head-on collision, and Joel's neck was snapped from his spine. Had he been rear facing, his injuries would have been MUCH less severe. Please watch this 6 minute video that Joel's grandpa made to show the potential consequences of forward facing. It's full of statistics, photos and visuals to help you make your decision.

baby led weaning: UPDATE

[chicken and banana, 6 months old]

I thought that since Ryan is over a year old, and has been eating solid food for... well, quite a while (9ish months, I think) that I should give an update on baby led weaning and how it is going for us. You can read the original post here.

*disclaimer in case you don't read the post I just linked to, even though you should!: Baby Led Weaning is a British term, so their take on "weaning" is different than our take as Americans on weaning. When they say weaning, they mean the introduction of solids. When we say weaning, we mean weaning from breastfeeding or bottle feeding, decreasing milk feeds, and increasing solid food. To make sure no one gets confused, I'm going to call it Baby Led Solids (BLS) in the rest of this post, like I did in the post I linked to. 

To say it in three words: Ryan loves food. Sometimes I can never seem to fill this kid up enough! I'm so happy that we did BLS with him, and we will definitely do it with any future children. That's not to say every child will take to it as well as Ryan did, but we have just seen so many benefits with it that it just makes so much sense for us. The bonuses that I touched on in the original post still remain true... it's so nice to not have to feed him (a moving target) something while our food gets cold. It's nice to not have to make more than one thing because he eats what we do. It's super easy to go places because I don't have to worry about bringing him something special or jars of food. He also is pretty enthusiastic about new food and is eager to try things, and he has eaten a lot of things that not a lot of kids his age have. And as a bonus, we as his parents started eating healthier because I want to make sure he has a good start with healthy eating ;) There are some times when I think to myself, *gasp* "I wouldn't want him eating that!!" Welllll then I probably shouldn't either :)

I wanted to touch on one other thing... something I am not sure how to process quite yet. Most of us grew up with the instruction that we had to finish absolutely everything on our plate, especially in order to get dessert. While I don't agree with the wasting of food, I'm not sure I understand this thought. I'm not really referring to a child taking one teensy bite of something and then saying, "I'm done!!" I'm more so referring to when a kid eats a reasonable amount but is still required to clean their plate off so they can become members of "the clean plate club." It seems that this may be something that we have just carried with us through the years and is an "old fashioned thought," because maybe in the past food was not as easily purchased or obtained. I obviously don't think food should be wasted, and we should be good stewards of what has been given to us, but completely cleaning off our plates every single time, regardless of being hungry or not? How are we supposed to teach our kids good eating habits when they are forced to finish everything, even if they are no longer hungry? Most of us as adults sometimes fore-go finishing something on our plates because we are no longer hungry, or because we want to "save room for dessert." Or maybe we don't take as much to begin with. I don't understand why parents are always pushing their kids to take "just three more bites." Maybe it's because I haven't walked in those shoes yet, as Ryan is still quite young... but I guess I just don't quite understand. We don't force Ryan to finish what is on his plate, because he of all people should know how hungry he is (or not). We've let him take the lead with how much he eats from the beginning, so it seems to make sense to let him continue to do so. Plus we also take into consideration the varying appetite of a growing toddler... some days he eats a lot, some days he doesn't eat very much. You know how, as a parent, you have to pick and choose the battles you fight? I guess at least for us personally, this is one we don't plan on fighting. But maybe you see it different in your family, and that's okay :]

Here's some fluff to close this post out... he's getting pretty good at eating with a fork and spoon!!

[eating a home made chicken wrap]

[mmm, pasta and veggies!]

[dipping his grilled cheese into his soup]

[mmm, avocado!!]

Wednesday, May 2, 2012

A Little Helper

All I can say is... I sure hope Ryan likes sweeping, doing the dishes, helping with laundry and putting away his toys later in life as much as he does right now!! 

He truly is such a good helper to me. We obviously haven't gotten to the stage of having regular "chores," but I try to include him in everything that I do so that he can learn from me. We make it fun!

A few of the things that he does (at 15 months, tomorrow):

-dusts (I give him a rag and he wipes things, like the book shelf, the books, the cats, his tractor, mama... lol, etc)

-hands me a piece of clean laundry for me to fold

-pushes the full laundry basket of folded towels down the hall for me to put away

-"helps" with the dishes

-"sweeps" the floor

-"helps" with baking (I let him dump in dry ingredients)

-puts his toys and books away

I'm pretty sure he likes to think he is helping by bringing me the toilet brush, but I won't count that one!

One thing about being a mama is using all the little opportunities you have been blessed with by God to teach, instruct, train, love and encourage your little one. It's super important to me to take advantage of these times and help cultivate a good work ethic in my son, as well as respect for others and good stewardship for our things. Sometimes it's hard to want to let Ryan "help" with the dishes or the laundry, because it would be so much easier and faster if I could just do it on my own. Oh, how my attitude should change and look for these golden moments with anticipation! And with a smile on my face, gladly say, "Yes, you may help mama!" and afterwards (until he can tell time, hehe), "What used to take me 30 whole minutes now only takes me 45! Thank you, love." Being a mama is letting your little one learn from you, mimic you, follow you, soak it all in... but yet realizing that it won't be "perfect" or by your standards, and it will likely take twice as long. But what a joy to have such a sponge of a shadow! 

[he put his books away]

[the towels Ryan put in the drawer; great example of how things will not look how you would prefer them, but to take the opportunity to teach!]

Tuesday, May 1, 2012

A few of Ryan's {undesired} firsts

We've had quite an interesting weekend. We cancelled dinner plans with friends on Wednesday because Ryan and I both weren't feeling all that well. I was exhausted and had several days of bad headaches, and Ryan seemed to be teething and just not feeling well in general.

Thursday was a better day; I was able to get the house picked up from it falling apart the last few days and Ryan was doing "okay." We spent the evening snuggling on the couch; Jake was still at work and put in a 16 hour day.

That night, I noticed he was a little warmer than normal, but it didn't seem to be anything to worry about. He had a pretty restless night and was crying out in his sleep a lot, which woke him up fully and then he was hard for me to settle back down. He was biting his gums and grinding his teeth together, so I knew he was teething and just tried to keep him comfortable.

We were both very tired on Friday morning. We did what we sometimes do on mornings like that: snuggle on the love seat and watch the birds out the window. As he nuzzled his head into my shoulder, I felt his skin and he definitely felt like he was running at least a low-grade fever. I decided that we should probably make a trip to the drug store to get a thermometer because I couldn't find ours. But, it was before 7am and it wasn't open yet.

I sent this picture to Jake at 6:34am, telling him I didn't think we should have Jake's dad over for dinner that night because it was very obvious that Ryan wasn't feeling well.

17 minutes later, his body went completely limp. He fell back over my other arm, his eyes rolled back into his head, and he started convulsing. I knew right away that he was having a seizure. I used to work at a facility for developmentally disabled adults, many of whom had frequent seizures. We didn't typically have to call 911 for their seizures, but I didn't even think twice about calling because this was Ryan's first one and I didn't know if it was serious or just one of those possible childhood things.

Within 10 seconds of him starting to seize, I had my phone in my hand and dialed 911. I honestly don't remember what I said, except for my name, my address, and that "my 15 month old son is having a seizure." I felt unusually calm AND extremely freaked out at the same time. God totally gave me the grace to keep my head on straight and do whatever I could to help Ryan. As I was talking to the 911 dispatcher, with Ryan convulsing in my arms, I unlocked the front door and opened it, so they could get inside. All my memories of the seizure training we had at work came into my head: turn him on his side so he doesn't choke in case he vomits. Don't restrain his movements. Keep calm.

I held him on his side in my arms and kept talking to the dispatcher. I heard sirens in the distance. Then there was a knock on the door... I heard someone yell, "Police!" I said, "In here!" and he came into the living room. I didn't even look up at him as he knelt down next to me and Ryan. Ryan stopped convulsing at that point but was obviously still in the seizure. I thought the officer was going to look Ryan over, so I laid him down in front of me. The officer didn't move, but he said a few things... then said something a long the lines of, "I'm not really sure what to do." Then he said, "He's a beautiful baby." Well, duh. Part of me wanted to smack him for not knowing what to do but I tried to understand that they aren't always trained in every medical aspect.

I heard more sirens and saw an ambulance back up into our driveway. It felt so surreal. The cats freaked out and darted over the couch behind the officer because of the noise. An EMT and paramedic came into the house with their massive bags of equipment. After about 5 minutes asking questions and watching Ryan, who was still in a seizure (but not convulsing), the paramedic asked me how long ago it had started. I checked my phone, and it said I had called 911 eleven minutes ago. A few minutes later, she decided that we should give him a shot of something (I don't remember what) to help him out of the seizure. She said it would probably knock him out, too. She got the meds together and injected it into his arm. His eyes were still staring out the corner and he was moaning. He started mumbling and I could hear him saying, with a shaky, quiet voice... "Ma... ma... ma... ma..." I kept telling him over and over that I was right there and he was going to be okay. His seizure lasted probably just short of twenty minutes total. The paramedic decided it was time to take him in to the ER, so I asked if I could grab a few things. I hated leaving my baby on the floor without me but I flew to our room, changed out of my pajamas, got my shoes, his diaper bag and came back out to the living room. The paramedic was holding Ryan and talking to him.

I'm telling ya, by the grace of God I was able to keep my head on straight. I shut off lights, I grabbed my keys, phone and charger. I figured Ryan might want the blanket he sleeps with at night so I got that, and his stuffed monkey. The paramedic handed Ryan back to me because he started to wake up a little bit, and then we walked outside, locking the door behind me. They helped me climb up into the back of the ambulance with Ryan in my arms, and strapped me to the bed. Going around corners strapped to a bed in an ambulance is kind of a freaky thing. I felt like I was going to fall over with no way to support myself. I asked the paramedic to put the rails up on the bed and she did. Then she started doing some vitals on Ryan, checking his oxygen and pulse. I felt like the drive was taking forever. I knew this wasn't a life threatening situation, but I still felt like they should drive faster than they were. Ryan was basically asleep this entire time, but after a little while, he started to "talk" and make angry, babbling sounds.

I called Jake and told him what was going on and asked him to meet me at the hospital. He left work right away and was at the hospital before we even got there; he met us in the ER. We got wheeled in and it felt like it was straight out of a movie: a ton of people swarmed around us as the paramedic read off her information and what had happened. Ryan started to wake up at this point, when people were poking him and checking him out. The doctor looked him over and sent at least half of the people away, saying they wouldn't be needed.

They started to run a lot of tests. His temperature was taken (101*), blood was drawn, his nose and throat were swabbed. They attempted to do an IV a few times, but the nurses couldn't get it in right. He screamed the entire time and I felt awful, but I tried to reassure him that I was right there and it would be over soon. The next test they wanted to do was a urine sample, which involved getting a catheter. As soon as I heard that, I froze: I've heard so many terrible stories about doctors and nurses forcefully retracting an intact boy to cath him. Something I'm pretty passionate about is sharing with people about the negative affects of circumcision and that it's not even recommended by any medical or health organization in the US. The US is the only country that does circumcisions as routine as well. I honestly haven't studied it too extensively in the Bible (and I should), but I don't think it's something we are held to by law anymore. Buuuut that's a topic for another day... and one I might not even touch on, because it's a hot one and I don't really care for debates. ;) I don't expect people to agree with me, but, like how I didn't know the facts about it when I was pregnant with Ryan, I know a lot of other people don't know either, and I share about it when asked. I just want people to make educated decisions, that's all... and it's good to know both sides before you make a decision.

Anyways, my stellar husband immediately piped up, "We are  very concerned about the retraction of his foreskin and don't want that to be done." I pulled up an article on my phone that explained how cathing an intact baby can be done without retraction and asked the nurses to read it before they attempted. The nurses unfortunately didn't really seem interested in our opinion and were very firm in saying that the foreskin needed to be retracted, "just a little bit," so they could get a clean specimen. I said that I would not allow them to retract Ryan, even a little bit, and if they weren't comfortable doing the cath without retracting him, to find someone else that was. I tried to be firm but polite at the same time. We knew that normal and healthy separation will happen on it's own and often times not until puberty. Jake and I said that we weren't trying to be difficult to work with, but this was something that was of concern to us and we knew it could cause him harm if done.

The nurse finally agreed to just look and try without retracting him. As they wiped the area clean with iodine, Ryan started urinating. They grabbed the specimen cup and he peed right into it. "That means he doesn't need the catheter, right?" I said with huge smile on my face. "Yep," the nurse said. I was SO relieved. And so proud of my little guy :)

Another nurse came in, and although she wasn't the most friendly nurse we've ever had, she was able to get the IV inserted in one try, which I really appreciated. Ryan was obviously upset with all the poking and testing but was easily comforted by snuggling with me. I was thankful that he was willing to nurse so he would stay hydrated and help fight whatever was going on in his little body.

The rest of the day, honestly, was a blur. Lots of tests were done, and one by one, they came back negative. Ryan slept for an hour and a half on the bed next to me. 

In the early afternoon, we were moved to a smaller room because things obviously weren't critical. Ryan was awake now, and was very irritable. The doctor came back with more test results and said that he was a pretty healthy little guy and that they didn't see any obvious warning signs. He diagnosed Ryan's seizure as a febrile seizure... a seizure that is caused by a rapid rise in temperature. They can be pretty common in kids and don't typically do any damage. He gave us instructions and things to look out for, and said that he wanted to keep an eye on him for a little bit longer before he let us go. He asked if Ryan needed anything, and I said that he might be hungry... the doctor, who was a super nice guy, asked me what he would like... and I knew that if he found a banana for Ryan, they'd be best friends. He returned not long later with a banana, and Ryan devoured almost the whole thing.

Jake left to take his truck home and come back in the car, which had Ryan's car seat. My mom stopped by for a little bit, and offered to run to Target to get a few things for us.

Finally we were able to go home! Ryan slept the whole way home. He was very, very tired. Jake decided that he should go back to work to help the guys out. I was fine with it, but I was scared to be alone with Ryan and was just pretty overwhelmed from everything. That night was extremely rough... he was really unable to rest, screamed out in his sleep, was hard to settle, and just seemed to be in a lot of pain. I don't think he slept longer than 10-20 minutes at a time, and then was awake for some time before he slept for a little bit again.

Saturday was also a rough day. I texted Jake at 7:30am asking him to come home (even though I knew he probably couldn't)... but he wasn't able to come home until after lunch. Ryan seemed a little better when Jake got home... maybe because he hadn't seen his daddy for a while, other than yesterday at the hospital.

[Ryan, finally able to rest, in my lap]

We needed to get a few groceries, so we decided to make a quick run to Walmart and get some things. I was picking up shampoo when Jake answered my phone; it was the ER doctor. Apparently some of the blood tests that they had run had grown bacteria, and they wanted us to come back in ASAP for antibiotics.

I felt absolutely sick to my stomach. I did NOT want to go back! But we knew that bacteria in the blood can be very serious, so we left our cart with a few items in it where it was (yep, we were one of "those" people) and headed straight to the hospital. We were already in the same town as the hospital so it didn't take us long to get there. We called a few people on the way to ask for prayer for Ryan.

We got checked in to Urgent Care and they sent us through to the ER. A doctor came in to talk with us and explained that the blood might just be contaminated from inserting the IV but that it was possible it was an actual blood infection, so he wanted to give him some antibiotics. The doctor wasn't the most understanding about our parental choices (delaying vaccines, not going to every well-child checkup, etc) and also thought Ryan was "too small and needed to be checked out." I told him I wasn't really concerned because he was meeting developmental milestones and was otherwise healthy. He didn't say much more but suggested we take him in for a visit to get someone watching his weight.

(he's 17lbs 14oz now, or at least he was when he got weighed on Sunday. So he's lost a little bit of weight but he's also been sick and not eating... so I'm really not worried about it).

The doctor figured out the source of the virus was in Ryan's throat, and that was the cause of the fever and ultimately the seizure. Ryan had all sorts of painful sores in his throat and mouth. Official diagnosis of hand-foot-and-mouth disease, which is basically a really gross sounding but mild and common virus. It's not fun but it's not really harmful, either; you just have to get over it, like a cold.  Ryan got two shots of an antibiotic for the possible bacteria and was observed for a little bit... then we were let go home. Thankfully it was only a couple hour visit this time. We were asked to follow up with a doctor the next day because the blood results that they were re-testing should be in by then.

On Sunday we took Ryan to a pediatrician who was open from 10-1. She was great; I think I want to go see her from now on if we need to :) She hadn't heard any results yet, and after discussing a few options, thought it would be best to give him another shot of the antibiotic to be on the safe side. She wanted us to follow up (yet again) the next day because the results would probably be in by then.

We decided against taking him in on Monday because we hadn't heard about the results yet... and they said they would call if the results were positive (actual bacteria in the blood). We kind of figured that it was pointless to take him in if the results weren't positive because... well, it's pointless. Now it is Tuesday, and we have yet to hear anything. Which is a good thing: "no news is good news," right? Situations like this make me wish that doctors called you back regardless of the results... I know it would take a lot more time, but it sure would be nice to not be left wondering if they really are negative or if the results were just misplaced or they forgot to call. :)

[sleeping on the way home from the doctor]

Ryan is slowly but surely getting back to his normal, happy self. He is very tired but isn't resting well at night and is up often, crying from the pain. We spend many-a-hours in the rocking chair in his room, or snuggling in his bed. He is still teething on top of having the virus to fight, so he has his work cut out for him. His appetite is returning too, thankfully.

For the first few days after the seizure and the hospital stay, Ryan was very clingy (I don't say that in a negative way; nothing wrong with a snuggly little boy!) and got very scared every time we laid him down, tried to change his diaper, or if I walked out of the room. I think the whole experience was pretty traumatic for him... he clung to me with fistfuls of my clothes and did not want to be put down. A nurse said that "babies don't remember those things" so it was "probably him just not feeling well." Yah, I highly doubt he forgot all about it all and he's just freaking out when I try to change his diaper just because he can. Riiiiight. He seems to be a little more comfortable now but not without some hesitation.

We are so thankful to God for answering our prayers for our little boy's health! And we will continue to trust in Him that whatever he brings us to, He will carry us through. Friday was one of the scariest moments of my LIFE but looking back, I can see so many moments where God gave me extra grace to carry me through the moment and keep my eyes focused on Christ.

[enjoying a popsicle... sure feels good!]