Monthly Archives: November 2008

Are you sure you want that to be one of your three hundred questions?

The title of this post, by the way, is a family in-joke.  Do shout if you want it explained. 

Anyway.  Longstanding readers of this blog may distantly remember that, some months back, the Interview of the Three Hundred Questions officially confirmed that Jamie had mild autistic spectrum disorder, and that I reported on that in brief and expressed a hope that I'd get round to writing a more detailed account some time within the next several months.  So, lo and behold, here I am several months later with a more detailed account.  Never let it be said that I welsh on my obligations.

We received an interview date for Tuesday, August 5th, with a warning that we could expect the interview to take around three hours.  This was no great surprise – after all, three hundred questions have got to take a while to get through – but it did raise the issue of what to do with Jamie, who was never going to play happily in the consulting room for anything like that long.  The logical thing to do would of course have been for Barry to go along on his own, leaving me to take care of the kids, but I was far too interested in the whole process to want to miss it.  Fortunately, my mother came through like the star she is and rearranged her work schedule to be able to stay with Jamie (we took Katie along).

We were the only people in the waiting area, this time.  Dr M. arrived after only a few minutes to usher us through into the same consulting room we'd been in before, complete with same formaldehyde smell.  He asked us how things had been going since he last saw us.  Very well, as it happened.  I have a slew of planned but unwritten blog posts about this, but, in brief: over the previous few months, Jamie had been doing more imaginative play, he'd finally got the hang of using first- and second-person pronouns correctly, and there had been a couple of times when Katie had started crying and Jamie had come to grab the hand of whichever parent happened to be available and pull them over to her.  ("Katie is upset," he told me as he pulled me along the hall.  "I think she needs a…" slight pause for consideration… "a cuddle.")

Incidentally, a few months prior to this he'd had his booster jabs – the dreaded Multiple Vaccines At Once.  Eight, in fact.  Three of which were the infamous MMR.  And it was roughly around that time that all this improvement started.  I don't see this as anything more than a coincidence, but it's one that leaves me dryly amused.

Dr M., in turn, filled us in on the reports he'd had from the speech therapist – which we had a copy of already – and the nursery, which we didn't.  I had a quick look at that one, which was a standard form, mostly a tick-box format looking at the frequency with which they'd observed various behaviours with regard to areas like social interaction, imaginative play, other forms of play, and emotional expression.  (There was also a section at the beginning for writing a brief description of him, but that hadn't been filled in.)  Dr M. has sent us a copy, so I've had a chance to look at it more closely since, but even on a quick glance at that one, it was clear there were a lot of things he wasn't doing in the nursery setting (some of which he does do at home, such as looking at our faces).

Having caught up on all that, we got down to business.  The official name for this interview was, Dr M. explained to us, DISCO – the Diagnostic Interview for Social and COmmunication disorders.  He tentatively reminded us again that it was, um, quite long.  Were we all set…?  We confirmed that we were fully prepared for it to be a long haul, and ahead we went.

It was, in actual fact, a lot easier than I'd expected.  I'd had mental images of gruelling exams, but this was really just talking about our child in great detail, no more a chore to us than to any other doting parents.  Katie played with the toys for a while, although, as time went on and she became increasingly fractious over her insufficient nap, I picked her up and walked the few steps across the room and back with her on my shoulder.  Barry and I fortified ourselves with his supply of blackcurrant squash (Dr M. declined when offered) and, all in all, it felt like a lot less than three hours.

The questions were arranged in sections.  Having confirmed that there had been no problems with Jamie's birth or my pregnancy, Dr M.went on to ask us about his babyhood – about how he'd been in terms of feeding, weaning, sleeping, crying, and about whether or not he'd started to show various behaviours (lifting his arms to be picked up, turning to us as he pointed to something to check we were watching) at particular ages as he grew. Trying to remember a negative reliably is difficult under any circumstances and more so when trying to think back three years – no, now you come to mention it I don't remember ever seeing him doing that – do you? – but did he really not do it, or is it possible that we just aren't remembering?  We continued to on to questions about his development in toddlerhood, and thence to further sections – eating, sleeping, toileting or lack thereof, speech, socialisation, imaginative play, physical development, what sort of things he does on a typical day, and a whole load of others that I can't even remember.  Katie played with the toys for a while, then got grumpy as her usual practice of waking up from a nap far too early started to catch up with her; I spent a large part of the interview walking back and forth across the width of the small room with her against my shoulder.

The clear pattern that was emerging was no surprise to any of us – we'd reached the stage where the DISCO was merely a formality (albeit an important one) in establishing the diagnosis.  However, this was the first time that we'd put it all together in so much detail, including some points the significance of which we hadn't even realised at the time, such as some of the things he should have been doing in late infancy/early toddlerhood and wasn't.  I found it absolutely fascinating – not only going through and building up the full picture in such a way, but also learning more about the finer details of normal development in a non-autistic baby.  It's going to be so interesting watching Katie do these things as she grows.  (I know I'm making an assumption there, but I don't think it's too far out; just as I had an inkling from very early on that Jamie would have some form of autistic spectrum disorder, so my gut feeling about Katie from the start was that she was going to be my neurotypical child, and already she's doing things that bear that out, such as lifting her arms to be picked up, or imitating us.  Little details which I'd have taken for granted if not for having learnt more as a result of Jamie's differences highlighting what the norms should be.)

Finally, we were finished.  I'd assumed that there would be some complicated system for totting up and scoring all the answers, such as there'd been with the Schedule of Growing Skills that we'd done with the health visitor, and had wo
ndered how on earth this would be managed for three hundred questions; I had, in fact, been fully prepared to have to wait until a further appointment for an answer to give Dr M. time to calculate the scores on the doors.  In fact, it was much simpler than that.  What he did was to use the DISCO to see whether there was a problem in each different area covered; yes or no?  Then he went through a list of the ICD criteria for autistic spectrum disorders and ticked off the symptoms that had shown up as problems on the DISCO, to see whether enough showed up in each category to meet the official criteria for a diagnosis, thereby neatly summarising the salient information from the three hundred questions without having to come up with detailed counts for each category.  It reminded me of what I'd heard about the US electoral college system, though without all those problems with hanging chads.

Having talked us through the symptoms he was ticking off as he did them (I was a little distracted by Katie growing increasingly fractious, but I appreciated the thought), Dr M. arrived at the bottom line; yes, he confirmed, it did indeed appear that Jamie had a high-functioning autistic spectrum disorder.  I'd wondered beforehand how I'd feel when those words were finally said – after all, although I wasn't bothered by the thought of the emerging diagnosis, perhaps having it made official would feel different.  Perhaps I'd suddenly feel my heart plummet at the reality of it all.  Perhaps, on the other hand, I'd feel relieved to have the diagnosis made.  As it turned out, I was distracted from any profound emotional reaction by Katie choosing that moment to utter a loud annoyed squawk into my ear.

(Although, while we're on the subject, can I just mention here that I hate the term 'high-functioning' to qualify autism?  I know many people are offended by the corresponding term 'low-functioning', and with good reason, but does anybody else apart from me feel the term 'high-functioning' damns with faint praise?  Machines function, for goodness' sake; my child lives his life just as anyone else does.  I'd like him to be able to do a lot more in life than just function, and I'm not wild about the implication that the best he can hope for is to be able to do so on a better rather than worse level.)

"I gather this doesn't come as a surprise to you?" Dr M. asked diffidently.  I confirmed that it did not, and we moved on to talking about what would happen next.  What would happen next, it appeared, would be various different acronyms.  First of all, he would get another IEP; then there would be something called a LISM, which stood for Local Inclusion Support Meeting and would involve all relevant people getting together to discuss how he was doing at nursery and what the plan there should be; and, at some point after he'd received his school allocation, there would be a TISM, which stood for Transfer Inclusion Support Meeting and would be the discussion of what support he would need on going up to big school.  Dr M. would see us again in around six months. 

That seemed to cover everything for the moment, so we went back home to relieve my mother.  She and Jamie and my grandmother, who was also visiting, had been having an absolutely grand old time with a giant alphabet floor puzzle, which Jamie thought was wonderful.  (Which, come to think of it, is rather apt for a boy with so many new acronyms in his life.)

Just to close, a quick update as to what's happened since: Manda did his updated IEP (we have a copy – the goals are to encourage him to partner other children at relevant times in the nursery games, to encourage turn-taking within small groups, and to support him to use visual communication systems to initiate requests).  The LISM is scheduled for this coming Monday, which is what stimulated me finally to get into gear and finish this off; I didn't want to be too many acronyms behind.  I shall try and write my account of that, um, let's see… at my current rate, probably by some time around next February.

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Just begun

One year ago today – one year ago almost to the minute, as I start typing this – our daughter hurtled screaming into the world to complete our family.  I lay in bed first thing this morning, looking at the numbers on my clock radio, remembering myself doing the same thing one year ago as the early contractions picked up. One whole year of having this new, wonderful little person in our lives, of learning who this person is who was inside that bump for so long. 

She likes banging things and pushing wheeled things and grabbing faces and opening cupboards and watching her big brother and playing hand-clapping games.  She hates having her nose wiped and being dressed.  (She used to hate having her teeth brushed, but the new strawberry toothpaste seems to have made this activity more popular.)  She lets us know what she likes and dislikes in no uncertain terms, just as determined and spirited as I knew she'd be back when I could feel her landing vigorous kicks in my insides.

"When Katie is bigger," Jamie told me today, "she will be nearly sixteen."  I'm not entirely sure what he was getting at, but the logic seemed unarguable.

Katie, my little Katherine Abigail, I've been grateful every day of this past year that you're in my life.  I'm so looking forward to seeing your exploits of the coming year and every year after that.  I love you and I am very, very glad to have you as my daughter.  Happy birthday, my wonderful one-year-old.

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How to save a life

On Thursday, 20th November – my son's fourth birthday, the fourth anniversary of the day on which I entered the wild, challenging, fascinating, wondrous world of parenthood – I spent the morning driving out to a distant service station to meet a woman in the car park and give her eleven and a half pints of breast milk.  Never let it be said that I don't push the boat out when it comes to marking significant dates.

I never expected to end up as a breast milk donor.  For one thing, the current obsession with keeping babies Exclusively Breastfed Until Six Months meant that I believed I should be stashing every ounce I could pump against possible future shortage once I got back to work.  For another, I couldn't see how I'd fit milk donation into a life already overbusy.  I vaguely assumed that the milk would have to be delivered as soon as possible so that it didn't go off, and pictured myself trying to make it down to the nearest neonatal intensive-care unit in my lunch hour with breast milk bags in hand – if I was taking the milk along on a daily basis, how would I ever find time to pump it in the first place?  As worthy as the whole endeavour of milk donation sounded, it also sounded like a complication in my life that I didn't need.  This may not be very noble of me, but I didn't want to bother.

Then, my sweet little daughter decided that she preferred formula to pumped milk during the days that I was out at work.  We discovered this just before she turned six months, and it was a revelation; suddenly it turned out that the hours of screaming with which she had tortured my husband every afternoon weren't inevitable after all, and that if Barry could stop reminding her of my existence by feeding her on my milk then she was far happier about my absence.  However, I still wanted to breastfeed during my days at home; and, although I tried cutting back on my pumping frequency at work, ultimately it didn't look as though I could manage to breastfeed her three days a week and still get through the other four without pumping.  Or, at any rate, I didn't want to risk it; that way lay supply drop and/or mastitis.  I was going to be stuck with hooking up to that pump for a good few months to come, and, since I didn't want to just chuck the milk out, I needed to figure out something to do with it.  So, that was how I ended up googling 'breast milk donation'.

The USA, I discovered, has rather more opportunities than the boring old UK for finding good homes for unwanted breast milk.  If I'd lived in America, I could have arranged to send it to Africa for HIV-infected babies or to pass it on to mothers who couldn't produce their own in a kind of long-distance modern version of wet-nursing.  Neither of those options seemed to be available to me on this side of the Atlantic, but what might be available was the United Kingdom Association for Milk Banking, a central organisation based at Queen Charlotte's in London. 

Yes, according to their webpage, they would take donations of frozen milk up to three months from the date of freezing.  This unfortunately excluded at least some of the milk residing in my freezer, as I'd been going by the LLL guidelines and saving it for four months; however, the standards for donated milk are stricter, which is fair enough.  It was even possible that they might send a courier out to pick it up.  On the minus side, it appeared that mothers whose babies were over six months – as Katie was by then – could not become new donors.  While this cut-off made a certain amount of sense, given that milk composition changes over the time that a woman lactates and therefore the milk I was currently producing probably wasn't of the ideal composition for a premature baby, it seemed illogical that it applied only to new donors; mothers who were already donating, the webpage informed me, could continue donating after their babies hit six months.  What the hell – since I was short of other options, I figured it wouldn't hurt to ring up and ask.

So I rang up and asked.  Well, actually I rang up and got a slightly breathless-sounding message on an answerphone from someone called Gillian Weaver, and rang up again and got the same thing, and rang up again… but, after a lot of trying, eventually got through to the actual Gillian Weaver and then asked.  Yes, she assured me, they could indeed use my milk, pumped more than six months after Katie's birth or not.  The fact that I didn't sterilise my pump parts after washing them – a necessity for pumping milk for donation, according to the website – would also not be a problem in practice, it seemed.  I wondered if a similar gap existed between their posted rules and what they'd actually accept as far as the age of the milk was concerned, but it seemed not – there was a bit of leeway, but they did need to receive the milk and start the pasteurisation process within approximately three months of it being pumped.  However, they could sometimes donate milk to research projects when it couldn't be used for babies, so it was just possible that they'd be able to find some use for even the older stuff.  I would need to fill out a questionnaire, and have blood samples taken and then repeated three months after my last donation to confirm that I was free of HIV or anything else that could be transmitted, and we would have to figure out somewhere to meet to hand over the milk; I lived too far away for them to send a courier, but it was possible that we could find a place to meet at some appropriate in-between point if we were ever travelling in the Londonwards direction, something we do do from time to time for various reasons.

All of this took even more time to set up (except for the blood sampling; Gillian gave me the forms and sample tubes she needed when we did eventually meet, I had the samples taken at work, and posted them back in a pre-prepared envelope).  Gillian, at the time, was managing the milk bank entirely single-handed; I was pleased to find out that she acquired an assistant a few months later, as it sounded as though she needed one very badly, but at the time I was trying to sort out the milk donation she was having to do everything herself and was swamped.  So, it took while for her to get round to sending out the questionnaire that I needed to fill in and send back before being officially accepted, and then a while more for me to get through to her again to arrange a date and place where we could meet up.  This was unavoidable, but pretty darned frustrating – I ended up having to throw out quite a bit of milk that had gone past its date.  (I kept what I could, even when it went over the date – after all, there was always the chance that they'd be able to pass it on to a research project – but the freezer shelf was filling up very rapidly, and I had to throw out some of the expired milk just to make room for the new stuff I was pumping.)

However, we finally managed to pull it all together.  Gillian would meet us in a layby on our way to visit my mother for the weekend; if we could bring the milk with us in a labelled bag inside a cool box, we could pass it over to her to take back to the milk bank in her own cool box.  I was a nervous wreck over the number of things that could potentially go wrong and leave me with a lot of defrosted, wasted milk (Gillian was totally blasé about it – she probably does this sort of thing all the time) but, in the end, it all went swimmingly.  I loaded the milk hastily into a large plastic bag inside our cool box while Barry and the children waited for me in the car, heaved it onto the back seat next to Katie (who then sucked on a bottle of formula as we sped down the motorway, a barefoot shoemaker's child), liased with Gillian via mobile, and we met up and exchanged the milk for the blood sampling kit with no problems.  (By the way, did I mention that this was on a Sunday?  And, as I said, Gillian apparently does this kind of thing quite often, on top of the hours she works during the week.  This woman is an unsung heroine.)

Three months later, we repeated the process for the milk I'd pumped since the first donation, with just as much associated hassle in arranging it.  I gather that my struggles will at least have contributed to making life easier for the next person, since Gillian started looking into the possibility of me posting the milk and it does look as though that's going to be an option they can arrange for future donors.  However, I did not want to waste more milk waiting around for this to get set up and confirmed, so I arranged to meet Gillian again.  In the end, once again, it did all fall into place.  Gillian had a trip in our vague general direction planned for November 20th, and I'd already booked the day off in honour of Jamie's birthday.  While this wasn't exactly how I'd planned to spend it, it did have the advantage that I could tie the trip in with our annual trip to buy Jamie's clothes for the next year (and, this year, to buy Katie a few appropriately pink things to supplement her brother's hand-me-downs) and leave the kids with Barry, thereby meaning that for once it would be possible to do the clothes shopping without having to chase Jamie round the stores simultaneously.  Also, as it happened, the date worked out perfectly from the point of view of the milk expiration; it was exactly three months from the date I'd pumped the oldest milk that I had in the freezer at that point, so that was the ideal date for donating the maximum amount without wastage.  The town we go to for the shopping is on the way to London, and Barry suggested a service station around twenty miles further on for the handover so that the driving would be at least vaguely divided between us (though I think Gillian still bore the brunt of it.  Oh, well – at least I put some effort in.)

Once again I was somewhat nervous about it all beforehand, but this time was actually easier than the last as I had less milk to load into the cool box and didn't have three people waiting impatiently for me in the car while I tried to pack it.  I loaded the milk into our cool box, piled every freezer pack we possess in on top (probably a mite excessive, since I suspect the risk of it it defrosting on the way was not really that great, but "Let's err on the side of caution" will probably be engraved upon my tombstone), drove out to the service station, handed over to Gillian, drove back to the town with the clothes shops in, and did the necessary shopping (and a bit of Christmas shopping for Katie while I was at it) before heading back home.  As mornings away from the daily grind go it was a mite unconventional, but a trip without the kids is a trip without the kids and I treasured it.

Gillian will post the stuff for my final blood tests to me in three months' time, and that will be the end of my involvement with the world of milk donation.  I'd always planned to pump until Katie's first birthday before stopping, and had in fact reached the stage of counting down Pumping Days Till Birthday before I got the November 20th date sorted out for the milk drop-off with Gillian.  Since there wasn't going to be anything I could do with any milk I pumped after the drop-off (this close to my original target for stopping pumping, I was certainly not going to keep going for long enough to collect enough milk to make a third drop-off journey worthwhile), I then made that my target date instead.  Stopping date would not be quite accurate as stopping pumping is something that shouldn't be done too abruptly and I knew I'd need a bit of extra time to wind down production to a point where I could stop without undue discomfort, but I aimed for that date as the start of the wind-down.  I pumped with renewed vigour in the days leading up to the 20th, pumping as much as I could to hand over to Gillian, and after that I was very ready indeed to call it quits.

There have been some minor inconveniences associated with milk donation (apart from all the major hassles over getting the milk to Gillian).  I have to keep to stricter lifestyle standards than I would if I were merely pumping for my own healthy child – these haven't been unduly onerous, as I'm a rather boringly clean-living person by nature, but there have certainly been times when I'd have liked to be able to have an extra cup of coffee without worrying about going over my limit or to be less obsessive-compulsive about hand hygiene for each pump.  While it's good to be free of those strictures, they were never more than a minor and manageable hassle.

The grand total of both donations, by my calculation, was just over three and a half gallons.  Some of that won't have been usable for babies, having been more than three months old by the time I could donate it; still, since there's always the chance Gillian found a research project to give it a good home, so I shall count that.  I did ask her whether they'd been able to use any of it in view of it coming from a mother whose baby was over the six month mark.  Oh, yes, she assured me.  While she needed to be very careful with the milk given to babies who were exclusively on breastmilk, supplementing babies with small amounts of milk was a different matter; they could certainly use my milk for that.  Even subtracting whatever was more than three months old (I haven't worked that out, as I don't really want to know how much may have been wasted), dividing the remainder of three and a half gallons into appropriately small amounts could add up to a hell of a lot of babies.  It's a peculiar and awe-inspiring feeling to realise that I don't even know, and will never know, just how many babies have been fed on my milk; that it could easily be dozens.  It certainly helped reconcile me to the prospective end of lactation.  If I have to bid farewell to this amazing ability of producing milk, at least I have the consolation of knowing that I made very thorough use of it while I had it.

While the title of this post is probably over-optimistic, it seems not unreasonable to believe that all that milk might ultimately have provided at least some benefit to some baby somewhere.  At any rate, I'm glad that circumstances led me down the path of being a milk donor; it's something I look back on with pride, and I'm writing this post in hopes of making more breastfeeding women aware of milk donation as an option worth considering.

Incidentally, we also celebrated Jamie's birthday in more conventional fashion by giving him a large box of Lego.  He loved it.

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Yes, I know the feeling

"It's stopped!" Jamie announced, halting midway through putting his T-shirt on.  I looked up at him.

"The batteries," Jamie continued with deliberation "have fallen out.  We must put them back in."

And he proceeded to bend over, carefully pick up an imaginary battery, and insert it into an imaginary slot on the back of his neck.  Then he repeated the procedure three more times before resuming putting on his T-shirt.

(For future reference, three of his imaginary battery slots are on his upper chest and the other just below the nape of his neck.  I feel that as a parent I should know these things.)

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Pumpkins? Smashing

My mother sent Hallowe'en cards for both children and a small present for Jamie.  I was a few days late in passing these on to the children due to having mistaken them for birthday presents and put them aside until closer to the date; it wasn't until I peeked inside the package and noticed a definite Hallowe'en theme to the contents that I realised I should actually have dispensed them on October 31st.  Ooops.

However, wrong date or not, the gift was definitely a hit. "This is a great card," Jamie declared to me.  "It has a spider in it.  An' a web."  It did indeed – a very impressive pop-up one.  But the present – a small box of magnetic pumpkins with facial features to stick on and assemble your own pumpkin face – was even better. Jamie spent most of dinner playing with them, starting out with what he declared would be a Ten Questions Quiz for me and Barry ("Question 1 – which two pumpkins are stuck together?  Very good – well done!  Question 2 – which pumpkin is missing?  Very good – well done!  Question 3 – which pumpkins are upside down?  Very good – well done!") before getting sidetracked somewhere around Question 8 by the fun of actually assembling a face.  Having put one face together, he was so pleased with it he kept on disassembling and reassembling that one without even trying any of the alternate eyes, noses, or mouths, merely turning the mouth he was using upside down for a bit of emotional variety ("Now, someone has made this pumpkin very sad.")

Katie, meanwhile, although too little to be allowed near magnetic pumpkins, did get her own card, which she tried to eat.  (This is hardly surprising – she tries to eat anything she's handed.)  So, all in all, the Hallowe'en package was a major hit, with big thank yous to Granny Constance.

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Eleven Months – Evolving

Things that Katie learned how to do in her eleventh month:

Cruise.  For those not familiar with the lingo, this refers not to holidaying on expensive boats but to the sort of sideways shuffle babies do while holding onto furniture.  She rarely actually does this, preferring crawling as her means of locomotion, but she has cruised a few steps from time to time and thus gets to count it officially as a milestone. 

Stand unsupported for an approximate half-second before folding in slow motion down to the ground. 

Pincer grasp.  She is not yet deft at this, but can manage it well enough to supplement her diet with lots of crumbs and the odd bit of carpet fluff.

Drop things.  She has reached the stage where this counts as a lovely game.

Sleep for more than forty minutes at naptime.  The forty minute thing is, apparently, very common in babies, due to this being the length of one sleep cycle (the time it takes a baby to go from wakefulness down through increasingly deep levels of sleep and back up to light sleep again) – many babies wake up too far as their sleep cycles crest the surface, and can't drop back off to sleep again easily even if they really need to do so.  This, of course, then means that you have an awake, overtired, irritable baby instead of a peacefully asleep followed by awake well-rested happy baby; so you can imagine that I was particularly pleased about this particular achievement.  Katie is now taking two naps of an hour or more each day.  (Exact duration varies hugely, but the point is that she now actually seems to be getting the sleep she needs during the day, rather than waking up from her naps far too early.)  As to why it happened now, I think that's down to the recent night weaning.  That, plus the extra formula supplements we gave her during the day, got her settling more easily at night and sleeping for much longer stretches, and, after a few weeks, this eventually had a knock-on effect on her daytime sleep.  

Possibly saying her first word or two.  Maybe.  Sorry to be vague on such a particularly important milestone, but the problem is that The First Word just isn't the same kind of clear-cut event in real life as it is in all those books and films where a previously non-verbal child suddenly comes out with a clear "Mummy!" or "Dog!" or "President!" or whatever happens to suit the plot development.  What actually happens in real life is that babies spend months babbling merrily away with any old random syllables which, every so often but no more than would be expected by sheer coincidence, happen to approximate to the beginning sound of whatever or whoever they happen to be looking at at the time.  Then you start thinking that maybe this is happening a bit more often than coincidence would suggest… or maybe not.  And it just gradually goes on from there until it eventually becomes pretty obvious that they are in fact using "Ma-ma!" to refer to their mother, or whatever, at which point you realise that they have, in fact, probably been doing it for months.  This is what's happening with Katie.  She says "Ma-ma!" a lot, usually with apparent randomness, but there do seem to be a lot of occasions on which it's connected with her looking at me or hearing my voice on the phone or looking around in a lost kind of way when I'm not there… enough to have Barry convinced that she's doing it deliberately, and me thinking, hmmmm, maybe, maybe not.  I'm a sceptic when it comes to milestones – I like to have clearcut evidence.  Similarly, she did once look at her brother and announce "Jay-jay!" but doesn't seem to have done that on any subsequent occasions, so, well, who knows.  But the babbling is going beautifully.  She can now chat away very happily about life in a variety of random syllables.

She now has almost seven teeth (top right incisor now through, top left incisor lurking coyly just beneath the surface).  She is still breastfeeding two or three times a day.  (I did also go back to breastfeeding her once at night as well for a bit during her eleventh month, but have now dropped that again.  Long story which I may or may not go into at some point, time permitting.)

She has been to her second restaurant (the first being when we were at the Convention and went to a superb Birmingham restaurant called the Spicebuffet, which does a wide variety of different types of ethnic food; I collected a plateful of appropriate bits for Katie, and she munched away very happily while I ate).  This latest restaurant visit was for the small party Barry's parents held to mark their ruby wedding anniversary.  I approached the evening with a certain amount of trepidation (get two small children into smart clothes and keep them looking appropriately presentable at least until after the first round of photographs?), but it went rather well – everyone cooed over Katie and she managed not to spit up on her party dress.  Barry took charge of Jamie during the meal and I gave Katie the toast-and-paté starter and a selection of vegetables from the serving dishes, the combination of which kept her happily occupied for long enough for me to eat a quick meal myself before rushing off to take my turn following Jamie, who had, as usual, decided to wander around the place once he finished his food.  All in all, it was a pretty good evening.

So, she is now taking steps (literally and figuratively) in the general areas of upright locomotion, use of opposable thumb, and possibly expressive spoken language.  That seems to be the three major evolutionary landmarks that separate humanity from other animals, right there.  Pretty impressive going, I'd say.

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The night weaning story

On the basis that I'm probably not the only person who finds it
useful, or at least interesting, to read about how other people have
handled various parenting problems, I'm posting the detailed
night-by-night record I kept of how the night weaning went.  If you're not interested in such things, this will be a long dull post to plough through; by all means skip.

The
backstory: Although I always tried, with general success, to avoid
nursing Katie to sleep (because that's the sort of thing that sets up
the dreaded Sleep Associations and thus ultimately makes it harder for
children to learn to get to sleep on their own, which then makes them
poorer sleepers overall because they can't get back to sleep themselves
when they wake up in the middle of the night), I did nurse her into an
appropriate state of drowsiness prior to each nap and bedtime.  I also
had a low threshold for offering her the breast whenever she woke up (I didn't want to be spending ages trying to put her back to sleep if all the time the problem was actually that she was hungry, and it was a simple enough thing to check),
so she was getting nursed several times each night. Thanks to co-sleeping, this wasn't actually anything like as bad as it sounds – when she woke up after I'd gone to bed,
I'd just hoik her out of the cot, haul her into bed with me, park her on my nipple, and go back
to sleep myself.  However, it was nevertheless becoming a mite awkward; even without nursing to sleep, it seemed that the nursing was having an
effect on how well she slept.  She was waking more often in the evenings and I was spending more and more of each evening nursing and resettling her.  In the daytime, her naps were far too short because she couldn't get back to sleep when she surfaced before the end of the nap. 

All this was something of a nuisance for me.  For Barry, it was rather more than just something of a nuisance; he had to deal with her during the day without benefit of breasts, and the problems he was having with getting her to nap properly and with dealing with the moodiness that resulted from her not napping properly were making his life miserable. Eventually, a week and a half before she turned ten months old, I got home one evening to find a very irate husband issuing me with an ultimatum; Katie was becoming impossible to look after in her current state of sleep ability, and I'd better wean her.  Now.  I hastily suggested night weaning as a reasonable compromise, Barry agreed, and we started that night.

My night weaning method is simple enough; give baby a bottle at night instead of breastfeeding so that I know how much they're taking, and then cut down at a reasonable rate so that I can feel confident that any upset they feel during the process is only due to annoyance at the change of normal procedure and not due to actual hunger.  (The latter I figure I'm obliged to do something about; the former I don't.  Therefore, I like to be able to tell which is which.)  This is how I night-weaned Jamie, but it was a whole lot easier in his case for two reasons.  Firstly, he would happily drink milk straight out of the fridge and thus I could simply put the portable fridge next to my bed, put a bottle in it prior to going to sleep, and still feed him at night without needing to get up; secondly, switching him to the bottle confirmed that, as I'd suspected, he was hardly taking any milk at all, and thus I could simply cut the feeds straight out.  I tried giving him a dummy instead, he accepted it with a minimum of sleepy fussing, and that was that.  I think I probably have one of the easiest night weaning stories of all time. 

Of course, things weren't so easy the second time around.  Katie, as I'd thought, was indeed taking a substantial amount of milk during the night.  What's more, she insists it being served warm.  So, two children down the line, I got to find out just what I'd been avoiding by breastfeeding and thus not having to get up and warm bottles during the night.  It wasn't actually as bad as I'd anticipated, once I gritted my teeth to the necessity of it all – I held her against my shoulder while the bottle heated, sat on the bottom of the stairs for a rather nice snuggly quiet few minutes of feeding it to her, and then took us both back to bed – but I'm still glad that I wasn't doing this for months of her babyhood.  So, if you happen to be trying to decide whether to breastfeed or formula feed an upcoming baby, I have no intention of getting all preachy on you but I can definitely recommend breastfeeding from the practical viewpoint as well as the health viewpoint.

Since the whole point of all this was to break the feeding/falling asleep associations, I also stopped giving her any feeds in the bedroom (I've loosened up on that one since, but this was what I did at the time).  Prior to this she'd had the first side of her bedtime feed downstairs so that I could spend some time with Jamie and the second side upstairs in hopes that this would help relax her and get her ready to fall asleep, but I started giving the full feed downstairs and going upstairs after that.  (Which meant that this was a useful point at which to start brushing her teeth after the bedtime feed, as well, which I'd been thinking I should probably do; so that worked out well.)  For night feeds, I took her downstairs (hence the sitting on the stairs as mentioned in previous paragraphs).  Paradoxically, this meant that I was actually doing stuff that was possibly counter-productive from the point of view of getting her to sleep, but I figured I'd worry about one thing at a time and I'd concentrate on getting her off to sleep without the incessant feeding first.

So, the lengthy and tiresome night-by-night details:

Monday 15th September
(Night 1)

I put her to bed around 8-ish after having given her her night-time feed downstairs.  She settled fairly quickly.  She woke up some time after 9 p.m but settled with me giving her a cuddle, turning the musical star on, and
sitting with her for a bit.

She woke again around
11.20 and I did the same, which seemed to work at first.  However, by 11.40 she was awake again.  By that time we'd made some formula for the next day, so Barry gave
her a 7 oz bottle.  After a bit of turning her head into his arm in a futile attempt to nurse, she accepted the bottle and
drank all but the last few drops, then settled after only a minute or two of crying.

She then woke up around 4 a.m. and I tried taking her into bed with us to settle her.  However, after five minutes of screaming I gave up, got
up, & gave her the 6 oz bottle I'd prepared earlier.  (This was actually watered-down cows' milk – I hadn't expected she'd need any more formula than the 7 ounces.)  She took the lot and, although she was still a bit squeaky and unsettled afterwards, she was calm enough to settle down in bed with me and fall asleep until 6.05.  At that time, since there wasn't any more milk prepared, I tried taking her downstairs to nurse her, but she only seemed to be comfort sucking rather than actually taking any milk, so I took her back upstairs again and back to bed and got her to settle for about another half hour.  She woke up at 6.38 and seemed quite awake, so I just went ahead and got both of us up.  End of Night 1.  Grand total of milk consumed: 13 ounces.

Tuesday 16th September
(Night 2)

After a day of trying to ensure she ate plenty of solids (it was my day at home with the family), I put Katie to bed around 7.00 – this was a bit earlier than normal (bedtime is generally from 7.30 onwards depending on how late I get in and how long the bedtime routine takes) but she was looking exhausted.  I'd already misjudged things once with her nap and accidentally nursed her to sleep because I hadn't realised quite how tired she was – not, obviously, something I wanted to be doing at this point.  As it was, she was nearly asleep when I put her in the cot for bedtime, though not too asleep to wake up and scream when I switched the musical star on.  I don't know whether she was just annoyed at being disturbed when she was so close to falling asleep, or whether she'd worked out that this was the signal that all parental presences were about to remove themselves from the vicinity.

She had a very unsettled evening, drifting in and out of sleep – she woke up half an hour after going to sleep although I settled her again fairly quickly, kept crying out in her sleep every so often while Barry was showering, woke up again at 8.45 (I tried taking her downstairs for a feed that time in case she was hungry, but she didn't seem that interested and settled quickly when I took her back upstairs) and at 9.20 when I brought a bag of laundry in.  That last time, although I tried to settle her by sitting by the bed with my hand on her, I eventually did have to leave her alone for a few minutes of screaming (six, in case you were wondering), to get herself off to sleep.  At 10.45, when she'd woken up yet again and this time wasn't showing any signs of settling down after a few minutes, I tried her with some milk again and this time she took 3.5 ounces.  After that, she eventually settled down (it took a while) with me sitting next to her. and slept through until 3 a.m., when I took her into bed and she settled down again within a couple of minutes.  At 5 a.m. she woke up and seemed hungry, and I went ahead and gave her 7 ounces of milk.  Total milk consumption during the night: 10.5 oz.

Wednesday 17th September (Night 3)

When I got in from work, Barry reported that Katie had drunk three ounces more than usual of formula during the day.  Although this might or might not have been a coincidence, this was almost exactly the amount by which she'd cut her milk intake on Tuesday night compared with Monday night; I hoped this was a sign that she was shifting her intake from night to day.  Her napping, unfortunately, was as bad as always, with her waking up from both her naps after only 45 minutes and refusing to settle again.

I put her down to sleep at 7.30.  It took a while to get her to settle (I spent twenty minutes sitting with her and resting my hand on her, lying her back down again every time she tried to sit up, then tried leaving her for about eight or nine minutes to see whether she would settle more easily without me there, then went back in to comfort her again as she was screaming instead of settling) but, when she did fall asleep, she slept through to 12.45 a.m.  At that point I came out of the en-suite bathroom after my shower, and the snick of the door woke her.  She had slept through more disturbance than that during the evening, so presumably she'd been close to surfacing anyway at that point.  Anyway, I gave her a bottle and she took 3 oz and then took around 20 minutes of me sitting by the bed for her to settle again.  She woke up again just before 2 a.m. (I think that was actually the waking-at-45-minutes thing, since that was about how long it had been since she'd gone to sleep) and I took her into bed, which settled her down.

She woke up again shortly after 4 a.m.  I had a 5 oz bottle prepared, as I wanted to start to reduce the amount she took, and she drank it all (she looked a bit taken aback at finishing it, but settled down after a few minutes of me walking around with her).  She woke up again at 5.50 and seemed upset.  I thought she might be hungry and took her downstairs to nurse her (I didn't have any more formula prepared) but she just seemed to be comfort sucking; I brought her back upstairs and put her on the bed with Barry (I was up and getting ready for work by then).  Total milk consumption during the night: 8 oz.

Thursday 18th September (Night 4)

Again, she drank around 23 oz
during the day. Barry was too fed up even to tell me about what her napping had
been like, which was presumably an answer in itself.  That set the tone for the night.

I tried sitting with her as usual to get her to settle, but she was obviously in a mood to keep fighting off sleep and trying to play with me as long as I was there.  In the end, I went out and let her scream about it.  She settled down within a few minutes of me leaving.

She woke up forty minutes later.  I went in and sat with her for ten minutes.

She woke up around 10.45 p.m and I sat with her for nearly an hour before she settled.  (Some of this was due to Barry, who'd just had a shower, drying his hair and getting dressed – that did make it harder for her to get back to sleep.)

She woke up at 12.45 a.m.  I offered her a bottle, but she didn't want it.  When I tried to put her back in her cot, she screamed; that one-note waah that babies do when they're tired, that Tracey Hogg calls the 'mantra cry'.  As usual, I tried sitting next to her with my hand on her to settle her, but it didn't seem to make much difference to her – she went on crying.  In the end, I left her for just long enough to get a quick shower and by the time I got back to her fifteen minutes later her crying had tapered off, but she Just. Would. Not. settle down completely.  I sat with her for over an hour, trying to get her off to sleep; she kept seeming nearly settled and then waking up and sitting or standing up.  In the end, I lay down on the bed with my hand through the cot bars holding her, mumbling "Bedtime, Katie" at her when she stood up again.  In that way, I managed a quick doze for around 25 minutes before waking up to see her wide awake and very cheerful about what an excellent game this was.

By this time, it was around 2.35 a.m.  I tried taking her into bed to settle her down, whereupon she gurgled happily and grabbed at my face while I tried
to sleep. I tried taking her downstairs for her bottle, but she still didn't want it.  Finally Barry, who was coming up to bed at this time (this is not unusual for him – he is a complete night owl), offered to take on the job of holding her while at least I got some sleep, and I finally dropped off around 3.20 a.m.to the sound of Barry struggling to keep her lying in one place rather than crawling round the bed and playing.  He told me the next day that she'd stayed awake for ages after that, struggling and screeching when he tried to keep her still.

She did in the end fall asleep some time before 5.00; I know this because that's when I had to wake up to get ready for work.  When my alarm went off, she was peacefully asleep in the crook of Barry's arm, looking quite angelic.  She woke up again at 6.15 and I gave her a 6 ounce bottle; she drank it all and settled down without a whimper when I put her back on the bed next to Barry.  Total milk consumption during the night: 6 ounces.  Total parental sanity consumption during the night; practically all of it.

Friday 19th September (Night 5)

Things fortunately started to improve.

Katie settled to sleep just after 8 p.m, after only a few minutes crying.  The phone rang around 9 and woke her up, but she settled again within a few minutes and then slept all the way through until 2 a.m.  At that time, she seemed quite happy just to be picked up, but I gave her a bottle then anyway, figuring that if she was going to need some milk during the night (I didn't quite have the nerve to expect her to go all the way through without a feed at this stage) then I'd rather she take it earlier than later so that it didn't have a knock-on effect on her breakfast.  Besides, if putting her back down was going to be the same kind of hassle that it
had been the previous night, I wanted to at least be certain
before I started that hunger wasn't the issue.  (I can only assume that that last reason made some sort of sense at 2 a.m. after a night like the previous one.)

But this time it all went smoothly.  I gave her a 6 oz bottle, she
took nearly all of it, I put her back in her cot, and she drifted back off to sleep without a murmur.  She woke up again
sometime around 6, and I think I just took her into bed (by then, I
was in a sleep-deprived fug), and then she slept through until 7.35.  Total milk consumption during the night – around 5 oz or so (yes, I'm sure in retrospect that I could have reduced it further compared to the previous night, but I'm also sure you'll understand why my priority that night was to get both of us the hell back to sleep as quickly as possible, even if that wasn't the best way to obtain longer-term gain).

Saturday 20th September (Night 6)

(This night I didn't get a chance to write up until more than 24 hours later, hence the vagueness on some of the details.)

Katie woke up twice during the evening, which was a bit awkward as Saturday is one of my nights for putting Jamie to bed and thus I was occupied.  The first time Barry went to her and she settled down fairly shortly, but the second time Barry was in the shower and I had the choice between going to her with Jamie leaping around in the background or leaving her alone crying.  (Going to her while Jamie stayed in his room was not, I knew from experience, going to be an option short of applying physical restraint.)  As it was tired whingy I-need-to-get-back-to-sleep crying rather than frantic I-need-help crying, I opted for leaving her, and just tried to finish off Jamie's stories reasonably quickly.  It took about 30 – 40 minutes before I could get to her, but when I sat with her and rested my hand on her she settled down fairly quickly.

After that, she slept a nice long stretch.  She woke up around 5.15 or thereabouts and at first seemed to settle when I took her into bed, but by around 5.40 she was getting restless and squeaky and seemed hungry.  I gave her a 5 ounce bottle of formula and took her back into bed with me, and she settled down until morning.  Total nocturnal milk consumption: 5 ounces.

Sunday 21st September (Night 6)

On Sunday, it occurred to me to try giving her a formula top-up after her evening breastfeed.  She took 3.5 oz, settled after the usual few minutes of crying, and woke up three times during the night.  Once in the evening, when I was able to settle her as usual; once some time after 2 a.m., when I took her into bed and she settled; and once around 5.15, by which time I was up and getting ready for work and thus left her on the bed with Barry.  I went downstairs and switched the bottle warmer on in readiness, but it wasn't needed; by the time the water had warmed up, the sounds from the baby monitor had settled.  She'd gone back to sleep, and she stayed asleep through until morning.  Total nocturnal milk consumption: zero.


Epilogue

Looking back on that account now, my main thought is that I was probably quite excessively soft-hearted in how I went about it.  I daresay that she would have been fine with me cutting down the milk more quickly, and I think, with the benefit of hindsight, that all those lengthy attempts at settling her gently to sleep were probably what was keeping her awake for so long.  I suspect she'd actually have gone to sleep far more quickly if I'd just walked out and let her cry for a few minutes.  (Which is, in fact, what I now do when putting her to bed; I can't remember when I finally started doing that, but now, when it's time for her to go to sleep I put her in the cot, kiss her goodnight, and walk out.  She cries for less than ten minutes, of which a few seconds is indignant yelling and the rest is whingy tired crying.  I've tried going in during the whingy tired crying to see whether that comforts her, but invariably it makes things worse – going in wakes her up just when she's dropping off, and that gets her more upset.  Sometimes she just seems to need to cry for a few minutes before she goes to sleep, and I've learned that we're both better off if I just leave her to it.)

However, I'd rather err on the side of excessive gentleness than otherwise; and the way I did it did accomplish the goal.  In the subsequent weeks, Katie's sleep has improved considerably.  Not so much her night sleep (that improved as well, at first, but then it got worse again and has now reached the point where I'm once again taking active steps to improve matters; but that's a whole other story, and a longer one than I've got time for here) but her daytime and evening sleep.  She's now settling far more quickly and easily, sleeping through the evening, and taking two long naps a day.  And we're all happier for it.

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Filed under Don't let the bedbugs bite, Here Be Offspring, Milky milky

Fireworks

"Can you see the fireworks, little one?" Barry hoisted Jamie up into position on our bedroom windowsill.

"Oh, yes!  They're over there."  Jamie pointed, bouncing up and down with excitement.  "And there are more!  And more!  And maybe that one's red.  More and more!  They go 'Zeeeeeeoooooooow', and then there's a bang.  Crackle, crackle!  Sparkle, sparkle!"

Exactly three years ago, I was in that same bedroom, though with somewhat less furniture, vastly less assorted clutter, and fifty per cent fewer children.  We weren't due to move into the house for another three days, but it had a good view of the local firework displays and so we took the chance to spend Bonfire Night there.  It was one of those wonderful heartfull moments, with the three of us snuggled up together on the bed and Barry and I having one of our few chances for a peaceful chat about inconsequentia.  I thought contentedly of the Bonfire Nights we would enjoy similarly in the years to come.  And here we are in one of those years, with Jamie now almost four and his little sister now a part of the family, balanced on my hip as I stood behind him.  As treasured moments go, it was a lot less quiet and peaceful and a lot more bouncy than the moment I'd treasured three years ago at that time.  But there it was, one of the future Bonfire Nights I'd anticipated, one of the magic moments I'd looked forward to; and I am pleased to report that I am every bit as happy with my life now as I'd believed then that I would be.

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Filed under Here Be Offspring