Developmental Evaluation

Isaac had his first developmental follow-up appointment today at the Neonatal Clinic. There was a few people at the appointment--a nurse, a developmental nurse, a physical therapist and the neonatologist. Basically they played with Isaac for 20-30 minutes and evaluated his development.

(They base the evaluation on his adjusted age of five months. Until he is 2-3 years old, they look to see if he is on par to where he would have been if he was born on time. )


They determined that he is a bit behind in his development. Not in everything, but definitely in his muscle tone and motor movement. They said he was where they would expect a 3 1/2 month old to be. He has had so many strikes against him with being born so early and then being so sick in the NICU with his CMV that his body just wasn't doing anything beyond fighting being small and sick for so long. I know he will catch up from that, but it may take a while longer than I hoped.

I think the hurdle in his development since he's been home is his reflux. We give him as much "floor time" as we can to strengthen his muscle tone, but whenever he's not upright, his reflux really acts up and then he won't eat all day. I know he hasn't been getting as much time as he needs to strengthen his muscles. It's so frustrating.

The good news is I think we finally found a good stride with his eating. Fortifying the breast milk just wasn't working. The formula really exacerbated his reflux. We finally got him on a super gentle formula, similar to the Progestimil he was in the NICU, but while it didn't worsen his reflux, he simply refused to eat it. He would take only about half of what he should be getting--basically enough until he wasn't hungry anymore. I tried for a week to make it work and our stubborn little guy won out this time. :) So--he's back on just breast milk and in the three weeks he's been on it, he's gained a whole pound. A POUND people! After two months at 11 pounds, he finally made it to 12 pounds. I couldn't be happier! On just the breast milk, his reflux is back under control and he is eating like a champ. It was a struggle to get him to eat over 80 mls, every three hours. Now he's taking 120-150 mls!


So now instead of focusing all my time and attention on getting him to eat, I can focus it on getting him strong.

Other than that, he is doing so fantastic. He's back to his goofy self. He's still a bit of an attention whore who will yell at us until we pay attention to him--then he'll flirt and laugh and talk like he's been storing it up for days (even though it's just been an hour or so).

He's sleeping well and on a pretty good schedule right now. He'll sleep from about 7pm to 7am with a sneak feeding at 11pm (we feed him without waking him up). He takes a two hour morning nap and a three hour afternoon nap.

One other good thing that came up in his evaluation is his head size. Apparently his noggin is huge. :) Which is a good thing. He's still at risk for some pretty serious neurological damage as a result of his prematurity and CMV. Having a big head, means he has a big brain. When the brain is healthy, any nourishment the body gets, goes to the brain first. It's a great sign for his mental development.

We love our little man so much. He's really put us through the ringer since coming home--but it's still so worth it. We are so happy he is home with us and that we get to raise such a special little man.