Monday, December 18, 2017

Evan: 12 months!

Evan is one! You'd think by the third time my heart would be better prepared to handle a baby's first birthday, but that's a big fat NOPE! I was on the verge of tears - both happy and sad - all day. Thinking back to my pregnancy with him, his birth story, the ups and downs of his first's all just so, so precious to me. These babies just arrive and never slow and I want to be in the moment and freeze time and rewind time and prepare for the future all at once!

Evan is cruising, free standing for a moment, making new sounds, and playing games with us (like throwing and chasing balls). He's my little sleeper, and I've yet to discover how much sleep is too much sleep for him. I think this kid would sleep all day if I'd let him! Right now he's on a morning cat nap and mega nap in the afternoon, and then his standard 7:30p - 7a overnight.

He's not taking a very big bottle before bed (maybe 3 ounces), which is nice because it shouldn't be too difficult to cut that feeding out eventually. Now that he's one, I'm going to slowly start removing breastfeeding sessions and offering a sippy cup with his table meal instead. I have a feeling my supply my tank when I remove a feeding, but now that he's 1 I'm okay with that. I have loads of frozen breast milk stored up, and it's time to start transitioning him to other liquids anyway. I've found that he can't yet do dairy straight-up (like yogurt, cheese, or milk), so I'm going to offer him breastmilk in a sippy at first, then almond milk and/or water. My other kids long ago ditched the cow's milk and just drink water at every meal so that's the plan for Evan, too.

We had a very small little celebration with family this past weekend to celebrate his birthday. And now I have a one year old! I just know I'm going to blink and have a full blown toddler.

I don't have his weight or height stats yet because his well visit isn't until next week, so I'll have to update this post later with that (for my reference, mainly, haha!). Here he is in all his little cuteness!

Tuesday, December 5, 2017

Update on Stephanie

I haven't been very active on this blog (intentionally, since I got pregnant with Evan), and this post is a departure from my normal topics, but this felt like the best place to share this information as easily as possible with those that want to know.

This past October I suffered a brain bleed that has caused me significant vision loss. This bleed was caused by a cavernoma (more on what that is below). We've been waiting to tell people aside from close family and friends because up until today we simply had more questions than answers. Now that we have more information, we feel like it's time to share what's happened and what life will look like for our family moving forward. I'm so sorry if you're a close friend or family member and this is the first you're hearing about it; we weren't trying to keep this from anyone, it's just hard to bring up something so serious in casual conversation, and we really didn't have many answers until today.

{ what we know about cavernomas }
We are still learning more on a daily basis, but here is a summary of how we understand things right now. A cavernoma (also called a cavernous malformation, cavernous angioma, or just simply a benign brain tumor) is basically a cluster of unnecessary blood vessels that are thin and susceptible to bleeding. The damage done by the bleeding depends on where the cavernoma is, how often it bleeds, and how heavily it bleeds. The bleeds cause lesions (like scabs) and swelling, and all of that combined is what causes the symptoms that people experience. Sometimes the symptoms are reversible once the bleeding stops and the brain heals, other times permanent damage is done. This condition can be familial (hereditary) or spontaneous (non-hereditary). A person can develop more cavernomas over time, although that's most common if your condition is hereditary. They don't necessarily grow in size, but the effects of the bleed can spread farther each time (kind of like a bruise is much larger than the actual injury site). They don't know what causes them to bleed, although some have hypothesized things like hormones, high blood pressure, or excessive strenuousness activity. If the cavernoma(s) is located in a place in the brain that surgery is safe, they can be surgically removed. If removed, there is no more risk of bleed but there is no reversing any damage already done from the bleeds and there are serious risks involved with open brain surgery.

I'm recalling statistics that said roughly 1 in 600 people have a cavernoma(s) and 70% of those people never have a bleed or resulting symptoms. Of the 30% that do have symptoms, seizures or loss of gross motor function are the common symptoms with vision loss being less typical but still common.

{ my current condition }
I have 1 cavernoma, and it's 1-2 mm in size (small), and we believe it's spontaneous. It has bled once, that we know of. Mine is located in my right basal ganglia. The cavernoma is affecting my visual tract, which is causing blank spots in my vision field. I have a large (about the size of my hand) blank spot in front of my left eye on the bottom part of my vision field, and a small blank spot in front of my right eye in the center part of my vision field. The best way I can describe it is it's like wearing a pair of glasses with smudges on the lenses, and you're trying to see around the smudge marks. This affects me most when trying to read as some of the first part of every word is initially missing, and looking at people as part of their face is initially missing. My eyes have been compensating for this by rapidly scanning back and forth to fill in the missing spots, so I am eventually able to read and see people but it just takes me longer. My eyes also get tired quickly, and I've been having headaches that are common with eye strain. I've also got a bit of brain fog and I'm finding it harder to process new information or make decisions about things. 

About 6 weeks after what we now know was the initial bleed, I experienced a significant second decrease in my vision (it's when the blank spot appeared for my left eye, whereas I previously only had one that I noticed in my right eye). That was either a new bleed or it was just part of the healing process from the initial bleed (there is swelling as the brain reabsorbs the blood and that can make things worse before they get better). 

My cavernoma is not located in a place that's safe to operate. My symptoms would have to be so severe that the risks of brain surgery would seem inconsequential to us.

It's not totally back and white, but it's been said my risk of re-bleed is only 6% within a 12 month period.

My limitations are few: in regards to the cavernoma, I should avoid blood thinning medications and supplements. In regards to the vision loss, I need to take that day by day to see what I'm comfortable doing. In regards to the headaches, rest helps the most and my husband is very on-board with getting me rest!

The best case scenario is that my vision would return as the bleed heals, and that I would never have another bleed. Worst case scenario is that my visual tract is permanently damaged, or that I continue to have bleeds that cause worsening symptoms.

{ timeline }
October 19th - noticed problem with my vision in my "good" eye*, but I waited a week to go in because I was hoping it would resolve on it's own. I've had headaches cause vision problems in the past, and although I didn't have a headache that day I was still just hoping whatever was causing my vision issue was temporary.  *I have one good eye that sees 20/20 and one bad eye that sees 20/200 because of a congenital cataract.

October 25 - visited my optometrist, and my eyes were fine. He had me do a field vision test, however, and that revealed some blank spots in my vision that were consistent with what I was telling him. He referred me for an MRI.

October 28 - MRI

October 31 - picked up MRI results, talked with my optometrist about the findings and he referred me to a neuro-ophthalmologist. At this point we could see the cavernoma on the MRI results but had no idea if that's what was causing my vision problems, and no idea what a cavernoma even was.

November 7th - saw a second optometrist for more detailed testing of my eyes, including photos of my optic nerve, just to make 100% there was nothing wrong with my eyes. My eyes were fine.

November 13 - visit with the neuro-ophthalmologist. He confirmed the MRI report findings of a cavernoma, and was able to determine that the resulting lesion is in a place in my brain that's affecting my visual tract. He then referred me to a neurointensivist to deal more directly with the cavernoma.

December 1 - repreat field vision test documented 2nd decrease in vision

December 5 - visit with the neurointensivist, where we asked dozens of questions to try and get the best understanding of what is going on.

{ what happens next }
Right now, we wait:
  • We wait to see if my vision is restored, which would likely happen within the next few months if it's going to happen.
  • We wait to see if there is another bleed.
  • We wait to see if I ever develop more symptoms.
  • We wait on the Lord, which is something He has already walked me through once before and I know He'll do it again.
Next appointments: 
  • Angiogram in early January to get a better picture of the cavernoma and what the blood vessels are doing.
  • Repeat vision field test in 6 weeks to see if vision has improved, stayed the same, or decreased.
  • Follow-up with neuro-ophthalmologist in February to check on my vision and see how I'm coping with any still-present vision loss.
  • Follow-up with neurointensivist in March to discuss any change in symptoms and re-assess our current options.
Continue to collect information: 
  • There's no known treatment or prevention for these bleeds, but I'm always up for entertaining ideas of how to promote brain health. If you have any, please email me!
    •  I'm currently seeing my chiropractor (with modified adjustments), using essential oils, and taking some supplements (looking at adding magnesium threonate and spirulina).
    •  I eat a healthy diet full of veggies, seeds (flax/hemp/chia), beans, some meat, some grains, and very limited dairy and sugar. 
    • I limit caffeine, do moderate exercise 1-2/week (outside of caring for 3 small children!), and get decent-ish sleep (despite said 3 small children).
  • I have three main doctors overseeing my care, but am open to second opinions!
    • Dr. Karrick is my optometrist at Edmonds Eye Care who does the field vision tests
    • Dr. Hamilton is the neuro-ophthalmologist at Swedish Cherry Hill, he is overseeing the vision loss related to the cavernoma
    • Dr. Loh is the neurointensivist at Swedish Cherry Hill, he is overseeing my care related to the cavernoma
    • In the coming weeks, I'm potentially meeting with Dr. Monteith (neurosurgeon at Swedish) and/or Dr. Sekhar (neurosurgeon at UW/Harborview)
I've found this website as a great resource:, but would love to read (slowly, haha!) other sites with information. If you know anyone who has this condition, I'd love to talk with them.

{ praises }
  • I only have ONE cavernoma!
  • It's only bled ONCE (that we know of) and it was a small bleed!
  • My cavernoma is NOT hereditary, meaning my kids have no increased risk of this condition!
  • I only have vision loss; no seizures or loss of gross motor function!
  • I don't have a cancerous tumor!
  • My vision loss was not from a stroke!
  • This condition is not fatal!
  • I can still drive!
  • My eyes weren't the problem!
  • God WILL heal me, whether on earth or in heaven!
{ prayers }
  • Complete restoration of my vision
  • No additional bleeds
  • No additional vision loss
  • No additional symptoms from any additional bleeds
  • No seizures
  • Less headaches
  • Pray that doctors would find a way to treat or even prevent ALL cavernomas for all people!

{ how I'm doing }
I can still drive, but prefer not to drive in the dumping rain or at night so sometimes I may ask for a ride somewhere or ask someone to pick up my kids. 
Some days my eyes do better than others, so if I'm slow to respond to a text or my response is short please forgive me! If you're talking to me and I look confused, I'm having a heavy brain fog day and it's taking me longer to track with what you're saying.
Family (usually my dad) has been able to watch the kids for all of my appointments and tests so far, which is so great.
One of my favorite hobbies is reading books, so I've switched to audio books (using Audible) for the time being. 
I do all of the admin stuff for our family, and I'm still able to do that but it just takes me longer now (both to read and to think). 
I love knowing what's going on in the lives of my family and friends (the good and the bad!), so please please please don't stop telling me things or asking me for mom advice. I may not have all my vision or a clear mind but my heart for my friends and family is still the same!

God is good and in control, and I put my hope in Him. My family puts their hope in Him. We firmly believe that everything God does is for His glory and our good, and that hasn't changed. I don't know why He is allowing this, but I know He can heal me at any moment by any means. I love God, I love my husband, and I love my family. And I'm going to serve God, my husband, and my family until the Lord renders my body useless. 

"The Lord gave, and the Lord has taken away; blessed be the name of the Lord." (Job 1:21)

Tuesday, November 28, 2017

Evan: 11 months

Evan's bad mood seems to have passed and he's having happier days again. He is getting better at expressing himself - like getting excited when he sees Kyle or my dad after they've been gone at work, or by throwing little baby tantrums when a toy isn't doing what he wants it to. He's getting around the house just fine by crawling, so he hasn't shown much interest in cruising yet. He's got the skills, but it just hasn't clicked yet. He scoots up the stairs so fast though! Now we need to teach him how to safely get down them.
Meals are going well, and I'm still nursing him 3 times a day, and then a small bottle of breastmilk at bedtime. I think at this point my plan is to just nurse through 12 months and then go from there. I never thought I'd be someone to go a full year of nursing, but here we are...might as well make it the whole way!
I don't have any big plans for Evan's first birthday. Partially because I'm must totally in denial that my baby is 1, and partially because of the holidays...and because he's 1 and has no idea what's going on, and already has every possible toy a 1 year old could need!
Love this baby boy of ours!

Wednesday, November 1, 2017

Evan: 10 months

(Evan was 10 months on October 16th)

Evan is doing great with crawling! He crawls everywhere now, including up stairs. He has also started pulling himself up to standing and is flirting with the idea of cruising. He's also been fond of the "all-fours" pose (like the pic above). Each day he seems to get a little more confident with this gross motor abilities. His PT was so pleased with the progress he's made, and we're considering him "caught up" at this point! 

Evan finally had surgery to repair his undescended testicle. It happened really quickly after we had the consult with the specialist. The Lord really gave us peace about the decision ahead of time, and the surgery went wonderfully. He did have to be fully put under, and I got to stay with him until he was asleep and then was reunited with him before he woke up. He recovered within a day, in terms of mobility. The surgeon was able to descend his testicle as well as repair a significant hernia. All in all, it went really well and I'm thankful this is all behind us now.

That being said - Evan has had a really, really fussy month. There could be a million reasons why: teething, new skills, growth spurt, cold/sickness, appetite changes, emotional development, the disruption of his surgery. He's been sleeping a ton, refusing purees (only wants finger food) and taking full nursing sessions still. He escalates so quickly when I leave his side, lay him down on the changing table, or put him in his car seat. He's still cute as a button though, so I've been as patient as I can be with him while he goes through this phase.

He's still nursing, and I think I'm safely in the zone where I could wind down the nursing and have enough freezer milk to last him until he's 12 months old. But it takes time and effort to end nursing, so I keep putting it off. I'm still producing so much milk that it's just hard to stop a good thing, ya know?
We're starting to see more of his personality come out, and he may end up being a bit feistier then he's previously let on. I'm so excited to get to know him better as he continues to grow. My baby boy! Love him!

This month's photo session is an accurate depiction of his mood right now, haha

Tuesday, October 3, 2017

Evan: 9 months

Evan was 9 month on September 16th, so I'm a tiny bit behind :-)

Evan is crawling! He finally took off crawling just shy of 9 months old. He's now very content to be plopped down in the playroom and just busy himself among the kids and toys. We're still working with the PT to continue to improve some of his gross motor skills, but overall I'm so pleased with his progress. Just today he started clapping (at a football game, no cute is that?!), so I know he's going to continue making progress just fine.
He's got 7 teeth, and he's weighing in at 19.5lbs. He's 28.5 inches tall, and his current car seat height max is 32 inches so I'm hoping to keep him in that seat a bit longer. We do have a convertible seat ready for him when it's time, but the infant seat is just so convenient to click right into the stroller when we are out at about.
He's been babbling quite a bit lately, and started playing games with us. He's favorite is just shaking his head back and forth and laughing. The kids love joining in the fun and engaging with him, and I'm just so happy with how well they are all getting along right now. Drew really steps up from time to time to help me with tending to Evan or Mary, and even Mary has started helping here and there. I'm really trying to teach them how to look out for each other and not just rely on me to mediate their relationships. I love it when I see Mary go to Drew for help with something, or I watch Drew grab Evan a toy to chew on if he's getting fussy. Evan really, really likes Drew and considers Drew a suitable replacement for me or Kyle if he's upset. But it's very clear that I'm Evan's favorite, and I'm totally okay with that :-)
He's still nursing, which is so fun. I do feel like he's been getting less interested in it recently, and his solids intake has really increased. So this may be the final descent in our nursing relationship. I have about a months worth of milk frozen, so I'd love to make it to 11 months old with nursing and then do frozen milk until he's 1, but we'll see! We are having a lot of fun with solids. I've mostly done veggie purees that I make at home, and then these last few weeks I've been doing more purees of whatever we are eating for dinner. This week I made some batches of pancakes using the Trader Joe's pumpkin pancake mix, but adding in spinach to one batch and sweet potato to another. Both batches I made with coconut/almond milk and coconut oil instead of milk and butter, and then I also added a chia/hemp/flax seed blend to both. The texture and consistency of the pancakes are perfect for him right now!
Sleep is going great, he's on 2 naps a day. I've started capping the first nap to be shorter just to line his second nap up better with Mary's nap and Drew's quiet time. I've been trying to get to bed earlier at night so I'm really relying on that 1-2 hours in the middle of the day to tackle computer work so that I'm not up at night doing it.
Lastly, we finally had Evan's consult for his undescended testicle. They located the testicle (phew!) but he will need surgery to correct the issue. They will also assess his descended testicle (as it may not be fully descended either), check for hernias, and check for any other abnormalities. I really like his doctor; she studied at UW medicine, trained at Seattle Children's, and now works at Swedish. Also, one of my best girlfriends also works at Swedish in another field but highly recommends this doctor - so that is great peace of mind!

Wednesday, August 30, 2017

Evan: 8 months

I think the biggest deal in Evan's life right now is he's finally rolling from back to tummy! He does this while he's sleeping, and now I typically find him on his tummy when I go into wake him up. Also, we've started physical therapy with him here at the house to help him work on some other gross motor skills. It's a really neat program through the county, and they send someone out to the house so I don't have to pack everyone up which is so great! When they did the assessment, he actually didn't qualify as having any significant delay. But the gals doing the assessment saw my concern and decided to override the score and qualify him for services. We're only doing 30 minutes every other week, which is hardly anything. I love the PT that comes out, she's so friendly and knowledgeable. We have a great time playing with Evan on the floor and she shows me little moves for him to practice so that we can get him motivated to make progress on his gross motor skills. He's already advancing and it's so cute to watch him grow! Hopefully by next month he'll be crawling and maybe even cruising.

We're still nursing, which is so fun. Older babies really know how to take care of business while nursing and it's so much easier than nursing a newborn! Still staying away from dairy, but not as strict as I previously was. I have yet to introduce him directly to dairy, and I'm not sure how and when I want to go about that.

Tuesday, July 18, 2017

Evan: 7 months

Evan had his 6 month appt a month late because I wanted it to coordinate with the kids 2 and 4 year well child visits. What a circus that was! Bless my husband for wrangling the kids in the waiting room while I cycled through children in the exam room. Fortunately our pediatrician is simply wonderful and it was so great to be able to do all three kids at once. Anyway - I finally got some updates stats on Evan and got to ask some questions about lingering issues he's having. Despite his chunky thighs, he's actually not all that big for his age. At 17.5lbs and 27 inces long, he's in the 35-37% for weight and height. This is confusing to me because he's about to grow out of his 9-month bodysuits, so I'm not sure how a baby that fits in 12-month clothing is only in the 35% at 7 months old...but, he's sitting nicely on his growth curve so I'm not concerned.

He's cut his two front bottom teeth, which is a new experience for me in terms of nursing. Normally I wean around 6 months old, but I don't have any desire to do that with Evan so we're forging on. But teeth = not fun. So I guess I'll be cracking down on teaching him proper nursing behavior, because the latch and then turn your head to look at your siblings move is getting old (and painful). 

I had two other concerns at today's appointment, one being his undescended testicle and the other being that he's not rolling from back to stomach yet. I probably wont say much more about his undescended testicle just to respect his privacy, but from what I understand it's a simple procedure to correct and we'll find out more when we meet with the pediatric urologist in a few months. His ped was waiting until the 6 month mark to make the referral, and now it's time to move forward with accessing things further. 

I had a hunch that his superman reflex has something to do with him not rolling back to front, and his ped agreed. Whenever I pick him up or place him on his tummy, he pushes his arms out straight behind him (like superman pose). He also sleeps with his arms tucked under his back. His ped isn't too worried about this long term, but our county offers a program where a PT will come to your house and work with baby to correct any motor delays so I think we're going to take advantage of that. Fun times!

I'm still off dairy, although I think at this point he could tolerate it reasonably well. However, since I've been off dairy my headaches have nearly disappeared! I've suffered from tension type headaches for a decade, at least. Who knows if it was dairy related the whole time, but I figured it out when I trialed back on dairy a few months ago. I had such a strong headache the next day! So then I went back off dairy for several weeks, and 2 months later tried again and the headaches returned. So that was enough evidence for me to lead me to decide to give up dairy for good. At this point, if I can avoid it, I do. If I ingest a bit on accident though, I don't fret about it too much. I just know that I'll have a headache and Evan's spit-up will be more frequent for a few days.

He's still sleeping great. I've been extending his wake times a bit to keep up with his needs. He's down to 2 naps now (most days) which is nice!

Evan enjoys sitting up, his jumperoo, stroller rides, playing peek-a-boo with Drew, and smiling. He seriously smiles all day long and it's adorable. He's so squishy and happy and we just love him!

Monday, June 19, 2017

Evan: 6 months

Evan is doing so, so great. He's such a happy baby, it's hard not to smile at him when he's around because his cheeks are always so rosy and he's just so cute and smiley.
He's on a 4 hour feeding schedule with 4 liquid feedings and 3 meals of solids. He's doing much, much better with the spoon in his mouth so now that he's officially 6 months old I'm introducing a wider variety of solids: squash, sweet potato, banana, avocado, green beans, pears, applesauce, carrots, and prunes. The solids have made his digestive track slow way down, so we do prunes one meal a day to keep things moving. Breastfeeding is still going great and I'm still off dairy.
He's almost sitting up on his own now, and he's found his feet which will likely lead to rolling over back to front soon. He lays on his back and grabs his feet and kind of rocks back and forth. Although he hates tummy time, so I doubt he's that motivated to roll onto his front. 
He's getting coordinated at grabbing toys and bringing them to his mouth to explore, so we have to make sure there aren't things within his reach that he shouldn't have because he's quick!
His 6 month appointment isn't until next month because I lined it up to coincide with the kids 2 and 4 year well-child visits, so I don't know Evan's stats right now but my guess is he's on the same growth curve and doing just fine. He's so adorable and we love him so much!

Tuesday, June 6, 2017

How to Get Baby to Sleep

If you've found this post, it's because you're looking for ways to help your baby sleep. Welcome, tired mom friend!

Warning: long post ahead.

I've racked my brain for several weeks and compiled everything I can think of that's relevant to baby sleep. I'll continue to update this post overtime as I think of or learn new things.

The information below is compiled from the Babywise book, my friend Val at the Chronicles of a Babywise Mom, countless tips and strategies shared by hundreds of women over several years through I Love Babywise and Babywise Mamas, my pediatrician, and my own personal experience with my kids and the bonus kids that I've nannied or cared for over the years. You'll notice below that I don't take much time justifying the information provided; chances are if you are reading this post, you believe it's possible for your baby to sleep through the night and you don't need convincing so much as you need explaining of how to help your baby reach this milestone. If you're still in the "needs convincing" stage, then you're likely not in a good place to coach your baby through this milestone and you'll want to spend more time researching various sleep training methods to suite your family's beliefs, goals, and lifestyle.

It goes without saying - but I have to say it - I'm not a doctor or medical professional. The information given here is not medical advice. You are your child's mom and it's your job to know what they need and to provide it. If you baby is hungry, feed them. If your baby needs you, be there for them in whatever way they need you at that time.

OKAY - LETS GET STARTED! There are three sections below:
  • healthy sleep foundations
  • how to sleep train
  • addressing common questions
Heads up: if you are about to bring a baby home or have a baby just a few weeks old, you can read through Bringing Baby Home: Goals for the First Four Months where I lay out the order in which to implement the fundamentals of good sleep. If your baby is older than 6ish weeks, you'll want to continue reading and work on implementing the info below. Some of the elements below can be done right away, others will take a few days/weeks to see progress with. Change what you can right now, and work on the other things as you're able. Whatever you do, just keep going! Your baby is counting on you to help them learn healthy sleep habits.

{ healthy sleep foundations }
A baby sleeping through the night is about so much more than just their sleep; baby's feedings and time spent awake both affect their ability to take naps and sleep through the night. The info in this section is arranged in "eat", "wake", and "sleep" because that should be the rhythm of your baby's day. 

{ full feedings } A hungry baby wont sleep long. That means full feedings are the first step to a baby sleeping for a full nap or through the night. A full feeding for a newborn is considered 10-15 minutes per side, if nursing. As baby gets more efficient at nursing, timing is less important than other cues: empty breasts, enough wet diapers and poos (check with your ped on what is "enough"), baby stayed awake for the full feeding, baby appears satisfied after feeding, and baby is making it until next feeding time without problem.

{ total ounces per day } Babies 1-6 months old need an average of 25 ounces of milk within a 24 hour period. If you're exclusively breastfeeding, you can determine how much your baby is taking per feeding by:
  • Taking baby to a breastfeeding support group for a feed and weigh
  • Pumping just before feeding time and seeing how much you put out to get an estimate of what you're capable of providing (this works best if your breasts "like" the pump)
  • Feeding baby a bottle of pumped milk or formula to get an idea of how much baby takes at a standard feeding (works best if baby takes a bottle well)
I've done all three of the above with all my babies and gotten consistent results across all three, so I am then confident that what my baby takes from a bottle is similar to what they transfer during breastfeeding. If I'm ever questioning, I take my baby back to the breastfeeding group for a feed and weigh as that's truly the most accurate way to tell how many ounces a baby transfers in a feeding session.

Getting baby to sleep through the night requires that baby's stomach is big enough to get enough ounces per feeding during the day to hit that 25 ounces ballpark. Some examples:
  • A 1 month old may take 3oz per feeding, thus requiring 8-9 feedings within 24 hours to get enough ounces per day. This requires feeding every 2.5-3 hours to fit 8-9 feedings in.
  • A 3 month old may take 4-5oz per feeding, and thus only needs 5-6 feedings within 24 hours. Those 5-6 feedings could happen during the day (7am, 10, 1, 4, 7, and 10pm) and that baby may then be capable of sleeping through the night.
  • A 6 month old baby may take 6oz per feeding, 4 times within 24 hours (about 4 hours apart during the day)
If baby is still waking to eat at night, the first thing to consider is if baby actually needs those ounces. If baby is under 10-12 weeks old, it's highly likely - almost without a doubt - baby still needs a middle of the night feeding to get all the ounces they need. Your job is to continue to push full feedings during the day so that baby soon wont need to eat during the night. Again, a breastfeeding support group that allows you to feed and then weigh your baby is the best way to determine how many ounces baby is transferring during a breastfeeding session. If you're bottle feeding this makes it super easy to tell how many ounces baby is taking per day.

{ day vs. night feedings } Day feedings should be happy, bright, and lots of eye contact. There should be much snuggling and smiling. This is a wonderful time to bond with your baby!

Night feedings, however, should be quiet, dark, and very little interacting. This is not social hour, this is time to eat and get back to sleep. It's okay to nurse directly to sleep for late evening or middle of the night feedings. As long as you're doing eat/wake/sleep during the day, nursing to sleep during the middle of the night will not create a bad habit. You certainly don't want baby having any wake time during the middle of the night! If you're going to do a diaper change at a night feeding, do it before the feeding so that there is no disruption if baby falls asleep while nursing. If baby poops while nursing, do change the diaper and then attempt to nurse just a little longer to get baby back to sleep. Around 8 weeks old, I stop changing baby's diaper at any night feedings. By 10 weeks old, I stop changing baby's diaper at the late evening feeding as well. Basically, baby will soon be sleeping through the night without a diaper change anyway, so no need for me to disrupt sleep by doing a diaper change now.

{ consistency } Some babies don't need rigid times, others do. I prefer not to gamble with this and simply be consistent from the start. If you've far been ballpark-ish with bedtime and morning feeding time but baby is having sleep issues, then locking down baby's first and last feeding of their day is the first step. Regardless of what happens in between those two feedings, you want morning feeding and last feeding of the day before bed to become consistent. You'll often see 6-7am as first feed of the day, and 7-8pm as last feed of the day; these are common first and final feed times for Babywise moms as those times generally allow for enough other feedings spaced thorough the day for baby to get enough ounces for the day.

Don't worry - life will not always be this rigid. The point of consistency is to be able to enjoy some flexibility from time to time. To be flexible, you have to have something to flex from. Just being willy-nilly isn't the same as being flexible; willy-nilly is simply being unpredictable. Babies and kids like predictability. As they are growing their whole world is naturally unpredictable, so you providing as much predictability and routine as possible is so, so comforting to them.

{ wake time length } A well-rested baby will having sufficient energy to take a full feeding. Then, a well rested and well fed baby will have a happy and suitable awake time, after which they'll be ready for a full nap. Some babies have great sleep cues when they are ready for sleep, and others really don't have any. Sleep cues can include: crying, staring blankly, yawning, hand sucking, or general fussing. Other babies act like they are content to stay awake for hours, when in reality they should be put down to achieve enough day time sleep that they aren't overtired for nigh time sleep. An overstimulated or overtired baby will not sleep well. Some standard awake time ranges:
  • 0-6 weeks: 30-60 minutes
  • 6 - 12 weeks: 60 - 1hr20 minutes
  • 12 - 24 weeks: 1hr15 minutes - 2.5 hours
  • 16 - 28 weeks: 1hr30 minutes - 2.5 hours
  • 28 - 52 weeks: 2 hours - 4 hours
Baby's awake time factors into how often baby is being fed during the day in that both wake time and ounces per feeding work together in tandem to help set baby's ideal schedule. For example, a 3 month old baby may be able to handle 6oz per feeding but that does not mean baby can be on a 4 hour feeding schedule because a 3 month old likely can't stay awake for the requisite 2 hours required in a 4 hour feeding schedule. A 3 month old can likely stay awake for 1-1.5 hours and then sleep for maximum 2 hours, landing baby on a 3 - 3.5 hour schedule. As long as baby can eat enough per feeding to make it 3-3.5 hours until the next feeding, then that's a great schedule. If baby can't eat enough, or can't stay awake long enough, feedings need to move closer together. If baby can eat more, and stay awake longer, then feedings can begin to be spaced out and/or condensed.

Check out my sample schedules to what I've done with my kids.

{ stimulation level } Babies need some stimulation, and human interaction with mom or siblings is best for that, but do pay attention to baby's cues. Baby consistently looking away from you is a common indication that baby is done with face to face time. A baby in a very loud environment may become very still or rigid as they look around and take it all in, whereas a baby in a quiet room on a play mat may happily kick around and flap their arms while they "play".

As it is for adults, it's hard to go from massive stimulation right to sleep. You'll wan to consider the quality of awake time that baby had when putting baby down for sleep. What this looks like practically: if we've had visitors over and they've been coo'ing in baby's face for an hour, I know that baby has likely had more than enough face time and is totally "done". Baby might be extra fussy for that nap and have a hard time settling into sleep, so I would put baby in the swing for nap knowing that the gentle rocking motion would provide the extra help baby needs to settle into sleep. Thus, paying attention to baby's stimulation levels will help you better time baby's nap - and have grace for baby if they are struggling with their nap because of over-stimulation (common when there are older siblings around!).

{ sleep environment } The following are optimal sleeping environment considerations for a baby sleeping through the night:
  • Dark room: Most babies benefit from near complete darkness, meaning blackout shades over the windows. At some point closer to toddlerhood, this becomes less necessary depending on the child and how well of a sleeper they become.
  • White noise: A white noise machine or box fan will help block out house noises. There are so many options available for babies are toddlers, but for babies I would say nothing that projects light - just white noise. The "ocean" or "white noise" setting on most sound machines will be the most beneficial for baby. You want the sound machine close to the baby (not hanging off the door handle, for example), so put it directly under the crib or on a shelf near the crib (but never in the crib). A loud fan will also do the trick, just don't point it on baby. Also, check the air flow from the fan to make sure it's not blowing on anything in the room that will distract baby while sleeping.
  • Separate space: To prevent against SIDS, the APP now recommends keeping baby in your room for first 6-12 months - so definitely use your own discretion on this next consideration. Baby sleeping in your room can result in baby waking when you get up to use the restroom, husband snores, toddler comes in from a bad dream, etc. Baby can also more easily smell you when in your room, so when they wake naturally in between sleep cycles the smell of you can trigger them to want to eat when they otherwise would eventually go back to sleep. You're also more likely to intervene with baby learning to self soothe if you're right there next to baby. Moving baby to their own room for sleeping is helpful to give baby their own space to sleep without distraction. Given the new recommendations by the APP, you need to decide what to do in this regard. 
  • Swaddle: most babies drop the startle reflex around 3-4 months old, so having baby sleep in a swaddle until that point helps prevent baby from waking when their arms involuntarily move during sleep (more on the swaddle in the third section).
Sleep is one area where I really encourage beginning as you mean to go. Before 6 weeks old, babies will really sleep anywhere. After 6 weeks, baby become more aware of when they are awake vs. asleep and thus you'll often notice a change in baby's sleep behavior around this time. I learned this the hard way with my first, so with my second and third I started putting them to sleep in their own crib within the first week. I would do a sleep routine too (see below), even though they totally didn't need it during the early weeks. I wanted the sleep routine to be associated with sleep, so I started it from the beginning.

{ sleep routine } Start this from early on, before baby even needs it. Even though a 1-week-old doesn't "need" a sleep routine to sleep, eventually that 1-week-old  will be 6 weeks old and will start having a hard time getting to sleep as they becomes more alert/awake during wake times. Putting a sleep routine in place from the start will really help baby through development leaps that are often disruptive to sleep.

Our sleep routine for a baby looks like this: diaper change, swaddle, lights off, white noise on, sit in rocking chair on my lap facing out while I sing a song (same song every time). I then sit with baby until baby stop fidgeting, and then place the drowsy baby in crib on their back (with no blankets or pillows in crib!) and leave the room. You can read more about a sleep routine here.

{ sleep needs } Sleep begets sleep. A tired baby wont sleep well, or wont sleep well for long. Baby sleep needs do decrease over time, so staying on top of how many hours your baby needs is important.
  • Overnight sleep: In general, babies need 10-12 hours of nighttime sleep, even if you're still doing late night of middle of the night feedings. A late bedtime almost always results in early morning wake-ups. It is common for babies to wake during the 5-6am hour and have trouble going back to sleep; don't let this become your first feed of the day! If you must, feed baby a small nighttime (dark, quiet) feeding and then put back to sleep until 7 or 8am, and then feed baby again and start your day.
  • Naps: A successful nap is typically 1.5-2 hours (or 2-3 hours once baby is down to 1 or 2 naps). 
The main point about sleep needs is that a well rested baby will sleep better than a tired baby. You want to teach baby how to sleep before you teach baby where to sleep. So if you're starting brand new at this, it's okay for baby to take naps in their swing, a carrier, a rock n' play, etc while you work on things like full feedings and implementing a sleep routine. You can work on moving baby to their crib at a later time. I'm a big fan of this sleep hierarchy from Val at Chronicles of a Babywise Mom.

{ how to sleep train }

The goal of sleep training is full naps and overnight sleep in their crib without intervention from mom or dad. If your baby isn't yet sleep trained, they will likely be doing one or more of the following:
  • needing to be fed.and/or rocked completely to sleep
  • waking 45 minutes into naps and not returning to sleep
  • only sleeping in a swing, carrier, or bouncer 
  • waking to eat during the middle of the night past 6 months old
Before any sleep training is done, the following things should be in place:
  • full feedings every 2.5-4 hours depending on age of the child (total average of 25 ounces per 24 hours)
  • appropriate sleep environment: dark room, white noise, swaddle (if baby is under 3-4 months old), not co-sleeping
  • set time for first and last feeding of the day
  • pattern of eat, wake, sleep during the day
  • a sleep routine
Let's start off at the sleep routine, as it is paramount to sleep training. The sleep routine works best when initially paired with successful sleep. So if baby will only sleep in a carrier or in a swing, do a solid 1-2 weeks of the sleep routine with baby still in the carrier or swing before attempting to move baby's sleep location. We want baby to associate the sleep routine with sleep, and that works best if baby is actually sleeping directly following the sleep routine.

The sleep routine is based on the 4 S's (explained here on Val's blog). I wrote a separate post highlighting the importance of a sleep routine, but I'll repeat the basics here. The sleep routine is something you do before each nap and bedtime to signal to baby it's time to sleep. The goal of the routine is to help the baby settle/become drowsy and thus prepare to go to sleep. The benefit of the sleep routine is that it brings baby to the brink of sleep but then allows baby to actually fall asleep on their own. This is the cornerstone skill that allows baby to take full naps or sleep through the night. If baby isn't reliant upon mom to actually fall asleep, baby wont call for mom when they wake naturally in between sleep cycles.

Our sleep routine looks like this:
  • diaper change and sleep gear - can be jammies and/or sleep sack, swaddle, etc
  • give sleep props (should you choose to use them) - paci and/or lovie
  • lights out (it's okay to have the hallway light coming in for the sleep routine), white noise on
  • sit in rocking chair and sing one song (same song every time) 
  • turn baby facing outward on lap and just sit together until baby is drowsy (no rocking, no talking)**
  • place baby in crib sleepy but awake, close door
**This is the key step to the sleep routine. If you're doing this with your 0-6 week old, you'll likely have no problem as babies that age fall asleep without issue most of the time (which is why this is a great age to implement the sleep routine!). If you baby is older, this is the step that you will become annoyed with. Baby will likely fidget around and seem like they will never settle down. Be patient. Shhh baby if needed. Be more patient. Eventually, usually, baby will settle down and just kind of sit there. This is when you then move baby to their crib, set them down, and leave.

If baby is sleeping somewhere else other than the crib: still do the sleep routine, and then place baby in whatever place they are enjoying sleeping right now. We want them to associate the routine with sleep (just like they associate mom or a bottle with being fed - they are not too young for these associations!).

Sleep training is often synonymous with "cry it out (CIO)", but it really doesn't have to be. See, in reality, all moms sleep train their children. Some babies are trained that they need mom by their side to fall asleep, some are trained to sleep in a swing, some are trained they need a pacifier, some are trained to sleep on their see? All children are trained - conditioned - to sleep in some way. So even moms that say they haven't sleep trained their kids have, in fact, sleep trained their kids - they just may have inadvertently trained them to sleep in a way that no longer works for the good of the kid, the parents, or both.

The aim of sleep training, as I'm explaining it here, is for baby to learn to fall asleep without assistance from mom. This not only helps baby go to sleep easier, but also helps baby to stay asleep for full naps and overnight sleep. All babies - and adults - go through sleep cycles when they sleep. A baby that is sleep trained still slightly wakes in between sleep cycles, but has the ability to put themselves back to sleep without assistance from mom. Learning to self-soothe during sleep is a skill, just like learning to nurse effectively (or even to take a bottle). It's a wonderful skill for baby to learn, but it takes some serious coaching from mom because it's a just that: a skill. And skills need to be taught and practiced and coached along the way. As a mom, you're going to spend a lifetime coaching your child on learning things they are capable of learning. It will be difficult int he midst of it, but the results will be well worth it. So this is as much a learning exercise for them as it is for you!

Here's what this looks like in practice: I'm picking up where I left off at the "sleep routine" section above. The sleep routine is to be done before every sleep session. Mom puts baby down and leaves the room. Baby cries. Mom waits 1-10 minutes depending on baby's age. Mom enters the room, picks baby up, shhh's baby (often releasing a burp), places baby back down, leaves the room, and waits again. Maybe mom waits longer this time, and then re-enters room. This time, mom pats baby on the tummy without picking baby up, shhhh's baby, leaves the room. Mom waits again, repeats. This continues until there is 45-60 minutes left in the desired nap time, at which point mom can move baby to whatever situation will help baby actually sleep before the next feeding (so swing, in mom's arms, wherever). Baby naps, eats, has wake time, goes down for next nap and the training begins again.

Regarding the amount of time mom waits between check-ins: I think this really depends on the age and demeanor of the child. If baby is single-digit weeks old, I think waiting just 1-2 minutes is enough time to see if baby will resettle on their own. If baby is 3-4 months old, I think 5-10 minutes is suitable. Some moms will find that going back in really just upsets the child more (two of my three were like this). Listen to the sound of the cry - this is where your mom instincts really come in. This is the part where mom is learning, too. Pause, really listen. Get to know your baby's cries. It's not abnormal for babies to cry or fuss a bit before transitioning to sleep. Any ladies out there ever feel like you need a good cry before bed some days? Babies, too, need to let off steam from their awake time sometimes. Not all crying is "bad" or needs to be tended to immediately.

If it helps, which is usually does, keep notes of how long baby is crying for, how many checks you do, etc - it's helpful to see if baby is making any progress. If baby is making progress, eventually you will see a baby that maybe fusses for a few minutes after being places in the crib and then goes to sleep. Baby make wake and fuss again midnap, and then return to sleep. Count those wins! If baby successfully goes to sleep at any point, that's a win! That's the ball connecting with the bat, that's riding a few feet without training wheels...practice makes perfect, but there will need to be ample time to practice this new skill before "perfection" is achieved. I didn't really understand how this worked until I had my second child. By default, I simply couldn't run in every time she cried. I often had to get my toddler secured with an activity so I could dart up to the nursery; by the time I got there, she was often already settled. So by default, I figured out what it really meant to give baby a few minutes to settle before intervening to help.

How well will your baby sleep train? I think it's equal parts nature vs. nuture. With my third, I really learned that some babies are just naturally predisposed to be good sleepers. It may be the confidence I've gained from the previous two, but I really think my third is just a natural born sleeper. I did - more or less - the same thing with all three kids and all three have responded differently to the same methods.

{ addressing common questions }

{ the "dream feed" } There is often confusion around the term "dream feed". In the 2012 release of the Babywise book, the dream feed is explained as a 10-11pm feeding that is offered past 16 weeks in effort to maintain mom's supply (but baby no longer needs it for their own caloric intake). Before 16 weeks, this feeding is just referred to as the "late evening feeding" and is offered as part of baby's necessary feeds. The confusion comes from the term "dream feed" also being used in a book called The Baby Whisperer (which I have not read); in this book the author refers to any late night feeding at any age as a "dream feed". This becomes a problem when a new mom is told to "drop the dream feed" if her baby is still waking at night, because up until 12-16 weeks the feeding between 10-11pm is still needed for baby's total intake and if not offered baby will wake to eat in the middle of the night to get those ounces in. My blog friend Valorie explains this in detail on her blog. My point is this: up until 12-16 weeks, a feeding between 10-11pm (regardless of what you call it) is likely necessary for baby's total intake of ounces within 24 hour period.

{ waking up every 45 minutes } A common nap issue is waking 45 minutes into the nap (known as the 45 minute intruder). This happens because baby's sleep cycles naturally run in 45 minute intervals, so they are in a light state of sleep at the 45 minute mark. If baby thinks they need help going back to sleep because they are used to being rocked or nursed to sleep, baby will cry for mom to come provide this service for them so they can return to sleep. The point of sleep training is to help baby learn how to self soothe so that when they wake naturally during their nap they don't cry out and wait for mom to come put them back to sleep, they just do it themselves.

{ night feedings } Here is what we have done: if baby is under 5 weeks old, I feed baby at 10pm and then put back to sleep and let baby wake naturally to eat for the next feeding. The caveat to that, is I don’t let more than 4 hours pass between the 10pm feed and the next feed. If baby hasn’t woken to eat by 2am, I feed baby and put baby back to sleep, and then continue on every 2.5 – 3 hours from there.

Once baby is 5 weeks old, I then allow one 5 hour stretch between the 10pm feeding and the next feeding. At 6 weeks old, I allow a 6 hour stretch, 7 weeks/7 hour stretch, etc.

It’s not necessarily a “great” thing if your 5 week old is taking one long stretches at night without eating, because they’ve got to get those ounces in at some point. Going long stretches at night will likely cut out an entire feeding that they will make up for during the day with short naps because they are hungry and need more frequent feedings. Likewise, doing long naps during the day with long stretches in between feedings will result in a baby that wakes frequently at night to eat. Baby has got to get that 25 ounces average within 24 hours, and the best way to do that (for sleep purposes) is feeding every 2.5-4 hours during the day depending on age and how many ounces they take per feeding.

Okay, so say baby is still waking every 3 hours at night but I know baby could go longer: If I feed baby at 10pm and then baby wakes at 1am when I was hoping baby would make it to 2 or 3am, I will first give baby a few minutes to fuss and see if they are just transitioning sleep cycles. If still crying, I’ll go in (or send my husband in - because baby smells me and thinks "food!") and offer some other type of comfort first (paci, rocking) as a way of stalling and/or putting baby back to sleep. If baby is still obviously hungry, I’ll feed baby just enough to lure them back to sleep and then unlatch, place baby back in crib, and scurry out of the room. No diaper change, no unswaddling, no lights. Even if baby does need to eat, I’ve still then pushed the feeding time out upwards of 20 minutes depending on how long I stalled for. Eventually, if baby is getting enough ounces during the day, this method of “wait – stall – small feeding if necessary” will work to help baby drop feedings in the middle of the night. If you're totally sure baby doesn't need the feeding and is just waking out of habit, you can do cry-it-out, but I would save this for an older baby (4+ months) just to be really sure baby doesn't need the feeding.

{ reflux } There are many, many ways to handle reflux and your pediatrician can work with you on that. A reflux baby does not mean you need to abandon Babywise! The biggest thing you’ll need to figure out is how to sleep baby in a comfortable way. The Rock 'n Play or swing is just fine for now! Sleep do a sleep routine with baby, and then just place in the RNP/swing for nap. If you want baby in the crib, or baby wants to be in the crib, the best thing to do is elevate one end of the crib several inches (not the mattress, but the actual bottom of the crib). To prevent baby from sliding down while sleeping, take a hand towel and roll it up the long way. Slide it under the mattress sheet between the sheet and mattress, making it into a capital U shape. Snug baby’s bottom into the bottom of the U, so that baby’s legs are draped over the bottom of the U. This will help baby feel snug in the crib and prevent baby from sliding down from the incline.

If baby has reflux, it will be hard to get full feedings during the day – and that’s okay. Baby’s tummy being too full can make reflux worse. So take baby’s lead and finish the feeding when baby is clearly done. This may mean it will take baby longer to consolidate night feedings because baby will need smaller more frequent feeds (maybe every 2 – 2.5 hours instead of every 3 hours). Once the reflux is under control (through meds or diet changes for mom) then you can resume coaching baby to take full feedings during the day to maximize chance of baby dropping night feedings as the weeks go by.

{ pacifier } There are several types out there, so try a few. Also, if you want your baby to take a paci but they don't seem interested, keep trying. It can take days/weeks to get a baby to adapt to something new. 

The paci is a great tool for delaying a middle of the night feeding (a paci will reveal if a baby just wants to suck for comfort or if they are actually hungry). The paci is also a great sleep association if you reserve paci for naps and nighttime only. The paci is also easier to take away (than a thumb) once baby is a toddler and it’s time to move on from it.

The negative of the paci is the dreaded paci game you have to play until baby is 6-7 months old and can put the paci in their mouth by themselves. Until then, you may often find yourself running into their room during naps and overnight to put the paci back in their mouth for them. For whatever reason, my 1st child only needed the paci to fall asleep and then didn’t care if he didn’t have it mid-nap or overnight. My 2nd though, she needed that thing in her mouth to sleep and it was not fun for us. My 3rd has been a thumb sucker and it’s been GLORIOUS because he’s barely needed any sleep training. My hope is to transition him to a paci when he’s 7-8 months old and get him off his thumb, because it will be hard to get him to drop the thumb habit when he’s older and I’d rather replace it with a paci habit and then take away the paci in a few years when it’s time.

{ swaddle } The swaddle is used to prevent baby’s moro reflex (the “startle” reflex) from waking baby during sleep. Baby is also used to being all snug in your womb, and the swaddle mimics that feeling. Baby naturally grows out of that reflex by 4-6 months old, but you don’t have to swaddle that whole time. Most mom’s swaddle baby until they start showing signs of being ready to roll back to front, or if mom wants baby to have their hands available for self-soothing. To drop the swaddle, you can do one arm out first (one of my kids loved that, two of them hated it) or go cold turkey no swaddle (my 2 boys preferred this). Or there are many swaddle transition products available, but we’ve never used any of those because really it’s just another thing you have to transition out of and I don’t like adding more work when I don’t have to. I usually swaddle my kids until around the 3-4 month mark. We use these SwaddleMe pods the first few months (with the double swaddle method). We then use the SwaddleMe original next, and finally the Swaddle Sleep Sack, before transitioning to a sleep sack for the long haul.

If baby "hates" the swaddle, keep trying. Because what baby will hate even more than the swaddle is being unnecessarily awoken from her nap because of her arms startling her awake. All three of my kids needed to be double swaddled to truly calm down, so consider that as well.

{ what to do now }
Go back to the "healthy sleep foundations" section and get started working your way through the changes you need to make. If you have questions about baby's schedule, you can post them on this blog post. If you have general questions about anything above, leave a comment below!

Tuesday, May 23, 2017

Evan: 5 months

I'm really loving this age right now. He's still 100% my baby, but he's less fragile than he was as a newborn so I'm able to let him explore his surroundings a little more confidently. Plus, the non-stop smiles are really great :-)
As a true third child, Evan is very much a tag-a-long kid. He is happy to just sit and watch his siblings play. If he's awake, his only care is that he not be left alone. If everyone happens to wander out of a room briefly and he's left behind, he'll start hollering about it. Otherwise, he's all smiles and all laughs.
He's on a 4 hour feeding schedule now with 4 liquid feedings and 1 meal of solids. Like with the bottle, he's needed a lot of practice with the spoon so we're just doing oatmeal cereal for now. Breastfeeding is going great and I'm still off dairy. I did have dairy at a wedding last weekend and Evan has not been happy with me about it. Mainly, when I have dairy he gets stinky gas (and I think some tummy pain from the gas, too), more frequent spit ups, and eczema flares. Those symptoms are all tolerable if I really wanted to be back on dairy regularly, but I'm fine continuing to leave it out.
He's not rolling over yet, but I also don't give him a lot of tummy time because he spits up every time we do it. He's sitting up fine in the Bumbo seat, high chair, jumperoo, etc. so he spends most his awake time on his play mat (which he loves) or sitting up watching the older kids play. I do have a concern about the "superman" pose he makes often with his arms; he holds them down straight and back from his body more often than I care for. The internet tells me this is called "unintegrated moro reflex", but I'll wait to see what his pediatrician says about it as his next check-up.