ear tube surgery

It's been nearly a month now since Shep had his surgery. It was on April 8 at Primary Children's Medical Center. I was quite nervous about him undergoing general anesthesia, as I had read there were some risks associated with it. Luckily, it was a short procedure and didn't seem to have any lasting effects. The surgery wasn't until the afternoon, so we spent a lot of time waiting. In the morning, we met with the ENT and an audiologist for some testing. We signed up to participate in a study to test an experimental antibiotic gel instead of the standard-issue ear drops. Shep would either get the gel during surgery or a sham, but we don't know which he got. So he's had some extra visits associated with the study. (He did end up getting a round of antibiotic ear drops anyway, though, because he had some drainage on one side, which was a bit of a bummer.)

It was hard because Shep wasn't allowed to eat anything, but he really behaved marvelously, considering. We parted ways when the anesthesiologist wheeled him away to surgery in a little wagon, and then we went into the waiting room. I wonder how he did once we weren't with him anymore. It was weird to part, and I sort of wished I could go to the OR. They called us back as he was waking up in the recovery room. Poor kid was not happy at all, and it was sad to see him so out of sorts. He was very disoriented and quite upset. I'm really glad Tim was able to take the day off work and be there, because he was actually the one who was able to comfort Shep the most as we waited to be discharged.

When we got home, we all took a long nap and Shep has seemed back to normal ever since. We haven't noticed a ton of developments with his expressive language skills, although he is saying "hi," "bye," and "uh-oh" much more often and at more appropriate times. We definitely have noticed that he can hear better and he seems to be understanding more. It's really nice to know that he can hear and not wonder if he's deaf when I talk to him. I'm glad we did it when we did, even though we didn't really know for sure how long he had fluid in his ears. I don't think it would have gone away on its own.

Now we're just trying to deal with getting reimbursed for self-pay and getting insurance billed. The insurance came through after the surgery and it's kind of annoying to jump through all these hoops. Ah well . . .

Zion's

Tim had a week for Spring Break a couple of weeks ago, so we headed to Zion's for two days and one night. It was a quick trip, but I'm glad we went! (Even though Shep is passionately anti road trip.) He did marvelously on our six-hour hike, though. That long hike involved us trying to make it to Kolob Arch, but we only made it about 4 or 5 miles in, about, and the arch is 7 or 8 miles in. It was brutal carrying a very heavy pack (30-pound-baby + water + food), even though we switched off. It took us days to recover.

The day before that, we rode the public transit up Zion's Canyon and did a short hike. Then we camped outside the park in our van. Is it just me, or is sleeping not in a bed always miserable? I always like the idea of camping, but I have a hard time liking it during the night when sleeping is turning out to be hard!

ear tubes

I wrote in my last update about S. that I was concerned about his language development. Thank you, by the way, to those who commented with encouragement to pursue this issue further. As a parent, it's absolutely impossible not to compare your child to other children. And it's hard to see your child not behaving in ways that are as "advanced" as others' children. It somehow seems like some sort of reflection on your success as a parent. I liked something that I read recently that said something like, "Are you a good person who is a mother? Then you are a good mom." (Sorry, I don't remember the source!) And I try to remind myself of that, because there really isn't any way to measure.

Instead of resisting the idea that something was wrong with my child, I decided to pursue our concern. After being evaluated by early childhood professionals, Shep qualified for intervention services for his language development. He was also referred to an audiologist for hearing screenings. Over the course of the last couple of months, several visits to doctors and audiologists led to a diagnosis of fluid in both ears and resultant mild hearing loss. He's never shown any signs of having ear infections, though, so it was a complete mystery to me. In a few weeks, he'll be getting ear tubes.

It seems very likely that this could be the majority of the explanation for his language delay. I hope it helps! I keep telling myself that it's super common for kids to have tubes in their ears, but it is still kind of scary.

21 months

We had a pretty good go documenting Shep's antics until he hit mobility, it seemed. I think part of the problem is that I feel that posting on the blog makes photo evidence requisite, and it's kind of a hassle to keep up the photography. Every single time I pull out a camera of any sort, Shep stops what he is doing and relentlessly pursues the new "toy." One time on the 4th of July, or maybe it was the 24th, he broke my point-and-shoot digital camera because I was stupid and said "You want my camera? Okay, here you go!"

But it is sad to think that his antics will be undocumented, and thus forgotten, so here are a few things that I want to remember about Shep right now. 

It's funny how a lot of these things are alternately precious/drive me batty. I guess that means I'm the parent of a full-fledged toddler, not a baby!

• He walks like a champ, and has the cute toddler run/waddle thing going on now, too. He actually has been walking for a while, but I don't think this blog has heard about it yet. He started taking steps independently when he was about 14 months, but it took him a good month or month and a half before he was comfortable with it.
  
  Despite being sure on his feet, he is still a cautious little guy. He doesn't really test his limits independently. We have to encourage him to do things he hasn't tried, such as walking on the snow (he still avoids that one), walking by himself in the shallow end of the pool, climbing up onto a step stool, etc. But he seems to pick things up quickly once he decides he's interested.
• He's expressing all sorts of personality of late. For example, he gets really mad if things don't go his way when he plays with his blocks. He got Lego Duplo blocks for Christmas and some Mega Bloks from the Stoddards. I think he prefers the Duplos, but I actually took them away and hid them just today because he gets super frustrated playing with them by himself. I guess his motor skills are not quite developed enough to take them apart and put them back together effectively, so he needs someone to sit down and play with him.
  
  I guess this is regular toddler behavior, but he gets pretty fixed on certain things and it can be hard to distract him and redirect his attention in order to avoid tantrums. I have been the mother of that child who throws himself down on the floor and screams at the grocery store plenty of times now. Though I think we generally do a good job at tantrum avoidance. It happens.
• He's not really talking much at all, but I can tell he understands several words. He says "hi" and "bye" inconsistently, but has just this week started using them more consistently at the right times. He also says "shoes" and will get his shoes when we ask him to. Sometimes he brings us his shoes when he wants to go outside, or brings us our shoes when he wants us to get going. He pushes our legs to move us to things, too. He knows a few body parts, like "nose" and "belly button." He knows "hot" and tries to say it, and I can tell he understands the meaning of the word, too, because he uses it when putting his hand close to hot food, hot water, hot stove, etc. He's known how to point to his belly button for like six months, but again, he's been pretty inconsistent. Sometimes I have wondered if his hearing is damaged, because I'll say his name or something and he doesn't respond at all. He is pretty selective at listening.
  
  I'm anxious for him to start talking more, especially as all of the recommendations say babies his age should be saying a lot of words. I think he knows he can communicate pretty well without words, so he isn't super motivated to learn English. He has a special dog-like pant when he wants something that we're eating or drinking, for example. There is a lot to be desired on the communication front, though. He seems to get particular scenarios in his mind that I don't telepathically understand, and it frustrates him to no end when they aren't carried out.
• He seems to like wearing clothes, getting dressed, etc. Most of the time! Sometimes he hates it. But I'll find him trying to put on his own clothes, too. Sometimes he brings us the clothes he wants to wear (those within his reach), and he seems really into zippers. He thought the words "zip" and "zipper" were hilarious for like two days a while ago, but then gave up thinking they were funny, apparently.
• He's been inconsistent with this one as well (I'm noting a theme here?), but he generally likes giving kisses. He is funny about his method: his kissy face is just opening his mouth in an O and then making sounds to get our attention. Almost inevitably, after giving one of us a kiss, he'll look for the other of us to kiss. Even if I'm alone with him, I'll ask him for a "kiss" and he'll give me one, but then look around for another source of affection.
• He likes to organize similar objects, such as sorting colored pencils by color or lining them up. 
• He loves taking things out of containers and handing them to people, or moving them. He seems pretty good at sharing, in a general sense. He likes to try to feed me the food he's eating.
• Maybe classic toddler behavior, but we have an inconsistent/picky eater.
• I'm a lot less diligent about using the nursing cover to nurse him in public (it's a source of some inconvenience), but when I bring it along, if he wants to nurse, sometimes he'll get it out of the diaper bag and bring it to me. On the topic of nursing, which my blog readers may be sick of (but I most certainly am not!), yes, it's still happening with a fair amount of frequency. Shep nurses to fall asleep consistently. He's wakes about twice a night on average, and nurses back down. I'm not really sure, but for the most part it's really quite manageable. He also nurses a couple of other times throughout the day, but I don't really keep track. If he's bored and fussy, he does more. I do feel like I'm not as concerned about his fussy eating habits when I'm still nursing, because I feel like he's still getting decent nutrition through that.
  
  I could write a lot about nursing in general (like why I even feel the need to talk about it, for starters), but suffice it to say I don't think he's ready to wean anytime soon, and I'm not interested in forcing it on him. I never imagined breastfeeding a toddler, but we take it one day at a time. It is frustrating to me sometimes to nurse him, but for the most part, I'm happy to continue as long as it interests him. I do worry about weaning him sometimes, though. I don't know if he'll ever lose interest! Self-led weaning might not work for us, so if any moms have any advice about that, please let me know!
• He has the funniest dance moves whenever we play music for him: lifting his arms like a cactus and turning in circles, bouncing and sticking out his bum, bobbing his head, etc.
• He loves pretending to talk on the phone and has been doing that for quite some time now. It's adorable. He also likes giving cell phones to their owners, and can identify ownership here.
• Lately (past week or so) he's really been into "helping" me with the dishes. He likes to get up on a step stool so he can reach the sink and generally make a mess with the water. He's also really into drinking water that he plays with the last few days, despite disciplinary efforts to dissuade him.
  
  I find myself tending to err on the side of "Whatever makes you happy, I'll allow" rather than preventing destruction, chaos, or whatever craziness might ensue from giving him free reign. This tendency worries me a bit (Is discipline something I'm even capable of?), but perhaps self-awareness will help me keep it in check. It doesn't help that when I try to say "no," Shep just laughs and does that exact thing more. It doesn't make me feel particularly effective.
• He's gone through several object fetishes. These don't seem to run the "normal" gamut of lovie objects, such as blankies and stuffed animals. For a while it was washcloths. He went through a snack cup (filled with Cheerios) phase. He also went through a phase where he was carrying pens. (Now I have to avoid giving him pens because he is dangerous with them!)
  
  I got a food processor on Black Friday and he got so much mileage out of playing with the packing Styrofoam that came in the box. I think it's because they were big and light, so he could carry them around and move them to different spots. (He also liked taking the meat thermometer and poking holes in the Styrofoam.) We also just got a new package of disposable diapers, and he was doing the same thing with the individual packs of 30 or so diapers. He'd just move them from place to place. I don't really get it, but it's funny.
• He doesn't laugh a ton, but he seems to be trying out different laughs from time to time. He went through an evil laugh phase a few months ago. It was so extreme that I got pretty fed up with hearing it, but then he stopped fortuitously. It was hilarious, though. Now he has different laughs for different situations, it seems, though I might not be able to define them all.
• The only time we really spend time apart from each other is when he goes to nursery. He does fairly well at going, though it took several weeks of us sitting in there for him to get comfortable. Now he's okay because he likes being around other kids and knows the leaders, for the most part, but it's still a bit hit and miss. I also have worries about him being bullied. Any other parents out there experienced this? Some of the more aggressive kids hit/grab/push/etc. Shep doesn't seem to mind, but this actually happens quite a lot, and I'm not sure how to respond. I don't want him to mimic this kind of behavior.
• (POST-PUBLICATION UPDATE) I forgot to write another thing: I love when Shep comes and sits in my lap. He does so when I put his shoes on, and when we read together sometimes. He's a cute little guy.

noisy sleeper

Shep makes his presence known when he's asleep. Right now he is sleeping next to me, and he is sighing softly on almost every exhale. He snores regularly. He is often a loud mouth breather when he's concentrating. It's a little embarrassing, occasionally, when it attracts attention from other people.

first snow

Snow is sticking on the ground outside for the first time this winter and I thought it would be fun to take Shep outside to discover it.

I thought wrong.

He refused to touch it, walk in it, or otherwise marvel in it. Time to move to Florida, I guess!

what I've learned about cloth diapers

Types

• Prefolds: flat cloth with more layering sewn into the middle

  

  image from bumritediapers.com

• Flats: Um...just flat cloth. Flats and prefolds are time-consuming to put on, but they are the cheapest cloth diapering option.

  

  image from clothdiapergeek.com

• Fitteds: cloth that is pre-shaped and has snaps. Fitted diapers are absorbent and offer great coverage.

  

  image from diaperjunction.com

Prefolds, flats, and fitted diapers need covers because they are not waterproof. You can put the diaper inside your cover and then put it on the baby, or you can fasten the diaper to the baby with a fastener (pins or the non-pokey Snappis) for better coverage and then put the cover on. There is a bit of a learning curve; look up special folding instructions for prefolds and flats.

• Pockets: waterproof cover with cloth pocket in which you stuff a liner/insert for absorbency. Pocket diapers wick away moisture from baby's bum and have customizable absorbency based on the number and type of inserts.

image from blueberrydiapers.com

• All-in-ones: absorbent cloth is sewn into a waterproof cover. Sorry, AIOs, you don't get a picture. I guess these ones are the least effort because all components are combined.

Cost

Total Cost: Approximately $300, not including the newborn rental kit.

I honestly have no idea how much money we've saved doing this because we've used a mix of both disposable and cloth, but I think we've probably spent as much on getting to this point in cloth diapering goods as we would've spent on the disposables we didn't buy doing cloth.

We now have a stash of 19-ish diapers, which I feel is a perfectly adequate number with changes every 3-ish hours during the day.

• 12 Alva pocket diapers ($5 per diaper from superstash.net. This site was such a find for me. Bonus, she gives you a sample of CJ's butter, a cloth-diaper-safe diaper cream!)
• 5 BumGenius 4.0 pocket diaper (approximately $20 per diaper, which is so expensive, but I do really like them!)
• 1 CharlieBanana pocket diaper (approximately $20 and not worth the cost, in my opine, but does have adjustable leg elastics, which is cool.)
• 1 Kawaii Snazzy Minky pocket diaper ($9)
• 1 Kawaii original diaper (approximately $7, but came free with a certain-size order at kellyscloset.com/)
• 2 Thirsties covers (approximately $13 per cover)
• 3 Gerber prefolds that we received as a hand-me-down

Accessories

• Reusable wipes ($12)—This expense is unnecessary, probably, because you could make your own easily or just use washcloths. We have used like one pack of store-bought baby wipes over the past 14 months for out-of-house diaper changes.
• Pail liner ($15)—Nice to have, but you could probably just use a pail without a liner.
• Pail ($6 for a garbage pail with a lid)
• Diaper sprayer ($30)—Very nice to have for solid poop that doesn't knock off into the toilet easily. Also doubles as a bidet, which saves on toilet paper! Too much information?

Cloth diapering a newborn

If you're interested in diapering your baby from the outset, you'll probably need a set of diapers specifically for the newborn phase (which is why I think rental kits are a cool idea). Most one-size diapers don't work amazingly well with tiny legs and bodies, but I've heard a few do. Fitted and prefold diapers are good options for newborn diapers, from what I can tell, because they contain explosive (read: exclusive breast-fed) newborn poop really well. Make sure to use a cover with leg gussets in order to get maximum containment!

Newborn cloth diaper rental

We did a newborn cloth diaper rental from a lady in SLC who runs Cloth Diaper Utah. I did not love the cloth diaper rental from her. First of all, the newborn AIOs that she gave us didn't actually fit Shepherd until he was 3 months old. It was a trial package of used diapers, 24 AIOs, and the fee was $100, only $25 of which was refundable. There are rental packages with better diaper options and better refund options available from cloth diaper stores online. (If you want a specific list for ideas about rental options, request it in the comments and I can e-mail you mine!)

Velcro (hook and loop) vs snap closures

I didn't love the velcro, which we used on our AIO rental and one of the Thirsties covers, because it gets worn easily and is scratchy/snaggy, and is harder to maintain. (If you do go with velcro, remember to close it/attach it in the wash to keep it nicer.)

Rashes and diaper cream

Haven't had a problem with rashes using pocket diapers, though Shep's skin is not overly sensitive. In fact, I've heard some people have fewer problems with cloth diapers because there are not as many chemicals in contact with baby's bottom, assuming you're using some good detergent. You should not use most rash creams with cloth diapers, though, because they don't wash out easily and can thus cause absorbency issues.

Type of inserts

I've heard that more natural fiber inserts (e.g., organic cotton, bamboo, and hemp) are more absorbent than microfiber, which is the type of insert that came with all of the pocket diapers we own. You can also use prefolds and flats as inserts.

Using both disposables and cloth 

We use disposables at night and sometimes if we have a diaper change while we're out and about. The next step in my cloth diapering progression is to use cloth diapers at night. I'm hoping to get a few more inserts to double up before I try this.

Laundry

Cloth diapers do require rather special laundry care. If doing laundry more often for you is a major problem, this may be a deal-breaker for you. Most detergents are not ideal for cloth diapers because they leave some residue on the diapers that make them less absorbent. I've heard some people say they use Tide Original without problems, but this seems specious to me. More environmentally friendly detergents that don't contain harsh soaps are usually a better idea, but they are also harder to find in stores and more expensive. (You really should not need to use much soap in your wash cycle, though.) You should also have at least one extra rinse cycle to get them really clean.

Hard water leaves mineral deposits and sometimes you'll need to "strip" your diapers to get rid of these residual deposits. RLR is a popular laundry additive used for stripping diapers, but like many detergents, it can be hard to get your hands on. I've also heard of stripping methods using Dawn, vinegar, hot water alone, boiling, and washing soda or baking soda. Boiling can harm the fibers of different inserts and ruin waterproof fabrics; hot water may not be incredibly effective; and RLR is basically the same thing as washing soda/baking soda, but in a more concentrated form. I really have a lot of faith in the power of stripping to increase the absorbency of diapers.

Make sure to follow the manufacturer's instructions on the diapers.

I never put my diapers in the dryer. I either hang them inside or outside to dry on a line. Hanging outside is nice because the sun does wonders on stains!

Getting used diapers

I wouldn't have any qualms about getting a rental kit of used diapers, especially from sellers that have care guidelines that renters agree to. Also because you only use rental diapers for a short time. I'd be careful about buying used diapers for a permanent stash, though, because you don't necessarily know how they've been treated, and many cloth diapers need a pretty assiduous wash routine in order to stay nice, absorbent, and functional. There are plenty of people who do not follow these recommendations and eventually it degrades the diaper. So that's why I would be wary of buying used. But if you have good, reliable information about the diaper's history before buying, why not?

Making your own cloth diapers

I actually know nothing about this, only that it's possible.