A special thank you to Hayley for the beautiful photos that she took of our children at 3 months. She is a very talented photographer. Her patience over the five-hour shoot was divine!
Be sure to check back at her homepage for more Photos by Hayley.
We have a few photos to share below, and are excited for the rest!
The Vanderwall home has quickly transformed into baby central with pack and plays, bouncy seats, burp cloths and pacifiers abounding. Everywhere you look you see signs of our little ones. We are also trying hard to create an environment at home that is conducive to growth and development.
We hope that the V-5’s domain will:
During the day the kiddos stay on the main level in well-lit areas. Here they are exposed to the sounds and hustle and bustle of day time. At night we keep them upstairs in their nursery where it is dark and quiet. We also are intentional about not talking or playing with them during their night-time care times. We are down to business at 12am and 3 am. This has proven to be very helpful in getting them on their care schedule.
All of the quints enjoy breastmilk for all their meals. However, since they were premature it is common practice to fortify their milk for additional calories, protein, vitamins and minerals (sodium, calcium, phosphorus to name a few). Their calorie goals vary quite a bit and like adults are based on their weight, ranging from 108-120 Calories per kilogram body weight. On average breastmilk has 20 calories per ounce, whereas the quints require 24 to 26 calories per ounce to grow at the desired rate. Therefore, we are adding Similac Neosure to their milk. We also are sure that they get their multivitamin (poly-vi-sol) daily.
Lots of time and attention is poured into identifying strategies to develop baby’s brains. There are an assortment of toys, books, apps, programs, etc. that promise to make your baby a genius. However, I’m a firm believer in simplicity and believes that attention, bonding and communication, or ABC’s, develop the brain just as efficiently as any of these other tools. I have actually learned that some toys touted for brain development can actually over-stimulate the child and increase the risk of ADHD/ADD.
Currently, the V-5 enjoy tracking exercises where we use a black and white images or toys and move the image from left to right. This activity strengthens communication between the left and right hemispheres of the brain, or communication across the corpus callosum. We also love to chat and sing with our little ones. An ideal time to chat is when we are changing them, because we are 12-14 inches away from their little faces and are able to maintain their attention.
There are many benefits of baby massage, including stress management. Massage can help to foster emotional health and promote self-soothing. Touch via gentle strokes stimulates the central nervous system to produce more serotonin, the happy hormone, and create less cortisol, a stress hormone. Typically, as a result the infants breathing and heart rate will slow and they become more relaxed. Often times, this relaxed state does not result in sleep but rather a quiet, alert state perfect for play-time, snuggle-time, or positive feeding interactions.
Our quints are a gassy bunch. It is no joke that post-feeding sounds much like a barnyard. Therefore, anything we can do to ease their gas pains and help their digestion is a must. Frank loves to take them on bicycle rides all over “town,” moving their little legs in a circular fashion. They have also come to enjoy this and almost do it on their own when you lay them on their backs. Frank tends to take them to the Candy Shoppe, where Mom prefers a trip to the Puzzle Place. We also practice the “I Love You” strokes on their bellies, which can help to stimulate movement throughout the digestive tract. A fool-proof method for gas relief is to place them on their tummies with rounded shoulders and knees tucked up and to glide your hands down their back while supporting their bottoms.
Since sleep is one of their favorite past times, these little ones can get awful stiff. We continue to try to prevent flattening of their heads and promote good neck mobility. Moving their limbs up and down and inward and outward can help to preven
t these little hedgehogs from staying all bound up. We also like “windshield wipers” with their bent knees to help open up their hips.
Tummy time is also a great way foster good motor development and upper body strength. It is best done when the infant is alert. Some of the quints love tummy time and others are still learning to like it. It can be quite a frustrating position for them, so we are sure to keep the sessions short and sweet.
Newborns are able to open and close their hands, but often times these movements are reflexive. During the first three months of life grasping becomes more intentional and an ideal time for developing foundational skills for hand-eye coordination. The quints are already starting to show signs of good coordination as they reach and grab items from their mobiles, as well as, objects near their face…including mommy’s hair.
All of these activities certainly add up for a full day, but there’s nowhere else we’d rather be!
The V-7 is one happy family! After one week of having the quints home, reality has settled in and it truly feels like we are one big family. There have certainly been some trying moments in the last week, but overall we are amazed at how well the children have adjusted to being at home. They slipped right into our “care” schedule, are getting to be more comfortable in their cribs, and their feeding skills are drastically improving.
We have made several trips to their primary doctor for weight checks. Their growth is a primary concern upon discharge and thus remains a primary goal in the outpatient setting. Often times their weights will be checked every few days, but more often one time per week. All of the quints are growing somewhere between 15 to 30 grams per day, which is an appropriate growth velocity for their age. The higher end is almost an ounce per day. We are excited to see them tracking on their growth curves. Often times, we are not sure where they are packing away the pounds, but when it comes to Theo we are positive its building that melon head and that Bella is tucking it away in her sweet cheeks.
This week has also been quite busy socially! The quints have met their great Grandpa and Grandma, great Aunts, and cousins.
It is such a pleasure to see all of the love these little kiddies are getting. It makes for one happy family!
On Saturday, October 20, we welcomed home the last, but certainly not least, of the V-5- Lillian Grace. It was a very happy homecoming and exciting to know that we are beginning the next chapter of our family’s life together. We are truly overjoyed every time we look to our living to room to see all of the bouncy seats, previously filled with their teddy bears, now filled with our beautiful children; It is quite a surreal moment.
It has been quite the past few weeks getting everything ready around the house for all the little ones and finally transporting them home. Here’s a quick look at how it all went down:
Indeed, getting the opportunity to be with the quints 24/7 has opened our eyes to their little quirks and deepened our understanding of their budding personalities. There were some assumptions we made about these little ones early on, which are proving to be a bit off, and some that were and still are spot on. Here’s the latest update on each of the quints, in the order they appear in the group photo above.
Isabella Marie
Our Sleeping Beauty, would much rather spend her day catching some zzzz’s than anything else. She is a tough one to arouse, which is good and bad. It’s a struggle at meal times, but a joy when everyone is wound up and she is just relaxing. But, when she does wake up and join the party she can be quite the happy little girl.
Theodore Joseph
Tutti Frutti, leads this Barnyard bunch in their animal chorus with his manly toots. Theo is definitely a little boy, but also our little cutie. He has the most precious face, and loves to lock eyes with you. He continues to be a champ when it comes to downing milk and apparently has shared this skill with his sisters because their feeding skills are getting much better.
Elliott Rose
Ellie has earned the nickname, “Cray Cray” for her recent frantic antics. Our experience living near Cabrini Green tells us this little one is proving to be quite the little gangster, rolling around the west-side of Madison with her hat pulled up, or down, and we swear she’s throwing signs, too. She also is learning how to play her parents and can turn on and off the tears like a light switch. She is still our little doll face, but definitely not the saving grace we thought she would be. She is our feisty little peanut.
Kali Mae
Our little screecher monkey, still can hit the high “C” with the best of them. But, she has proven to be more mild mannered than we thought and is turning into a fair self soother. She still has the most definitive features with her dark, thick hair and darker complexion. She also has a smile that can melt anyone’s heart.
Lillian Grace
Our silly Lily, tends to still be our quiet observer. During her alert times of day, she will sit and just look around for hours. She also loves to be spoken to, and truly appears to be listening empathetically. I often think she will be a counselor one day due to these budding listening skills. She is also our silly one with the most adorable smile. She will smile in any circumstance, which is a wonderful reminder to smile, too.
We are cherishing each and every moment with these little ones. Now that we are all home we are excited for our family time spent reading books, checking out black and white baby flash cards and laughing our way through the feeding frenzy which comes around every 2-3 hours. It’s a riot!
The V-5 are 2 months old today!
At these monthly milestones, I look back and truly cannot believe all that we have experienced in the last 2 months. It seems like just yesterday that I was trying to figure out how to change the diaper of a 2lb baby in an isolette without lifting them, while being blinded by their “bili light.” Today, I can walk right up to their crib, move a few cords, and lift them up to comfort them. I am eager for the day for them to come home where we can snuggle gown, glove and cord free!
It is also amazing to watch them grow and develop. We knew at birth that they had defining characteristics, but with each day they look more and more different. We thought we would share this growth one-by-one.
Big Brother Theo
Theo celebrated his 2-month birthday with a celebratory surgery. He had his reanastomosis today where they reconnected his ileum, or the lowest portion of his small intestine. His surgery went very well and they are planning to extubate him in the next 24 hours. He had his spontaneous bowel perforation on day 3 of life, so we were very happy to say goodbye to the smelly ostomy bags today. Now, at 6lbs and 7oz this little boy is a fantastic eater and we have no doubt that once he is recovered from his procedure he is in the running to be the first or second one home.
Big Sister Bella
Isabella has been our rock with no significant issues from day one. She has become the sleepy one of the bunch, nicknamed Sleeping Bella, aka Sleeping Beauty, and has maintained her quiet personality. She is learning how to eat by mouth and is a champ when it comes to taking a bottle. Breastfeeding is not her forte partially because she’s a biter- not fun. This little beauty is now weighing in at 5lbs and 14oz and leads the girlies in size. A few of the nurses bet that she will be the first one home.
Ms. Lillian Grace
Little Lily continues to amaze us with her resiliency. We have had many scares following her grade 2 IVH with surrounding PVL, but she has showed no signs that this is hindering her development. She is one of the stronger eaters in the bunch and her growth has also been stable. She now weighs 5lbs and 13oz.
Kali-Mae
This little monkey maintains her feisty personality. She has been struggling with GER the last several weeks, and is now on a formula for spit-ups. It was quite difficult to see this happen, since breast milk has so many benefits. But, when I see how much better she feels and looks, I know it was the right choice. We are hoping that she will quickly grow out of it and be back on mommy’s milk soon. Kali is on the smaller size, but is holding her own with the other ladies in the room at 5lbs and 12 oz.
Baby Ellie
Our little Princess Ellie also celebrated her 2-month birthday with a reanastamosis. She had her jejunum reconnected and was able to be extubated today. It was wonderful to see her breathing on her own and even smiling after they removed the tube. She truly is a tough cookie. Her tolerance for pain and her ability to self-soothe are amazing. We have no doubt that this was only a speed bump on her journey home. She is our little peanut at 5lbs and 7oz, but keeps pace with Theo in the eating department and definitely may beat the other girls home.
We are so grateful for the continued well wishes and prayers for the V-5. Hopefully, in another month we will be snapping these photos from the comfort of our own home!
The V-7 were reunited this past week. On Sunday, Theo and I landed in Madison after an uneventful flight. Theo was a champ and slept most of the way.
It was quite emotional to walk into the Madison NICU and realize that we were all here, and here to stay. I just stood for a brief moment at the entry way and could see all of the entrances to their rooms and my husband standing right in the middle. My mind took me home to when some day soon I would be able to stand in the hallway and peer into their nursery and do this exact same thing. Needless to say, many happy tears followed.
The following day, our family joined us for the reunion on Labor Day. We also were welcomed by NBC, ABC and Fox/CBS who helped to capture this exciting event for our family, but also for the city of Madison as we are the first quints to reside here. Our interviews with NBC and ABC are featured below:
The remainder of the week has truly flown by. The V-5 celebrated 1 month on Tuesday and in the NICU this celebration includes a battery of tests. All of our kiddos had repeat head ultrasounds and eye examinations to assess their eyes’ maturity, and to rule out retinopathy of prematurity (ROP). Also, Bella had an echocardiogram to investigate her persistent murmur. All of the quints have murmurs, but we now know that Bella does not have a PDA, Patent Ductus Arteriosis. Theo also had an examination of his intestines to see if they could begin refeeding and wake up his large intestine, just like his little sister, Ellie.
All of the tests brought reassuring news, except for one. Our little Lily Bug had minor PVL, which is Periventricular Leukomalacia. The good news is that her grade 2 brain bleed is resolving and healing, but this new finding of PVL was disheartening. PVL is an injury in the brain that affects the white-matter neurons. Infants with PVL most often display deficits related to motor control (movement), developmental delay and are at a greater risk of cerebral palsy and epilepsy later in life. Only time will tell if our little Lillian will face further challenges.
All of our little miracles are now a corrected gestational age of 34 weeks, which means we get to truly start focusing on feeding and growing. Enter this excited Mama who cannot wait to begin truly breastfeeding. No offense to my trusty pump, but nothing beats nuzzling with your babies. The next few weeks will help us to further assess Lily’s potential for feeding and motor issues, as well as, reveal our kiddos’ abilities to suck, swallow and breathe- a touch task for preemies.
It has been quite a busy week, but overall the Vanderwall family is over-joyed to be reunited. We are forever indebted and grateful for the all of the new and donated items that awaited ua at our home. I have had so much fun going through all of the items, organizing and partaking in some long-overdue nesting. So, thank you once again from the bottom of our hearts for all of the love, support, financial contributions and gifts that we have received. I can confidently say that the quints now have everything they need for when they arrive home. The only remaining item is a way to get them home. Next up on the to-do list…the V-7 mobile, or perhaps we’ll give new meaning to a VW bus!
When becoming a new parent, best practices, guidelines, and all of the “must-do’s” flood our mind. All mom’s and dad’s want the best for their children. I find peace in getting back to basics and focusing on two simple acts: Kangaroo care and Breastfeeding. Both of these can be practiced whether a parent takes their newborn home shortly after birth or for those trying to learn how to be mom and dad in a NICU setting.
Kangaroo care is an endearing term used to describe skin-to-skin holding. This snuggle time has benefits for both mom, dad and baby. The newborn benefits from skin-to-skin holding because they learn their parents’ scents. The sense of smell is the first to develop and is quite strong, which is why many encourage the use of scent cloths. Additionally, the baby’s vitals mimic those of the person, which is holding them and can help to regulate their heart and respiration rates. When mom is caring for her baby this way, the infant can be soothed by the sound of her heartbeat since it is what they heard for many months while in utero. Kangaroo care can foster quality sleep for infants. This is why it is typically done for at least 90 minutes at a time. We know that sleep is critical for a newborn, or preemie because it encourages both growth and healing. If time is of the essence, swaddling and hold the baby is also beneficial and many hospitals have “cuddlers” who are happy to help.
Kangaroo care also benefits parents as a unique bonding experience. One is able to simply hold, love and adore their baby. This is also a great time to sing, read or gently speak to the baby while they drift to sleep. A mother can specifically benefit from this practice because oxytocin is released during infant bonding.
Oxytocin is known as a love hormone, but plays a significant role in building, maintaining and letting down a mother’s milk. It also can cause uterine contractions that help the uterus return to its normal state. Therefore, it is evident how the first act leads to our second- breastfeeding.
The breast is best! Breast milk is often referred to as “liquid gold,” due to its nutritional superiority over other methods of feeding. A mother’s milk may vary in composition of nutrients, but on average it is 4.5 % fat, 7.1 % carbohydrate and 0.8-0.9 % protein. It is produced in the body by the mammary glands by pulling sugar, protein, cholesterol and other nutrients from the mother’s bloodstream. Therefore, good nutrition is also very important during the “4th trimester.” Most hospitals recommend fortifying breast milk to increase the calories from the natural 20 calories per ounce, to 22-24 calories per ounce. These fortifiers can also supplement the baby with much needed vitamins and minerals.
Breast milk is also unique because it contains IgA, or Immunoglobulin A, which is critical to helping to build the infant’s immune system. IgA is quite high in breast milk from day 10 through the 7th month. Additionally, if the mother is breastfeeding, the child can expose the mother to their bacteria and in turn the mother will create antibodies to fight the bacteria, which in turn will be delivered back to the baby via the breast milk.
I have never breast-fed; I have only pumped, but I certainly hope to in the future. The act of breastfeeding is a remarkable bonding experience that also provides an outlet for giving the infant attention. Pumping, with a caretaker present, is also not bad and can grant mother’s a few minutes alone to think, pray, or even grab a quick snack. Another benefit of breast feeding for mothers is that it can foster post-partum weight loss to help the mother achieve a healthier weight after pregnancy. Typically, mothers burn 300 to 500 Calories when breastfeeding or pumping 8 times per day, or every 3 hours. Again, it increases oxytocin which assists the uterus in returning to normal size. For further tips and information on breastfeeding, visit La Leche League.
Both of the acts described above may be simple on paper, but more difficult to practice in daily life. I hope the benefits listed above encourage mom’s and dad’s to explore these ways to attend to, bond and communicate with their baby.
This has been the week of travel for the Vanderwall quints. Isabella and Elliott celebrated their 3 week birthday by departing for a Madison NICU. Early Saturday morning, August 24, we packed up Bella and Ellie into a single isolette and began our transition. I joined the sisters, a nurse and a respiratory therapist for the trek on the medical transport prop plane.
It was an emotional 24 hours to say the least and got a good taste of what it may be like to go back to work and leave my little ones at home. I truly felt heartbroken to leave Lily, Kali and Theo for that day and a half. Tears flowed until we boarded the plane. I am happy to say that my heart perked right up when we landed near green grass and fresh water lakes. It also was such a blessing to see how excited Frank was to welcome our daughters home.
The girlies handled the flight and transition really well. Halfway through the flight Bella wet the bed through her diaper, living up to her latest nickname of “Bella Blowout,” and Ellie was not happy about it. For the remainder of the flight, Ellie proceeded to kick her sister to the side of the isolette. By the time we reached Wisconsin, Bella’s face was nearly plastered to the side of the chamber. Firsthand witness to sisterly love! Now settled into their new NICU home, they continue to advance in their feedings and are getting to be better breathers!
After a quick night in my own bed, I boarded a plane on Sunday morning to return to the remaining quints in Arizona. My Mama mission was and is to continue to urge the medical team towards quick, yet safe, transfers home.
Lily and Kali’s turn was early this morning. They have been ready to head home since yesterday morning but there wasn’t any room in the inn… or the new NICU.
So, we packaged these little ladies up this morning and watched as the ambulance drove away.
Again, tears flowed. Although it truly is a bittersweet event and more of a “see you later” than a goodbye, I learned that a parent’s unconditional love does not make sense. There simply is no logic in my love for our children.
Lily and Kali also arrived safe and sound in Madison. They are now enjoying their new homes in a room right next door to their sisters. The nurses reported to me that the plane ride was uneventful, which is exactly what I was hoping for.
Now, all but one are only 20 minutes from their final destination- our home. Theo and I will remain in Arizona until he is also ready to get his wings. He is doing very well and has achieved 4lbs!
He and I have already logged quite a few hours of Kangaroo care, which I believe has definitely helped his breathing to get stronger. It is amazing to watch how his vitals normalize as we snuggle together. It also helps me to continue to provide “liquid gold” for all of these hungry babies… as evidenced by the overflowing freezer dedicated to the V-5’s breakfast, lunch and dinner!
So, that is the latest and greatest regarding the V-5. Prayers remain that all five and mommy and daddy will be reunited soon! Please join me in praying that we will all be back in Madison by Saturday to celebrate their 1 month birthday!
Lillian Grace is one tough cookie. She has certainly had one of the more rough transitions to life outside of Mommy. This little love bug has faced breathing issues, a puncture in her lung, a brain bleed and an infection scare. But, she has conquered all of them! She is now leading the pack of ladies in growth and is one of the stronger breathers. You will notice below that she has fewer photos than the rest of the V-5. We did not want to bother her while she was healing, so we have some catching up to do now that she is well.
Little Lily has Daddy’s light hair, but Mommy’s nose. She is definitely a cutie like the rest! Our little Lily Bug is a great self-soother. Once you put on her little Lady Bug hat she is as happy as can be. She also cannot stand dirty diapers and she will let you know it. The minute she wets her drawers, she’s wailing. However, once you clean her up, she’s good to go.
If you click on an image, it will give you a full-screen slideshow of all the pictures.
We are so proud of Lillian and very thankful that God has granted her grace and has helped her to heal from her ailments. Please pray that His hand remains over Lillian and the rest of our Quints, so that they will continue to grow stronger and be able to return home together.
I believe further explanation of how we went from “status quo” to “the babies will be delivered within the next 45 minutes” is warranted. I was settling in for a day’s work on the morning of July 31st, when I felt like I wet my pants. Now to be honest, I just assumed little Theo was going to be controlling my bladder for the day. But, upon further investigation, I realized he had popped his little sac and I had “broken my water.” I called my doctor’s office, but since they were closed it directed my call to the physician on-call, which just so happened to be Dr. Elliott’s “bat phone.” I felt awful for bothering him on vacation, but he didn’t mind one bit. He encouraged me to pack a bag and head to Ob triage (the moms’ ER).
We arrived at the hospital and were quickly shuffled in for an assessment. They tested the fluid and confirmed that indeed it was amniotic fluid. Then, they discontinued my nifedipine (calcium-channel blocker), gave me a steroid shot (Betamethasone) to enhance fetal lung development, and started me on 3g of Magnesium sulfate. I was then whisked away to ultrasound to confirm the culprit. It was indeed little Theo (baby A) whose deepest vertical pocket went from around 5cm to about 1.6 cm, which indicated that he only had about 1.6 cm of fluid surrounding his little body in his sac. His head was now so low in my pelvis he appeared as though his little body stopped at his neck.
The nurses assured me that once my contractions stopped, it was entirely possible I could remain pregnant for several weeks. This amazed me but they said it happens all of the time. Unfortunately, this scenario is only true if 1) your contractions do stop, 2) you tolerate the medicinal anti-contraction regimen and 3) you do not develop an infection. My contractions did stop, thanks to the “mag.” But, it was clear after 24h on the magnesium sulfate that I was not tolerating it, and my lungs began to fill with fluid.
Magnesium sulfate is used for contraction management. It is thought to affect calcium channels to slow uterine contractions. Typical side-effects include water retention, muscle weakness, sweating/flushing, nausea, vomiting, constipation, and blurry vision. For most, these symptoms are tolerable and some mom’s of multiples can again remain on magnesium sulfate for several weeks, in order to prolong their gestation. Unfortunately, I hit the jackpot and experienced all of the symptoms noted above.
My body was only able to combat these side effects for about 3 days. I was placed on b-pap to increase my oxygen saturation and Lasix to try and rid my body and lungs of the extra fluid. On the morning of August 3, I was moved back to labor and delivery due to my pending diagnosis of pneumonia. When I spiked a fever and my white blood cell count shot up, we knew today was the day. It was then that we got the news that we would get to meet the quints within the next few hours.
They informed us that Dr. Elliott was speeding to the hospital, on his way back from vacation, and we were going to try and wait for him to arrive around 4pm. But, when he heard that I had a fever, he gave the go ahead to deliver in his absence.
Thus, they unraveled the most well-orchestrated delivery I have every heard of. With over 20 people in the delivery room (6 teams: one for me and one for each baby), they delivered the quints in about 3 minutes. The entire “operation” took about 45 minutes. I vaguely remember these moments, but Frank was right by my side to catalog it all.
Following delivery, Frank headed to the quints’ recovery room. By the time I arrived, all were gone and up to the NICU. My mom awaited me in the recovery room, and was over-joyed to see me safe and sound. I, unfortunately, could not see our little angels until my fever subsided and my breathing had stabilized.
Dr. Elliott arrived and it was clear he was upset that he could not deliver our babies, but we truly respected his decision. He shared with Frank that sometimes as a physician you have to make a decision with your head and not your heart. If we had waited even a moment longer my infection may have complicated the babies course.
Those 48 hours preceding the birth of our babies, were some of the worst of my life. But, I know that without that treatment regimen, our 5 little miracles would not have passed the “steroid efficacy window” and may have been at an even greater risk for serious complications.
Our heartfelt thanks goes out to Dr. Elliott and the teams at Banner Desert for their superb, patient-centered care, compassion and wisdom. For I know that if we were anywhere else, the circumstances and outcome may have been very different.
We have much more to share with everyone and are working on getting some fantastic pics of the quints, so look forward to some more baby updates in the near future!
Your One Source For Wellness Information.
Bump 2 Bab[y]ies 