Saturday, May 5, 2012

Spencer's Well Child Visit - 4 months

I am a bit delayed with this update. Spencer had his 4 month check up a week or two ago. Here are some of the things we covered...

Post-Bath NapNaked naps after a bath are some of the best naps ever!

  • Spencer has gray around the whites of his eyes. Our pediatrician says this is normal. No worries.

  • Sometimes he has blood shot or even blood spots in his eyes. This is also normal and may even be caused from crying very hard sometimes.

  • We'll get a referral for Spencer's first actual eye exam at his 6 month visit.

  • We followed up on the fontanel on the back of his head. It was a little uneven at one time, but it seems to be growing normally now.

  • We discussed Spencer's stridor. It could simply be from having an immature, soft throat. He will eventually grow stiff tissue that strengthens that. His throat probably closes partially when he breathes, causing the odd sound. Our doctor also pointed out something he figured we probably already noticed: our pediatric cardiologist tends to flip out over little things then later seem very calm about them. The fact that he has not had the lead cardiologist look over Spencer's file or mentioned her is a good sign. Spencer could also just have a small airway.

  • Spencer is still gasping, mostly in his sleep. It is actually happening less frequently, so there no concern at this time.

  • Spencer tends to have a slight rash in his neck under his chin. Our doctor suggested using any sort of diaper cream we prefer. He also has some red marks on the back of his neck, but I was beginning to suspect they are just birth strawberries. Our doctor agreed they are just birth marks (strawberries).

  • During our last check up, our pediatrician told me we would review whether Spencer needs private physical therapy in addition to the assistance he is already getting from his in-home Sooner Start visits (done by a Child Development Specialist). We could go for more preventative therapy, but it would just be more appointments to attend when Spencer doesn't appear to need them. I am not pushing him anyway, so I'm fine with not adding to our schedule.

  • Spencer has had some unreasonably stinky and very firm poop. I suspect diet changes may be the culprit, though. Our doctor saw no cause for concern so long as Spencer is not in pain during bowel movements. He was also amused by my complaints of stinky poop.

    Vascular Ring - MedLine PlusClick photo for more information about Vascular Rings

  • We discussed Spencer's hypertension. Our pediatrician suggests that it could be caused by a vascular ring that goes around the throat. We could get a referral for further testing, but it is more invasive than the testing we've already done. No surgery would be recommended until / unless the hypertension gets much worse, so our doctor didn't recommend doing more testing at this point. We'll just keep following our cardiologist schedule. We'll revisit the topic later. I get the impression that if Spencer does have a vascular ring, it could also be causing the stridor (see above).

  • I recently noticed that Spencer's ankles turn out when he lifts them close to his hands. The doctor wasn't concerned, but said we'd revisit at 9 months to see if Spencer needs any help correcting them. They may develop normally on their own.

I always keep a running list of questions for our pediatrician. He is very available to us via phone and email between appointments, but a lot of this isn't pressing enough. I am fine asking my list at appointments and am still very happy with our choice. As you can see, some of the issues we face are typical while others are specific to having a son with Down syndrome. Spencer's stats are good, too:

Head circumference is 40cm, placing Spencer above the 50th percentile on the Head Circumference for Age (Down Syndrome) growth chart.

Weight is 14 pounds, 8 ounces, placing Spencer at the 90th percentile on the Weight for Age (Down Syndrome) growth chart.

He is 25¾" tall (long), placing him over the average range on the Length for Age (Down Syndrome) growth chart! Henley even pulled up the typical growth chart for comparison. Spencer lands somewhere around (but above) the 50th percentile on it, if I recall correctly. We do have a tall boy!

Overall, we're (including our doctor) very pleased with Spencer's development! We have some things to watch, but he is doing well and is also very engaging. He is off to an amazing start and we're very lucky!

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