Betterness by Kawika Holbrook

Eat This

2010-01-10T08:54:43-08:00

On January 3, 2010, my wife and mother attempted to feed our six-month-old daughter Sloan solid food for the first time. Attempted.

To My Daughter at Six Months Old

2009-12-15T23:01:00-08:00

Hi Sloan,

Today you turned six months old. My how you have grown. Just a few days ago, the doctor weighed you at more than 12 pounds. That means you are catching up to babies who were born after nine months in their mothers. You do not need extra formula any more, just mom's milk. And you are outgrowing all of the nice newborn clothes our friends and family bought for you.

We could not have been happier. Or so we thought.

Three days ago, while I was strapping you into your car seat, you smiled at me. I smiled back. Your smile grew bigger and bigger. I laughed. And then you giggled. It was your first laugh. Your mother was by the car and heard it. She came running back into the house. I laughed again, and so did you. I decided that was the best sound I have ever heard.

Soon, though, things will change around the house.

Your mother is going back to work in two days, and she feels like it is too soon. Most people our age want things to speed up -- traffic, lines, the Internet, and so on. We are happy to take our time with you, however. You don't need your teeth yet. You don't need to eat solid food yet. You don't need to be out of diapers, or sitting up, or crawling around, or anything else other than being who you are right now.

This is hard for adults, to be right here right now. We often think about other places and other times. We think about past or the future. We think about home while we are at work, or work while we are at home. I think about all the chores that have to be done. A lot.

You have a way of bring us back to here and now, for which I will always be grateful.

I have only taken off one or two days since you were born two-and-a-half months early. That way your mother could be with you as long as possible. On the day your mother goes back to work, I will be taking two weeks to spend with you. And then, just before Christmas, my mother will come to spend three whole months taking care of you during the day while your mother and I both work. Thankfully, we will always be close by and should get to see you at lunch time several days a week.

Well, it is late. You and mom are asleep. I have not written nearly as much as I would have liked to these past few months. I will try better. But know, no matter what, you are always in my heart.

Love,

Dad

To My Daughter on Her Homecoming

2009-08-10T23:20:12-07:00

Dear Sloan,

We've had you home for nine days. I wanted to write to you sooner, but the time has gone by faster than I expected. We have celebrated a lot of firsts so far:

Your first meeting with Kona, our dog, who seemed more interested in your bassinet than you at first (but still walks by to lick you at
Your first night at home, when we barely slept without monitors to tell us how well (or whether) you were breathing.
Your first trip outside, when you and mom surprised me at the office for a baby shower with my coworkers.
Your first visit with my best friend and his family, when we had such a good time that a two-hour afternoon barbecue lasted seven hours.
Your first visit to our new pediatrician, who dressed like I did in high school almost 25 years ago (but unlike me did not forget how to speak when in a room with girls).
Your first vaccination shots with us watching. I think you stopped crying before mom.

Those shots today seemed to make you fuss whenever mom tried to put you down, so she held you almost the entire day. I sent her to bed a few hours ago after she started getting one of her bad headaches. She needs more sleep, which means we have to be less concerned about all the noises you make all day. Everyone says they're normal, so we have to trust you are not suffering some malady or episode if we are to rest at all.

Regardless, you are doing very well at home. For the record, you are now 5lbs 15oz and 18 inches long, which is just what the doctors wanted to see. Of course, you are just what we want to see. And I am happy, so very happy, to have you with us at home just looking up at me while I finish typing this to you. Thank you. You do not know it yet, but this right now is the best gift in the whole world.

Love,

Dad

To My Daughter on Small Steps Back Before Big Steps Foward

2009-07-30T18:53:32-07:00

Dear Sloan,

I'm sitting in the hallway outside the NiCU as your mother and my mother prepare to feed you. I have a bad sore throat and cannot come near you right now without a face mask and plenty of extra hand washing.

So far, you are doing everything you need to do in order to come home. You are finishing all your meals. You are gaining weight. And for three days in a row you haven't stopped breathing even once. Two more days of progress and your doctors might let us take you home. Almost seven weeks have passed since you were born, and we are excited to have you finally with us for a night.

Except for brief moments, you haven't traveled more than a couple feet from your isolette or been free from the wires that monitor your heart rate, oxygen saturation or respiratory rate. You've been weighed daily, had blood drawn regularly and been watched over viligently by some of the best nurses in the world.

All that will soon change. At first I couldn't wait for all the monitoring and testing to end. Now I have to prepare for the time when we won't have machines to tell us how you are doing.

We've been told that "Everything will fall into place" and "You'll know what to do when the time comes." Perhaps. But so little about your arrival has been expected, and I've been on guard for so long, that it may not be easy for me to believe things will settle into a routine.

But, you know what? I'm watchIng you through the glass. Your mom is changing you diaper. I can hear my mom telling any nurse who walks by how wonderful you are. You are squirming around, making faces, and -- well, here is your mom picking you up to show me a big, beautiful girl who looks very ready to come home.

You make everything better, Sloan. Thank you.

Love,
Dad

I'm a Big Sucker, Now

2009-07-17T11:54:12-07:00

Our one-month-old daughter, born 10 weeks early, takes matters into her own hands. She's gaining weight, needing less oxygen, and handling a pacifier on her own. This video may bore the world, but I could watch it all day.

I tried editing this video on the iPhone for the first time and discovered by accident that once you trim a movie you can't revert back. (Something the iPhone OS 3.1 should remedy.) My wife has given me strict instructions not to delete a second of video no matter how much is filmed or how bad the shot is.

The scene I cut, apparently, is Sloan counting to 10 in Mandarin.

To My Daughter on Kindness

2009-07-08T12:24:57-07:00

Dear Sloan,

A couple of weeks ago, a package arrived for us at your isolette. We did not know who sent it or why. We took the box home but were too busy to open it for while. When we finally did, we found gifts and treats from Graham's Foundation, an organization to help support the parents of "micro-preemie babies" with "care packages that are both practical and inspirational."

Here is the quick thank-you letter I wrote them:

We certainly didn't expect our daughter to arrive two-and-a-half months early, but the love and support from friends and family has helped us cope with the challenges. It was a pleasant surprise, however, to find a care package from your organization waiting for us at our daughter's isolette. Your timing was perfect. One day my wife was cold and hungry. Waiting in the box was a blanket and granola bars. I got thirsty and didn't want to leave my daughter. A juice box quenched the thirst. I can't wait for our daughter to come home and complete the coloring book, or take photos with the disposable camera. Thanks for putting a smile on our faces and warming our hearts. Feel free to share this message with anyone you'd like. We'll certainly share your mission with others.

Best regards,
Kawika Holbrook

The care package was addressed to "Jennifer Sloan Holbrook," which is a name your mother uses on Facebook so old friends and classmates can find her using the last name she had when she was born. My guess is the nice people at the foundation heard about you from a connection there.

Your mom has many connections helping us today.

Friends have brought us dinners so we did not have to worry about cooking. They drove your mother to visit you when she was still healing from her surgery. They offered to help move furniture or paint walls so we can build you a nursery. Your grandparents are visiting from far away just to look at you. All of this makes things easier for us and better for you.

Why are so many people so kind to us?

You do not have to look any further than your mother. She has many, many friends. They care about her not just because she is smart and fun, or because she treats others the way she wants to be treated. Your mother celebrates the happiness of everyone around her. When they suffer her compassion is deep and real. And her heart is never so full that she cannot find room for another friend.

(My mother has the same qualities, which is one reason I love them both so very much.)

One day you will disagree with your mother. You may think she is being too strict, or stingy, or smothering, or something else. When that happens, if you can, come back and read this note. The kindness so many people are showing us today is helping make a better world for you.

To My Daughter on Labels

2009-07-04T16:40:41-07:00

Dear Sloan,

I'm watching you sleep in your isolette. You look very peaceful on your back, resting your head on your right hand. Sometimes, though not now, you put one or both hands behind your head, just looking around to take everything in. I love that about you.

You had a big day today. Your mother fed you for the first time from a bottle. You weighed in at 1510 grams, which is another solid gain. A few more weeks like this and ... well, I don't want to get ahead of myself.

I learned the other day that your doctors called you a "micropreemie." The state of California considers you, at least temporarily, "disabled." Later, when we're allowed to take you home, we'll get visits from a social worker because you'll be an "at-risk infant."

These are standard labels to classify your care. But I want you to know that they are not you. As you grow up, schools may label you as someone with "special needs" or "gifted." Other kids may label you with nicknames because of your size, eyesight or some other difference. Adults may label you because it's easier for them if you fit into their understanding of the world.

Just remember that you are filled with infinite possibilities, and no one can predict with certainty your measure or contributions in life.

Your nurses and doctors help me remeber this fact, too. They won't predict when we can remove your nasal cannula or feeding tube. They won't give me an estimate of when you can come home. And each time I ask if some issue or report is "normal," the reply never includes a simple yes or no.

Instead, I sit by your isolette. A monitor beeps out stats. Yours are good for the moment. Other babies fuss and cry. But you, with your hand on your cheek, are sleeping after a big day with your mom.

I am happy.

Love,

Dad

Ants Marching

2009-07-04T13:30:23-07:00

The Raid Double Control Ant Baits have 24 more hours to work before I go nuclear.

Through the Looking Glass

2009-06-30T00:23:34-07:00

Sloan needed her rest, so we just spent this evening watching her.

To My Daughter on Her Care

2009-06-29T01:18:39-07:00

Dear Sloan,

We leave you each night in the care of kind and gentle nurses. It is hard for us to go when you are awake, but we know you need time to sleep and grow. You have a good home for now in the Neonatal Intensive Care Unit at the Kaiser Permanente Santa Clara Medical Center. In addition to all the nurses and doctors, each preterm baby there has a case worker. Yours was kind enough to write us a progress report on June 23. I'm saving it here so our family and friends can learn more about how you're doing. They are so kind to us, but we can't always write or call them with updates about you. I want you to know that, next to your health and own happiness, keeping friends and family in your heart is more important than anything else in the world.

Developmental Care Plan
June 23, 2009

Competencies
During this behavioral observation Sloan was observed as the nurse took her vital signs, changed her diaper, repositioned her, and fed her. Sloan was able to maintain a steady heart rate, good oxygen saturation and pink color while she was quiet, as well as during the time she was handled. As she was handled, Sloan became very active, but kept herself calm by bringing her hands up to her face and by clasping her feet together. She made soft mouthing movements on her feeding tube to show that she was getting hungry, but she was tube fed at this time. Sloan transitions from light sleep to brief periods of robust crying, spending most of the observation in a drowsy to quiet alert state. When in alertness she raises her eyebrows to show her interest in social interaction, however, she only locked her gaze with her nurse very briefly.

Sensitivities
Sloan is sensitive to sudden changes in her environment, and to handling. As the observation began, she was hiccoughing and breathing at an irregular rate. Her hiccoughing stopped as she was handled, but she began breathing fast after she was handled. Although her color is pink, she has an underlying yellowish color to her skin. This is very normal for her and should diminish within a week or so. Sloan was very active, moving about with jerky, flailing movements. As she was turned to her back her arms spread wide apart (airplaning) with her fingers spread wide apart (finger splaying) as well. While the nurse handled her she frequently extended her arms out in front of her (saluting) with her fingers splayed. However, she calms easily with hand containment. Sloan fussed briefly with her diaper change, but generally stayed calm. As she tires of socializing, she averts or closes her eyes.

Recommendations
Continue to keep Sloan in the covered isolette until she is at least 32 weeks, adjusted age, and is closer to 1500 grams. Since she still requires having the nasal cannula in place we don't want to make her try to maintain her own temperature as well as try to regulate her breathing. handle Sloan very slowly and gently to help keep her well regulated. use frequent hand containment by placing one of your hands over her head and the other over her hips and legs. provide this containment prior to handling her to prepare her for a change; during handling to keep her calm and well regulated; and following handling to help her smoothly transition back into deep sleep. Position Sloan with her arms and legs flexed (bent) and tucked in close to the midline of her body. Bring her hands up to her face, and bring her legs together to allow her to self-calm herself. When on her tummy, bring her arms up under her chest to keep her shoulders rounded forward, rather than lying flat on the bed. When placing her on her side, bring her well over onto her side with a small roll in front of her to drape over and hold on to. Use a size appropriate snuggle-up, keeping her down in to the fold of the snuggle-up to give her close, firm boundaries to push against. use the straps of the snuggle-up to bring her boundaries in closer for a more secure feeling nest. Sloan is getting close to starting to breast/bottle feeding, but she has some requirements to be met to ensure a successful breast/bottle feeding session. She needs to be able to maintain alertness throughout most of the feeding, as well as to exhibit hunger cues. These cues include making mouthing movements, searching for something to suck on, and sucking eagerly on a pacifier. These requirements need to be in place whether offering the breast or the bottle. Allow mom to put Sloan to the breast when she visits, and if Sloan is acting hungry. When starting bottle feeding, use the green rimmed nipple for a slower flow of milk. Gently rub her lips with the nipple until she opens wide. Allow her to take 4-6 sucks on the bottle, then lower the bottle to encourage her to swallow and breathe. Do not push her, but allow Sloan to set the pace of the feeding. As she slows with the sucking, gently turn the nipple in her mouth to encourage her to start sucking once again. After long pauses in sucking, remove the nipple and sit her up to burp her. Watch her closely for subtle color changes around her eyes and nose, suck as pale or slightly dusky colored, or for sudden sleepiness. If this happen removes the nipple an sit her up to encourage her to take deep breaths. Encourage the parents to participate in Sloan's care as much as possible. Allow them to kangaroo hold (skin-to-skin) each day, as tolerated. It is important to know that Sloan may not be able to tolerate being talked to and touched at the same time, so try to just hold her quietly when kangarooing. As she averts her eyes from yours or closes her eyes, she is telling you she has had too much stimulation. Provide support and encouragement to the parents as they begin their journey with Sloan.

Best Father's Day ever (even if it was my first)

2009-06-22T02:07:00-07:00

Held my daughter for the first time on a few hours ago. Definitely the best gift Father's Day gift I have ever received. Okay, it was my first Father's Day. Still, my daughter is practically glowing with pride for her dad.

(The bili light is a phototherapy tool to treat newborn jaundice, called hyperbilirubinemia, which was a symptom of Sloan's early delivery. It's working.)

To My Daughter on Life's Plans

2009-06-19T08:30:00-07:00

Your mom is resting right now in a part of the hospital called "Mother/Baby." This is where both moms and newborns recover from the hard work of birth together. Moms learn how to feed their babies, change their diapers, and hold them tight to keep them safe and make them happy.

I hear baby noises in the other rooms. I see families hugging happy dads in hallways. The smell of talcum powder floats from somewhere. New parents are kissing their babies and stroking their faces. After a day or two, they pack everything up and go home together.

But you and your mom aren't in the same room. The two of you have only been together a few times so far. Your doctors say that stroking your cheek or playing with your fingers will hurt you right now. Everyone congratulates us on your arrival, but the timing seems a bit off.

Your mom's friends and family didn't have time to throw her a baby shower. She didn't have time to build a nursery. She didn't get to see her belly grow big like other moms. And, even though it's not her fault, she feels as if she did something wrong because you couldn't stay inside her even one more day.

Despite all of this, last night your mom saw that I was very tired. She told me to go home and sleep in our bed.

I was sad to leave her alone for the night. I dropped off a small bottle of her milk for you at the NICU and said goodnight. As I bent down to kiss the glass of your isolette, you opened your eyes a bit and reached out with your tiny, tiny hand. I didn't want to leave you alone with all the wires and tubes and monitors and scary beeping noises, but I promised your mom I would get some rest and I know your nurses take good care of you.

So I left the hospital and went home. I even left our wonderful dog overnight at a kennel.

But I couldn't sleep. Instead, I thought about everything you and your mom did not get to have. I decided to play some music, hoping it might make me feel better. I played your mom's favorite song, "Somewhere Over the Rainbow/What a Wonderful World" by Israel Kamakawiwo'ole. It always makes her cry and smile at the same time.

I played a song John Lennon wrote to his son, explaining that "Life is what happens to you while you're busy making other plans." And I played a song by The Rolling Stones called "You Can't Always Get What You Want," where they reminded me that if I try, I might just get what I need.

That's all I remember before falling asleep.

It's morning, now. The sun is shining through the blinds. The time is later than I wanted, but I feel better now.

See, you're going to grow. Your mom will get her shower. The nursery will be built. In time, we'll get to kiss your face and play with your fingers and put you in a stroller to take you home and get to do everything else parents get to do.

And there won't be a single day for the rest of my life that I won't look in the mirror and see the luckiest husband and father in the whole wide world. Because with you and your mom, I have everything I need.

Love,

Dad

To My Daughter on Her Name

2009-06-17T12:38:39-07:00

Your mother got to see you for the first time yesterday afternoon, and she cried. That made me happy. I know this sounds odd, but I think you'll understand in time.

Your mom was getting medicine that made her sleepy, so she couldn't spend much time with you before going back to her hospital room. In that short time, though, she fell in love.

Your mom saw herself in your face. That made me very happy, because I think she is beautiful.

Late last night, she was able to make the tiniest amount of food for you, which the doctors say will be good for her and good for you. We came to visit one more time with a surprise called "kangarooing." Very slowly, and with a lot of care, your nurse removed you from your isolette and laid you on top of your mom's chest.

For the next two hours, your skin touched her skin. You look at your mom. "She's so tiny," your mom told me. "I didn't know it would be like this."

She was scared. That didn't last long, though, because "skin to skin" made both of you feel better. You stopped fussing and she started beaming. I saw joy wash over her like a warm shower. When you open your eyes to look up at her, everything was right with the world.

You may be tiny, but you're also strong. "She's a trooper," your nurse said. "She's a fighter," your mom's doctor said. "She'll battle through this just like her mother is doing," two friends said.

And that helped us decide your name.

Before she married me, your mom's last name was "Sloan." She liked it very much, and trading it for my last name wasn't easy. In Irish, "Sloane" means warrior. Sloan is a shorter version of that.

So, because you'll need all the strength you can get. And because you're mom's family name means so much to her. And because I thought of it first (ha ha), your first name will be Sloan. It's a good name, and I hope you like it.

We also get to give you a middle name, too. I grew up in Hawaii. My first name, Kawika, is Hawaiian. Everyone loves Hawaii. They are they most beautiful chain of islands in the world. In Hawaiian, "Kai" means sea and "Lani" means heaven or sky. "Kailani," then, seemed only fitting for you because we could search heaven and earth -- or sail the seven seas -- and still not find a daughter better for us than you.

Welcome to the world, Sloan Kailani Holbrook. Get ready for a great adventure.

Love,
Dad

To My Daughter on Her Birth Day

2009-06-15T23:59:00-07:00

I can't wait for you to meet your mother. She's recovering in the ICU. You're in the NICU, tucked in an isolette, with lots of doctors and nurses to make sure you're comfortable (and me, too -- it's kind of overwhelming to see all the monitors, tubes, and wires all over the two of you).

You came into our lives a couple of months early, and —- to be honest -- we weren't really prepared. We don't even have a name for you yet. Maybe once mom gets to see you in person she'll like what I have in mind.

I named this place "Betterness" a long time ago, not truly sure what the name was supposed to mean. An ironic commentary on life? Storage for the stuff that I found interesting? Thinking aloud to understand myself? Perhaps. But after today, I think I have a much better idea. I'll write more about this soon.

Meanwhile, stay warm, be nice to your nurses, and get ready for a big, wonderful life. I'll see you in the morning.

Love,

Dad

How Social Media Really (Really) Works

2009-04-05T14:34:10-07:00

Matt Haughey blogged on buying his 4-year-old a new swing set, and used the opportunity to warn against wasting money on self-described social media gurus:

So maybe instead of getting your company on twitter, paying marketers to mention you are on twitter, and paying people to blog about your company, forget all that and just make awesome stuff that gets people excited about your products, hire people that represent the company well, and when your stuff is so awesome that friends share it with other friends, you may not even need "social media marketing" after all.

I decided to comment, which I'm copying here:

As a father-to-be, I'm prowling the net looking for the right crib, the right stroller, the right advice on preventing boys from ever dating her, and the right everything else. I wouldn't know about most of these products (or of Howie Mandel's decision to prevent boys from dating her daughter by not potty training her) if the companies didn't engage in some type of marketing or PR.

For every good company that is fortunate to have news about its products or services included in a popular news story, there are plenty of other good companies that need help getting the word out.

Matt, you wouldn't have known about the swing set if Lilly hadn't blogged. Lilly may not have known had she not read the wire story on the Argus Leader website. The story's reporter may not have known unless he or she researched the news release from the White House. And, regardless whether Rainbow Play Systems had publicity help, the chances of getting noticed (or even called) by a reporter on deadline increase tremendously with the hard and/or smart work of a PR, SEO, or [shudder] a "social media marketing" agency.

I shudder at "social media marketing" because I work in IT for a public relations firm with tech clients, and we no more pitch a "social media strategy" than we pitch an "email strategy" or a "phone strategy." Twitter, Flickr, YouTube and the rest are simply ways to share and converse with people.

A good chunk of our clients' sales comes from people who read business, trade and daily publications either in print or online to help inform their decisions. Many of the people who write those stories work for companies struggling to stay in business. A good PR firm works to understand their needs, cultivate relationships, and connect them with people, products, stories or insights that add something of value to their work. (Meanwhile, a bad PR or "social media marketing agency often floods reporters, analysts, bloggers, and networks with unwanted voice mails, irrelevant emails, useless Twitter chatter, or valueless multimedia.)

Of course, none of this matters if a company's product or service doesn't have enough value in and of itself, but -- as @rick suggested in the comments above -- neither will it matter if people such as you (or Lilly or the reporter or even Rear Adm. Stephen Rochon) never hear of or learn about the Rainbow Play Systems of the world.

Matt, congratulations on finding the right swing set. If we ever get a yard, your choice will probably going on the top of our list. And for all the companies selling stuff I might want to buy, make sure it's solidly built, sustainably sourced, smartly designed, fairly reviewed, truthfully marketed, and easily searched. If that requires the services of a PR firm, an SEO expert, or a social media guru, just do your homework first.