Another bump in the road

Before we visited in July our Good Agency had told us that their coordinator in Guatemala was concerned about the size of PBJ's head. It is very large. The doctor thought it was fine and the foster mother thought she was fine too. But, as we all know, medical care in Guat isn't the same as what we are accustomed to in the USA. The fact that they were concerned was enough for me to be concerned too.
Once I saw her I realized that part of the problem was that the back of her head is as flat as a pancake, and it has expanded sideways and upward in the back to compensate. Add to that the fact that she is a tiny little peanut which makes her head look even larger. Hopefully in these photos you can get an idea of what I am talking about.
Developmentally she was very delayed. She was just over 9 months old but had the development of about a 4 month old. She could not sit up, even assisted. She couldn't bear any weight on her legs. She wasn't rolling in either direction. At the beginning of the week we had her she wouldn't reach out and grasp a toy held in front of her, but by the end of the week she had mastered that one. She had overall poor muscle tone. She had no pincer grasp and appeared to just be learning to grasp with her whole fist. She did interact well, kept good eye contact, made noises back and forth, laughed at funny things appropriately and communicated her needs clearly.

Her fontanels (soft spots) were of normal size and not bulging so she didn't appear to have a fluid build up as far as I could tell. Her hearing and sight seemed fine. She ate and slept like a champ. She seemed like a normal baby who had very little stimulation and was just behind. There is a helmet in her future to re-shape her head, but our doctor here felt she was not delayed due to any organic issues.

Today I got an e-mail from our Good Agency and they are again quite concerned about PBJ's head. They suggested I fly down and go with her to see a specialist. I have asked that they get me an update on her development. I gave them a list of milestones to look at. Depending on what they find, I may be heading to Guat very soon. Honestly, I think she is fine. My Mommy radar did not go off when I was with her, and I usually have very good instincts. Levi had such a big head they did a CT scan when he was 15 months old. From that expereince I knew what to look for and what warning signs would be. PBJ had none of them.

What she needs is to get here, home with us, and so that we can start early interventions right away. Get the helmet, get her health and development assessed, see the specialists, start therapy and stimulation exercises. We have all of that ready and set to go, we just need the baby!