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Are anyone else’s kids obsessed with telling knock-knock jokes that make absolutely no sense at all?

Here’s one I overheard recently:

Charlotte: “Knock Knock.”

Eloise: “Who’s there?”

Charlotte: “Eyeball.”

Eloise: “Eyeball who?”

Charlotte: “Eyeball on your face!”

(Both girls laugh hysterically.)

My girls needed better material to work with. But what makes a knock-knock joke difficult for children is the joke’s reliance on homophones (groups of words that have the same pronunciation but different meanings; ie: “I scream” and “ice cream.”) So, I can tell the girls a perfectly good knock-knock joke but the humor is lost on them because they miss the duality of the words. As an example:

Knock knock.

Who’s there?

Mikey.

Mikey who?

Mikey won’t fit in the keyhole.

They stumble making the transition from “Mikey” to “my key,” and I have to pantomime a failed attempt at unlocking a door with a key.

The solution to teaching my kids good knock-knock humor? ILLUSTRATED knock-knock jokes! And it doesn’t get much better than Dial Books’ compilation of jokes, illustrated by some of the greatest picture book illustrators alive today.

Knock Knock Cover

The 14 artists who contributed to “Knock, Knock!” include the geniuses behind “Strega Nona,” “The Dot,” “Big Red Lollipop,” “Zen Shorts,” “A Series of Unfortunate Events,” “Imogen’s Antlers” and “A Ball for Daisy.

Each right-hand page of the book is the illustrated set-up for a knock-knock joke. Take Saxton Freymann’s classic, for example:

Lettuce In 1

You turn the page, and the punchline is revealed:

Lettuce In 2

The visual helps children understand the play on words more quickly and also helps them put the joke to memory — all the better to entertain their family and friends.

My girls’ favorite, which they’ve repeated with some success, comes from illustrator Laurie Keller:

Impatient Cow

 

As a side note, Iowa appears to have a place in knock-knock-joke history. Wikipedia cites the Rolfe Arrow of Rolfe, Iowa, as one of the very first places a knock-knock joke (in the form we know it today) appeared in print in the United States. It took some digging (Wikipedia references an incorrect date and page) but I eventually tracked down the original humor column (“HeeHaw News”) in the Arrow’s online archives.

Original Knock Knock Joke

 

The Pittsburg Post-Gazette had earlier reported in their Aug. 9, 1936, edition that knock-knock jokes had become a popular parlor game that year.

Pittburg Post-Gazette

 

Thank goodness knock-knock humor has improved a bit over the past 75 years. I got a genuine laugh or two from this mostly-kid-friendly list at BuzzFeed.

What are your favorite knock-knock jokes?

Lost Things

Speaking of “Mom Brain”…

Cell phone, keys, sunglasses, credit cards, books, chargers, jewelry, slips of paper … I am perpetually – as in EVERY DAY – losing these and other essential items. Not too long ago, I accidently left my wallet (with all my credit cards and ID) in a box I dropped off at Goodwill, never to be seen again

One of the many challenges of becoming a parent has been the added responsibility of keeping track of my children’s possessions as well as my own.

Granted, at 6 and 5, the older two should really take care of their own things, but I know that I’ll end up being the one who suffers the most when Blankie turns up missing at bedtime or when their MOST SPECIAL stuffed animal is MIA. Plus, I feel a tad responsible for handing down the tendency-to-lose-things gene, and I never quite recovered from the loss of my own baby blanket at a hotel in Minneapolis (even if it was in seventh grade).

So…if that means making trips to Hy-Vee, Target, Wal-Mart and a half dozen other places in pursuit of a stuffed moose called Tyrone, so be it. (He turned up a few weeks later inside a wicker pumpkin stored with our Halloween decorations). And it only took three months of searching every crook and cranny of our house and half the town, but I eventually tracked down Charlotte’s missing back-up blankie here:

Blankie Found

(Really? What motived her to store her blankie in a bundt pan in a rarely-opened drawer of baking supplies?)

One of the absolute best picture books about lost things is Mo Willems’ “Knuffle Bunny: A Cautionary Tale,” the first in his trilogy about a girl named Trixie and her beloved stuffed rabbit.

Knuffle Bunny Cover

The book earned a 2005 Caldecott Honor, and I suspect its enduring popularity has a lot to do with the fact that the story is inspired by the true events of an outing the author took with his daughter:

“The whole Knuffle project started by accident,” Willems told Leonard Marcus, author of “Show Me a Story: Why Picture Books Matter.” “One day I was sitting in my art director’s office with her and my editor, telling a funny story while we waited for some printouts. Immediately, Alessandra Balzar, my editor, said, ‘That’s a book!’ I said, ‘No, no. It’s just a funny little story.’ But she insisted (and Alessandra is very good at insisting), so I went home and thought about it seriously. In the process of expanding and fictualizing the story, I realized she might just be right.”

 

Mo Willems' Family

(Mo Willems with his wife, Cheryl, and daughter, Trixie)

Dedicated to the “real Trixie and her mommy,” “Knuffle Bunny” is described as a “tale about what happens when Daddy [presumably Willems, himself] is in charge and things go terribly, hilariously [though not hilarious to Trixie] wrong.”

Here’s how the adventure begins:

“Not so long ago, before she could even speak words, Trixie went on an errand with her daddy…”

Trixie and Daddy Leaving

Can you see Trixie’s mommy sitting on the front stoop of their brownstone with a book in her lap, anticipating a nice hour or so to herself? Not only will she be freed of parenting duties, but her husband also will be off completing a tedious household chore. It’s every mother’s dream and almost as rare as Halley’s comet passing.

Trixie and Daddy walk down the block, through the park, past the school to the laundromat, where they load their basket of dirty laundry into the washing machine before heading back home.

Doing Laundry

But here’s where things go so terribly wrong, because “a block or so later … Trixie realized something.”

Trixie Realized Something

Astute readers are already aware that Trixie is missing her treasured friend, Knuffle Bunny. Trixie’s father, however, is clueless. Unable to make sense of her babbling, Daddy trudges toward home, toting Trixie, now in full-tantrum mode.

Tantrum

I love the accuracy with which Willems has depicted Trixie’s meltdown: she pleads helplessly, is dragged, goes “boneless,” is carried while flailing and kicking her daddy in the chest before finally succumbing to hysterics. I equally adore the oh-so-familiar progression of expressions on Trixie’s daddy’s face (shock, helplessness, frustration, embarrassment, anger) and the gawking and judgemental faces of passersby.

Can we pause here to say this is just the sort of thing that happens when a dad is on duty? Moms are like nurses in an operating room, counting each and every surgical instrument and sponge before closing up. When the girls and I prepare to leave the pool, the library, a play date, the doctor’s office, a park, the gym, I’m counting heads, shoes, lovies, towels, diving sticks, water bottles and myriad other things. (I also try to remember my own phone, sunglasses and wallet). Admittedly, items are left in our wake, but their absence is usually quickly noted and U-turns are involved.

When Trixie and her daddy arrive at their doorstep, it comes as no surprise that Trixie’s mommy is able to assess what’s amiss in no time at all.

“Where’s Knuffle Bunny?”

WheresKnuffleBunny

Trixie is rightfully indignant, and Daddy panics as he realizes the consequences of the situation. The family races back to the laundromat where, much to everyone’s relief, Daddy is able to redeem himself by rolling up his sleeves and diving head first into the washer to dig out Trixie’s well-loved rabbit. The icing on the cake? The incident prompts Trixie to speak her first words: “Knuffle Bunny!”

Trixie's First Words

As an aside, I was reading an article Willems did with the online newspaper seattlepi.com, and they raised the question about how one pronounces the word “Knuffle.” In the second book in the series, “Knuffle Bunny Too: A Case of Mistaken Identity,” Trixie squabbles over the articulation of the name with a girl who owns a rabbit identical to hers: Trixie says “ka-nuffle” while her rival, Sonja, says “nuffle.” It turns out Trixie has it right. “Knuffle” is a Dutch word that means “to snuggle or hug.” Willems is the son of Dutch immigrant parents, so it would make sense that his own daughter (fictional or not) would know how to pronounce the word correctly. Unfortunately, the spelling of the word is another story:

Willems learned — too late — that he goofed by transposing the “e” and the “l” in “knuffel” all through the original book.

“After it was published my mother said, ‘Why did you misspell it?'”

His only excuse: “It didn’t come up on my spell check.” (Cecelia Goodnow, seattlepi.com)

The Knuffle Bunny series and all of Mo Willems’ books, for that matter, are lauded for the way in which they so accurately reflect the emotions, challenges and development of children. Young readers quickly identify with Trixie’s difficulties communicating, with the Pigeon’s frustrations at always being told “no” and with the stumbling blocks in Elephant and Piggie’s friendship.

What makes “Knuffle Bunny” a standout, however, is the unique illustrative methods Willems employed to bring it to print. Willems’ typical cartoon doodles are easily recognizable. In fact, his mischievous Pigeon is familiar to parents and children practically around the world. But in “Knuffle Bunny,” the expressive cartoon characters are creatively placed on photographic backgrounds, taken from Willems’ own Brooklyn neighborhood. The marriage of cartoon and photography was a happy accident, according to Willems:

“The characters weren’t popping and I couldn’t get it to work. Then one of my drawings accidentally fell on top of one of the photographs on my light box, and I suddenly had the idea to combine the two.” (“Show me a Story: Why Picture Books Matter”)

The resulting product was the first Caldecott Honor winner to contain photography in any way. I particularly like the way in which Willems allows his characters to walk in and out of the photographs.

The adventures of Trixie and Knuffle Bunny continue in “Knuffle Bunny Too” and the final installment, “Knuffle Bunny Free: An Unexpected Diversion.” Together they chronicle Trixie’s transition from baby to youth as well as the evolution of her relationship with Knuffle Bunny. Each book is absolutely fabulous for its own unique qualities.

Maybe A Bear Ate It CoverOne last book worth mentioning — another favorite about lost things — is “Maybe a Bear Ate It,” written by Robie H. Harris and illustrated by Michael Emberly. It’s the story of a monster child who heads to bed with his favorite book, only to lose it in the covers as he becomes heavy-eyed. When he notices the book’s absence, he’s startled awake and begins thinking of the most irrational possibilities for where it might be (“Maybe a bear ate it!”). I love this book because it’s just the way my mind works when I’m frantically searching for a misplaced item and I’ve already checked all the rational locations — my worst assumption is always that it might have been thrown away. In the case of Charlotte’s missing blankie, I was convinced it had been tossed with the wrapping paper from her birthday presents.

Have You Seen My New Blue Socks CoverI also plan to check out “Have You Seen My New Blue Socks?,” written by Eve Bunting and illustrated by Sergio Ruzzier. It promises a similar theme, and my interest is particularly piqued because of the involvement by Ruzzier, who has authored/illustrated such amazing books as “Bear and Bee” and “Amandina.”

When Charlotte, now 5, was about 18 months old, I discovered “Edwin Speaks Up,” written by April Stevens and illustrated by Sophie Blackall. The book originally caught my interest because the title character, almost-1-year-old Edwin, is quite the babbler, yet no one in his family can figure out the important things he’s trying to tell them.

Edwin Speaks Up Cover

At the time, Charlotte was similarly indecipherable. She’d say something three or four times and, eventually, I’d just have to smile and say, “Ok.” She had so much to say and she was so certain of herself; sometimes it just broke my heart not knowing what big ideas she wanted to share.

And while Stevens’ clever book certainly sympathizes with the unheard and overlooked younger child, over the years I’ve come to appreciate “Edwin Speaks Up” for its other wonderful themes, as well, particularly its hilariously accurate portrayal of the dreaded phenomenon we call “Mom Brain.”

The affected mother, in this case, is Mrs. Finnemore, a lovely ferret with five little ferrets to mind. The youngest Finnemore, Edwin, is about to celebrate his first birthday, and the story chronicles their trip to the grocery store to pick up sugar for Edwin’s birthday cake.

Finnemore Family

Can a children’s book actually be written about a trip to the grocery store, you ask? Of course! I’ll wager a bet that most moms have at least one whopper of a story from the grocery store aisles. I’ve made trips to Hy-Vee that have garnered a handful of good anecdotes in one go – fussy babies, misbehaving toddlers, blown out diapers, time outs, gawking strangers.

Mrs. Finnemore’s first challenge, as it is for many of us, is simply getting out the door. She can’t quite recall where she left her keys, and in the opening spread, we see her dashing about the house, in search mode, as a brood of exasperated ferret children wait reluctantly and little Edwin babbles unintelligibly on the floor.

Or maybe his babbles are more intelligent than we thought…

Searching for Keys

“Gloo poop SHOE noogie froo KEY,” Edwin asserts, to an oblivious audience.

Sure enough, Mrs. Finnermore eventually locates the missing keys inside her son’s shoe on the hall table.

Challenge #2 is loading her five children into the car. In the midst of refereeing arguments over who gets which seat and buckling Edwin into his carseat, Mrs. Finnemore ends up leaving her pocketbook on the roof of the station wagon, a fact only Edwin seems to note: “Figbutton noO noO pocKY BoOKY froppin RoOf.”

Purse on Car Roof

I’d be curious to see the results of a survey polling mothers on whether they’ve ever left their purse or wallet on the roof of the car and driven off. My suspicion would be that most have, because it’s an unfortunate feat of absent-mindedness that both the author, April Stevens, and I have in common with Mrs. Finnemore.

In Stevens’ case, she admits in the book’s dust jacket that her wallet once miraculously survived a 15-mile drive home from the supermarket. I was not as lucky – mine toppled off my car as I drove home from book club one blustery night. I discovered it missing well after midnight and had to trace my path back through the city’s snow covered streets until I found it.

Mrs. Finnemore is relieved to discover hers still in place when she arrives at Fineson’s Fine Grocery, because is there really anything worse that loading up all of the kids only to discover you left your money at home?

Well…I suppose I can think of one worse scenario: loading up all of the kids, somehow managing to complete your entire shopping trip before discovering AT THE CHECK OUT LANE!!! that you don’t have your wallet – been there, done that.

When the Finnemores finally make their way into the grocery store, more chaos ensues. The oldest four children upend a display of canned peas, then engage in a wrestling match in the produce aisle. Meanwhile, Mrs. Finnemore confuses someone else’s cart for her own, and takes off to get the all-important sugar, unaware that she’s forgotten her birthday boy.

Shopping Chaos

“Did someone take my cart?” Mrs. Finnemore could hear Mrs. Lutzheimer call from aisle number one.

“However could someone lose their cart?” Mrs. Finnemore clucked and shook her head as she turned into aisle three.

Mrs. Finnemore’s obliviousness makes her carelessness all the more comical. And don’t we all pass those small judgements? “Oh, I would never do something so ridiculous!” And then we do. But how can we blame Mrs. Finnemore or ourselves, for that matter? How can one possibly expect the brain to function properly under such trying conditions? Just once I’d like to finish a sentence, finish a meal, finish a phone call, finish an email, finish a thought without being interrupted by somebody crying, somebody fighting, somebody asking for more milk.

Mrs. Finnemore’s blunder is eventually discovered and Edwin is reunited with his family but the sugar is lost in the process of sorting out the carts. Once more, only Edwin seems to have a clue.

“Rootin popel CART no no SWEETY,” he tells them.

Edwin tries again: “Gimpin chalk lil wiz um SWEETIN do a bye bye.”

His siblings are too distracted arguing over ice cream flavors and his mother, well…. she might just be in a Xanax haze because how else would a woman survive a trip to the grocery store with five kids without ever losing her cool? My face NEVER looks that blissful when I’m shopping with my kids!

Edwin, on the other hand, is becoming increasingly distressed, as his mother heads to the check out lane, unaware of the missing ingredient:

“Plopin grouff shooop CAKE sweet NO NO.”

“SWEETUM NO NO!”

“Oh, Edwin honey, is your diaper wet?” Mrs. Finnemore sighed.

Unheard and unobserved, Edwin decides to take matters into his own hands. He climbs out of the cart, crawls to the baking aisle, grabs the sugar, pushes it to the check out lane and plops it on the belt.

Edwin Gets Sugar

As the Finnemore’s head home to prepare for Edwin’s birthday (this time with the sugar on the roof of the car), Mrs. Finnemore remarks:

“Tomorrow is Baby Edwin’s birthday—he’s growing up so fast. Soon he’ll be talking. Can you even imagine that?”

Mrs. Finnemore’s statement reflects the ways in which many of us continue to view our youngest children as babies, long past the point at which they’ve transitioned to toddlers or older.

If Stevens’ story wasn’t amusing enough, Sophie Blackall’s illustrations are the cherry on the top. She’s taken some artistic liberties, giving the book an irresistible fifties feel, with that classic pastel color palette and everyone dressed in the fashions of the era, geometric fabrics and belted waistlines included.

Blackall’s illustrations are incredibly charming, but they also add a rich layer of detail to the story, particularly elaborating on the mischievousness of the Finnemore children: the looks of disdain when they’re informed of their impending trip to the store, Finney sticking his tongue out at his sister, Fergus giving Fiona the death stare during their ice-cream-flavor debate, and three of the four oldest children ransacking the dreaded candy displays that are so “conveniently” located in such close proximity to the check-out lanes.

Mischief

In fact, Blackall’s pictorial storytelling is so wonderfully endearing that I often think of her name before the names of those who have authored the books she’s worked on. Some of my very favorites are “Big Red Lollipop” and “Ruby’s Wish,” and when my daughters finally corner me with that dreaded question (“Where do babies come from?”), I’ll be sure to get my hands on “The Baby Tree,” just released and also authored by Blackall.

Sophie Blackall Covers

Sophie Blackall PrintIn the meantime, I’m enjoying this gorgeous signed print from Blackall, which I ordered from her fabulous Etsy shop to celebrate my husband’s and my 9-year wedding anniversary. The image is part of a collection of illustrations Blackall created that were inspired by amusing Craiglist “missed connections” personal ads. And if I didn’t already love Sophie Blackall enough, she packaged my print with these adorable extras!

BlackallExtras

My husband and I are celebrating the ninth anniversary of our wedding tomorrow. We’re high school sweethearts who sometimes act more like quarrelsome siblings — we did, in essence, grow up together.

I first set eyes on Austin a little more than 16 years ago, in April, during soccer season. I caught sight of that tall, blonde drink of water on the field from my vantage point in the stands and that was it.

I had a penchant for stalking boys (just ask my other adolescent crushes), so I spent the next four months “running into” Austin at Taco Time, his place of summer employment, or at his house (my best friend was dating his younger brother and I was the frequent third wheel). He finally succumbed to my charms and asked me out on our first date: dinner at Garfield’s in south Des Moines on August 21st, 1998.

Now here we are, with a life together more rich than we could have ever imagined as teenagers.

However, when it comes to traditional romantic occasions, such as our anniversary or Valentine’s Day, our mutual efforts leave more than a little room for improvement. There was the first year, when Austin attempted to frame our wedding vows but ended up slicing off the tip of his nose when the glass in the frame tipped out while we was cleaning it. The experience must have been particularly scarring (figuratively AND literally — just take a close look at his nose), because that was probably the last time we exchanged anniversary gifts.

That said, I scrounged up a little something this year to commemorate our 9th year of matrimony. But if I’m being perfectly honest, the only reason I have any gift at all is because I was researching children’s book illustrator Sophie Blackall today for another blog post I’m working on.

Blackall is the artist behind such fantastic books as “Big Red Lollipop” and the Ivy and Bean chapter book series, in addition to many others. Her Chinese ink and watercolor images are amazingly detailed and incredibly distinctive, making her one of my all-time favorite illustrators. Thus, you can imagine the happy dance I did when I discovered she has an ETSY SHOP!!! where she sells incredibly reasonably priced prints of some of her amazing illustrations.

Many of the prints are from a fascinating collection of drawings illustrating actual Missed Connections Craigslist classifieds from New York City, which were published as a book, “Missed Connections: Love, Lost & Found.” Others are simply beautiful images celebrating love. Here’s the one that’s en route to my house:

Sophie Blackall Print

It’s a sentiment about our relationship I feel quite profoundly; if things hadn’t lined up just so, we never would have met, fallen in love and brought our beautiful girls into this world. I love you, Austin.

 

 

April marks two years since Austin and I lost our third child at 22-weeks gestation. It’s hard to believe two years have passed; the pain can feel as fresh as yesterday but it can also feel like I’ve carried the weight of it for decades.

My love for our baby is not complex; it is pure and unending. But my comprehension of and reflection on what happened is VERY complex, and I’m not certain I will ever make sense of it all in my lifetime. I do know that I’ve been changed by his existence in many important and wonderful ways. His life and death brought me to know God, to literally hear Him speak to me, as I never expected I would. If you know me, ask me about it some time.

These and many, many, more thoughts are with me every day, but I share them now because I believe God gave me my son for a purpose – both to shape my life in many large and small ways but also to influence the lives of others. For that reason, I feel compelled to share how my experience has shaped my thoughts on the importance of first trimester prenatal testing.

 

WHEN THINGS WENT WRONG

Our baby, a boy, had a non-hereditary, chromosome disorder called Trisomy 18, in which three copies of the 18th chromosome are present. It occurs in 1 in 2,500 pregnancies. The abnormality caused countless malformations of the body, including missing and abnormal organs, bones and limbs. The results were fatal, as is almost always the case with this syndrome and especially for boys.

For the 5 months prior to our 20-week ultrasound, we had envisioned and loved a child we thought would now be nearing his second birthday, toddling around, learning new words, being played with, snuggled, kissed and hugged a million times each day. In reality, from the moment of his conception, that life we envisioned for him could never have been. But once imagined, it was impossible to un-imagine. As I recently told Austin, you can’t change where your heart has been.

When I was pregnant the first time around with my oldest daughter, Eloise, I was young, 25, with no family history of birth defects or chromosomal abnormalities. My risk level couldn’t have been much lower.

When offered prenatal testing, I declined and told my doctor, as many women do, that if I were to learn our child had Down syndrome, we wouldn’t choose to do anything differently. More specifically, we did not intend to abort a baby who had Down syndrome.

We went through a scare at our 20-week ultrasound when they discovered Eloise had a single umbilical artery. Umbilical cords should have two arteries and one vein, but a missing artery occurs in about 1 percent of babies and a percentage of those occurrences has been linked to structural anomalies and chromosomal disorders such as Trisomies 21 (Down syndrome) and 18. Subsequent ultrasounds reassured us there was no cause for concern, and Eloise was born healthy.

Similarly, I did not undergo testing for my second daughter, Charlotte’s, pregnancy, and she was born without issue.

When we conceived a third time, I was still in my late-20s and still blissfully naïve. No testing necessary.

But then, the world fell apart at our 20-week ultrasound. Our 4- and 2-year-old daughters were in the room with us, excited to learn if they’d have a new baby brother or sister. Our families were planning to meet us at a restaurant afterward for the big gender reveal. Half-made whoopee pies were sitting in the fridge at home, waiting to be filled with pink or blue-colored icing. Then, the ultrasound technician told us something was wrong and that we’d have to talk to the doctor. And at that moment, here’s what I learned:

Those bad things you feel silly worrying about? Chromosomal disorders and birth defects? They happen every day, there are statistics for a reason, and there’s no reason they can’t happen to you.

I had been reluctant to acknowledge or act on my fears. It was almost as if I superstitiously thought that by choosing not to do prenatal testing my pseudo-confidence would somehow keep those scary things at bay. I also feared that if I said “yes” to testing, it might give people – my doctor, in particular – the impression that I wouldn’t accept a child with Down syndrome.

 

THE BENEFITS OF FIRST-TRIMESTER TESTING

What hadn’t sunk in for me until then, and what I learned on our long and painful journey, is that prenatal tests aren’t just about Down syndrome. They also test for other, more severe, often fatal disorders. And opting to participate in prenatal testing shouldn’t be associated with any sort of stigma or shame. It doesn’t necessarily mean a parent intends to end a pregnancy in which an abnormality is detected. Instead, prenatal testing allows parents to prepare themselves as fully as possible for whatever the pregnancy might bring.

In many cases, prenatal testing will result in a pregnancy with significantly reduced stress levels thanks to clean test results. (Maternal stress has been shown to increase the risks of miscarriage and negatively affect a baby’s development.)

It might mean making plans to deliver at a hospital with a skilled neonatal team that’s prepared to treat complicated health issues that have been identified, possibly saving the baby’s life.

In the case of a Down syndrome diagnosis, in-utero therapies are beginning to be implemented to foster optimal brain development before birth.

On the other hand, it might mean preparing for the loss of the pregnancy because of a fatal disorder or defect, but beginning that process months earlier than we were able to.

Most importantly, if genetic testing reveals an abnormality, the information enables parents to prepare emotionally as early as possible, adjusting their expectations, evaluating how they plan to share the news with their other children or friends and family, making plans for how or whether to proceed with the pregnancy and seeking the best medical, psychological and spiritual help possible.

What would it have meant for me? Surely I would be living in an alternate universe.

I would not choose to change where life has taken me in the wake of our loss. However, I wish I could have spared my daughters the confusion and uncertainty of that time in our lives—being ushered out of the ultrasound room, watching their mother disappear into the darkness of grief, having their lives turned upside down when we immediately moved in with my parents, struggling to understand the explanation that our baby was too sick to live with us and that God needed to take care of him instead.

 

THE BARAGE OF PRENATAL TESTING OPTIONS

When I was pregnant with Flora, our now-7-month-old, I could no longer let my naivety lead me blindly, hoping for the best, assuming lightning wouldn’t strike twice. I’d lived through hell and barely climbed my way out; things were going to be different this time around.

Thankfully, I had the guidance of skilled perinatologists who thoroughly explained the various testing options available. (The American Pregnancy Association offers a good overview here.) Doctors now recommend that all women be screened for Down syndrome and other trisomy disorders. But this information, when presented in the doctor’s office in the early stages of your pregnancy, can be overwhelming. And when you think you have nothing to fear, it’s easier to just tune it all out and choose not to participate.

  • The maternal blood tests most widely used in the first two trimesters are not “diagnostic,” meaning they cannot tell parents definitively if their baby has an abnormality or not. Instead, they measure hormone levels in the mother’s blood, combine those with ultrasound and information about the mother (including age and ethnicity) to offer an estimate of the baby’s risk for abnormalities. Both false positives and false negatives can and do occur. When an abnormality seems likely, a diagnostic test becomes necessary. In the case of false positives, the parents are subjected to unnecessary emotional stress and the baby is subjected to the risks that accompany invasive testing.
  • Diagnostic tests for chromosomal disorders and genetic abnormalities include chorionic villus sampling (CVS), which tests tissue from the placenta, and amniocentesis, which tests the genetic material in the amniotic fluid. CVS is available between 10 and 12 weeks, allowing earlier results, but does not test for neural tube defects. Amniocentisis is usually performed later, between 15 and 20 weeks, and does test for neural tube defects. Both procedures report abnormalities with 98-99 percent accuracy. However, both procedures also carry the risk of miscarriage. For CVS, the risk has been reported at 1 in 100 procedures resulting in miscarriage. For amniocentesis, the risk ranges from 1 in 200 to 1 in 400 procedures resulting in miscarriage.

It would seem there are no good options. But miraculously, my fourth pregnancy perfectly coincided with a major breakthrough in prenatal testing: cell-free fetal DNA testing.

 

WHY WE CHOSE CELL-FREE FETAL DNA TESTING

Using a basic blood sample drawn from the mother as early as 10 weeks gestation, a testing lab is able to sift out cell-free fetal DNA present in the mother’s blood. This fetal DNA gets into the mother’s bloodstream when cells from the placenta die and come apart, releasing genetic material that’s absorbed by the mother’s blood stream. The test is able to isolate this genetic material and examine it to determine if there are abnormal numbers of chromosomes, specifically Chromosomes 21, 18 and 13 and the X and Y sex chromosomes.

Cell-free fetal DNA was discovered in 1996, and the first genetic testing based on the technology was offered in 2011. In late 2012, the American Congress of Obstetricians and Gynecologists recommended the test for patients at an increased risk for chromosomal defects, but many OB/GYN’s have never heard about the test. Mine hadn’t.

However, we now have a history that includes a pregnancy with chromosomal abnormalities. My OB/GYN directed me to the Perinatology Center of Iowa where we were offered a cell-free fetal DNA test, under the brand name Verifi, as an alternative to CVS during the first trimester of my pregnancy.

At first glance, I assumed the test was no different than the traditional first trimester maternal blood screening, in which I would receive results that outlined the baby’s relative risks for various disorders. Those tests did not offer the certainty I needed, nor could I imagine surviving the possibility of a false positive after what we had already been through. However, I also knew I could not proceed with my pregnancy uninformed only to find out later that the baby could have something drastically wrong, however slim the chance.

We agonized over the choices but were enlightened when we did more research on the Verifi testing option. We discovered that the test detects greater than 99.9 percent of all cases of Down syndrome, more than 98 percent of all Trisomy 18 pregnancies and about 65 percent of Trisomy 13 pregnancies.

Equally important is the incredibly low rate of false positive results. A study published in the New England Journal of Medicine in late February 2014 made a head-to-head comparison of cell-free fetal DNA tests and standard screening methods. Cell-free fetal DNA tests were found to have a false positive rate of 0.45 percent while standard testing resulted in false positives 4.2 percent of the time.

With this information in hand, we felt confident relying on the Verifi test to provide us with the best, most accurate, information possible about the health of our baby. My blood was sent away last March and, 10 days later, we were called with clean results. Because we had opted to test for sex-linked chromosomal disorders as well, we had the added benefit of learning the baby’s gender. We were expecting our third girl.

 

WHY ALL WOMEN SHOULD CONSIDER FIRST TRIMESTER PRENATAL TESTING

When I look back on April of 2012, I remember how alone I felt. I couldn’t imagine that anyone, especially not anyone I knew, could have suffered in the unique ways we had. But one of the blessings and sadnesses of enduring this pain is learning just how much company we have. Countless people sought us out – neighbors, friends of friends, people we’ve known for ages – they sent us messages, called us, to tell us that they, too, endured something similar and that they had survived.

According to the March of Dimes, 1 in 150 babies are born with a chromosomal disorder and 1 in 33 are born with some sort of birth defect. How many women do you know, and how many pregnancies will they have between them? It starts to feel much closer to home.

I don’t intend to incite fear. Being pregnant is joyous and beautiful and exciting, and you have every right to expect that your baby will be the picture of perfection. But you know the old adage “hope for the best and prepare for the worst?” I know just how devastating it can be when all you do is hope because you’re afraid of the worst.

Think about it this way: The average person is expected to be in a car accident every 17.9 years, but hopefully you wear your seat belt every time you’re in the car. Buckling up doesn’t mean you’re afraid you’ll crash that day; it’s just the smart thing to do.

First trimester prenatal testing is the smart thing to do, ESPECIALLY if you would continue a pregnancy with a chromosomal abnormality or other birth defect. Most issues will be caught in a 20-week ultrasound, but, in my experience, finding out this far into the pregnancy causes emotional trauma that should be avoided at all costs. (For the perspective of another mother who chose cell-free fetal DNA testing, read “Why I Wish I Had Chosen Prenatal Testing,” a moving essay written by Patti Rice, the mother of 11 whose 10th child was born unexpectedly with Down syndrome.)

If you are pregnant, planning to become pregnant or know someone who is, I strongly urge you to ask your doctor about a cell-free fetal DNA test. Doctors who are aware of the test are recommending it as an option for those who are of advanced maternal age, have irregular standard maternal blood screenings, have irregular ultrasound findings or have a personal or family history of chromosomal disorders. However, ANYONE can request the testing. If your doctor isn’t familiar with it, don’t be afraid to ask them to look into it. It’s available in all 50 states. Just three insurance companies cover it (Aetna, Cigna and United Healthcare), but in our case, the testing company reduced our personal cost to under $200 when it wasn’t covered by our insurance.

I believe that this sort of testing will quickly become the standard of care, but in these early stages, I want to share what I’ve learned with as many people as possible. I can only hope that learning about cell-free fetal DNA testing will save one person from suffering the way we did. Or maybe it will keep someone from unnecessarily undergoing a more risky, invasive test like CVS or amniocentesis.

If you do choose to do prenatal testing, please tell people. Hopefully sharing your decision with others will help reshape how we look at prenatal testing, transforming it into something that’s viewed as one of the most caring, responsible choices you can make for your baby, yourself and your family.

GOOD EGG

For months, I’ve been hiding Barney Saltzberg’s “Good Egg” in an out-of-the-way cabinet, having found the PERFECT book for Flora’s first Easter basket. Pull-tab books aren’t always a good idea for hands that haven’t quite learned a gentle touch, but this book was just too witty and innovative to resist.

Good Egg Cover

On color-blocked pages, Saltzberg introduces us to “Egg,” whom he issues commands, much like you would a dog, on the subsequent pages. When the reader lifts the flap or pulls the tab, Egg adorably executes the command and its praise (“good egg”) is revealed.

Lie Down Good Egg

Suspense builds when the egg is asked to “speak,” and a crack appears. When the command is reissued, the top off the eggs lifts to reveal a very talkative chick within.

Speak Egg Chick

 

LITTLE BUNNY FOO FOO: THE REAL STORY

For the older reader, I love “Little Bunny Foo Foo: The Real Story,” by Cori Doerrfeld. The book is based on the nonsensical contemporary American folksong whose authorship and exact date of origin are unknown. The general consensus is that the song popped up in the mid-1960s as a camp song, confirmed by my Boomer-era mother who recalls singing it at summer camp about that time.

The song was certainly a part of my childhood. I remember singing it and gleefully “bopping” my younger sisters on the head. So caught up in the silliness, I suppose I never stopped to ponder would could possess a cute cottontail to abuse her fellow forest friends in such a fashion.

Little Bunny Foo Foo Cover

That’s just the question Doerrfeld set out to answer in her quirky picture book. The illustrations reveal that Bunny Foo Foo may not be as malicious as we thought. And those poor, defenseless field mice? Not so poor and defenseless.

Bunny Foo Foo 1

In Doerrfeld’s version of the story, the field mice sneak into Bunny Foo Foo’s house while she’s cleaning up from baking cupcakes and make off with her sweet treats. She goes “hopping through the forest” in pursuit of the thieves. When she catches them, she smacks the mice on the head and takes back her cupcakes.

Down comes the good fairy who decides to stick her nose where it doesn’t belong.

GoodFairyComesDown

“Little Bunny Foo Foo, I don’t want to see you scooping up the field mice and bopping them on the head.”

The fairy tells Bunny Foo Foo she’ll turn her into a monster if the abuse continues and allows her two more chances to behave. Unfortunately, the field mice, now in cahoots with the other forest animals, have already made off with Bunny Foo Foo’s cupcakes again, and Bunny Foo Foo isn’t going to stand for it. She burns through her remaining chances, becoming increasingly enraged by the pilfering rodents, and the “Good” Fairy follows through on her threat, turning Bunny Foo Foo into a monster.

Bunny Foo Foo Mad

The monstrous Bunny Foo Foo exacts her revenge, however, and satisfies her sweet tooth by gobbling up the saccharine fairy, a consequence the Good Fairy obviously hadn’t considered before wielding her wand.

Foo Foo Eats Fairy

“And down went the Good Fairy, who tasted very good indeed.”

Doerrfeld’s acrylic illustrations hold all the appeal of your children’s favorite animated movies. She’s drawn mice and birds whose rascally behavior is at first disguised by their Disney-esque cuteness. Her Good Fairy is as sugary and frosted as Bunny Foo Foo’s cupcakes. And Bunny Foo Foo’s expressions of frustration-turned-fury make her a sympathetic heroine.

Doerrfeld’s lyrics vary slightly from the original (in which Bunny Foo Foo is given THREE chances before she’s turned into a GOON, rather than a monster); but this book is sure to inspire a rollicking sing-along and inevitably a game of head bopping, but hopefully all in good (and gentle) fun.

When I was preparing for Flora’s arrival, there was very little shopping that needed to be done. We had five years worth of girls’ clothes and all the baby essentials. Our car seat was about to expire and we decided to upgrade to a video monitor (singing its praises), but other than that, it was pretty much diapers and baby shampoo.

Oh, and did I forget to mention? A little bit of book shopping, too, of course.

It was just so plainly obvious that our board book collection was lacking, and I’ll use any excuse.

As attractive as their near-indestructible format is, I have always been a reluctant consumer of board books. Primarily because too many great picture books have been inappropriately repackaged into board book format.

Click Clack Moo CoverTake “Click, Clack, Moo: Cows That Type,” for example. It was one of the founding editions of my children’s book collection, purchased long before any of my girls were even conceived. This incredibly witty, amazingly illustrated story is intended for children ages 3 to 7, and appropriately so.

Would I have ever considered this book in board book format? No!

Why not? For several good reasons:

1: Its sharp humor, creative plot and detailed illustrations would go completely over the head of a baby or toddler.

2: The complexity of the text would likely test the patience and interest of these young readers.

3: All of the aforementioned elements that make this an exceptional picture book would be diminished in the board book’s small-scale format.

But most importantly, by the time your baby is 7 years old and capable of fully appreciating this story, how enthusiastic do you think she’ll be about pulling out a board book at story time? Not very.

The best board books are written and constructed with babies and toddlers in mind —hence the thick sturdy pages, with wipeable, glossy surfaces designed to withstand little ones’ not-so-gentle hands. School Library Journal offers a good summary of what constitutes a truly successful board book:

“The best ones tell a simple story with few or no words, allowing readers to invent their own. Ideally, illustrations are crisp and clear, with limited images on each page, offering plenty of contrast between the background and the pictures. Occasionally, a picture book makes the successful transition to a board format, but be warned that not all picture books are equally engaging as board books. Too much text on the page is distracting and crowded, and the smaller trim size can make illustrations appear crammed on the page, losing detail and focus. The absolute best board books are the ones that withstand the test of time: not only in being indestructible, but also in holding young children’s interest as they explore and point to pictures, exclaiming, ‘again, again!’ when reaching the last page.”

Stumped by the ill-suited board book release of “Cloudy with a Chance of Meatballs,” Horn Book contributing editor Cynthia Ritter suggested that publishers are catering to “parents who want smaller, sturdier, and cheaper versions of picture books.” She suggests that money-smart parents seek out paperback editions of books before succumbing to the allure of board books. They’re “lighter and, while less durable, similar in cost to the board book and in size to the original,” she writes.

Here’s how I see it, if a book is available as a picture book, I choose that format almost without exception. Even if I incur double the cost of a board book, I gain three times the life. Inevitably, all children consider themselves “too big” for board books, usually by the time they’re two. If a picture book can survive those first two years, it will be read many more times in the years that follow, both to your first child and as well as any that may follow.

Conversely, if I’m going to buy a board book, it’s going to be specifically suited for children under two and it had better be pretty outstanding. Keeping my prejudices in mind, I’ve sought new baby-friendly titles to complement tried-and-true board book favorites like “Brown Bear, Brown Bear,” “Moo, Baa, La, La, La,” and “Goodnight Moon.”

In the process, I’ve noticed an interesting trend in my preferences: I now have a significantly larger collection of books derived from folk songs. It’s a trend that isn’t completely surprising. Many nursery rhymes and folk songs are so engrained in our memory that they’re easy to fall back on as you rock your baby to sleep in the middle of the night or attempt to distract a toddler causing a raucous at a restaurant. “This Little Piggy” and “The Itsy Bitsy Spider” never grow old and rarely cease to elicit a baby’s adorable chuckles. The lyrical verses are just what you need to hold an on-the-go toddler’s attention.

 

HUSH. LITTLE BABY

One of my favorite board book discoveries in this genre has been Marla Frazee’s “Hush, Little Baby.” As a child, this was the song my parents would sing to us at bedtime, and it was the first thing that popped into my head when I was a new mom attempting to console a colicky infant.

Hush Little Baby Cover

 

Frazee’s rich watercolor illustrations make her one of my all-time favorites. I adored her work in “The Seven Silly Eaters” and “Everywhere Babies.” Her humor is wonderfully evident in “Boss Baby,” which she authored and illustrated. She’s also responsible for bringing “Clementine” to life in Sara Pennypacker’s popular chapter book series.

In “Hush, Little Baby,” Frazee’s beautifully detailed images lend a clever backstory to this traditional American folk-song. The opening pages of the book depict a frontier family returning home at sunset, the eldest daughter envious of the attention the new baby gets as her parents tuck the baby into bed. Turn the page and the reader spies big sister shoving her baby sister’s cradle, waking the baby and setting the song in motion.

Hush Little Baby 1

Hush Little Baby 2

Hush Little Baby 3

While Mama attempts to console the baby, Papa and Big Sister visit a peddler on the road to see if they can find something to “hush the baby.” We all know how the story goes, though, and despite their many desperate attempts, Baby howls all night long. Just as the sunrise is tingeing the sky pink, the family tumbles out of a horse drawn cart and the baby finally decides she’s tired out.

Hush Little Baby Ending

I love how Frazee has captured the siblings’ reconciliation and the parents’ utter exhaustion. Best yet, I love the sweet and innocent look on the baby’s face, in sharp contrast with earlier images of a seemingly possessed child. Isn’t that just how babies are? Utterly exhausting and maddeningly frustrating during sometimes endless fussy periods, but angelically loveable the very moment it passes.

Angry Baby

As an added bonus, the last page of the book offers the accompanying lines of music, which will be helpful for those readers who can’t exactly remember how the tune goes.

 

MARY HAD A LITTLE LAMB

I discovered Tomie de Paola’s petite gem “Mary Had a Little Lamb” at The Pumpkin Patch, our local, independent children’s book and toy store. It always astonishes me how poorly big box bookstores stock some of the children’s book greats like de Paola, Eric Carle and even some of Dr. Suess. I’ll never forget when our BAM bookstore failed to turn up either a copy of “The Cat in the Hat” or Mem Fox’s “Ten Little Fingers, Ten Little Toes.” And they wonder why I have absolutely zero interest in their ridiculous membership program!

Conversely, it was a pleasant, but not completely unexpected treat to discover a de Paola with which I was previously unfamiliar while browsing about The Pumpkin Patch. The proprietor, like most indie sellers, knows her children’s book authors and is a particularly ardent de Paola fan.

Mary Had a Little Lamb Cover

Originally published as a picture book in 1984, de Paola’s “Mary Had a Little Lamb” is a rare example of a book that’s been appropriately repackaged as a board book. The song’s succinct verses, paired with de Paola’s vibrant artwork make it perfectly suited for toddlers and babies. Of course, there are other board book incarnations of “Mary Had a Little Lamb,” but there’s none better than de Paola’s. His illustrations, in themselves, are masterpieces of contemporary American folk art and are ideal for bringing to life one of the best-known American folk songs. He’s also done a masterful job of interspersing wordless pages between verses of the song, creating a pacing that’s ideal for impatient readers eager to turn the page.

For example, the page spread following the verse “And every where that Mary went / The lamb was sure to go” illustrates the little lamb following Mary while she washes the dishes in the kitchen, reads a book in the attic and then nods off to sleep.

Mary and Lamb

Mary Had a Little Lamb HousesIn addition, I appreciate the historical accuracy with which de Paola approached the project, incorporating the concluding verses of the song that few of us know and illustrating the pages with landscapes, buildings and dress that are true to the time and location in which the song was composed —1830, rural New Hampshire countryside.

De Paola also had an interest in the supposed controversy concerning the rhyme’s authorship, about which he writes in detail on his website. Traditionally, the writer Sarah Josepha Hale of Guild, New Hampshire, is credited with the creation of the original poem. However, a Mary Sawyer of Sterling, Massachussets, claimed she was THE Mary who took her pet lamb to the town’s one-room schoolhouse. She asserted that a visiting pastor-in-training witnessed the incident and composed the verses, which he gave to her.

De Paola read everything he could on the topic and concluded that he sided with Hale, especially in light of her deathbed oath that she was the sole author of the poem.

Mary Author

“I shared all of this information with Margery Cuyler, my editor at Holiday House. We agreed to produce a picture book of the poem and credit SJH (Sarah Josepha Hale) as the AUTHOR — what fun! I went to Newport and sketched actual buildings that would have been in Newport at the time of SJH. I even put a portrait of sorts on the title page of an 1850’s-1860’s lady writing at a desk with a toy lamb pull-toy near her. And guess what? I ADDED to the controversy. Letters poured in — well, OK, dribbled in — correcting me about the ‘TRUTH.’ I sent them to the Richards Free Library whose staff enjoyed answering them. I DON’T WANT ANY MORE LETTERS ABOUT WHO WROTE ‘MARY HAD A LITTLE LAMB.’”

 

CHILD’S PLAY “BOOKS WITH HOLES”

Another treasure trove of song-based board books are those offered by Child’s Play, a British publishing company that’s employed nearly every nursery rhyme or folk song one could name, from “This Little Piggy” to “”If You’re Happy and You Know It” to “Head, Shoulders, Knees and Toes.” I’m particularly fond of their “Books with Holes” board book series. These books utilize unique die cuts in their pages to reveal images that enhance the story’s development. I’ll use our favorite, “The Farmer and Dell,” to illustrate the technique.

On the opening page spread, we meet “the farmer in the dell,” seen through the first hole holding a bunch of flowers. The accompanying second verse tells us “the farmer takes a wife,” and we’re shown a group of a dozen potential spouses — some scary, some frumpy, some quirky and some sweet. The reader gets the fun of guessing whom the farmer will choose.

Farmer and the Dell 1

The page spread that follows reveals the selected wife through a new hole. In addition, we’re shown a crowd of a dozen potential children, one of whom belongs to the couple. Will it be the girl in the flowered dress or the boy on the skateboard? Maybe the boy with the chickens? Turn the page to find out.

Farmer and the Dell 2

The bright, playful illustrations and lyrical, repetitive verses make this book enjoyable for our baby, but the guessing game has captured the interest of our 4- and 6-year-old girls. They almost always choose a “Book with Holes” when I encourage them to read to Flora; and because they know the songs so well, even our pre-reader Charlotte can “read” these books. They may have the most fun with “The Farmer and the Dell,” but they also love the inventive new verses in “Little Miss Muffet.”

Miss Muffet Parrot

Along came a parrot, who crunched on her carrot.

You’ll also meet a bear who gobbled her pear, mice who munched all her rice and a poodle who nibbled her noodles, among others.

Our collection also includes “One Elephant,” which brings back fond memories of Sharon, Lois and Braham, as well as “The Ants Go Marching.” We have “Old McDonald,” too, but this edition was a case in which Child’s Play’s traditional British verses didn’t quite match up with our familiar version of the song. For instance, their horses “whinny” rather than “neigh” and their pigs “grunt” rather than “oink.” Check out their full collection of books on their website.

 

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