Surviving 10 minutes of hell

Are you like us who struggle when using a nebulizer with a sick child? My son's been sick for the past days - a bad cold plus weeks of coughing. His pediatrician heard some wheezing during his lung checkup and my kid is now being monitored for asthma. Hayy... i hope everything clears up.

Anyway, his doctor prescribed medicine that should be given through a nebulizer at home. The nebulizer turns medicine, especially those for asthma, into mist so it goes easier into the lungs. The solution for his age and weight totals to 2 ml (1ml salbutamol diluted in 1 ml saline solution). This takes about 10 to 15 minutes to consume on the nebulizer. That means he has to hold still for that period. And it's been hell for all of us. He would cry during the entire period. Husband and i get into each other's nerves as we try to restrain the crying child. It was a total nightmare, considering that we had to nebulize every four hours.

My Teething Toddler

At 14 months, my son only has three prominent teeth and the rest are just about to pop out!  Teething usually starts from  4 to 7 months but my baby's first teeth appeared at 11 months. The order by which his teeth are coming out is weird too! Usually, the molars appear next after the front teeth. But lo and behold, his canines came out next to his front teeth!

[caption id="attachment_3283" align="aligncenter" width="300"] This is my adorable son sporting his first tooth at 11 months![/caption]

We are actually quite delighted that at long last, his teeth are coming out. These are signs that my baby is slowly becoming a big boy. If you are dealing with a teething toddler, consider these tips!

Expect low grade fever or diarrhea.

•  We’re lucky our son does not have these symptoms. A toddler's immune system is down at this point so be extra careful. This may be due to the stress on his developing body. Our pediatrician suggests avoiding  close contact with sick kids when teething so he won't catch any infection.

His behavior might change, too.

• Your toddler can be quite cranky at this time. I noticed this because he’s not his usually jolly and always smiling self.  I guess he’s irritated and bothered by the new thingies appearing in his mouth. He would often shake his head, pull his ear and touch his cheek, all these signs of teething.

He might refuse to eat!

• A toddler with a few teeth may be a bit harder to feed! His three teeth is his handicap! While some kids his age are learning how to chew and grind their food into small pieces, my son still has a hard time swallowing.  Make sure to give small, manageable pieces. Slice his food into cheweable pieces but always be on guard against choking.  I would still boil and mash hard foods like apples, peas or carrot because he can’t chew that much yet.  Give additional water to aid him is gulping down his food. We're trying to balance giving him infant cereals or giving him "real" foods.

Introduce oral hygiene at this time.

• This is easier said than done! I'm actually having a hard time cleaning his mouth and teeth.  He would clamp his mouth closed when i try to wipe his teeth with cotton or cloth.  When cleaning becomes a struggle, stop and try again next time. His gums are quite sensitive at this stage or may be painful too.  Don't force cleaning because he might develop fear about this and refuse tooth brushing altogether.  Take your time and just offer more water to rinse his mouth.

Biting during nursing sessions 

• A teething toddler is harder to breastfeed because he may bite. We discourage biting by asking him firmly to stop.  My baby seems to understand that biting hurts mommy so he must not continue. At times i would cringe in pain because of his bite, but i avoid letting him see my reaction. I think he sometimes finds it funny when i cringe in pain so he repeatedly bites!  So better to avoid making outbursts or react outright, even if it hurts so much.  Some kids do have a nursing strike at this stage, but not my son.  He would nurse to sleep for hours and he would wake out once my nipples get detouch from his mouth. So this mommy is also losing sleep as the baby is gaining more teeth.

Have fun dealing with your teething toddler!

Also worth reading: 

• Toddler feeding issues

***

Of Baby Spit Ups and Vomits

Are you the panicky parent type? Well, my husband and I may well be on the top list of panicky parents. We are the type who rush to the Emergency Room after a day of vomiting or out-of-the-ordinary bowel movement. Yes, we’re panicky that way, we would always say that it’s better to be sure.

Just a few weeks ago, we were at the Emergency Room because baby vomited five times the night until that  morning. Baby’s diagnosis was food intolerance. Thankfully, it was nothing serious. I guess, he ate too much,   like us during the Holiday season.

[caption id="attachment_1620" align="aligncenter" width="240"] Like diaper changing, dealing with baby spit up  is a part of a mommy's life.
Source of photo: cdc.gov[/caption]

Keep this in mind in case of baby vomits and spit ups:

Procedure at the emergency room. 

• Doctors will check for fever, rashes or diarrhea.  They'll ask for urine sample to track if he has urinary tract infection.  Doctors say bacterial infection in babies can manifest in urine. They'll ask to withhold other foods and any other liquid. They may instruct you to give oral rehydration salts.    

Keep baby hydrated.

• Offer small amounts of oral solutions like pedialyte. The amount you give her depends on your child's weight. My one-year old is 9.5 kilos, the dosage for him is 40mL per hour. Pedialyte is given to replace the nutrients your baby lost when he vomits or during excessive bowel movement. Note that pedialyte solution, those colored fruit-flavored ones, are meant to be consumed after 24 hours. After this period, you'll have to throw it away. I did not know this until i asked the seller in the drug store. I gave baby pedialtye that's been open for days and i found no adverse reactions.

Go on a soft diet. 

• After vomiting, observe baby then wait for about 20 minutes before offering any liquid or soft foods like cereal or lugaw. 

Watch what your toddler eats. 

• Remember that your one-year old's digestive system is still underdeveloped so you better be careful what you give him.  That time, i gave him avocado for breakfast, rice and egg for lunch, yogurt for merienda, then pizza and mojos for dinner. Plus unlimited breastfeeding!  Aside from what he eats, offer enough amounts. I guess the OC mom in me gave him too much to eat! 

Vomits and spit ups are part of a baby's life. 

• Blame it on your baby's still undeveloped system. To reduce spit ups, breastfeed in upright position.  Keep baby's head higher than his stomach to avoid milk from backing up. According to NIH, spitting up peaks in infants aged 4 to 7 months.

Before getting worried sick when your baby vomits, observe baby.  How often does he vomit? Is he fussy?  Does he have fever or rashes?  Does he have difficulty in breathing or is he still queasy? If the answer is no, then it's probably nothing, just part of growing up. Read this for more information about baby and toddler's vomiting!

***

Why Breastfeed Even during Disasters

Breastfeeding is best ESPECIALLY during disasters and emergencies! I’m lucky I have not yet experienced any severe any disaster like flood or typhoon like Pablo and Sendong as a nursing mom. But I imagined it will be more practical to be breastfeeding during a catastrophe like Pablo,  rather than to be on infant formula.

[caption id="attachment_1531" align="aligncenter" width="600"] Disaster strikes when you least expect it! It pays to be prepared. Breastfeeding gives the mom a sense of comfort, knowing that she can readily feed her infant on any event, disaster or not.
Source of photo:pcoo.gov.ph[/caption]

Breast milk is the only complete ready-to-eat meal for baby.

• Imagine having prepared a complete meal for your baby anytime and anywhere you go! Breast milk alone is best for babies until 6 months! You don't have to give any formula supplement or extra water.

Breastfeeding is the safest method of infant feeding! 

• The thing is, during disasters, access to clean water is probably impossible. On disasters, infrastructures might fail so potable water can be compromised. Formula feeding requires clean water to sanitize those synthetic nipples and bottles. Formula-feed if you have a constant and sure supply of clean water to dilute formula. Instead of being a lifesaver, formula can even do more harm if the water you used to dilute the powdered milk is safe.


• We usually see a rise in the number water-borne diseases like cholera, diarrhea and gastroenteritis  in the aftermath of floods or typhoons because the supply of fresh clean water was depleted. Would you risk using unclean water to feed baby?

Nursing comforts babies.

• On disaster events, a mom's warmth can help calm and soothe a baby in distress.  You can amplify the comfort by nursing baby in times of disasters. Skin to skin contact between mom and baby is maximized when breastfeeding. Babies older than 6 months can enjoy the warmth and comfort during nursing. 


• Breast milk has antibodies that strengthen the baby's immune system, which could be at risk during severe weather.

Nursing calms mom’s stress.

• To say that nursing moms in devastated areas are stressed in a understatement! Disasters of Ondoy, Sendong or Pablo proportions may leave the nursing mom in misery, hence the possible reduced capacity to produce milk. This situation will be overcome with the help of  a well trained health worker. It’s a must for evacuations centers to have a designated breastfeeding station. This way, moms and baby can concentrate on nursing.

According to WHO, malnourished mothers or mothers who lack food can still adequately breastfeed, if they are given extra fluids and food to protect their health.

Among the countless reasons, this, by far is the best reason to breastfeed!

Also worth reading:

• Top 10 reasons why breast is best


• Keeping your breastmilk safe during brownouts

***

What to Do When Your Baby Has Colic? 5 Solutions that May Help

Do you have a baby who cries.. and cries a lot? I'm one of the lucky ones who was seldom been up late at night to comfort a crying baby. Baby has been very mabait that when he stirs for a bit, he returns to him calm self after i nurse him. Some moms complain of overnight crying. The old wives explanation is kabag (or stomach gas).

Others refer to prolonged crying as colic.  Below is a piece submitted by Heather Green, our guest blogger! She's a mom of two and has long bouts with colic. Her worst bout was when baby cried nonstop for 24 hours! In the post she shares tips on how to deal with a colicky baby.   

[caption id="attachment_1522" align="aligncenter" width="300"] The crying baby: Every mom had to deal with one once in a while!
Source of photo: tuczonaz.gov[/caption]

All babies cry. Some babies cry more than others -- and they don't stop. Some babies will cry for hours at a time -- each and every night for months. But how do you know if your baby has colic or is just plain fussy?

The secret to understanding if it's colic lies in the threes: It involves crying that lasts for at least three hours at a time at least three days a week for at least three weeks. It usually begins when your baby is about three weeks old and lasts until about three months of age.

Three-hour-plus stretches of crying on a near daily basis for weeks or months on end? It's enough to make anyone go crazy. Of course, your baby probably doesn't enjoy it very much either. If you (and your baby) have been unlucky enough to experience colic, here are a few solutions that may help:

Check Your Diet

Doctors don't know what causes colic, but they believe it may be related to digestive issues -- gas, specifically. If you are nursing, what you are eating could be having an impact on your baby's sensitive tummy. Some common offenders include dairy products, chocolate, caffeine, and gas-inducing veggies like broccoli and cabbage.

Try an elimination diet in which you cut out the common offenders for a few days or a week and see if you notice any changes. You can start adding these foods by one at a time to see if any cause symptoms again.

Check Baby's Latch

When babies take in a lot of air, they can suffer bad gas pains, contributing to colic. This might happen when they become upset and cry for long periods of time (we see a cycle...). It can also happen when they are breastfeeding and don't have a proper latch, allowing too much air to enter when they are feeding.

Make sure your baby has a good latch when feeding, forming a solid seal. Listen to hear the soft "k" sound that indicates your baby is swallowing and not just sucking in air.

Try a Foam Wedge

Some babies suffer from acid reflux, causing their colic. Using a foam wedge to prop up your baby during sleep can reduce the symptoms of acid reflux. The wedge props your baby into a semi-inclined position, helping to reduce the severity of the reflux.

You can put the wedge under your baby while sleeping, or put it under the mattress to incline it slightly. Always be sure to use a foam wedge that has been specially designed for this purpose.

Use the Five S's

Dr. Harvey Karp brought relief to parents everywhere with the techniques he calls "the five S's" in his book and DVD "The Happiest Baby on the Block."

These include:

• Swaddling, or tightly wrapping, your baby, emulating the close comfort of the womb. • Side holding your baby, like a football tucked across your chest, and facing out.

• Shushing your baby or using white noise.

• Swinging or jiggling your baby to create a rhythmic motion Sucking -- allowing your baby to nurse, take a pacifier, or suck on your finger.

All of these techniques are intended to calm and soothe your baby, helping to reduce the symptoms of colic and to promote longer and more restful sleep.

Try Gripe Water

Finally, there is a homeopathic remedy called "Gripe Water" that many parents swear by for calming colic. Different brands have different ingredients, but the primary components are bicarbonate, ginger, dill, fennel, and chamomile. The ingredients work to relieve digestive issues and to calm your baby.

Some parents never have any luck with Gripe Water, but others swear by it to get them through the long weeks of colic.

Being a new parent is hard enough. Dealing with colic makes it even harder. Though there isn't any "cure" for colic, these time-tested remedies have worked for sleepless parents the world over. Try these the next time you can't get your baby to stop crying.

Heather Green is a mom, freelance writer, pet lover and the resident blogger for OnlineNursingDegrees.org, a free informational website offering tips and advice about online healthcare administration programs. Note:  To determine whether or not your baby has colic, consult your pediatrician. Every case is unique so always follow your health practitioner's advice!

Note: Every baby is different so seek advice from your doctor before trying any of these!

Nice-to-Have Items for Baby's Medicine Kit

Every home should have a kit for baby's medical maladies. The medical kit will be your first line of defense in treating baby, or at the very least, in keeping baby comfortable.

Baby had pneumonia recently so we got to test drive some stuff that can comfort baby through his bout with common symptoms like colds and fever.

Below are some of the stuff  we found handy if,  God forbid, that poor baby gets sick again :

What to expect : the First Year (or any book about dealing with sick babies) 

Of course, i won't discount the fact that your pedia's opinion and diagnosis is the foolproof way of treating your baby's condition.  But having such a book on hand will definitely keep a mommy calm. What to Expect books are such mom friendly resources.  It has sections on disease symptoms and possible treatment for common infant diseases.  Any first time mom will find the information useful, hence keeping her sane on crisis events like these. Plus, there may be some questions that bother a mom which seem to foolish to ask the pedia. WTE books might answer some of these questions!

[caption id="attachment_1400" align="aligncenter" width="300"] It pays to be informed. Books like these provide some guidance during days when baby's sick.[/caption]

Ear thermometer

It's much more convenient to use, especially when your baby is  fussy or agitated. A sick child is uncomfortable and unruly so getting his body temperature through the armpit can be such hassle. It's even harder if you'll be getting the temp rectally, which is said the be the most accurate! Read BabyCenter's notes on how to take baby's temperature here.

We got this Safety 1st thermometer from SM Baby Company. It was on sale for Php 1,800.

[caption id="attachment_1401" align="aligncenter" width="300"] Get an ear temperature when your baby has started getting more mobile - when he's learned to roll over or sit on his own. You'll be able to get his temp in just one snap.[/caption]

With an ear thermometer, you can take his temp in seconds! Some models will also indicate if your baby has fever.  It was very handy, even  throughout the period of baby's confinement in the hospital. Nurses were able to record P's temp faster.

Ask your pedia about baby's baseline temperature and the temperature she considers low grade or high grade fever.

Snot remover 

A snot remover will help clear baby's stuffy nose. Babies usually have stuffy and runny nose when they have flu or colds. Unlike adults they don't know how to clear their noses from mucus and snots. The snot remover can pickup dry or wet blockage in your little one's nose.

[caption id="attachment_1402" align="aligncenter" width="300"] This is an ear pick for adults but we use this to remove P's snot. We can only remove his snot when he's sleeping. BTW, this has built in lights![/caption]

You may also use ear buds wet with salinase to clear baby's nose and keep baby his nose hydrated. What to Expect.com suggests dabbing a thin layer of petroleum jelly under baby's nose to avoid reddening or chapping of that area. Chapping usually happens when the nasal mucus dries up.

Cool Fever

I think the cool fever strip helps a lot to relieve baby's discomfort when he has fever, especially when he's sleeping. The cool strip helps absorb heat when placed on baby's forehead.

[caption id="attachment_1403" align="aligncenter" width="225"] The strip stays in place so it's safe to stick it for use overnight[/caption]

Nebulizer

Nebulizers are usually used to treat lung diseases like asthma.  The nebulizer is used to convert  the liquid medicines into mist which is then inhaled by the patient.  When your child has colds, nebulizing with saline solution can help loosen his airway. It will be a lot easier to remove sticky mucus and snot in his nose after nebulizing.

We purchased an Omron Nebulizer for Php 3.580. It's a bit loud when you use it, so be ready to distract your child.  He may freak out during neb time especially on his first few sessions.

At home, we nebulize a few milliliters of salinase (saline solution). Depending on how much salinase you put in, the procedure can last for 10 to 20 minutes.  While confined in the hospital, baby had to take in  Salbutamol (for his cough) through the nebulizer every six hours.  Just a note: always consult a doctor before using,  Our pedia warned to avoid using nebulizer at home too much, or baby's lungs could be filled with water.  So limit using the nebulizer. Only use it to ease baby's severe cough and colds.

[caption id="attachment_1404" align="aligncenter" width="300"] At home, we use the nebulizer for baby only when absolutely necessary.[/caption]

So there, just some items to keep a mom from freaking out on sick baby days. On sick days,  it's best to coordinate and consult with your doctor for the correct treatment.

Also worth reading:

• Lessons learned after my baby got sick


• Tips on using the nebulizer on your child

***

Lessons Learned After my Baby Got Sick

Baby recently got hospitalized and confined in the hospital for a few days! I really pitied him as he cringed in pain as the needle is pierced in his small baby hands as the IV was being placed. I shed some tears knowing that he is still too young to feel such pain! And as the heartbreak song asks, "Where did i go wrong?". Surely any working mom would have some guilt not being able to be with baby 24/7 and hopefully guard his every move to reduce chances of him catching any virus or germs.

Aside from the IV, he was pierced once again to collect a small amount of blood for CBC. Hayy... awang awa talaga ako. But what can i do? His fever has been on the 38 level for more that 3 days.  The pedia also suggested that he stay in the hospital for observation.  I obliged since i know he'll be  better taken care of there.

At first baby had cough, then the next day he was sneezing more frequently. This was followed by colds and a bad case of stuffy nose. We gave him Disudrin for this.  On the 5th day, i think, he had high fever. The fever did not come down even if we gave him paracetamol (Tempra). We then gave him a paracetamol in suppository form. Husband and i agreed that if the fever, which was at 39 centrigrade at this point, does not come down, we'll take him to the ER. The fever came down a bit so the next day we opted to have him checked up the next day.

[caption id="attachment_3271" align="aligncenter" width="300"] No one ever wants for a baby to get sick. I was really crushed as my baby was pinched for the IV. On times like this all moms and dads is just to stay strong and hope everything clears up.[/caption]

The doctor immediately said he should be admitted since he seemed to be catching his breath. She said the warning sign, if you would check his breathing was when his breathing is so deep you can see the outline ribs and if he seems to be inhaling and exhaling faster than usual.

After the xray and the blood test, the diagnosis was pneumonia, viral lang so he would not be given antibiotics.  Thank god it's not dengue or any other worse disease. He had to stay in the hospital where his meds (Salbutamol) was given through the nebulizer + Disudrin drops.  His fluids was also constantly replenished through the IV. The doctor says he might have caught the virus from his caregivers. That was my suspicion, too since the house is seemed to be plagued with coughs and colds.  It's flu season and family members caught the virus.

So after 3 days he was up and about so i'm happy. He shed some pounds but at least we know he's clear of any disease. Now he's slowly gaining weight.

Here's what hubby and i learned and relearned after baby got sick:

Baby's immune system is still developing. 

Remember that even if he's still getting the vaccine almost every month, he'll still catch some type of disease. Shots can only prevent a number of diseases.

Avoid going to crowded places where he's most likely be in contact with sick people. So, noted. We'll limit his trips to the malls! Since convergence ang mall ng napakaraming tao, pati na rin mga virus.

We've been having colder nights since the end of October. For chilly nights, since Amihan kicked in, keep baby in thicker clothes so he won't get too cold.

Health starts at home. 

Sa bahay, since hindi naman maiiwasan magkasakit, i''ll have take take vitamins. Next flu season, i'll insist na talaga that they do get the shots. As my pedia said, having baby vaccinated against flu will be useless if the rest of the household won't get the shot too.

To prevent or at least limit the spread of diseases within the house, always wash hands when handling baby. Use baby's own utensils when feeding him. Avoid face to face contact if you feel you're developing a cold. Never sneeze around the baby.

Keep breastfeeding!!! 

It's the best way to comfort the baby. His appetite was down and limited. It was quite hard to breastfeed him while lying down since he had colds. Moms will need to nurse with baby in upright position to keep milk from backing up. Limit nursing in the side lying position. Baby might lose his appetite for nursing, but be sure to keep that skin to skin contact to reassure him that you're always there for him. After nursing, place a pillow under his back to elevate his lungs.

[caption id="attachment_3273" align="aligncenter" width="300"] This was our position for almost the entire time my baby was in the hospital. A mental note for moms with sick babies: Give more hugs![/caption]

Aside from nourishment, babies  get solace knowing that he'll be hugged by his mommy for the rest of the time he's sick.  The only silver lining was that during the period when he was sick, we got to cuddle and hug most of the time. He just laid on top of me... and i secretly enjoyed.

So there, take good care of the precious little prune!!!

Also worth reading:

• Nice-to-have items for the medicine kit

***

Guest Post: Tips for Staying Healthy During Pregnancy

This article was written by our first ever guest blogger, Katie Moore.  A mom of one. Katie says the best thing about being a mom is continuing to watch her daughter grow and develop into a little person, along with the joy and happiness she brings to her life every day.  She started blogging as an outlet to write and research and to connect to other moms and women online... and that's how she found my site!  

Katie is an active writer within the blogging community who discusses maternity, motherhood, prenatal health, childbirth and other topics within this niche.

In this guest post, she shares tips for staying healthy during pregnancy. Once again, thanks for these tips, Katie.  

Not surprisingly, pregnant women should pay special attention to their bodies and health during pregnancy in order to provide an optimal environment for the baby to develop in.  By taking advantage of these tips, a mom-to-be can ensure she’s starting her pregnancy off on the right, and healthy, foot.

[caption id="attachment_406" align="aligncenter" width="300"] Source of photo: ods.od.nih.gov[/caption]

Keep doctor appointments

When a woman realizes she is pregnant, the first thing she needs to do is make an appointment with her ob-gyn, to check how far along she is and to monitor her health and the baby’s health. Throughout pregnancy mom’s doctor will be essential in helping plan for her delivery; there are many choices that should be discussed and made in advance, such as what type of birthing process she would like, what pain medicines to use and other optional procedures like cord blood banking and circumcision.

Eat a healthy diet

Many women think that it’s okay to eat whatever they want when they are pregnant. While it’s okay to occasionally indulge in sweets, pregnant women should eat a mostly nutritious diet. They should consume 300 extra calories a day to give their babies the nutrition they need. A pregnant woman should eat a diet filled with lean meats, whole grains, fruits, vegetables and low-fat dairy products. They should stay away from raw foods, processed meats, certain fish and soft cheeses. A pregnant woman should also drink plenty of water. Water can help keep a pregnant woman hydrated and prevent constipation.

Get plenty of rest

Pregnant women feel more tired than usual, so it is important for them to get plenty of rest. As a woman’s stomach grows bigger, it will be difficult for her to sleep in certain positions. A pregnant woman should sleep on her side with her knees bent to ensure comfort. Lying on her side can also prevent hemorrhoids, veins and swelling.

Exercise regularly

Even though it is more difficult to exercise while pregnant, women should make the effort to work out regularly. They should get at least 150 minutes of moderate physical activity each week. They could do yoga, go for walks outside and swim. Exercising during pregnancy can increase energy, improve sleep, prevent extra weight gain and reduce pain and swelling.

Avoid alcohol and nicotine

Women need to stay away from alcohol and nicotine while they are pregnant. Alcohol and nicotine can cause birth defects, low birth weight, stillbirth and asthma.

Take prenatal vitamins

Even if a woman eats a very health diet during pregnancy, she can still not consume enough vital nutrients. That is why she needs to take prenatal vitamins during her pregnancy. Taking prenatal vitamins every day can help prevent neural tube defects, reduce the risk of low birth weight and promote strong bones and teeth.

[caption id="attachment_418" align="aligncenter" width="201"] Source of Photo: chfs.ky.gov[/caption]

With all of the above health tips taken into consideration, as well as any special recommendations for her a doctor, a woman will be doing her best to stay healthy throughout, and even after her pregnancy.

***

If you have any questions or would like to connect with Katie please contact by visiting her blog, Moore From Katie or her twitter @moorekm26. A copy of  this post is also published at http://tiffskinnyjeans.blogspot.com

For Breastmilk Givers and Takers

"Welcome to the Milk Mama Diaries Carnival (September). For this month, we will tackle milk sharing and how it can nurture the community, and how this spirit of giving can be sustained. Participants will share their thoughts, experiences, hopes and suggestions on the topic. Please scroll down to the end of the post to see the list of carnival entries."



Being able to donate milk is a great    sense of pride. What better way to spread the culture of breastfeeding than sharing the precious liquid to babies in need? I'm overjoyed to be successfully breastfeeding my son and helping other babies in the process.

Yup, beyond the need to free our freezer of ounce and ounces of EBM is the genuine desire to help other babies in need of breast milk. Nagpaparinig na din kasi si MIL na wala nang space sa freezer. haha....

I’ve kept tabs of the amount of breast milk I’ve shared – about 800 ounces so far!  An online ad selling breast milk at Php 150 per 5 oz! Imagine, add that rate, I would have earned Php 24,000! Kaaashhiing... Kashinggg. When i'm preparing milk for donation, my husband would jokingly ask, "Kikita ba tayo dyan?”

But seriously, I don’t believe breast milk should be sold or bought. I’d be uncomfortable about earning over something that some one else is in dire need of. I’d rather give than sell. I’d rather receive than pay for it.

[caption id="attachment_1079" align="aligncenter" width="300"] Building an EBM stash is a pumping mama's goal. Blessed are those who have enough ... and more to share to other babies.[/caption]

Having shared BM for some time, let me share my notes for breast milk givers and takers.

Choose your method of sharing. 

You can contact hospitals with milk banks to donate. Puede rin namang peer to peer lang, kagaya ng sharing among office mates. Kahit sa web, through sites like  Human Milk for Human Babies, puede naman makahanap ng willing magdonate.

My first milk sharing experience was at the Philippine Children’s Medical Center in QC. Initially I wanted to share milk strictly to formal systems – like hospitals, since there are strict rules for donors. They can also pasteurize the milk. This way, makakahinga ako ng maluwag, knowing that what i'm sharing only goodness to the babies, hindi bacteria or virus.  Sayang nga kasi tatlo lang yata ang milk bank sa atin - UP Philippine General Hospital, Dr. Jose Fabella Memorial Hospital and the Philippine Children's Medical Center.

Donating to PCMC is really fulfilling, knowing that it’s for needy baby patients.  PCMC admits only high-risk pregnancies, so there are limited breastfeeding moms in the hospital. Kaya sila umaasa sa mga outside donor. Since hindi naman kami mayaman to donate financially, I donate breast milk, which i had in abundance at that time.

My next donation was through informal platforms. Actually,  it was to my nephew. My sister had difficulty producing milk after giving birth due to flat nipples.  Nakatulong din naman ang milk ko kasi natuto sya magpadede.   Actually, pinilit ko talaga sya magpadede. Kaya ako nagbigay ng gatas sa kanya para di na sya bibili ng formula. I think supplementing with formula is the first step to sabotage breastfeeding.  Now, I’m happy  she’s exclusively breastfeeding her two-month old.

Nakapag-share na din ako sa katrabaho. It was for newborn who's hypoglycemic. The mom had APAS while preggy and she  gave birth thru c section. I commend her  for actually working hard to produce. I know she’ll manage to produce enough. Napapraning lang siguro kasi konti pa lang ang napapump nya.

Breast milk sharing has risks.

Importante din na aware ang mga tumatanggap ng milk na may health risks. Even the  US Food and Drug Agency discourages informal breast milk sharing, like through the internet.

According to the FDA, risks to baby include exposure to:
infectious diseases, including HIV
chemical contaminants and illegal drugs 
prescription drugs that might be in the human milk

Possible rin na hindi maayos ang handling and tranport ng milk. Hindi naman makakasiguro unless kilala mo mismo ung nagdo-donate diba?

Maihahambing din daw natin sa mga organ at blood donor ang mga breast milk donors. Diba ganun ka-delicate. Kaya dapat talaga mula sa mapagkakatiwalaan ang tatanggaping gatas! Bukod dito, malay mo ba kung tumira ng ilang galong kape ang milk donor. Eh di good luck sa baby mo,baka 24/7 syang mulat!!! hahaha....

In the Philippines, donated breast milk seems a much more limited resource than in the US.  We only have a few milk banks, which could make breast milk sharing much safer and easier. To donate to milk banks, moms need to undergo screening by filling out an application form and undergoing a blood test. Puede rin makabili ng breast milk dito, kaso may kamahalan. Saka dadaan talaga sa butas ng karayom ang mga bibili. Recipients will be screened under a strict criteria. Saka madalas daw na ubos ang breast milk sa milk bank.

At dahil nga kakarampot lang mga milk bank natin, malamang hindi rin pasteurized ang makukuha sa mga donors, like your friends or ung nakotantak mo sa FB. You may also be taking milk from a mom who's not screened as a donor.

Hindi naman ako tutol sa peer to peer breast milk sharing kaya lang dapat aware lang ang mga recipients. There are ways to mitigate the risks.

Naniniwala din naman akong walang masamang intensyong ang mga milk donor. Syempre, isang gatas lang naman ang ido-donate nila at yung ibinibigay nila sa mga anak nila diba.

Just to be safe, recipients should inquire about the donor’s health background before accepting milk. Alisin na ang kyeme ng mga donee moms sa pagtatanong, para ito sa kapakanan ng baby.

Another safety measure donee moms can take is to have the milk pasteurized in hospitals with milk banks. You can inquire if they offer such service. You can have the milk pasteurized there for a fee. Kung taga Quezon City, you can contact PCMC Milk Bank at 9246601 local 288.

You may also opt to do some pasteurizing at home.  Here's USAID's instructions on how to heat treat breast milk while keeping nutrients for babies. Kung para sa  premature babies, you might want to pasteurize milk since premies have weaker immune systems.

Breast milk expression is not free.

There are some expenses involved in this whole pumping at work system, like breast milk bags!  Sa totoo lang, medyo magastos din pala ang storage bags, lalo na kung madaming gatas ang nae-express. Donee moms can at least replace the bags.  I recently asked my breast milk recipient to replace the bags I used.

At first I was hesitant to ask for replacement bags. But I’m surprised because the recipient was happy to replace them. I guess it was her way of giving back and saying thanks.

Watch out for INVALID breast milk recipients.

Breast milk seems to be scarce resource when in virtually every mom can make enough milk for their babies, that's according to WHO.  So I really think donor moms should choose the recipients wisely. Expressing breast milk takes time and effort, you know. I’ve allotted time to pump while at work. I’ve let go of long merienda breaks just to express milk for my baby. Other moms should do the same for their babies.

I figured, I’m not actually helping such moms, because I tolerate their “katamaran”. Breastfeeding succes takes time, effort and the right information. Your breast milk is better off donated to babies and moms in GENUINE need of breast milk.

Nabasa ko dati "It takes a village to raise a child"?  Well, in so many ways,  breast milk sharing is a top way how moms can help in raising healthy children in the community. I am happy to share the best nutrition my baby enjoys to other babies.

Bukod sa pasalamat na natatanggap ko, sharing breast milk is a privilege. I hope to do this as long as possible.

***

In commemoration of World Milk Sharing Week 2012, share your own experiences as a milk donor or a recipient. Don't forget to visit the other participants of our blog carnival:

Mafeth wrote about being a milk donee
Cris donated her liquid gold
Pat had a happy problem donating solved
Jenny wrote about wet nursing from a relative's experience
Rachel discussed how she felt about receiving donated milk and nursing an adoptee's baby
Mec insists it takes two to Milk Share Tango
Cai received milk from her sister
Nats has a Milk Sharing Story too

Also worth reading:

• Alarming facts about breastfeeding in the Philipines


• Rights of the Filipina working mom 

A Working Mom's Guide on Thawing and Serving Breast Milk

Most of the thawing and the bottle feeding is actually done by my MIL, my trusted caregiver. I'm away for about 8 hours daily for work, so i make it a point that i personally thaw and prepare his breast milk for the day.

How to thaw breastmilk

• Heat in warm (not boiling) water in pan. To speed up thawing put milk container in pan with warm water, gradually add hot water to speed up melting.


• To slowly defrost milk transfer it to the ref the night before you need it. Milk usually thaws in the refrigerator for 12 hours.


• When thawing don’t  submerge the container in water. This prevents water from seeping into the container


• Never leave frozen milk to thaw at room temperature because this will promote rapid growth of bacteria


• The US FDA warns against using the microwave to thaw milk. The agency says microwaves can cause dangerous hot spots that could burn you or baby.


• Don't boil breast milk. This will destroy the antibodies and other nutrients present in human milk.

Note: You can also serve breast milk cold. I have given baby cold breast milk on several occasions.

Time limits of thawed breast milk

• La Leche League says breast milk at room temperature stays good  for 4 to 6 hours.  During summer in a tropical country like the Philippines, this period is should be shortened. High temperature increases risk of spoilage.  I follow a three hour-rule for breast milk at room temp. The key here is to follow a lower limit, especially for preemies and newborn.


• Thawed breast milk  should be as consumed within 24 hours.


• Breast milk that has completely melted should not be refrozen.

Reusing breast milk

• There are times when baby doesn't  finish the entire contents of the bottle. So moms ask, can i reuse  breastmilk? Actually there are conflicting recommendations on reusing breast milk. Read Kellymom's discussion here.


• As for me, i reuse leftover breast milk. It will be a total waste if i don't! I refrigerate it as soon as baby refuses the milk. Then i just warm it for the next feeding. If he does not finish this, then that's when i throw out the milk.

Preparing baby bottles

• Number your child's breast milk bottles. This is useful if you serve both thawed and cold milk. If you're serving thawed and frozen breast milk during the day, you have to serve the thawed milk first.  Thawed fresh milk has shorter shelf life than refrigerated milk.

• Double wrap the milk in the refrigerator so it won't absorb odors from other stuff in your ref.

[caption id="attachment_3263" align="aligncenter" width="300"] Here's how i put labels on my ebm containers. This is a must so your helper knows which bottles to serve first.[/caption]

 

On BM containers

• Choose breast milk storage that can double as feeding bottles.

• To lessen milk wastage, store in containers that double as feeding bottles. Transferring milk from one container to another encourage milk wastage. I use Avent storage bottles, when serving i just snap off the sealing disc then replace with nipples.

Serving breast milk

• More often, your caretaker will be the one serving the BM so you should leave clear instructions. Let them know about the proper handling milk. Examine EBM before serving.Breast milk could sometimes smell slightly sweet or soapy, depending on mom's diet. Discard milk that smells foul or sour.

[caption id="attachment_3264" align="aligncenter" width="300"] My breast milk: the creamy stuff rises to the bottle's edge. Color and consistency of breast milk varies depending on your diet.[/caption]

 

• Breast milk is not processed like cow's milk. Some cream can separate from the rest of the milk after days of refrigeration. The cream rises near the rim of the container. Just swirl the container to mix the cream and the rest of the milk.


• Always check the milk's temperature. It should not be too hot for risk of burning.

So,  that's how i'm thawing and serving expressed milk to our baby! Hope you find the tips useful!!

***

Walker for Baby, Anyone?

Would you buy an infant walker for baby? Do you know someone who was not "trained" to walk on a walker?

It's a contraption to support baby while he's practicing his strides and steps. It has wheels and a seat made of fabric to suppport baby while he's standing on his toes.  Some walkers also have toys and a table in front.

[caption id="attachment_1077" align="aligncenter" width="300"] The baby walker: Is it a friend or a foe?[/caption]

I really felt coerced into buying an infant walker for P. Before buying I did some research and found that most baby care websites in the US  do not recommend using walker. As a  matter of fact, the American Academy of Pediatrics recommend banning the sale and use of infant walkers. Based on their study, 8,800 infants aged less than 15 months were rushed to hospitals in the US due to injuries related to using walkers in 1990. Walker injuries may be caused by falling down stairs or poisoning, since babies have access to cleaning products tucked around the house.

While banning and using baby walkers in virtually impossible, the US Consumer Product Safety Commission imposed stricter rules to improve walker safety.

Walkers may not encourage development – baby might be forced to walk before he's ready. According to Baby Center, babies learn to walk by understanding how their feet and legs move.  There's actually a time frame for babies start and learn to walk - 9 to 18 months.

But in the Philippines the infant walker has been a staple in training babies to walk. I was put on a walker. My siblings were put on it too.  My husband and all his siblings were, too. Actually, I really don't know anyone who was not trained on a walker.

Come to think of it, the infant walker was the only gear my MIL insisted on buying.  She said it will encourage baby to walker. Ganito pa ang banat niya. “Tingnan mo ung apo ng kumare ko, 7 months pa lang ang bilis nang maglakad!".  My husband also wanted to buy one, despite the facts i presented based on my research. He said, "Eh sa US kasi hindi naman natututukan ang mga babies, pagkalagay sa walker, pinababayaan na. Si baby naman andami nagbababantay." 

I consulted our pedia about my walker dilemma, she said it's fine so long as baby can sit on his own na.

So i gave in. Mukha naman hindi ko sila makukumbinse otherwise. So off we go to the mall to buy one. To be extra careful I researched on what type of infant walker to buy.

Here are some walker safety features you might want to look for, based on US standard for walkers (ASTM F977-96)

• must be wider than a 36-in doorway


• must have a braking mechanism so walker will stop during a change in surface, say when approaching a stairway

Here are some more cool safety features to look for:

• the more wheels, the better. Wheels will add stability to the walker to avoid tipping over when the babies use it.


• adjustable height so baby's feet can touch the floor

Baby was about 7 months when we bought that Ashworthy Walker from Trinoma. It cost us a whopping Php 3200.  We opted for a high-end walker since it has most of the safety features we were looking for.

If you’re like me who’s hesitant to put baby on walker here are some safety tips:

• Never ever leave baby on walker alone. Guard him closely and make sure he doesn’t stray on stairs and doors.


• What to Expect suggests limiting walker time for 30 minutes every sesion.


• Baby-proof your house early since with walkers, he'll be mobile. It's a good idea to install safety gadgets like these:
  
  [caption id="attachment_975" align="aligncenter" width="225"] Use a safety door gate to limit baby's access to selected grounds only.[/caption]

[caption id="attachment_976" align="aligncenter" width="225"] Put cushions on corners of table or cabinet as buffer for any head bump while baby is mobile.[/caption]

To encourage baby to walk, here are some suggestions:

• Encourage him to learn to stand on his own first, before training him to stride or cruise.


• Get him a push toy, like a doll stroller or a push cart. WTE  says push toys provide support for babies who are not quite ready to walk. They also help build baby's strength, balance and confidence so eventually he can stroll on his own.


• Keep his foot bare so he'll get a better touch and feel of the floor. Shoes or slippers distracts your walker candidate. Curious babies will try to "eat" his slipper or shoes instead of focusing on his steps.

Lastly, genes can influence how early baby will walk. If moms or dads walked later on his infancy, chances are baby will walk later on as well. You don't need to rush since baby's  milestones will come at his own pace.

As for baby, i think he enjoys being in the walker so long as he sees other people in the room. He stays there standing and sometimes gliding. After 10 minutes, he gets tired and just wants to be carried and cuddled. For my piece of mind, i just make it a point some one's looking out for him while he's on the walker. The walker must be used only on adult supervision.

Ok, moms and dads, have fun and stay safe always!

***

My Pregnancy Complication: Placenta Previa

My pregnancy story is not at all riddled with groans and pains of labor in a vaginal delivery, as i imagined it would be.  I had to undergo cesarian delivery, not by choice but out of necessity. My baby had to be delivered via c-section because of a pregnancy complication known as placenta previa.

What is it?

The American Pregnancy Association defines placenta previa as a "condition where the placenta lies low in the uterus and partially or completely covers the cervix."  I understood it as the condition wherein my baby can't pass through my vagina because the placenta blocks his passage.  The placenta is the pancake-shaped sac inside uterus that holds blood, nutrients and food for my unborn baby.

[caption id="attachment_465" align="aligncenter" width="300"] Source of Photo: tbh.org[/caption]

How it was diagnosed

Four months into my pregnancy, i was rushed to the hospital because of spotting.  We got worried because it was the first time ever that i leaked some blood.  The OB in the emergency room ordered an ultrasound. I  had to be admitted for overnight observation.

At the ER i was asked several questions like:

• "Nararamdaman mo ba parang may menstruation ka before ung bleeding?"


• "Napagod ka pa recently?"


• "Kailan ang last contact nyo mag-asawa?" Translation: Kailan kayo last nagsex?

Yup. That intrusive. But ok lang, para maliwanagan ako, saka ung mga doctor kung anong nangyari.

When the ultrasound results came out, my OB confirmed it. Placenta previa nga.  Hindi lang basta previa ha. Sa ultrasound report ang nakasulat: Placenta Previa Totalis. This means, sobrang laki nung overlap ng placenta at nung opening. This means the placenta completely covers the cervix. Argghhh...

It was the first time i ever took placenta previa seriously. I read about this haphazardly in the book "What to Expect When You're Expecting" but it didn't really strike me as important. From then on i tried to know everything about this condition.

Doctor's orders

I was ordered to have a 2-week bed rest after the scare of my first spotting event. So bale, naka-emergency leave ako for 2 weeks. Complete bed rest daw talaga kailangan para ma-relax ang uterus ko. Tumatayo lang ako sa kama pag kailangan mag-weewee at mag-poopoo.  OB also prescribed duvadilan twice a day and once when i feel any contractions. In my medical certificate, i was ordered bed due to threatened abortion...yikes!

A note on bed rest, not all previa cases require bed rest. According to my OB, some get by even without bed rest.  It really depends on two factors: how far along in the pregnancy and how profuse the bleeding is.

My OB says the condition isn't really that bad. Having this condition is not life threatening. I just have to take extra care and be on guard for any spotting at any point in your pregnancy. She said i should avoid getting tired.

Complication

The worst scenario is excessive blood loss. The danger is, according to the OB, once you have severe spotting, she’ll need to deliver baby even if i'm months before due date. Ito ay kapag sobrang dami ng dugo ha.  Nung narinig ko ito talagang natakot ako. For the first time sa pagbubuntis ko, napraning ako. Posible pala ako makunan!

We asked our OB about the implications of placent previa on my pregancy.  My OB says that i'm more prone to severe blood loss, so i'm more likely to undergo a cesarian delivery.  According  to her,  I should not reach the point of active labor since placenta previa cases are prone to excessive blood loss. As soon as baby has reached his full term, he'll be delivered.

However i'd like to point out that not all previa pregnancies end with cesarian. Placenta previa may clear up in the late stages of pregnancy.  My OB said the position of the placenta can shift as the uterus muscles stretch to accommodate my growing baby. She said she had one patient whose previa cleared up in the last trimester.

Well we did pray and hoped that later in my pregnancy, it will improve. But in our last ultrasound (7th month), I still had it. So we had to accept that in deed, I had to deliver baby via C section. We were  scheduled for a C section any day from January 6  to 13, 2012, which corresponds to baby's 38^th week of gestation.

[caption id="attachment_3269" align="aligncenter" width="277"] This was baby's last prenatal ultrasound. Can visualize the placenta on the upper left portion? It lies right next to baby's forehead. At 7 months, my placenta still blocks the cervix, which is baby's natural way out![/caption]

Who's at risk?

While doing a research on my condition, I came across a list of risk factors why some women are prone to placenta previa. Here's the list as stated in the Mayoclinic article.

Women are at higher risk for placenta previa if they've 
had previous surgeries involving the uterus, such as:
• A C-section
Surgery to remove uterine fibroids
• Dilation and curettage (D&C), though this is a much lower risk
Placenta previa is also more common among women who:
• Have already delivered at least one baby
• Had placenta previa with a previous pregnancy
• If you are carrying twins, triplets or other multiples
• Are age 35 or older
• Are Asian
• Smoke

I’m really baffled because I did not  fit into these characteristics, except for being  Asian. I don’t smoke. It was my first time to pregnant. I was just 29 when I got pregnant. Hindi ko talaga matanggap noong una na considered "high risk" na agad ang pagbubuntis ko.

So I asked my OB, why and how i had this condition. What did I do that put my placenta in such problematic position? Could i have prevented this? Bakit ako pa eh wala naman akong risk factor?  She said there’s really no clear explanation why and how placenta previa develops. They're no really sure what causes this pregnancy complication.

Moms, if you're diagnosed with placenta previa, you need to take extra care.  Be on guard for any bleeding.  Avoid excessive activities as this can cause uterine contractions. After i was diagnosed, i was not allowed to climb stairs, go on long walks and even have sex. (Sadddd)

The good news is: Placenta previa has no long term effect on baby or on you. Once you pass the 7^th month, you can relax a bit because at this stage almost all of baby’s organs are formed. Past seven months, it’s a matter of waiting for (and preparing for) your baby's full development and maturity.

Also worth reading:

• Placenta previa do's and don'ts!


• Learnings from an emergency cesarean delivery

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