Local myths (pamahiins) about breastfeeding

I understand that as a developing country not everybody gets a good science (anatomy and reproductive health) education, so it was no surprise that I heard many many myths about breastfeeding. Even the real science behind bfing can be bizarre after all, why wouldn't the whole mystical process inspire mistaken conclusions about how best to bf your baby? A couple of the strangest I encountered:

1. The left boob only has water, and the right boob has rice (this is Asia after all, rice is a staple so why shouldn't Asian mommies have rice in their breastmilk)? This only naturally means that the baby should drink from both at all meals.
2. Don't breastfeed if you're tired, cranky, or in a bad mood because your milk will be sour. Who wants to drink sour milk? Maybe this one was thought up by a tired and cranky mom to get her husband to take better care of her.

We live in the city so we don't hear a lot of these, but whenever I visit my in-laws in the province their helper likes to school me on all things baby and breastfeeding. She thinks using a baby carrier/sling will make the kid bow-legged...so there...

Funny moments in breastfeeding

What many moms neglect to tell other moms, is how bizarre and funny the breastfeeding experience can be. It's not even having this little "pet" baby suck on the end of your booby, that's nothing. It's witnessing your body do these strange things, or rather, your boobs do these strange things. Seriously, there's MILK squirting out of your BOOBS! That's totally weird. Literally I have laughed out loud while I pump milk as I witness the stuff coming out of the boob at full force. Other funny things:

1. There were drops milk all around our room during the first month. In the first few weeks you will find yourself basically topless most of the time, there's hardly any point bothering to put on a shirt when you are on boob duty every hour. So, you walk around and leave a trail of milk behind you.
2. Once I was sleeping beside Baby J, woke up, reached over him to pick up my phone on a table beside the bed. On the way there SOMETHING latched on to my boob! It was like some 6th sense the baby, had, there's a boob coming at me! Wake up and grab it!

Photo credit: http://www.myspace.com/breastfeedingsupport

3. Several times, I turned over in my sleep and ended up sleeping either on my side or on my stomach. When I woke up in the morning the sheets beneath me were drenched in milk.
4. The experience of attempting to shove my milky boobs into an old bra was hilarious, it was like trying to fit a melon into an egg cup.
5. The bottomless milk duct. No matter how empty I think my boob is from pumping and nursing, when I squeeze on this one milk duct, milk goes squirting out and hits the ground 2 feet away.
6. Seeing the baby try to latch onto your boob through your shirt...funny. Seeing your baby try to latch onto your friend's boob through her shirt...funnier. Seeing your baby suck on daddy's nose in hopes of getting milk...funniest.
7. Babies will go through this phase where they're feeding and you're watching them, then they will look up, see your eyes, and smile at you with a big grin with your nipple in their mouth. Funny also.
8. Lately, my baby will be nursing on one boob and fiddling with the other boob. It's embarrassing in public but kinda funny at home. Not a behavior I encourage, but sometimes he just likes to have something to fiddle with and that other nipple is right in front of him.

TWENTY-FOUR (COUNT ‘EM, 24) HOURS OF LABOR

“Childbirth is not beautiful,” she writes. “Children are beautiful. Childbirth is disgusting. Anyone who says otherwise has never met a placenta. I’m surprised ob-gyns don’t have post-traumatic stress from seeing a few of those a day.” - Scottoline

What does it mean to go through 24 hours of labor? What does one do through 24 hours of labor? How does one keep sane through 24 hours of labor? Have I mentioned I went through 24 hours of labor? Only to end up with a C-section, oy. 

It is true that the pain and the details can get blurry in one’s pregnancy and post-birth brain. I can’t exactly remember all the pain, but I remember getting pissed. Pissed that they don’t tell you how unpleasant and violating it can sometimes feel to be in labor in a hospital. So I’m telling you now what to watch out for.

1. Several doctors peek into your hoo-ha. The longer you’re in there, the more doctors and nurses you will encounter because they change shifts. These doctors, they do internal exams every few hours. One might poke you in there to break your water, another might go in there to check how far you’re dilated, and yet another might go in there to check that the estimation of dilation of the first doctor was correct. 
2. Internal exams are a bitch. They are a bitch. A bitch. I am aware that the previous two sentences are not exactly grammatically correct, but it just feels right. In the medical shows they say so-and-so cm dilated, but they don’t tell you how they know. I went into labor mistakenly thinking that they measure the cervix through ultrasound. But NOOOOO! They measure it by sticking their fist in there and seeing how many fingers they can poke through your cervix. For me this meant check at 1cm, 3 hours later it’s 1.5, 3 hours later it’s 3, 3 hours later it’s 1.5 again! It took a lot of strength not to smack the doctor upside her head. 
3. When they say they will break your water, watch out. They will come in with a monstrosity of a crochet hook. It really looks like a crochet hook, a really big one. It will be scary, I can allay fears only by saying that it doesn’t really hurt. After all those internal exams a skinny metal wand with a hook at the end is a piece of cake.

If you've never met a crochet hook, here's what it looks like. Photo credit watermarked.

1. If you are in a teaching hospital there may be up to 50 doctors and nurses attending to you by the time the 24 hours are through. Some of them will stand around doing nothing, learning I guess. It’s annoying. It sort of makes you feel like you’re part of some  freak show as they watch someone else stick their fist up your hoo-ha.
2. Boredom. Bring all your gadgets and tricks to entertain yourself.
3. The royal annoyance of hearing activity in other delivery suites. As I lay there for hours on end, I had to listen to squads of nurses and shouting “push!push!push!” in unison as they cheer on the nth woman lucky enough to be at that point. This is followed by rehearsed gushes of cheerful congratulations. I must have heard 5 deliveries by the time they wheeled me to the OR.

OK so those are the annoying and painful things. I don’t want you to think that there is nothing magical about childbirth, after all most other women say it is magical. It can be fun if you have someone around to talk with. I was lucky that my husband can see the humor in the smallest things, so a lot of chuckles were shared as we ribbed nurse after nurse about their silly uniforms. 

So after giving the little guy a more-than-fair shot at squeezing himself out of my womb, my wonderful and unusually-perky OB decided it was time to open up a new door. They had already popped my water bag which made my belly deflate considerably. It was sort of freaky, like my skin was shrink-wrapped around the baby. To be honest I was glad he made the call to do a c-section. I was exhausted beyond the ability to push. It is a total cliche, but it needs to be said, it truly is worth it.

A Medicalized Birth

Now I am all in support of home births for those women who have the courage and emotional balance to do it. I am not one of those women. There was never a question in my mind that I wanted a magical birth free of pain. I had already gone through so much physical pain during the saga of our (equally medicalized) conception, was not in the mood for more. I would not necessarily advocate pain medication during birth, it is really and truly a personal choice based on a woman’s threshold for pain. Some superwomen can smile through the sensation of having a jaws-of-life clamp squeezing their belly and pushing a baby through their 10-cm diameter birth canal. I am not one of those women.

So I asked for all of it. Before the drip by kind OB told me that he was feeling generous today, he would let me eat whatever I wanted. By this time I was starving, I must have not eaten for more than 12 hours. What was near Medical City that was still open late at night? McDonalds ick. So I went full monty and sent my dutiful husband out for a quarter pounder, a large coke zero, and a large fries. He took a picture of me to commemorate the moment, some of our final moments as DINKS (dual income no kids).

Photo from McDonald's

Except for a few choice friends, nobody will ever be shown that picture. I looked horrid, all swollen in the face, but happy. Until I saw that picture I imagined myself as I was pre-pregnancy, with a full face of make up and looking ready to conquer the world with eager eyes. Instead I found that I looked fat and tired, pale with bags under my eyes, acne across my face, and hair all unwashed and askew. 

I digress, this is supposed to be about the medication. Through 24 hours of labor I must have had, on top of the initial epidural drip, 4 “refills.” Those things don’t last very long, after a few hours you start feeling the pain again. Epidurals are magic, it made my painful contractions feel like Braxton Hicks contractions where I can feel only a pleasant squeezing. For the epidural virgins out there, the procedure can be intimidating. First, it’ll take an army of doctors and nurses to administer it, including a big burly man whose job it is to hold you down in a fetal position while someone else administers a spinal tap. There’s a small needle pinch to numb you in the site where the big needle goes. Then the big needle goes, into your spine, you can feel the doctor poking around in there looking for the sweet spot. After you’ve been tapped, they run a thin plastic line across your back and tape it to your shoulder, Through this line they feed the magic contraction-numb-ers. 

Photo from: http://solutions.3m.com.sg/
This is what an epidural looks like

On top of the epidurals, I also had the rest of the stuff they give women for a C-section. Was numbed completely from the waist down. That was very very strange and scary, good thing I was already so tired and almost in shock from the cold of the OR that I couldn’t completely process it in my brain. 

So all in all it was an extremely medicalized birth, with all manner of pain killers. What would this mean for my breastfeeding prospects? The question I never did get to ask myself. I only realized what it meant a week after Baby J was born.

The Day I was Admitted to Give Birth

*I realize these posts are out of chronological order, sorry about that. This blogging thing started out late in the game so am just now catch up with the birth stories.

I had already been “phoning it in” at work for a couple of weeks, partly because I was expecting Baby J to arrive at any moment, but mostly because it was just getting too darned difficult to move around. I felt huge, heavy, unwieldy, and all other synonyms of “large” you can think of. Mostly I was sitting on the couch watching reruns of Law and Order until it was time for naps. Except for random Braxton-Hicks-type contractions several times a day, which were painless, this pregnancy was exactly where it should be at 38 weeks. 

Photo from: http://www.totalfitnessexperience.com/wp-content/uploads/2012/01/pregnant-belly.jpg

On one of these weekday mornings the contractions suddenly felt painful, very painful! I was groaning in pain, holding my belly, and kneeling on the floor waiting for each wave to subside. Time to alert the husband to take me to the pre-delivery room at Medical City, where I was going to give birth. This was a first pregnancy, so I had absolutely no idea what contractions would feel like and how to know when I was supposed to go to the hospital. We texted the doctor and he said just go and get checked. When we got there, I was hooked up, checked, poked, and put on standby. Wouldn’t you know it, contractions stopped when I was there. Feeling silly for pressing the play button too soon, we were discharged and sent home with instructions from the doctor to come back only when contractions were 15 minutes apart and coming in regularly.

After the false alarm my husband, my giant belly and I went out to lunch with friends, hung around the house, I may have even gone to the mall to walk around. In the early evening the painful contractions started again and this time we know enough to actually time them. 

You know how some women who give birth say they have a high tolerance for pain? Well, this one has a very low tolerance for pain. I was squeezing B’s hand, twisting and writhing in pain with each wave of contraction. At 10pm, we went back to pre-delivery room. There they waited and waited and waited, contractions were very irregular but very painful. Internal exams show I was dilated 1cm, that’s nothing! That’s a polite way of saying “honey you are so not ready yet but i’ll say 1cm so you don’t feel stupid for taking up our time.” Baby J hasn’t dropped into my pelvis, he wasn’t going anywhere. Still, since I was in so much pain the residents probably took pity on me and got me ready to move to the delivery room.

Brilliant tip from our OB, book the Lamaze room, the best room and you don’t actually have to use Lamaze techniques to give birth. It was huge, had a couch, a tv, its own bathroom and enough floor space to do a Zumba class for 6 people. Sure it was windowless, but it had an entire wall covered with a mural of a pretty garden of flowers! I had my Kindle, my ipod, my phone, and my husband, I was ready for the wait. So we waited, and waited, and waited. 12 midnight became 4am which became 11am and became 6pm. This baby was not dropping! There were long stretches of time with no contractions, then some contractions close together, then they’d disappear again. Poor intern had to sit there half-asleep recording all my contractions. 

Photo from: http://www.mommylace.com/2010/02/21/cost-of-giving-birth-normal-and-ceasarian-delivery/

I don’t remember exactly when I asked for an epidural, it was probably halfway through my labor. My OBs resident asked me if I was in pain and I enthusiastically said hellz-yeah I’m in frickin’ pain! At this point I sheepishly asked when I can get pain killers to which she replied “ anytime you ask for it ma’am!” See, if they had explained this to me when they admitted me then I could’ve asked for it 6 hours earlier and I wouldn’t be so exhausted. 

There were all manner of unpleasantness during this period of labor which I will warn all you out there about in a following post. 

Milk not coming in? The importance of pumping

All pregnant women who want to breastfeed should have a pump before they give birth. Full stop. No negotiations.

It does not have to be a fancy branded electric pump, if all you can really get is a manual pump (new, borrowed, used, doesn't matter) then get one. In fact for me the manual pump got more milk out. Yes yes you can hand express, but that will really take a lot of time and patience which you DO NOT HAVE when you have a newborn.

Since I had such a medicalized birth (c-section, induced labor, epidural, da works) it took probably a full week before my milk came in in any real volume. I had colostrum only for a week and had no idea. The only reason I found out that my milk had not come in yet was at my baby's first week checkup with the pedia his weight had dropped significantly (insert mom meltdown and hysterical fear here). At that point I desperately wanted to supplement with formula but my doctor said wait a week, make sure I nurse as often as I can and in between, pump and feed expressed milk.

So I did that. I was attached to the pump between feedings for a full week almost every hour. Eventually the milk came, then the problem became too much milk (that's a different post). Pumping as often as you can is so incredibly important during the first two months as you establish your milk supply. Even if you do end up deciding to supplement, you can still move to exclusive breastfeeding eventually if you pump religiously at least every 2 hours (even at night) and every time the baby takes a bottle of formula.

When pumping, pump until nothing comes out and then keep pumping for another few minutes before stopping. Also, squeeze your boob and massage from the outside in while pumping, Piga-in ng husto! It will be frustrating seeing 1 ounce of milk after half an hour of pumping but this is normal, eventually you will get more.

I am lucky that my pedia held out on the formula and my baby at 7 months has not had a single drop. However for some moms it REALLY can get scary when baby is not gaining weight or is losing weight so I understand the instinct to grab the can. What is important to know is that even if you supplement, you can still move to exclusive breastfeeding when you have enough milk. and that pumping and nursing are the most important things you can do to bring your milk in. The more you pump and nurse, the more milk you have.

Breastfeeding through growth spurts

Breastfeeding through growth spurts can be harrowing, and I suspect, the reason why many moms who set out to exclusively breastfeed, end up supplementing with formula. When baby goes through a growth spurt he can make you feel like you are not making enough milk, in reality what he is trying to do is to make your body adjust to his demand. Supplementing with formula through a growth spurt diminishes your supply, the best way to deal with a cluster feeding baby undergoing a growth spurt is to just be there if you can be. What to expect and how to cope:

1. Expect baby to basically camp out on your boob. We had our first growth spurt at 2 weeks. He went from nursing every couple of hours to nursing ALL THE TIME. Literally, on the boob from feeding to feeding. I'd put him on there, he would be there for an hour (no joke), and then he would sleep. In an hour he would want to be on the boob again. This can go on for 2-3 days. I once had some guests in the house, they were there for 3 hours and the entire time except for the time it takes to switch boobs, he  was on my boob under a nursing cover. Good thing our guest was also a nursing mom, she made me feel ok and explained that maybe the baby is just making me make more milk.
2. Get comfortable and surround yourself with entertainment. It will get boring. Thankfully, the pain is not so bad because for me the pain was bad when he was latching on, it'll last for a minute then i'd be fine. SInce he was nursing almost nonstop the pain was few and far between. Have a nursing station where you can raise your feet up, keep your nursing pillow there, celphone to have text conversations with your friends, have water and snacks on hand, a book, and a tv.
3. Have your husband or partner or maid check up on you every half hour. Just to ask if you need anything. Useful for bringing you water or changing the tv station etc.

When it seems like the baby is just never full and you think your milk is not enough, take comfort in knowing that you won't need to supplement. What the baby needs is just more time on your boob. It is temporary and you can weather that storm. Sometimes baby is just comfort nursing, not really drinking but he just wants to be near, hey, that can't be a bad thing.

Pre-birth shopping

New moms can be easily immersed in the overwhelming task of shopping for baby. It was fun for me but ultimately overwhelming. You can drop a lot of cash buying things you thought you'd need but never will, things websites try to sell you, things your friendly SM saleslady will convince you is necessary but is absolutely not. I fell prey to many such traps, and wish I had taken a seasoned mom with me to the big shopping trip, I would have saved so much money. There were also items I wish I bought more of before the baby was born.

Things they will tell you to buy but you might not need:
1. Mittens and booties. My baby refused to wear these from day 1. I know they are cute and are so hard to resist at the store, but believe me they are optional. Buy 1 pair of mittens to check if the baby will tolerate them then buy more as needed, or better yet ask your friends if they have any to spare. Booties are silly, who wants to tie stupid ribbons? Buy socks instead, those are more useful.
2. Washcloths. Don't let the SM lady talk you into buying washcloths, these are glorified bimpos. They are too small for any kind of practical use. Just use regular bimpos or lampins for washing needs.
3. Shoes for newborn babies. Experts say babies should not start wearing shoes until they are walking so don't waste your money on shoes. Besides, you will receive several as gifts. I am guilty of gifting these a lot because they are so damn cute and didn't know any better. Now I know, baby shoes are useless, buy your pregnant friend a couple of onesies instead.
4. Pillows. They have these all wrapped up nice in the baby departments, sets of 2 bolsters and 1 baby pillow. Experts say don't put pillows around your baby, so don't buy them. The lady is going to try to ram these down your throat and make you feel like an irresponsible mother for not buying special pillows (and the linens for them!) for the baby, resist. Instead I suggest investing in a swaddle or just getting a big receiving blanket to make baby feel like he is still snugly in your uterus.
5. Bigkis. Don't believe the pushy lady, these are not recommended by pediatricians. They will not make your baby's bellybutton an innie.
6. Baby fabric softener. Completely useless, minimize use of any chemicals.
7. A large bottle of baby soap. Babies use very very very little soap, AND they could be allergic to certain kinds of soap. I made the mistake of buy this large bottle of Chicco's baby soap because it was on sale, turns out it reacted strangely to my baby's sweat and made him stink to high hell. Sayang ang pera.

Things I wish I had bought more of before I gave birth:
1. Cotton onesies, and button-down shirts. See my post on saying no to tie-sides.
2. Large receiving blankets, at least 4. Don't get the small ones, you can't swaddle a baby in those.
3. Newborn diapers. Stock up whether you are cloth or disposable diapering. I thought 1 big bag would be enough to hold us over, but these little buggers can go through a dozen a day! Also cloth diapers are usually too big for newborns, so you'll probably be on disposables for at least the first couple of weeks.

Remember that babies really only need: mommy's boobs, diapers, clothes. All other things are pretty optional, so if you are trying to save money in preparation for those hospital bills when you give birth remember to shop frugally. Also, ask your friends for stuff, the mommy supply chain is a beautiful thing for both receivers and givers (storage space!).

Git yur paws off mah baby!

Ok so yes I know and understand that we are a baby-worshipping country here in the Philippines. People have a LOT of kids, babies are blessings, yada yada yada. And like in any other culture, most adults find most babies cute and will remark about it when they see a baby held by a stranger. Seriously though, can be have some boundaries? I am not at all a germophobe, I will happily let me baby lick the floor of our house if that's what he wants to do, it's good for his immune system. My objection to random people touching my baby is not based on a fear of germs, it is just based on my personal space issues.

Is it unreasonable to ask that random strangers not touch my baby even if it is with admiration? Here are some odd experiences of baby touching (not in a pervy way mind you):

1. Security guards, especially male ones, they like touching my baby. They will hold his hand and shake it, or touch his feet because of the belief in usog. I don't know what "para wag mausog" means but it sounds creepy. What is creepier though is random people touching my baby.
2. Salespeople at stores like to go in there and pinch his cheeks. I get that they are trying to say he is cute, but can they use their words instead?
3. Here's a doozy. A waitress in a restaurant looked into his bassinet admiring how adorable he is, then she literally reached in there and plucked his pacifier out of his mouth and told ME NOT TO USE IT BECAUSE HE IS HUNGRY AND HE SHOULD EAT! THE NERVE! I was so shocked I couldn't react properly, I wanted to make a scene and get her fired.

Ok it sounds like i have something against servicepeople touching my kid, but that's not true, I hate all strangers that touch my baby, it's just they are typically the strangers that like to touch my kid for some reason. And I spend a lot of time in the mall.

I have been told I need to get used to unsolicited advice from strangers when I'm pregnant or holding a baby. I can deal with unsolicited advice, but touching my baby is another thing altogether. If I don't know you and I've never met you or I haven't had more than a 2-sentence conversation with you, don't touch my baby.

Diaper changing when out and about

Road trips, walks in the mall, walks everywhere, or at dinner parties, your baby will poop whenever and wherever he chooses. There are many lucky moms out there whose infants will have a scheduled poop once a day, some will even poop every 3-4 days. My little man will let his loose bowel movements loose every two hours. He did this for more than two months! Then after that it became 3 times a day until he was 6 months. Once he started solids he was down to 1 poop a day or every other day.

If your baby is like mine, and you don't want to be homebound for months, you gotta get over the dread  of dealing with runny breastmilk poop-cleaning in public bathrooms. My husband and I have mastered diaper changing, and myself, well, I have bullied salesclerks into letting me change in the oddest places in the mall. (photos posted were lifted online, unfortunately we did not take photos of our own diaper changing activities)

On road trips, we often make nappy changes on top of the trunk of our car. Decent changing tables are difficult to come by once you take that off-ramp on SLEX or NLEX. You are much better off looking for a safe place to pull over (not too close to the road) where there is decent shade so your baby's "gadgets" are not all out in the sun, and doing a quick change. Or if you have a roomy car, kneeling on the floor and putting the baby on the seat works too, but definitely pull over first.

This is a brilliant idea, changing inside a shopping cart, if I ever find myself in a pinch I just might do this. However, inside stores I have charmed/bullied salespeople and clerks to let me change the baby behind the counter. They will be nervous, they will ask the manager, they will hem and haw, but they almost always relent. You just have to be comfortable with the looky-loos who will make comments about how cute your baby is, not a bad thing. OH, and be polite, throw your dirty nappies out yourself and wipe down their counter with a wet wipe before and after.

When out with my husband, we will often sit in a coffee shop that has a long couch and just change the baby there. Since we are both so seasoned we can do this in under a minute, nobody's the wiser. 

Establishments really have to learn that men are equal partners in child care (ideally), that means putting changing tables in men's restrooms! Gee is that so hard to do?

Some tips for finding changing tables:

1. If not in the ladies room there is sometimes a changing table in the room for the disabled (true for Nuvali shopping area and a couple of other places).

2. If not a full-on changing table, most restrooms in large gas stations on the main highways have long counters that will give you enough space to change.

3. Breastfeeding/nursing rooms almost always has a nice changing area. Moms who do not nurse may not be aware of this because they don't go into these rooms.

Attachment fathering

I've mentioned in a previous post that we did not set out to be attachment parents, and that the decision to exclusively breastfeed changed all that for me. Baby J and I are very lucky to have a dad who wants to be just as involved in infant care as mom (that guy in the picture isn't dad btw, it's the guy from Twilight:). We are also fortunate enough to be able to work from home, so we were both around a lot in the first months of baby J's life. 

Now, I'm a big believer that men and women are equally responsible for child care and was surprised when I had to repeatedly entertain questions from people who were in awe that my husband knows how to change a diaper. Having gone through the intensity of the first few months of motherhood though, I realize that it is difficult for dads to be involved, especially when mom is breastfeeding. Also, the level of involvement in infant care in the very beginning can determine how much dad can help around when baby gets bigger, so moms, start them early! 

What can dads do in the first couple of months? First, take as many days off as he can after the baby is born and BE HOME during those days. Second, while mom takes charge of all the "input" (i.e. feeding), dad takes charge of all or most of the "output" (i.e., pee, poop, spit-up). Third, while the nursing mom is dealing with all-day feeding sessions during those growth spurt days, dad can be around to bring water, lampin, change the channel on the tv, anything tired ol' mom needs. After all, between nursing and pumping in those first couple of months mom really has very little time for anything else. Finally, dad should put baby to sleep often. This gives the two of them some alone time and dad can be 100% comfortable holding and talking to and rocking his progeny. This is how Baby J and I got an attachment dad. 

I think the most important determinant of whether this will work is the mother. I am completely aware that I can be a control freak with the kid, I want things done my way and when my husband is changing his diaper and I don't like his style of doing it, I want to take the baby and do it myself. The trick is to fight the urge to do that (unless the baby is in real danger of getting hurt, which is almost never the case anyway). So now my husband changes diapers, does the nighttime bath, puts the baby down for his naps when possible, and by the looks of it they both enjoy it very much. 

It's quite wonderful to take care of a baby, more when s/he hits the 3-month mark than in the first couple of months admittedly, and if dad was not fully involved from the start he can miss out on all the fun later on. Equal parenting folks, whenever possible, it's a beautiful thing. 

I Say No to Tie-Sides

All new Pinoy moms feel like they ABSOLUTELY NEED tie-sides, that newborn infants cannot wear anything else but these strange shirts with lots of string that you need to ribbon together. I am guilty of this ten times over, and issue my formal apologies to all those expecting moms who I gifted plenty of tie-sides. It's not until recently that I realized that in many other countries, like the US for instance, they don't even see these around much:

I have news for all you expectant Pinoy moms out there, these are completely optional! In fact I wouldn't recommend buying a single one. Buy soft cotton shirts that button or snap in the front instead. Can't tell you how many times my husband and I, while struggling to catch up with all the demands of a newborn, screamed at the top of our lungs "STUPID F^*CKING TIE-SIDES". They have invented buttons, and snaps, and hooks, all manner of snapping together parts of the shirt that do not require fussing about with ribbons. Don't let the overly-eager salespeople at SM baby, force these on your shopping basket (along with the bigkis that you also absolutely do not need). You can find button downs, or if you're more progressive, onesies. Our favorite is a winnie-the-pooh button-down, we bought 3 really tiny ones and they were used a lot.

It is not easy to tie 4 ribbons while your frazzled self is listening to piercing screams of an unhappy baby. Besides, those pieces of string seem like a choking hazard. The ones be bought have gone to the donate pile.

So, skip the tie-sides and I think you'll be all the more relaxed during changing time.

Nursing in Public

Being willing to nurse in public is a big part of successfully breastfeeding a baby exclusively for six months. Infants EAT ALL THE TIME! Especially during those growth spurt days, o lordy, they will refuse to leave your boobies alone. So if you are like me who goes stir crazy after 2 days in the house, you will have to accept the idea of whipping your boob out anywhere anytime.

Yes there are options. You can go to nursing/bf-ing stations, there are some nice ones in some malls, or to a quiet roomy restaurant with hidden corners, but sometimes your kid is already screaming bloody hell and there is no time to walk to the other end of the mall. A few tips to make it easier on you.

• Get two nursing covers, one for your diaper bag one for your purse. Get covers that are lightweight and more importantly, have that wire along the top so you can see your baby while sh/he is eating. Some covers don't have that wire, I had one, threw it out because it got so annoying. You need to see down to your boob so you can aim that thing into the baby :)
• Wear stretchy shirts or button-downs for easy access to the milk bags. When wearing button downs, unbutton from the bottom to the breast, so it's like pulling up your shirt from the waist. This makes you feel less exposed, less boobage out in the open public air. 
• Buy nursing pads or cut some pantyliners into two and stick them onto your bra. If you're a leaker like me, these are necessary. 
• If your baby takes a pacifier, take one along with you everywhere. It will calm him down while you look for a place to sit and nurse and set up for a comfortable feed.

Sadly, in Manila there is not much else to do but walk around in the mall on weekends. A really nice nursing friendly mall is Shangri-la Plaza, the Rustan's Dept store has a plush bf-ing room with changing station in their baby section. Eastwood Mall also has a bf-ing room, comfy enough with a changing station. Megamall, not so good, bf room is tiny and cramped and inaccessible. 

In our country breastfeeding in public is completely acceptable and breastfeeding in general in encouraged. So nurse away!

Weaning from Bottle to Boobies

At week 2 or 3, Baby J had gone from breast to drinking exclusively from the bottle (breastmilk). We had to move to the bottle in week 2 because he had lost weight from birth, a lot of weight. After I had my first mommy meltdown we went into feeding frenzy mode. When babies nurse we have no idea how much milk they are actually drinking, J was nursing enough times per day and for long periods, but it turns out my milk hadn't come in fully yet and I had no idea. So I pumped and bottlefed for a full week just to be able to track exactly how much he was consuming, every ounce was recorded. A few times a day I'd nurse him just to get the stimulation but not really expecting him to get milk. At the end of that one week, he started to reject the breast and wanted only the bottle. Enter the second mommy meltdown.

It was terrible, I was awash with hormones, exhausted, frustrated, scared for my shrinking baby, and now I was being rejected. I couldn't accept that our nursing relationship was over, I missed him too much, so we set about figuring out how to put him back on the breast. It CAN be done, with some strategies I found online and some patience, we were able to nurse again. Here's my list of tips, as always most come from kellymom:

1. Attempts to put him on the breast should be well-timed. Don't try to do it when he is really hungry, he will be frantic and frustrated. Try it when he is relaxed and sleepy, either before sleep or as soon as he wakes up to feed.

2. If he clearly doesn't even want to try, don't force the issue. Try to put him on the breast every time you think he might be in the mood, if he doesn't want it, move on to the bottle. Angering him by forcing the breast will just make him dislike the boob even more.

3. Have lots of skin-to-skin when attempting to nurse, you will both be more likely to succeed if you don't have clothes. That skin2skin stuff really works, even if you think it's hokey and too crunchy granola, do it, it works. Trust. This is the same reason why babywearing and cosleeping work for nursing moms.

4. Get your boob started by expressing some milk, if your milk has let down already by the time he starts drinking he will be less frustrated about the slowness of the boob compared to the bottle.

5. Finally, follow all the other pieces of advice on latch (wait for fully open mouth, fish lips, he should be facing the boob and not have his head turned) so that he can get a lot of milk.

I did this for about a week, and at the end of it he was back on the breast almost full-time. At around 4 months he was going seamlessly from bottle to boob and back with no problems!

Breastfeeding is a Challenge for Many

This long thread of posts from breastfeeding moms who had problems always helped me stick to my bf-ing plan. It was comforting to know that I am not the problem, many others have trouble as well.

The consensus? It's all worth it.

Hospital births and breastfeeding

Having a medicalized birth in a hospital can have long term impacts on the chances of exclusive breastfeeding. In this area I have to hand it to the Philippine Milk Code, their regulations in hospitals work really well, although in its present form the code is unnecessarily restrictive in other areas.

The Medical City adheres to some basic rules which are listed in the nursery. First, regardless of manner of delivery, the baby is put to the boob as soon as he is cleared by doctors, in our case under 2 minutes even if I had a c-section. Second, babies are not given any formula by hospital staff and all the staff we encountered encouraged breastfeeding. Third, rooming-in is encouraged by the floor staff, although it was discouraged by our OB. Rooming the baby with you as soon as possible I think is critical to bf success, that baby will want to be on your boob constantly, and scheduled visits to a nursery will derail this. Fourth, even when we pressed, our pedia never recommended a baby formula brand.

Most important, Medical City had midwives making rounds every couple of hours checking in on mom and baby. They are the de facto lactation consultants. Be prepared though, if you have never had a baby, you will be surprised at how midwives will just reach in there and pinch your nipple to get the baby to latch properly. At that moment you will realize, those are milkbags and no longer your property but your kid's. They taught me to use warm compresses to make the milk flow and made me feel better that the little droplets of colostrum I would get at every feeding is enough because the baby's stomach is only as big as a calamansi.

Digression: One warning about midwives in hospitals, they will teach you how to swaddle and bathe your baby, don't try to do those fancy moves at home! They have the most complicated expert ways of swaddling, very hard to replicate, find a simpler method or buy a swaddler. They bathe the baby with one hand while holding his entire body in the other, moving him from batya to batya, not safe if you're not an expert, stick to a little tub.

Yes I am a Cliche: Attachment Parent

I never set out to be a Dr. Sears attachment parent. I thought I was a Manila Mom at heart, with yaya on hand wherever I went and leaving most of the tasks of infant care to someone else. I don't believe that having a nanny takes the bond away from the mom, same way I don’t believe that formula-fed infants have less of a bond with his mom than breastfed infants. Yet somehow I ended up being a full-blown breastfeeding, baby-carrying, co-sleeping, cloth-diapering, crunchy granola Dr. Sears fan-girl. 

Intermission: Check this out! Babywearing around the world. 

It all changed between childbirth and month 2 of having an infant. It all changed because of breastfeeding. I am stubborn, and goddammit I wasn’t about to get beat on this breastfeeding thing! With the pedia on speed-dial on-the-ready in case we wanted to buy our first can of formula, I slogged through the constant nursing and all the pain and sleeplessness associated with it. When you're nursing a growth-spurting infant, co-sleeping is a survival tactic. It will help everyone in the family get more sleep and stay more sane.

Exclusively breastfed babies can either poop a lot, or hardly poop at all. Our baby pooped EVERY SINGLE TIME HE ATE! That meant 12 or more diaper changes in a 24-hour period for at least 2 months. That's a LOT of diapers to throw out if you're on disposables. I never thought I would cloth diaper, it sounded like a lot of laundry, but when you need a dozen disposables a day they no longer are affordable! We could see the money being thrown into the garbage, all covered in poop. So cloth diapering it became. Then as you start to move around and try to get work done around or outside the house you have to bring your baby with you, hence, the babywearing, which incidentally also helps you make more milk.

The whole Dr. Sears attachment parenting system all cascades down from a singular decision to breastfeed exclusively. Since I did all of it, the babywearing the co-sleeping the everything else, there was really little room for a yaya. Of course I am very fortunate to be able to do this because I didn't have to go back to work full-time after 2 months. I am in awe of all those who did and successfully maintained the bfing (see chronicles).

All the other tenets of attachment parenting are based on what will make life easier for you if you breastfeed. Not that it's impossible to do on the bf part and have baby in a crib and stroller and disposable diapers, it is possible, it's probably just harder on mom. 

Sling, Wrap and Carry

From:http://www.hybridrastamama.com
/2011/04/babywearing-around-world.html

 My first piece of babywearing gear was a Baby Bjorn, bought online and shipped here from Amazon. It was around $60 and looked incredibly cool and hip with a babywearing dad on the box. I used this until the baby was too heavy for front carry. Then a pouch sling from an IndigoManila kiosk at the SM baby sale, really cheap. Finally a ring sling bought from Rustan's, Next9 brand. Reviews below:

1. Baby Bjorn. It's really cool and modern. Baby can face front and be completely entertained as you walk around. If the kid faces your chest he can sleep. The downside is that it's hot in there for the little man, the thick foamy cushion is wrapped around his entire torso down to his bottom. A serious consideration for us tropical dwellers. The thing is supposed to be good for until he is 25 pounds but once he hit 16 pounds we started throwing our backs from carrying him. This would last longer with slower growing babies, but our kid was 20 pounds by the time he was 6 months so the Bjorn was sent to storage earlier than anticipated. 

2. Pouch sling (P500 on sale). I kept this sling in the diaper bag all the time. It's not adjustable so only has the fabric you absolutely need to sling around your baby. Problem is, it's not adjustable. I bought the biggest size and since I'm a tad taller than the typical pinoy mom it was still about 4 inches too short for my taste. I could still use it, the baby was just higher up on my hip than I would prefer. Now that the baby is 7 months he has almost outgrown it. Since it was cheap I'd still recommend this, not as a primary carrier but as a backup to bring around with you.

3. Ring sling (P1000 at Rustan's Next9 brand). (*Update below) Ring slings are notorious for having a steep learning curve. The accompanying DVD helped with step-by-step instructions on the many ways you can carry a baby with a ring sling. I was afraid it would not feel secure because it is so easily adjustable, but it actually does, although at this point I wouldn't sling him to my back. There are more options for carry styles on this. The problem with the one I have is the fabric, I chose based on color, a color my husband wouldn't feel too undignified in (i.e. no pink teddy bears). Got the green one with little prints on it, but the fabric was way too thick and stiff for a ring sling! I had it laundered to try to make it softer, had it doused with fabric softener, but no dice. It was practically impossible to adjust while the baby is on, which is supposed to be a big advantage of the ring sling. It know it was the construction because I've seen a ring sling (a friend's) that works well, but I can't find that brand in Manila, I'd have to order it from Amazon. 

So far local brands have been disappointing, and i'm not likely to buy anymore as it feels like having 3 carriers is already too much and the baby is already 21 pounds. I might change my mind though since he is getting to that needy age of wanting to be carried all the time, and I don't have the arm strength for long periods of carry.

*Update on ring sling: The very nice proprietress of Next9 was so kind to send me a replacement ring sling (thank you!). Very thoughtful to send over a sling in a manly blue color as well. The fabric on this one is much thinner and it made a huge difference in terms of adjustability. So, if you do decide to buy a ringsling (the Next9 ones are the most widely available in Manila and online), pick the one with thin slippery fabric for ease of use. Those rings are very very sturdy so you'll find that it will still feel robust even if the fabric is thin. 

Green baby poop and oversupply

When my exclusively breastfed baby was still tiny he had a lot of poop issues. Foremost of which was green explosive liquidy poop. For about 2 months his poop was like this, and he was going every single  time he ate! Incidentally the reason why we went from disposable diapers to cloth was the sheer amount of diapers he needed on a daily basis.

I was aware that the consistency and frequency of his poop was normal for exclusively breastfed infants, I also knew that the green poop was not. On top of this, whenever he was feeding he was pushing my boob away, fussing, arching his back, and being generally frustrated. I KNEW he was hungry and needed to be fed, so it wasn't like I was forcefeeding him or anything. Other things that signaled something was wrong was constant gassiness, really loud adult-like toots, lots of spit-up, and other GERD-like symptoms. My pedia said this was all within normal, he just needed to grow bigger. I insisted on seeing a specialist when he started having blood in his stool, the specialist said it was all within normal so long as he was growing and gaining weight.

I was frustrated that my baby had to go through this, I knew he was in pain and there must be something I could do! Turns out, I wasn't asking the right people. We don't have lactation consultants, so I googled. There were plenty of resources so I was kind of lost among the possible diagnoses, until one day... I was feeding him in the middle of night while we were both lying in bed. He unlatched for a second because I was shifting my position and I saw a SPRAY of breastmilk hitting him in the face. It was like a high-pressure hose, I kid you not. That's when I knew it was oversupply, too much milk, the opposite of what most nursing moms worry about.

You never really think that oversupply can be a problem, it must be a good thing right? Well it turns out that oversupply caused most of the symptoms my baby was having, especially the green liquidy explosive poop, AND was exacerbating his reflux causing the blood in his stool and spit up.  He was pushing my breast away while feeding because he was trying to slow down the flow of milk. One of the blogs I was reading said, imagine if you had to drink from a garden hose going full stream, that's what he was trying to deal with while he was hungry and angry.

The green poop was because of a foremilk-hindmilk imbalance (caused by the oversupply), too much foremilk also gives him gas which explains the explosiveness of his poops and toots. AGH! My poor baby! He had to deal with all of this and he was in pain, and hungry all the time!

I reversed everything I was doing to bring my supply up and eventually things all settled into normal poops and baby happiness and easier less frequent nursing. For months my husband and I were obsessed about the color and consistency of his poop, after doing all of the following his poop turned mustardy (the best kind!).

1. Stop the galactagogues. I was drinking 3 pills of Fenugreek (can be purchased for P800 per bottle at Health Options stores Solgar brand). Fenugreek really really works, ergo, bad for those with oversupply.
2. Reduce the pumping sessions. My first instinct was to pump before feeding him to fix the foremilk imbalance problem, but I was told this was just going to make things worse. Made perfect sense of course.
3. Most importantly, block feed for a few days until your supply adjusts down. This means using only one breast for a number of hours. In the morning the left, afternoon right, etc etc. The non-feeding breast will get engorged, when it gets to that point switch.

Eventually I was able to get a reasonable supply amount going, enough to bf exclusively and about 5 ounces extra during the day to pump and store.

Cloth Diaper Purchases in Manila: Review

So Baby J has outgrown the wonderful Mother-Ease Sandy cloth diapers we inherited from a good friend. These are not available in the Philippines, in fact the entire system of fitted cloth diapers don't seem to be available. All we have are pocket diapers, of which there are many brands. Was not, still am not, a fan of the pocket system because of all the fussing around with stuffing pads into pockets. Turns out though that there are no other cost-effective options for cloth diapering systems around Manila, of course except for the traditional lampin which is too complicated for me.

In my search for affordable cloth diapers in Manila I went through many many baby retail shops and kiosks and department stores. The pocket diapers will cost anywhere between P600-1400 per piece! I will need at least a dozen and at those prices the whole argument of cloth diapers being cost effective flies out the window. The solution was found online. I went to three sites to purchase different brands: Bambino, Alva, and Next9.

My criteria for selecting these brands are that they don't use velcro (irritates baby's skin), they will adjust to fit the baby until he should be out of diapers altogether, and they will dry easily after laundering. All three brands fit these criteria, all three cost the same (3 for P1000). All were purchased from online retailers and all retailers were prompt in delivering and easy to contact.

So here are the reviews:

1. Alva diapers. The lining on these are not as soft as the good quality fleece on expensive brands like Charlie Banana. They look good though, and there is a very wide selection of cute designs. The tabs have rounded edges which flip over, exposing the white lining when it is on the baby. Not a big deal but slightly annoying. The outside cloth is sort of shiny, which I think makes it look a little cheap.

2. Bambino. These I found on their fb page, very helpful and professional customer service and prompt on email. The diapers look bigger than the rest so may be in use longer. Construction is the same quality as all the others but for some reason I can't think of, these leak easily. Maybe it's the size, I don't really know. It's not as snug on the legs as the other brands. The pee will leak out of the snaps in front and from the gussetts. Also the fleece is the same not-so-good quality as the Alva. Too bad because I really like that it comes in black with white snaps.

3. Next9. This brand now sells the velcro kind, I had to make sure they sent me the ones with the snaps.  Of the four kinds I tried, this is the one I liked best. It fits nicely around Baby J's bum, doesn't leak easily, and comes in fun prints. Its most appealing quality is that it uses a very soft fleece lining inside that always feels dry even when the soakers are completely full of pee.

A word on the soakers, the system that worked for me is to have 2 soakers per shell. All the soakers are P100 each regardless of where you buy them and quality is the same. When you buy a shell it comes with 1 soaker. I don't recommend the bamboo soakers, they are slippery and annoying to deal with when in the pockets they don't stay in place.

So the winner is Next9, I bought a few more to complete my daytime cloth diapering needs. Glad I went online to look for these, all these brands are not easy to find in retail stores and when you do find them they have like, 2 pieces in stock.

As for the whole pocket diapering system, not as good as fitted diapers definitely. There is a lot of work in this system, if I had to do the stuffing myself I'd be really pissed, luckily we have helpers to do that but still...takes up time. There is room in the Philippine market for fitted diapers, somebody bring them in and make them affordable.

Stuff that Helped me Breastfeed

Ok so as I said before, I needed a lot of gadgets to help me get through all the challenges that nursing my tenacious little infant presented. Below is a list of the ones that helped the most and where I got them. 

1. Nipple shields. The ones I used often were Avent brand that my mother-in-law found at SM Megamall (around P800 for a pair). I’ve also seen them at the Hypermarket in libis and in Rustan’s. They were recommended by the midwife at the hospital when she noticed that baby J just couldn’t latch on properly. Frustrated and scared, I asked my mother-in-law to find me nipple shields so these were sort of an emergency purchase, no time to read reviews or comparison shop. Eventually I found a better kind, Medela brand available at Rustan’s (I think 1,200 a pair), but by then the baby wasn’t using them as much anymore. Take note that these things have sizes! I made the mistake of buying smalls and ended up never using them, buy the mediums to be safe.

I used these not so much to prevent soreness, they don’t do a good job of that, but to help baby latch. For latch these are great. You place them on top of the nipple and the baby’s suction will pull your nipple into the shield’s shape. For us the problem I think was that my nipples were flat and almost inverted, then the baby’s mouth was too small. So I credit these shields for my success in nursing, used them until he was about 3 months old. There are certainly downsides to these, including inefficient milk transfer (see kellymom for a full discussion), but women like me just cannot nurse without them. Just wean as soon as you are able, when baby is big enough to learn how to nurse without them.


For more see: Medela site on nipple shields

2. Breast shells. Great invention these things. Also used Avent brand since these were cheapest at Amazon when a friend was able to bring them home. I have seen them at SM stores as well for P1200, really expensive considering they were $12 on Amazon. When nipples get sore from friction with the baby’s tongue as he nurses, the pain sometimes gets worse when it then chafes against your bra or top. The shells protect your boobs from friction against clothing, giving them time to heal up and you some freedom to move around without pain. Put on some Lanolin (available at most baby sections in department stores and possibly Mercury Drug) after nursing then wear the shells.

3. Manual breast pump. I had an expensive brand electric pump which I used at home, a Medela that a friend gave me, that one is for the everyday pumping. For travel and overall mobility, have a manual pump. I bought a cheap one at Shopwise (P700), it doesn’t even have a brand, but it works well. These actually feel like they have more suction than the electric pump. You will need it for when you’re on road trips, on weekends out of town, for dealing with plugged ducts when you need stronger suction.

4. Warm compress. Warm wet heat is best for dealing with plugged ducts and mastitis. Believe me these are a b*tch to deal with and you want to make sure you are vigilant about checking for them and getting to fixing them before they get infected. If you don't feel like spending, make your own: put some bigas (uncooked rice) in a couple of socks, sew up the open ends, microwave for 30 seconds until warm. 

Some of these are tricky to find the Philippines. If you are not in a terrible hurry I suggest going online and checking if you can find these on the many mommy sites on multiply.

Breastfeeding for this ManilaMom was hard

Breastfeeding is hard. It may be easy for many, those who repeatedly say “it is the most natural thing in the world,” but for people like me, it is HARD. There are many reasons why I was able to survive breastfeeding and believe me it was a survival thing as every day I was pondering whether it was worth all the pain and frustration of both me and my baby. I’m not at the end of it either, 7 months of exclusive breastfeeding, I still deal with some pain and a lot of inconvenience. 

I don’t mean to harp on how hard bf is to discourage others from doing it, I want more women to breastfeed! I do think though, that if more women come into it prepared, knowing it could be hard and where the difficulties will come from, they will be more likely to stick with it. So below is a summary of what worked for me in terms of survival tactics:

1. Turn to your mom friends, those who have been there before and are kind enough to take the time to write you an email every now and then to share survival tips. Those with some “technical knowledge” and those who are supportive and not all oh-it-was-so-easy-i-don’t-understand-why-more-people-don’t-do-it.
2. Read read read. I read blogs, babycenter, baby books, videos and all other manner of information transference. I learned how to latch the baby properly by watching videos on YouTube, learned about oversupply on kellymom, learned about weaning from the bottle from ... somewhere. Arm yourself with information because you are your best advocate, you know what you can and cannot deal with and you are the one who knows what is bothering your baby. 
3. Do not rely on your pediatrician or OB for lactation and nursing advice. They know next-to-nothing. What they know can be summed up in the following sentence: breastfeeding is best for babies, keep doing it. Most of the information you will need is online, or if you’re not a reader, with a lactation consultant or midwife.
4. Buy and use the gadgets and meds. I used a lot of them: nipple shields, breast shells, lanolin, saline solutions, hydrogel packs, etc etc. I even cling-wrapped my nipples once. Believe me, you’ll do anything to deal with the pain.
5. Sleep with your baby. This one is not for everybody and is truly a personal choice based on what you and your partner are comfortable with. After around a month of sleepless nights I finally did it, put the baby in the bed, lay down beside him and breastfed him until he was asleep. It changed everything for me. I got more sleep, the baby got more sleep, my husband got more sleep. Everybody was happier. Plus I really believe that it increased my milk supply having the baby around me all the time. 

Breastfeeding did not “come naturally” to me until month 3, when I could whip out my boob with no additional equipment (i.e. nipple shield) and know that wherever we were and no matter how hungry he was he could latch and get a good feed. Now I feel like a pro, but still feeling pain as the baby starts growing teeth. Overall it was a struggle worth going through. Keep your eye on the prize and don’t hesitate to ask for help.