Taking baby to the ER: Tips

Baby J has inherited from me, the nasty habit of getting seizures when he has a fever. I've discussed seizures before, this post is about taking babies to the ER. As a nervous mom who lives 5 minutes away from Medical City and has a kid with medical insurance, it doesn't take much for me to decide to take J to the ER. We have taken him for fever/seizure 3 times, and for diarrhea countless times. Our family is there so often the floor nurses at the pedia area and at the ER pediatrics section know us already.

All this experience has taught us how to prepare for a trip to the ER. If you can't bring all of these when you first get there (emergency and all), get them immediately afterward or have someone bring them for you. SOme of these are for convenience and others are to save you money.

1. With every trip to the ER make sure you have with you (no matter the reason for going):
       -a feeding bottle or sippy cup: if he is there for diarrhea they will give him rehydration salts and they don't supply feeding bottles
       -a change of clothes for the baby: if he has a fever they will give him a sponge bath and he will need to change afterwards
       -a washcloth: spongebaths in the ER, if you don't have one they will charge you for one
       -disposable diapers even if your kid wears cloth: among other reasons, they use disposables to wrap around the area where the IV is tapped
      - drinking water, snacks for the baby (cheerios are good food and entertainment): it's annoying to have to run to the store when someone gets thirsty
     - sandals/shoes, socks: it will be tough getting your child to stay on the bed, they will be restless so having shoes will give them some mobility, the socks are primarily for the cold

2. Before the nurse puts in the IV tube, have her give you some time to decide where they will put it. They can put it on a foot or on a hand. If your baby walks, foot is a bad idea. If the iV will be on a hand make sure you pick the non-dominant hand (read: the one he doesn't use to play with the ipad). They do these things in a rush and don't consult the parent. If you end up at the hospital for several days the baby will be miserable if his right hand is all tied up.

3. Bring paracetamol and other medicine with you everywhere. Nurses know to ask if you have your own medicine. It is much much cheaper to bring your own than let the hospital supply something as simple as paracetamol drops.

4. Ask your resident/doctor incessantly if the IV drip can be disconnected. As soon as we knew Baby J was safe, we asked his doctor and he said it was fine. It bought J back a lot of comfort. The IV was pointless once his fever broke. They will just keep the tap open through a Heplock but the tube and bottle goes.

5. Bring chargers for your electronic devices. These are mostly to keep baby entertained.

6. If you plan to sleep at night, ask the nurses and housekeeping staff to minimize their visits to your room in the middle of the night to the absolutely necessary ones. I swear it is much harder to get well at a hospital because they just don't let you sleep! They are in there every 15 minutes mucking about. If you were not able to sleep at night, consider putting a sign on the door in the morning indicating you don't want any housekeeping visits. Housekeeping folks are noisy, they do their work in the morning so they are confident about knocking loudly and screaming "housekeeping!" when you and the baby are trying to catch up on sleep.

Lastly, sleep next to your kid on the bed if it's possible. They feel so much better when they are being cuddled and sleep very soundly when next to mom or dad. Also if you have a toddler it'll help avoid nasty falls from the bed :)

Nursing bras and jog bras

Nobody really warned me about exactly how much bigger one's boobies gets when breastfeeding. I mean seriously, these missiles are logistical problems now, presenting a multitude of fashion dilemmas.

Nursing bras are fairly easy to find in department stores, if you're a cup size A-C and generally Filipino-size all around (i.e. petite and slim), which I most definitely am not. I didn't shop for nursing bras before giving birth because a generous friend gave me a couple of really expensive ones and I wasn't really sure yet that I'd be able to nurse. So by the time I did decide to buy a few nursing bras it was already an urgent purchase. No time to comparison shop online and off. So to trusty SM Megamall I went.

The cheap brands have decent nursing bras but they only go up in size to 38 C, given how badly they fit I would guess I'm at least a D cup. So-en had these for under P400 (apologies I forget the exact figure), and the Avon store had a couple in stock for the same price. The So-en one was tighter even if both were the same size, and less comfortable than the Avon I think because the fabric was less cotton-y. Between the two I recommend the Avon if you can find a store or seller. They are cheap and do the trick, so long as they are the right size for you.

Also spent some time at the Centris Sunday Market looking for nursing bras, there are sellers there that carry export overruns of imported brands. Not a lot of options on size but I did find a couple ones for really cheap (P150) even though they were the wrong size, 40 A, I figured I could make up for the cup size with a larger circumference. WRONG! I would only wear these around the house because they fit so poorly and held nothing up. So don't buy ill-fitting bras, they're a waste of money.

There are a lot of imported expensive nursing bras available online, but I wasn't really willing to pay more than P600 per bra. I only need the convenience when am out with the baby. When at work and all I need to do is pump I can wear a normal bra.

Two months after giving birth I felt ready to go to the gym, maybe do some running. Boy was I wrong. Running with size D breasts is practically impossible without a good supporting bra. So off I went again to buy new jog bras. On these I spend more money, around 800, because I had exacting standards. I hate those bras that you have to pull over your head, so needed ones that snap in the back. Found them at Jockey in SM. Even with supposedly rock hard support and making sure I nurse or pump both boobs empty before i leave the house, I was still jiggling around quite a bit at the gym. When I did finally decide to do a full-trot jog on the treadmill, learned that jog bras were not enough. I did a DIY fix and strapped those babies close to my chest with the stomach binder/girdle the hospital gave me when I gave birth. Worked like a charm! Not exactly comfy but they held me in!

Now that I'm back working full-time I have to invest in good going-out bras. Even though I'm not nursing as much as before it doesn't look like I will be back to my old size anytime soon. They don't have to be nursing bras because i don't take the baby with me so it'll be an easier purchase. Back to Centris we go, there's a lady there that sells overrun Victoria's Secret and CK:)

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.