Free Internet Access??

I was given free internet access yesterday when I checked in at my favorite hotel here in KL. As I was typing, I wondered whether it truly free as now the rate is RM214 as compared to years back it was in the range of RM 180 - 190. Perhaps that's the price for the new upgraded LCD TV and also so called "free internet". I can't be bothered about having new or clearer TV as I'll be using the hotel to catch forty winks only. I need a fridge more to store my precious milk. Pretty frustrated when I was given a room with a malfunction fridge. I requested a new room and was given this more spacious room. Now, happy me is pumping while typing this entry.

That's the fridge, the LCD TV and the jug kettle.

Close-up my ice packs (in black pouch) and 2 bottles of fresh milk expressed late night yesterday. Missing my tiger cub a.k.a Noah. I bet he misses me too.

4 months Noah

Noah is 4 months! He is now 7kg and 64cm in length.

The nursery told me he turned-over on Friday. I'm yet to witness the momentous event myself. He is getting more 'botak' everyday. In fact, Noah has least hair s compared to his siblings from birth.

Still fully on breastmilk and I intend to continue as long as Noah wants. I love to see his satisfied face when he had done with breastfeeding.

Milk: Does it Really Do a Body Good?

This is for my own info and motivation to keep breastfeeding Baby Noah despite the troubles and busy daily schedule.

Source - http://drjaygordon.com/pediatricks/dairy.html

In August 2000, the American Academy of Pediatrics issued an official statement about allergenic proteins in a mother’s diet appearing in her breastmilk and creating problems for her baby. They stopped far short of talking about excellent research showing that cow’s milk in the diet of a pregnant or breastfeeding woman creates even more problems than we ever thought for her nursing baby.

Breastfeeding moms get lots of advice about the food they should be eating while nursing their babies. I try to discuss this with the mom- and dad-to-be when we meet during a prenatal appointment. I often wish I could talk to more women before they become pregnant to discuss anti-allergy measures and other topics.

Please don’t misunderstand the incredible superiority of human milk for human babies. Infants who receive formula have more intestinal problems by far than infants who drink breastmilk. Uninformed medical practitioners have actually told mothers that their babies were “allergic to their breastmilk.” Nothing could be further from the truth.

Babies can be allergic to protein fragments from mom’s diet which end up in the milk, but if they are sensitive to those proteins, they would be much more affected by an artificial baby milk made entirely of non-human protein. Even so called “hypoallergenic” formulas are rarely any better. They are made of proteins broken down into smaller fragments to provoke less of a reaction. They are still allergenic and don’t solve the problem for many babies.

Common Symptoms of a Reaction to Dairy

• Green, runny stool
• Blood tinged stool
• Skin rashes
• Chronic nasal stuffiness
• Vomiting
• Diarrhea
• Excessive abdominal discomfort
• Cramping
• Coughing
• Mimic of GER (gastroesophageal reflux) symptoms
• Heartburn
• Spitting up
• Gassiness
• Constipation

Gassiness

Babies are gassy. That is an immutable fact caused by the need to double or triple one’s weight in a year. Try doing that yourself and see if you don’t spend a little time gassy.

I have seen the gassiest babies get better when moms removed dairy products from their diets.

Some babies seem to cry much more than others and their parents describe them as “writhing in pain.” Changing the nursing pattern helps some newborns and older babies if overactive milk ejection reflex (OMER) or a hindmilk/foremilk imbalance is the cause, but many more babies are helped when mom changes the way she eats. My list of allergens begins with cow’s milk and continues with eggs, peanuts, wheat and citrus. The most important change a mom can make is to stop drinking milk and eating things made with milk.

Blood in Stools

Babies with blood in their stool often stop having blood when moms stop drinking milk and eating other dairy products.

Cow’s milk protein irritates the intestinal lining and virtually always causes what’s called “microhemorrhaging.” Sometimes this bleeding is quite visible and helps alert parents to the need for mom to change her diet. Blood in the stool can be frightening but is rarely dangerous. It has a few other causes such as viral irritation, but the most common reason I have seen it is dairy allergy.

Eczema

Eczema lessens and often goes away completely when breastfeeding moms become dairy-free.

Skin rashes occur frequently in newborns and babies. The most common, worrisome, persistent problem is an allergic rash called eczema. Dermatologists and allergists describe eczema as not a “rash that itches, but an itch that rashes.” That is the first thing that happens and the first thing the parents may notice: increased irritability and “face rubbing” by their baby. They may also see a red rash which becomes more and more “angry” looking and eventually gets scaly and even bloody. Superficial skin infections can follow and be difficult to treat.

Dairy elimination is crucial. Long before you use cortisone cream, stop all dairy. Stop peanuts and eggs, too.

Constipation

Babies who are constipated often improve when dairy is eliminated from mom’s diet. Older children may also get relief from constipation with complete dairy elimination. In older children, studies have shown that some bedwetting may also be cured by dairy elimination. The allergic reaction to the offending protein in milk is exhibited in a variety of ways that affect the bowels and urinary tract. If your child is suffering from problems in these areas, dietary restriction should most certainly be considered prior to doing further testing or using medications.

Changing a breastfeeding mom’s diet or changing the diet of an older child eating solid foods will often lessen medical problems dramatically.

Cold Symptoms

Babies who have constant runny noses often get better when moms stop all dairy. Cow’s milk allergies may look just like “hay fever” at any age: stuffiness, cough, runny nose that seems to persist for weeks and weeks.

Older kids with ear infections often stop having ear infections when dairy is removed from their diets.

This has been a key intervention in my practice. I have cared for hundreds of kids who have taken ten or even twenty courses of antibiotics and even steroids. They were able to cancel scheduled ear surgery because they got better when they stopped drinking milk and eating cheese. The ear infections just plain stopped for many of the children and for others they decreased to manageable childhood illnesses rather than being a constant source of pain, school absences and incapacity.

Read more at: http://www.notmilk.com/mucus.html

GER (Reflux)

Before a baby gets evaluated for GER (gastroesophageal reflux), breastfeeding moms must eliminate all dairy from their diets. To some, this seems like a drastic step. It is far less drastic or invasive than the tests and medications for GER in babies.

When eliminating dairy and watching for a reduction of GER symptoms, patience is a key. The offending protein can take a few weeks to be completely undetectable in breastmilk. Many will see improvement within days, because the levels begin to decrease as a diet devoid of dairy is consumed. It is not unusual to see little change until two or three weeks after eliminating dairy.

The almost miraculous improvement in hundreds of troubled babies in 22 years of practice might be the strongest evidence, albeit anecdotal evidence, that I bring to the table. Does this work 100% of the time? No, nothing works 100% of the time, but dairy elimination is the single-most important advice I give to dozens of people each and every week.

Casein and B-lactoglobulin

The two proteins that trigger the biggest allergic response are casein and b-lactoglobulin. If your baby doesn’t get as much relief as you had hoped just from dairy elimination, read labels carefully. Soy cheese and many other foods that we expect to be dairy protein-free are really not. Even diaper creams may contain casein.

Read more at: http://www.drjaygordon.com/nutrition/dangerousfood/dairy

Increased exposure to allergens like dairy allergens can even lead to fatal reactions. Fortunately, the “minor” symptoms almost always go on for a long time before major reactions in almost all babies, children and adults.

Lactose Intolerance

The major “sugar” in cow’s milk is lactose and some people confuse lactose intolerance and cow’s milk protein allergy. Lactose intolerance evolves gradually after about age 7 or 8 years and is particularly common in those of Asian, Native Alaskan and African decent. Gassiness and bloating after drinking milk, eating cheese or ice cream occur in many people. Some choose to ignore it, others limit dairy and still others just use supplemental lactase (an enzyme) to lessen their symptoms.

Viral stomach flu can create temporary lactose intolerance.

We adults are clearly not meant to drink cow’s milk and the number of children adversely affected by dairy protein and dairy sugars is underestimated in mainstream nutrition books.

A very informative article in August 2000 issue of “Discover Magazine” features a discussion with T. Colin Campbell, an ex-dairy farmer now a Cornell University nutritional biochemist:

“The bottom line for Campbell is simple: ‘It’s unnatural to drink milk.’ Most adults in Asia and Africa, along with many in southern Europe and Latin America, have trouble digesting lactose, the main sugar in the milk of both humans and cows. Some suffer from bloating, cramps, or diarrhea if they try. A 1978 population survey, compiled by geographer Frederick J. Simoons of the University of California at Davis, suggests that it was only because of a genetic aberration that milk became a food staple in northern Europe and North America. Nature normally programs the young for weaning before they reach adulthood by turning down production in early childhood of the enzyme that breaks down lactose. But a gene mutation inherited by people of northern European descent prevents the production of this enzyme from being turned down. As a result, the majority of Americans can drink milk all their lives.”

This excellent, short article also talks about osteoporosis as it relates to dairy consumption: Countries with the highest dairy intake have the highest incidence of osteoporosis. This striking fact seems at odds with everything we think we “know” about calcium and nutrition. Osteoporosis is related more to calcium excretion due to salt and protein intake than to calcium deficiency in the diet. The entire article and the attached graphics are well worth a look.

Read more at: http://www.discover.com/aug_00/featmilk.html

Other Medical Experts on Dairy

Hundreds of medical articles and many books have been written about the problems with milk products in humans. The authors are physicians of great standing in the medical community. The late Frank Oski MD was head of the Department of Pediatrics at Johns Hopkins University and the editor of the Yearbook of Pediatrics. The late Dr. Benjamin Spock was the most famous and most influential physician of the past 100 years and many other doctors have participated in trying to bring dairy’s shortcomings to the attention of doctors and patients alike.

Dr. John McDougall often cites milk’s problems alphabetically:

Allergies (dairy is the leading cause of allergies in adults and children) and continuing with a discussion of . . .

Anemia. Again milk products are the number one cause of this problem because they cause blood loss and also interfere with iron absorption. Additionally, kids who drink lots of milk feel very full and often have no “room” for healthier iron-containing foods. Dr. Oski wrote many articles about milk’s role in causing anemia in America’s children.

Arthritis is the third on Dr. McDougall’s list and he documents published studies from the British Medical Journal, the Journal of Arthritis and Rheumatology and other major medical journals. The mechanism of action involves antibody/antigen particles which lead to inflamed joints.

Atherosclerosis, or heart and blood vessel disease, make the third “A” on the list. Milk is the number one source of saturated fat in most diets. A further problem involves the antibodies formed against milk attacking the delicate lining of arteries.

Blood loss, constipation, and diabetes follow in alphabetical order. The medical evidence strongly points to early exposure to cow’s milk leading to an increase in Type 1 diabetes. I have seen constipation clear up in a matter of days when parents remove dairy products from their child’s diet and the intestinal blood loss from drinking milk (or exposure to milk protein through breast milk) is an accepted medical fact.

Read more at: http://www.ffl.org/html/milk_facts.html

Talking to patients about dairy products is a lot easier than it used to be because the “problems with milk” are better known than just a few years ago. Still, it’s hard to combat the $400,000,000 annual advertising budget available to the purveyors of dairy products. Milk does not “do a body good” nor build strong bones. It is a traditional food which has become a lazy staple of the American diet.

Children (and their parents) get healthier when they have fewer dairy products and are healthiest when they have none.

When I’m talking to older kids about making dairy a smaller part of their diets, I tell them that it’s kind of like an old Seinfeld joke: “Hey, look at those large animals in the field! Let’s go squeeze those things underneath them and then drink whatever comes out. Then, let’s take whatever’s left over, put it aside for a year or so and . . . eat it!” The kids respond with a hearty “eeeeew!” Even adults get it sometimes.

Colour of the Day

Whew... glad I found this article related to baby stool. Very useful info to moms out there too if you are concerned about your newborn baby stool.


Source - http://drjaygordon.com/pediatricks/general/poop.html

The Color of the Day: Solving Bowel Movement Mysteries

I have often asked parents not to bring poop samples into my office. While there is a lot of information to be gleaned from studying full diapers, I think I can do most stool analysis on the phone or online unless an emergency situation occurs.

There is a wide variety of color and consistency of bowel movements. In my glamorous job as a pediatrician, I discuss this hot topic every day.

A change of pattern can throw the most confident mom for a loop and can even confuse an experienced pediatrician. Babies have blood in their stool fairly often and it virtually never is the sign of serious illness, but I pay a lot of attention to this because it alarms parents and requires that a reason be found.

We shouldn’t be any more surprised to see a variety of bowel movements in our babies than we would in anyone of any other age. In breastfed babies, the mom’s diet can affect the color or consistency of a baby’s stools, particularly if the baby is showing an allergic reaction to a certain food or food group.

Sticky, tar-like and green or black
This is meconium. The first stools of a newborn will be this consistency and color. It is what is present inside the bowels of a newborn upon birth and will clear itself out within the first couple of days and represents the “byproducts” of building an entire human being for nine months.

Greenish or Yellow/Brown, grainy or seedy
This is the transition between meconium and a regular breastfed stool and begins as mom’s milk is coming in on the second, third or fourth day of life. There may be three stools each day, ten, or even twenty. Occasionally, even a baby in the first week of life will skip a day and have no bowel movements at all. Call your doctor to discuss this even though it is normal. This does not require a dietary change or supplementation of a breastfed baby.

Light yellow to bright green, loose/runny, curdy, lumpy, seedy, creamy, mustard-like
These are normal breastfed stools. The consistency, frequency and color vary from day to day. My wife described the smell as “curried yogurt”. Opinions on this odor description differ widely.

Frequent Watery Stool often “Greener” than usual
How can you spot diarrhea in a baby who has loose frequent stools every day? This type of poop is “diarrhea” in a breastfed baby. It can be due to a virus, a bowel infection, stress, anxiety or a food intolerance.

Hard, pellet – like, presence of blood or mucous
This is constipation in a breastfed baby and is so very rare that I cannot recall ever seeing it in a baby who is receiving breastmilk as a sole source of nutrition, as are most babies in the first six months. It could be related to a food allergy. Formula fed babies get constipated much more often and may even have harder bigger stools like older kids and adults. Getting these stools softer is a balancing act of great proportions.

Black stools often accompanied by constipation
This is the result of iron supplementation. Iron fortified infant foods and infant vitamins can cause constipation. A healthy breastfed baby does not need iron supplementation. The iron in breastmilk is much more bioavailable than any other form.

Red streaked stools
This usually comes from bleeding in the lower intestine or rectum. Most often it is caused by rectal fissures which are tiny “cuts” around the circumference of the anus. This can be a reaction to dairy in mom’s diet. Elimination of all dairy is the first line of defense in this situation. I have seen countless babies who had blood in their poop which resolved when mom stopped all dairy products and returned with even a small amount of milk or cheese. Other dietary changes may be needed for breastfeeding moms. Formula fed babies lose blood from the lower intestine when they drink cow milk formula and some have the same losses on soy formula. Occasionally, this “micro-hemorrhaging” can become visible as blood streaking on the surface of the stool. Persistent or increasing blood in the stool or blood mixed with mucus (described as “currant jelly” stool in the texts) requires an immediate call to your doctor.

Green, frothy stools
This can be a result of a hindmilk/foremilk imbalance. A true imbalance is rare. It is often seen accompanying a forceful letdown. Lactation consultants will help moms find a nursing pattern which works to combat this problem. If letdown it too forceful in the early weeks, the solution can be to allow milk to leak into a cloth diaper during letdown, then latch baby back on. Feeding two to three times off the same side may also show improvement. Caution should be used with same side feeding as it can decrease supply.

Green, mucousy stool
This can be a result of a virus. Often the only sign we see of a virus is in the green stool. This is evidence of malabsorption in the intestines. Watch for how many days and with what consistency it is occurring. With a virus, it will run its course over a few days and begin to improve.

Another cause of malabsorption in the intestines can be teething. The profuse saliva of a teething baby can cause irritation in the intestines interfering with proper absorption. When babies teethe, we can see lots of drooling. Large quantities of saliva is swallowed which can irritate the intestines causing runny, acidic stools. This can also cause a rash in the diaper area.

There is something important to point out regarding frequency of stooling in an exclusively breastfed baby. Many parents are concerned when after the early weeks where they may have been seeing a little bowel movement in almost every diaper, they suddenly begin to see days go by without any. This is perfectly normal. There is a great range of frequency of bowel movements with exclusively breastfed infants, ranging from a couple of times a day to several days. There are completely healthy nursing babies that have a bowel movement once a week, once every ten days, or even a few that go a bit longer. If your baby is healthy, developing well, nursing well and the consistency of the bowel movement when it does make its appearance is soft or loose, then do not be concerned. It is not constipation if it arrives in soft form. Constipation would arrive in pellets and hard formed pieces.

In summary, stools in breastfeeding babies are predictably green, brown, yellow or orange. It is runny and has curds almost every time. It changes color with viruses, may have a small amount of blood (call your doc) and may come once a day and even taper off to once a week or more after a few weeks of age. Formula feeding babies may show a little trickier set of changes involving constipation and diarrhea. This is just one small reason to strongly recommend and support breastfeeding your baby.

Revision and bla-bla-bla...

Just wanna paste a link here on Breasfeeding Colicky Baby for my self-revision and reminder. It's been 6 months since I last breastfeed little Titi and I feel that I need to re-learn the skill again with the new baby.

On another note- here's something I heard on RTM1 pidato Antarabangsa competition (don't get me wrong -I don't always switch to RTM1 and watch this kind of program but that was during my out-station trip to KL and was left with limited channels to choose from).

"Seorang ibu boleh membesarkan 10 orang anak tetapi, belum tentu 10 orang anak ini boleh menjaga seorang ibu yang tua."

In this current era where everyone is earning a living (either by choice or by circumstances), this statement has some thruth. We tend to neglect our parents, but what is the little time we have to spend with them everyday as compared to the years they have spent raising us up until what we are today.

We need to sacrifice a bit of our time for them while they are still around no matter how busy we are - after all when they are gone all is left is the memory we have with them. So it is our choice really - whether we want to have good memory that we have done our best while they are still alive or regrets for not having done our responsibility as children.

Breastfeeding for Jaundice Baby

*** I found this article is useful in preparation for the coming birth.
*** Another tips I got from a teacher at my son's school while attending PTA meeting 2 weeks ago - boil "tulod-ulod" or if cannot get the fruit just boil the leaves and bathe the jaundiced baby. Not sure how true is this but can try with the next baby.


The diagnosis of jaundice in their newborn baby is often very frightening to new parents. They immediately begin to think that something is very wrong with their infant, and may not be fully informed about the facts, which are actually very reassuring. Because jaundice is such a common condition, some medical professionals don't take the time to explain all the details, because they deal with jaundiced babies every day. However, when the baby in question is your own precious newborn, you need to get as much information as possible to put your mind at ease.

Nearly all infants are jaundiced to some degree. In the vast majority of cases, newborn jaundice is a normal process, which many researchers feel may even serve protective functions, such as guarding the infant from the effects of oxygen free radicals. It makes sense that something that occurs in the majority of babies so routinely may be part of nature's plan for the human infant.

Jaundice occurs when a yellow pigment called "bilirubin" accumulates in the tissue, especially the skin, where you can see it as a yellowish or orangish tint. In adults or older children, jaundice is considered a pathological condition, but this is rarely the case with newborns. The very common type of jaundice that most babies experience is called normal, or "physiologic" jaundice. Physiologic jaundice is not a disease; it is nearly always a harmless condition with no adverse after effects, as long as the bilirubin count doesn't reach dangerous levels.

Before babies are born, they need high levels of red blood cells in order to get oxygen from their mother's blood. Immediately after birth, when they begin breathing high-oxygen blood outside the womb, they no longer need their fetal hemoglobin. The red blood cells containing fetal hemoglobin now need to be broken down and eliminated from their bodies. Bilirubin is a by-product of the breakdown of these extra blood cells, and is removed from the bloodstream by the liver and excreted in the stool. It accumulates in the meconium (fetal stool-the black, tarry stuff that the baby excretes the first couple of days after birth) and if not excreted, can be re-absorbed into the baby's system. The newborn's immature liver may not be able to process and excrete the bilirubin fast enough in the first days after birth, so jaundice often develops. This is especially common in premature infants.

Bilirubin is measured in milligrams per deciliter of blood, or mg/dl. The average level for an adult is 1mg/dl. The average full-term newborn will have a peak level of 6mg/dl on the third or fourth day of life. Levels usually go down to about 2-3mg/dl by the end of the first week, gradually reaching the adult value of 1mg/dl by the end of the second week. It usually takes the newborn's liver a week or two to mature enough to handle the build-up of bilirubin in the blood. It is important to know that there is no evidence that bilirubin levels of less than 20mg/dl during the first week of life, and less than 25mg/sl after that have any harmful effects of healthy, full-term babies.

So, if jaundice is such a normal condition, why all the concern? Because there are rare medical conditions which cause bilirubin to rise to dangerous levels and can cause brain damage. Years ago, before we had the diagnostic tools and treatment options that we have today, some babies with very high bilirubin levels suffered from a condition called bilirubin encephalopathy, or kernicterus. This is rarely seen today, and then usually only in very premature or sick babies. Doctors today monitor bilirubin levels very carefully, and initiate treatment well before levels get high enough to cause problems.

There are three types of jaundice: Normal, or physiologic jaundice, affecting the majority of newborns; pathologic jaundice, caused by medical conditions such as blood type incompatibilities (the most common cause), as well as prematurity, infection, liver damage from rubella, syphilis, or toxoplasmosis, and metabolic problems such as hypothyroidism; and late-onset, or breastmilk jaundice (probably caused by a factor in some mother's milk that seems to delay or prolong the excretion of excess bilirubin).

It is important to understand the different types of jaundice, because each has different causes, consequences, and treatments.

Physiologic jaundice affects nearly all newborns to some degree. It is more prevalent in certain ethnic groups, such as Chinese, Japanese, Korean, Hispanic, and Native Americans. If you define jaundice as bilirubin levels of greater than 10mg/dl, one study found that Japanese newborns were more than three times as likely to be jaundiced as white newborns. Babies who are premature or are low birth weight are more likely to become jaundiced. Babies who don't feed often enough during the early days, and who don't stool often, are also more likely to become jaundiced. This underscores the importance of early, frequent feedings. Colostrum (the sticky yellow fluid produced before the milk comes in) acts as a laxative. Bilirubin accumulates in the baby's stools, and if it isn't excreted, it re-circulates in his system. Frequent stooling helps lower bilirubin levels.

In the baby with physiologic jaundice, bilirubin levels will usually peak between the third and fifth days of life and are usually less than 12mg/dl. Occasionally they will go higher than 15mg/dl. Most doctors will monitor levels closely during this time, checking the baby's levels with a blood test, pricking his heel, toe, or finger. If the levels are rapidly rising, or are 20mg/dl or higher (lower levels are used with premature infants), phototherapy is often suggested. This is a treatment which involves exposing skin to blue range light which breaks down the bilirubin and makes it more easily excreted. Years ago, nurses found that babies who were in beds near sunny windows had lower bilirubin levels. Researchers then found that phototherapy can make bilirubin levels drop quickly. Until the past few years, babies with high bilirubin levels had to be in the hospital for phototherapy treatments. Now, with new technology, babies can receive phototherapy at home using bili-blankets, provided by home health care providers. In most cases, bilirubin levels drop rapidly after phototherapy is initiated, and once the levels begin to go down, they almost always continue to decline. Usually only a day or two or therapy is needed. Most cases of physiologic jaundice will resolve without the use of phototherapy.

Here are some suggestions for preventing and/or treating normal, physiologic jaundice:

Feed your baby early and often. Remember that colostrum acts as a laxative, and frequent stooling lowers bilirubin levels. Keep track of urine and stool output (see article on How to tell if your baby is getting enough milk).

Avoid water supplements. Only 2% of the bilirubin is excreted in the urine, and 98% in the stools. Colostrum and milk contain fat, which stimulates bowel movements, and water can fill your baby up so that he is less interested in nursing.

Encourage your baby to stay awake and to feed at least every two hours. One of the things jaundice does is make your baby sleepy, especially is he is "under the lights". (See article on Waking sleepy babies).

Supplement with your expressed milk. If your baby is sleepy at the breast, and is having fewer than three large bowel movements in 24 hours, consider expressing your milk after feedings and giving it to him (preferably not with a bottle at this stage; he may become confused by rubber nipples if he is only a few days old). Use a dropper, syringe, cup, or tube-feeding device if possible. If your only option is hand expression or manual pumping, you may want to consider renting an electric pump for a few days until the bilirubin levels go down. Babies are often sleepy and lazy nursers as long as their levels are elevated, and the pump can provide extra stimulation to ensure an adequate supply.

Expose him to indirect sunlight. Undress him down to his diaper and put him in a room that gets a lot of light. His skin is very sensitive, so never put him in direct sunlight.

Avoid medications such as aspirin and sulfa drugs. Make sure your doctor knows which drugs you are taking, so that you can discontinue or find substitutes for drugs which might cause problems.
Pathologic, or abnormal jaundice is caused by medical conditions, and usually shows up at birth or within the first 24 hours after birth. The levels often rise quickly (0.5 mg/dl or more per hour). The baby may need immediate treatment, but breastfeeding can and should be initiated and continued. The colostrum and milk he receives will help him move his bowels, speeding up the elimination of bilirubin from his system. A sick baby needs the benefits of breastmilk even more than a healthy baby. In some extreme cases babies may be given exchange blood transfusions. This is the fastest way to bring down the bilirubin level, but is seldom needed these days since phototherapy is usually effective. If you are separated from your baby during his treatment, ask for information about where to obtain a hospital-grade breast pump to use while in the hospital and after you go home. A sick baby with elevated bilirubin levels will often be too sleepy and weak to nurse effectively for a while, and you may need the extra stimulation from the pump to ensure an adequate supply of breastmilk for him.

There is a third type of jaundice called late-onset, or breastmilk jaundice. This type of jaundice shows up during the second week of life, and peaks around the tenth day or later. It affects a very small percentage of infants (between 2% and 33%, depending on how you define "jaundiced" -- usually a level of 5-10mg/dl). The bilirubin count can remain elevated for weeks or even months, but will eventually level out at adult levels of 1mg/dl. The diagnosis is usually made in a healthy, thriving infant, and only after all the pathologic causes of jaundice have been ruled out. Often, this type of jaundice runs in families, and breastfed siblings are likely to be jaundiced as well. No one is sure why this type of jaundice occurs, but there seems to be something in some mother's milk that increases the reasbsorption of bilirubin, or decreases the liver processing of bilirubin. When the baby is temporarily given formula, either as a substitute for, or along with mother's milk, the levels drop quickly, rising again as the baby returns to total breastfeeding. Even though we are not sure of the cause, what is important to remember in cases of late-onset jaundice is that the baby is not harmed in any way by continued breastfeeding. There has never been a case of kernicterus associated with this type of jaundice, or any detrimental after effects. Because we know the well-documented benefits of breastfeeding, the baby should not be denied the advantages of breastfeeding, given the fact that the slightly elevated bilirubin levels will soon return to normal levels without any intervention. Once pathologic causes are ruled out, nursing should continue. Sometimes babies are taken off the breast for 24-48 hours just to make the diagnosis of breast-milk jaundice, though this is seldom necessary. If your healthcare provider wants to go this route, and the levels drop significantly, then breastfeeding should be resumed.

In most cases, jaundice is a normal, possibly even beneficial process that can be managed without interrupting breastfeeding. The treatment for physiologic jaundice is more breastfeeding rather than less, and sick babies with pathologic jaundice need breastmilk even more than healthy babies. Even in rare cases where the jaundice is caused by the breastfeeding, there is no reason to wean and every reason to continue giving your baby the best possible nourishment -- mother's milk.

Jaundice
by Anne Smith, IBCLC,
http://www.storknet.com/cubbies/breast/AS-jaundice.htm

I won these...

RM 200 Cash, RM 200 Hamper (from Johnson&Johnson),
Certificate and Silver Crown

I feel so proud, elated, adrenaline-rush, I-don't-know-how-to-explain feeling when the emcee announced my name as the 2nd prize winner for the "Outstanding Breastfeeding Mother Award" during the "Our Little Wonders - Our Future" Baby Contest held at City Mall today 06 June 2009. I registered TeeTee too for the baby contest. He cried as soon as he saw the judges (perhaps he was terrified by their un-friendly faces).

I didn't expect to win (though I hope to win) as there were so many people. I was tired and the kids need their afternoon nap but luckily hubby suggested we hang around a bit till the result is out.

We didn't manage to take any photo as me & hubby busy minding the kids.With 3 kids on-tow it's hard to move around, we even lost UaUa for a while when I went to take the prize.

I personally feel my breastfeeding experience really paid-off. Special credits to hubby too for the encouragement and support (especially when I'm outstation). Tomorrow, I'm going to watch the news. Most probably the news will come out in the Chinese paper. Heee... I'm just so happy.

I will post the photos once I got hold of it..

Thank God for more milk...

aaah... This morning I woke up at 5.30 am admiring my growing collection of milk....

Collection on Tuesday...

This morning I have 10 bottles... 5 to the nursery and 5 as a stock.

Perhaps it's madness (my colleague pun kesian at me) but this is the least I can do for my children. If a cow can do it so can I... hehe... small scale industry grade milk.

Milk Supply issues...

While researching about milk supply booster I came across this site and I found it very entertaining and enlightening.

Milk supply is getting better after a little rest yesterday and papaya soup in the afternoon and evening (heee... I'm desperate - I don't mind drinking papaya soup day and night as long as breast co-operates). Also, I shall feed the milk making machine with protein, fats and water (as recommended in here)... hehe and that means me.

While milk supply is getting back, I'm still having major headache due to blocked sinus and tried nose/sinus wash (as recommended my kid's paed). The result - I'm still feeling congested but nope... I'm not going to take any flu medicine (even the doc I met yesterday smile in disbelief at this). I've bad experience with them while breasfeeding Moira.

I'm off now to breastpump again... hehe... happy to have more milk again. Hubby called it industrialisation (what a big name...). Thanks Aunty J & Jasica for the tips and advice.

In pathetic state...

My health condition has been pretty bad lately due to lack of sleep. Milk production has reduced tremendously. I've tried Milkmaid tea but the result still not satisfactory. Poor TeeTee... he's been behaving like hungry baby for few days already... I'm still not ready to let him take any formula due to so many virus flying around the house and outside. I know once he take formula he'll get sick himself (from past experience with Moira).

Kasian... my hungry TeeTee... so hungry he has to put both hands in his mouth

Later I'm going to try Jamu Selapan - saw this from here... hopefully milk production will rev-up.

Latest update - TeeTee was able to turn by himself last week... Hooray!
Another baby fast growing and mama wish TeeTee's babyhood period is forever...

Taming Theodore

I'm doing this post just for my own record as well as reference for others who might need it.

Like the usual saying - taming a horse, some babies need to be tamed as well, particularly if one has been breastfeed exclusively for more than 3 days. Theodore is no exception, not to repeat the same mistake I did with his sister Moira whom I breasfeed exclusively for 1 month and then only introduce EBM(Expressed Breast Milk) in a bottle which she refuses to drink. So this time I try to introduce bottle earlier to Theodore at 1 week old. To my dismay he refuses to drink his milk from the bottle at even 1 week old!

When we went to check his jaundice on the 5th Jan, hubby suggested that I bring a bottle of EBM (just in case he might need them). So when we arrived at the clinic and the nurse finish taking his blood sample, we sat down and there I was trying to persuade a hungry baby to drink from his bottle. One senior nurse passed-by (after sending some hospital guests to the door) and asked why the baby not taking the milk. I told her that he is used to breastfeeding. So she smiled and said - let me show you the technique how to tame a breasfed baby taking their bottle. So here's the technique - she even taught me and hubby how to handle and properly bottle feed a baby and many other tips (really glad I met her but silly me forgot to ask her name).

(Perhaps if I have time I'll do the illustration later with baby Theodore)
1. Sit comfortably on a chair.
2. Hold baby head with one hand supporting baby neck. Baby held away from body in semi-recline position. (Looks more like sitting position)
3. Hold the bottle with the other hand. Place the bottle in between the thumb and index finger and use the thunb and index finger to hold the bottle. The other three fingers should be free to move.
4. When baby open mouth, push the bottle into baby mouth with the teat 3/4 or whole-length inside baby mouth. Put the three fingers below the chin and stimulate the baby to drink the milk by using the three fingers to lift the baby chin (so that baby closes his mouth).
5. Continuously use the three fingers to encourage baby to close his mouth with the teat inside his mouth until he begin to suck.

Baby may cry a little as a show of his preference- but it's a battle of the strongest - baby or bottle-giver. Once baby accept defeat, he will suck from the bottle.

It took around 15 minutes for the nurse to tame Theodore to take his bottle. Me and hubby were so delighted when at last he began to suck (can't believe can tame a baby like that). At first I was thinking of changing the teat to wide-neck size and other shapes, but since we manage to tame him I just stick to his ordinary teat. Ever since being tamed I give Theodore one bottle-feed daily just so he remember how to feed from the bottle. After my 1 month confinement, I will then breast pump to stock -up for work. I plan to fully breasfeed at least till his 6th month when we introduce solid food to his diet (dunno if I can last that long with the frequent outstation trips I have to make - we'll see how). Huhu... I'm now officially moo-moo in the house again.

Theo is 1 week old!

Time flies so fast and it's been a week since baby Theo first introduction to the new environment (other than the darkness in the womb). Here is his photo at 1 week...


He still looked bit jaundiced but he is feeding well and now start to have regular bowel movement. Hope this will help clear the bilirubin. Actually, Theo has undecended testicle (both left & right) at birth but I got one of the local masseurs to correct the position and lucky she managed to get one testicle down. The other one still a bit higher but I can see that he is finally wetting more nappies now as compared to the first few days only3 nappies in a day (Perhaps it was due to his testicle being undecended).

Theo is also exclusively breastfeed and I was quite amused at 1 week old he totally refused to suck the expressed breastmilk from the bottle. I guess I have to train him to accept bottle earlier - otherwise I would have problem when I go to work or outstation later.

Life is good at the moment after 1 week with a new-born baby - long break, spending more time with the kids but I was a bit sad that the school holiday is going to be over soon and I didn't do much things with Uaua - I have lots of plans of things to do with him but somehow it didn't materialised. The only thing that I manage to get him to learn is swimming which starts 28 November 08. It was his first time in the pool and having sensitive nose he sneezes all the time - poor boy.

Momoi is also pretty grown up now - I spend most of the time with her during the 2 weeks nursery break. Comparing her with Theo now I can't believe she has grown this big - I still miss the baby Moira. She is so adorable with her smiles, big eyes and chubby cheeks. She can sing A-Z, say 1-10, sing few nursery rhymes (in her own language) and can understand simple instruction. She eats on her own (starts taking solid - rice & family meal when Theo arrives). I can see she can be independent and loves her baby brother. I guess the timing is just right - the only thing that I didn't manage to teach her yet is potty training. At night, she still try to escape from her brother's room to our room to sleep next to me.

While Dodu (MIL) was busy bathing Theo I manage to catch Moira doing her funny stuff again - she took the small bucket and put on top of her head. MIL & I can't help but laugh... hehe...


Finally thanks to MIL for helping with bathing Theo and cooking delicious meals for hubby and kids. All this time I never get bored with my confinement food until I saw my MIL cooking in the house - I almost forgot I am only allowed to take my food. Thanks to Mom & Dad too for sending me my delicious confinement soup (so eager to have them- my favorite lihing soup) and bath daily and even stayed with me in the hospital until I delivered. I know mom is not feeling very well but she still stayed on. I am so lucky to have such wonderful parents and in-laws.

Here's a photo of MIL with Theo at 1 week. This photo was taken by our talented Joshua.

Picky Little Moira...

Just recently when my girl turned 1, I had another headache trying to figure out which milk brand to give her.

I fully breastfed her until she was about 8 months and until that time I had no headache what-so-ever on which milk brand to choose. From the start, Mom's milk is the best Brand for her and apparently all the Milk companies print this statement on their packaging. I tried to introduce formula to my daughter earlier at 5-6 months but my picky daughter only drink either Mom's milk or water. At one time, she even lose almost 2kg when we try give her formula - she would vomit her whole tummy content everytime we feed her. She is very persistent in her stand against formula.

The paediatrician mentioned to us that the rejection is probably due to the taste of Mom's milk is better than most Formula. In fact, no formula can even closely replicate mom's milk as it changes according to the different diet everyday - how unique.

But...(sadly but...) I have no choice as my work requires me to travel quite a lot and sometimes for more than 3 days. And that forced me to introduce formula to her but at later stage, i.e. 7-8 months. I tried so many brands - Anmum, Enfalac, Friso... and finally she agree to take Similac... whew after that we never looked back. She was on Similac until she's 1 year and we only finish her last tin last week as we needed the milk to help her in the transition period.

I thought this time around at 1 year of age, my daughter already accustomed to formula and I should have no problem changing her milk. I was totally wrong! This time the same thing happen, I tried all the brand samples I collected from the paediatrician and she likes none of them. One suck from the bottle and she throw or push away her bottle - very picky girl. Concurrently, Moira was also down with bad fever due to re-infection so the paediatrician suggested one particular brand that might help to boost her immune system.

I have no choice - I want to make her better and I want her to drink the milk, so I mix 1/3 new formula + 2/3 Similac in a bottle. Like magic, she suck the bottle but with funny looking face staring at me. I looked back at her as if nothing strange happens and try very hard not to smile.

The mix continue for 1 week and I slowly increase the new formula ratio to 2/3 the week after and by the 3rd week she's finally taking her new formula. Yay...

Now... I have another dilemma whether this new formula is the right one for her? I think I'll continue on my next post...

Bye-bye Breastpump....

Nicely packed breast pump & milk bottles for my future project ;-)

I'm finally saying bye-bye for now to my faithful breast pump after 8 months of milking in the changing diaper's room, meeting room, hotel room, wash room & filling room (basically any room with a private space).

What a newly found freedom for me...
1. I don't have to worry about pumping at the exact time morning, noon & evening.
2. No more leaking milk, painful & swollen breast if I don't do or forgot to do or no time to do no1.
3. I can eat & drink the taboo food - coffee, chilli, liver, black beans & chives (I did eat some chillies & chives while breastfeeding though).
4. I don't have to worry about coming home on time for Moira's feeding.
5. I don't have to worry about keeping stock whenever I have duties away from home.
6. I don't have to carry my ice-packs everywhere I go.
7. I don't have to worry where to store the milk when I'm away from home. (I have even tried persuading the hotel personnel to help me freeze the milk at the hotel's F&B dept fridge against the hotel rule. I was lucky, he finally agreed after reasoning with him.)

Although some mothers continue to fully breastfeed their babies until the age of 2 years, I don't think I'll be able to make such commitment due to the nature of my work. Most of the time I have to work away from home for 2-4 days. I have only been able to keep stock for 3 days supply of breast-milk. There is one time when Moira totally refused to take formula (Mama's milk taste nicer...) and my milk supply was low that it got me worried sick. I'm lucky now Moira is fully adjusted to taking her formula and she is ready to wean from the breast. However, I still breastfeed Moira for her late-night feeding/sucking needs.

Anyway, being able to fully breastfeed my baby for almost 7 months is the most satisfying achievement for me as a mother. Everywhere I go with my pump, bottles & ice-pack bag, I always get the encouragement from other moms who have been through the same experience and respect from others who didn't persevere or didn't have the patience to breastfeed. Personally, I have learn a lot through my own experience with my baby Moira and I would certainly fully breastfeed my baby if I have the chance to do it again in the future.

I'm 100% Mama's Milk
(Moira at 2 months 1 week)