Breast is indeed best and hospital review

Sophia is sick yet again! Just one week after she recovers from the last bout of sickness.

Just to give a bit of background, I fully breastfed (ie no formula no other milk but yes solids from 6 months) Sophia for a bit more than 1 year then slowly weaned her off to full cream cow’s milk over the next 2 months. For the first 14 months of her life she only caught the flu once and that was when she was just 6 weeks old and a terrible strain that the whole family also caught. Other than that she was spared even when some of the family are sick. However, very soon after coming off breastmilk completely she caught a cold. After she fully recovered she went for her mmr jab and was well for a week then developed a high fever complete with runny nose and cough.

Of course, the spike in temperature has to come on a sunday when all the clinics that are halfway decent are closed. So we brought her to KK’s A&E department.

Upon entering the A&E department, the first thought was “wow, its quite empty, great, the wait won’t be long.” We took a queue number from this unconspicuous box that was horizontal from the entrance so its not really in our line of sight.

Queue ticket here

While waiting Sophia was actually still quite the happy camper.

Happy Sophia at the waiting area

After a short wait our number was shown on one of the triage doors.

Triage

We were attended to by a Filipino nurse who handed us a disposable kidney dish with some paper napkins and tap water to sponge Sophia with. Sophia was not too keen about the stethoscope and screamed very loudly. So I had to bring a very unhappy girl to the registration counter and pay up the $90 registration fee. We were then told that the wait was 2.5 hours!! Once we entered the real waiting are which was hidden from sight of the entrance we understood why. It was packed to the brim and every other child had a cold pack to his/her forehead so I asked Sophia whether she wanted to go to the playground. She immediately nodded her head. How she knew what was a playground is beyond me.

Look, mummy, I'm driving!

We barely played for 5 minutes though before grandpa called us saying they called her name but he can’t hear which room she was supposed to go to. So I had to bring Sophia over and ask around till I finally was told which room. We saw a doctor who was clearly an Indian national and rather young. She was very kind but Sophia similarly didn’t care for her stetoscope so we ended up with another very upset baby again. Her diagnosis was virus infection ie the-doctor-doesn’t-know-what-it-is-either and we were prescribed some paracetemol, ibuprofen, and iliadin.

So we jumped the queue to be ahead of some 80+ people just because Sophia had a sufficiently high fever. But half the people had fever pads on so I wonder whether they just had like 37.x degree fever or something. Else the priority queue would be ridiculously long anyway.

I hope this past month is not indicative of what it will be like on an ongoing basis. She’s sick for half the time ever since she came off breastmilk. So mummies out there, breastfeed as long as you can. It is, however very liberating when I finally stopped and didn’t need to be attached to the pump.

UPDATE: We suspect she has been falling sick because of the new milk we introduced. We’ve been rotating between fresh full cream cow’s milk from Horizon (organic), Organic Valley and Pura and I recently found an organic cow’s milk farm right here in Singapore that delivers their milk so I started ordering from them and the times when Sophia started falling sick roughly coincides with starting of that milk as well. Sophia has also been getting hives which she didn’t used to have so it does seem like a sort of allergic reaction. We’re stopping that milk to see whether the situation gets better. Already after stopping it as of yesterday, her temperature has gone back down to the 37s from the 38s and 39s, but it could also just have been a case of the infection having run its course and is dying down. I do hope its an allergy to that milk though, then the solution is an easy one.

Don’t shake the milk!

I’ve seen too many of my very smart and very educated friends, as well as random strangers, shake breastmilk violently to motivate myself to bring this blog back to its roots, which is to give wholly unsolicited and unqualified advice based on my own research and biased experience having been there and done that with just one child. Of course, when I say milk, I mean breastmilk. Or, I suppose, if you ever give your baby RAW cow’s or goat’s milk, which I doubt anyone in Singapore would do.I always try my very best to swirl as gently as possible when trying to mix in the fats that coagulated on the sides of the container while in the refridgerator. And have often told family members off for swinging the baby bag when we bring expressed milk out. I cringe when I see mothers or caregivers shake breastmilk as it destroys the molecular structure of important proteins. But I never tell them not to do so because I don’t want to sound like a smarty-pants know-it-all. They may already know it but think its more important to shake off the bits stuck to the container, or to get the milk heated/cooled more quickly. That’s perfectly fine, everyone is entitled to raise and feed their children in whichever way they think is best.

Another thing I’ve been researching now that I’m very slowly weaning is whether there is any harm in mixing breastmilk with other milks (in my case fresh full cream cow’s milk but most research turns up information about formula, which can be used as ancillary information too). Long story short, I have not found anything that says there is any harm in doing so (eg if the 2 somehow reacted chemically to form toxic substances). The only so called harm is if hte child cannot finish the milk then some breastmilk will be wasted which would not happen if breast milk is given first. My child generally finishes her bottle (as long as it doesn’t contain any formula or artificial substances like vitamin drops) so I don’t really have that concern.

So there. 2 hopefully helpful bits of information for today 🙂

Formula for sleep

There was a post on The New Age Parents‘ facebook page yesterday featuring a question from a mum on whether she should partially breastfeed her baby because her confinement nanny told her that formula at night helps the baby sleep through the night. I was about to comment but the reply got too long. And it seemed to me that I was the  minority and I was afraid of getting rotten eggs thrown on me. So I retreated to my personal sanctuary that if my own blog on which I can say whatever I want without fear or favour.

I don’t think making babies sleep through is a good reason for partial breastfeeding. I have been exclusively breastfeeding for the past 11 months, with solids from 6 months, of course, and my baby slept through the night from 6 weeks onwards. Its not true that formula is more filling. It is more difficult to digest and hence stay in the stomach longer, that is true but volume for volume babies actually need less breastmilk for their energy needs. This must mean that breastmilk is more “filling” in that more nutrients and calories actually absorbed. My experience is that letting baby sleep through the night is a poor reason for not exclusively breastfeeding. It may not help but yet baby is deprived of exclusively breastfeeding benefits.

There are also a lot of benefits of exclusively breastfeeding that is lost once any other food, even formula, is given. The most common benefit of exclusively breastfeeding is a heathier “flora” in the intestinal tract but there are also lesser known ones for example iron in breastmilk is absorbed much better than other forms of iron but this benefit is lost once other forms of iron is introduced to compete with the iron in breastmilk. I don’t explain it wekk as I’ve digested all these informatino and retained only the conclusion I drew but see for example the following article: http://www.drmomma.org/2010/10/virgin-gut.html. Kellymom’s Why Delay Solids also has a lot of information that I drew analogies on . In a sense formula and solids are similar – both are not nature’s intended food for very young babies – even though formula is closer.

That said, genuinely not having enough milk after an earnest effort, or an ill mother or medically unwell baby or just being unable to cope with the hassle of breastfeeding due to say lack of help with babies are all valid reasons for not being able to exclusively breastfeed and formula is close enough to breastmilk for mothers to really not have to bash themselves up for not exclusively breastfeeding. All I’m saying here is make an informed choice, not a choice based on with frivolous words of a well meaning confinement who probably doesn’t have evidence backing her speech.

Weaning on fresh cow’s milk

Unheard of in Singapore but I am likely to do it. I’ve been in 2 minds becaue all the books and articles I’ve read said you *can* give baby full cream milk at age 1 but doesn’t say you *should* do so or its preferable to do so. I’ve always instinctively felt that the more procesed food is the less “healthy” it is. In general. Hence I instinctively prefer fresh milk to highly processed formula. Yet everyone around me seems to believe that formula for toddlers contain more nutrients necessary for brain development, increased immunity, eye development and a whole host of other benefits that is difficult to ignore.

The only support I had for my view is this post by this mum who put breastmilk, fresh cow’s milk and formula under microscope and found that breastmilk was the most “lively” followed by fresh cow’s milk and formula just looks dead. But then that is just how it looks and not what all those things we see do so its not super convincing evidence to say that fresh cow’s milk is better. So I have put off the decision since Sophia is still drinking only breastmilk. But now that I am less than a month away from Sophia’s first birthday which is when I plan to wean her from breastmilk (I think I hear the husband heave a sigh of relief and whispering “finally”), I’ve stepped up the research on this point and am still seeing all the “can”s but not the “should”s, until I found this:  http://www.chroniclesofanursingmom.com/2009/08/formula-milk-for-toddlers.html. Yay! Vindication for my views! I shall be a one mum army in my campaign for fresh cow’s milk for babies.

Plus fresh milk is cheaper than formula, I think. Though since formula is dry a small tin can presumably make up a lot of milk so the could well end up not being so different. Anyway, I shall assume its money-saving too and can probably then use the saved amount to purchase organic fresh milk then. Isn’t it great?

I’m sure the grandparents will frown, but I’ll deal with it then.

Oh wait. Then there’s the question of whether goat’s milk is better since 1) I’ve heard somewhere that goat’s milk is actually closer in composition to human milk and 2) there is a goat’s milk farm in Singapore but no cow’s milk farm so its possible to get fresher goat’s milk. But that means organic plan is out of the window? More research is in order! Stay tuned!

How much milk?

These days my baby is finally capable of eating a lot of solid food, like between 2-4 ounces per feed, depending on whether she likes the food. Even parents of a 13 month old commented that she is eating more than their son. Ok, that would also mean their son has a small appetite but still, the point is she is eating a significant amount of solids. Correspondingly I’ve reduced the amount of milk I feed her. We have now converged with my initial plan for weaning but unfortunately have also reached the point where I was stuck. Gina Ford enourages not feeding milk with meals once baby is taking a substantial amount as calcium apparently interferes with iron absorption, but at the same time she says 600ml of milk is needed a day. With between 10-12 hours taken up in a stretch of uninterrupted sleep at night, I can’t see how I can fit in so much milk in teh remaining 12 hours or so without bursting Sophia’s tummy at some point.

Recently my breastmilk supply has been going down, probably because I’ve dropped my pumping to 3 times a day from 4x not long ago. I’m only producing about 500ml a day the past 2 days and it suddenly struck me that I may be reducing the amount of milk Sophia drinks by too much and for the wrong reason viz that I don’t have enough milk!

As such, I sat down and seriously started rethinking my feeding plan and have come up with the following revised schedule:

  • 7am wake up
  • 7.30am – Light breakfast (2 T cereal / half slice of bread / 2T yoghurt)
  • 8am 150ml milk
  • 12noon – Lunch (4T protein with vege/grains + 2T fruit)
  • 3pm 200ml milk
  • 6pm – Dinner (3T protein with vege/grains + 1T fruit)
  • 8pm 170ml milk

That totals 520ml milk a day which I reckon should be ok because Gina Ford was afterall catering for a caucasian baby who will be bigger and hence need more nutrition. As Sophia’s appetite increases, the solids can increase but the milk intake would stay the same. That’s the plan for now. What do you think?

Dropping the dream feed

From the time she was 6 weeks old sophia has been “sleeping through the night” ie from about 10 – 11 pm to about 7am. When she was around 3 weeks old I decided to go with the western rule of putting children to bed early and started putting her to bed at 7pm and it worked quite well. I’ve always woken her up for a 10pm dream feed though. And when I was still on maternity leave and my dad hasn’t retired this was also his training feed. After I went back to work this was my bonding time with my girl. I was reluctant to drop the dream feed even after dr low gave us the all clear to do so because (1) I was worried she wouldn’t get enough nutrition since she wasn’t eating much solids so its hard for me to accept that she’s older but needs a lower amount of food overall, (2) I was over producing breastmilk as it is so if I drop another feed there will be even more excess. I felt as if I’m leeching all these nutrients for nothing and (3) the dream feed is my bonding time with Sophia. In short, I probably needed the dream feed more than Sophia.

As of Friday 5 August 2011, I dropped the dream feed and it was perfectly fine. She didn’t wake up for milk and didn’t eat more in the day as well. Hopefully she will lose some of her baby fat as a result. I suppose its never healthy to have food while sleeping. Its as bad as supper for adults. I’m quite glad I’ve made the decision.

Pump of my life

I’m checked in at the luxurious Capella hotel, my husband is still sleeping after watching the 2am soccer match and I am pumping by the large window on a comfy daybed, reading magazines and looking out to lush greenary. A butterfly flutters by and repeatedly bumps into the window as it attempts to get in but fails. Sure beats being cooped up in a smelly cockroach infested closet in a mall with nothing to do but to stare at the bottles NOT filling up because I’m not able to relax.this is the life!