Sunday, July 29, 2007

To tear or not to tear

There's something about child birth that's not often talked about so that it doesn't scare you. Human babies are born three months premature compared to our primate relatives. New born babies are all head, all brain, and not ready for action in the physical department. They are so floppy!
Basically, human evolution is skating a knife edge. We have got to the point where, on the balance of probabilities, child birth won't kill a mother so long as the babe is born at 40 odd weeks. We couldn't survive and give birth vaginally if babies were to be nurtured in the womb for that fourth term - their heads would be too big.
So, child birth won't kill you. But you don't come off unscathed, either. We only recover from it as well as we do because we support each other in a society. We have people who know what to do to help you birth with as little damage to you as possible, and people who know how to help you if you do suffer injury.
If you ask your mother, she most likely had an episiotomy, or tore if she had a natural birth. If she had an obstretrician and private health cover, she will have had an episiotomy as a matter of course, perhaps even without her consent. In medical circles it's taught that giving routine preemptive episiotomies is better than letting the woman run the risk of tearing. This is because conventional wisdom says that a clean cut heals better than a tear.
Not every one agrees with this approach - if you don't tear, you don't have to heal at all. And just because you do get cut doesn't mean you won't keep tearing - in this instance, your tear will be even worse. Whatever the case, episiotomy or tearing, child birth is a savage initiation into motherhood. Having a new baby clamber over your breasts searching for a nipple whilst a team of people hold your bits together and stitch you up is a surreal and overwhelming experience that I have difficulty recommending.
I tore giving birth to my baby's shoulders. I was so sensitive, I had to have two rounds of anesthetic - they couldn't give me any more than this - and use gas for them to stitch me. Even then, I could feel every stitch, and screamed throughout. In terms of healing, my tear healed up just fine. Unfortnately other complications arose because of the trauma but I think these would have occurred whether I'd torn or had an episiotomy. I was just extremely unlucky - my obstretrician may only see one or two women like me a year.
You've got to make the decision for yourself whether or not you will have an episiotomy. Giving birth in a position other than on your back, such as all fours, will make a big difference. Effective also are warm moist compresses applied regularly to the perineal region during the labour. Best of all is giving birth in water, because then your perineum is supported.

What decision have you made?

Friday, July 27, 2007

Immunization and Babies

There's lots to think about when considering immunization for your baby. What to immunize them for, and what age to do it.

Today our baby was immunized for the first time. He is three months old. We vaccinated him with DTPa-IPV (Infanrix-IPV), 7xPCV (Prevenar), and Hib (Hiberix). We had chosen not to get the Hep. B. vaccine after a careful analysis of the adverse event
rates vs the incidence of the disease. For DTPa, Pneumococcal, Polio and Hib the safer course of action is on average to get vaccinated - the diseases are either dangerous or common enough to outweigh the vaccine risk (all vaccines have some risks associated with them).

About two hours after the vaccine, it was just him and me in the house. He had screamed a great deal for about half an hour after the vaccination, but now he was quiet down, and even smiled and laughed before falling asleep. Because I wanted to make it up to him, I put him on my chest to go to sleep. We lay on the bed, Wagner's Parcifel playing on the radio.

It's wonderful having a baby asleep on your chest. They make the cutest snuffling and snorting sounds while they sleep, pucker their lips as if they are dreaming of sucking at the breast, and massage your skin lightly with their small hands. We'd been lying for about half an hour and I had started to day dream. Then it occurred to me that something was quite wrong.

Baby was quiet. His back wasn't rising and falling as he breathed, and I could no longer hear his breathing, his mouth only twenty centrimetres from my ear. The thought that he might be dead slipped across my mind but I brushed it away. I picked up his arm - it was floppy. Babies often go floppy when they sleep, but if you pick up their arm you get a response, such as curling of the fingers.

I picked up his arm and let it drop again. Still no response. I wiggled his legs. They were floppy to. I tipped my chin forward and listened harder, in case he was breathing quietly, but he was not. I put my hard on his back, but there was no movement there either. I felt a wave of shock rise up through my belly and ricochet out across my torso, my limbs, my fingers and toes. At once I felt so incredibly light, yet also as if I was sinking into a cold bottomless lake. My baby was dead?

I picked him up off my chest and shook him lightly. After a few more seconds, he roused, and started breathing again. Colour returned to his face.

The Infanrix-IPV datasheet contains the following statement:

"Very rare allergic reactions, including anaphylactoid reactions, have been reported following vaccination with DTPa containing vaccines.

"Extremely rare cases of collapse or shock-like state (hypotonic-hyporesponsiveness episode) and convulsions within 2 to 3 days of vaccination have been reported for infants receiving pertussis containing vaccines. All the subjects recovered totally without sequelae."

He had suffered a hypotonic-hyporesponsiveness episode. He may have more of these over the next couple days. We rang the GP, so that he could report it. GPs are meant to report adverse events following immunization to the Australian Drug Reactions Advisory Committee.

Our GP said he will not report it, because hypertonia is not listed as a side-effect on the packet of any of the vaccines that he administered. If the baby did not go blue, there is no need to worry. It is quite possible that hypotonic-hyporesponsiveness is not an extremely rare event, it's just that it's extremely rare for a GP to report it.

How can ADRAC give the right advice on the safety or otherwise of vaccines for babies if GPs grossly under-report these adverse reactions? How was your baby after being immunized?

Monday, July 23, 2007

Am I a mum or what?

One of the hardest things about bringing home a first baby is coming to terms with being a mum. You're used to going to work and socialising, grooving at rock concerts and seeing movies. Suddenly, all this is gone. You have none of the things you used to define yourself by present in your life any more. What you do have is this new critter, this new person, entirely dependent on you for survival and development.

After 30 odd years of "me me me" it takes a few months to get used to the change. You want to lash out a bit, but don't know where. You can't lash out at your kid - whenever he cries for whatever small reason your heart almost breaks. And you can't lash out at your partner, who is doing his best to be there totally for you and understand what you are experiencing. And there's no point lashing out at yourself - you've already been through the wars.

Eventually, you just have to let go and come to terms. You bury the old you. But you don't necessarily give birth to a new you, a new mum. You just get by day to day, scratching together some food when you can, getting some shut eye when he's alseep, and doing your best to make sure there is as few stains on the clothes and furniture as possible.

I found reading some Eckhart Tolle to be helpful:
"The most common ego identifications have to do with possessions, the work you do, social status and recognition, knowledge and education, physical appearance, special abilities, relationships, personal and family history, belief systems, and often political, nationalistic, racial, religious, and other collective identifications. None of these is you."

"Whatever the present moment contains, accept is as if you had chosen it. Always work with it, not against it. Make it your friend and ally, not your enemy. This will miraculously transform your whole life."

What was it like for you?

Saturday, July 21, 2007

Buying our Mountain Buggy

Before baby came, it was clear that I wanted a pusher that could go from cafe to national park, was strong and durable, and light. Light is important, because you think about the last time you lugged a heavy sack of potatoes up the stairs or into the car. Many top brands sell prams 14+ kilos!

The buggy brands that fit my criteria were either Phil and Teds, or Mountain Buggy. Both are New Zealand made. Good on you New Zealand, you've got lots of great baby products! Phil and Teds make heaps of well thought-through stuff, like a travel cot that's only 2 kilos, and baby back-packs. Mountain Buggy specialise in prams.

The Phil&Teds Sport Buggy is 10.5 kilos. It is slimline but long, has swivel front wheel, and can be used from birth. It's most marketable feature is that the parcel tray can be converted into a toddler seat, if you were thinking of having a second kid under 3.

The Mountain Buggy Breeze is Mountain Buggy's minimalist pusher. It is 8.5 kilos, very, very strong, and suitable from birth. It's small enough to be easy to travel with. The reviews online written by mums highly praised both the Mountain Buggy strollers in general and the Sport. Which one mums purchased was mostly a matter of personal preference.

Eventually, the only way to decide was to take a friend and try them out. We stuck her heavy purse in the seat, and pretended it was a baby, and pushed them around the Brisbane Bubs store in Fortitude Valley. They both were really easy to push. Even though the Breeze has a static front wheel, its lightweight and compact design made it just as fun to scoot around with.

How to decide? We settled on trying to lift and fold both. The Mountain Buggy won hands down. Those two missing kilos make a huge difference when you are 8 months pregnant (and who knows, you may be again before your babe is kindergarten age).

We actually had to ask the shopping assistant how to fold the Phil&Teds Sport Buggy. It's a three step process, and even she seemed a bit confused. On the other hand, with the Mountain Buggy Breeze was a straightforward clip and fold.

If you haven't seen a these three wheel buggies in the flesh, I hope this has helped inform you a bit. Just because the Breeze worked for us, doesn't mean it's for you. The Breeze is limited to one baby, as you can't fit a toddler stand or seat to it like you can with other Mountain Buggy models.

Also, for $500 the Sport Buggy gives you a whole lot of extras like Bumper Bar, Storm Cover, Travel Bag, and Insect/Sun Cover. It's really good value. It was $600 for the Breeze and Mountain Buggy expect you to purchase these extras separately for about $70 each! I don't think so!

If you don't have stairs, have a low car or a willing husband on hand, are on a tight budget, and are hoping for a second child before you've even lost your jelly belly, the Sport Buggy is for you. I'm short, mostly out and about with bubby on my own using public transport, and am crossing my fingers that I don't fall pregnant for at least five years, maybe even twenty!

As a word of warning, try your buggy out as soon as you get it home. We didn't take ours out of the box until after the bundle of joy exploded into our lives. The wheels turn out to be a bit wobbly and don't track straight. I am sure Mountain Buggy would fix this for us if we took it back to the store, but I couldn't live without the pram long enough for them to fix it and send it back to me.



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Friday, July 20, 2007

New biodegradable disposable nappies


There's a new biodegradable disposable nappy on the market. It's Safeties, and they are available from Babies Galore. Good on Babies Galore for stocking them. Babies Galore also stock other environmentally friendly brands, like Nature's Child, and Seventh Generation.

I haven't tried them yet. What are they like? It's great to have another nappy available that doesn't use Gel to absorb wetness. Gel interferes with baby's sex hormones, so who really wants to put that poison next to their babe's genitals?

We've been using Bambo Nature during the day. Mums Happy Nappies has them at a very economical price for an environmentally friendly disposable that is Gel free. Postage is free too in the Brisbane area. Seventh Generation make nappies that are chlorine free, but unfortunately they do contain Gel.

What other biodegradable nappies have you tried?

What I want to know is, what is the differernce between "Infant" and "Crawler"? They are for the same weight range. Do babies that are crawling have different nappy needs to slow fat babies who are still just wiggling around?


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Disposable wipes


If you are using disposable wipes, and almost everybody does, you'll want to steer away from ones that contain alcohol. The last thing you'll want to put near your babies pristine tush day after day is something that is going to irritate or inflame the skin.

There are two very good brands of disposable wipes that are alcohol free. These are Tushies and Seventh Generation. Both are very high quality: thick, absorbent, soft and durable. Seventh Generation is slightly moister. Tushies cost $7 from Mrs Flannerys Supermarkets in Brisbane, and Seventh Generation cost $10 from Mums Happy Nappies. We use Tushies and add a bit more water.

There is one other brand of alcohol-free wipes on the market. Tender Care. Avoid these, as they tear, are hard, small and dry. They are also impossible to get out of the packet and expensive.




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The best clothes for newborn babies


Dressing a newborn baby can be kind of daunting. They feel so soft and vulnerable, you don't want to hurt their floppy neck or bend their tiny fingers. The best cloths to have are ones that are open at the front, like onesies and kimono bodysuits. You can lie baby down on top of them and do them up the front, rather than having to pull anything over heads or feet.

Onesies can be found pretty much everywhere, from K-mart to boutique baby stores. Kimono bodysuits are harder to find, but worth the effort if you live in a warmer climate. The comfiest ones are stocked by Nature Baby, and Sckoon Organic.

Just remember, always get size 00 (3-6 months) just in case you have a big or fast growing baby!



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What will I need after the birth?

In preparing your nursery, don't forget to take the time to think about your own needs. You are going to be very tired, and in a great deal of pain after the birth. To put it lightly, you'll feel like you've been hit by a truck. Devote some time into putting some nice things for yourself around the house, whether it be yummy foods in the fridge, or a book by your favourite author by the bed.

What else will you need?

  • Towels Towels Towels. At least a dozen. Ones that can be warm washed and won't run dye. Good quality ones too, that don't scratch the skin. You'll need them under you and baby on the bed, to catch milk, blood, wee and poo. Expect to change them multiple times a day.
  • Maternity Pads. The best thing you thought about pregnancy was that you didn't have your period for nine months. Well, think again. After birth, you can bleed very, very heavily for up to six weeks. Hmmmm, so chunky you could carve it. For at least four of those weeks, you be wanting to change your pad every time you visit the loo, to make sure you don't get eczema on those tender bits. So, buy at least six packets of maternity pad. Ultra slim is best, because they irritate the perineum least.
  • Organic honey on the comb. Slather it on the pads to make them more soothing.
  • Litres and litres of water. Take the volume you usually drink, and at least double or triple it. Giving your baby liquid food really makes you dehydrated, and before you know it it's been half a day since you peed. Have lots of insoluble fibre too, but avoid Metamusil because the citric acid it contains irritated baby's tum.
  • Pure Vitamin E oil for any stretch marks, raw nipples or scars.
  • A sympathetic partner, who will attend to you every need, and close family who will bring takeaway.
What things did you find helpful post-partum?


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Inducing Labour


First babies usually gestate for 42 weeks. A baby can feed safely from the placenta for up to 3 weeks past the "due date". Your obstetrician will probably ask to book you in for an induction at 10 days post term, maybe even 7.

Inductions carry their own risks, because they make labour faster and more painful for both you and the baby. And, really, who wants pig's sperm put up their fanny?

So if you want to birth naturally, close to term, here are some things you can do:
  • Stay fit. Up till you give birth, walk at least an hour every two to three days. I found meeting my partner at work, and walking home with him, a great motivation.
  • Swim for relaxation. Floating in the water, you can get in touch with how your baby feels in the womb. Jump gently up and down against the floor of the pool - it really helps the baby's head to engage.
  • Have a regular massage. You need as much luxury as you can get before baby comes, and a pregnancy massage makes you feel wonderful. In the last weeks of my pregnancy, I would experience pre-labour after each massage.
  • Make yourself feel safe. Burn essential oils, like Perfect Potions' Beautiful Baby . And put relaxing CDs on repeat, like Peace Baby, Deuter's Earth Blue and East of the Full Moon, and Ronkorb's Japanese Mysteries. Kick anyone you don't like out of the house.
  • Drink nettle tea three times daily to increase the strength of your contractions. Mix it with peppermint to make it more palatable.
Don't be in too much of a hurry to bring baby. Once he's here, it's at least a month's whirlwind of pain, exhaustion, and overwhelming emotion. Be grateful for the time that you have alone with him now, snug and safe inside your belly.


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Thursday, July 19, 2007

Which bouncer is right for my bub?


The best way to be hands-free is to have a bouncer on hand. Babies love to sit up in them, playing, and you get to do important things like shower and clean your teeth.

You'll want to go to a store to check out bouncers. You need to feel them and rock them to see which one you like. Here are some criteria to judge them by:
  • If I was a baby, would I find it comfortable to lie or sit in for up to an hour?
  • If I was a baby, would I find it fun to sit in this? Is there a bar to hang toys from, and can the toys be swapped to keep my interest?
  • Is the harness easy to do up and undo so that I can be put in or taken out without waking up?
  • Does the bouncer have a smooth rocking action that will soothe me when I am unsettled?
Many bouncers also come with fancy extras like music or vibrations. In general, the KISS principle works well in baby buying. There's nothing to say these extra gadgets are good for baby, they are just something extra that these brands can use to market their product.

We bought a Chicco bouncer, which has a newborn insert and is ultra comfy. They sold out the first week of being stocked by Babies Galore, and ours was the display model that had only been on the floor for two days. Bub loves being in it while you chat or dance for him, and will sleep in it too if he has colic. But it fails the last two criterion.

What do you think of your bouncer?

The cloth nappy road test


Disposables are quick and easy and very comfortable for baby but they do have their downside. They leak at night, which is bad for doing anything the next day except another load of washing. They also give babies eczema on the legs, back and bum; and who wants to spoil that beautiful soft baby's bottom? Most brands also promote the Gel in their nappies. The chemicals in Gel makes them more absorbent, but also interfere with the sex hormones of your baby.

Cloth nappies used at nighttime are really great. They are much more absorbent than disposables, so stop leaks. Our baby won't tolerate them during the day, because he wees too often, but at nighttime when he is asleep they give him great relief from any possible nappy rash or eczema that he's developed.

There are just as many cloth nappies on the market as disposables. So which one do you buy? It's a big thing to get wrong, they are so expensive. You could purchase according to your budget - from flat nappies to fully fitted. But each cloth nappy has its strong points that doesn't necessarily correlate with their cost.

We bought a few of about eight different sorts, and here is what we found.
  • Number 1 for absorbency, value and versatility: Eenee Microfiber Nappies. These are flat nappies, which you fold inside a water-proof cover. They are great for padding out other nappies, and as a nappy in their own right for the younger baby. We also use them to dry him and to wipe him down when dirty. If you are only going the flat nappy route, these are for you. Just invest in a really good cover, such as Kushies Waterproof. If you are going to buy fitted nappies, still stock up on at least a dozen of these, maybe two. They cost $25 for half a dozen.
  • Number 2: Imse Vimse Countour Shaped Nappy. The quality of the brushed organic cotton fabric and workmanship in these really stands them apart. They feel crisp and new even after washing. They are very easy to put on baby. Just tuck them under, fold the flaps, and put on a cover. They grow with baby, fitting newborns to toddlers. Don't bother fishing out the extra 20 bucks for a fitted nappy which has elastic, studs, and whatnot. These are less than half the price and catch the poo just fine. Whatever you do, get the Kushies Waterproof covers rather than the Imse Vimse covers. One, they are cheaper, and two, the velcro doesn't catch on your bare breast when you are burping him after a feed - very important. These nappies cost about $12 each.
  • Number 3: Kushies Ultra Nappy. You can't get easier than this cloth nappy. It comes with the cover attached, which is perfect for those bleary nights when it's 2am, you've had 10 hours sleep total for the last three days, and you can't remember where your hands are let alone find a cover for the nappy. They do have a few downsides though. The plastic cover makes them slower to dry. The elastic legs catch icky stains, and you can only wash them in cool water. Also, you need one size for infants, and one size for toddlers, which means double the outlay. However, they are the excellent quality, and at about $20 each are still half the price of other fitted nappies.
What do you think of bamboo and hemp nappies, like Baby Beehinds? We didn't try those. Which cloth nappies do you recommend?


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Pubic synthesis is the pits

About two weeks after giving birth, I experienced the constant sensation of a bowling ball hanging from a ring in my clitoris. I hear you: ouch. I thought I was going to die. I spent all day with my legs up the wall, dreading the moment I would have to get up to pee.
Luckily, it was only pubic synthesis. A condition caused by the relaxin in your bloodstream that stretched the pubic bone for you so you could give birth. It was easily fixed by a few regular visits to a pregnancy chiropractor, who put my hips on triangular blocks, to push the pelvis back together.
So, don't let pubic synthesis get you down.

What troubles did you have after giving birth?


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Liz Leys, woman of the year


Fairly early in my pregnancy, it became evident to me that I would want a doula. I was going to have a natural birth, and I was the first of my peer group to be giving birth. My partner and I knew nothing about the business, and we wanted someone around who would keep us calm, let us know that all was well, and support us in whatever way necessary through the birthing journey.
I was very lucky to hear about Liz Leys through Yoga Baby classes. She is a well-respected doula in the Brisbane region. She was everything we needed her to be - met with us during the months leading up to the birth, taught us about breastfeeding and not fearing pain, and coached me through the labour, which was mostly at home. She gave my partner tips on how to help me at every step, and even made me toast with honey when I needed it to keep going. After the birth, she popped in to see how we were, and would do little things that at the time were a big help, like our dishes.
I really couldn't have gone through with my natural birth without Liz. Her being there, with her experience of 100 or so births, gave me confidence to surrender to my body and let the labour take place without fearing what was happening to me. She told me constantly, "You are stronger than the pain", and I was.
She is so amazing, because she is on-call 24 hours a day 7 days a week. She will support you through your birth whether it goes for 10 hours or 50. She will do her utmost at every step to make sure you have access to all the information so that you are free to make the decision that is best for you. The more you need her, and in whatever way, the more she is there for you.
Quite sincerely, Liz deserves to be made woman of the year.


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The myth of "Hands-free"


Remember pregnancy? Dropping food between your bosoms every time you ate a meal because you couldn't reach the table? Doing your best to enter the pregnant-lady wet-T-shirt competition whenever you did the dishes? You couldn't wait till you gave birth so that you could have your body free again.
And then you have this creature who needs to be on your shoulder being burped, on your breast being fed, in your arms being played with, so that now not only do you not have your front free, you don't have hands either! All of a sudden it seems like they were a lot less maintenance when they were inside.
Then you hear about "hands-free" baby carriers and they sound like a godsend. Slings, wraps, polkadots, florals - there are so many to choose from!
Baby carriers have their place, but they aren't what they are made out to be. After giving birth, you don't necessarily have the abdominal muscles to carry your baby around for very long - let alone the energy! A lightweight and easily folded pram, like the Mountain Buggy Breeze, is much better for going for a walk. If you suffer from pubic synthesis, carrying the baby can be downright painful.
They are unpractical too. You still can't reach around your baby to the sink - your baby is even bigger now. And try bending down or reaching up such as when you hang out washing - it's uncomfortable for you and the baby.
They are great if you are looking for something to put the baby in when there's nothing else for it, he just wants to sleep on your shoulder. My baby is asleep in a Moby Wrap while I type this, for example. Just be warned that there's nothing else for it, you are just going to have to spend your days rolling in the bed or develop arms of steel.

What do you think about your baby carrier?


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Pants or rompers?


Before we had our boy, an experienced mum told us that rompers were the way to go. I stocked up on four pairs before baby was born.
She was right. Family have since bought us pants, and they roll up the leg, you need to constantly keep chasing socks out from under the furniture, and the cotton goes tough after a wash or two.
You need at least ten pairs of rompers in your baby's size. They are great because they tuck under body suits. When a nappy leaks (which occurs <10% of the time, which can be once a day) they protect the body suit. It's much easier to change a pair of rompers than undress the whole baby.
Nature Baby make very soft, and extremely cute organic cotton footed rompers in generous sizes. They make your bub look like a little elf. They end up about $15 AU, which seems a lot, but try walking into a baby store and finding a pair of pants on sale under $30! They are extra good, because they fit over cloth nappies and covers too.


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Wednesday, July 18, 2007

These are a few of the most useless things..

There's quite a lot of stuff marketed at families to be. The thing about babies, is that you have to buy all the stuff before they come - you don't have much time even to get eggs, bread and milk once they do. But how are you to know what you need when you don't even have the baby yet?

Well, here are some things you don't need:
  1. Newborn size clothing (000). Baby clothes sizes are based on averages. Up to 50% of babies will be bigger than average. Our boy grew out of anything 000 by his sixth week.
  2. A bassinet or basket. Our boy refuses to sleep on his back, and insists on being where you are. This means he more often than not sleeps draped over a pillow on the floor of wherever we are: invest in a comfy firm pillow instead.
  3. Muslin wraps. I'd heard a lot of high praise for muslin wraps - such as from Kaz Cooke's book, Kid Wrangling. So I spent a lot of money and got a multi-pack from Nature's Child. They say you need at least a dozen baby wraps, and that they have many use. To tell the truth, I haven't found a reason to use one yet.
  4. Breast-feeding pillows. Babies grow so quickly, and you quickly get so good at breast feeding you could probably do it hanging upside down from a trapeze if you had to. If you have difficulty breastfeeding sitting up, try side-lying. It's our babe's preferred position, and it's way easier on you shoulders.
  5. A breast pump. "Tell me again, you want $100 for $2 worth of plastic?" If only sex toy manufacturers would take on making breast pumps. They leak, are inefficient, and damned uncomfortable. Yet you will need to get the milk out some time or other, because your baby is feeling under the weather or you ate something that made your breasts explode. Mine, a Medela, apparently is the only brand recommended by the Australian Breastfeeding Association, but it doesn't hold much chop. I found hopping in a hot shower and squeezing the breast gently from base to aureole works much better than the pump.
I'm interested to hear from you about what products you've found to be useless.

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