Travelling to Europe with an (almost) 1yr old

“All you need to know is that it’s possible.” -Wolf, an Appalachian Trail Hiker

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So many many hours of planning, wondering, worrying, waiting, packing and packing again finally culminated on the 26th of August at OR Tambo airport when we could check in all our baggage and go through customs. We were on our way to Brussels Airport (via Dubai) for our one-year adventure in Leuven. We have travelled with Eran before, but never internationally, so this was a first for all of us.  Here are a few of the tips and tricks that made the journey enjoyable:

  • Pray, plan, pray! The moment we started dreaming about this adventure, we asked God to go ahead of us and open the right doors. It is so comforting to know that we can trust Him with the big plans for our life, but also with the little daily details. I spent many hours researching prams, carriers and blogs to get the best advice for travelling with a little (Thank you @thebugthebird and @stellarizeyourlife).

“Many are the plans in a person’s heart, but it is the Lord’s purpose that prevails.” Prov 19:21

  • Invest in a carrier. It is stressful enough to book in your luggage (we were overweight with 2 of our luggage pieces) and to go through customs (take off your belt, sometimes your shoes) without having to worry about how to get your baby safely through. With a carrier you have both hands free to manage your stuff, and baby stays nestled close to your heart. We LOVE our Ubuntu Baba carrier (currently using the Stage 2), we have used it on an almost daily basis and it is always with us as our first/last resort!

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  • We took a stroller. It made things easier when navigating the airports, and Eran could take his naps in there, giving me some time and space to also relax. It was very important that it could fold up tiny and steer comfortably with one hand. See my review for the Banimal Stroller in my next blog.
  • Timing is everything. We chose a through-the-night flight as we knew this would be the best way for Eran to sleep most of the flight. He fell asleep when we finally cleared customs, and he thankfully stayed asleep even through the chaos of take-off. (We boarded first to have time to settle ourselves before the masses streamed in). One thing we did not know, is that the bassinets are only issued after the seatbelt sign is switched off for the first time. Eran thus slept on my lap for the first hour. You also have to take the baby out of the bassinet every time they switch on the seatbelt sign (for turbulence inflight). This caused some interruptions in his sleep, but it is still nice to have the extra space to use as necessary.
  • Visit your GP / Pediatrician before you go. Eran had his One Year Check up just before we left, so I was confident that he did not have extra fluid build-up in his ears or any other issues that would bother him during the flight. I also asked his paediatrician (yes, even thought I am qualified, I strongly believe in not doctoring my own family) for something to help him calm down / sleep if it should be necessary. We took Vallergan Forte (an old, sedating type of anti-histamine), and we used it once when he woke up at 3AM in the plane. It helped him to calm down and then he could doze back to sleep.

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  • Breastfeeding saved me!! Even though his entire routine was upside down, a quick breastfeed could usually settle him and give him the comfort and reassurance that everything will be ok.

 

  • During our lay-over we booked into a lounge. It was lovely to have access to healthier food (there were a lot of fruit and vegetables and salads available at the buffet), and space for Eran to roam and explore. Eran tasted his first hummus and olives and loved it! He even made friends with one of the welcoming personnel, and the two of them had a lot of fun.
  • Our second flight was during the daytime. Eran took one nap during the flight, but the rest of the time we had to keep those little fingers and toes busy. Granny made a few Ziplock bags with activities / stickers / new toys to entertain him, and that really worked wonders! (Thank you for the idea @thebugthebird) We also had some rice cakes for him to chew on, and he ate from my plate for his meals.

So all in all we had a very blessed trip with minimal tears. We were all very tired when we finally reached Brussels and we were thankful to just fall into our beds at the hotel we booked into for the night.

Feel free to ask if you have any more questions and come back soon for a full review of the Banimal stroller.

My Breastfeeding Journey

6H3A2872kIn my 3rd year in medical school we had a few lectures on breastfeeding. Firstly a lecturer from the Physiology department taught us exactly how the hormones oestrogen and progesterone assists in the development of glandular tissues in the breast, and the changes that take place in the areola and nipple as you go through puberty. We were taught how the pituitary gland secretes the hormones oxytocin and prolactin that assists with the let-down reflex and milk production. We had a session on the 10 steps to successful breastfeeding (from a hospital-management point of view) that would save the whole community. And then we had a lecture with Sister Vanessa Booysen. She is a registered Nurse that has worked in the NICU for many years, and that has an absolute passion for breastfeeding and the nurturing of babies.

She lovingly taught us about the benefits of breastmilk (especially in the premature babies she has worked with for so long), the immune benefits, the bonding, positive emotional outcomes for mom and baby, the ultimate love story that is breastfeeding.  It was inspirational! When we walked out of that class we all (the male students included) just wanted to go and breastfeed something! 😉

In the 8 years of working that followed I always very passionately explained to the mommies in the obstetric unit and sitting beside the beds of their babies in Neonatal ICU how very important breastfeeding is. It broke my heart when a mother chose to bottle feed before even trying to breastfeed or when we had to start a premature baby on formula milk because the mother was not interested in expressing. I believed everyone could breastfeed if they tried hard enough! I probably was a little bit of a “breastfeeding-cheerleader/tirant”!

Fast forward another year and now I have my own little milk monster that have been on this breastfeeding journey with me for almost 7 months! I have learned so much and have definitely gained a lot of respect and empathy for breastfeeding mothers. My cheerleading-approach will be more thoughtful and caring in the future.

(Warning– I am sharing my journey openly and honestly! If you are not comfortable with your boobs yet, this might get a bit squeamish!)

Despite all my physiological knowledge about the breast and breastmilk, I did not know much about breastfeeding and the trouble-shooting of the niggly-midnight-issues. I read a lot of blogs and attended the ante-natal classes to make sure I was as prepared as I could be.  We attended the class on breastfeeding when I was around 28weeks pregnant. We were shown the technique for hand-expressing, and that night I tried it out… great was my surprise when a drop of milk appeared!!! How amazing are our pregnant bodies that our breasts are ready to produce milk the moment that it is needed!

Seeing as I did not have a normal vaginal delivery, I was adamant that I would at least get this breastfeeding thing right! When our midwife placed the crinkly, pink, warm body of our son on my chest in the theatre and he looked me in the eyes, the oxytocin surge was immediate! Our midwife assisted me right there to help him to latch on my breast (quite an awkward feat while still lying on the theatre table with all the drapes and cables in the way). In the recovery room our little boy finally got the hang of it and tried the sucking thing for a few minutes. I was overjoyed!

The next three days in hospital were mostly a bootcamp of breastfeeding! I made sure I had an easy-access top on, and baby stayed in or  next to my bed so that I could feed him on demand. I was very worried when he did not pee for a whole day (yes, I kept checking for the blue line on the nappy!) and woke my husband in the middle of the night with a photo of the blue line when it eventually appeared! J Luckily the nursing staff was very supportive, and the baby-sister gave a pearl of wisdom : if baby has passed both stool and urine once after birth, we know he can do it. Then you do not worry too much for the next 3 days as output can vary. They take in very little fluids (colostrum is very concentrated) so they do not produce a lot of waste initially. Once your “milk has come in”, then they should have 4-6 wet nappies a day if baby is drinking enough.

As with any bootcamp you are tired, sore but satisfied by the end of it! Baby fed almost hourly the first two nights (clusterfeeding), this was necessary to stimulate my breasts enough for them to realise they need to up the production as they have to provide milk for a hungry little human for the next few months. My nipples where very tender, but fortunately did not bleed. I had the nipple-cream in my hospital bag, but in the end it was much easier and much more effective to apply colostrum to my nipples after each feed and let it air-dry.

By the time we went home, we were both a little bit more comfortable with the whole process. By then my milk had come in (this basically means that the milk has transitioned from colostrum (very rich, concentrated milk, 1ml colostrum = 25ml formula milk, looks golden in colour) to normal breastmilk (whiter in colour and baby needs more of it to keep him happy) and your breasts are now ready to produce larger volumes.) In the beginning your breasts overshoot in supply and baby still has a relatively small demand, and thus your breasts end up looking and feeling huge, heavy and warm (engorged). I was privileged that my milk-factories was moderate in their supply, so I never had hard, lumpy breasts. Another pearl of wisdom from my lactation consultant, Sr Vanessa Booysen, was that told me that I can feed from one breast per feed (this was at about day 6) so that baby can empty the breast completely – good for me and baby (he gets both the fore-milk and fattier hind-milk to keep him full for longer). At times baby struggled to latch as my breast was too full and I had to hand-express a little bit to make the areola-area soft enough for baby to manipulate.

After one week we went to a clinic to have baby weighed. I initially thought weekly weigh-ins are unnecessary, but in the end it was so comforting to know that baby was growing well, and the sister gave me a wonderful pep-talk each week. Baby always became hungry in the middle of the consultation, so his latch and positioning and my posture could also be evaluated, and the sister gave valuable tips each time. I also joined La Leche league on Facebook, and a local breastfeeding whatsapp group. I learned so much from the other moms, and it was wonderful to know I was not alone.

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At 2.5 weeks I noticed that there was a little blister on our son’s upper lip that sometimes formed after a feed, then would fall off and then form again. I asked around and heard that it was mostly associated with a lip-tie. After some more investigations, I realised that he had a small lip tie of his upper lip, but because he was latching and feeding and growing so well, we decided to just watch it. Lip ties usually resolve later (while for example brushing your teeth), and mostly does not need any interventions. Speak to your breastfeeding consultant, paediatrician or ear-nose and throat specialist if you are worried.

By week 3 my parents came to visit and baby and I started practising to feed with a feeding-cover. It was good to become comfortable with this in my own home, as it has saved me during many coffee-shop or mall visits. I only started expressing after 6 weeks as I did not want to mess with the demand/supply process (your milk production is relatively stable after 6 weeks) and we only tried to give baby a bottle after 10weeks (mostly because I was too lazy to express). Many moms express/bottle feed much earlier with big success. In my experience very few babies really get “nipple confusion”, they may start to prefer the bottle because it is so much easier to get the milk out. Breastfeeding is hard work! It is thus important to do paced feeding if you do give some bottles in between.

After 6weeks my nipples and breasts were not sore anymore, baby latched like a pro and suddenly only drank for 5-10minutes per feed (he used to take at least 20min per feed initially). Suddenly all the initial worries, pain, frequent feeds was worth it and I started to really enjoy these special times with my little boy.

And my God will meet all your needs according to the riches of his glory in Christ Jesus.” Phil 4:19

We fell into a synchrony of request and production and all was well until he was almost 5months old and hit yet another growth spurt. I received very sad news from a friend and suddenly my milk production dropped! Baby boy wanted to drink every hour (grazing is also not good for milk production, as he only drinks a few sips and then stops, so the breast only replaces those few sips). I drank litres of water, jungle juice and tea, and spoke to my lactation consultant again. She advised that I use a few Rescue tablets and just relax, Oxytocin will do the rest. I also visited my clinic again, and seeing that our little boy actually gained some weight helped a lot to calm me down! After praying and declaring that God is my provider, and believing that He will also provide milk for our baby, I could finally feel my breasts filling and having a proper let-down again. I am so thankful that we can continue our breastfeeding journey for now.

So in a nutshell… make up your mind, have a good support system (especially a passionate lactation consultant) and believe that God will do the rest! What did you learn during your breastfeeding journey?

Mother knows breast – benefits of breastfeeding for baby (Part 2)

“ …A little child, born yesterday, a thing on mother’s milk and kisses fed…” Hymn to Mercury (one of the Homeric Hymns written in the 6th century), translated from Greek by Percy Bysshe Shelley.

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Babies have been breastfed since the beginning of time. It is interesting to read about the history of infant feeding and how the role of breastfeeding has changed over the eras and according to the cultural expectations. There has always been a need for an alternative feeding mechanism (when the mother died or was very ill), and initially wet nurses were used to fill this need. From about 950-1800BC mothers often opted to use a wet nurse due to social conventions (it was hard to play cards during afternoon tea or wear the beautiful corsets if you were breastfeeding).1

Alternative milk sources have also been used with varying levels of success since early times. Initially only animal milk was used, but as food preservation became more successful, and chemistry evolved, scientists developed substitute infant foods which were advertised widely as the perfect infant food. (This perfect infant food initially consisted of cow’s milk, wheat, malt flour, and potassium bicarbonate!)1 Advertising campaigns in developing countries and directly to the general public did a lot of damage as it painted an ideal picture, and many moms chose formula- over breastfeeding.

So what did you base your feeding choice on? History? Cultural expectations? Need? Social conventions? Advertising? Social media? Your mother or grandmother’s choice? I would like to give you some facts, and then I hope you can make your choice based on love and evidence!

“A baby sucks a finger as instinctively as the breast – but the breast is better for the baby.” Martin H. Fischer (1879-1962)

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Here are some of the benefits for your baby

Preterm infants:

A large part of my career consists of working in the Neonatal ICU, and I have seen the wonder of breast milk for these teeny tiny humans! Although the mother’s milk is the ideal, most of these benefits are also attained if pasteurised donor breast milk is used for the babies.

Short term benefits:

  • Breast milk is better tolerated by the immature bowels, and thus the volume of feeds can be increased quicker and these babies are discharged sooner from the Neonatal ICU.
  • Necrotising enterocolitis (NEC) is reduced up to 6-10 times2 in prems receiving breast milk
  • Breast milk may contain some beneficial factors to reduce the severity of Retinopathy of Prematurity (ROP).3
  • Fewer episodes of late onset sepsis4

Long term benefits: 5

  • Improved Neuro-developmental outcomes in mental, motor and behavioural aspects
  • Lower rates of metabolic syndrome (obesity, heart disease, high cholesterol, diabetes) and thus better insulin metabolism and lower blood pressures.

 

Benefits in Term, healthy babies 5, 6:

Short term :

  • Decrease the risk of otitis media (middle ear infection), and lower respiratory tract infections. I will not bombard you with statistics, but for illustrative purposes hear me out. Your baby’s risk for middle ear infection is 50% less if you breastfeed exclusively for more than 3 months, and 23% less with any breastfeeding! You can give your baby some of the benefits even if you are struggling… just try!
  • Decreased risk for diarrhoea… up to 64% less with any breastfeeding!
  • 36% decrease in the risk of Sudden Infant Death Syndrome.
  • Great for bonding as explained in my previous post, very convenient as it is free, always available, always clean, always the perfect temperature.

Long term:

  • Protective effect against allergic diseases, celiac disease and inflammatory bowel diseases
  • 15-30% decrease in adolescent and adult obesity with any breastfeeding
  • Lower risk of Type 1 Diabetes and childhood leukemia / lymphoma

These are only a few of the benefits that were researched in developed countries. In South Africa it has been found that the risk of a baby dying increases 10 times if a baby is not breastfed, due to the higher risk of poverty, malnutrition and HIV.

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” Mat 7:11

I have used a lot of medical terms in this blog, so I hope you see my heart through the strange words. If you are a prem-mom, then you will know all the scary conditions like sepsis, NEC and ROP very well. There are many high quality studies that prove that breast milk really is the best food for your baby for the first 4-6months. Currently the World Health Organisation recommends exclusive breastfeeding until 6months, and then continuing to breastfeed until 2years or beyond to achieve the optimal growth, development and health. 7

Will you at least try to give your baby the golden liquid that your body is capable of making, even if it is only for a few months or supplemented with formula? Surround yourself with people who will support you on this journey, join a breastfeeding group and become an advocate for breastfeeding among your friends! In my next blog I will share my journey until now.

If you have any questions or comments, you are welcome to contact me and I will gladly chat with you.

 

 

  1. Stevens EE, Patrick TE, Pickler R; A History of Infant Feeding; J Perinat Educ. 2009 Spring; 18(2): 32–39.
  2. Lucas A, Cole TJ; Breast milk and neonatal necrotising enterocolitis; 1990 Dec 22-29; 336(8730):1519-23.
  3. Okamoto T, Shirai M, Kokubo M, Takahashi S, Kajino M, Takase M, Sakata H, Oki J; Human milk reduces the risk of retinal detachment in extremely low-birthweight infants. Pediatr Int. 2007 Dec; 49(6):894-7.
  4. Underwood MA; Human milk for the premature infant; Pediatr Clin North Am. 2013 Feb; 60(1): 189–207.
  5. Ip S, Chung M, Raman G, et al. Tufts-New England Medical Center Evidence-based Practice Center; Breastfeeding and maternal and infant health outcomes in developed countries; Evid Rep Technol Assess (Full Rep). 2007;153(153):1–186p
  6. American Academy of Pediatrics; Policy Statement, Breastfeeding and the Use of Human Milk; Pediatrics; March 2012, VOLUME 129 / ISSUE 3
  7. http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/

Benefits of Breastfeeding

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There are a few brand new babies in our friend-circle, and looking at them, I cannot believe how far my little boy and I have come on our breastfeeding journey in just 5months! I have already forgotten the difficulties of those first few days, and he is now breastfeeding like a pro!

“If we wear our nursing covers backwards like capes, then everyone can see we’re breastfeeding superheroes.”  Cassi Clark, Breastfeeding Is a Bitch: But We Lovingly Do it Anyway

Let us be honest with each other, breastfeeding is the most “natural” choice, but it is definitely not the easiest initially and it does not always come naturally to a brand new mom. As you might know, breastfeeding is ruled by two hormones: Oxytocin and Prolactin, both secreted by the pituitary gland in the brain.1 The regulation of both these hormones are very sensitive to pain, fear, stress, love, happiness and bonding with your baby. So basically, breastfeeding is “all in the mind”…

If you choose to breastfeed, make up your mind that you WILL BE ABLE TO! Your body was made wonderfully, so do not let anybody stir doubt in your mind. Surround yourself with people who will be supportive, and people who can help you when you are struggling and then give it your all. It truly is one of the best gifts you can give your baby and yourself.

“Yet You are He who pulled me out of the womb;
You made me trust when on my mother’s breasts.” 
Ps 22:9

I really want to encourage you to breastfeed! There are so many benefits for mom and baby. To help you stick it out over the long haul, I want to look at a few of the benefits of breastfeeding with you. Today I want to only look at the benefits for mom (after all, you will be doing all the hard work), next week we will look at the benefits for baby in both the short and long term, and then I will share a little bit about my own journey.

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Immediate and Early Benefits for Mom:

  • Bonding. This has a lot to do with the hormone Oxytocin (so called “love-hormone”) that is released both in you and your baby while breastfeeding (the suckling, the close skin-to-skin contact and the eye contact  releases oxytocin, but there is also some of the hormone in your breast milk).2 Oxytocin is also released when you hug someone for longer than 6 seconds and after sex… so it is safe to say that a trusting, positive bond should develop between you and your baby.
  • Reduce bleeding after delivery.Once again… that wonderful hormone Oxytocin! It helps the uterus to contract (just like in labour) which in turn limits the bleeding.
  • Reduce stress and improve sleep. You probably know the answer by now… Oxytocin! 🙂 It makes you feel calm and produces feelings of trust, thus lowering your stress levels. It reduces cortisol, lowers blood pressure and improves digestion. This in turn is the perfect recipe for sleep, giving you a little more of a very valuable and scarce commodity in those first few days.
  • Prolong amenorrhoea and an-ovulation.Breastfeeding exclusively has the natural effect of suppressing ovulation, thereby acting as a natural birth control for up to 6 months (or as long as the woman is exclusively breastfeeding and her menses have not returned). This is not 100% fool proof and your gyne will usually discuss other methods of contraception with you at your 6 week follow-up, but it helps. And who will not take the chance to be free of “Aunt Flo” for as long as possible!

Long-term Mom-Benefits

  • Postpartum weight loss. Yes ladies, you heard right… finally something that burns fat!! Pregnancy tends to add on the kilos, but luckily we have a built-in solution. In a large prospective cohort study, Baker et al.4 showed that greater exclusivity and duration of breastfeeding was associated with greater weight loss at 6 and 18 months postpartum in women of all BMI categories. Another great reason to stick it out!
  • Reduce Type 2 Diabetes Mellitus, Metabolic disease and Cardiovascular risk. During pregnancy your body adapts in order to sustain your growing baby. Some of these changes include a mild degree of insulin resistance and changes in your lipid profile. There is some evidence for a “Reset Hypothesis”5 that happens when you breastfeed so that your cells are once again more sensitive to insulin, and that changes your lipid profile back to a healthier combination, thus decreasing the risk for chronic metabolic diseases.
  • Reduce risk for breast and ovarian cancer. According to a 2002 meta-analysis6 (a very trustworthy type of study), your risk for developing breast cancer is reduced by 4.3% per year of breastfeeding. There is also a decreased risk for ovarian cancer. It is thought that this is due to a decrease in the time that your body is exposed to estrogen (during breastfeeding this hormone is suppressed).

 

Benefits that spill over to the whole family…

(These have nothing to do with your biology or health, but believe me they play a big role in your overall well-being!)

  • It is FREE! Babies cost a lot of money, but this is one area that does not have to cost you a cent for at least 4 months. No need for bottles, formula or sterilizing equipment.
  • It is always the right temperature (no more stumbling to the kitchen to try and heat the bottle in the middle of the night)
  • It is naturally sterile! This saves a lot of time, as you do not have to wash and boil water or microwave or steam bottles and teats. In fact, the microbes that baby get into contact with during breastfeeding are GOOD for him! (More on that in the next post).
  • It is always available! If you stay out for longer than planned and baby wants to eat NOW, it is very easy to just find a quiet corner and let baby eat.

After saying all of that, I am sure you can start to understand why I am very passionate about breastfeeding. In the end however I agree that “fed is best”. I do understand that there are some circumstances where the ideal is not achievable, and I know your mommy-heart only wants what is best for your baby. The goal is to have a baby that is healthy, growing well and loved.

“Successful breastfeeding take courage, resilience, patience, and support and it always has. If your partner or support group hasn’t piled on the accolades for your heroism, then let them know you will expect oohs and has when you make it through the first two to three months (no matter how you got there) and your baby is happy and healthy — because you are awesome!” 
Cassi Clark, Breastfeeding Is a Bitch: But We Lovingly Do it Anyway

 

**** Photo’s taken by myself in multiple museums in Italy and Slovenia in 2015.

 

  1. SESSION 2, The physiological basis of breastfeeding; Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals
  2. Takeda S, Kuwabara Y, Mizuno M; Concentrations and origin of oxytocin in breast milk; Endocrinol Jpn. 1986 Dec;33(6):821-6.
  3. Dieterich CM, Felice JP, O’Sullivan E, Rasmussen KM; Breastfeeding and Health Outcomes for the Mother-Infant Dyad; Pediatr Clin North Am. 2013 Feb; 60(1): 31–48.
  4. Baker JL, Gamborg M, Heitmann BL, Lissner L, Sørensen TI, Rasmussen KM; Breastfeeding reduces postpartum weight retention; Am J Clin Nutr. 2008 Dec; 88(6):1543-51.
  5. Stuebe AM, Rich-Edwards JW; The reset hypothesis: lactation and maternal metabolism; Am J Perinatol. 2009 Jan; 26(1):81-8.
  6. Collaborative Group on Hormonal Factors in Breast Cancer; Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease; 2002 Jul 20; 360(9328):187-95.