Breastfeeding or Formula ?

'Breast is Best' vs 'Well I grew up on formula and I'm just fine'

The big debate that will go on as long as mother's give birth to babies. Both sides of the argument are sound, breast is the most natural way to feed your baby. It's on tap, its loaded with nutrients (provided you are eating well !! ) and it doesn't requiring mixing, heating, storing or working out how much to take with you when you are out and about. The downside for me what that I never really knew how much my baby was feeding and if it was enough.

Equally however formula contains all the nutrients a baby needs and even when you consider the antibodies it lacks that breast milk does have, there is no evidence of stronger or weaker immune systems in adults that were formula fed versus breast fed. It also means you know how much your baby is having and when and typically as it can be richer, formula feb babies sleep through the night sooner. It also means someone else can help with the night feeds !! Enter daddy.

One thing is for sure though, neither method comes without it's own set of issues. Some mother's simply can't breastfeed. For a variety of reasons from being unable to get a good latch, to simply not producing enough milk. Why can't some mother's produce milk if it's the most natural way to feed their newborn? sometimes it's the mother's nutrition, sometimes psychological issues, and other times there IS no reason. I really struggled with breastfeeding Isabelle. To me it felt like the most UNNATURAL thing. I couldn't get her to latch on properly so as a result instead of my nipple being far back on her soft palate, it would rest of her hard palate leaving me sore and bleeding and once that starts, so starts a viscous cycle that makes it harder and harder. I also wasn't producing enough milk as I wasn't really eating that well as I had big time baby blues in the 1st few weeks; and as you know the more you make, the more your baby feeds the more it stimulates the breasts to make more. I was the opposite and the more time passed the less milk I made. And not even good milky milk; it started to look very clear and grey, and eventually the doctors told me I had to supplement with formula as Isabelle wasn't gaining enough weight. With Sebastien it was a totally different story, he latched on well, he drank well, I made good milk and all was well. But then I had to go back to work and I wanted to transition him to formula before my start date.

Formula has it's own set of issues. Isabelle took to the 1st one we tried. Sebastien had VERY bad colic with almost every type of milk we tried. He had colic on breast milk too but the formula made it worse. We tried 3 different milk brands and nothing helped, eventually I switched back to the 1st brand as I felt perhaps I hadn't given it as much of a chance as the others and had moved on from it in my haste to find something better. It was the one that Isabelle had used too and a part of me wanted Sebastien to use that one as well. Surprisingly it DID work well. I don't know if it was because I hadn't given it enough of a chance to settle with him the 1st time or whether it had taken so long to wok our way back around to it again that he had actually grown out of his colic Was he dealing better with formula in general or was he dealing better with this brand?

So a little on the science: what do they contain and lack ??

BREAST MILK

FAT: if you take the water out, 50% of breast milk is FAT, and in there a fair bit of cholesterol. Some research shows that this early exposure to cholesterol results in adults with lower cholesterol as they are able to regulate their levels better. The fast cells in breast milk are also smaller (broken down by an enzyme in breast milk called Lipase) than the fat cells in formula (which comes from cow's milk) and therefore easier for babies to digest.

CARBOHYDRATE: makes up 37% of breast milk. The carb in breast milk is lactose (made up of two sugars galactose and glucose). Lactose provides the energy that will allow babies function (breath, eat, cry, grow, and develop).Lactose is also converted to lactic acid which makes the baby’s stomach acidic. This in turn prevents the growth of harmful bacteria.

PROTEIN: There are high levels of protein in colostrum. The sticky thick part of milk that comes in the 1st few days after birth. 60 to 80% of the protein in breast milk is Whey. It's a smooth, liquidly-type of protein that is said to be easier to digest and it is absorbed well in baby’s stomach. This is also why their stool is runny, and they feel hungry more often.. The other important proteins in breast milk are the antibodies (helps fight against bacterial and viral infections), lactoferrin (binds to iron and helps iron absorption. It also prevents the growth of harmful microorganisms that use iron), bifidus factor (encourages the growth of lactobacillus which helps prevents the growth of other harmful stomach bacteria), lipase, amylase, lysozyme, and other enzymes (helps in digestion and creates a healthy environment in the intestines).

VITAMINS & MINERALS: Breast milk advocates say that it is considered to have the perfect combination of nutrients: Vit A, D, C, E, B1, B2, Pantothenic Acid, Biotin, Niocin, Folic Acid, B12, B6. These are just some of the 100 different components. Don't forget CALCIUM !

FORMULA

Infant formula is designed to match the ingredients of breast milk, but an exact replica is not yet possible. The FDA requires all infant formula to comply with strict nutritional requirements. The FDA requires all iron fortified formulas to have at least 12 milligrams of iron per liter and 2 milligrams of iron per liter for low iron formulas. DHA and ARA are also added to formulas to increase proper brain and eye development. A large difference between breast milk and baby formula is that formula contain saturated fats, such as oils and corn syrup. You will also notice that babies fed on infant formula are often fatter than babies fed with breast milk. The other issue is that most infant formulas are cow milk based which in some cases can result in lactose intolerance. For a full breakdown of the components you can go to www.fda.gov

SUMMARY

The MOST IMPORTANT issue I think is to believe in the choice you make and not let anyone tell you that one is better or worse than the other. You can make your choice on convenience, preference, cost, because you are going back to work, or because one is simply easier on you than the other; whatever your reason is, IT'S YOUR REASON, and you should stick to it.

Swim Class - when to start ?

The 1st time we took Isabelle into the water was in Sanya, Hainan Island where we were for a friend's wedding. She had just turned 6mths, the expression on her face (like most new things she has tried) was priceless - utter indifference and an air of 'and so?'.
Back in HK we took plenty of other opportunities to take her to the pool at the LRC and also on subsequent holidays to Dubai and France. She officially started lessons when she was around 16mths old. It had taken up almost a year on the waiting list to get a weekend slot at the LRC ! That's a entirely different issue.

Soap box for a moment: at the LRC nannies are only allowed to drop off and collect children, and are then banished to a room smaller than a prison cell with no natural light, a few plastic chairs and one water dispenser. For working mothers this means that the kids can't enjoy any of the facilities or many activities during the week if they are small enough to need supervision. On certain days of the week nannies are allowed into one of the playrooms (aimed at toddlers) and not the soft padded room that typically babies would go to. So for now Isabelle can go to the playroom with her nanny on some week days but Sebastien has to stay at home. As for the pool....no nannies allowed in the water. And so my dilemma of having to wait a whole year for a saturday slot. My other frustration is that several of the other mother's in the weekend classes are mothers that don't work and could just as easily come on a weekday. Soap box over

So back to the swimming classes. Isabelle LOVED the water and literally couldn't get enough of it; that is until she started the swim classes. In the class they had to be dunked under the water. Parents are taught to blow into their child's face so that the child reacts by holding her breath and closing her eyes at which point you dunk them under the water and back up again. Well Isabelle HATED it, she managed to swallow water despite this technique, and burst into tears. The result of this ONE isolated incidence was months and months of the followed: at each class she would cling on for dear life and whine or cry; even when all we did was sing songs and play with toys and play various games in the water. She absolutely did not want to be there. After a few classes whilst I wanted to push through and get to a breakthrough, there wasn't a moment I didn't consider pulling her out of the class. Was this negative experience going to make her hate swimming for ever ?

Then Sebastien was born at the end of October and we were so busy with him, and at the same time the winter arrived and we stopped classes altogether. In fact we lost our slot as many parents continued through the winter and had to wait all over again for a slot. I thought the break would work. It didn't. When we resumed in the summer of 2010 again, it was the same thing all over again. Tears and trauma, again we decided to give it a few turns and see what happens. Finally on saturday in August I decided that's it this is the last class, and that day she actually giggled during the class. Incidentally we never dunked her head again after the first few times went so wrong. We thought she needed to just be happy again in the water first. After that breakthrough class I thought 'yes we can do this'. I took Isabelle a few extra sessions just on my own with my mother was who was with us in HK and then we all went away for our summer holiday to LA. The real breakthrough came there. Almost everyday in the pool she built her confidence and was having fun.

We are back now and back to swim classes and we have days where she is very happy and wants to be as independent as possible and days where she still gets clingy. She still doesn't love going under the water but if she does she at least isn't in tears. It's taken a long time, Isabelle is now 2yrs and 4mths as I write this.

The question however is why do we feel compelled as parents to have our kids start these things as soon as possible. Is there really a difference between starting at 6mth and starting at 3yrs ? Does she want to be a swim champion??

I think recognising that the world we live in can be so pushy when it comes to our kids is really important and armed with that, we can step back and make more sensible decisions.

Sebastien's 1st swimming experience was also in Sanya, Hainan Island where we went for a short Easter break. He was also around 6mths, and true to his character when trying anything new, he burst straight into tears. He really doesn't like the temperature change and you know what....?? This time I am not going to push it. He will swim when he is good and ready.

Playgroups and Gyms

Hong Kong isn't short of extracurricular activities for toddlers and babies and half the time it's more about finding the right balance for them than finding a place for them. You can fill your baby's day 7 days a week if you wanted to, but over stimulation is really not a good thing either. When Isabelle was in her 1st year I found that 2 organised activities a week and a play date at home were plenty, anything in addition to that just comprised to taking her for a walk in her stroller. By the time she started pre-school 3 mornings a week at around 13mths old we kept t that schedule and now that she goes 5 mornings a week we have 3 afternoons that we fill with organised activities. I'm trying to do something similar for Sebastien too now that he is 10mths old

So where can you send them for organised activities.

My Gym, Kids Gallery and Gymbree are my favourite. But there is also Panda and many more.

So what do they provide.

Gymboree has different activities that include the below:

- GymCore (these are the sessions in the main padded room, themed each week and tailored to different age groups. There is circle time with song, exploration time around the room based on the theme of the day, there is parachute time (the kids get under the parachute or sit over it and sing songs) and there is bubble time, and off course Gymbo the clown is always around for a cuddle.
- Gymboree Art - this is great for kids to learn different colours and textures, they create art using all sorts of things like brushes, sponges, fabric, sequins you name it. Lots of fun
- Gymboree Music - all about learning rhythm using different fun instruments, and singing songs

I found that GymCore was great from 6mth to 18mths, after that 'parachute time' and 'bubble time' weren't so exciting anymore and My Gym was MUCH better for an active toddler.

Gymboree Art is great for toddlers and Gymboree Music is again great for ALL ages.

My Gym is brilliant for toddler, its a large safe room with all sorts of gymnasium activities like swings, bars, trampolines and s much more, they also have circle time, themes to follow for the day. They do however have the longest waiting list so best to sign up well in advance.

Kids Gallery is great for toddlers too, again they provide a variety of arts and crafts classes but we love the Ballet there and it's one of the few places that has ballet for under 2's. They go accompanied at first and after 2 they can go on their own to class.

I don't know PANDA well so if anyone would like to comment please do so.

details for the gyms are below

Gymboree
31st Floor, Universal Trade Centre, 3 Arbuthnot Road Central HK
+852 2899 2210
info@gymboree.com.hk
www.gymboree.com.hk

My Gym
17th Floor. Coda Plaza, 51 Garden Road, Central
+852.2577.3322
admin@mygymhk.com
www.mygymhk.com

Kids Gallery
21/F Coda Plaza, 51 Garden Road, Central
+852 2501 4842
infoHK@kidsgallery.com
www.kidsgallery.com

Weaning

This is such an exciting time...the look on your baby's face the first time they eat solids (if you can call watery porridge like baby rice solids!?). Isabelle took her first mouthful and looked at us with a 'yeah and?' expression on her face. When Sebastien took his first mouthful, he looked up and me, thought about it, scrunched up his face and started to cry...very loudly with a 'that's not my milk' look on his face.

So where to start? Traditionally babies were weaned around 4mths old, now it's advised to wait until 6mths unless advised otherwise by your Dr. The theory here being that in fact at 4mths their digestive tracts are not mature enough yet and early weaning can lead to digestive issues later in life. That means an awful lot of us must have digestive issues right? Who knows, advice changes with the wind. For us the Dr said we should start at 5mths. In fact I started both of them just past 5mths. Isabelle took to it really well, Sebastien didn't so I put it off for another 2 weeks and tried again.

In the 1st month of weaning you are not trying to replace their milk. Their milk should still be their main source of nutrition. You are just trying to introduce different tastes to the. Baby rice to start with, then various puree fruits and vegetables. Apple and pear work best as starting fruits, and carrot and pumpkin works a treat for starting veggies. Basically the sweet ones. If you are still giving a 5 or 6 ounce 10.30pm feed to your baby (Gina Ford style) weaning also means you can start to eliminate this feed. Reduce the milk by an ounce every 3 days once you start on solids, and eventually by the 2nd or 3rd week you will cut this feed out altogether.

Durung week 1 of weaning you can start by giving baby rice at the lunch time milk feed (just after the milk) - only a tablespoon or so. This is normally around 11am. By the end of the week you can add a teaspoon or two of fruit puree. Usually it is advised (if you want to be cautious) to try something new for 3 full days before moving onto the next thing as that's when you really know if your child develops an allergy to it or not. I didn't do that, I tried a new fruit every other day. By week 2 you can start to give a 2nd solids meal at super time; and by week 3 a 3rd solids meal at breakfast time.

When you start weaning around 5 or 6 mths your baby could be on as much milk as 26oz. What you are aiming at is that once 3 solid meals are introduced along with 3 milk meals that the milk intake is around 18oz. OF COURSE each baby is very different and you have to tailor this to yours. But you need to work out how to increase the solids and decrease the milk. Eventually by the time you have weaning well established your day will look something like this:


7 am - 6oz milk followed by breakfast of 1-2 table spoon baby rice PLUS 1-2 teaspoon fruit puree.

9am – morning nap for 45mins

11.45 - 2 tablespoons CARBO (eg baby rice / sweet potato) PLUS 2/3 teaspoon VEGGIE puree . drink of water (OR well diluted juice, eg 1 teaspoon of puree fresh juice in 2 oz boiled cooled water)

12.00 - Lunch time nap for 2hrs

2.30 – 6oz milk

4.15 – a drink of cooled boiled water (1-2 oz)

5.00 - 1 or 2 tablespoon baby rice with 3 teaspoon FRUIT puree

6.00 – bath time

6.30 – 6/7oz Milk

7.00 - bedtime

Are you a working mother?

Do I feel guilty that I work ? ABSOLUETLY! but you know what? whilst of course there are moments I miss that can never be captured again their are ways to make it work. For a start I'm earning a salary, a salary that will go towards giving my kids a more comfortable life and a better future. Somewhere in that sentence you get the sense that there is no choice, that if one were married to an extremely wealthy man that there would be no need to work. I have two comments to make on that. (1) I know some mothers who don't work and spend even less time with their children than I do (2) there are plenty of mothers who whilst they don't have a salaried job or a high salary job due to the success of their business, run businesses, do charity work etc.. It all comes down to staying ahead of the game and staying stimulated and fullfilled in yourself too.

So how to find the balance

1) I never EVER miss a FIRST (1st ballet class, 1st dentist appointment). I will diarise it into my work diary and I will go to it as if it were a meeting just as important as a work meeting

2) I never leave home before the kids are both awake, I make sure it's me that says goodmorning and gets their day started

3) I have a 3 day a week target where I MUST be home before the go to bed, to read bed time stories, to tuck them in or to just kiss them goodnight and you know what if I get home in time for bath time then HURRAY it's an added bonus.

4) Weekend are ONLY about the kids. Yes it means than anything and I mean ANYTHING that I would want to do on a weekend is out the window, but I don't even think twice about that. Saturday and Sunday are my days to be with my children !!!! It's a no brainer.

Some tough rules to stick by and no it doens't get rid of my guilt but it goes some way in making me feel a bit better. I like to think of myself as very hands on, I may not be home from 7.30am through to 6.30pm Mon to Fri BUT, I micro manage my nannies to such an extent down to the last pee they kids eat for lunch to get as close as possible to me being home and me being the one to make the decisions.

The million dollar question: will I always be a working mother?

I MOST CERTAINLY HOPE NOT :-)

Paeditricians & Clinic

I've been through quite a few of these in HK (and abroad) with Isabelle. You think that when baby no 2 comes along you won't be going back and forth to the doctor as much....hhmmm not necessarily true. I've probably been as many times with Sebastien too, the difference is that you are possibly not so worried and stressed out about the whole process.

Some paediatricians in HK

Dr Joseph Pang
Rm 901 Hing Wai Building
36 Queens Road, Central
tel:2526 7633
pager: 7202 8139

Dr Steve Wong
Rm 901 Hing Wai Building
36 Queens Road, Central
tel:2526 7633
pager:7388 7999

Dr Mark Chan
818 Health Professionals
Suite 818 Central Building
1 Peddar Street
tel:2526 6332
mobile: 6629 7322

General Family Practitioners

Dr David Owens / Dr Brigitte Schlaikier
5/F Century Square, 1 D'Aguilar Street Central
Tel: 2521 3181
OR
Room 1501-1503 Shui on Centre, 8 Harbour Road, Wanchai
tel: 2824 9112

Dr Sue Baldwin
Dr Fosters & Stevenson
13/F Hing Wai Building
36 Queens Road, Central
tel:2537 7281

in the UK:

Dr Stanley Rom
+ 44 20 7637 0358

Can you prevent the whole household from getting sick when 1 child falls ill?

This week was my first time with both kids sick at the same time. It started on Saturday when Isabelle woke up at 5am saying 'hot mummy! hot!' followed by 'drink water mummy, Isabelle drink water'. We couldn't get her back to sleep so by 10am we were all patiently sitting in the doctor's surgery. Sore throat, fever, cough, runny and congested nose.....When we got home we started the process of 'ISOLATION'. The idea was that if we kept Isabelle away from Sebastien, if we made sure that no one who looks after her then picks up Sebastien, then by some miracle the 2nd child in the same household wouldn't get sick....WRONG!

We followed the strict rules to isolating the children from each other, washing hands and using alcohol if we had to go from one child to the next, changing bedsheets and hand towels each day...did any of it work ? NOPE! First I started to get sick (headache, sore throat, dry cough). Then Isabelle's nanny started to complain of a sore throat and cough, by Thursday morning Sebastien started coughing. Back to the doctor we went. He also had Bronchiolitis and I now had sinusitis on top of everything else (oh and did I mention that Sebastien's nanny also started to get sick?).

It's now Saturday again, after several sleepless nights trying to console 2 inconsolable children, after my own sleepless night last night and prescription of anti-biotics and a bucket full of medicines for everyone else, I've concluded that this is the start of many many many more episodes to come in a household with more than one child. There is nothing you can do to stop the spread, these things are airborne anyway (which reminds we even aired the flat to no avail). You just have to ride the wave. Good hygiene and handwashing are still good practice, as for stopping the spread of anything..? you just have to accept there is nothing you can do and know that this time next weekend we will back to our routine of playgroups and school where a whole host of new viruses are awaiting our arrival with open arms.