Lilypie Third Birthday tickers

Tuesday, March 31, 2009

Thoughts on Confinement #5: Preparing for the long haul

I believe that it is very important for parents to make their own decisions in how to raise their child and to apply these principles in a consistent manner. The first month is often a sensitive time for new mothers who tend to have high anxiety levels, especially first-time mothers who may also be feeling awkward and inadequate. These emotions can lead to tension between the new mother and any secondary caregivers who are helping out at home (e.g. mothers, mothers-in-law, confinement ladies, domestic helper), especially if their beliefs on child-rearing differ.

In order to mitigate these problems, it is advisable for potential mothers (and fathers) to discuss their views on child-rearing with the secondary caregivers, especially if the designated caregiver will be taking over after the mothers return to work.

Personally, I found this particularly difficult as my own mother had volunteered to help me during confinement and everytime I tried to talk to her about baby-related issues, she would wave me away saying, "Aiyah, when the baby is here, then we can talk about it.". Now, I really felt that the time for discussion (or argument, as the case may be) should not take place over the cradle of a squalling newborn, so I persisted and in the end we did manage to have a proper talk.

After chatting with some other mums who have had secondary caregivers during the confinement month, I realised that most of us had to deal with similar issues. I have consolidated these issues into the following categories:
1. Feeding
2. Sleeping
3. Soothing

Here are some things that expecting mums might want to ponder over with their husbands and their secondary caregivers (this is by no means an exhaustive list - there are other issues that will be specific to each family):

1. Feeding
- Will you be breastfeeding, bottle feeding or using a combination?
- Will you be expressing milk or using formula or a combination for bottle feeding?
- What kind of bottles/teats will you be using?
- If you are bottle feeding, who gets to feed the baby?
- Who gets to feed the baby at night?
- How often will you be feeding the baby?
- How long will your feeding times be?
- If the baby is sleeping, will you wake him or her for a feed?
- Do you plan on supplementing your baby's milk feeds with rice cereal, water, vitamin drops etc? When and how much?
- What will you do with the baby directly after a feed?
- What will you do if the baby falls asleep halfway during a feed?
- What will you do if the baby appears hungry but cries when put to the breast?
- What will you do if the baby has finished a feed but starts crying a short while later?

2. Sleeping
- How do you plan to put your baby to sleep?
- When will you put your baby to sleep?
- Where will the baby be sleeping during the day/night?
- In what position will the baby be sleeping?
- How do you plan to ensure the baby's comfort whilst sleeping?
- How long will you allow your baby to sleep in between feeds? Any change during the night time?
- What will you do if you put your baby to sleep but he or she is still crying?
- What will you do if your baby wakes midway through a nap and is crying?
- What do you do immediately after the baby wakes up from a nap?

3. Soothing
- When the baby is crying, who picks up the baby first? What happens if it is nighttime?
- What methods of soothing will you use?
- Do you plan to allow pacifers, finger/thumb sucking, gripe water, medicated oil, swings, brandy etc?
- What will you do if the baby is crying but is clearly not hungry/uncomfortable/sick?


Read the rest of the series here: Part 1, Part 2, Part 3, Part 4

Monday, March 30, 2009

Shopping for warpaint

Today I have succeeded in carrying out part of my Plans For Change - namely, to think about using makeup. I am pleased to announce that not only have I thought about makeup, but I actually went out and bought myself some. I am doubly pleased to tell you that not only did I purchase warpaint, but I also did it whilst wearing something pretty.

(Tangent: I am rather pleased with the white cotton halterneck blouse with the pleated bib that I purchased from Bonitochico - another very cool homegrown online store found in the fashion alleyways of Livejournal. It goes very nicely with my brown corduroy high-waisted Banana Republic pencil skirt and my tan Converse plimsolls. End of tangent.)

To be perfectly honest, I was only vaguely mulling over the faint possibility of using cosmetics but a friend of mine (whom I am just getting to know) called my bluff and asked me if I was serious about my commitment to the aforementioned Plans For Change. Of course, I indignantly told her that I was Very Committed Indeed - at which point she, being a retail guru, offered to take me shopping.

I have a fear of cosmetic retailers because they always have a way of making me feel like a mud-encrusted guttersnipe who is in dire need of salvation from the purchase of a few expensive products. I get so intimidated by them that I often find myself nodding dumbly at their hypnotic ravings and later, holding several boxes of unguent whilst being gently ushered towards the cashier. At this point, I will normally come to my senses with some sort of shriek, thrust the armful of boxes willy-nilly onto the nearest shelf and make haste for the exit whilst the enchantresses screech after me in anger.

However, with the Retail Guru at my side wielding her Nokia E71 like a large baton, the cosmetic sirens (who initially seemed eagerly poised for a quick kill) at the M.A.C. counter were quickly subdued. One glance at the Retail Guru's arched eyebrow and pursed lip and they quickly began to sing me a different tune - one with the words 'minimalist' and 'essentials' in it.

Now, I chose M.A.C. knowing that they produce wide range of quality products which seem to last a long time and are also the most affordable 'beauty hall' brand. The ingredients of the cosmetics are kind to sensitive skin and the counter staff are always very knowledgeable and immaculately made up.

With the help of the Retail Guru (who was able to compensate for my ignorance of facial creams) and the advice of the M.A.C. staff, I came away from the counter with only 3 things - a stick of concealer for covering up the evidence of years, a little case of very light pressed powder for a polished look, and a blusher in a lovely warm colour that brings out the barest hint of rose in the cheeks. Not too much, just enough to start out with.


I think it just might work.

Thursday, March 26, 2009

We're going to the zoo

We're going to the zoo, zoo, zoo!
How about you, you, you?
(Clockwise from top: Watching the dancers and the noisy schoolkids at the Shaw amphitheatre, Getting up close and personal with a python after the show, Listening to the loud macaws having a laugh, Observing a tightrope walking gibbon.)

Tuesday, March 24, 2009

Survival Tips for House Officers #3: Preparing for war

As a brand new House Officer, one quickly realises how fast time just seems to slip away. I know that I used to wish that there were more hours in an afternoon for me to finish all the jobs from the morning ward rounds.

I used to have 2 goals for each working day which helped me to be a more efficient doctor:
1. Eat a decent lunch
2. Leave work on time!

In order to accomplish these goals, I would have to be prepared for each day and try my best to minimise time-wasting events. The easiest way to waste time is to wander around the wards looking for paraphenalia. Thus, I set out to make sure that I well-equipped with the appropriate battlegear.

Unlike the medical student, who has the luxury of carrying a massive survival kit with them everywhere they go, the house officer has to be able to travel light and look professional (we're not playing the Legend of Zelda here!). The House Officer's equipment cannot be carried in a backpack as this looks sloppy, and a briefcase is too bulky and liable to get misplaced. Additionally, the House Officer may need to run to attend emergencies, so it is imperative to limit the weight of the gear.

I recommend carrying only 3 items to fit all your inventory - all of which can be worn on the body or carried under the arm and should be able to get you through the day:

1. Stethoscope: worn around the neck
Even if you do not tend to use your stethescope much, you should still wear this as it helps your patients identify you as their physician.

2. Hardcover file or binder with clear pockets: light enough to carry with one hand, slim enough to tuck under the arm.
On the front of the binder is where you will carry your patient list for quick and easy access.
Inside the binder is where you will keep the following:
a) Request forms for common investigations - especially the ones that need to be signed by the consultant.
b) Referral forms specific to your speciality eg. If you are in gastroenterology, you will carry referral forms for endoscopy or abdominal surgery. Similarly, if you are in vascular surgery, you will carry referral forms for doppler studies and anticoagulation clinic.
c) Patient labels to save you having to write all the details down onto forms
d) Blank sheets of label stickers. Try to beg these off your ward clerks. These stickers are especially useful when you have to take telephone reports of results or if you have to take down notes when the patient records are unavailable - saves you having to copy everything out again!
e) Daily record of patient blood test results - you should probably have one of these per patient, espeically if you have patients who need daily blood tests (eg. patients on new medication, on dialysis etc.). It is useful to keep a trend table of results so that you can see, at a glance, if the treatments are causing any subtle changes in the patient's biochemistry. Additionally, you can whip out these tables during the ward round and save everyone the trouble of flipping back and forth through the notes trying to find the recorded results.
f) Spare patient history sheets or drug charts in case you happen to run out midway through the ward round
g) Anything else that requires a consultant's signature or can be filled out whilst walking in between patients (eg. discharge forms, GP followup letters)

3. Utility belt (or small bag that can be slung across the body) containing the following:
a) Extra pens - you will always lose the pen you came to work with.
b) External brain or pocket reference book. I personally preferred using the Cheese-and-Onion (so named for the colour of the bookcover).
c) Small notebook for writing down useful information relevant to your specialty - eg. contact details of multidisciplinary team, outpatient clinic dates, treatment regimes and dosages.
d) Disposable gloves - you never know when your consultant wants you to feel the femoral pulse of an unwashed groin.
e) A set of phlebotomy apparatus and bottles - this is especially useful if you have to take blood during the ward round or if you have to see a patient on an unfamiliar ward.
f) Pen torch - you will be using this quite alot, especially if you have to access an unconscious patient whilst on call.
g) Examination materials relevant to your speciality (eg. if you are in neurology, carry neuropins. If you are in ENT, carry a disposable nasal speculum. )
h) Optional items - water flask, coins for the drink/snack machines, sweets

Other survival tips: #1, #2

Sunday, March 22, 2009

Who watches the Watchmen?

The Venue: Vivocity GV cinema
The Outfit: Babydoll dress from Portman's, paired with green leather moccassins
The Dinner: Chicken and chips with a fizzy grape drink
The Movie: Watchmen
The Verdict: I don't feel any desire to watch it again or read the comic book. Despite Singapore's censorship laws, this was every bit as violent and bizarre as an Alan Moore comic could be. And there was a very, very naked blue man in it! Wow! I don't know how he slipped by our censors, but there he was, flapping in the breeze.

Friday, March 20, 2009

Morning constitutional

As part of my Plans For Change, I have decided to begin taking Stardust to out for walks as often as possible in the mornings. Getting out of the house before 8am is a little bit of a challenge, as it means that I have to be more organised getting both myself and Stardust ready.

By the time we reach the park, the tai qi enthusiasts are already dancing in slow motion to the tinny melody issuing forth from a battered-looking stereo. The dew is still shimmering purple on the grass, and the mynah birds and sparrows hop ahead of us, their heads tilted hopefully. There are a few people walking their dogs, pairs of jogging women with blond ponytails and iPods, bird-fanciers togged out in camoflauge gear and toting giant cameras...but Stardust is always most fascinated by a group of hardcore exercisers led by an aging aerobics instructor.

"Yap, Ee, San, See!!" yells the geriatric Jane Fonda vehemently, punching the air. Stardust flails his arms wildly in imitation, chuckling loudly. I am pleased to see that amongst the group there are a few wheelchair-bound folk present with their friends or helpers who are participating enthusiatically, wiggling their hips in their seats.

Further on, we reach the waterlily pond and stand by the edge, waiting for the ducks to swim towards us. The pond is crowded with fish, all pouting in the shade of a wooden pavilion. Now and then, an archerfish will swim up and send a jet of water flying to shoot down a wandering insect. Something spooks the fish and with in a silver flash of tails and bubbles, they are all gone.

The sun is rising higher and I can feel the sweat beading across my nose. From the depths of my bag, I fish out a tumbler of water - still icy cold. Stardust gulps down the water greedily, holding the tumbler in his two little hands, then generously offers me the rest. He waves goodbye to the park as we leave.

Thursday, March 19, 2009

Lunch in town

Meeting a friend for lunch.
Wearing:
1. Stardust (in a sling)
2. Sportsgirl tunic dress
3. Esprit blouse
4. Black ankle socks
5. Khaki converse plimsolls

One year of Stardust

We threw a party for Stardust's first birthday. What a palaver it was! Not the planning, the cooking or the decorating, but having to convince my own parents that we could throw a party without having to spend a fortune.

I refused to buy a birthday cake, insisting that I could carve and decorate it myself. The food would all be cooked with the help of my numerous willing aunties, all of whom are excellent chefs. This suggestion was met with a wail of protests from Stardust's indignant (indulgent?) grandparents. I am stilled puzzled about this reaction - after all, when I was little, they threw parties on a tight budget as well. The whole week preceding the birthday party, the two of them conspired with Stardust against me. "Poor boy!" they moaned, rattling their chains, "No birthday cake for you!".

Despite the weeping and gnashing of teeth, I still managed to get the cake done, waking up at 5am on the morning of the party to decorate it with fresh cream and icing. I'm not a very good pastry chef, so the cake had a very wonky do-it-yourself look to it, but it was bright, festive, birthday-looking and smelled cheerfully of vanilla and lemons, which was the main idea.

The party was a success. It was crowded, noisy and rowdy. There were babies everywhere. The adults played pass-the-parcel with Stardust who was cossetted and coddled within an inch of his life.

And it was cheap - which means now we can afford to take Stardust to visit his grandparents in the UK this year - YAY!

Wednesday, March 18, 2009

Plans accomplished

Earlier this week, I published a list of plans and I am happy to report that I am making some headway.

1. I have had a haircut.

Oh yes, I went to the hairdresser's and I told them to cutcutcutcutcut off my hair and send it on its way. The hairdresser very obligingly complied with my request, although he did talk me out of a drastic pixie crop. Hence, I am now sporting what I believe to be a concave bob.

Stardust was with me at the time and was most bemused to see my black locks falling away. He pointed at the pile of hair on the floor (which resembled a rather tired and disgruntled yorkshire terrier) then at my head and signed 'all gone' over and over again. He also waved goodbye to it as we left.

2. I am starting to revamp my wardrobe.












Oh, the wonders of online shopping! Singapore's own big name retailers do not have online stores, which is something I find rather surprising in this country that relies so much on technology and the internet.

There are, however, tiny little webshops spun by local stylistas who scour the world and bring back fashion beauties to share with the rest of us.

I found Little Red Heels by accident whilst trawling local fashion blogs, and was totally blown away by the pretty, pretty clothes. Zi & Min, the brains behind the concept, are lovely girls and a pleasure to deal with, providing a very efficient and personalised service. I was surprised and delighted to see my order arrive at my doorstep in just a few days.

It's obvious that they have a good eye for quality and value - the zebra print chiffon blouse that I bought from them is very well-made and only set me back a mere $25. I could not resist purchasing this really fun navy playsuit in cotton with a lace trim as well. I was coveting a few other pieces featured on their site but after some deliberation, I decided to pace myself - it will not do to be too greedy!

Poor little bub


Stardust was wobbling around the room today and bopped his chin on the top of the coffee table, poor little tike. After it happened, he turned towards me with pitiful wail, his little mouth wide open and dripping blood in a most horrific manner.
He was pretty brave about it, though and calmed down after a little bit of a cuddle. I washed out his mouth so that I could have a better look and the bleeding had already stopped, leaving a tiny cut on his tongue where he had bitten it.
It's amazing how quickly he forgot what had happened - he happily ate up a little biscuit and was back again, teeter-tottering around the furniture.
I, on the other hand, am rather traumatised by it all!

Tuesday, March 17, 2009

Survival Tips for House Officers #2: Managing your workload

The consultant and the other senior doctors, who have to run the hospital and outpatient clinics, will not be spending as much time on the wards as the the house officer. Therefore, the house officer is expected to know the wards better than anyone else on the team.

The most difficult part of the house officer's job is keeping track of patients, especially if your patients tend to be spread out over the entire hospital or if your hospital has a merry-go-round system of patient organisation. It is just too easy to get things confused, especially if you work in elderly care, where one crumbling old lady is almost the same as the next. During ward rounds, however, you will be expected to update the other members of the team as if you have thoroughly memorised the entire life history of each patient.

If you are unable to give a running commentary on each patient, you will end up looking like a clown as you mumble to yourself whilst frantically flip through the patient notes with one hand, whilst and at the same time, juggling the other 30 sets of notes in the other hand. Despite what you might think at this stage of your medical career, you are NOT sideshow freak - you are a doctor. And doctors have to appear to know everything.

The patient list will be your cribsheet, your lifeline. A key part of your job is to manage and maintain the patient list. If your team does not have a computer generated list, then it is up to you to create one and make sure that it is updated daily.

Your list should contain the following information:
1. Patient's name, initials or preferred nickname
2. Age of patient
3. Location of patient - your list should be organised by ward and bed number
4. A brief summary of patients current problems and current therapy (updated daily)
5. A brief summary of patients previous or underlying medical problems
6. Results of pertinent investigations (updated daily)
7. Investigations or referrals requested but still pending (updated daily)
8. A space to jot down notes from the ward round (this will probably turn into a 'to do' list of jobs)

If you are worried about not being able to maintain patient confidentiality (this only happens if you lose your patient list - in which case, you will be totally screwed anyway), then write your list in a shorthand code that is understandable only to you and the rest of your team. In any case, the information on your list should have very few patient identifiers - you are not writing a biography here! In fact, the total amount of patient information on your list should not exceed 2 sides of printed paper (you should probably aim to fit it all on one side of paper).

The purpose of this list is to serve as a memory aid in a world where the patient turnover is high and it is easy to get your patient details muddled up. One glance at the sheet should be sufficient enough for you to be able to recall the rest of the patient details clearly enough for you to discuss the case with another health professional. This helps especially if you are dealing with anxious relatives or if you are unable to access the patient notes.

Additionally, if you are on a particularly fast-paced ward round, it helps to only have ONE sheet of paper to write notes on instead of having to run around balancing 30 sets of patient files on your stethescope (remember, you are not a clown - you can always go back and write legibly in the patient notes at your leisure!).

The best part of the patient list (apart from helping you appear competent) is that it is very useful for making patient handovers. At the end of the day, before you leave the hospital, you should update the list and mark out the patients who are particularly ill and need to have special attention from the night staff. Give this list to the poor soul who is on-call that evening - it'll help them out tremendously if they are asked to review one of your patients at night.

(Other survival tips: #1)

Monday, March 16, 2009

Plans for the woman in her late twenties.

This week I plan to:

1. Get a haircut.

And I want it short. SHORT SHORT SHORT. Short and flippy.

2. Start a proper skincare regime

I have let my skincare regime slide since pregnancy. This is not a good thing. I keep forgetting that I'm not 18 years old anymore and I no longer have that teen-skin that never crinkles from lack of sleep. I should probably invest in a good eye-cream. Any suggestions?

3. Attempt to lose some weight.

I have been one of those fortunate girls who never seems put on weight despite a sedentary fish-and-chips lifestyle. This is why half of my wardrobe dates back to my early teens.

I put on an extra 3-4 kg during my pregnancy and I haven't been able to shift it (probably because I'm not 18 anymore and I can't eat myself slim like I used to). 3kg may not seem like much, but I am a person of very little height so the extra pudge is rather obvious.

I suppose I should try and workout at home but I lack incentive. Perhaps I can borrow some postnatal exercise videos from the library. It's worth a try.

4. Reinvent my wardrobe.

Like I said, half my wardrobe dates back to my early teens. This is no longer acceptable.

Since I spent most of my adult life in the UK, my grownup wardrobe is all about layering in various fuzzy textures which are totally unsuitable for Singapore weather. The only additions I have made to my woefully sparse summer stylings are a couple of maternity blouses and loose fitting cotton Tees.

If I don't do something quick about my clothes, my mother will take it upon herself to pad up my closet. Don't get me wrong - Mum has a great sense of style. However, she does occasionally have eccentric moments of colour blindness which coincide with memory lapses in which she thinks I'm 10 years old again. Just last week, I caught her fingering a batik racerback dress with bilious green turtles swimming in an electric violet sea. She didn't say anything, but she had that glint in her eye. I have to get a move on, or I'm going to end up looking like a Purple Rain blacklight poster.

5. Think about using makeup

As I keep telling myself, I'm no longer 18 and it's starting to show and I don't like it at all, NOT ONE BIT. I have very little experience with warpaint - except stage makeup - so when I do wear it, I tend to look like I'm taking part in a wayang. I don't really know where to start, though, but I promised myself that I would take some pride in my appearance and not slowly morph into a crumpled-pink-plastic-bag market auntie.

Sunday, March 15, 2009

Movie night

To eat: Spaghetti bolognese with cheese and more cheese

To drink: Appletiser

Today's screening:
Hellboy
Hellboy II

Ensuing thoughts:

TSCD: Hey, the Hellboy guy! Who is he?
MDH: He's the actor, um, that actor who has a head like a marrow.
TSCD: He was in that movie where he was a rat-eater.
MDH: Yes, the Sean Connery one.
TSCD: Oh, he must be so glad that he can stand up straight for once, use his real voice and act like a normal person.
MDH: Oh yes, he doesn't look at all like a weirdo here.
...

TSCD: Where have I seen that girl before?
MDH: She was in that movie that you liked, you know, with the pink lawyer.

Friday, March 13, 2009

The sunshine of your smile

During those early days, I was fraught with guilt over my indifference...but that was before I knew that the strength of my anxiety for your well-being was a measure of the depth of love I felt for you.
Weeks later, you looked me in the eye and smiled. When I saw your big gummy grin blooming on your face, when your little dimple made its first lopsided appearance, I recognised you, finally. A flash of memory briefly flickered in my mind, and I remembered that I had seen your sunflower smile many, many times in wispy cobweb dreams that I rubbed out of my eyes in the morning.
I have known you and loved you for a very long time. I have walked a long way to see the sunshine of your smile.
And now, you are here.

Thursday, March 12, 2009

Survival Tips for House Officers #1 : Handover

It's pretty scary, the first day of work, when you step into the hospital wearing your 'Doctor' tags, wielding your stethescope like a talisman. There's an awful pressure on your chest which is later identified as the Fear Of Screwing Up.

There are a few things you can do to try and mitigate the stress of the first week. The most important thing is to get a good handover from the house officer who is leaving.

If possible, try to visit your future workplace the day or week before you actually start working there. Get in touch with the house officer and get him or her to show you around. If you can't do that, at least call them and have a chat with them over the phone.

Here are the top five most important questions you must ask during your handover:

1. Where do you keep the patient list and how do you update it?

If you are fortunate enough, the houseofficer will have kept an up-to-date list of all the patients under the care of the consultant's team. The list is your lifeline- it will have important information stored in it, such as a brief summary of the patient's problems, a list of significant results and pending investigations, as well as a few notes on the care plan. It also doubles as a shield (just hold it up and pretend to scribble on it).

In order to respect patient confidentiality, most houseofficers will not only limit access to the list, but will also use a personal shorthand in compiling it - so it's useful to find out the relevant passwords and ciphers from them. This will save you from having to decipher the hieroglyphics of the patient case notes which can take HOURS.

2. When are the consultant ward rounds?

Not every consultant shows up for ward rounds every day at 8:30am, but all consultants will have a favourite time and day for showing up on the wards. Some consultants will arrive after clinic or before clinic. Some will insist that you turn up for the 7am post-call rounds even if you weren't on call that day. Some will expect you to attend breakfast meetings before the ward round. There will also be the evil consultant who will pop by at 5:05pm, just to check on your progress.

Finding out about how and when the consultant conducts ward rounds will give you an idea of what kind of person your consultant is. Is he a control freak? Is she too busy to give a care about the small stuff? Is he highly flexible? Is she so relaxed that she's almost asleep? The more you know about your consultant, the easier you will find it to adapt to your environment. I will write more about managing your consultant in another post.

3. Does the consultant have a pet care-plan for his patients?

All consultants, especially the ones who are working in very specialised fields, will have developed their own tried-and-tested methods of patient care. They will like to know that certain investigations are done, they prefer to use a particular cocktail of treatments and medications and they have good relationships with certain allied health professionals.

Some of their methods of treatment may not be as up to date as you would like...however, as a house officer, your job is to pre-empt the consultant's wishes and follow instructions, not to be a smarty-pants newbie and assume that you know better than someone who has had at least 10 years more experience than you and is clever enough to have passed all his post-graduate exams. If you want to change the way things are run and patients are managed, then do your job well, study hard and pass your exams. The best a houseofficer can do is make sure patient care is delivered efficiently and with finesse.

4. What are your consultant's pet peeves?

There are some things that are guaranteed to make your consultant grumpy. It is your job to avoid making gaffes. Angry senior doctors = grouchy nurses = sad, sad patients = It Is All Your Fault.

5. Where do you keep all your essential equipment?

It's useful to know where the crash trolley is, but it is even more useful to know where the equipment is kept for doing minor ward procedures. You won't end up running around the ward, wringing your hands and looking like a fool as you ineffectually try to find a nurse who knows where everything is, whilst your patients watch you from their beds with disgust (or amusement).

Of course, the most essential piece of equipment is the hot water dispenser. There is nothing like a robust cup of tea for rallying the forces, especially at 6:45pm on a very Long Day!

Wednesday, March 11, 2009

Disclaimer

MDH would like me to state that he does not only bond with Stardust over the Playstation 2. Here are a few of the other ways he bonds with Stardust:
1. Going swimming together
2. Chasing him around the dining table
3. Reading him 'Goodnight Moon' over and over and over and over and over
4. Putting him to bed at night
5. Feeding him dinner
6. Cuddles before naptime
7. Changing his nappy
8. Splashing during bathtime
9. Piggyback rides
10. Playing the 'stick your fingers into Daddy's nose' game

Tuesday, March 10, 2009

Boys and their toys

This is what happens when you ask Daddy to watch the baby for five minutes. The two of them start bonding over a game of 'Burnout Revenge'.

Seriously. I was hoping he wouldn't grow up to be a video game junkie.

Well, it isn't my fault if he starts fighting with Daddy for control of the Playstation!

Monday, March 09, 2009

Thoughts on Confinement #4: Foods

In my previous posts (part 1, 2, 3), I mentioned the fact that there are strict rules regarding what the new mother is allowed to eat or drink during her month of confinement. These rules are sometimes so specific and complicated, that families will often hire a confinement nanny who is also the chef of the month, or order meals from a specialised catering company. Some people really enjoy the confinement foods - but it can be tiresome for the mother after a while.

One of the big complaints about confinement is that mums are not allowed to drink plain water or soft drinks. Personally, I don't see a problem with this. Why replace fluids with that which has poor calorific or nutritional value? Even sick people in hospital receive salt or sugar water through a drip - pure distilled water is not recommended. It makes much more sense for fluid replacement to come in the form of nourishing soups and teas, especially during the early days of confinement, when the mother (especially those who had a longer fasting period due to prolonged labour) may still be too weak to eat and digest solid food.

Tea made with red dates appears to be the preferred postnatal drink of choice. Red dates are very sugary and loaded with iron, making it a very energising drink. It is unsurprising that these iron-rich red dates appear to be added to most confinement dishes.

In general, confinement foods tend to have a high content of iron, protein and calcium which are all essential for replenishing and rejuvenating the body during this time of recovery. Iron, which is required for the manufacture of red blood cells, is especially necessary during the postnatal period as mothers tend to bleed heavily during labour and in the days afterwards. Protein, of course, is necessary for rebuilding the body. Calcium replacement is also very important as the calcium used to grow the infant skeleton and in milk-production is actually leached from the bones of the mother.

Pork knuckles stewed in black rice vinegar is one very popular confinement dish. The knuckle or trotter portion is chosen for its lean, tender meat, proteinaceous gelatin and marrow-filled chunky bones. The acidic vinegar dissolves the calcium in the bones, making the stew a fantastic source of calcium - very important as dairy products such as milk and cheese are hardly ever used in Chinese cooking.

It is really very important for new mothers to eat well and make sure they are well hydrated - especially those who have chosen to breastfeed. Everything that is eaten by the mother is certainly transmuted into the breastmilk - even the taste of the breastmilk is affected - so it is useful to keep a food diary as well as observations on the changes (both physical and behavioural) in the newborn.

Friday, March 06, 2009

Glorious food

It is so much fun teaching Stardust how to enjoy his meals. Stardust eats well and is quite adventurous - happily eating foods in a wide variety of flavours, colours and textures. He approaches new foods rather apprehensively, but I am pleased that he at least gives everything a taste. If he rejects the new food outright, I usually take it away and try re-introducing it a week or so later.
Not all babies are ready for solid foods at 6 months, which is the recommended age to begin weaning. Stardust certainly was not ready for solids but I was in a hurry to get him weaned at the time, which meant that mealtimes during the first few weeks were rather a struggle.
Limited mealtimes are a big help in maintaining my sanity. If Stardust is refusing food or eating reluctantly, I will end his mealtime after 45 minutes and just assume that he's full. I know some very patient and longsuffering parents spend an hour or more trying to coax their baby to eat. However, I personally feel that it is not worth the stress just to force another 2-3 teaspoons worth of food into a protesting baby who is just plain tired of sitting still.
One another thing I refuse to do at mealtimes is try to entertain or distract Stardust so that he sits still long enough to eat. At most, I'll sing or talk whilst feeding him but I will not prance around with the spoon pretending it's an aeroplane. He isn't allowed any toys either - the only object he holds in his hand during mealtimes is a damp cloth for wiping spills.
Once we got over the initial difficulty of weaning, everything just fell into place. I love how his face just lit up today when I brought out a steaming bowl of stewed pumpkin, golden and smelling of sunshine. And how his eyes grew big and round when he had his first bite of it.
Mama's little baby loves pumpkin, pumpkin
Bebop-a-lula, pumpkin pie!

Thursday, March 05, 2009

Thoughts on Confinement #3 : The rules

One of the biggest complaints that women have with the practice of postnatal confinement are to do with the rigidity of the manifold rules which they are forced to abide. Staying indoors for the whole month with a tiny squalling infant and a gaggle of clucking grandmamas, will often induce claustrophobia in an independant woman - not to mention having to endure the constant nagging on what to eat, drink, wear and do.

Most of these rules are centred around the concept of keeping the body of the new mummy as warm as possible. Traditional Chinese medicine symptomology is often described using the balance of body humours which are identified as 'cold' or 'hot'. During pregnancy, the woman retains 'heat' in her body, which is apparantly lost at an appalling rate during the postpartum period.

In truth, pregnancy is indeed a high energy state. During the 1st and 2nd trimester, a pregnant lady goes through a number of physiological and physical changes that are necessary to provide for the baby growing within her. The volume of circulating blood increases dramatically by nearly 50% by the end of the 3rd trimester, and even the size of the red blood cells increases by a third. The blood vessels within the body dilate to allow better circulation and heart starts working much harder leading to a rise in blood pressure. The speed of metabolism increases phenomenally, as the body tries to store up fat, protein and water.

After delivery, the new mum starts to shed all the previously stored up energy. In the first 24 hours, she rapidly loses body heat through bleeding (as remaining uterine contents are expelled from her body as lochia) and a raised core body temperature. Furthermore, not only does her body have to repair itself to its prepregnancy state, but also manufacture colostrum and milk to nourish the infant. These energy losses account for the so-called 'cooling' of the body.

Thus, the goal of keeping the mother's body 'hot' during confinement is in order to add or conserve as much energy as possible, so that more of it is directed towards healing and milk-production instead of regulation of body temperature.

As jadeite pointed out in the comments section of my previous post, one of these rules in postnatal confinement includes not bathing (or, in some cases, washing hair). A rather nasty thought, especially in our sweaty Singapore climate. I am personally unable to lead a bath-free existence, which is why I hardly ever go camping.

I suppose this rule sprang into existence because of the lack of hot water storage systems in Asia-that-was. A nice splashabout in icy water is a quick way to lose body heat and thereafter, lose energy via shivering. It is also a sure-fire way to reduce milk-production - indeed, cold compresses are used in the treatment of breast engorgement from overzealous lactation.

Additionally, a shower will wash away the natural oils and the traces of milk that scent a mother's skin. The newborn infant has rather poor eyesight - so the identification of people is dependant on senses of smell and hearing. This is why a crying infant will often be calmed by the sound of a mother's voice or heartbeat. Some mums even find that placing an item of clothing (such as a breastpad) in the cot will create a familiar environment for their little sleeper.

During my pregnancy, I discussed the rules of confinement with my mum who would be looking after me during that time. I think this really helped me to establish the boundaries of what I would or would not be able to tolerate during confinement, which led to a less stressful situation all round. I would recommend that all women do the same with their respective confinement caregivers! Less stress = happy mummy = happy baby!

(Thoughts on Confinement series: Part 1, Part 2)

Wednesday, March 04, 2009

Thoughts on Confinement #2 : Postnatal Depression

Postnatal depression is a fairly common occurrance - about 1 in 10 women will suffer from depression after having a baby. The symptoms of this are terribly insiduous, and can be mistaken for 'baby blues', which about half of new mothers will experience.

The stress of this new position of responsibility often kicks in three or four days after the initial excitement of motherhood fades away. A new mum will naturally feel tired, weepy and anxious for a few days until she starts to figure out how to manage herself and the baby. In postnatal depression, however, these feelings persist and become more negative. A depressed mother can feel wretchedly guilty and is convinced of her inability to cope or she may be unable to enjoy being with the baby and be incredibly panicky about the baby's well-being.

It has been noted that postnatal depression occurs most commonly within the first month after giving birth and is especially prevalent amongst women who have poor social support or have a stressful home environment. I have noticed that many mothers in the UK live quite far from their parents or in-laws and often do not have any help managing the baby. When their husbands head back to work, they often have to manage their usual household chores alongside caring for their new baby whilst dealing with being sleep deprived. Imagine if they have other children or elderly family members to look after, or if they are entirely new to motherhood and have nobody to turn to for advice and support - what a lonely and exhausting situation to be in.

It is no coincedence that the practice of confinement takes place during this critical postnatal period. Having an experienced relative or a confinement lady to help with the baby is a really positive experience. One can draw on the wisdom of an experienced person in looking after the baby, and free oneself of the burden of running the household. One is also cared for, nourished, and has more time to rest. The new mother only needs to think of looking after herself and bonding with her baby.

Additionally, it is nice to have another adult around the house to lend a hand and a listening ear. There is nothing like a reassuring word, or even a hug, to soothe the anxious soul.

It is such a gentle way of easing oneself into motherhood.

(Read my other thoughts on confinement here)
(Where to find support on postnatal depression: information, UK support, Singapore support)

Tuesday, March 03, 2009

Trash Ties

Check out this wicked hairdo featuring 'Trash Ties' which have got to be the most cool hair-thingies ever!
The picture on the left is of Heather Bailey's little girl who asked her mum to make 'a hairdo nobody has ever seen before'. That has got to be one trendy little miss!
Heather even includes a step-by-step how to on her blog...but what really impressed me is that the fabric of the ties seem to grip hair really well without damaging or pulling, like plastic lackybands. I have been looking for something like this for ages - the problem with my hair is that conventional hairties and scrunchies slip off too easily, so I end up looking like a frazzled hausfrau with a disintegrating head-broomstick.
I wonder if she ships to Singapore.

Monday, March 02, 2009

I Spy #2

Top to bottom:
A koala in the city
Walking along the beach on a windy day
Admiring the scenery
Meet-and-greet with the locals

Sunday, March 01, 2009

Fleurette

I am a really big fan of Etsy - the idea of industrious hands working away to produce something lovely and loved really appeals to me. I often browse through the different shops, admiring all the creativity and thoughtfulness that goes into each product.

These lovely poppies are freshly picked from Fleurette - a little etsy flower shop set up by a young mummy called Jo (the pictures of her daughter on her blog are really precious). You can tell that she has put in some effort choosing her materials - and I especially enjoy reading the descriptions she has written about each item. If I was looking for romantic wedding hairpieces, I would have most definitely asked her to make up something sweet and pretty for me.

Best of all, she's a local girl from the little red dot, which means that all her fleurs are homegrown. Buy local and buy indie, that's what I say! I am looking forward to seeing what other posies springs from her creative mind.

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