Health News: Breastfeeding, Formula and Jaundice

RJ and I had breastfeeding problems after she was born. Then she developed jaundice which extended our hospital stay. When she was around 4 days old, the jaundice was bad enough to require medical intervention — phototherapy.

This is what RJ’s phototherapy looked like, except she had a blindfold on too

I cried. I felt that it was my fault for not suggesting that she be fed formula while we worked out our breastfeeding problems. None of the medical staff at the hospital suggested formula to me (although they bent over backwards to send in lactation consultants). A family friend (who works as a nurse in the Children’s Emergency department) had suggested that I feed the baby formula and pump like crazy until my milk came in, but after I gave birth I told the nurse that I intended to breastfeed (and she wrote it on the whiteboard in my room) and from that point on, the word ”formula” became taboo. I was too dazed and sleep-deprived for the first few days to do what, in retrospect, I should have done. Finally, after watching RJ starve for a couple of days, I surreptitiously rang the bell for the nurse at 3am and begged her to help me give some formula to RJ. I felt like a failure.

In reality, that was probably the moment that I found my mommy-voice and put some faith in my parenting intuition. But enough of the touchy-feely personal anecdote, let’s get to the research.

Jaundice is a common health concern in newborns: up to 80% of full-term babies will have some jaundice (Maisels, 2015). It can, however, cause brain damage if left untreated. According to a medical review in the March 17, 2015 issue of the Canadian Medical Association Journal, Canada has the highest rate of brain damage due to complications for newborn jaundice in the developed world (Maisels, 2015).

Phototherapy is not the last resort against brain damage caused by hyperbillirubinemia (the build-up of the bio-molecule that causes jaundice). Phototherapy is used to prevent the need for a blood exchange transfusion, which is a more serious intervention. This article, however, argues that we may be overusing phototherapy: for every 3000 infants who receive phototherapy, only one infant is prevented from requiring a blood transfusion (Maisels, 2015). This is no small matter, as DNA damage is a potential side-effect of phototherapy.

And this is where the article gets quotable. The author suggests that rather than jumping to phototherapy to treat jaundice…

we should consider other options, such as improved lactation support or formula supplementation. This latter option, although opposed by some, deserves serious consideration when one considers the alternative and cost of hospital admission and phototherapy to a blindfolded infant, an intervention that interferes with parent-infant bonding, interrupts breastfeeding, and is, at the very least, disturbing for the parents (Maisels 2015, p. 342)

The author then goes on to describe a couple of studies that have shown formula supplementation to be an effective treatment for jaundice. One study showed that substituting formula for breast milk for two days was as effective at treating jaundice as phototherapy (Maisels, 2015).

I know which one I’d choose.

Source: Maisels, M.J. (2015). Managing the jaundiced newborn: a persistent challenge. CMAJ 187(5), 335-342. 

Baby Shower Gifts

A friend of mine needs to buy a baby shower gift so I thought this would be a good opportunity to compile a list of suggested gifts. My first suggestion is to ask the mom-to-be if she is registered somewhere. If she is, just buy something from the registry. If she isn’t, here are some ideas, based on things I own and like or wish I own.

1. A Wubbanub, as I have previously mentioned

2. Books: your favourite children’s book, or books with high-contrast graphics (or in black and white).

3. A rattle: I like these ones from IKEA. They are RJ-approved. They have a few skinny limbs for her to grab onto and also suck on.

4. Sophie the Giraffe is a classic, but please include a gift receipt if you get one, as they are a popular gift.

Sophie the Giraffe: A Classic

5. A random toy: I just bought RJ something along these lines from Walmart. It has everything a baby could want in a toy: an internal chime, crinkly wings, a teething thing to chew on, and a mirror. Bonus if you find a toy that can go in the washing machine.

6. Tommee Tippee Air Style Pacifiers and a soother clip. For whatever reason, these pacifiers stay in RJs mouth, whereas a normal pacifier doesn’t. Look for a soother clip with no metal parts (I’ve seen either plastic or silicone clips) because a metal alligator clip (which is really common) can really be hard on baby’s skin (I know this from experience).

7. A rear-facing carseat mirror (something along these lines): I should really just buy myself one of these. I imagine it would be super useful for when you are driving and the baby is crying (which is about 50% of the time and super distracting, I might add) so you can see if they are crying because something is covering their face (e.g. a hat or toy) or just because they are a baby.

8. Baby hygiene products: I really like the Earth Mama Angel Baby line of products. It has a good price point considering the quality of the ingredients (and lack of weird chemicals). I’ve used their baby lotion, mama lotion for stretch marks, and diaper balm.

9. Baby clothes: this should be a post unto itself.

The perfect 24/7 outfit for the first 6 months of baby’s life

0-6 month clothing: PLEASE don’t buy a new mom outfits that require socks. It’s way too much hassle. Maybe if it’s a spring/summer baby they just have bare feet? Babies have pretty bad circulation though. I’m a fan of cotton footed pyjamas with zippers instead of snaps. Especially if they have pretend shoe appliqués. Then it’s like a daytime, going out outfit. And try not to buy anything that needs to be pulled over baby’s head. This is unpleasant for everyone involved.

6 months and beyond: by this age, a parent is probably less overwhelmed with the effort of looking after a baby. This is the stage where I’ve started to be willing to pull things over RJs head and put tiny socks and her for the sake of UNBELIEVABLE CUTENESS. So if you can’t resist buying adorable and less practical outfits, buy them in larger sizes and remember to think of what season it will be when the baby fits into those clothes (RJ fit 6 month clothes at 4 months which I think is not uncommon).

10. A BabyHawk Carrier: These work well with a newborn or older baby. I was at a baby wearing meet up the other day and there was only one man present. He said that this is the one carrier he uses (his wife has multiple types). My husband also uses this carrier. It’s user-friendly and popular with men and women.

Final bonus gift suggestion… a gift certificate for massage (search around to find a RMT who has specialized training in pre- and postnatal massage).

Book Review: Parenting Without Borders

Another book in the cross-cultural parenting practices genre. This was my least favourite one. In any parenting book there is always an agenda: how will reading this book make you a better parent?

In Bringing up Bébé, the message I took from it was that complete self-sacrifice for the sake of your child is unhealthy for both you and the child.

When I read How Eskimos Keep Their Babies Warm, it started to dawn on me that some of the difficulties and frustrations I have with parenting are not inherent to the process of raising children, but are very much a part of the way my culture deals with raising children. In a way it is both hopeful and depressing because there are many societal influences on raising children that are beyond our control.

Parenting Without Borders seemed to focus a lot of using scientific studies to confirm that other specific parenting practices around the world are superior to those that are used in America. “Superior in what way?” You might ask yourself. Well, the book jacket tells us that this book will offer “research-based insight into which strategies can help us improve our own children’s chances.” By this I think is meant their chances at doing well in the global marketplace.

And this is the point at which every parent should stop and ask themselves: what is my goal in parenting? Do I believe that society is so competitive that I need to focus on doing everything I can to boost my child’s IQ? Or do I believe that (HERE COMES MY CHRISTIAN BIAS) God will provide and the goal of parenting is to encourage my child’s appreciation of life and their integration into the family unit in a happy and harmonious way that doesn’t necessarily prioritize them above the other thinking/feeling members of the family? (Okay we do prioritize RJ above the cat though).

Christine Gross-Loh focuses a lot on Japan in this book because she has spent time living there. She also talks about a few other countries. Unlike in How Eskimos Keep Their Babies Warm, she provides very little detail about how the concepts in this book have affected her own parenting. The result is a book that replaces that personal memoir quality with descriptions of scientific studies, making it drier and less relatable than Eskimos.

Overall though, this book did have some interesting information in it. One stand-out part for me was its discussion of education in Finland. By international measurements, Finnish students perform much better than American students. They also have shorter schooldays, no homework or grades until grade 11, more recess and teachers all have Master’s degrees and more autonomy over the classroom curriculum.

Although I find the attitude of emulating other cultures so we can be more “successful” a bit suspect, I read this book cover to cover. Would I recommend it to a friend? If you’ve already read Bringing up Bébé and How Eskimos Keep Their Babies Warm and are still craving something in this genre, then yes, I would. But it’s not as good.

Book Review: How Eskimos Keep Their Babies Warm

Before I bought this book, I read some of its negative reviews on Amazon. I particularly enjoyed the review titled “Not worth the money if you actually want to learn something”. This reviewer informed me that this book is “laid out as part memoir part light (very light) cultural anthropology.”

Very light cultural anthropology was exactly what I was in the market for, so I ordered the book and I was not disappointed. It was an enjoyable read. It did not contain a bunch of concrete parenting tips (perhaps what the Amazon critic was looking for) but it was pleasant armchair travel and helpful for me to get more of a sense that some of my difficulties with North American-style parenting are not necessarily because I’m a failure, but perhaps because different cultures have different strengths (and weaknesses!) that we can learn from in order to make this whole parenting thing a little more… fun? Smooth? Survivable?

I appreciated that Mei-Ling Hopgood talked about experimenting on her own child with some of these parenting practices, especially hearing about the times when it didn’t go well. Not that I took pleasure in hearing about her struggle, but rather it just made the book very relatable for me.

I would recommend this book to a friend.

Book Review: Bringing up Bébé

Vive la France, a nation of formula-feeding, makeup-wearing, relaxed mommies who sleep through the night, according to Pamela Druckerman, an American expat living in Paris. This book was recommended to me by a mommy friend and it might be the best parenting book I’ve ever read. I got this from the library at the same time I got a book about attachment parenting. Let’s just say I did not finish reading the attachment parenting book, but I devoured this one which is both informative and entertaining.

One of the most striking things about French parenting (the way it is described by Druckerman) is its emphasis on pleasure. At one point in the book when Druckerman consults Pierre Bitoun, a French Pediatrician and breast-feeding advocate, to find out more about his work promoting breast-feeding in a country with high rates of formula feeding, he tells her that

“he’s found that French mothers aren’t generally won over by the health arguments involving IQ points and secretory IgA. What does persuade them to nurse, he says, is the claim that both they and the baby will enjoy it.”

(Druckerman also mentions, by the way, that “even though French children consume enormous amounts of formula, they beat American kids on nearly all measures of health.”)

Reading Bringing up Bébé opened my eyes to how a lot of our North American parenting practices are not the only way to parent. Looking at our extreme self-sacrificing parenting methods through the lens of another culture gave me some much-needed perspective (because the other book I was reading on attachment parenting absolutely terrified me).

This book made some excellent points about finding balance in one’s life as a parent, prioritizing one’s relationship with their spouse and their own personhood. I greatly admire the idea that rather than focusing on RJ’s IQ or her acquisition of skills that will give her a competitive edge in society, we might focus on enjoying life together as a family, cherishing small pleasures and allowing ourselves to live fully in this time without trying to rush her through milestones.