Confinement Lady II Review

Her background in brief:

• Malaysian, born in 1956 in KL, now stays in Pontian
• Has 4 children 
• Dialect: Foo-chow (Fu-zhou) but converse mostly in Cantonese and Mandarin
• Has vast experience in taking care of babies; speciality: taking care of twins 
• Good cook, used to help out dad in hawker stall
• had prior training in Mount Alvernia Hospital
• was working in an agency for 9 years prior to freelancing after getting more word of mouth services

=)

• understands benefits and woes of breastfeeding; able to massage to relieve engorgement ( she managed to squeeze as much milk out from my breast as the other using my Avent single electric breast pump within the same time frame, haa...)
• understands the frustration as a mother during confinement - sweating, breastfeeding, etc
• Excellent cook - knows all types confinement food and can mix and match ingredients well, cook according to your taste - not too salty or sweet; I got so sick of soup noodles for breakfast that she tried to change types of noodles and do her style of "rotti chennai" for me. 
• clean up the kitchen properly - mop the kitchen after cooking 
• sweep and mop the floor on alternate days 
• able to soothe the baby from crying; understand baby's temperament fast  
• did not take afternoon nap (actually I am quite ok with her taking short naps in afternoon but since she did not, I leave it to her); watch tv for 1-2 hours at night and then sleep around 11:00 pm (sometimes even earlier depending on situation) after the night feed
• prepare food at night for tomorrow (where necessary if she thinks she needs more preparation)
• takes initiative - refill water for washing hands, drinking (even refill with hot water if she deems too cold for usage in the morning); clear rubbish bins for toilets and kitchen everyday
• made small cotton balls from the big roll while watching tv to help save costs buying packets of ready-made ones
• hand wash baby (definite) and mummy (if small amount and the washing machine is not full) clothings 
• clean and tidy up the whole kitchen thoroughly the night before she left

=(

• very chatty - will yak non-stop sometimes about her past confinement experiences, her family etc...(lol, but at least I got my mum to entertain her; being someone who needs more personal spaces than others, I really suck at small talk when I am not in the mood, especially during sweaty confinement period, not to mention breast engorgement sometimes.) 
• feel that she can be quite manipulative and shamelessly proud of her capability sometimes.
• Doesn't look as pleasant as the previous - but I am ok, no point having someone who looks nice but  can't deliver up to your expectations. sometimes we just can't get best of both worlds.
• slack slightly towards the last week (sigh, being human beings ... I can't expect full 100%) 
• take my part time helper for granted and get her to help even when she can do herself
• not sure if she drank some of my vsop as she poured one cup to boil with chicken and herbs but the amount looks lesser than before. I asked casually why it was so little, she answered in an offended tone that the alcohol will evaporate and she can't drink since it will be extremely heaty for her. However, she complained to my mum that she was having ulcers the next few days. Big question mark here. 

Last day of confinement, it's time to slog again......

So here I go again: Daily Routine

Zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

Happy First Month yr !

yr lazing & stretching on the cl's lap:
hey mum, don't I look cute in this new outfit?

We didn't hold a 1st month bash cos we were all so tired and hub was down with Dengue. So we only had a mini immediate family gathering at my mil's place and my mil did the praying ceremony for yr to mark his first month. 

yr, please don't blame us ok, I know we did one for sister but we will make up to you with a big one ok? 

Roller Coaster Week

It has been a roller coaster ride for me for the past week:

• yr's bottom is still red despite applying creams prescribed by the PD. He is using Neoderm and Desitin cream (the blue packaging, and then followed by the strongest - purple packaging but still remain reddish) My gal uses Drapolene cream and is completely fine with it. It was suggested by the cl that it's better to use the cloth diapers. Imagine we have to change his cloth diapers every time he peed and pooed. Of course now the cl changes but once she leaves, either I have to be the super woman or use disposable diapers and kept throwing them with every slight tinge of poo in it as yr's bottom is very sensitive. 
• yr's jaundice level has stabilised but is still around the mid range level. doc said is ok, just needs to go for another check next week. I am still feeling uncomfortable with this. 
• hub was down with Dengue and when he was on his way to recovery, he was hit by severe rashes (don't know what kind of rash- just big patches and super itchy and the cause). Went down to Mt Alvernia A&E in the middle of the night and was given a jab. Puke shortly after the jab. 
• got chided by hub even for the slightest thing and I can't speak to him unless really necessary. Guess both of us are just stressed.
• yr's appetite increases - gotta breast feed him longer and I just feel so worn out just by breast feeding him.
• feels yx is not too attached to me anymore after staying in my mil place since my delivery, kindda depressing but i know this is just a passing phase. She is ok with her little bro but still display some jealously when we fuss over him when he cries. 

Crazy. I need some "me" time. Perhaps I should consider bottle feed (with my breast milk) instead of latching on. 

..........................

Jaundice Results

Level as at 4 June 2013: 11.60 =(

Doc advise us to alternate breast milk with powder.

Sigh. My girl didn't latch on well due to my csect wound (and partially my fault - due to my incompetence in getting her latch on) and this time, with experience, my boy is latching on well and enjoys breast milk BUT now I have to alternate with milk powder due to jaundice. What an irony.

Now my boy looks a little chao da (due to the daily "sun-tanning") which makes me even more frustrated!! >.<

yr down with jaundice =(

1. 20 May: 8.2 - initial test result
2. 22 May: 6.5 - after phototherapy
3. 27 May: 17.4 - admitted immediately to hospital for 2 days  (phototherapy + on ebm and similac formula alternatively)
4. 28 May: 9.9 - not low enough to be discharged
5. 29 May: 9.2 - discharged but need to do another test next week

I reckon it's daddy's blood group (O+) that is causing this base on the following observations:

• yx's blood group which is the same as mine (A+) did not have jaundice, neither did myself nor my bro who is also in the same blood group.
• My elder niece who has the same blood group as her dad (ie. my hub's bro) also suffered the same.

Then again, the above observations does not fit into the "Risk Factors for Pathologic Jaundice"

Doc suspect is "breast milk jaundice" since:

• he is on total breastfeeding 
• he is not a pre-term baby 

There is a third type of jaundice called late-onset, or breastmilk jaundice. This type of jaundice shows up during the second week of life, and peaks around the tenth day or later. It affects a very small percentage of infants (between 2% and 3%, depending on how you define ” jaundiced” – usually a level of 5-10mg/dl). The bilirubin count can remain elevated for weeks or even months, but will eventually level out at adult levels of 1mg/dl. The diagnosis is usually made in a healthy, thriving infant, and only after all the pathologic causes of jaundice have been ruled out. Often, this type of jaundice runs in families, and breastfed siblings are likely to be jaundiced as well. No one is sure why this type of jaundice occurs, but there seems to be something in some mother’s milk that increases the reabsorption of bilirubin, or decreases the liver processing of bilirubin. When the baby is temporarily given formula, either as a substitute for, or along with mother’s milk, the levels drop quickly, rising again as the baby returns to total breastfeeding. Even though we are not sure of the cause, what is important to remember in cases of late-onset jaundice is that the baby is not harmed in any way by continued breastfeeding. There has never been a case of kernicterus associated with this type of jaundice, or any detrimental after effects. Because we know the well-documented benefits of breastfeeding, the baby should not be denied the advantages of human milk, given the fact that the slightly elevated bilirubin levels will soon return to normal levels without any intervention. Once pathologic causes are ruled out, nursing should continue. Sometimes babies are taken off the breast for 24-48 hours just to make the diagnosis of breast-milk jaundice, though this is seldom necessary. If your health care provider wants to go this route, and the levels drop significantly, then breastfeeding should be resumed.- Source: link

So my guess is somehow right - perhaps due to the blood that runs in my hub's family, the blood is resisting some substance in the breastmilk that prevents bilirubin from breaking down. 

Ok, anything bad = dad's the cause; anything good = mum's the hero! =D

What we are doing now to reduce jaundice level:

1. Doc's instructions - sun baby 9am and 5pm daily, 10 mins per session (to cover baby's eyes with handkerchief or the special eye band from hospital)
2. Traditional method (by confinement lady and mil) - bathe baby with ng kee ( available in medicated halls) twice a day

Hopefully everything goes well. I can't wait for next Tuesday to know the jaundice level. Confinement lady said he looks better now, but I need some proof from the doc. urgh. 

Medela Freestyle Breast Pump vs Avent Single Electrical Breast Pump

Thanks to Stella who lend me her Medela Freestyle Pump, I managed to pump out milk within 15 mins from both of my breasts.

The accessories looked kindda intimidating at first:

Fortunately, the confinement lady is experienced enough (she said she has come across so many pumps that she is now quite used to handling them) to know how to assemble and then taught me how to use it, else I have to go through the instructions manual which is quite tiring for me at this stage.

My verdict for now:

Criteria	Medela Freestyle	Avent Single Pump
1. Pressure	Pressure (Vacuum increase) = L5 Breast Shield: medium - 24 mm* Feels not as strong but after 15 mins, my breasts (even my left side which always feels more engorged than the right as baby prefer the right) feels more soft and supple. Can't feel any block ducts around the breasts.	Pressure: Can't control - as per default stronger than Medela but still feel some block ducts around the breasts.
2. Motor Sound	soft drumming	loud rumbling
3. Features*	On/off (std by mode) button Vacuum increase Vacuum decrease Let-down button/timer reset button Memory button Timer display Stimulation phase indicator Expression phase indicator Memory "on" indicator  Battery status indicator AC power indicator	On/off button  handle for electronic memory on your pumping rhythm
4. Milk Yield	110 ml in 15 mins	120 ml in 15 mins (1 pump = approx 60 ml, assuming 2 pumps x2)
5. Ease of mobility*	didn't used straps - holding the bottles so doesn't really feel much mobility.	just single pump, the other hand is free.
6. Assemble Time	Slightly longer than Avent (but if used to it, should be quite fast)	more straightforward
7. Costs	More expensive SGD 530 (base on online purchase price)	SGD 179 - bought in Dec 2011 (after promotion, initially SGD 199 )

*Notes:
1. Pressure - breast shield - I would try large - 27 mm and see how's the result later.
3. Features - I prefer Avent's soft cushion funnel on the breasts but Medela funnel without the cushion is still acceptable. 
4. Milk Yield - for more accurate results, I would probably need to test on:

• on the same breast (at the moment I feel engorged), ie. Left breast using Medela and then the next pump period: Left breast using Avent and the same steps for Right breasts later. 

It seems that my areola still has some milk (after I "squeeze" gently) after 15 mins for Medela but for Avent my areola is slightly drier.

5. Ease of mobility - for both pumps I used the other hand to massage the sides while pumping; have to try with straps later to see how's the results. 

Smiley Baby

hey mum, I love to sleep on big bed. So nice and comfy.
So don't put me back in baby cot ok?

My birth story

18 May 2013, Saturday

1. 2:00 pm+: did exercises to try turn the baby naturally and speak to baby
2. 4:00 pm+: went to playground with hub and yx, having erratic contractions, sat on the bench while hub played with yx
3. 11:00 pm+: hungry, ate some porridge and on the way back to kitchen, I felt something watery down under and I realised I was bleeding. Mucous plug suspected to be out. 
4. 11:30 pm: went to sleep, whole night feeling slight cramps; did breathing exercises throughout the night

19 May 2013, Sunday

1. 2:00 pm: slight cramps, felt like pooing
2. 3:00 pm: hub went to playgroup with yx without me. 
3. 4:00 pm+ - 6:00 pm: felt like pooing again; pooed about 4-5 times in a day
4. 7:30 pm: Dinner - chicken rice
5. 8:20 pm: head to the hospital; mild contractions coming 8 mins apart
6. 9:00 pm: discussing with Dr Benjamin Tham, he was not too happy that I came in 1 day later after I had some bleeding but I told him that my contractions was not regular. Dr did a vaginal examination, I was told that:
• I had dilated 2.5 cm; could feel baby's toes near my cervix
• dangerous to try VBAC due to the transverse lie (see images below)
• Likelihood umbilical cord might be coming out first which is dangerous
• I shouldn't be too "foolhardy" (yes that's the word he used, but it's ok, I don't mind him being forthright) "to pursue a dream" that is beyond the circumstances. 
7. 9:30 pm:  decided to go for csect; Dr Lo Wai Kit, the anaesthetist suggested spinal block which is more straight forward than epidural
8. 9:45 pm: push to operating theatre
9. 10:05 pm: Spinal block given; shivering all over (side effects); could feel numbness slowly set in, surgery starts after confirmation from me that I couldn't feel any pain; used visualisation techniques to relax myself
10. 10:30 pm+: baby out; hub took pictures of me and baby 
11. 11:00 pm+: Surgery completed; wheeled to ward 

My baby was lying in this position (head on my left):

Taken from Google images search

but this would be a "better" transverse lie - less dangerous as the umbilical cord is not facing outwards but inwards:

Taken from Google images search

After surgery, Dr said that he had a hard time trying to get baby's head out first, thus I felt lots of tugging and pulling around my tummy. As expected, the umbilical cord was out and he has to shoved it in immediately. In the end, he tried getting baby's legs out and then quickly the head which explains baby was a little blue when he came out but regain colour gradually.

The next day, I asked Dr if ECV could have helped turned the transverse baby, and he replied "in retrospect, you have made a timely decision to go for csection. I wouldn't advise you otherwise given the circumstances. I can't forecast accurately but given the position and your dilation, it is fortunate that your waterbag did not break, else it could really have been a mad rush." 

After thoughts

I am really glad that both baby and myself are safe and healthy.

If only:

• I have done more exercises to try turn the baby naturally (but then again, I knew on Friday after seeing Dr Paul Tseng that the baby turn again from head down to transverse; and even if I have known earlier, it is also unknown that if the exercises would successfully turn the baby - but the thought of - at least "I did ALL I can" would reduce my guilt.)
• I see Dr Paul maybe 2 days earlier, actions would have been taken earlier - more exercises and make appointment with Dr FM Lai for 2nd opinion. (I am supposed to go see Dr Lai on Monday but just too bad....)
• I go for chiropractic therapy as advised by Eunice - another vbac mummy few months ago. (not 100% guaranteed but at least just try.)

Fortunately, I was mentally prepared for csect and also given the types of anaesthetic a thought so the experience was not as bad as before. Am I going for number 3? haha, it's almost definite that the answer is negative. I can't imagine having an unsuccessful vbac2. It's gonna be quite a toll on me I guess.

Well, if only, if only. Life's like that. There is nothing I can do now but just give my best to baby and my family. We love you yr. 

This is the way I slide ......

The following pix are taken on 18 May - the day before the "BIG DAY". I was having mild but erratic contractions and I just can't think of anything but to spend more time with my gal and to just concentrate on my breathing when the contractions come. 

My (unexpected) labour story will probably kick in later as I am just too exhausted now to type out anything decent and I don't wanna miss any detail. 

See how I slide ....

 

Whee ~ ~ ~here I come!!

I miss you my miss little sum seng. Be good at ah ma's place and mummy will play with you soon ok? Mummy & daddy still love you as much, we promise - even when we have your little bro.

Pig out @ Brauhaus Restaurant & Pub

Was too hungry to take any photo of the food ,
in the end, I snapped on the serviette.

Food was only so-so. Paulaner Bräuhaus at Millenia Walk taste so much better. I wonder if I would be critical when it comes to food after I give birth as it seems snakey junior has made me craved for good food - as in - really up to standards! I am not a foodie but it seems that my taste buds have changed. Damn, I guess I wouldn't even want to taste my own cooking if this high standards were to continue. =\

Confinement Lady II

I managed to confirm a confinement lady last year after I passed the 1st trimester. With the previous experience, I had a better idea of what to look out for. Fortunately, hub got a recommendation from a friend who had a very good experience with her confinement lady who took really good care of her twins (yes, twins!! I mean if she can handle twins, I don't see why can't she handle single baby) and also had good comments from her friends after she recommended the CL to them. It is also good to know that she has prior training with Mount Alvernia Hospital before freelancing on her own. So she understands the benefits of breastfeeding!

With that and 1 interview session, I confirmed her with $300 deposit.

I am quite pleased that she did a follow up call on 5 May to check on my delivery status and confirm my address to ensure that she got the details right. 

Hopefully everything goes well.