Baby-wearing

Before Luke was born, I hadn't given much thought to 'baby-wearing.' Naively I had no idea there was a quasi-religious movement concerned with using baby carriers. We bought a structured carrier and a pushchair (AKA stroller) and thought we would use either depending on convenience.

As we travelled and lived with Luke we discovered the ease of baby-wearing outside the home and bought a Maya wrap and most recently a Mei Tai. So here are my opinions of the carriers we have used so far - I have included the pushchair as I am all about practicality rather than philosophy. 

Pushchair (Graco Metrolite - HK$1500)

- pluses - lightweight, great shade hood, folds down small enough for car-boots etc.

- negatives - wheels already bent ??durability

- uses - long walks when baby very small - great for sleeping on the go

Maya-wrap (from La Leche League - HK$500)

- pluses - lightweight, versatile/adaptable to different ages/stages e.g. newborn - used cuddle/cradle carry and at 6 months - use hip carry, easy to breastfeed discretely

- negatives - definite learning curve and husband doesn't feel confident wearing

- uses - 1-2 hour walks, breastfeeding in public, airports

Structured Carrier (from Sweden - will edit to add the name when I can get into the baby's room without waking him - cost HK$1000)

- pluses - ease of use, most useful once Luke had head control - months 3-6, forward facing possible

- negatives - not great for our backs as Luke got heavier, much less comfortable than Maya-wrap

- uses - short trips e.g. supermarket 'pop-outs'

Mei-Tai (from China - actually has clips - only cost HK$59!) 

- pluses - husband will wear it, folds down to nothing

- negatives - only just bought it - will edit once we've more experience

- uses - we bought it for trip to Vietnam - we'll see how it goes

Second, third and fourth languages!

Just a quick one tonight 'cos I'm buggered! 

Gratuitous shot of flower market...

(Thanks ladies - dim sum, Fa Yuen street market then afternoon tea - hmmmm - 'French toast' which in HK is 'stuffed' with peanut butter and condensed milk!)

PLEASE take the opportunity to learn another language - even a few words. 

I have had the privilege of learning French, Mandarin and now Cantonese along with my native English. I am ashamed to say that my  Maori only extends to greetings and ceremonies. Speaking a few words has improved my experience in Tahiti, France, China, Hong Kong and Singapore; better service, easier travel and a more authentic 'experience' of the culture.

Case in point:-

Today at afternoon tea in Mong Kok (very busy part of Hong Kong with markets, a whole street of goldfish shops (amazing!!!) and a flower market) we struck a lovely waitress with minimal English. The menu was bilingual and we were all getting on famously with pointing and smiling. 

....and fish on Tung Choi Street

Hong Kong restaurants love 'sets' - combo deals. At this particular place, a coffee/tea cost HK$19 (US$2.50) and a 'set' HK$21. The waitress was shocked that two of our party would not want food for just HK$2 - surely you can always eat - and expressed as much in Cantonese. I laughed, translated and then explained in Cantonese that they weren't real Hong Kongers but I would have the 'French Toast' - 西多士(literally Western many soldiers/knights - sai do si - often Cantonese words for European concepts are transliterations rather than translations). The poor lady almost fell over when she heard me speak Cantonese - a pleasant surprise I hope! 

The farce regarding hot water to heat a baby's bottle was more French than the toast! Three attempts were needed before a vessel large enough for the bottle materialised!

Evidence Based Mothering

Some people just have a way with words - this one is for Ayesha - who has beautifully trained words dripping from every orifice!

EBM = evidence based medicine. So a potted summary for the 'lay-person' to make the rest of this post intelligible. 

The theory is, we, as doctors, should move from the hocus-pocus of dogma and towards medical practice defined by scientific method. The gold standard being randomised controlled trials preferably performed blinded with large populations. Where it is impractical or unethical to perform interventional trials; epidemiological observational studies are performed to identify 'best treatments' and risk-factors. 

In an interventional trial one treatment is compared with another e.g. two different kinds of chemotherapy for a defined cancer and outcome measures are assessed e.g. overall or disease-free survival.

There are two common ways to perform an observational study. 

1. Try to find the difference in outcome between two groups who are very similar except for a difference in behaviour/exposure (prospective). For example, comparing the cancer rates between a group of people exposed to a nuclear test with a matched group who were not exposed.

2. Compare the difference between two groups with different outcomes and assess whether there were any significant differences in exposure/behaviour that might have led to the different outcomes. For example, comparing lung cancer patients with matched people without lung cancer identified the risks of smoking.

Observational studies can only discover correlation. Causation is suggested if it is scientifically plausible BUT confounds (other factors that may also influence the outcome that are linked to the behaviour/risk factor) may actually be the causative agent.

So, to evidence based mothering and a controversial subject on birth-boards currently - sleep-training (an awful term)

1. Does sleep-training at six months result in better sleep patterns in later childhood?

2. Does sleep-training at six months result in psychological effects in later childhood?

3. Does sleep-training at six months result in differences in attachment in later childhood?

4. Is sleep-training at six-months effective in breaking negative sleep associations?

5. How long does sleep-training take to be effective?

Difficulties !!

-- An interventional trial can't be performed as the pro-sleep-training parents and anti-sleep-training parents won't be randomised or matched resulting in selection bias. And forcing parents to raise their children in a certain fashion is draconian and won't work!

-- how to perform an observational trial ? 

1. so many confounds as the parents will differ in so many other ways
2. children with 'bad-sleep' may be more likely to be sleep trained and may have differences in psychology, sleep patterns, attachment inherent to them as individuals
3. how to measure outcomes? what is normal sleep? what is abnormal sleep? what is normal/abnormal attachment?
4. how many children would be needed to attempt to get any sort of statistical power?
5. what sleep-training method to choose? 
6. how to teach/observe/enforce/ensure consistency of practice?

Research is defined by the questions asked but can not be performed ethically without a reasonable expectation of useful data. I can't imagine a study design that would lead to meaningful results. So the trial will never or rather should never be performed.

An illustration of why mothers will be relying on anecdote and word-of-mouth advice for many years yet!

Gran

Matthew 7:1-5 

 ¹ “Do not judge, or you too will be judged. ² For in the same way you judge others, you will be judged, and with the measure you use, it will be measured to you.

   ³ “Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye? ⁴ How can you say to your brother, ‘Let me take the speck out of your eye,’ when all the time there is a plank in your own eye? ⁵ You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother’s eye.

Luke 6:37, 41-42

  ³⁷ “Do not judge, and you will not be judged. Do not condemn, and you will not be condemned. Forgive, and you will be forgiven. [...] 

   ⁴¹ “Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye? ⁴² How can you say to your brother, ‘Brother, let me take the speck out of your eye,’ when you yourself fail to see the plank in your own eye? You hypocrite, first take the plank out of your eye, and then you will see clearly to remove the speck from your brother’s eye.

My maternal grandmother believed in taking every one as you find them, expecting the best from others and giving of your best to all, regardless of who or what they are. Although she died many years ago I am reminded of her philosophy almost daily. 

Gran died following a long fight with breast cancer and 'designed' her own funeral Mass complete with readings. I read one of the above with Dad holding me from behind. 

Gran and Grandad with Mum - about the same age and stage as we are now!

I was reminded of this on the weekend when I met a woman for the second time. The first time I met her I didn't warm to her; she is immaculately turned out (I just can't manage that anymore so I am jealous) and she is a smoker (hate the sin and not the sinner Kate!) so I didn't make conversation and talked to the people I already knew. After TALKING to this lady over a glass of wine I discovered we have a lot in common BUT more importantly my snap judgement was WRONG. 

Sorry Gran, point taken, will try harder.

(Those of you who are wondering - yes Luke is named for the apostle. Saint Luke the Evangelist was a doctor himself and is the patron saint of physicians, surgeons, butchers and students. Very appropriate for the child of a veterinarian and physician.)

Balancing household needs

Luke is a delightful, happy, growing (75% weight, 97% height - tall and skinny like his Dad), 6 month-old. I'm not someone who believes in Mummy-martyrdom; my needs and the needs of his father need to be considered alongside Luke's. 

AND Mummy and Daddy are tired!

Luke has slept reasonably well for some time now - up 1-2 times a night. He has gone 11-12 hours without a feed a handful of blissful times. Some 'experts' say based on that he should now sleep through the night without a feed and we should institute a strict regime. Some say he should not be feed until 6-7 hours have passed and then 3-4 hourly after that. Some say we should co-sleep to minimise the disturbances to my sleep. Some say solids will make him sleep better; some make him sleep worse. Some say day sleep begets night sleep; some insist babies need to be tired out to sleep well!

AAARRRGGGGHHHHHH!

Luke has a myriad of reasons to have disturbed sleep - recently - jet lag, vaccinations, ambient noise (Chinese New Year), a curious cat, a cold, an itchy facial rash following pumpkin contact, learning to roll/crawl, solids, disturbed schedule due to outings, distracted feeding during the day leading to catching up at night! So hardly surprising he is a little up and down with his waking.

Luke also refuses to read the books! He doesn't always have his longest sleep at the beginning of the night. Even when he wakes up only once it is sometimes at 4-5am and sometimes at midnight! 

We did a very-modified CIO for 3 nights to break his nursing to bed addiction and now he goes down awake after solids/bath/feed/cuddle and is normally asleep after some gurgling if any noise at all. He doesn't feed for naps either so I know he can 'self-soothe.'

At this point I've decided to just keep doing what we're doing. I can't face or stomach 'CIO' at 3am and can't justify it at 6 months. I'm getting 8 hours most nights (in pieces) and his Dad is getting enough sleep for work. Luke is getting 14-16 hours per day and obviously thriving. 

I'm sure things will get better, Luke has the skills he needs to sleep through the night, he just needs time!

Luke with Miffy the transitional object!

Now if only we could train the cat to sleep through the night so Luke was the only disturbance we had!

Me

I spend a lot of these posts talking about Luke - he is my 24/7 focus currently so that's not surprising.

But this is a letter to the younger me and all the younger women out there standing naked in front of the mirror despairing at their 'less-than-model-perfect' bodies and wondering if anyone could love them.

Dear Miss Younger Kate 

(just a side note here an Afrikaans friend calls me Miss Kate and although it's inaccurate I LOVE IT!)

You hate so many parts of your body - take a breath - relax - look at each part in turn - me (older Kate) loves that same body as I've grown into it and learnt why each piece was gifted as it was.

You hate the too-big-for-high-street-feet, but they have carried me around the world, on safari, through street markets, over mountains, up aisles, around hospital wards, up and down corridors and soon you will find shops that make to measure!

You hate your too thick hair and bushy eyebrows that need constant maintenance, but as I get older I don't worry about thinning hairlines or tattooed makeup - we are future proofed.

You hate that your weight yo-yos; too skinny as a teenager, too fat in your twenties - punishing yourself into a svelte frame with running. But I love my allergy-free, sexually-responsive, Luke-carrying body -- which, now changed by the job it most recently performed, will God-willing house this soul for decades yet. These arms are strong enough to baby-carry, these legs firm enough to withstand Wellington winds, these hands delicate enough to stroke my child's forehead.

You hate your too flat breasts, your not-like-the-porn-mag nipples. After six months breast-feeding they're not flat anymore, the nipples are perfectly functioning, the baby is thriving and I am at peace with these beautiful boobs.

As I age, I look back at you, younger Kate, and remember some of the anxieties that kept me awake at nights. I know I would not be the same person if I hadn't experienced those worries. But just wait, hold on, and at every new challenge, remember; for better or worse - this too will pass.

Good luck

Love Older Kate

Existentialism

I've been thinking....

Those of us with children conceived with reproductive technology owe their unique existence to so many happy accidents.

Naturally conceived children - two people met, they have sex, a random sperm find an egg one month, the baby survives gestation and is born.

Luke's conception - Grant and I met, had sex, sperm never met egg...

.....so we met a doctor in UK who wasn't any help - those eggs, those sperm missed out
.....so we met a doctor in HK who was great - those eggs, those sperm met - 8 embryos formed
.....of those 8 embryos - 5 were not healthy so 3 were left
.....of those 3 embryos - 2 were replaced, 1 was frozen for later
.....of those 2 embryos - Luke was the only one visible at 6 weeks

((success or otherwise may be attributed to the embryologist having a good day!))

Was 'Luke' waiting for a vessel and we just happened to be carrying that vessel when his turn arrived?
Is 'Luke' something inherent in that combination of sperm and egg?

If you believe the latter, then you have to grieve the combinations that didn't happen, the embryos that didn't survive, the chances missed.

If you believe the former, then someone else could have been raising my beautiful happy boy if we had got pregnant earlier, later or not at all.

Luke in Chinese New Year outfit

Or was Luke 'meant' to be ours, meant for our family, designed to be raised by us?

I'm glad the series of happy accidents, or fate, or biology led Luke to us, to our home, to our family.

Luke is a gift but a temporary one.... we are custodians of this magical person, entrusted with loving and raising him so he can become who he is meant to be.....He belongs to our larger family, his community, the universe.....

No more thinking for today!