Baby-wearing Part Two

Just a short one today...

To clear our heads and get out of the concrete jungle, hubby, baby and I walked in one of the country parks in Hong Kong today. We took turns wearing Luke; Grant in the Mai-tai style carrier and me in the Maya-wrap both hip and back carry.

Maya Wrap in Back-carry

Good points
-- Luke slept for 30mins or so - which he needed
-- Neither of us have sore backs (yet!)
-- Handsfree for both of us all day

Bad points
-- HOT - Luke didn't enjoy being up against sweaty Mum and Dad
-- Luke can't see us in the back hold and apart from some 'smacking the sherpa' has little interaction with the carrying parent so prefers the hip hold

Should be OK for Vietnam though!

So far away

Tuesday 22nd February 2011 will be remembered as a sad day.

Today at 1250 NZ time a 6.3 earthquake struck Christchurch - less than 6 months after Christchurch experienced a 7.1 earthquake. NZ congratulated itself and breathed a sigh of relief at dodging the bullet of casualties the first time; today we were not so lucky. 65 dead - scores missing/trapped....

I say 'we' because I am that strange creature - the 'ex-pat' - I am still a New Zealander 100%. Through the wonders of modern technology I was connected; a witness but the 'tyranny of distance' meant I was impotent. 

Today, my fellow NZers were killed by the wildness that makes New Zealand so beautiful and I watched. I watched and cried along with those who were rescued, narrowly escaped and surveyed their broken homes and workplaces. I gasped at the mess of the Cathedral. I felt the shock and fear through the camera lens.

I go to bed tonight sad, praying that the morning brings news of miraculous rescues, survival after a cold night and not statistics.

God bless Christchurch.

Yesterday and today

Yesterday I made my husband come home early from work because I just couldn't do it anymore. Luke hadn't napped for longer than 30 minutes all day, the cat was under foot, the harbour was shrouded in mist and, as it was too cold for a walk, my world had shrunk to 600 square feet! 

Today a cloud lifted in everything except for the weather. Luke's naps were better; I had a chance to read and study. Our fantastic part-time maid came so the flat looks great and everything fits better into its tiny little space. Luke and I managed two walks - one for coffee (for me anyway) and one to the supermarket. Even the cat was less annoying.

Why? No real reason..... Yesterday my mood started low even before the circumstances turned bad. I get down sometimes - thankfully only for 24 hour spurts. Today I was in a better space and then the world joined me.

1 in 3 people suffer depression during their lives. They have 'bad days' for months, even years, at a time. Depression is a relapsing, remitting condition so there is likely to be more than one episode in their lifetime. 

You never know who is going through what, when.....

My baby doesn't STTN!

STTN = sleep through the night

So Luke isn't as bad as some babies - he has managed a few 11-12 hour stretches and mostly wakes 1-2x/night at his worst 3x/night - he goes straight back to sleep after a feed BUT I'm whinging cos it's not fair!

He doesn't nurse to sleep.
He has regular naps with age appropriate wake times.
He has an early bedtime of 18h30.
He has a regular bedtime routine.
He breastfeeds 2-3 hourly during the day and has started solids.
He goes down for his 3 naps and bedtime awake and is able to self-soothe.
He sleeps in a sleep sac in a non-cluttered bed.
He always sleeps in his crib.
He doesn't have a pacifier.
He has white noise on at a sensible volume.
His room is dark and at a controlled temperature.

So, according to the books, he should be sleeping 12 hours a night without a feed or stirring!

His wakings are irregular so are likely hunger related. Luke is 6.5 months so probably going through another growth spurt - at 72cm he is desperately trying to out-grow all the other babies in Hong Kong!

I'm tired and as much as I love Luke and being a stay-at-home-mother, I would love some time off.

A breast-feeding baby, who is always growing, is not mad-keen on solids and won't take a bottle means a permanent need for Mummy!

I want my night out with the girls!!!

Any ideas ladies?

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!