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Friday, June 26, 2009

All Good Things Come to an End

And by all good things, I mean my maternity leave. As of July 1st I no longer get to pretend that my only job in the world is being a wife and mommy. It's time to iron my white coat, dust off my stethoscope, and make my way back to the hospital. This is a very bittersweet time for me (and, I am sure, all working moms). It's difficult for the obvious reasons - turning her care over to someone else, missing her like crazy, being afraid something will happen while I am gone, etc. Despite all of the worry and sadness, I have to admit there is a bit of excitement in the challenge of going back to work.

My whole life I've wanted to do it all, be it all, and have it all. I want to be there for my husband and kids, but also to have a career that means something to me. I want to be a mom, a wife, a sister, a daughter, a friend, and a doctor. I want to have nice things for my family and know that I helped earn them. So, as hard as it will be to leave my beautiful baby girl come Wednesday morning, this is my first chance to prove I can be everything I want to be. Bring on the challenge!

Wednesday, June 10, 2009

Vaccines

One week ago Maddie and I reached a milestone - her two month doctor visit. As all parents know, this is when the vaccines start. Since I started residency last July I've been telling parents how important the vaccines are, how unlikely reactions are, giving them vaccine information sheets, and then running away while the nurses take on the dirty work of actually administering the shots. But today, there was no running away. Not only was I there, but I had to play an active role in the process. First, I had to hold her in my arms while she received the oral Rotavirus vaccine. She didn't like the taste and cried a bit, but her protest was mild compared to what was coming. Then, it was time for the shots (<---for full listing of each disease, see the links on this general info page). My job was to hold her little arms and look into her little eyes while the nurses each took a leg.

I have to admit, the nurses were amazing. They coordinated the first two shots by counting down together (one, two, three...stick!), one nurse did the third shot, and she was back in my arms in less than thirty seconds. I'm not going to lie, she cried and gave me a look of utter betrayal when they stuck her, but it was short-lived. As soon as the nurses left the room, I sat down with her and let her nurse. She was asleep within five minutes and stayed that way for the whole ride home. She was her usual happy self when she woke up from her nap and continued to be herself the rest of the evening. One leg had the tiniest of bruises at the injection site the next day, but the other leg was perfect.

So, what did I learn? Here's my advice for a happy vaccine experience with an infant
  1. Give them a dose of tylenol approximatley 1 hour before the expected administration. Tylenol dosing for infants is based on weight, so you have to CALL YOUR PEDIATRICIAN for a dose recommendation. If you forget, ask your doctor to give your baby some tylenol in the office.
  2. Be prepared to do whatever usually comforts your baby when they are excessively upset immediately after the shots. If your baby takes a pacifier or likes a certain toy - bring it with you!
  3. Give your baby a second dose of tylenol at home later in the day (at least 4-6 hours after the first dose!!). The point of the tylenol is just in case they have any pain at the injection site.
  4. A common misconception is that it is normal for babies to get fever or sickness from their vaccines. A slightly elevated temperature (99-100) is normal, but anything over 100.4 is still a reason to call the pediatrician as your baby could be developing another illness. Also, you always need to take rectal temperatures in your 2 month old for the most accurate result!

Tuesday, June 9, 2009

Breastfeeding - The Facts

I thought it was about time I made a post talking about the activity that has basically consumed my life since my daughter was born. Working in the field of pediatrics, I know a lot about why breastfeeding is the best option for babies and that's what I want to talk about today. More on the actual logistics on learning to breast feed and planning to continue breast feeding after going back to work in future posts.

First, what is breast milk? It is essentially the perfect blend of fat, protein, glucose or sugar, and water that babies need to grow. Each ounce of breast milk contains approximately 20 calories. If this sounds familiar to popular infant formulas, it should! All of the formula companies have spent plenty of time and money trying to replicate breast milk. For the most part, they have done a good job and formulas will provide almost the same blend of nutrients and pack the same caloric punch. The differences? Breast milk protein is easier for babies to digest than the cow's milk protein used in infant formulas. On the flip side, formula is fortified with Vitamin D which breast milk is deficient in. This means myself and other breast feeding moms will need to discuss initiating a supplement (vitamin drops) for their baby around 1 month of age.

What else makes breast milk best for babies? In addition to providing the best nutrition, nursing also provides baby with mom's antibodies to help fight disease before their own immune system kicks in and allows for important bonding time between mom and baby. If that isn't enough, breast feeding actually has been proven to have some pretty impressive medical benefits that include: protection from SIDS, fewer ear and respiratory infections, less risk of asthma, eczema, and other allergic conditions, less risk for both type I and II diabetes, and less obesity later in life. Breast fed babies have also been shown to have higher IQs and better academic performance than their formula fed counterparts.

There are also huge benefits to breast feeding for moms and families. For moms, breast feeding can help take off pregnancy weight more quickly, lowers the risk for postpartum depression, and even lowers risks for ovarian and breast cancers. Families can also save a significant amount of money if moms breast feed. The obvious savings is due to not having to buy formula, but families will also save money due to the health benefits listed above (fewer doctor visits, fewer prescriptions to fill, and less time off for parents to care for sick children). Exactly how much money can you count on saving though? From research I've done, it appears that a large can of powdered formula translates to about 200 ounces of prepared formula. For my baby who is 2 months old and should be eating around 24-25 ounces a day, this would last 8 days. Each can of formula (and this is your basic formula, not any of the special formulas for reflux or milk protein intolerances) costs around $30 where I live. Which means this month I will save approximately $120 by breast feeding.

And finally, how about breast feeding in combination with formula feeding? For some moms, this seems like a much easier option as bottles can be easier to feed the baby in public and will allow breaks for the mom if others can feed baby too (information to come on pumping). Some moms are also worried that they aren't going to be able to produce enough milk and will use formula to supplement their babies (research speaks against this fear as in studies >90% of women were able to produce an adequate supply of milk). In general, some breast milk is always going to be better than no breast milk, BUT research has shown that by an as of yet unknown mechanism, formula decreases the protective affects that breast milk has on babies. Does this mean that moms shouldn't breast feed if they plan to use formula too? Of course not! I just mention it because knowing this provides extra incentive to me to push through the days that breast feeding is hard or inconvenient.

And that's all I have to say about the facts around breast feeding. Much more practical information to come over the following days and weeks. For more information you can visit these legitimate websites: http://www.4women.gov/Breastfeeding/index.cfm and http://www.aap.org/publiced/BR_BFBenefits.htm

***Please note, this blog is meant for the sharing of information only and should not be considered medical advice. Please use this information only to start a discussion about breast feeding, formula feeding, and vitamin supplementation with your child's pediatrician***

Thursday, June 4, 2009

Recipe Day!

I decided to unofficially make Thursday the day to post recipes. Today I'm going to share two - an old favorite that I adapted from a college friend's recipe and one I just made up last night when my husband asked for something sweet for breakfast!

Fresh Salsa Two Ways
This is a very forgiving recipe that you can adjust to your tastes and to adapt if you have slightly different ingredients. For example, you can use lemon zest/juice instead of lime, any color peppers you want, or even basil instead of cilantro.

Ingredients
5-6 Plum Tomatoes
2-3 Bell Peppers (I usually use green, yellow, and orange for a colorful salsa)
1 Red Onion (you can use white onion instead, I like red for color)
2-3 Cloves of Garlic
1 Tbsp Fresh Cilantro
Zest and Juice of 1/2 Lime
1/4 - 1/2 cup Vinegar (add more or less for your tastes)
2 Tbsp Olive Oil
Cayenne Pepper, Salt, and Black Pepper to taste
+/- 1 medium can of Tomato Sauce (no salt added)

Preparation
Wash, seed, and dice the tomatoes and peppers. Finely dice the onion and mix it with the tomatoes and peppers in a bowl. Mince the garlic or use a garlic press; add to the other vegetables. Finely chop the cilantro and add to the bowl. Add the lime zest and juice to the mixture. Now you are at the point where you get to add more or less of the vinegar, oil, salt, and peppers to your taste.

After getting the flavor just right you can stop right here and you will have a delicious fresh salsa. If you are like my husband and prefer to have more of a "saucy" salsa, add the can of tomato sauce. If you want some of each, split the salsa you have made in half. Keep 1/2 as is and add a small can of tomato sauce to the other half.

Easy Berry Bread
This recipe was a creation of my desire not to go out to the store, to use ingredients from my pantry, and to make something really quick while the baby was sleeping that my husband could have for breakfast. I always prefer to make things homemade, but sometimes you just don't have time. Think of this as a Semi-Homemade recipe ala Sandra Lee on the Food Network...

Ingredients
2 pouches of Pillsbury Muffin Mix (I used one Mixed Berry and one Blueberry)
1 cup of skim milk
1 3.9oz cup of Mott's Healthy Harvest Blueberry Delight applesauce
1 cup of frozen blueberries

Preparation
Preheat your oven to 375 degrees. Grease a loaf pan (or use a silicone one as I did). Blend the muffin mixes, milk, and applesauce together in a medium mixing bowl. Stir in the blueberries. Transfer the batter to your loaf pan and bake for approximately 35 minutes or until a knife inserted in the middle comes out clean.

Enjoy!

Wednesday, June 3, 2009

On becoming a mom

I thought it was only appropriate (since I started this blog to talk about the issues of a working mom) to talk about how I got to where I am today. I started my internship in Pediatrics the beginning of July 2008 and found out I was pregnant later that month. Therefore, in addition to facing a whole new career with 80 hour work weeks, 24 hour calls, a solid month of working night shifts, and the emotional stress of taking care of sick kids, my body was going haywire. Anyone who knew me during my pregnancy knows that I was NOT a good pregnant person. I had a hard time adjusting to the changes in my body and the drain on my energy. I hated that my body ached all the time, that my shoes didn't fit (I wore Crocs for almost my entire pregnancy), that clothes were always too big or too small, and that I was usually too tired to do the baking and sewing that I usually love. With all that in mind, I also constantly felt guilty that I hated being pregnant so much. I dreamed of being a mom my whole life, and there I was on the brink of it - how could I hate it so much? Did this mean I wasn't ready to be a mom? Did this mean I would be a bad mom? The self doubt was overwhelming.

Then, April finally arrived. 9 days into my maternity leave I went into labor and after 46 hours (24 hours of mild contractions, 5 hours of ascending contractions, 12 hours of active labor/agony before the epidural, 3 1/2 hours of peaceful labor post-epidural, and 1 1/2 hours of pushing...) my daughter was born. To make a ridiculous reference, I felt like Dr. Seuss' Grinch - all the bad feelings I had been harboring about my pregnancy just dissipated and I literally felt like my heart was swelling. After years of wondering what it would be like to be a mom and 9 long months of fear that I was somehow unequipped for this new task, I finally got to hold her. Everything I had been up until that moment shifted because I was now a mom too.

I've often heard people refer to babies as a gift (from God) or in other terms that I associate with instant, yet fleeting gratification. I think this is what I was hung up on during pregnancy - if someone was giving me a gift, I must be a terrible person to be unhappy about it. That's when I realized, I couldn't think of being Madelyn's mom as a gift. To me, she is an experience. Sometimes, she will be like a gift bringing me great happiness. Other times, she will keep me up all night bringing me exhaustion. Yet others, she will act out bringing me fear and anger. If I thought of her as a gift, each time she bought anything other than happiness into my life it would feel like a disappointment or a personal failure (similiar to how I felt during pregnancy). But by thinking of her as an experience, I can take the bad with the good and learn just as much from her as I hope she learns from me.