2008-12-31

How we started baby-led weaning



After wasting an whole month (the sixth) persuading DS to be spoon-fed puree, we offered him finger foods instead from the seventh month on, and since then have never looked back. Now DS basically eats 2 meals (breakfast, lunch) and 1 snack (late afternoon) together with one or both of us everyday.


What? We started with sweet potato, broccoli, potato, banana, avocado. But during 4 months of practice, we have already offered DS virtually everything: (except potential allergens, and we monitor the sugar and salt level very carefully): greens, apple, "p" fruits, chicken, fish, dry cereal, ricecake, rice, (homemade) bread, tofu, all kinds of melons, egg yolk, macaroni, spaghetti, baby corn, baby carrots,..., etc. We make sure that we offer DS a great variety of food which together provide balanced nutrients like carbohydrates, proteins, good fats, (soluble) fibre, and vitamin C (from fruits and vegetables) and minerals like iron (from fish, chicken and egg yolk in our case).

(DS is still being breastfed 6~7 times per day - so actually we are not worried about nutrients - we just want to build a good foundation before DS is older.)


How much? To prevent premature weaning from breastmilk we only offer solid after DS is nursed (we try to wait 20 minutes to prevent interference with iron absorption, but somtimes we can't). When DS is full he will let us know he's enough. Actually he does not eat much solid (but sometimes he surprises us a lot!), maybe just several bites (or occassionally none) of every type of food we offer: we know that at this stage our aim is to let DS explore the world of food and develop his mouth and hand skills, not to concern with the amount of food he actually swallows.


What size to prevent choking? To the contrary, we think bite-sizes are not safe for the beginner solid eater - we are worried a bite size piece can go through the mouth too quickly. At first we always give DS a food piece cut in chip, stick or finger size that he can hold it with his little fist. Then he can suck the portion going out of his fist.


To ensure safety, we always make sure that DS sits upright, and resist the temptation to put food directly into DS mouth. Even when we must use a preloaded spoon (e.g. with very runny food like porridge), we let DS grasp and put it into his mouth himself (while we hold the spoon handle in position) - we hope to give the control back to DS to feed himself.


At the beginning we only offered food pieces after we had tested: those we ourselves can eat by mashing in our mouths with our tongues (without using our teeth), to make sure that the texture is soft enough for DS to chew and swallow. We concern this much less now, not only because DS has learnt how to use his teeth to gnaw (e.g. as in the everyday apple - his top favourite), but also his gums have become very strong.


DS has never choked but still occassionally gags (though it becomes much less frequent now), because sometimes he doens't know how to "process" the texture of the food (esp. fruit skins), and we know the gagging protects him from choking, so we are not worried (actually DW is more scare and sometimes needs my resurrance ;-P). I remember the first time when DS ate plum, he gagged a lot and spitted the flesh out with a lot of saliva (I don't know where the huge amount came from)! But after one month of "practice" the plum was already one of his favourites. So, gagging is a valuable lesson for DS to learn eating food safely.


If you are really fearful of choking, I suggest you to have some knowledge of baby first-aid, then you will be less frightened and more relaxed (you should know the difference between real choking and mere gagging). But anyway if you observe the principles of baby led weaning stated above (e.g. baby sitting upright, never put food directly into baby's mouth, avoid hard round small food like peanuts, grapes, etc.) this should be very safe. No need to be panic.

Re: pincer grasp?

The term "pincer grasp" appears in the "nine to twelve months" section of Sears's babybook, so no worry if your lo is just eight months old and hasn't developed it yet.

Having mentioned that, you may try peg puzzles. I mean those lovely wooden puzzles of which each piece has a hardwood peg installed in the center for easy pick-up (they are often marked "for age 2+"). DS loves picking them up with his developing fingers.

2008-12-27

"Baby-led Toothbrushing"




I have started cleaning DS's gums with a gauze-wrapped finger since his sixth month, and everything was fine. Later, when his first tooth appeared in the 7th month, I changed to a finger brush, and was still OK...until last week. Suddenly, DS didnt want us to brush his teeth. Toothbrushing became a battle...(changing his diapers is already a war - just like everything else done TO him)

...until I bought him his own tooth brush (He always excitedly looks at us when we are brushing our teeth in the morning). When he is happily "brushing" his teeth and opening his mouth, I quickly insert my finger/another brush to complete the cleaning.

DS now has six teeth. Every teething is a torture to us three (we cosleep)...as the pain or itch would wake this ultra sensitive baby up every 30 minutes. This means a dozen awakenings at nighttime. Poor DS....

2008-12-26

Re: Unable to get DD to eat green veggie

We have never tried veg purees but have successfully offered greens in the following ways:as finger foods (e.g. brocolli, cauliflower - DS's favourite food) or chopped in small pieces and spread in porridge (spinach and other greens). You may also try stirring greens into pasta or mashed potato, or spread the puree on ricecakes.

2008-12-19

Re: Preservatives in bread


Reporting back our progress....

Finally we decided to buy a bread machine. So, we can skip cow milk powder (we use oat milk powder instead) and of course there is no more preservative problem and we can monitor the salt level too.

Initially I was hesitated of this step because I had had no knowledge of bread making (I am only good at dishwashing), but ...

On that day ... at 8:00 am we brougt DS to the kitchen, and let him watch how we shaked the loaf of wholegrain rye bread out of the machine and sliced it. Then we offered him a little bread to see his reaction ... his first bread in his life ... his eyes were shining! We immediately put him in the highchair and ate together!

We have made our breads three times since then, and served them as breakfast. DS loved our breads so much that he kept on asking more of them, whether it's with butter, nut butter or just plain!

Nothing comparable to the joy of watching a baby eating and loving good food, esp when the food is home-made.

2008-12-03

Preservatives in bread

Tried to introduce bread to DS, only to find that the bread sold in local supermarkets or chain bread shops all contains preservatives (as shown in the packages) and many many other additives. This is legal in our city, but does not mean this is healthy.

I have read that food additives (in particular preservatives) can make your children more susceptible to ADHD...perhaps DS has already received many chemicals from breastmilk (of course the benefits of breastfeeding are indisputable) because we eat those bread everyday...we don't want to think more about that.

Feel very frustrated....

So parents, do you make your own bread, or you rely on some reputable local shops?

Re: Is there such a thing as too soft?

Steamed broccoli and baby sweet potatos were DS's first food and are still his favourites. I always steam boil them for 10 minutes to make them soft enough for DS to eat (but not too soft so that he breaks it before putting into his mouth). DS never eats the stalk of broccoli....he always spits it out after eating all the flowers because it is not soft enough.

If you are still worried...this WAS my rule of thumb when I first started BLW (actually someone in this forum has mentioned this before) if you can use your tongue to mash the food (you are going to offer to your baby) in your mouth (without using your teeth), then the texture of the food is probably safe for your baby too.

Don't panic - your lo may sense your feeling and become nervous too. You may search previous posts (and refer to the blog too) to know more about the differences between gagging and choking. Even your lo can't "process" a piece of food, she may just gag and spit it out. Real choking is very rare if you follow the golden rules of BLW - e.g. sitting upright, don't force food into your lo's mouth, avoid hard round food like nuts and grapes, etc.

Peel Fascination




Recently DS is fascinated by the skins of fruits and eats them too (even he gags on the skins most of the time). I am also worried about that.

Nowadays, I always wash fruits with Environne and then rub them against a brush under running water before offering them to DS, hoping that this can remove the surface pesticide, but I don't know how much it remains inside the skin.

Peeling the skin can eliminate the risk (also suggested by our government's centre for food safety), however this also means much of the fiber is gone.

Buying organic fruits may be the way out, but they are very very expensive here. Sigh.


2008-11-21

Homemaking bread

We tried to introduce bread to YS, only to find that the bread sold in local supermarkets or chain bread shops all contains preservatives (as shown in the packages) and many many other additives.

Neither do we know any reliable local shops.

Food additives (in particular preservatives) can make children more susceptible to ADHD....Ascorbic acid (E300) as antioxidant and preservative may be OK, but not things like E927(a) (Azodicarbonamide), E282 (Calcium propionate), etc..

Finally we have decided to buy a bread machine. So, we can skip cow milk powder (allergen) (we use oat milk powder instead) and of course there is no more preservative problem and we can monitor the salt level too.

On that day ... at 8:00 am we brougt YS to the kitchen, and let him watch how we shaked the loaf of wholegrain rye bread out and sliced it. Then we offered him a little bread to see his reaction ... his first bread in his life ... his eyes were shining! We immediately put him in the highchair and ate together!

We have made our breads several times since then, and served them as breakfast. YS loved our breads so much that he kept on asking more of them, whether it's with butter, nut butter or just plain!

Nothing comparable to the joy of watching a baby eating and loving good food, esp when the food is home-made.

2008-11-20

Re: Helping baby adjust to Mei tei wrap

Just like using the sling, I've found that my action has to be quick when using a mei tai, before DS becomes impatient.

I have used the sling since the 2nd month, and the MT since the 4th month. I am still using both.

To the contrary, DS likes the MT quite tight (snug fit). If it is too loose (e.g. so low that his bottom is below my tummy) he will fuss. Tightness seems to give him security. If it is too tight DS will let me know, so I am not afraid if I have squished him.

My trick: when DS starts to fuss, I make a few bounces and cheer him up. It usually works.

2008-11-19

Re: Self feeding with drinking water?

We have given DS a sippy cup (with a hard spout, no valve, 2 ears) since the 4th month, because he resisted the bottle and DW was going back to work. He (tomorrow 9m) uses it very well since 6~7m (unaided)! I give him the cup after every meal or snack of solids to help clean the teeth and prevent constipation. He loves drinking just plain water (in fact, this is often a good way to prevent him from getting bored when sitting at the table)!

I think practice can make perfect.

Preloaded Chopsticks




DS (tomorrow 9m) never allows us to spoon-feed him since day 1 (6m) of starting solids. He is also not very keen on using a spoon. However, recently we've found that if I use a pair of chopsticks and hold some rice in front of him (and say, "Do you want rice?"), he wil grasp the chopstickes (while I am still holding them in position) and quickly (yes very quickly ) put the ends into his open mouth. In this way, he can feed himself 7~8 very small lumps of rice each lunch (total volume not exceeding one level tablespoon I think) before he stops.

I have restrained myself from putting the chopsticks directly into his mouth. If DS doesn't grasp the chopsticks himself and open his mouth for the rice, I will move the chopsticks away. I have also tried to tell him this is "rice" each time (though I don't know if he understands!). So far rice is the only food I've held for him in this way.

I guess it's because he knows that spoon is not our usual "cutlery", but chopsticks are (Ms. Rapley doesn't mention this cultural difference in her book :-).

So just as many people use preloaded spoons, I use "preloaded chopsticks". But, since I am holding them for him, do you think I am still violating the principle of BLW?

2008-11-06

Re: why does she cry for DH??

After being a SAHD for a while I feel that the role can be no less socially isolated and unrecognized than many SAHM (well, at least there is no KellyDad forum :-). It can be very frustrating experience when things not go smooth. Too many frustrations can turn into anger. When I suggested DHs "be forgiving" in my first response, what I meant was not just "to their los", but also "to themselves".

Why does she cry for DH??




I am a SAHD. My DS (now 8 months) is also a high-need spirited (intense, sensitive and energetic) baby. I have never been successful to bottlefeed him (maybe I haven't tried enough), and he also resists spoon-feeding when now it is time for introducing solids. You may search my previous posts on this forum to know the difficulties I have encountered previously.

From day 1 I have shared parenting responsibilities with my DW, and I have become the main caregiver when my DW went back to work in the 5th month. I wear DS almost everyday for hours since his 2nd month, and DS naps excellently on my sling or mei tai (front-carry despite my thin chest). Despite the fact that DS should have developed a more solid relationship with me, when his mother went back to work I also experienced some very hard time: DS refused to co-sleep with me (when both of us were really really tired), and he could cry in my arms for an hour non-stopped until his mother returned. I felt very incompetent then.

However, I think this tough moment has passed. Although DW is still DS's primary subject of attachment (DS becomes very excited whenever his mother returns, something that I can only be jealous :-), he is now quite content with me, incl. carrying, eating together, playing, learning new skills, soothing for comfort and napping (co-sleeping) together. Today I just told my DW that I think DS fusses less when only I am with him! :-)

So my advice to your DH is: don't give up! Just take a deep breath, relax and be patient and forgiving and understanding. The difficult time will pass. At the moment, I will suggest him just continue to wear her often (and go out for a good walk everyday!), and be nurturing as much as he can (but don't take it too personal if she still resists - she needs time to adapt)- your DD will appreciate the difference your DH brings with him/to her eventually and he will enjoy the rewards then.

(Also, I have deliberately memorised a repertoire of children's songs and sing to my DS many times everyday, for fun, for transiting to specific activities and for soothing, and he likes this very much. I hope this helps!)

2008-10-31

Rice cakes

DS loves eating rice cakes.


One day, we saw a mom feeding his baby (just 1 yr old) a very creamy cake and a bottle of orange juice. We were shocked - the milk, the egg, the fat, the citric, and the sugar!


We are careful not to let DS eat too much added sugar (and salt) from his diet. He is still quite satisfied with feeding himself just rice and water. We are proud.

2008-10-18

A new "technique"

Baby-led weaning is a social activity which means eating together not gazing at the baby! These days I have found a simple technique of encouraging my son to "eat" more....

We share the food. When he becomes less eager (you know, I observe him only secretly :wink: ) to a piece in his hand, I will bite a tiny bit from the piece (still in his hand). Whenver I do this, he will smile and will try the piece again for longer. 100% success rate!

Perhaps he thinks that he has a chance to feed his father! :-) Anyway, eating is fun when it is like a play which is always two-way.

Maybe you have known this "technique" for many months. Sorry!

Re: DH doesn't allow finger foods

Hope your DH understand that many babies are taking finger foods when they are 8 months old, no matter their parents believe BLW or not. Depriving them the opportunty to self-feed themselves is not good for the development of their new skills (pincer grasp and chewing). Many babies are too get used to purees that they have to wean pureed food when they are older!

I am also a worrier-father (my DW would consider me the world's top worrier). I still choose BLW because I know that spoon-feeding is conducive to choking as well if the food goes to the back of the mouth before the baby has developed the ability to process it (this often happens especially when feeding is done in a hurry). On the contrary, BLW can be very safe because the baby is not forced (or even made) to eat (+ common senses of safety applied to all babies e.g. no peanuts or other round hard or slippery food, never leaving the baby unattended when eating).

To end, I just want to say a few words of concern about your nanny. Since she is too accustomed to spoon-feeding if you really want her to practice BLW, please make sure that she knows the differnece between gagging and choking and knows what to do when seeing your baby gags or chokes. The latter (very rare in BLW as mentioned) of course requires first aid. Some people are too afraid of gagging (in fact, afraid of giving control back to the baby) that whenever they see any sign of gagging they immediately put their fingers into the baby's mouth wanting to take the food out! This may only push the food to the further back part of the mouth and result in real choking. The core issue to me is, then, WHO carries out the BLW. Perhaps in your case it is only you at the moment when only you are eating together with your baby. Although it's not perfect but to me it is not a failure, just a temporary compromise between feeding, safety and unique family situation (and family pressure).

2008-10-09

Re: question for babywearing DH

I don't know if my experience applies to your DH. I am very thin, and chest muscles are weak. However, DS naps quite easily on me if I wear him in a MT (front carry), despite wife has far better "cushions".


When it's close to time for a nap and I am wearing DS, I will stop talking, take a good walk outside (around the park, the pier, etc...or just the pavement if there is no choice - but I hate the noise and air pollution) and walk very steadily (non-stop). I will pat his hip lightly to aid him too. Normally he will fall into sleep in less than 10 minutes. Then I can sit down (e.g. on a chair in the park - but make sure that no one is smoking or shouting beside) and enjoy a book's chapter or the sea or just feel the little one's breath.


I do this almost everyday for DS's third nap (late afternoon). For his first and second nap, I use a sling and wear him down to bed (previously after he entered deep sleep but now just put him down when he is sleepy). He is now 7.5 months and I have done these daily for 5 months.

I think the cue is to let the baby get used to Daddy's difference and accept Daddy as the comforter. So just keep practise! (and tell your DH he is not alone !

2008-09-21

The beginning of Baby-led Weaning




When DS was 4 month old, I tried to introduce a bottle to him, in case mother was out for work and I needed to feed him expressed breastmilk. Although I followed the best practice of introducing a bottle to a breastfed baby (and had changed different brands of teats and bottles - which were more and more expensive), but after weeks of attempts he still just resisted every one. I was worried initiallly, but later relieved because I 've found that he can hold and drink from a "cheap" sippy cup. Also the need to feed him expressed milk is virtually non-existent because DW's workplace is so near our house that I can just bring DS to her for a feeding (In fact we have stopped making and freezing expressed milk bags because we don't want to waste this liquid gold!).

When DS was six month old, we encountered another problem - introducing him solid food. We'd soon found that DS hated being fed - no matter the food on the spoon was baby cereal mixed with mother's milk, mashed banana or softened apple, all kinds of "standard" starter.

The only way out was to introduce finger food directly- i.e. to allow DS to feed himself. The photo shows DS picked up a sweet potato. Guess what happened then?

YUMMY!

Though we have to skip baby cereal, there is no regret because according to UNICEF there is no scientific research justifying the need for baby cereal and spoon-feeding. And it is really exciting to see how DS plays with the food.

We have decided to let DS lead the pace of weaning and not force nor even make him to eat solid food if he is not ready. This means solid will most likely be only complementary to, not substitute of, breastmilk in the first year. We guess this is the best way to respect DS's (difficult :-) temperament.

2008-08-21

Eczema



DS was suffering from eczema. Although his symptoms were just mild (compared with other poor babies's), they were enough to cause him frequent night-waking. We thought that he might be allergic to the dust mites or flea of the bed /bed frame or the recent high humidity. So we have tried to lower the humidity level (which also deactivates the dust mites) in the bedroom and spread some galangal powder around the bed to deter the flea. We have also bathed him at first with dead sea salt and later a moisturizing cleanser, and apply a moisturing lotion to his skin. Now his problem has largely been improved! I think the antibodies in breastmilk may have also prevented him from being too serious.

Doctors are used to prescribe steroids to treat eczema so readily. Don't they know that relying on it without treating the cause leads to serious complications?

Although the ointment given to us by the doctors is only very mild cortison (< 1%), we still use it very very carefully - only for breaking the itching and scratching cycle when it really itches. Most of the time we used cortison-free alternatives, like ointment made of Chinese Herbral medicine. The picture shows dead sea mud.



2008-07-21

Feels very sorry unable to explain our parenting style to grandparents patiently.

2008-07-02

July Ist


Worn DS to July 1st March, and he became one of the 47,000 people. We were careful not to let him suffer from heat stroke.

2008-06-16

2008-06-04

人類可有未來 ?















"Every time I see an adult on a bicycle, I no longer despair for the future of the human race.¨ - H. G. Wells

"Every time I see ______________, I no longer despair for the future of the _________." - Anonymous

(照片:六四屠城十九周年燭光晚會,香港維多利亞公園,4.8萬人參加。攝影:魚仔)


(暫別。歡迎留言。也請參觀筆者的首頁。)

2008-05-21

Cosleeping problem solved


DS will not sleep lonely in the crib again! We have bought two large ottomans (footstools), use them as an extension to our bed, place a tailor-made mattress on them and sleep sideways.Our bed is now a "king-sized" one! For the past month we three are (safely) co-sleeping together, and every one of us loves this arrangment (DS sleeps very well). (We are just adopting the most time-tested nighttime parentling style of human cultures, and in particular the practices of Hong Kong's lower class families, so this is not special at all.)


Fleas, help!

Recently we are attacked by fleas. Our feet are their targets. This has aggravated the sleeping problem of DS.

We suspect they are due to the poorly-installed wood flooring of the house we rent, and the fleas are activated by the recent very wet weather.

We have tried to lower the humidity by using air conditioning and a dehumidifier, and vaccuming the floor very often. However whenever we put DS down for floor play he will get several bites. And everynight the fleas just "jump" onto the bed and bite our feet (you know we are co-sleeping)!

I have placed natural flea deterrent (galangal powder in socks) everywhere, but the fleas just move from place to place around the house.

When I walked past the supermarkets they sell "flea fumigators/ flea fogger". But I am very hestiated to use these poisons.

So besides galangal powder what we can do is covering the ground with a play mat.

2008-05-10

期望香港,對母乳餵哺友善 ──寫在2008年母親節前夕

(本文的撮錄版亦刊於香港母乳育嬰協會《母乳育嬰專訊季刊》第三十九期,2008年6月。﹞

母 乳是嬰兒的最理想食物:廉宜、安全、衛生、環保、容易消化和吸收,有齊嬰兒出生後頭六個月所需的所有營養。母乳中含有二百多種物質,除了營養素外,還包括 荷爾蒙、活細胞、酵素、免疫球蛋白等,可保護嬰兒免受感染、預防各種敏感和疾病、對大腦和視網膜發育尤其重要,嬰兒配方奶粉無可代替。

世 界衛生組織認為,嬰兒出生後頭六個月應該以純母乳餵哺,在隨後添加固體食物的同時,母乳餵補可持續至兩歲或以上。這建議對不少所謂「第三世界」國家尤其意 義重大,因為跨國奶粉工業在當地傾銷﹝包括誤導市民母乳不夠營養、向當地醫護人員贈送禮品等﹞,但由於基本衛生條件惡劣,大量嬰兒因為食用以受污染水源開 調的奶粉而死亡,而不是受到母乳的天然抗體保護。

有見及此,世界衛生組織和聯合國兒童基金會再一步定出了多個步驟,要求各國所有醫院實 施,目的是保持嬰兒吸吮乳房的頻率和力量,減少乳頭混淆及維持母親的泌乳量,包括幫助母親在嬰兒出生後半小時內開始餵哺母乳;即使母嬰分離,亦應教導母親 知道如何繼續餵哺母乳;除醫生指示外,不得給嬰兒母乳外的任何食物;實行母親與嬰兒每天24小時同室;鼓勵按照嬰兒需要隨時餵哺母乳;不要讓嬰兒吸吮人造 奶咀等。﹝關於世界衛生組織對母乳餵哺的權威立場文件,請參考本文文末﹞

近年香港衛生署支持母乳餵哺,並已制定母乳餵哺政策的文件。既然母乳餵哺有如此多的好處,並得到政府的宣傳,為什麼根據衛生署的資料,本港的母乳餵哺比率仍然落後於國際水平?為什麼在不少親子網站和活動裡,參與者好像絕大部份仍是以奶瓶餵養嬰兒?

最 近收到由香港母乳育嬰協會出版的《母乳育嬰專訊季刊》(第38期),署名Ivy的媽媽分享當初餵哺母乳的困難,包括因為所入住的私家醫院的行政安排和部份 醫療專業人員的認識,不讓寶寶出生後儘早餵哺初乳、只能按鐘進入大房餵哺、及因嬰兒「面黃」,醫生要求以奶粉餵養﹝衛生署的單張清楚指出,完全不需要單單 因新生嬰兒黃疸而停止餵哺母乳﹞。雖然出師不利,但作者出院後堅持以純母乳餵哺。儘管周圍有很多親友對母乳存有誤解,上班工作又忙碌,在如此艱難的情況下 作者仍以純母乳餵哺了寶寶九個多月。不過同期的十多個朋友全早放棄,作者感到孤軍作戰。

這個個案顯示,本港部份醫院沒有實施世界衛生組織 的指引,部份醫護人員亦沒有真正支持母乳餵哺。不過該個案發生在私家醫院,公立醫院又如何?當日筆者和妻子知道懷孕後,我們選擇了一間著名的公立教學醫 院,以為該醫院應在政策和實踐上順應潮流,積極推動母乳餵哺。不過,兒子出生後,醫護人員不是立刻拿給與他一起共生九個月的母親作必要的肌膚接觸,和讓寶 寶依本能吸吮乳房(latch-on),而是在產房外面進行了整整一個鐘頭的例行檢查。回到大房後,母親無錯是與嬰兒同室,亦沒有規定只准按時鐘餵哺﹝這 方面比起前述的醫院要進步得多﹞。但是,妻子最需要的幫助──由有經驗或受過訓練的人士﹝於最適當的時間──產後﹞在現場指導正確的餵哺姿勢和嬰兒吸吮技 巧──卻欠奉。

筆者認識一名親戚,懷疑就是由於寶寶吸吮方式錯誤﹝再加上過早使用奶咀補奶粉,導致乳頭混淆﹞,乳汁未能被有效吸取,結果 導致乳房腫脹,在極痛苦的情況下放棄母乳餵哺。另外一位親戚,嬰兒出生後一直兼用奶瓶,結果漸漸地嬰兒愛流量快的乳膠奶咀,抗拒需要較複雜口部肌肉技巧吸 吮的乳房﹝母嬰健康院的護士長對我們解釋這個現象時,比喻為「知道有叉用,唔肯用筷子」﹞,最後差不多要完全放棄直接授乳﹝不是沒有方法解決,但不容易 ﹞,打擊甚大。在香港筆者相信有類似經歷者,大有人在。

為什麼所謂「正確」的吸吮技巧和餵哺姿勢,在此時此地的香港變得如此重要?整體社 會大環境不利母乳哺餵可能是主因。筆者自己出生後頭四個月內是吃全人奶的﹝後來媽媽要服用避孕丸才停止授乳﹞,據媽媽說那時﹝直至七十年代初期﹞人奶是 「窮人的選擇」、「食奶粉好矜貴」。雖說餵人奶「好黏身」,但據人類學家Kathy Dettwyler的考察,在很多傳統社會裡,整天頻密地餵哺是很平常的事﹝嬰兒甚至會以揹帶掛在母親的胸前,讓勞動階層的母親一邊幹活、一邊餵哺﹞,吸 吮方式只要不太差,便「相對」不重要,而且頻密餵哺保證較高脂肪﹝有助嬰兒成長﹞的後乳的獲得。

可惜在本港,母乳餵哺的記憶好像遭集體遺 忘,媽咪缺少觀察學習的對象﹝有多少人親眼見過別人「埋身」授乳、而不是以奶瓶餵嬰兒?﹞。根據外母大人的憶述,七十年代中期本港公立醫院開始向產婦宣傳 「奶粉好營養」,結果,妻子、兩個弟弟和所有堂表兄弟姊妹﹝推而廣之,甚至香港一整代人口﹞都是以奶粉餵大的,沒有任何一位姨媽姑姐有直接授乳的經驗﹝但 婆婆的九個兒女,包括外母大人,都是吃人奶大的﹞,在母乳餵哺上香港出現了「經驗斷層」的現象。短時間內,奶粉跨國財團、醫療專業、文化工業與港式資本主 義生產體制合謀,成功使奶粉奶瓶成為餵養嬰兒的主流標準:當社會要求事事與時鐘競賽、僱傭關係排斥育嬰、社區又欠缺對母乳育嬰的支援﹝太太說,打來關心餵 哺進展的問候電話,最多收到的竟是來自奶粉公司職員的「慰問」﹞、配方奶粉又被西醫論述「黃袍加身」......時,表面上「不夠效率」、「不能量化」的 母乳餵哺便容易被邊緣化了。

當家人、親戚朋友、甚至醫護人員只有以奶瓶餵奶粉的經驗、對母乳缺乏認識,他們的育兒意見便可能對有心授乳的 母親造成壓力,甚至變成「好心做壞事」。要知道「頭幾個月應否給嬰兒餵水?」「應否給初生嬰兒安撫奶咀?」「應否訂立餵哺時間表?」「那些食物母親要戒口 /多吃?」「嬰兒一兩小時要吃一次/嬰兒體重增加得不夠快/...,是否奶水不足,要補奶粉?」「用什麼容器來餵奶粉或餵擠奶?」「晚上可否改餵奶粉,讓 嬰兒『一覺睡到天亮』,讓父母可以休息?」「可否/如何與嬰兒安全共眠?」等等諸如此類的問題,從餵母乳和餵配方的角度,答案未必完全相同。真心支持母乳 餵補的專業人員(如Jack Newman)會告訴妳,只要改善嬰兒的吸吮、配以一些小技巧﹝例如按摩和乳房擠壓﹞、營養和水份等,絕大部份的母親都有足夠的天賦能力授乳。但若錯誤地 把餵配方奶粉的有限知識,不加思索地套用在母乳餵哺上﹝例如規定餵哺的時間和次數﹞,嚴重的甚至會導致母親的乳汁供應減少﹝乳汁是按需要生產的﹞,造成惡 性循環,最後甚至會授乳「失敗」。

如果筆者的解釋沒有錯,難怪根據2004年衛生署的調查,高達37%的媽媽認為停止餵哺母乳的原因,是由於「奶水不足」,儘管香港這一代媽媽的營養,只會比起筆者當年的母親或更早的授乳前輩們,有過之而無不及。

當 然,要在香港推展母乳餵哺,除了改善醫院的行政、醫護人員的態度和家庭的支持外,一些配套措施也十分重要。政府的母嬰健康院雖然大致支持母乳餵哺,也只是 暫時中和了奶粉財團一浪接一浪、無孔不入的宣傳攻勢而己。當母親出院後,馬上必須面臨家庭和社區生活的挑戰,數星期後更可能是回到職場的沉重壓力﹝前述的 調查同時顯示,26%受訪媽媽因上班停止授乳﹞,無時無刻不在要求嬰兒與母親乳房過早分離。

香港的公眾地方普遍缺乏育嬰間和母乳餵哺室, 迫使佷多哺乳母親放棄外出,或寶寶被迫﹝在管理人員要求下﹞在洗手間「用餐」。妻子雖然一向少理世人的目光﹝只用一塊頸巾遮擋,便在餐廳授乳﹞,但是也曾 經迫不得已地在著名百貨公司的「洗手間/育嬰間」授乳,結果別人大便時的氣味幾乎令她作嘔。其實,政府應該帶頭規定在文娛中心、圖書館、主要政府部門、車 站、公園、公屋商場和街市等設立設備合格的獨立哺乳間及育嬰間﹝育嬰間應獨立於男女洗手間,安全衛生和提倡性別平等,鼓勵父親參與育嬰﹞,甚至參考美國多 個州的做法,立法保障婦女可在公眾地方授乳。

在推動宣傳僱主支持母乳育嬰時,政府更應根據國際勞工公約,延長有薪產假至最少十四週﹝現時「前四後六」的安排,母親往往還未從產後虛弱中完全康復過來,就要趕著上班,極不人道﹞、立法規定配偶享有陪產假、規管職工過長工時、
保 障工間休息、哺乳或集乳時間 (台灣《兩性工作平等法》及《勞基法》便規定,女性員工每天可以有兩次各三十分鐘的哺乳時間 )、推動彈性工作時間、保障部份時間僱員的權益、資助企業設立職員育嬰間等,讓親職得到﹝性別﹞平等的尊重。把遭主流經濟邏輯顛倒的優次──為資本家利潤 而生產,而不是為生命需要而生產──再重新調轉過來。

母乳餵哺不單只是一種餵食的方法,它更能建立母嬰的親善關係和緊密連繫,促進嬰兒的 生理發育和情緒安定。與奶瓶餵養比較,母乳餵哺減少廢物和污染、保護環境,並透過保護嬰兒的健康,減低社會在醫療方面的開支,及雙親因請假照顧而造成的生 產力降低。哺餵母乳成功與否,絕不只是母親一人的事。若本港促進母親哺育母乳的制度、環境、文化和社會網絡沒法大幅改善,大部份勞工階層母親不是繼續苦苦 支撐,就是過早放棄母乳餵哺,屆時母乳餵哺恐怕只有淪為少數有閒階級婦女的特權而已。


﹝攝影:筆者﹞

附錄:

因挪千替宣言(Innocenti Declaration) (節錄)

﹝世界衛生組織 日內瓦 1989﹞

我們了解母乳哺餵是一個獨特的過程,它 :

o 提供嬰兒理想的營養,促進他們健康的成長及發展;

o 減少感染性疾病的發生率及嚴重性,因而減少嬰兒的死亡率及罹病率;

o 減少婦女乳房癌及卵巢癌的危險性,增加懷孕的間隔,因而促進婦女的健康;

o 提供家庭及國家社會上及經濟上的好處;

o 當順利哺乳時,提供多數的婦女滿足及成就感。

同時最近的研究發現:頭六個月愈完全純哺餵母乳,好處愈明顯;之後添加副食品並持續哺餵母乳愈久者,好處也愈多;介入性的計畫可以正向的改變母乳哺餵的行為。

因 挪千替宣言是由世界衛生組織及聯合國兒童基金會的決策者會議" 九十年代的母乳哺餵:全球的運動" 中的參加者所製作及採用的。此會議於1990年七月三十日到八月一日在義大利佛羅倫斯,斯巴達德里,因挪千替舉行。這個宣言反應了該次會議的原始背景文 件,及會中討論的結果內容。有三十二個政府及十個聯合國組織採用。 因此我們宣稱:

o 為了全球母親及兒童的健康及營養,所有的婦女都應有權利可以完全哺餵母乳,所有的嬰兒應從出生到四到六個月大中完全純哺餵母乳。

o 之後,在接受適當的副食品的同時,兒童應持續哺餵母乳直到兩歲或兩歲以上。

o 要完成這種理想的餵食方式,我們必須建立一個適當而支持的環境,讓婦女可以這樣的方式哺餵母乳。

o 在很多國家要完成這個目標必須重建母乳文化,並積極抵抗奶瓶餵食文化的侵入。這需要鼓勵及承諾,需要運用社會各個階層領導者的名望及權威。

o 應努力增加婦女對自己哺餵母乳的信心,清除母乳哺餵的限制及障礙,這些障礙通常是以潛在間接的方式影響對哺乳的看法及行為。這個工作需要敏感、持續謹慎、 及理解性的溝通策略,應包括所有的媒體,並散播到社會各階層。進一步,醫療系統、上班場所、及社區中母乳哺餵的障礙也必須清除。

o 應確保婦女得到足夠的營養,更要確認婦女得到家庭計劃的資訊及服務,使她們可以持續哺餵母乳,避免太密著生產而損害她們及孩子的健康及營養狀態。

o 所有的政府應建立九十年代國家的母乳哺餵政策,並設定適當的國家目標。 他們應建立國家監測系統來完成他們的目標,並建立一些指標,如產婦出院時完全哺餵母乳的比率,及嬰兒在四個月大時完全哺餵母乳的比率。

o 國家相關單位更應將他們的母乳哺餵政策融入所有的健康及發展政策,他們應鼓勵及加強在相關計畫中所有保護、促進、及支持母乳哺餵的行動,例如:產前照顧、營養、家庭計劃、母親及兒童常見疾病的預防及治療等。所有保健工作人員應接受訓練,以獲得執行母乳哺餵政策的技巧。

完全哺餵母乳表示不給嬰兒其他飲料或食物,嬰兒應經常餵食,不限制時間。

[…]

答讀者問

問:地球這麼多污染,母乳會否受到污染?配方奶粉是否更安全?

答:先撇開「嬰兒配方奶粉所包含的污染物」、「奶粉的生產/消費過程對環境的影響」和「母乳所提供的免疫力」不談,若真的認為地球污染已到了如此嚴重的地步,那凡婦女一旦懷孕都應該擔心,因為環境污染物對在母體的胎兒的傷害,遠遠比對吃母乳的嬰兒為大。

母乳餵哺對母親、嬰兒和環境皆有益。為了保護母乳這個珍貴資源,我們更要設法救救地球,使母乳餵哺的文化能延續下去。

2008-04-21

The Pacifier


We have been told many many times the pacifier could solve the problems of a fussy baby...I don't believe this but there is some pressure from the relatives who have experience in "bottle babies"...

We have deliberately delayed the introduction of pacifiers to DS - to avoid nipple confusion - until 6 weeks (as recommended by some lactation consultants who really support breastfeeding) when proper latching-on has been established...

but...after several attempts...

...DS doesn't like the dummy at all - just blow it away.


I don't mind this - as research has shown that the pacifier is associated with early weaning of breastmilk. I don't want this.





DW, you've made it!

To improve breastfeeding skill, DW sought help from a La Leche League leader, Sarah Hung. She was so kind to invite us to go to her house and practise. Thank you, Sarah.

We discussed about attachment parenting, co-sleeping, etc.

I don't worry this would "spoil" the baby as what many people believe. I consider this the best way for a child to develop hsr sense of security, trust and the capacity to love.

Although I had found tons of information about breastfeeding on the internet for DW, she was still not confident enough about her self-learning skills. Also I wanted to know whether better latch-on could be attained to reduce sore nipples and feeding time, especially when DW was feeding on her right breast or lying down position, so I encouraged her to consult. Because her previous skills were not bad (better than what some nurses have taught I think ;-P ), she made it after receiving just some guidance. She was so happy.



On Vaccination

DS was having a fever after a vaccination. We were worried.

There are controversies surrounding the safety and /real/ benefits of vaccines. I am thinking whether to let DS risk adverse reactions again.

2008-03-31

DW's overcoming the pains of breastfeeding

Since breastfeeding, DW started to develop sore nipples. The pain was so intense that made her cry while feeding DS. How sad seeing her miserable tears! But later we have figured out the proper latching position of the baby, and the pain is considerably reduced.

She is now fluent in cradle and football hold, and begins to practise lying down position.

We live in an era with nearly no relatives of the older generation and friends having experience in breastfeeding (Becasue in the 70s, the hospitals said "formula feeding is more nutritious for babies" to all mothers). Even today, the nurses and doctors in the maternal and child health centres cannot figure out the cause of her wound, and they only want to know if the baby gains weight and gets enough fluid (yes he does!) - and if they need to prescribe "supplemental bottles" (this reveals that they don't support breastfeeding wholeheartedly). We have to rely on ourselves.

Perhaps co-sleeping (more appropriately called sleep-sharing) is the best way to solve the sleeping problem of both mother and baby...

...a practice widely adopted by many cultures throughout human history, but not openly admitted by many parents in Hong Kong (& US)...worrying that their relatives would say this would "spoil" the baby...

...mother can comfort the baby timely and get him into sleep again before he wakes himself up, without leaving her bed and being fully awaken.

But DW is still reluctant to sleep with the baby all night. She doesn't want me to sleep outside the bedroom (Because of the size of our bed, I must move out to ensure the baby's safety)

2008-03-20

Feels relieved as I bathed DS and then the cat today and neither one displayed his claws.

2008-03-15

Practising using my hands to comfort DS while using the feet to comfort the cat.

2008-03-13

大雄的宇宙心靈














臨睡前,靜兒走進父親的房間,想向父親最後一次說晚安。

明天一早便與大雄結婚了。

此時,叮噹的「坦白電波」發生作用,靜兒不吐不快:

「爸爸!我不嫁了!若我走了, 爸爸便會很寂寞了。」

「那當然。」爸爸輕輕回應。

「到現在為止,我一直受你們的疼愛和愛護......但我甚麼也不能替爸爸媽媽你們做...」

「不!妳已留給我們很多禮物了!」

「禮物!?我留下的?」

「對。數之不盡。
第一件禮物就是妳的誕生。
深夜三時......妳的哭聲如天使吹奏的喇叭聲般。我從沒有聽過這麼快樂的音樂。
當我離開醫院時......東面的天邊微微浮起一片白色,但我頭上仍然只是星空一片。
在這廣闊宇宙的一角,有一個承繼我的血脈的生命誕生。這麼一想,我便十分感動!淚流過不停。
以後的每天......都是快樂的。每天都充滿著回憶。這就是妳給我最好的禮物。
雖然有點兒寂寞,但回憶會溫暖著我的心。妳不用為這件事擔心。」

「我...擔心的是......結婚後能否順利和諧地相處下去。」

「一定可以的。妳要相信大雄。
我認為妳選擇大雄是對的。
那年青人會為人謀求幸福,亦會為別人的不幸而傷心。這是作為一個人最重要的地方。
我相信他一定會帶給妳幸福的。」

﹝節錄自:藤子‧F‧不二雄著,《叮噹香港中文版》,第二十五卷,文化傳信有限公司,1993年8月29日出版。」



願我的小寶寶,長大後像大雄......

2008-02-20





Relieved because both DW and baby are safe. It was an exciting moment when the new-born felt the first taste of his mother's breastmilk.




Pretty nervous. Today is the expected due date, but BB still prefers the warmth inside mother's tummy. We have to wait....

2008-02-18

Mozart

I like the tone colour of acoustic guitars, violas, and recorders. I prefer sophistication in simplicity, as in Mozart's music, but I also enjoy Brahms's deepness. With a few exceptions, I don't like electronic music - feeling that it's far less green and healthy.

2008-01-09

為何無地方晾衫曬被?














筆 者經常向親人說:除非住村屋或唐樓,否則大概要租/買個好幾百萬元的單位,才有回以前舊 式廉租屋的露台。今天母親年事已高,她雖仍住這些公屋,但已經很久沒有使用危險的「三支竹」,只是把衫掛在騎樓晾乾。以前曬被可以在走廊或樓下欄杆,但由 於有「維護市容和公共衛生」的扣分制 ,唯有每次給乾衣鋪幾十元烘乾,既花錢又不環保。

先前住的私人屋苑,也是實用面積三百尺的小單位, 剛搬來 (八年前) 的時候,管理公司在每戶洗手間的窗外外牆「自發地」﹝當然羊毛出在羊身上﹞鑲上一個頗大的晾衫架,不過因為樓上總是有人倒污水、扔煙頭,而且又近廚房抽油 煙機出風口,所以很少住戶用這個架,非常浪費。結果,每天仍有很多人把濕衫掛在屋內超大的窗台上晾乾,或者把衣架掛出窗外、或自己安裝的晾衫架上(但鑽在 外牆上違反大廈公契,許多住戶因而遭警告)
。相信香港很多住戶都是這樣做,真如萬國旗般,煞是港式奇觀。間中聽見有鋁窗墮下,想必與此有關。

不 過,以前的屋苑卻有一個「德政」,在符合消防走火條例的情況下,容許住戶在天台曬衫,天台上設有四個晾衣架,安裝在地台的三個方位,每個上面有幾條鋼線供 住戶「浪衫」。筆者由於住在較高層,所以過去幾年差不多每個周日都捧著一大盆剛洗好的衫步行幾層上天台 (老婆大人負責洗和套上衣架,筆者則負責浪)(住在較低層的可乘電梯再行上一層),享受夏天中午時頭頂可以烚蛋的高溫、行樓梯的運動和天台的「開揚」,有 時還可以與平時沒有溝通的鄰人講幾句話,算是一個不錯的公共空間,感覺很好。在曬被季節,鋼線經常不夠用﹝總有人一張被「霸」足三、四條鋼線位,無可奈何 ﹞,有人會自行拉繩浪衫,不過這是禁止的,也有告示勸籲住戶互相禮讓一點。初初搬入時管理員曾警告慎防有人偷衫,不過筆者晾的多是不算昂貴的便服,多年來 也未遇過失竊事件。最近搬遷,與大部份私人屋苑住戶一樣不可以在公眾地方晾衫,地方大了,生活質素卻下降了,情緒有點低落。
聽說某些有所謂「環保露台」的貴價屋苑,業主竟然連在自己的露台晾衫也可招民事控告 (影響大廈外觀?但窗台窗花上橫七豎八全是衫褲又很美嗎?),港式「美滿家居生活」,是虛偽造作 ,還是逃避現實?

從 來不喜歡在起居室內晾衫,一來地方小,二來覺得會令屋企濕氣太重,人更不健康。筆者在以前單位的浴室企缸位兩面對牆近天花板的高位各鑲上一條不銹鋼通,兩 頭用十元店浪衫繩來回三次縛紮連起﹝感謝外母大人既精美又牢固的繩結) ,即成下雨天或懶惰撐樓梯時的晾衣間,參考「女人街」賣衫檔鋪掛衣的方法,把幾件衫掛在同一條膠鍊上,一個企缸位便可掛十多件衫。若多衫要乾又適逢下雨 天,會拉上浴簾把衫團團圍著,蓋上廁所板,然後放個抽濕機在企缸上,把衫烘乾一些,雖然需要半天,但仍較乾衣機省電,
衫又不會變形。除非真的趕時間,否則也盡量不幫襯樓 下的獨市洗衣鋪磅洗。這個方法把濕和氣稍為局限在洗手間這個有抽氣扇有窗的地點,地心吸力也可把濕衣弄直一點。密室晾衫會積存毒氣,但若通風足夠,相信總比部份洗衣鋪奉上的VOCs (揮發性有機化合物) 少。而且自己洗衣,亦可選擇較簡單和天然的清潔粉液,謝絕電視傾銷的化學合成漂白劑。當然在室內晾衫,始終並非理想,與陽光的 效率、殺菌、熱香和無價不能比較。

所 以,為何無地方晾衫?應是造成樓宇過度擠密﹝和昂貴)和缺乏考慮民眾健康 (如空氣流通和污染)和需要﹝如合理的晾衫和煮食空間﹞ 的房地產開發體制 (這也是當年沙士在私樓爆發的部份原因,屏風樓其實不算新發明矣)、設計 (男造環境)的歧視,再加上對公共空間和居民的規管所共同造成。不食人間煙火者 (規劃師、高官、發展商、管理機構﹞設下的規則,結果苦了家務勞動者,迫中下階層市民在健康、環保和金錢之間取捨。

延伸閱讀:
一蚊健:師奶唔易做,晾衫有煩惱
阿丙:環保露台不准晾衣的聯想
阿丙:晾衣服豈止是巿容問題?
記憶回收筒:曬棉被