Showing posts with label breastfeeding. Show all posts
Showing posts with label breastfeeding. Show all posts

2012-02-02

My experience of homebirth


I never thought I would write this article: Because my body did not directly experience labour, my wife's perspective was far more important than mine. However, after one year now I think that maybe I have something to share with any dad who is reluctant about home birth.

I have two children, DS (now almost four years old) and DD (just past one year). DS was born in a public hospital; DD was born at home.

More than four years ago, I was quite determined to participate actively in my son's birth and in parenting. I resigned my job. I attended all the necessary childbirth classes with my wife (DW), whether theorectical or practical, and thought I was able to support her effectively even in the unfamiliar environment of the hospital's birth room.

However, to our great shock, after DW's admitting to the hospital we had reserved shortly following her "water breaks", a doctor speculated (and it was very likely that he was wrong) that DW had had prolonged amnion rupture, and treatments stimulating contractions were applied to her to induce labour. This totally ruined our original plan of applying what we had learnt together to ease DW's pain (through, e.g. massage, different postures, birth ball, etc.) - because DW was then made to lie still on the bed without any food or water, and after that Caesarean section would be performed if childbirth was not "stimulated" in 12 hours.

Although at last DW gave a vaginal birth to DS at midnight after nearly 12 hours of continuously laying on bed, the experience of total passivity, the worry that we did not get off to a good start of breastfeeding, the feeling of loss of control of oneself, the sense of powerlessness as our desire for mutual help was replaced by the dominance of expert control, technology and pain relief medications, and the sick and docile role unidirectionally created by Western medicine all made us feel extremely demoralized.

Even more, immediate extensive skin-to-skin contact between mother and the newborn was deprived because DS was taken away from us for nearly one hour (against the recommendation of WHO) for numerous, arguably needless (in Jack Newman's, M.D., words), "examination" by medical professionals. Hospitals for us were intimidating.

(On the other hand, the benefits of labouring in a public hospital in Hong Kong, in contrast to a private but far more expensive hospital, are that it is the public policy that they won't give your baby a bottle of formula without your consent, and that in most cases the baby and the mother room in together.)


But when DW told me that she was attracted to the idea of homebirth when she was pregnant again, I was a bit hesitated. Although I had been rather critical of Western medicine since I first read books on the sociology of medicine (when I was a university undergraduate), I was a bit worried if there would be any unanticipated negative consequences. (And, as the main home-maker, I didn't feel like the idea of my cleaning the mess of the house after delivery :-P)

However, I felt more relaxed after reading the statistics showing the comparative safety of homebirths vs hospital births for most normal pregnant women, and that all the prenatal check-ups attended by DW showed that the conditions of the fetus were normal, stable, and indeed good.

And above all, I respected my wife's will to more control of her own body free from unnecessary medical interventions: she had read a lot of books and articles on homebirth, and I had never seen her being so interested and indulged in a particular subject before - she desperately needed her husband's unconditional support.

Together we agreed to go for it, and later DW told me that she had found an experienced mid-wife. I have to confess that I was a bit lazy this time, although I went to a Yoga class for pregnant women with DW and read a chapter on the role of fathers from the book "Birthing from Within" written by Pam England and Rob Horowitz.

And finally the day came. At midnight DW suddenly had contractions and they quickly became regular, stronger, longer and closer together in early morning. We knew that DW was elbowing her way out, and I immediately called our mid-wife.

Meanwhile DW was already lying sideways (to prevent the baby from coming out too quickly) on the protective floor cushions in front of our DIY "king-sized" bed: the pain was so intense that she could hardly move. I tried to make her comfortable by massaging her back, handling her a hot pack and reminding her to breathe. I tried to make the bed more suitable for labour, but I also had to prevent our spirited toddler DS from entering the bedroom and I did this in a way that he did not feel excluded and overwhelmed. Fortunately, although two of our friends who had agreed to come during DW's labour could not come at last because of busy jobs, another two came later and one of them could look after DS in the living room.

In thirty minutes' time the midwife came and under her instructions, I helped make the bed, sterilize the clips, scissors and other tools. I supported DW by running my hands gently through her hair while confirming her that she was doing good work and was in control of her own body, and that thanks to her we were about to see our new baby.

Although my role was always very minimal especially after midwife's arrival, I felt like myself acting like a lion, guarding the birth place, handling phone calls (e.g. from relatives) and visitors (e.g. a post officer, a courier and the very baffled security officer of our estate), dividing labour among friends and myself, and providing materials to midwife and gentle compassionate support to DW to ensure a smooth delivery (although recalling retrospectively, I wish I had given her still better support).

Thanks to the familiar and warm environment of our home, I felt myself relaxed, calm, assertive, motivated and my mind clear, and indeed empowered, feeling capable of handling even the worst situations.


It did not last long before the birth of our new baby - indeed, the stage was very quick, and I guess it only lasted less than half an hour - I don't know if this was related to DW's better contributing of her all strengths and efforts in a familiar environment, the fusion between her mind and her body (which would otherwise be forcifully separated by medical professions), to help her body do its work to cope with the natural intensity and the expression of pain in labour.

The baby's head emerged after a few strong guided pushes by DW, and she was then fully born (I hope DW can write the whole process down in details - sorry I did not directly experience such rich huwoman experience). Midwife immediately brought our newborn to her mother, these two having been living in a relation of harmonious symbiosis for nine months, and it's their first face-to-face encounter! And this was the most magical moment. The immediate response of DW, although obviously having emotionally prepared for this moment for so long, when holding our beautiful, delicate, crying princess in such an intimate distance, was totally enraptured; her (and indeed, our) emotions were so overwhelmed and powerful that we were speechless.

My gratitude to my dearest wife who coped with all these intense release of pains was beyond words.

And of course it was always exciting watching the new-born felt the first taste of his mother's breastmilk immediately after her birth, in such a natural and familiar environment without unnecessary medical interferences. They were perfect rewards to each other.

With the help of our midwife, I cut the umbilical cord myself. I was glad that I did not scare blood this time (unlike DS's birth), perhaps I had been cutting fishes and meats for dinners for several years! :-)

After the delivery of the placenta, DW and I brought the baby to his brother, who was watching Sesame Street in a separate room when his mother was labouring (I hate using videos as childminders but it was the only way to divert his attention for 2 hours). We gave him a gift for "upgrading" to the brother status immediately after we introduced his sister to him - this was one of our tricks to reduce his anxiety.

DS was a little bit upset the first day - kept asking mother to "put the baby down" - but this amazing child shortly began to adjust very well to the change (which we had prepared him psychologically for months) that although mother would be less available, he could still enjoy special time with her alone and even receive more attention from his father who had determined to be a father before his birth and strengthens this determination every day.


2011-01-10

DD's first month



1. DW has been breastfeeding so well that the baby redeemed her birth weight in a week and her jaundice went away without any need to follow up medically! This surprised doctors and nurses in the Public Maternal and Child Health Centre a lot because they had insisted us to send the baby to the hospital for phototherapy (this would result in mother-baby seperaton - this is another example showing that professionals in HK are not supportive of breastfeeding ( see Jack Newman, M.D., and Teresa Pitman [2006], The Ultimate Breastfeeding Book of Answers.NY: Three Rivers Press.)

2. When the baby's jaundice was still worrying DS suddenly developed a high fever and we were hesitated whether to send him to the private hospital (it was on the weekend). Then we made a wise decision - bringing him to a good Chinese doctor. DS completely recovered after only two days (he can drink Chinese herbs better than many adults). Unlike many children of his age, he still hasn't "tasted" any antibiotics since birth. I hope he never has to suffer the side-effects of antibiotics!

3. Compared to DS, DD is a very good sleeper - she can sleep on my arms without my moving them. And no wake up even putting on the bed then. Because DS has taught us too much :-) how to deal with sleep problems of babies, taking care of DD is (a little bit) easier than we expected - at least during these few weeks - though I hope DW can have a few hours personal time every week later - she is attending to the baby almost 21.5 hours a day (the other 2.5 hours are for DS).

4. DS adjusts very well - we can't demand him more! He has begun to exhibit very loving and caring behaviors to his sister. We have taken some interesting pictures showing the interactons between the two. Hope each day has 26 hours so I can upload them asap!

2010-12-13

Homebirth

DW laboured at home on Saturday and gave birth to our beautiful daughter! Thank you, Dear Wife!

(The baby was delivered by a professional homebirth midwife ... though I helped make the bed, sterilize the clips, scissors and other tools, and cut the umbilical cord myself :-))

2009-08-02

Baby親子雜誌 第189期 對我的訪問原文

1. 你現在有多少個孩子,孩子有多大呢?

我們有一個16個月大的孩子。

2. 是從第一個孩子就開始實行母乳餵哺嗎?餵了多久?

是的。我們參考世界衛生組織的指引,頭六個月以純母乳餵哺孩子,由第七個月開始成功引進固體食物,現在孩子每天大約吃七餐:三餐固體食物 + 約四餐母乳。我們希望讓母乳餵哺能持續至最少兩歲。

3. 你和你太太的家人是否支持她餵哺母乳呢?

我們的家人口頭上都支持我太太餵哺母乳,不過他們由於對母乳餵哺的認識不深,往往會把對奶粉/奶瓶餵養的有限認識套用在母乳餵哺上,有時會對我們造成壓力。例如孩子初生時,他的胃只有他的拳頭仔般大小,但母乳很易消化,孩子每一、兩小時便要餵一次,我們聽了多次「是否媽媽奶水不夠,BB肚餓,要不要補奶粉?」之類的疑問。就算是現在,太太餵了孩子十多個月,而孩子的體重發展一直甚佳 (與同月份出生的嬰兒比較,曾經達97個百分位數(Percentile)呢!),還是有人會武斷地說:「孩子晚上睡得不好,一定是不夠飽的緣故。」

4. 你和你的太太都是從一開始就決定以母乳餵哺BB嗎?懷孕的時候有沒有商量過照顧孩子和餵哺母乳的事呢?

對,我們以前曾閱讀過許多文章,認為配方奶粉容易令BB敏感 (而太太的弟弟小時又的確對奶粉嚴重敏感,故我們可能有家族敏感史),而母乳是對BB健康的最大保障,故此在懷孕時我們已經下定決心以母乳餵哺BB。由於我本身曾經從事勞工政策研究工作多年,對「香港的職場是否促進母乳餵哺」有一定的了解,加上我們的親友幾乎沒有人有母乳餵哺的經驗,我們已有心理準備需要兩人互相依賴、並肩作戰。為了能成功餵哺母乳和照顧孩子,我們做了一些預備。

當時的我既有一份受薪工作,又正在唸一個學位,我擔心沒有時間參與育兒的工作。由於太太在非政府機構從事一份對她職志有發展機會的工作,我決定辭去原先的工作,準備BB出生後日間在家照顧孩子和晚上繼續寫研究論文。此外,我們原本住在新界東,但太太的工作地點卻在港島東,為了讓回到職場的母親下班後與嬰兒有多些相聚時間,我們賣了原先的小房子,並在太太的工作地點附近租了一個單位居住 ,這些在太太產前已經準備好。


5. 你太太餵母乳的過程順利嗎?中間有沒有遇到什麼挫折或者困難?

挫折的來源有幾方面,首先親友對母乳餵哺的認識很少 ,他們的言語往往無意中加大太太的壓力(如前述),令太太更加懷疑自己的能力。而太太和很多香港人一樣,自小腦海裡對餵養嬰兒的印象便是奶粉/奶瓶餵養,產後仍在醫院時又沒有有經驗或受過訓練的人士在現場指導正確的「埋身」餵哺姿勢和嬰兒吸吮技巧 (latch-on)。

在沒有人指導的情況下,太太在技巧方面也自行摸索了個大概。雖然我在互聯網上找了不少相關文章和影像給太太看,但有些精髓單憑閱讀始終很難掌握。在孩子兩個月大時,太太的乳頭因經常與他的口腔摩擦而破損,每次餵哺都叫她痛楚難當,我鼓勵她去諮詢一些授乳顧問,結果立即改良她的一些姿勢,使嬰兒有正確的吸吮,乳頭不再痛楚,並使她的信心大增。我們從此明白到坊間說法以為「哺乳必然是痛的」的謬誤。

6. 你如何幫助太太持續母乳餵哺呢?
當太太放產假時,我便高度投入育兒的工作,包括料理家務、參與育兒 (例如沖涼、換片、哄BB睡覺)等工作,讓太太可專心餵哺。我希望為太太營造一個方便餵乳的環境。我常常鼓勵太太依照母親的直覺把孩子帶在身邊 (包括外出),孩子有需要時便可立即授乳 (若太太有需要獨自外出,例如剪髮,則由我稍後把孩子揹出街與太太會合)。由於孩子天生是位反應激烈的性情兒,晚上曾睡得很差 (最壞時每半小時或一小時醒來一次),兩個月大時我便索性把嬰兒床拆掉,把雙人床加上腳踏橫放改成一張闊六呎的安全大床,鼓勵太太實行親子共眠,孩子半夜醒來母親無須起身便可躺著授乳,兩人未完全醒來便可再度快速入睡,結果大家的睡眠質素都有顯著改善,晚上我們更從來未曾「補過奶粉」。

太太放完產假後,本來打算每天把母乳泵出來放入雪柜冷藏或冷凍,讓我在家以奶瓶餵給BB,但我嘗試了整個月和多個牌子的奶咀,BB也對奶咀有強烈的抗拒 (他卻較接受用杯餵)。幸好我們住得近太太的工作地點(快步行約十分鐘),結果不是太太在午飯時間回家,就是由我用揹帶揹起BB到太太的工作地點讓她直接授乳 (她的辦公室在港島東區,但若她需要到西區甚至九龍區開會,我也會把BB揹到她的面前)。這樣維持了差不多一年 ,每天下午我也先在公園裡哄依偎在我胸口上的孩子小睡一會,孩子醒來時張開眼睛便馬上見到媽媽,直到BB超過一歲,進食固體食物顯著增加,我才減少了揹他去吃奶的次數。

7. 在餵哺這方面,你覺得丈夫能幫到太太的地方多嗎?有那些方面可以幫到?

我覺得就算不是全職爸爸,仍可以在很多地方幫到太太餵哺母乳。首先要了解妻子產後疲累和賀爾蒙的改變,對自己的「興趣」可能比以前冷淡。其次丈夫不要給太太太多的餵哺壓力 ,反而應該常常為妻子打氣,及聆聽她的困難和擔憂。遇到有些親友不體諒或無知的評語,丈夫應該勇於為妻子擋駕 。當然,若丈夫能於下班後參與育兒的工作 (若在假期,最好還包括夜半育兒,讓妻子終於可睡個好覺)和主動分擔家務,這些實質幫忙對你的太太是十分重要的,這些關心的行為只會使你在她眼中變得愈來愈性感 :-)。

若爸爸能參與育兒工作、發揮他的父愛,他就能培養對弱小生命的敏感度,使他的人格發展更健全。

有一件事丈夫要緊記,就是降低對家居整潔的要求!產後的時間,妻子的責任是康復和學好照顧寶寶。如前所述,家務最好由你親自動手或主動分擔,或安排一些清潔工作在遲一點進行,當然若真的沒有時間,應該考慮僱用家傭或家務助理。

8. 你認為能幫助太太成功餵哺母乳,對你自己和你的家庭有什麼好處?
若太太能成功餵哺母乳,其實是有很多好處的。首先當然是昂貴的奶粉支出大幅減少!其次,母乳餵哺對寶寶的健康較有保障,與奶粉餵養比較,嬰兒的敏感病、濕疹等機會減少 (又無需擔憂「三聚氰氨」等毒害和污染問題),母乳內的抗體使寶寶較不易生病,這樣家庭的醫療開支和雙親因請假而少收的工作收入亦減少。當然,爸爸、媽媽和嬰兒三者間更親密的關係,不是用金錢可以量度的。

Franklen

Interview in Babynews


My interview in Babynews magazine (Baby親子雜誌), Issue 189, 08/2009, pp.26-7. Click image to enlarge.
(Baby親子雜誌 第189期 對我的訪問原文)

加入圖片

2009-06-27

DS was on the radio!

DW and I (shamefacedly) talked about parenting on RTHK Radio 2. The topics covered included: breastfeeding, babywearing, baby-led weaning, continuum parenting and social participation, discipline, etc. The program was broadcast on 26th 8:00pm: http://www.rthk.org.hk/rthk/radio2/89/20090626.html

2009-06-26

La Leche League newsletter

After my photo of DW's breastfeeding lying down became the cover picture of La Leche League Asia Newsletter (Vol.9 No.2 2008), I am so glad to know that my article "From Breastfeeding to Baby-led Weaning" will also be published in an coming issue of LLL Chinese newsletter. I hope I can make more contribution to the breastfeeding movement!

2009-06-24

"Modern Papas's Tips on Successful Breastfeeding" seminar



It was organized by the Hong Kong Breastfeeding Mother's Association and held in the Western District Community Centre on June 20.

Over 40 people attended the seminar, not bad! Made a nice presentation (IMHO :-). How wonderful DS was so calm sitting on my laps.

2009-05-28

從母乳餵哺到由嬰兒主導戒奶


(本文亦刊於《國際母乳會中文會刊 2009年第二期》及《香港母乳育嬰協會2009 年8 月季刊》﹞

「這天,十五個月大的新仔的胃口不錯。與爸爸一起吃的早餐,吃的是最愛的牛油果﹝夾在花生醬黑麥三文治裡)、小半隻香蕉和少許豆漿。

下午的點心是忌廉芝士有機糙米餅,用飲管杯喝開水。

像 過去幾個月一樣,今天的晚餐也是和爸爸媽媽同桌吃飯。新仔用咖啡匙吃了兩口白飯後,便用手指快速地拾吃了一握量的小雞丁﹝喔,他很愛吃白肉哩)。雖然新仔 剛滿一歲便懂得握叉和匙,但用手吃還是快得多。期間,還吃了兩小朵西蘭花和一塊紅蘿蔔。當他開始把玩高腳椅托盤上的餐具和食物時,媽媽趕快把它們拿走,並 遞上一小碗魚湯,讓新仔拿著小湯匙自行餵飲。飯後的水果時間,新仔用小鋼叉吃了一小碗全脂乳酪橙粒‧‧‧‧‧‧

雖然新仔食飯時經常弄髒頭 髮和衣服,有時也會因為出牙、疲倦和生病等原因心情和胃口欠佳,可是爸媽對他自行進食的能力(包括自我決定進食的量和種類)很有信心。況且,在正餐和小食 之間,新仔還繼續從媽媽身上得到最保障健康的母乳的補充,故此爸媽從不擔心他的營養。他們的理想,是盡量跟隨世界衛生組織的指引,自兒子六個月大後引進固 體食物起,讓母乳餵哺可持續至最少兩歲。」


和很多父母一樣,當BB六個月大時,我們本來打算跟隨主流的做法, 用匙羹餵BB吃糊狀食物。可是,花去整整一個月的時間、流了不少眼淚,無論匙上的是什麼﹝包括以母乳開稀的米糊、麥糊、果茸、菜茸等﹞,BB的反應不是緊 閉雙唇,就是立即把入口的食物吐出。我們開始焦急了:是否應像很多家長一樣,早在 BB三四個月大時就餵食,不理會敏感風險?BB會否永不接受固體食物?我們是否要像某位護士的建議,剛開始引入固體食物時便排在餵母奶前,不顧BB的需 要,「迫」BB因肚餓而接受?

可是,當我們夫婦倆吃飯時,當時這個已滿六個月大的BB,明顯地已不再滿足於只是坐在高腳椅上把玩玩具了,他要模仿我們把手上的食物放進口中!對我們來說,孩子已準備好接受固體食物了。參與成人世界多采多姿的生活,應該是一個愛探索的正常孩子的成長原動力吧。

既 然孩子已滿六個月大(我們的BB五個月時已能坐好),他的消化系統和腎臟功能應該比四個月時的好,食物致敏的機會亦減少(除非有家族敏感史),我們索性參 考英國衛生署的最新指引,直接向BB提供手指食物(讓BB用牙肉咬嚼),讓BB慢慢學習咀嚼食物和手部控制,並與我們同桌吃飯。起初是較軟的食物:牛油 果、香蕉和蒸腍了的西蘭花朵、番薯和薯仔。經過四個月的練習,未到一歲,孩子已差不多和我們吃著同類的食物了(除了小部份對他可能致敏和有毒的食物如牛 肉、牛奶、貝殼類、蛋白、酸果、蜜糖等):各種水果(切開一片片或整個地提供 [開始出牙後]如蘋果)、剪碎了的綠葉菜葉(在白飯中拌勻)、各類瓜菜、蒸腍了的小粟米、小甘筍、肉類如魚肉和雞肉、蛋黃、豆腐、五穀類如白飯/粥(加入 少許糙米)、加入全穀或黑麥粉的白麵方包、低鈉低糖餅乾、通心粉、剪短的意粉、乾穀和煮熟的燕麥片等。

我們盡量希望每餐或每天的菜式中也 能提供均衡的營養。為了孩子日後的口味和健康,烹飪時我們只用極少量的鹽和糖調味(從大人的菜餚中分取BB的部份後,才添加醬油到前者中);購買包裝食物 時(如作為早餐),我們會細心檢查它們的成份標籤,確保沒有可能損害BB健康的添加劑和過多的鈉和糖。每星期一兩次的外出吃飯,除了只幫襯那些對BB安全 的食肆環境,還不讓BB吃到味精、高鹽、炸油和反式脂肪 (有時只能自備食物)。

為了安全起見,我們確保BB進食時坐直身子、不向他提供 細硬(如果仁、果核)或細圓的食物(如每粒提子會先切開最少兩半)以免鯁喉;避開魚骨;不提供易粘住的全白麵包,並只薄塗果仁醬。最初我們把食物切成BB 可用整個拳頭握著的塊狀讓他咬和嚼一點 (或吸吮肉塊的汁),到BB能用手指拾起(pincer grasp)食物時才切粒,流質食物則在BB願意接受幫助時才提供預載食物的匙羹,讓BB自行拿著。進食時必把電視關掉以免BB分心 (其實我們從不讓他看電視)、不讓BB獨個兒或走動時進食;並且克制要填餵BB的衝動,以免不小心把食物送至BB口腔太後的部位(而BB又已無法透過作嘔 反射保護自己)。

在英國有超過20年保健視察員經驗的拉普利(Gill Rapley)把家長在引進固體食物時索性讓嬰兒自行餵食的做法(類似上述)歸納為「由嬰兒主導戒奶」(Baby-led Weaning)。根據拉普利的觀察,這個方法讓BB接觸和嘗試不同顏色、形狀、體積和質感的食物,與匙餵法比較起來,嬰兒對食物的興趣大增,更容易接受 一些要咀嚼的食物、減少便秘和日後偏食的機會,並使BB發展手部控制能力。當BB進食更多固體食物時,要求的奶量便會自然減少,過程由BB主導(或頂多由 BB和大人的共同主導),慢慢完成整個引入固體食物的過渡期。

現在回想起來,我們的方法適合自己的BB,除了因為他似乎天生是一個衝動 的性情兒外,還可能因為母乳餵哺本身就與嬰兒被動的接受餵食不太相襯。嬰兒在母乳餵哺中,是主動地依據自己的需要吸吮母乳的(如透過控制吸吮的時間來平衡 前乳和後乳的比例)。而母乳因母親的飲食產生不同味道,又令嬰兒日後容易接受不同的固體食物。可以說,由嬰兒主導減奶是母乳餵哺的合理發展,後者為前者提 供穩固的基礎。

現在BB已經十五個月大(十個月起已開始走路),已進入人稱「嘴刁」階段的幼兒期了。讓嬰兒主導減奶的思想再次提醒我們, 不以食物作為賞罰或逗哄的手段,尊重和信任BB自我進食的需要、意願和能力(大人的責任是提供健康和多樣化的食物和示範正確的用餐規矩),可能是保持進食 作為一種饒有趣味的家庭/ 社交活動、避免進食時間淪為父母和孩子的角力場的有效方法。


註:

1. 這篇文章是打算投稿到某支持母乳餵哺的刊物中發表,故嘗試整理母乳餵哺與由嬰兒主導戒奶之間的理論關係,並不表示作者認為以配方奶粉餵養嬰兒必然不適合這種戒奶方法。

2. 「Weaning」是指引入固體食物到完全離乳的過渡期,一般譯作「戒奶」、「斷奶」。可是,理想的Weaning應是指一個漸進而不是突變的過程,筆者 認為譯做「減奶」比較恰當。由於「戒奶」這個名詞在本地甚為流行,為方便讀者搜尋本文,標題沿用「戒奶」,但內文則兼用「減奶」、「戒奶」。



(圖片:新仔八個月大首次吃木瓜時的感動。攝影:筆者)


相關文章:期望香港,對母乳餵哺友善 ──寫在2008年母親節前夕

Related Website: Continuum Fathering 原續父職



答客問: 牛奶以外的選擇......
問:「既然餵人奶,其他牛奶食品可以減少乎?」

1 鮮牛奶:BB 一歲前,我們從沒有給他喝鮮牛奶 (所有嬰兒一歲前都不適合喝鮮牛奶,因鮮奶蛋白比配方奶粉更易致敏)。BB現在雖過了一歲,但也只「吃」過少量 (我視高熱量和高脂肪的鮮牛奶為食物 )──用來加入炒蛋、做粟米湯和拌粟米片,原因我懷疑(未能確定)他對鮮牛奶有少許敏感 (皮膚有輕微紅疹)。

人奶仍是BB的主要食物和飲料,其他時間我們是以清水 (大部份時間)、無糖 (市售) /有機(自造)豆漿、有機燕麥粉/杏仁粉開奶,或(一歲後) 溝稀了的橙汁給他喝的。

我個人不希望BB戒人奶後每天吃牛奶/奶粉 (就算他對牛奶無敏感),因擔心蛋白質結構本來是給牛仔飲的牛奶的蛋白、脂肪和乳糖長遠對他這位人類的營養和健康有害。

2 含有牛奶成份的食品:BB 和我們外出吃飯,也吃過一些有牛奶成份的麵包和中式點心。不過,我們現在基本上已沒有再買集團式麵包店的麵包了 (那些除了用奶粉外,還勁多添加劑,而太多的添加劑[和電視]被認為與兒童過度活躍症有關),改為用麵包機在家自製麵包 (只間中幫襯樓下的小麵包店的新鮮出爐麵包),那樣便可以在食譜中用燕麥粉取代奶粉。

3 乳製品:BB對牛油 (沒有含致敏的蛋白)、芝士和乳酪(經過發酵)均無敏感,故我們也有用無添加鹽的牛油自製麵包、蛋榚、鬆餅和曲奇,和用牛油和忌廉芝士塗麵包和餅乾。乳酪是BB最喜愛的食物之一,我們每星期也在家中發酵乳酪給他吃(多是拌水果粒同吃)。


問:「牛奶太多化學物質,生產過程又要牛受苦,又要花費好多資源。」

唔‧‧‧‧‧‧ 這真是個難題。其實不只是牛奶,畜養出來供宰售的牲畜,吃進的飼料往往有農藥,又給強行餵了太多激素和抗生素,和自小忍受工廠式生產的惡劣環境。作為消費 者的徹底應對辦法,似乎不是改吃目前還是偏貴的有有機/人道認證肉 (我們試過買有機雞和蛋,但覺開支太大),就是改為全素食(我們暫時未有足夠的營養知識[和勇氣]去這樣做──現在頂多是fishy-chicki- tarians)。我們現在的做法,是希望BB盡量多吃水果和蔬菜去均衡營養 (很多家長都有這樣的經驗:子女自小不愛[多]吃水果和[特別是]蔬菜)、並「間中」於早餐時以果仁醬和磨碎的種子和午晚餐以豆腐去代替肉類蛋白、以波菜 /乾果/豆腐等配合鮮果的維他命C去代替肉類提供鐵質和以燕麥奶、豆腐、豆漿、黑芝麻、杞子、綠葉菜等去代替乳製品提供鈣質。

From Breastfeeding to Baby-led Weaning

Chinese Title of the Original Article: 從母乳餵哺到由嬰兒主導戒奶
The following English version was translated by Google.

2009-01-25

Our best parenting decision ever made

Today DW and I talked about the numerous parenting decisions we've made so far and if there exists the best one (despite all our horrible mistakes!!! :wink: ).

For us, the best decision may be "moving house". The decision was planned, but the fact that it has been the best is retrospective.

DW and I had lived in a very small house (with a cat) for nearly 10 years before she was pregnant, and we had moved our house (still with the cat) to a place very near to DW's workplace (10 minute's walk suffices) just before DS's birth. At that time we only had a vague thought of "living close to MaMa's workplace so that mother and baby can see each other easily" (considering the general breastfeeding unfriendly environment here).

It has turned out that this decision was very correct because DW had problems expressing enough milk for storage, and DS actively resisted bottle-feeding (or any other containers holding BM - I was worried at that time - we had tried a dozen brands of bottles and teats). Since DW has resumed her job, there has been virtually no need for expressing breastmilk because either DW returns home to nurse during a short break or I wear DS to her workplace for a feeding (except once - but I used a banana instead of EBM!!! :D ).

Although usually everything is done in a quick rush - the timings between DW's scheduled meetings, DS's needs for feeding and naps often crash (which make me rather stressful)! But on the whole, we have been still able to manage it quite well IMHO (including the fact DW's bosses have never grumbled).

However, we may still move house again in the near future, because air pollution (and rent rate) is a problem in this most crowded part of the island. So if there is BabyFranklen2 (hopefully!) we may not be able to replicate this decision (I guess I will be very nervous again).

What about you? Could you share any best (planned or retrospectively speaking) parenting decision you think you've made so far?

2009-01-09

Re: veg then fruit?

I second the saying that breastmilk is so sweet it doesn't really matter whether vegetables come before fruits when introducing solids in babies. In addition, breastfed babies have already experienced different tastes from hsr mother's breastmilk. They are more likely to enjoy the different tastes of solids and be less picky.

Fruits were DS's first foods, but he still loves food with very mild taste (e.g. plain rice).

"Breadfeeding"

I don't know if you believe it or not, but it's very true that recently whenever I want to type the word "breastfeeding" in international forums, I will type it breadfeeding instead first. I am often laughed by others as a result.... Poor English from a non-English writer....

I guess I am being poisoned by blw and breadmaking....

So, please forgive me in advance!!! :)

(OK, I am not alone, there are 432 entries if you google the word.)

What is Continuum Fathering?

:oops: Actually I created this name for myself (you can't google it :wink: ).


I try to integrate the principles described in the book continuum concept into my (as a father) style of parenting:

http://www.continuum-concept.org/


I try to involve myself as much as possible in (supporting) breastfeeding, co-sleeping, baby-wearing, and being responsive to my babies' needs with respect, and I see children as inherently cooperative and social and capable of living in harmony with Nature, etc.


People may call this "attachment parenting" (some may even consider it a fad), but actually these principles have been practised by many traditional cultures for centuries, and so are not a modern ("Western") invention as is often assumed.


I am still learning what I want myself to be, so I'd better stop here :oops:

2009-01-04

Re: Facebook and breast feeding photos

What a shame. Breastfeeding is one of the most beautiful things in the world.

Will they also ban bottlefeeding photos? Why not?

2008-07-21

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

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.