Christmas Milk

milk_baby

Recently, I reached into the freezer to defrost a bag of breast milk that was due to expire.  I searched for the oldest date first, tossing aside a few from January until I came across one dated 12/25/13.  Unlike most of the dates on the frozen milk, this one had meaning beyond an expiration date.  I remembered tip-toeing downstairs to pump before everyone woke up and sitting in the glow of the Christmas tree lights anticipating the joy of watching my son run down the stairs yelling “Santa came!”.  I meditated to the whir of my pump, crunched on the sugar cookies left out for Santa, and inhaled the scent of a fresh pine.  I zipped the milk into its bag and tucked it in the freezer just before the city awakened around me.

Christmas 2013 was the first I celebrated without either of my parents, but it was also the first I spent with my new family of four, establishing our own traditions.  I remember watching the wonder of Christmas on my son’s face and how happy it made this newly-minted Santa.  We lingered in our red and green pajamas and ate a breakfast of sugar.  Still on my maternity leave, I sunk into the couch with my two-month-old daughter with the comfort of knowing that we had no place to be other than right there together.  It was as magical as a one expects of Christmas.

Here I was needing now to thaw the Christmas milk before it expired.  It reminded me how precious time is and that although there are so many cliché parenting expressions about how quickly they grow, it really is true.  Six months had passed since I pumped that Christmas milk; my baby daughter is now starting to talk and my toddler son is heading off to preschool.  Needing to defrost this milk made me thankful for 9-months and counting of breastfeeding and how much my baby and I have grown in our breastfeeding relationship.  In the way that perhaps only a day as magical as Christmas can though, that little bag of milk not only nourished my plump baby girl but made me take pause to cherish the present, stop for a minute and hug my kids tighter, thank my husband for joining me on this parenting journey, and look around at the life we are building with gratitude.

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Patient-led Learning about Baby-led Weaning

watermelon

Although I am a pediatrician and a parent, I learn new things from my patients continuously.  This is one of the best parts of my job too.  However, in the moment, I can feel foolish.  One example that comes to mind is when one patient’s mom asked me what my opinions were on baby-led weaning.  Thinking she was talking about weaning her baby from breastfeeding I launched into an explanation of how a baby eventually transitions from breastfeeding to cows milk, while the mom politely waited for me to finish and then said, “no, this is a British way of introducing solids.”  While I blushed, I let her explain the philosophy of baby-led weaning to me and we discussed the risks and benefits as best I could without knowing much about it.   After getting this impromptu lecture, I went home and did my own research so that I could be prepared to answer questions and advise them at follow-up visits as they trialed baby-led weaning over the next few months.

As patients expose me to a broader range of parenting philosophies, strategies, and techniques, I grow as a pediatrician and am able to share new information with other parents.  After learning about baby-led weaning from these parents, I was better prepared to discuss it with parents in the future.  I have even incorporated things I learned about it into my usual speech about introducing solids.  Also, I was able to have some academic discussions with colleagues on this topic, in some cases teaching them what I had learned and in other cases soliciting their experiences with this method of feeding to enhance my own knowledge.

pancake

Patients always ask, “what would you do if it were your child.”  Well, when it came time to introduce solids to my second child, I did a combination of traditional pureed baby foods and baby-led weaning.  It turned out that she wasn’t interested in foods for months so there wasn’t much eating initially, but lately her interest has grown.  Some of our adventures in baby-led weaning are less about making a conscious decision to follow a particular philosophical approach to food and more about convenience.  For example, if we are eating at a restaurant and she reaches for my bread, I let her try it.  Of course, I only let her try things that she couldn’t choke on and make sure that they aren’t overly seasoned.  Besides bread, she eats whole pieces of banana, avocado, carrot, pretzel rods, pancakes, lettuce, and watermelon.  When she goes to daycare though, I give her purees, as I worry about whether or not they can adequately supervise her self-feeding.  Luckily, she enjoys her purees too, especially lentils!

purees

Regardless of whether or not a family does purees or baby-led weaning, there are a few things that I advise all parents will be universal truths of introducing foods:

1)  It is going to be messy.  Be ok with getting a little dirty.  You can take off clothes and have the baby just wear a bib to help cut down on the laundry.  An easy-to-clean high chair also helps.  We had a cloth chair with our son, but switched to a cushioned wooden chair that is much easier to wipe down with my daughter.

2)  You need patience.  Since babies have a tongue-thrust response initially, more food comes out than goes in.  It may also take 10-12 times of trying a food before a child accepts it.  So, don’t rule out a food based on 1 or 2 lackluster responses.

3)  You need to listen to your baby.  Whether doing a “baby-led” approach or spoon-feeding, you should always follow your baby’s cues.  Babies will let you know when they are hungry and when they are full, so listen to their needs.

4)  Have fun!  Eating is a highly social experience and a way many people and cultures show their love.  Make the experience nurturing, calm, and interactive.  Your baby should eat meals facing you and with you.  Enjoy exploring new foods together and watching your baby’s reactions.

Without the opportunity to learn from my patients, I may not have tried baby-led weaning with my own child.  Now I have a handful of families doing a pure baby-led weaning approach and another group doing a combination approach and I feel more competent in guiding them through this process.  I look forward to what my patients will teach me next and passing it along to others.

 

For more information about baby-led weaning, you can read these resources, however you should always talk with your doctor before introducing solids to your child.  What works for one child may not work for another and there are risks to introducing foods before a child is ready.  This post does not constitute personal medical advice.  Please talk with your child’s healthcare provider.

Baby Led Weaning: the mush stops here. 

Trusting a Baby to Know How to Eat-  New York Times 1/2014

Really Risa: Baby led weaning, week 1-  7/2014

Worried about choking?  Take an infant CPR class from one of these local Philadelphia organizations/hospitals:

American Red Cross

Jefferson University Hospital

Penn Medicine

{I have no affiliation with these courses and cannot speak to their quality.  Please research the best class for your individual goals and needs.  In an emergency, always call 911.}

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High-flying Mommy

takeoff

From beginning to end, the staff at Fly School Circus made sure I was having fun.  While hanging from staff member Matt’s hands and swinging from the trapeze, he asked “smiling?”.  And I was.  After all, I went to the Fly School Circus trapeze class, located up on 5th and Cecil B. Moore, for fun.  There are many clichés that I could use for why a mom of two would take a Sunday morning trapeze class… taking a leap of faith like becoming a parent, showing my children that moms can still have fun, rising above perceived limitations so my children can learn the to do the same.  Really though, I signed up simply to try something different and fun.  Except something happened when I was standing on the tiny platform 25 feet above the ground… I realized that I was taking a leap of faith, showing my children that moms can have fun, and rising above my perceived limitations.  Hey… Fly School Circus tricked me into having fun and learning a few life lessons along the way.

leap_of_faith

After surmounting the ladder to the platform for the second time, the instructor told me, “first time is for fear, second time is for fun.”  As I am not afraid of heights, I didn’t imagine that trapeze would scare me.  I thought that I would show up, learn some techniques, and maybe swing from the bar a few times.  Instead, I found myself getting a quick instruction from leader Mary Kelly before hanging from my knees and doing a back flip!  I was amazed at how far they were able to take me in two hours!  By the end of the class, they assured me that I was ready for a catch– meaning that I would grab onto a staff member swinging from another bar, release from mine, and hang from his arms.  I had no idea that I was capable of completing this move, but with encouragement from Mary Kelly and the capable hands of staff member Matt, I found myself doing just that.

knee_hang

Besides a mom looking for some Sunday morning fun, who takes such a class?  Well, the other novices with me were a yoga instructor and a 6-year-old girl, showing the range of who takes these classes.  There were 3 other children in the audience watching our flying adventures, truly making it a family affair.  With Mary Kelly, a former Ringling Bros. trapeze artist and clown, running things, there was plenty of entertainment between fliers.  Besides the 3 beginners, the rest of the class seemed to be more professionally inclined, doing things without safety wires and performing tricks that left me holding my breath.  They were quick to warn me that once I performed my catch “the next thing you know you are wearing sequins.”  It seemed that most of them had been coming regularly to Fly School Circus for the past two years and so the atmosphere had the friendly and supportive feel of a family.

Jackie_splits

Jackie

My son watched the video of me flying about five times in the car ride home.  While I don’t know if he quite understood what mommy did, he seemed proud.  Most importantly though, I was proud of myself.  I came with expectations of swinging from a bar and left having done so much more.  I’m not quite ready to leave my job for the circus, but I got a great work-out without even realizing it, pushed my own boundaries, and overcame some mental hurdles.  The last time I hung from anything was when I taught my 3-year-old how to use the monkey bars at the park, so this was definitely a big challenge and change of pace.  Thanks to the Fly School team, this “Interdependence Day weekend” as Mary Kelly put it, I learned that I am capable of more than I thought, especially when I put my trust in a few new friends.

Christine_splits

Christine

 

To book your own flying trapeze lesson, go to:  http://www.flyschoolcircusarts.com/Fly_School_Circus_Arts/Schedule_Policies_Booking.html.  Book an entire class for 10 for $540 for your next bachelorette party, mom’s night out, or birthday!

{My Fly School Circus class was courtesy of Aversa PR.  I was not compensated for this post.  All opinions are my own.  All photos are with permission of those photographed.}

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A Very Different Kind of Helicopter Parenting

waterfront

One of the challenging things about being a working physician mom is the unpredictable nature of my work.  As a pediatrician I take calls from home and have a set daily patient schedule, which is certainly more routine than someone who responds to emergencies or attends deliveries, but there are still many things that come up and throw off my schedule.  My family has learned that sometimes a “regular day” can turn into more and that a certain degree of flexibility is needed when dealing with the unpredictability of illnesses.  I learned this lesson as a child watching my cardiologist step-dad in action.

One particular day stands out in my memory.  Knowing that my step-dad was working late, my mom and I drove over to the hospital to bring him dinner.  When he failed to respond to multiple calls and pages announcing our arrival, we grew frustrated and started to leave.  We grumbled about being inconvenienced.  As we drove around the side of the hospital, someone waved us to stop at the cross walk where a team of doctors and nurses escorted a stretcher over to the helicopter on the nearby helipad.  Much to our embarrassment, there was my step-dad leading the team.  Here we were worrying about his dinner getting cold and he was saving lives.

I hope that my kids will learn to appreciate this as well.  There will come a time when mommy is late because she was taking care of a sick child.  As “essential personnel” there will be snow days and natural disasters that close schools and offices but not mommy’s work.  There will be phone calls from worried parents overnight and on holidays that intrude into our own family events.  These obligations and interruptions are part of my job, and make it quite unlike many other jobs.  But there will be days like today that reaffirm the importance of my career to my kids, when walking in our neighborhood we ran into one of my patients and his parents who were excited to see me.  The dad said to my son, “your mommy takes very good care of my son.”  However, my son was oblivious to meaning of this conversation and I informed the parents that he still thinks that I work “at the pretzel store,” which is across the street from my office and his special treat when he comes to visit.  I appreciated the sentiment though.  It was kind of them to want to share with my children their positive experience.  So while he may never see me escorting a patient to a helicopter, I hope that he will see many other positive examples of how my career impacts children in our community.

 

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Baby Bookworms: New AAP policy promotes early literacy

bookworm

As a pediatrician, I dish out parenting advice regularly.  During well child visits, I routinely discuss everything from car seats to sunscreen to childproofing and parents rarely question or challenge this advice.  There has been enough media attention and word-of-mouth coverage of most of these topics that they are already familiar to most new parents.  However, one piece of advice raises some skepticism: reading with infants.

I remember recommending a dad read to his 6-month-old daughter and he laughed at me.  Another mom lamented that her 4-month-old must have something wrong with her because she didn’t like TV, but had never considered trying a book.  New parents of a baby girl raised their eyebrows when I suggested reading as an activity appropriate for a newborn.  Why was reading to an infant more unbelievable than stating that sleeping on ones back prevents Sudden Infant Death Syndrome or that wrapping a baby like a burrito is calming?

Well, as a new parent myself I read with my infant and discovered that it seemed he wasn’t interested in the book as anything other than a chew toy.  It took months before he started to engage with the books in a way that I recognized as reading.  So I understand the hesitancy of these parents.  Why would one read to a child who doesn’t understand story time, who doesn’t have the attention span to listen to a full book, and who can’t follow a plot?  So I encourage parents to think of books likes toys, allowing their kids to manipulate them, flip through the pages, and even chew on them.  They can read the words or just discuss the pictures and point to objects.  Simply sitting together and holding a book increases the language that a child is exposed to and teaches them an important lifelong love of reading.

My practice gives out a Reach Out and Read book at each well child visit from 6 months to 5 years of age.  This creates an opportunity for us to discuss the benefits of reading with children and allows me to model age-appropriate reading behaviors in the office.  Yesterday, the American Academy of Pediatrics (AAP) announced a new policy that will encourage pediatricians to advocate reading to children from birth and that CGI America, Reach Out and Read, and Too Small to Fail will be helping to expand our book giveaway programs to these younger infants as well.  I am excited that we can expand our efforts to get more books into low-income families’ homes.  Nothing makes me happier than when a child asks for a lollipop at the end of a visit and when I say that we don’t have any but they can have a book instead, I see a huge smile across their face.

 

Older posts about reading and Reach Out and Read books:

Book Nook

Bedtime Stories

Booking It Out of the Bookstore

 

What N is reading now:

Moustronaut

Chrysanthemum

 

What G is reading now:

Lilly’s Chocolate Heart

Olivia Counts

 

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