HAND EXPRESSION SAVED THE DAY!

Oh no! I left my electric breast pump at home!

Every working day, I bring to my office two containers--a Coleman soft cooler where I put my storage bottles, breast pump flanges and ice packs, and a white plastic box where I put my electric pump. While I always check if the green and white containers are in the car, I failed to do it this one time. Then, Murphy's law struck!

I have no choice but to learn how to hand express breastmilk. And I had to learn it fast.

Fortunately, I came across this video on the Marmet Hand Expression technique.

After watching the video twice, I was more or less confident to give the Marmet technique a try. I am happy to say that after expressing twice (one at 12 noon and the other at 5 pm), I was able to express 8 ounces of breastmilk. Not bad for a first timer!

Of course, this was way below my usual yield when using my ever reliable electric pump. But at the very least, I didn't have to endure the discomfort (and even pain) of engorged breasts.

Here are the things I learned while doing the Marmet technique:

• When done properly, it is NOT painful at all. The only discomfort I felt was in my right arm, the one I used  to express milk. I was able to lessen the ngawit by placing my right elbow on an arm rest. (I guess with more practice, I would be able to learn how to use my left hand effectively.)

• Use a wide-mouth bottle to collect the milk. I could just imagine how difficult it would be to collect the squirting milk with the more common narrow-mouth bottles.

• I was able to collect more by expressing alternately from right to left breast.

• Have clean tissues near you to wipe off milk drops. It is extremely difficult to get a good positioning of your fingers when the skin around/under the areola is wet. Without good positioning of fingers, you will not be able to express milk effectively. 

Hand expression of breastmilk is one HANDY skill to learn.

• This is especially important for moms who have just given birth and who, for one reason or another, cannot directly feed their babies yet. I found this video from Stanford School of Medicine's site showing how hand expression can be used in getting the much-needed colostrum. (If only I knew about this! In the hospital where I gave birth, I had to go to the nursery to breastfeed my baby during the first 24 hours. Now this was extremely difficult for someone who has just undergone a cesarian operation.)  

• For moms who are suffering from sore nipples, hand expression will buy you some time to rest and at the same time, you will still be able to feed your babies with expressed breastmilk.

• For stay-at-home moms who need to express milk occasionally only, why buy pump when hand expression can do the job?

• For working moms who have limited budget, why waste your money on a bicycle horn pump? True, it is inexpensive. However, it is not efficient at all and is even painful to use. Some experts discourage use of the bicycle horn pumps because they may be difficult to clean and dry. (Source: US FDA) 

• For working moms who have efficient pumps, in cases of emergency (e.g., you left your pump, some parts are missing, etc.), hand expression will save the day! 

WHY I DON'T NURSE IN BREASTFEEDING ROOMS

"Welcome to the Milk Mama Diaries Carnival (July). For this month, we join the National Nutrition Council - Department of Health in celebrating Nutrition Month with the theme "Isulong ang Breastfeeding - Tama, Sapat at EKsklusibo!" Participants will share their experiences in promoting breastfeeding or their tips on how breastfeeding should be promoted. Please scroll down to the end of this post and check out the other carnival participants."

*****************

I don't nurse in breastfeeding rooms. Never did. Never will.

Don't get me wrong. I laud the malls' program to put up breastfeeding rooms. In a country where malls spread like mushrooms and where malling has evolved into a national pastime, providing rooms where moms could breastfeed in relative peace is indeed commendable. 

But I don't nurse in breastfeeding rooms. And my decision has nothing to do with their location, size or cleanliness. (Considering how bad I am with directions, B might already be howling in hunger by the time I find the breastfeeding room.) 

It's about promotion. As an advocate of breastfeeding, I've been religiously writing blog posts about it. I talk to my friends and colleagues about it. I even wrote an article about my experience as a full-time working and breastfeeding mom in a local newspaper! But I know that nothing beats seeing a breastfeeding mom in action.

So when I'm in the mall, I don't nurse in breastfeeding rooms.

I breastfeed in cafes. 

While nursing B in a cafe...

Guess who passed by less than 2 meters away from me? 

I breastfeed in restaurants.

Breastfeeding while waiting for our food.

I love this red breastfeeding boncho!

Look how stylish it is!

With the SaYa carrier which doubles as a breastfeeding cover.

Come to think of it, I have nursed practically anywhere as long as there is a chair I can comfortably sit on.

Hmm, I think this was in Tree Top, Subic.

At a hotel-resort. (I just pull the boncho a bit to make sure that
B can breathe properly.)

By the beach.

Besides, breastfeeding in public places has become an opening (no pun intended) to a number of interesting conversations. One lola, seeing me breastfeed B, said that B is very lucky. Why? Because he's drinking breastmilk. She said that her apo drinks formula because her daughter-in-law is a working mom. Aha, you could probably guess where our talk led to.   

I understand that there are some moms who may feel uncomfortable nursing in public, what with so many prying eyes. But there are a number of ways in which moms can breastfeed in public discreetly. Here's an informative post on nursing in public.

I do not know what really happened. But somehow, formula-feeding became the norm. Ask yourself. When you are in the mall, how often do you see babies and young children drink formula from bottles? Now, how often do you see moms breastfeeding their babies and young children? 

More than ever, our generation needs to reclaim what has been lost. We need to send the message that breastfeeding is as natural as breathing. We need to educate the younger women that breastfeeding is normal and is not something to be ashamed of. We can only do that if people begin seeing moms breastfeed their young ones anywhere and everywhere. 

For in the end, actions speak louder than words. 

And this is why I don't nurse in breastfeeding rooms. 

*Please read the breastfeeding stories of other gorgeous moms here:

Three Ways I Promote Breastfeeding by Example by Dainty Mom

A Simple Breastfeeding Campaign by The Lazy Mama

I Am A Breastfeeding Mom by The Painter's Wife
On Promoting Breastfeeding by ImPerfectly Created
Breastfeeding Promotion Tips from a Formula Feeder by The Fearless Formula Feeder
The Low-Milk-Supply Mommy Did It! by The Odyssey of Dinna
Milk Mama Diaries 3 by Benz Rana
Breastfeeding Mama by canDIshhh
I *heart* Breastfeeding by The Mum Side
Spreading the Word on Breastfeeding by Mommy Kwentos
A Breastfeeding Formula-Fed Mother by Soprano Mom
Breastfeeding: Promoting It Even If I Didn't Get Lucky The First Time Around by Glamma Momma 
Taking Breastfeeding Further by Mec as a Mom

I am your breastfeeding friend by Chrissy 

More on Breastfeeding Promotion plus a Guest Post by Chronicles of a Nursing Mom 

Breastfeeding Promotion - A View from a UK Doctor by Dr Sarah
Thoughts of a Lactating Counselor: Breastfeeding is More of Psychology by Handy Mommy
Celebrating my Magic Milk by Denise Gonzales (@deelirious)
Breastfeeding Sisters by Isis Evasco


And a post by one really cool DAD:
Why It's Easy to Support Your Breastfeeding Wife When Your Favorite Sport is Basketball! by Jonathan Adam Roxas

YOU ARE AMAZING!

"Ate, you are amazing!"

This was Ina's reaction upon learning that her Ate Fran has been accelerated in her ballet class. A year after starting ballet together, Ina is now in yellow class while her Ate is in lavender, or two levels higher than yellow.

Not only that. Her Ate Fran is one of those chosen to take the Australian ballet examinations in April, an opportunity that is given to a select few.

I was really worried about how Ina would take the news. Would she be depressed? Would she be envious? With a mere two-year gap between her and Fran, it's not uncommon for Ina to compare herself, her abilities, her accomplishments with that of her Ate's. That Fran has this not so nice habit of telling Ina that she's better in Math, in writing, in drawing, oh the list goes on, does not help (we're working on this). I, as the mom/referee, usually end up telling Ina that Ate is better at some things because she's two years older.

"Wait until you turn 8," I told her.

To which Fran has this ready reply, "But when you're 8, I'll be 10!" Hay.

But it turned out that I need not worry. Ina, my lovely little girl, has shown maturity beyond her years. She was not only happy for her Ate, she was actually proud of her! She reasoned out that she would probably be in lavender class when she turns 8. But for now, she's happy that she's been promoted to the yellow class.

Besides, she may not be a good ballet dancer. At least not yet. But she is one terrific storyteller.

Thank you Ina for teaching me a valuable lesson. Thank you for reminding me that there is such a thing as finding joy in somebody else's happiness.

You are truly amazing.

Kung fu snake-style?

THE PROMISE

My first daughter started dancing ballet last year at the age of 7. I guess that's a little late. But at age 4, she was more interested in swimming.

F may have started late but she's dancing as if she's trying to make up for lost time. I've never seen her this passionate, this intense, this serious. Ballet simply brings out the best in her.

And so a year after starting ballet, she had her first recital.

F as a sprite.

That's her on the right side.

Doesn't she look good?

The Hawaiian number was such a big hit! F is 3rd from left.
My 2nd daughter is in front of her.

F is on the left.

F and I are in the front row.

With her superb ballet teachers and schoolmates.

Last Saturday, her teacher happily informed me that F will be accelerated from pink to lavender* class and that she is one of the few students who will take the Australian Conservatoire of Ballet (ACB) examinations slated in April next year. She emphasized that not all students are given this opportunity. She also suggested that F take extra ballet lessons.

Now, F is already taking street dancing classes on top of her regular ballet classes. I don't want to pressure her so I left the decision to her. Her decision? Yes, yes, yes.

As I looked at the older girls who probably have been doing ballet since they were 5, I saw the promise of what she, with hard work and dedication, could become.

For now, I would hold on to that promise.


*I never did ballet. But as far as I know, the beginning classes' uniforms in her school are pink, yellow, red, then lavender.
*My second daughter is in yellow class starting this month. Here is my post on her reaction when she learned that her Ate would already be in lavender class.

THE LISTERINE THEORY: IS YOUR CHILD PAMPERED?

"Is your child pampered in a way?"

I was asked this question by a colleague when I posted in FB that my firstborn is studying in a progressive elementary school.

Do I feel like my child is pampered? Definitely. And in many ways.

If it means that my child finds so much happiness in school that she looks forward to going to class everyday, then yes, my child is pampered.

If it means that my child is always eager to learn something new, then yes, my child is pampered.

If it means that my child is excited to do her homework (which doesn't feel like work) on her own even on a Friday night, then yes, my child is pampered.

If it means that my child asks, nay, begs to be given challenging problems in Math and Science, then yes, my child is pampered.

"Why are our schools not places of joy?" This was the question posed by John Godlad twenty five years ago. Alfie Kohn calls it the Listerine Theory of Education. "If it tasted vile, it obviously had to work well." Never mind about child stress. Never mind that young children barely have time to play.

Somewhere along the way, our educators equated more assignments, more advanced topics, more subjects with better quality of education. In the process, learning became a chore, a bitter pill to swallow.

I know how it's like to dread going to school. I know how it feels like to spend hours studying something not because I really like it but because I have to. I've been through that--when I was in law school.

My daughters can wait until law school to feel that. But for now, I want them to find joy in learning.



Source: Alfie Kohn, Feel-Bad Education

*If you want to read the free and abbreviated version of Alfie Kohn's Feel-Bad Education, please check this. But if you want to read more, then you may want to check the book itself.

EXPERIENCING "EXPERIENTIAL" LEARNING

Experiential learning.

I've encountered this term a number of times in the past 5 years. I've heard of it from school administrators, teachers and even parents. I've read about it in books, online fora and blogs. And with two daughters who are enrolled in progressive schools, I've actually experienced it.

So what is experiential or active learning?

"Active learning takes place with experiences. As students have various experiences, they pick up knowledge. Students will learn more about zoo animals by going to a zoo than by reading about a zoo in a book. Students will learn more about fall leaves by collecting them than by listening to a teacher talk about what they look like. Experiential learning includes all senses, such as sight, smell, sound and touch, to create an overall learning experience." (Source: Active Learning for Children)

Experiential education is often contrasted with didactic education, in which the teacher's role is to "give" information/knowledge to student and to prescribe study/learning exercises which have "information/knowledge transmission" as the main goal. (Source: What is Experiential Learning?)

And so in the spirit of experiential learning, my daughters and I have been to Sta. Elena Fun Farm to see farm animals in action. After seeing what a carabao looks like, my then 4-year old daughter exclaimed, "Oh, a carabao is different from a cow!"

The carabao at work. :)

The carabao at rest.

Do you know what a chrysalis is? I don't. At least not before my daughters pointed out that it's a pupa, the third stage in a butterfly's life cycle. Years after visiting the Marikina Butterfly Farm, they can still remember it because they actually saw a chrysalis.

What about the different rooms in a house? It might be a little boring for a 3 or 4-year old to read about it. But learning becomes more exciting when there's a house visit! 

The usual "What do you want to be when you grow up?" is a source of an animated discussion especially if a doctor or a dentist (or even a lawyer!) is invited to talk about what he or she does.

Who are the community helpers? Have you met them? My daughters did when they visited a fire station and met real firemen.

And how do you explain fractions to a 4 or 5-year old child? You invite them to a pizza house! After seeing how the pizza is cooked and sliced, the teacher can now start explaining the concept of fractions, and hopefully, before the pizza is all gone!

Is your child having problems mastering left and right, forward and backward? My daughter happily told me that she enjoyed a game in class where they were grouped in twos. To pass through an imaginary maze and reach the finish line, her teammate has to follow her instructions. "One step to the right. Two steps to the left. Two steps forward..."

Oh, and this one is a favorite. How will your child remember the different parts of a fish? By "inviting" Mr. Tilapia in class! How do you explain the difference between a living and non-living thing? Let the kids observe mongo sprouts grow side by side the "it's-not-alive" stone.

Of course, there are times when the subject matter could not, for practical reasons, be the subject of experiments, field observations, field trips, games, role playing. This is where imagination comes in. And so when my daughter was asked to bring a picture of an animal that lives in cold places, she also showed this picture to her classmates: 

and ended her show and tell with this question--"Doesn't Barkie look like an arctic fox?"

*If you want to know more about experiential learning, you may check this, this and this. But if you're really, really interested in it, you may want to check out John Dewey's book on Experience and Education.

RIZAL'S EXECUTION IN ACTION!

(Photo of Jose Rizal's execution taken by one
Manuel Arias Rodriguez
Courtesy of Norman Sison)

A Facebook friend who is a history buff shared this picture with the note that Dr. Jose Rizal, the Philippines' national hero, was actually shot by Filipino troops. Behind these Filipino soldiers were Spanish army troops who were there to insure that the Filipinos would do the job.

As 2011 marks our national hero's 150th year, I mentioned this tidbit of history to my 8-year old daughter.

"But I know that already!" she exclaimed. "Cesar Montano was in our school and there was a re-enactment of Dr. Jose Rizal's execution," she continued. I could only nod as she went on saying, "Some of the older kids played as members of the Filipino troops while the others played as Spanish soldiers."

Actor Cesar Montano as J. Rizal

(F with her classmates and "Dr. Jose Rizal")*

She probably would not have remembered this historical detail if she simply read it from a book. But to witness a re-enactment of Rizal's execution, I guess that's difficult to forget!

Now, this is one of the things I like about F's non-traditional, progressive school. And it's not the showbiz part. Lessons are presented and discussed in interesting, innovative and creative ways. Lessons and homeworks are engaging and never overwhelming. As such, F is always eager to learn. In fact, she loves going to school so much that she is extremely disappointed whenever classes are suspended.

I just hope that the next time F's school invites Cesar Montano to re-enact Rizal's execution, the parents are invited as well. After all, who wouldn't want to see "Rizal" in action? :)

*To protect the privacy of the other children, I did something to blur their faces. As I'm not a techie, that's the best I can do.)

THIS BABYWEARING MOM IS NOT ALONE!

(Photo courtesy of Benz Co-Rana of MimmaBenz.com)

I attended the Babywearing Meet 2 at Starbucks BGC last Saturday. And for the first time since I started babywearing, I didn't feel so different. So alone.

By now, I'm used to being stared at whenever I go out with Basti in a SaYa, my ultra favorite  infant carrier. I've received various comments ranging from "Di ba siya naiipit?" to "Para kang Muslim sa Quiapo!" (As if there's something wrong with that! Oh, but these moms are great! They found a good way to take care of their children while working.) 

It was good to see a lot of moms (and even dads) who practice babywearing. Everywhere I looked, there were moms and moms-to-be wearing pouches, ring slings, and SaYa. I even saw a dad with a "gear" that looked like a mountain climber's backpack babywearing his oh so cute baby. Cool! 

I also got to see my MBA friend Grace, a SaYa convert, with her adorable baby G.

(Photo courtesy of Grace)

I guess the Starbucks staff felt like there was a babywearing invasion! 

And if you think that babywearing is only for moms and dads, think again. My own tatay loves to babywear his first and only grandson Basti! He even knows how to use the ring sling.

Cool babywearing lolo using a pouch.

Babywearing is for Ates, too! I stumbled upon this picture taken by my hubby in Batad, Ifugao.

For sure, with more and more babywearing moms, dads, lolos, lolas, ates, and kuyas, this babywearing Mom is alone no more!

P.S. For attending the Babywearing Meet 2, I got these uber cute pins for free!

(Cute pins courtesy of Benz Co-Rana)

A WORKING MOM'S BREASTFEEDING STORY (PART 2)

Breastfeeding at the beach!

I'm a breastfeeding mom who has not bought a can of formula since the birth of my now 9-month old baby.

I also happen to be a full-time working mom. I usually leave the house at 6 am to bring my older daughters to school and I normally arrive back home at 8 pm, what with the traffic and all. 

In my previous post, I discussed the preparations I made before going back to work. These pre-work preparations helped me ensure that I would still be able to breastfeed Basti even if I'm not with him for around 14 hours each working day.   

5) Pumping at Work. Except for emergency meetings, I usually know what my work schedule would be for the day. I know beforehand if I have an out-of-town hearing or an out-of-the-office meeting on a particular day. 

Here are the things that I normally do on an ordinary working day: 

• I pump every 3-4 hours, schedule permitting. I pump upon arriving at the office, during lunchtime (I have a 2-hour lunch break), and before going back home. Note: Under the Expanded Breastfeeding Promotion Act of 2009, a female worker who is breastfeeding her baby or young child is entitled to lactation breaks. You may want to check my post on lactation periods here.
• I'm fortunate to have my own room and a small conference table which I converted into my "pumping station". (This is why lactation station in the workplace is so important!)
• While pumping, I don't think about work! During my first month of pumping at work, I did breathing exercises and imagined that I was holding my baby. But once I got the hang of it, I just breathe deeply  while reading the newspapers. (Well, you really need to take a deep breath when reading the papers!)    
• I don't sterilize the flanges of my breast pump after every use. I just put them inside a lock n lock box and store them inside the freezer. (Five years ago and not knowing any better, I used to sterilize my flanges after every use. I swear, nakakapagod siya!) 

(I once pumped at the basement ladies' room of Shangrila EDSA. Why? Because I was too lazy to pump before leaving work thinking that I would be home within an hour or two. And then the unexpected happened. No, it's not the heavy traffic because that's to be expected.)

6) Storage Tips

I use BPA-free plastic bottles and cups in storing breastmilk.  BPA-free and pre-sterilized disposable plastic bags are used only as a back-up. There are a number of breastmilk bags that are locally available. The cheapest but effective brand that I found is Spectra at PhP200 per 30 bags. 

Milk that could be consumed by Basti within 6 days from expression are stored in the refrigerator (the guidelines say 8 days). I don't put them in the freezer because I read somewhere that "the antimicrobial properties of human milk are better preserved with refrigeration." 

For more information on milk storage guidelines, you may want to check this and this. 

Oh, and since I'm a little OC when it comes to expressing and storing breastmilk, I'm using a separate small refrigerator for my stash.

Those that can be consumed within 6 days are not placed in the freezer.

The 4 bottles containing 5-6 ounces of milk on the upper tray are for Basti's consumption within the day. These are on top of his 3 meals of semi-solid food now that he's 9 months old. I do direct breastfeeding once I'm home.

These are my reserves. This freezer has its own door.

7) That Extra Pump.

While the milk that I expressed in the office is more than sufficient to meet Basti's needs for the next day, I made a commitment to do an extra pump at night. Not only are they my reserves. These are the milk that I could share with moms who need breastmilk for their babies. In a country where there are only a handful (one hand lang yata) of breastmilk banks, moms do not have much choice but to ask for help from one another. (This is another reason why the IRR of the Expanded Breastfeeding Promotion Act of 2009 should be prioritized. In the said law, health institutions are encouraged to set up "milk banks for storage of breastmilk donated by mothers and which have undergone pasteurization.")

I'm not saying that breastfeeding while working is easy. It is not. It requires commitment and hard work on your part. 

But it certainly is possible!

THE IRR OF RA 10028: NOW IT'S SIGNED, NOW IT'S NOT!

Fifteen months. It has been 15 months since Republic Act No. 10028, otherwise known as the Expanded Breastfeeding Promotion Act of 2009 (EBPA), was signed into law by GMA. 

Under Section 18 of the said law, the Department of Health (DOH), in coordination with the other departments and government agencies, is mandated to issue the implementing rules and regulations (IRR) within 120 days from the effectivity of the EBPA.

Obviously, that period has long transpired. 

So where is the signed IRR?

Sometime in March 2011, breastfeeding advocates got hold of a copy of the IRR signed by the DOH Secretary. This signed IRR created an uproar in the brestfeeding community. Why? It appears that its Sec. 10 imposed an additional condition, one that is difficult to meet that it effectively puts to naught the provision on the establishment of lactation stations. Sec. 10 of the supposedly signed IRR is quoted below:

"Section 10. Minimum Requirements in the Establishment of Lactation Stations. - It is hereby mandated that all health and non-health facilities, establishments or institutions, which have at least 100 women of reproductive age working in the establishment or institution, including public places, shall establish lactation stations. x x x"

For a more a detailed write-up on this, you may check the post of fellow lawyer J. of Chronicles of a Nursing Mom here.

So when I was writing my previous post regarding lactation periods, I decided to check the website of the DOH for a copy of the supposedly signed IRR. Lo and behold! As per the DOH website, the IRR of RA 10028 is for public hearing! I checked it again this afternoon and this is what I saw:

See the date and time on the lower right hand side!

Close-up view

I was able to download a copy of the draft by clicking "Draft IRR of RA 10028". Interestingly, the highly controversial Section 10 is worded as follows:

"Section 10.   Minimum Requirements in the Establishment of Workplace Lactation Stations. - It is hereby mandated that all health and non-health facilities, establishments or institutions shall establish lactation stations. x x x"

The questionable and highly contentious requirement of at least 100 women of reproductive age is no longer found in the said draft!

It's possible that the DOH website is simply not updated. I sent a message to DOH Breastfeeding TSEK asking if the IRR of RA 10028 has already been signed. The answer--Not yet.

Not contented with this, I called the DOH hotline and was able to talk with someone who confirmed that the DOH Secretary had indeed previously signed the IRR. Unfortunately, it was the wrong draft/version. Which is why the previously signed IRR has not been published!

So there you have it--the case of the now it's signed, now it's not IRR!