Tuesday, September 01, 2015

Hakab Na 2015: Breastfeeding and Work - Yes we Can!

My life revolves around family, kids and Attachment Parenting with emphasis to Gentle Birthing, Breastfeeding and Babywearing.  Whenever August gets closer, I get giddy in anticipation for the first of the many activities is the annual Big Latch On / Hakab Na.

This is an annual event that celebrates Breastfeeding Month and is incorpiration with Breastfeeding Pinays and KAYA.  This year's theme is Breastfeeding and Work: Let's Make It Work!

This year's Hakab Na! brought together 1,712 mothers simultaneously latching their babies in different gatherings around the country.  In Manila, it was held in 500 Shaw Zentrum in Mandaluyong and had over 1000 attendees – mothers with her family. The event was featured on major television networks like ABS CBN, GMA, ABC, and Solar; and major dailies like Philippine Star, Manila Times, etc.  Hakab Na! 2015 also had prominent online presence with features in Rappler, SunStar, Thomson Reuters Foundation News, Independent UK, The Telegraph UK and various blogs. 


This year's event is even bigger with a bigger venue to match it's sheer magnitude.  Not only is the simultaneous latching happened but there was a mommy-baby bazaar and talks that made the event a whole day affair!

These were the cool gate bands for registrants!

A mother's weakness...shopping bazaars!

Beautifying Breastfeeding Mommies - a nail salon at the event!

Speakers this year were Ines Fernandez, Dr Anthony Calibo, Dr Julie Smith, Eliza Ypon then the administrators of Breastfeeding Pinays had an Ask The Admin (Live) Session.

Nanay Ines spoke about breastfeeding and Nutrition

Our wonderful host, Abie was as lively and entertaining.

Elisa Santiago of MAC shared with how mothers can beautify and taking care of themselves even when they are breastfeeding.

DOH's Doctor Anthony Calibo spoke about the government's initiatives and importance given to breastfeeding.

There was also the FAQ Panel wherein the administrators and founders of Breastfeeding Pinays were there to answer live questions from attendees, which was a lot of fun.

Some of the photos of the event are below. Credits to the photographers since I wasn't able to get photos at the event.












A very jam-packed event! I can see so many wonderful and familiar faces...plus some new ones I've met that day.
Some of the Instagram photos with fellow committee-mates...

The loot that went home to each breastfeeding mother was a lot more than the entry ticket!

The Team...these people make doing this every year a truly wonderful experience.

There are also satellite venues that breastfed simultaneously to as far as Singapore and Paris, France!
We are thankful for our wonderful sponsors and media partners that helped make this possible!

Venue Sponsor: 500 Shaw Zentrum

Sponsors:-
David's Salon
Gymboree
Huggies Philippines
Orly
Party Boosters
Smart Steps
Unilab

Media Partners:-
NewlywedsAtWork
Gobreastfeed.com
Mommy Talk
MCNPinays

Print Media:-
Avax.news
News.abs-cbn.com
Interaksyon.com
PhilStar
Pinoythaiyo.com
Telegraph.co.uk
Thompson Reuters

Pilipino Mirror

The Standard, August 2, 2015, Page A8

The Sunday Times Aug 2, 2015 page A2

Manila Bulletin, August 2, 2015, Page 6


TV Patrol

Video Coverage:-

ABS-CBN News...I was very lucky to have met Ms Jasmin Romero of ABS who my whole family watches everyday and who we love...she was able to cover Hakab Na 2015! The interview with my good friend Ros and her hubby was aired!


Monday, July 27, 2015

Breastfeeding Month: Breastfeeding & Jaundice...my own experience



“My son was diagnosed with jaundice upon birth. Although the doctors informed us that my son’s jaundice “looks high” (due to his yellowish skin), we were allowed to go home by Day 4; we were then instructed to visit our pediatrician for further monitoring in two days time.”

About five years ago, with an “unexpected, untimely childbirth”, jaundice became the highlight of my postpartum journey. Between my Hong Kong pediatrician and my mom, who is also a pediatrician, had conflicting times on when I should be “sunning” my son - early morning or mid afternoon. This got me thinking on who do I listen to. Was “sunning the baby” the solution? What else could I do to make sure that the bilirubin gets excreted out, what are my other options? Do I need to stop breastfeeding since there were some who told me that the condition came about because of my breastmilk? There was so much panic on a baby being yellow as a big deal and monitoring is needed. I went on looking for answers to better understand this condition.

‘Jaundice’ occurs due to condition of “Hyperbilirubinemia”, the body’s inability to breakdown and to excrete broken-down red blood cells called ‘bilirubin’. Bilirubin build-up is the cause of the yellow pigmentation on the baby’s skin, eyes and other tissues. “Sunning a baby” , though sometimes effective, is not the only solution as I further learned below.

Types of Hyperbilirubinemia

There are so many types, as stated below by Stanford Children’s Org :
  1. Physiologic jaundice: is the "normal" response to the baby's limited ability to excrete bilirubin in the first days of life.  I remember lectures by Dr Jack Newman in the past where he stated “it is alright to have jaundice upon birth. No one said that Jaundice is bad within acceptable levels.”
  2. Breast milk jaundice: Research has shown that about 2 percent of breastfed babies develop jaundice after the first week, peaks about two weeks of age and can persist up to three to 12 weeks. This type of jaundice is thought to be caused by a substance in the breast milk that increases the re-absorption of bilirubin through the intestinal tract.
    Breastfeeding will eventually help in getting rid of the extra bilirubin as long as the latch and “stripping” of the milk Is done. It might be a slow process for some but if the bilirubin levels are in the lower end then there is no need for the rush.
  3. Breastfeeding failure jaundice: not enough breastmilk to help with hydrating the baby. The decrease in urine production would account for the increase built up of bilirubin. This is more commonly seen in babies with latch problems. Mothers of these babies need to seek help from lactation counselors or even peer counselors to be sure that proper milk transfer is happening.
  4. Jaundice from hemolysis: This may occur with the breakdown of red blood cells due to hemolytic disease of the newborn (Rh disease), or from having too many red blood cells that break down naturally and release bilirubin.
    Hemolysis inside the body can be caused by a large number of medical conditions thus specific medical interventions is needed to cure the problem. Breastmilk might be one of the cures that help the body be stronger.
How common is Jaundice really?  Am I the only exception? 
Statistically, about 60 percent of term newborns and 80 percent of premature babies develop jaundice. Infants of diabetic mothers and of mothers with Rh disease are more likely to develop hyperbilirubinemia and jaundice. While hyperbilirubinemia cannot be totally prevented, early recognition and treatment are important in preventing bilirubin levels from rising to dangerous levels.

What happens when bilirubin count is high?
Low levels of bilirubin are usually not a big concern but large amounts can cause seizures and brain damage. This condition is called “kernicterus”. Strict monitoring is required for possible “yellowing babies”

What should you really do if there is some yellowing?
The American Academy of Pediatrics has a protocol handling Jaundice. I am happy to report that breastfeeding seems to be stated as the best option to get the “yellowing” out of the baby’s system. I will not enumerate all the steps but will highlight what I think mothers should remember: 
  1.  Find out how high is the bilirubin count of your baby – get your baby tested. Visual estimates or simply looking at a baby’s “yellowish color” does not give a standard on what approach to help your baby.  It can lead to errors and may not apply for “dark pigmented” babies.
  2. Interpret bilirubin levels according to the infant’s age in hours.”  Mothers should also understand the bilirubin test ranges, if tests were given.  This would give you an indication of which direction to take with regards to the benefits to your baby.  
  3. Ensure that there is adequate hydration of the baby through breastfeeding or 
    expressed breastmilk.
    Breastfeeding be promoted and continued
    The concept of breastmilk versus formula is that the former option takes longer to excrete out the bilirubin since most of the nutrients and antibodies are biologically absorbed very well. Most doctors see the overall benefit (versus the cost) of breastfeeding – to not give up all the wonderful benefits of breastfeeding to just resolve the jaundice. Most will ask the parents to observe before giving the option of taking the breastmilk out of the baby’s diet.

    It is only when there is really high bilirubin count results that a doctor might look into alternative feeding options.

    Bottom line : “breastmilk excretes out excess bilirubin slower than formula, but the benefits to the baby and mother of the slower excretion is a lot more than if formula was to be used.”
  4. Look into “phototheraphy” and “friberoptic blanket” as other viable options.* Phototheraphy – jaundice and increased bilirubin levels usually decrease when the baby is exposed to ‘special blue spectrum lights’. There are different techniques may be used to allow all of the skin to be exposed to the light. The baby's eyes must be protected and the temperature monitored during phototherapy. The downside is that this may take several hours to begin working and it is used throughout the day and night.
    * Fiberoptic blanket is a blanket placed under the baby to better help absorb the “special blue light” or even sunlight – can be used alone or in combination with phototherapy.
  5. Blood transfusion techniques: The concept is that the exchange will help increase the red blood cell count and lower the levels of bilirubin. This can be a bit extreme for a baby since there is also the requirement of giving and withdrawing blood in small amounts through a vein or artery but it has shown faster improvements.
  6. Treat the underlying cause of hyperbilirubinemia, such as infection.
  7. Sometimes the infection is the one causing the malfunction in your baby’s system. It is an important factor to consider also.
Kindly refer to the below on what Dr Anne Smith, IBCLC and Dr Jack Newman’s opinions about Jaundice are:-
“In most cases, jaundice is a normal, possibly even beneficial process that can be managed without interrupting breastfeeding. The treatment for physiologic jaundice is more breastfeeding rather than less, and sick babies with pathologic jaundice need breastmilk even more than healthy babies. Even in rare cases where the jaundice is caused by the breastfeeding, there is no reason to wean and every reason to continue giving your baby the best possible nourishment.”
“Even though we are not sure of the cause, what is important to remember in cases of late-onset jaundice is that the baby is not harmed in any way by continued breastfeeding.“
– mother’s milk, Dr Anne Smith

“There is not one bit of evidence that this [so-called breastmilk] jaundice causes any problem at all for the baby.”
“Do not stop breastfeeding for “breastmilk” jaundice.”
Breastfeeding and Jaundice, Dr Jack Newman

Wow…that’s a lot of options, isn’t it? Thus to totally stop breastfeeding without consulting first the above options, is not a valid reason! First thing to check would be “the latch” and testing the levels of bilirubin in the baby’s system.

**Word of Advice: If your doctor/pediatrician immediately tells you to totally stop breastfeeding, even for a few days and switch to formula milk, please consider getting a second opinion from a breastfeeding-friendly/advocate pediatrician. There is the concept of Hierarchy of Breastmilk that I hope all, if not most, pediatricians will respect. I cannot stress enough that the benefits of breastfeeding totally outweigh any formula that might be prescribed to you for Jaundice.

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August 2015 Festivities by Kaya and BFP!

To know about breastfeeding this coming Breastfeeding Month, Breastfeeding Pinays have a few events lined up for pregnant mothers, already lactating mothers and breastfeeding advocates through the Philippines.

2015 August 1, Saturday
Registration starts at 8am
Zentrum, 500 Shaw Blvd, Mandaluyong City

This year’s going to be bigger and better than year’s past since instead of just The Big Latch On happening, it would also be an exposition with vendors, booths, promos – breastfeeding related products plus mother and baby needs. There will be discussion talks on breastfeeding, beauty and beyond. One of the most anticipated talks would be by DOH representative, Dr Anthony Calibo regarding Slow/No Weight-Gain Babies.
Don't miss out!!!

**Note: I’m been a regular attendee of this event since 2013. To know more about what we did in the past, you can read all about it here: 2013 and 2014.

Milk : the movie by Noemi Weis
2015 August 30, Saturday
time and venue TBA
A special movie hosting brought to you by Breastfeeding Pinays by Canadian film maker, Noemi Weis, that looks at childbirth and infant nutrition in various cultures and communities. It depicts the commercial, societal and other issues of motherhood.

“Sometimes, that’s a decision that a woman’s made on her own and sometimes it’s implanted in the culture,” Noemi said. “It can certainly be easier for doctors, who can just schedule a Cesarean instead of having a mother go into labour at 12 o’clock at night and then having to spend maybe the next 20 hours with her.”

Milk is the latest in a series of documentaries Weis has filmed, all of which tackle social issues. Through her production company, Filmblanc, she has touched on subjects ranging from child trafficking to domestic violence to the community-healing power of music. - From Insidetoronto.com

This film has garnered and continues to generate international attention. It also helped to make a lasting difference in the lives of individuals, communities, organizations and education.


Do join us in one of the events lined up for Breastfeeding Month!

Monday, July 06, 2015

When Survivors Give Birth: a return to Bastry U

February 2015

I want to share my experience at my recent trip to Seattle's Bastyr University to take up When Survivors Give Birth (Penny Simkins, Phyllis Klaus).  It was my second time now at the university for a short lecture course series. This trip was very important for me because it's been too long since the Penny has taught a class.  In the past, my good pal and Doula friend, Velvet, was lucky enough to be taught by her for Birthing Doula awhile back but is currently, hardly teaches anymore...until now!

It was a two-day course and was an eye-opener for me with regards to how I approach and see birthing mothers, in general. I would have to say that it is not for the faint heart since the course dives into all types of trauma (sexual, psychological, physical and emotional) and a lot of the approaches go into how to talk to these past sexually abused mothers (and even fathers) with the upcoming birth and postpartum.

Day One: Upon entering the classroom, a lovely first day of a pot of flowers met us that was lovely for a cold rainy morning.

The Simkins standee/banner! I remembered the same one was placed in my very first class (Lactation Education), just last year with Penny in the photo. Who knew that I would within a few months after the lecture, be in a class with Miss Penny herself!?! #blessed

This was literally when Penny and Phyllis came in to the class to start their slides set-up.  Both authors were the ones that taught the class since the book launched in 2004.

Annie Kennedy opened the class with an introduction of the course and school.

While Dr David Church, president of Bastyr U, introduced our lecturers that signal the start of the class.

Let the class begin...can you see my writing away in the photos? Thank you to Annie and her staff who took wonderful class photos!

After the lecture, there were a few points I noted in my head...
  • My take on the first day is that "treat all pregnant mothers as "survivors", whether they have been abused or not." This holds true and providing empathy and gentle, good care is every woman's right - whether a victim of abuse or not. The extra care provided will surely go a long way. --> from Miss Penny
  • Birth art prenatal and post partum is encouraged to help a care giver understand a mother's previous experience or even how they will see the birth.
  • Be wary on the Downward Spiral (can bring about "re-traumatization"). You can use the "I messages". Be real on what you can and cannot do as a counselor or caregiver.
  • Positive Cycle has the potential for healing. (note Power Differential) :- (a) assignment for selection, (b) good listening skill, (c) birth plan, (d) mutual expectations and acknowledgment, (e) possible rejection of options, need further discussion, (f) feeling of respect, (g) encouraged to discussion and give feedback, (h) good listening skills, problem solving and appropriate referrals, (i) both parties satisfied, (j) positive long term impact (self-esteem, confidence), (k) future pregnancy.
  • Remember the Caregiver's Motto: "She has a very good reason for feeling this way, behaving this way, saying these things, believing these things, etc...I may be the target now but I am not the reason."
  • Helpful Methods for Immediate Relief of Stress: relaxation breathing, etc.
  • Create appropriate boundaries: set priorities to help keep your professional and personal life separate.
  • Recognize and acknowledge common reactions and thus create sensitive presence and maintain appropriate reactions. I.e. vicarious traumatization  - survivors need to know that her care provider can hear her story without being upset. Care provider need to show strength and centered-ness to be the example...normal reaction to an abnormal event.
Day 2, our last day: we did a lot of group work and role playing as counselor, counseled mom and observer. I gave me a good gauge on how I fair with client contact and doing much active listening.
I still have a long long way to go. Good thing that my partners in the group was really patient with me.

Phyllis was such a lovely lady and it really a treat to listen to her stories. The Dona cup is Penny's. So cool! Even Velvet wanted one when she saw the photo.

Before the lecture ended, Penny shared with us a song her daughter made call the Reason Why.

Some of what I learned were:-
  • Be mindful of the "red flags" (or "triggers") when you do your interview/consultations. Also the words that can trigger a survivor to be "re-traumatized" since some of the words were used in the past. Touching or Breastfeeding can bring about possible trauma for mothers.
  • Quick Counseling Strategies: visualization or guided imagery, "tuning-in"/"tuning-out" techniques
  • Counseling after birth would help the mom and care provider assess how the birthing went.  If there is "unhappiness" after the birth - it is good to discuss and "resolve" the issue with a professional.  Yield if need be.
  • Listen to the music behind the words. Listen and reflect with passion.
  • Separate the present from the past. Inner child and grounded in the present
  • Practice makes perfect so if you can do role-playing or incorporate "active listening" as much as you could in your everyday routine, the better you would be as a counselor/doula, etc.  This would also help you develop tools and strategies for problem solving.
This whole lecture/trip has been a "privilege" and being in the midst of these really great minds. Their insight in birthing, trauma and postpartum with wit and humor was refreshing and insightful.

This is Annie Kennedy. She's one of my favorite people there and has extended so much assistance and guidance in everything. I do think about her often and pray that she is always going to have this smile on her face...and that I would see her again soon.  (Another one is Kay Hwang - though I wasn't able to get a photo with her twice over again! )

Thank you Penny for being an inspiration to all Gentle Birth Keepers all over the world!  You make me want to do good and to the best of my abilities. God bless your kind soul!

I cannot wait to see what else will bring me back to Bastyr!

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On another note, after comparing two campus lodgings - main building's 5th floor vs Student Village, I super duper enjoyed the Student Village dorms!  You can weigh in the below.

Student Village:
  • Private bathrooms. This made it love the Student Village! I didn't have to leave my comfy room to shower or go pee.  I can leave my toiletries for the rest of my stay.  Plus there is not much draft, which is a blessing in the rainy city of Seattle.  Dryers were provided which is a great amenity!
  • Newer, modern facilities. It is the first student housing project on the West Coast to receive the highest green building classification (Leadership in Energy and Environmental Design (LEED) platinum certification)!
  • The Kitchen/Living Room.The communal kitchen/living room is awesome to meet people and hang out outside of your room. It has a huge middle island that made making dinner or snacks with other students in the area easy since we can do it all at the same time without bumping in or stepping over each other. This reminded me of our Canadian home back in the day where I hung out with friends to talk and connect. I know I've made a few friends on this trip better since I wanted to hang there for my readings.
    *There is also an area for breakout rooms for groups in each of the buildings.
  • The Walk. Each day before and after class, heading back to the dorm room was an enjoyable one (even if it's in the rain) since it helped make me reflect what we did in class and also gave me a chance to get some "fresh Pacific North West air" that I missed.
  • Appliances for use. Washing machine & dryer, TV, couches for lounging, huge subzero type fridges available inside the building.
  • Individualized room temperature controls is a blessing! I kept my room at the temperature I wished.
  • Disclamer: Location! The dorm building assignment might be tricky since the closer lodging to the main building is left for long term residents/students of Bastyr.  The buildings starts from Letter A to K with the latter being the furthest from the school.  I was assigned in K. :)
You can view more about the Student Village below.


Bastyr 5th Floor Main Building:
  • Convenience. From arrival to classes to departure - it's normally the same building as where all the classes are held. For practicality though, the main building's lodging is the most convenient since when you get dropped of at the campus, you can roll your luggage to the elevators and get to your room.  I stayed here on my previous trip. Cafeteria and classes are just below.  No need to go out and walk to your classes.  
  • Communal cozy kitchen, bathrooms and toilets.
  • Mini sink in room. There is a small sink in each of the rooms for simple tooth brushing and washing purpose.  
  • Automatic locked room doors - a blessing at times.
  • In-room refrigerator! You can have your own things in your own room so you not need to go out late at night to go to the pantry in the long corridor. Plus you would not need to label your food for the communal fridge. 
  • Bigger tables for working on. I remembered that I had a long cabinet where I can spread out all my things aside from my working desk.