Little Jet setter !

I have always enjoy traveling. Penguin parade at Phillip Island, Australia; Tango at La Boca, Buenos Aires; Opera at Palais Garnier, Paris; Food heaven at Singapore hawker centers ....
So having a baby isn't going to change my life style. I was determine to bring along my baby with me, wherever that is.

When my son was 4 month old, I decided to bring him back to my home country, Malaysia to visit my family. It is 7674 miles away from where we live. The planning started few weeks before the trip, to begin, getting ready with the appropriate travel documents.
http://travel.state.gov/passport/get/minors/minors_834.html

When travel internationally, it is advisable to have an up-to-date vaccination for the child. Moreover, check to see whether additional vaccines are required. I will recommend visiting to a travel health clinic. CDC website provide a comprehensive health information base on destination.
http://wwwnc.cdc.gov/travel/destinations/list.htm

Here are my lists of things that I pack in my luggage whenever I travel with my kids:

Appropriate clothing for local weather
Baby formula (of course you can skip this if you are breast feeding!)
Baby food/ snacks
Sunscreen lotion (for baby older than 6 months old. Avoid direct sun exposure, cover with hat/clothing)
Diapers/Wipes (10/day for Newborn; 8/day for baby; 6/day for toddler)
Favorite blanket/books/toys (new toys to keep child interested on the long flights)
Thermometer, Baby nail clipper
Medications (fever reducer, benadryl, hydrocortisone cream, neosporin antibiotic ointment, Regular prescribed medication)
Insect repellent (especially for Malaria & Dengue epidermic regions)

Offer your baby breast/bottle/pacifier during takeoff and initial descent to reduce ear pain causes by changing air cabin pressure.
Expect that your baby will cry on the plane, most people will understand that baby cries. But bring along a few ear plugs and give it to those who don't !

Last but not least, don't forget to take lots of pictures for those precious moments.
Happy traveling !

Dulce de leche

I once overheard a wise nursery nurse telling a new mom that, "breast feeding is the best gift you could ever give your child. It beats any Burberry pleated jacket; Bugaboo baby stroller or Tiffany baby rattle !"
A very wise advice indeed.

According to CDC, 80-90% of pregnant women wanted to breastfeed; among infants born in 2007, 75% were ever breastfed; 43.8% were still breastfeeding at 6 month of age; 22.4% were still breastfeeding at 1 year of age.

AAP: "Breastfeeding and human milk are the normative standards for infant feeding and nutrition, given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."

Being a medical provider who strives to be a good mom, I have long decided that I will breast feed my baby. Armed with all the paper knowledges of breast feeding. I never thought that breast feeding can be so hard. You tend to hear the success stories of breast feeding, most people want to be encouraging. Even if you have heard some horror stories about bleeding nipple or infected painful breast abscess, you will keep telling yourself that it doesn't happen to everyone.

Breast feeding definitely did not come natural for me. I can still remember being poke by thousands sharp needles simultaneously when my firstborn latched on and sucked incorrectly. Each times he sucks, I get this very intense uterine cramp. Bear in mind, all these right after a 26 hours labor ! With all my haywire hormones, lack of sleep, high stress. I broke down, right in front of my families and nurses. At that moment, I just want to be a good mom, want to give the very best for my child. I am not the calm doctor that gives her patients sound advice.

Luckily, all the nurses and lactation consultants have seen it all. I learned that you can prevent cracked nipple by breast feeding your baby 15 mins on each side but more frequently. Apply expressed milk and ice pack to the sore nipples. Ensure a good latch that make the sucking more efficient and less painful. And most of all, be positive and be patience.

Breast feeding is a learning process, both for the mother and baby. It took me 6 weeks to become more comfortable and confident about it. As my piano teacher used to say: practice makes perfect !

A perfect smile :)

Talking about teeth has always been my pet subject. Either during my routine well check with parents/patients or over dinner table conversations with families/friends. In this day and age, appearance and first impression are everything. We need to start young to take care of our smile and teeth.

Childhood dental decay is the commonest chronic childhood illness in US. Its 5 times more common than asthma, and 7 times more common than hay fever. 40% of children will have tooth decay by the time they reach kindergarten ! Tooth decay in baby teeth means greater risk for decay in adult teeth.

I recently brought my 2 1/2 year old son to his dental appointment. His dentist recommend a xylitol dental wipe. Xylitol is a natural occuring organic sugar that is not fermented by bacteria in mouth, therefore create a protective coat for the teeth enamel. Tooth paste and dental wipe that contain xylitol are better for kids whom are still unable to spit out fluoride tooth paste.

Start a good habit by brushing and flossing twice daily, wiping baby's mouth/gum/cheeks/tongue after feeding. Wean off bottle by one year old; limit sugary food/drinks; no sharing of utentils from adult (definitely no mouth-to-mouth feeding like actress Alicia Silverstone !).

Visit a pediatric dentist by one year of age or 6 month after the first tooth eupted. Check to see that your city has 0.7-1.2mg/L fluoride added into drinking water.

http://apps.nccd.cdc.gov/MWF/Index.asp

Bowel matter !

My little 16 mo old daughter has always had more share of trouble with her gut system since birth. She had blood in stool at 6 weeks old. Even though I was only breast feeding her at that time. We found out that she had allergic colitis, I had to give up all the dairy to continue breast feeding. That resolved right before she turned 6 mo of age.

After introducing solid food to her diet, she suffers on and off bout of hard stool. Always straining and crying during her bowel movement. It is a common problem for infant becomes constipated with the introduction of solid foods. By adding more fluids and fiber to the diet may help. Diluted apple/pear/prune juice. Personally, I have found prune juice or pureed prune to be the most effective. You can get organic pureed prune for the little one. Or dried prune for the older kids.  Choose high fiber food group like whole-grain bread/cereal. Avoid bananas and applesauce, that generally can make firmer stool.

Rule of thumb: daily intake of fiber = age +5g. Up to a max of 35g/day