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Visiting a DevPed: what to expect, how to prepare

When I told some friends that we were going to visit a Developmental Pediatrician for our son, many told me it was a needless expense. There’s nothing wrong with your kid, they all said. He doesn’t have any learning disabilities, they assured me. Yes, Jan was hitting all his milestones, but I was still concerned about what I perceived to be a speech delay and wanted to discuss with an expert how best to navigate a trilingual household with a toddler.

It was just one visit, after all, and we do monthly trips to the general pediatrician to check if all moving parts are working. Shouldn’t we make that one visit to a devped to see if our child is developmentally at par with his peers? I felt that the answer was yes, and after our visit with the devped, I am more convinced that all parents should see a devped with their babies at least once.

We didn’t know what to expect for our first visit, honestly. There also weren’t many resources online, especially for Manila-based folks. I thought this little guide might be helpful for first-timers like us:

1. Set an appointment way in advance and prepare to wait.

There aren’t a lot of devpeds in the country. For a population of 108 million, where young people are the majority, we only have around 51 devpeds as of 2018. When we called to make an appointment for a devped in a hospital convenient to us, I was told that the next availability was February 2020! Good thing we found a schedule with Dr. Melinda Francisco Best. I called in June and got a schedule for August in Pasig Doctors Medical Center. Don’t be picky with the location, as a devped isn’t like a regular Pedia where you have to go monthly.

2. Make sure your child gets lots of rest before the appointment.

There will be lots of tests so it’s not a good idea to come with a cranky child. Make sure he or she gets a long nap before the visit and is well-fed and comfortable.

3. Come early

Coming early means your kid can get used to the environment first. Also, sudden tantrums, hunger issues, diaper issues can be addressed without rushing. This is really important because the child will be given a series of tests to test his skills and he or she needs to be in the right frame of mind.

4. Come with the child’s daily carer

A lot of questions will be asked about the daily routines of the child, questions that can be a challenge for the work-out-of-home parent, no matter how involved or loving. It is important to bring the daily carer of the child — yaya, grandparent, primary caregiver parent. Not only because the doctor will ask questions about the daily routine of the child, but also because advice will be given on how to interact with the child moving forward.

5. Be encouraging but don’t pressure!

The child will be subjected to maybe half a dozen of tests. Shape-sorting, identifying parts of the body of him/herself and of another person, matching household items with uses, grouping together same colored objects — all these tests in quick succession. It can be a bit stressful (naimagine ko na sarili ko pag nag-uUPCAT anak ko lol) but don’t show stress or anxiety to your child. Encourage good work, don’t look disappointed when your child can’t do some of the tests (it’s a diagnostic, not qualifying test!) and most of all don’t pressure.

6. Answer questions honestly.

Most parents’ natural tendency is to brag about their kids, but the clinic of a devped is not the place to overstate or go on and on a child’s achievements. Save that for mommy dates or shindigs with other parents. The point is to diagnose problems, and to diagnose them early. The doctor is trained to ask questions that will ferret out development issues, and honesty is absolutely critical.

7. Disclose.

Nobody wants to be shamed for how they parent, but full disclosure is important in allowing an optimal exchange between doctor and the parents. If your child is exposed to gadgets and TV has become a substitute nanny, that information has to be shared to the doctor. If parents are working through marital issues and they think it has been affecting the child, that information should be discussed as well.

8. Have a list of prepared questions.

Maximize the consultation by having a list of prepared questions. In our case, we wanted to ask questions about our peculiar language arrangement at home, about Skyping with his Dutch relatives and about encouraging speech.

9. Ask for tips

Similar to number 8, don’t be shy to ask for tips. Our doctor gave us a number of tips on how to stimulate our child’s brain development and language skills, considering that he doesn’t get to socialize with other kids. These included enunciating words very clearly, finding opportunities for interaction with other children, reading books several times a day.

10. Make sure you get the written evaluation of your child’s development

Your doctor should give you a written evaluation or your child’s development in all areas tested. It was helpful for us to see the areas where our boy was ahead of the pack (reasoning skills of a 2-2.5 year old, lol, hello future annoying teenager) and where he needed more help. If we come back after a year (our doctor said we might want to, just to check progress) then the written report is a helpful baseline.

***Our devped is Dra. Melinda Francisco-Best. You can contact her through her secretary at 09161128267. For the list of devpeds in the Philippines, check this out.

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There’s a baby on my bed

When I gave birth last year, my husband and I were VERY clear about the fact that we would not co-sleep. Nope. Uh-uh. No, sir. “Our marriage bed is ours alone”, “He needs to learn independence” — these are some things we told ourselves even when our son was a month old. For my husband, it’s the only parenting style he knows. For me, to be honest, after the long days of maternity leave and the rhythm of breastfeeding and baby caring, I welcomed and needed the, well, adult ‘energy’.

We even got ourselves a sleep coach who taught us all about routines and schedules. We knew our son wanted to snuggle in between us and could always sleep faster when burrowed deep in one parent’s armpit or splayed on one parent’s chest, but we wanted him to grow accustomed to sleeping alone in his bed. And for a while, he did. Fast forward to now:

Humble pie, right? 😂 We were as smug as a bug in a rug until we, umm, had to share the rug.

I think I know how it happened, and when. My husband — who had been running our small businesses and previously worked on his own time — got himself a job in BGC and found himself out of the house for long hours. He would come back to a sleeping baby who he had barely enough time to be with in the morning. So when Small Jan would cry for his midnight feed, Big Jan would scoop him up and put him next to us. It was his time with his son.

But sooner than soon, “baby energy” was all over our bed, along with toys, milk and random drops of pee. And of late, this baby energy also moves and kicks like crazy. And bends it like Bekema. (Haha. Yay me, good one.) This baby energy has colonized our bed completely. Husband barely gets sleep — last night, he actually moved to the sofa bed in the nursery after a particularly strong kick from our little tyrant. Me, I wake up earlier than I need to. A baby shaking you at 5am tends to lead to that outcome. And owing to all these, mornings feel stressed and harried.

This is not going to be a post with some big-ticket message at the end on how the nights are long but the days are short blah blah. This is a post about pee on the pillow, a happy meal toy poking up one’s spine, and all the other oddball 2am things about parenthood that don’t get written in hallmark cards.

And a shoutout to fellow harried parents just to say: hang in there, you’re not alone.

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Sick, sad or scared

When my son was around seven months old, he contracted a fever. It wasn’t really very high, and his pedia told us it was probably brought on by a tooth making its way out. But he was grumpy, woozy and wanted to be in my arms all the time. It’s not easy holding a baby through a long night, it’s harder still when the long night follows a long day at work. But every time I tried to put him down on his crib, he would start crying like crazy. And every time I brought him closer to my chest, his tiny body would visibly relax. He would bury his little self as deep as he possibly could into my chest, as if finding in it an escape from the world.

Two thoughts occurred to me. First was absolute amazement that I — with all my imperfections, insecurities and uncertainties — was all this other human being needed at that moment, nothing more and nothing less. I was his safe place, his perfect home. Second was panic: that this moment will not last forever, that he will grow and be independent. And he will start finding his own way and needing things I cannot provide.

As I was rocking him gently, I found myself making him a promise. I call it the “Three S promise”. When he is sick, sad, or scared — any or all of those three — no matter how old he is, no matter where I am and what I’m doing, if he needs me to hold him, I will hold him. My arms will always be his home.

Whether he is three and scared of a thunderstorm, thirteen and down with a tummy ache, or thirty three and blindsided by life, as long as I am around and as long as he wants it, I will hold him. And he doesn’t need to explain if he doesn’t want to. No questions will be asked. No judgment will be made. He just has to say he is sick, sad or scared, and I will hold him as long as he needs to be held.

It will be our code word for a lifetime.

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Best breastfeeding supplements in Manila

Two mommy friends who read my earlier blog post about how Trying your Best is Best asked me what I did to sustain breastfeeding for a year, given my undersupply problems. I told them that I tried virtually all the breastfeeding aids in the market in my zealous quest for more milk (this I was not a lazy mama about!)

So then they requested me to write this blog post to share what I thought of these products, considering that I tried them all. Just a small disclaimer: these are all just based on my personal experience. Some products that worked for me may not work for other Moms. And another thing, obviously, one should keep drinking lots and lots of water and eat healthy.

Let me break down this review into three categories: capsules and supplements, lactation goodies, drinks and teas.

I also want to say at this point that I bought ALL the supplements I tried.

1. Capsules and supplements

I experimented with a lot of capsules and supplements in the early days of breastfeeding. I tried Fenugreek, but I really did not like how it made my sweat smell like maple syrup. Hearing a lot of good reviews about malunggay supplements, I tried 4 brands for two weeks each: Mega-Malunggay, Natalac, Life Oil, and Atienza Naturale Malunggay. What I liked about Life Oil is that it doesn’t give off that “matcha burp” — that distinct matcha grassy flavor you get from the other supplements. It is likely because it is made of oil and not of dried leaves. Atienza Naturale, on the other hand, is the cheapest of all 4 supplements (not by a lot, though). So if you are price-sensitive, you might want to consider that. However, after the one month of experimentation, I noticed that my milk supply increased the most with Mega-Malunggay, and I get stronger letdowns. I didn’t like the matcha burp but, oh well.

Another kind of supplement I tried is the Legendairy line. They come in different variants, which you can read more about here. For me, Pump Princess worked the least and Liquid Gold and Lechita worked the most. Mega malunggay helped the quantity of milk supply and Liquid Gold and Lechita made my milk rich and fatty. I cannot going to be scientific about this — all I can say is that I definitely noticed that my milk became creamier after using Legendairy for a week. I used to take one capsule thrice a day of the mega malunggay and two capsules thrice a day of Liquid Gold or Lechita (alternating between the two month on month). This combination sustained me during the first six months when my son was consuming nothing but breastmilk.

2. Lactation goodies

I tried so many Lactation goodies, and to be honest, many were yummy but I cannot be sure if they helped my milk flow. My favorite and the yummiest for me was MilkingBombsbyABC. Those things are seriously addictive. I wolfed down cookie after cookie while breastfeeding and it does feel packed with ingredients, like flax seed and such. Another favorite of mine is MamaChows oatmeal cookies. I cannot be 100% sure, but it did seem like I had stronger letdowns after snacking on those two goodies. I take these goodies once in a while only because I’m scared of the calories hehe.

3. Drinks and teas

I love iced tea so it was great to discover that there was such a thing as lactation iced tea. I drank a lot of MQT Moringa Tea, and love the subtle lemongrass flavor. I am not a big water drinker so this helped me get my liquid intake up.

But I think what helped the most was Lactablend coffee mix. I was at a steady 4-5oz per pump session from the supplements (malunggay + legendairy) and when I tried Lactablend, my output shot up to 6oz per pump. It’s not the greatest tasting coffee, which was my biggest challenge because I need quality caffeine in the morning. What I do is I take the Lactablend at home, then when I go to the office, I get myself a proper cup of java.

SUMMARY:

So in sum, here is my tried and tested lactation support routine during my EBF days:

Morning – 1 capsule mega malunggay + 2 Legendairy, lactablend coffee

Lunch – 1 capsule mega malunggay, 2 Legendairy, MQT iced tea

Dinner – 1 capsule mega malunggay. 2 Legendairy, MQT iced tea

Mamachow and MilkbombsbyABC for snacks. MQT iced tea as thirst quencher throughout the day.

Now that my baby is 1.3 years and eating solids, I took out the Legendairy (too expensive!) and substituted with 2 capsules of Mega Malunggay thrice a day and Lactablend in the morning.

Baby Love My Baby Love, Uncategorized

Trying your best is best

I remember one afternoon, while on holiday in Singapore, I was breastfeeding my child at a nursing area. A woman and her child then sat on the seat in front of me. I smiled the mommy-solidarity smile, and then looked curiously at the bottle, only because it was of an odd shape. She caught my glance, misinterpreted it, and then said, “yeah, breast is best, right?”. I was startled for a few seconds, not knowing what to say. Finally, I just said, “no, no, I was just looking at your bottle. That’s an Interesting thing inside.” (It turned out to be a vent system against colic). She then smiled, like she didn’t believe me, and we went our separate feeding ways. Then when she was done, as she was packing up and leaving, she glanced at me and said, “For me, fed is best” and then walked out. I didn’t know how to react at that moment, but felt several things: resentment at being lumped into a ‘camp’ I didn’t want to be in, and whose members I actually dislike (the sanctimonious nursing-nazi camp), compassion for moms that feel judged all the time, sadness that there are even camps to begin with.

Few things divide moms as much as the “breast is best” vs the “fed is best” debate. Let me get one thing out of the way: I think there is enough peer-reviewed scientific evidence to demonstrate the superior benefits of breastmilk compared to formula. For this reason, I have chosen to breastfeed my child exclusively for his first year. I also think that the tag “fed is best” is problematic even semantically, because, err, feeding your child is the minimum. Starvation is, I think we will all agree, unacceptable. How can fed be the best and the minimum at the same time? Lastly, there are credible reports of milk companies that use predatory practices to aggressively push formula, and this should not be countenanced.

AT THE SAME TIME, I think something really needs to be said about the self-righteousness of “breast is best” advocates, and how this self-righteousness is really not helping further the breastfeeding agenda. Women are made to feel they are not trying hard enough, and are shamed for considering mixed-feeding or switching to formula altogether. In a breastfeeding group I used to belong to, moms were always told “unli-latch lang yan!” to virtually each and every breastfeeding difficulty reported on. Do they have any clue how hard it is to have a hungry, wailing child at the breast because no milk is coming out? Because I do. Do they know how stressful it is to be pumping like a fiend in the middle of the day, between work meetings, and then getting only 2 oz after thirty minutes of pumping? Because I do.

Yes, I soldiered on. And yes, I successfully exclusively breastfed my child for his first year, but it’s not because I’m some wondermama. it’s also because I’m in a position of privilege. I have a job where I know I won’t get fired for taking long breaks to pump milk. I was given maternity leave in accordance with law. These are things that are not readily available to a female worker working in a factory or fastfood joint on contractual status. Are they any less a wondermama than I am? I think not.

And so this is my alternative formulation for women (like me) who feel caught in the middle of ‘breast is best’ and ‘fed is best’: Trying your best is best. For mommies, let’s try to breastfeed our children, because the evidence of its benefits are incontrovertible. But if it doesn’t work out, we need to tell ourselves that we are not lesser moms for looking for acceptable, medically-sound alternatives. We need not only to forgive ourselves, but to trust that the best we can give is truly the best for our child.

For communities that surround mommies, for families and friends of mommies, the ‘trying your best is best’ framework means that, while we ensure the availability of information and resources to enable breastfeeding, we are not allowed to second-guess women when they say that they try but that it’s not happening. We are allowed to heckle pharmaceutical companies that push formula to moms, but we are not allowed to make mothers feel inadequate for the choices they make. We put the needs of babies as paramount, but we should not ignore the mental health needs of new mothers who are already overwhelmed by this bewildering new frontier called motherhood. Most of all, we need to trust that all mothers want the best for their child and would give an arm and a leg to nourish them in the best way possible.

Because when mothers give their best, they give enough.

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On her First Mother’s Day, please spoil her rotten

Dear husband of first-time Moms,

I am writing this to you because this might not seem so obvious. Maybe you’re one of those people who say things like “Valentines is just a way to milk money out of guilty husbands who ignore their wives 364 days in a year”, or “Santa Claus is capitalism in a fat suit”. Maybe you hate crowds and being a bandwagoner. Or you tell yourself that you don’t need an occasion to tell your wife she’s an awesome mother.

All valid (though the Santa bit is a bit of a gray area). But let me tell you this: if this is your wife’s first Mother’s Day, please PLEASE pull out all the stops.

Think about it. If this is her first Mother’s Day, it means that she probably is still healing from the delivery, whether Caesarian or normal. She will probably not have lost that baby weight, and is saddled with insecurities every time she looks at herself in the mirror. Maybe she is struggling with postpartum depression, maybe she isn’t. But she certainly is overwhelmed AF, struggling with providing for the 24/7 needs of a little human being completely dependent on her. She is up at 3am everyday, nursing or pumping — some days feeling nothing but pure waves of love for the creature on her lap, but some days thinking longingly of night outs with friends or date nights with you and feeling the weight of isolation.

So no, her first Mother’s Day is ABSOLUTELY not the time to talk about how it’s all Hallmark commercial crap and hell no you’re not a sucker. Spoil her, fuss over her, pamper her, tell her she’s beautiful, because guess what, she’s flailing. And she needs a day when it’s not about her baby, it’s not about your cute new family, it’s about HER.

So please daddies, go crazy on the First. ☺️

P.S. I personally didn’t have a pull-out-all-the-stops First Mother’s Day. But it was because we had just arrived from an emotional trip to the Netherlands with our then two-month-old where we said goodbye to my father in law. My Mother’s Day celebration was at a Chinese restaurant at the mall closest to our house, on the Monday after. It wasn’t exactly what I imagined, but it was the best at the time. ❤️

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Expanded Maternity Leave IRR: All you need to know (Part II)

This is Part II of easy-to-read FAQs on the Expanded Maternity Leave Law. If you want to check the full text of the EML IRR, you can check it out in Part I.

Are female workers of the informal economy, and voluntary SSS contributors eligible to access maternity leave benefits?

Yes, if they have remitted three monthly contributions to the SSS within the twelve-month period before the semester of childbirth.

Who are considered informal economy workers?

Female workers in the informal economy are those who are self-employed, occasionally or personally hired, or subcontracted; paid and unpaid family workers in household enterprises, including home workers; micro-entrepreneurs and producers, and operators of sari sari sores.

Who are considered voluntary SSS contributors?

These are Stay-At-Home spouses, an OFW who upon termination of her contract overseas, continues to pay SSS contributions, a covered employee separated from employment who continues to pay SSS contributions, a self-employed member who realizes no income in any given month but continues to pay SSS contributions.

Can maternity leave be allocated?

Yes, a female worker may allocate up to 7 days of leave to the father of the child, whether or not they are married. In case of death, absence or incapacity of the father, the female worker may allocate the leave credits to a relative within the fourth degree of consanguinity, or the current partner of the female worker sharing the same household.

May the current partner be female?

Yes. The IRR contains the phrase “regardless of the sexual orientation or gender identity” of the partner.

Is the option to allocate applicable in the case of miscarriage or emergency termination of pregnancy?

No.

How much will the female worker in case she opts to allocate?

She will be paid the amount corresponding to the period not allocated.

Who will pay for the seven-day allocated leave?

The seven-day allocated leave is paid leave and will be borne by the employer of the father, or the alternate caregiver as the case may be.

How is the intent to allocate conveyed?

The intention to allocate is conveyed upon application of the maternity leave. Likewise, the father or the alternate caregiver must also inform his employer of his allocated leave.

What if one of the parties is from the public sector, and the other from the private sector? Can the female worker still allocate leave credits in that case?

Yes.

Must the allocated leave be used in a continuous manner, or can it be used intermittently?

It can be either continuous or intermittent. However, it should be consumed within the period of the maternity leave of the female worker.

What if the female worker dies?

The balance of her maternity leave shall accrue to the father, or the qualified alternate caregiver. If the money benefits have already been paid in full, the father or qualified alternate caregiver may still enjoy the remaining leave credits but without pay.

Is it a criminal offense to deny maternity leave benefits to qualified female workers?

Yes. The law punishes with a fine of not less than 20,000 pesos and not more than 200,000 pesos and imprisonment of 6-12 years anyone who violates the provisions of this law.