Monday, December 26, 2011

Merry Christmas!

And there were shepherds living out in the fields nearby, keeping watch over their flocks at night.  An angel of the Lord appeared to them, and the glory of the Lord shone around them, and they were terrified. But the angel said to them, “Do not be afraid. I bring you good news that will cause great joy for all the people.  Today in the town of David a Savior has been born to you; he is the Messiah, the Lord.  This will be a sign to you: You will find a baby wrapped in cloths and lying in a manger.” 
  Suddenly a great company of the heavenly host appeared with the angel, praising God and saying,
  “Glory to God in the highest heaven,    and on earth peace to those on whom his favor rests.” 
- Luke 2:8-14

Tuesday, December 20, 2011

How to Prevent a Cold

This is a busy time for us in the office because everyone is calling us and coming in sick.  Thus, it is pretty inevitable that I get sick, too.  Now, I've heard people say, "doctors are not supposed to get sick!"  The reality is, doctors probably get sick more often because of the constant exposure.  So if you combine a busy job with frequent exposure to germs with sleep deprived mom of three young kids... definite formula for sickness!

So why do folks get sick so much in the winter time?  Cold weather does not actually cause colds as some may think.  Theory is that cold weather brings folks indoors and being inside near a lot of people is a way for cold viruses to spread.

Here are some practical tips to stay healthy:

  • Wash your hands a lot!  Touching doorknobs, table tops, etc that is infected with cold virus that someone else touch a while ago can transmit it to your hands (viruses can live 2-8 hrs on surfaces)
  • Avoid touching your eyes, nose, and mouth as much as possible
  • Avoid close contact with sick folks
  • Exercise regularly
  • Eat healthy
  • Avoid stress if possible
  • Get plenty of sleep
You may think it is basic...  but here is the 101 for handwashing:


As often as possible!  Especially...
  • Anytime you shake someone's hand who is sick
  • Anytime you pick up tissue or care for sick child
  • When come home from a public place (like school, mall, etc)
  • Definitely before you eat
  • Before putting contacts in your eyes
  • Wet with running water
  • Apply soap
  • Lather for 20 seconds (sing happy birthday twice!) and scrub all surfaces of hand
  • Dry with disposable towel or air dryer for best results
  • Turn off faucet with towel
**Using antibacterial soap may actually cause resistance which will make it harder to kill the bacteria in the future so plain soap and water is best!!

Two out of our three exam rooms in the office do not have a sink and running water.  So we have hand sanitizers instead.  Some say this is better than nothing... but the hand sanitizer needs to be at least 60% alcohol.  However, as this article points out, hand sanitizers should not take the place of hand washing.

So this is probably why I am sick all the time!  Well... that and the fact that I'm so sleep deprived.  Read my previous post here about lack of sleep and increase risk of colds.  Basically if you get less than 7 hours of sleep at night you are at significant risk of catching a cold!  So what am I doing blogging when my 5 month old will probably be waking up in the next couple of hours?  I better get to sleep...

Sunday, December 11, 2011

Christmas Traditions

Christmas is around the corner!

We're just starting to make some christmas traditions.  One thing we have been doing is getting a new ornament every year that signifies something special.  Here is what we have so far from the years past:

2002 - "Our First Christmas Together" precious moments ornament
2003 -  Nativity scene ornament from Honduras
2004 -  GI Joe figure
2005 - "Grace" ornament
2006 -  Little home ornament
2007 -  1st Christmas ornament for our daughter
2008 -  Graduation pic in frame ornament
2009 -  1st Christmas ornament for second daughter
2010 -  Philly Marathon ornament 
2011 -  "Blessings" ornament (and ornament for son)

So other things we're doing or hoping to do include...
  • christmas cookies
  • gingerbread houses
  • lots and lots of christmas books and stories
  • lots and lots of caroling
  • christmas eve service
  • matching pjs on christmas morning
So what do you guys do with your families?  Would love to hear...

Sunday, December 4, 2011

Words of Encouragement for Weary Mothers

As I had mentioned in previous posts, I love my MOPS group!  Every mom of a preschooler should go to a MOPS or a similar mommy support group.

This past Friday, I was encouraged and humbled listening to a couple share their testimony about how God has called them to be missionaries in the Kensington area in Philly.  Young married couple, not yet with children of their own... but due to circumstances found themselves in the roles of parenthood for 5 kids!  I think the age range was between 5 and 13.  I especially resonated with the young mom's sentiments when she described how some days it is hard not to complain when facing laundry and dishes that never seem to end!  Click here for a link to their blog.

Being a mother certainly has its challenging days.  I'm learning a lot about dying to self... however, I admit I feel defeated many times and wish I was able to do "better".  The strength, patience, and compassion that I wish to portray during those tough moments in the middle of the night when my body and mind is screaming "I want to sleep!" cannot come from myself because my flesh is so weak.  Rather, I need to gather wisdom and encouragement from the Word of God daily and find grace at the foot of the cross.

Here are some of my favorite words of wisdom and encouragement:

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me."  (2 Corinthians 12:9)

 “Come to me, all you who are weary and burdened, and I will give you rest. (Matthew 11:28) 

But those who hope in the LORD will renew theirstrength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.  (Isaiah 40:31)

The LORD himself goes before you and will be with you; he will never leave you nor forsake you. Do not be afraid; do not be discouraged.”  (Deuteronomy 31:8) 

Wednesday, November 23, 2011

Happy Thanksgiving

Thanksgiving in our office means a ton of college students home for the holiday.  I think everyone I saw today was between the ages of 19-21!

So... ten things off the top of my head that I'm thankful for this year:

10)  Baby E is sleeping longer than 3 hrs at a time!  Waking up twice now at night.. hoping it will continue to improve

9)  Toddler A continues to  be a great sleeper at night!  She is also starting to use the potty more and more... maybe no more diapers soon...

8)  Preschooler S has become quite the helpful big sister and there are fewer and fewer tantrums/emotional meltdowns overall.  Hoping that trend continues...

7)  Daddy is around for the entire Thanksgiving break!  Really feel his absence when he is on a trip.. thankful he can help with a nighttime feed here and there...

6)  Grandma is healthy enough to continue coming over to help with the kids... cooking... cleaning... taking care of me!  Sometimes.... I just need my "mommy"...

5)  Grandpa is healthy enough to occasional come over to "play" with the kids... though they probably stress him out...

4)  Our au pair has really worked out so far and been a tremendous help!

3)  Friends from far away that I can still count on to talk to and lean on...

2)  Friends close by to have adult conversations with...

1)  God who is always constant... always present... never failing...

Happy Thanksgiving, everyone!

Rejoice always, pray continually, give thanks in all circumstances; for this is God’s will for you in Christ Jesus.  - 1 Thessalonians 5:16-18

Monday, November 21, 2011

Should We Circumcise Our Son?

When we found out that baby #3 was a boy, we had to ask ourselves this question.  

Circumcision is the removal of the foreskin that covers the tip of the penis.  Studies do show some benefits to doing this, however, not enough for a formal recommendation from the American Academy of Pediatrics.  So at the end of the day, it is up to the parents.

In a nutshell, here are some reasons to circ or not to circ:

Reasons to circumcise:

  • A slightly lower risk of urinary tract infections (UTIs). A circumcised infant boy has about a 1 in 1,000 chance of developing a UTI in the first year of life; an uncircumcised infant boy has about a 1 in 100 chance of developing a UTI in the first year of life.
  • A lower risk of getting cancer of the penis. However, this type of cancer is very rare in all males.
  • A slightly lower risk of getting sexually transmitted infections (STIs), including HIV, the virus that causes AIDS.
  • Prevention of foreskin infections.
  • Prevention of phimosis, a condition in uncircumcised males that makes foreskin retraction impossible.
  • Easier genital hygiene.
  • May be tradition because all the other men in the family are circumcised or may have religious or cultural reasons

Reasons to not circumcise:
  • Fear of the risks. Complications are rare and usually minor but may include bleeding, infection, cutting the foreskin too short or too long, and improper healing.
  • Belief that the foreskin is needed. Some people feel the foreskin is needed to protect the tip of the penis. Without it, the tip of the penis may become irritated and cause the opening of the penis to become too small. This can cause urination problems that may need to be surgically corrected.
  • Belief it can affect sex. Some feel that circumcision makes the tip of the penis less sensitive, causing a decrease in sexual pleasure later in life.
  • Belief that proper hygiene can lower health risks. Boys can be taught proper hygiene that can lower their chances of getting infections, cancer of the penis, and STIs.

Wednesday, November 9, 2011

When will my newborn sleep through the night?

It is 1AM and I just put E back down after a quick feed.  This is a milestone!  Recently he has been sleeping from around 7p to 1a... usually with a short 10 second cry around 10p.  If only the 6 hr stretch is during the second half of the night when I'm not on the computer!  So I should be sleeping but sometimes I just can't fall back asleep...

So when will baby sleep through the night?  That is a question a lot of parents ask.  Well, it is different for every kid... and it also depends on the definition of "sleeping through the night".  For a new baby 5-6 hours is considered sleeping through the night.  I'm more interested in knowing when my baby will sleep until the morning!

Although every child has different temperaments and may require different amounts of sleep, there is a general pattern that most children follow.  For example, most newborns sleep 2-3 hours at a time, waking up to feed.  Eventually they skip a feed.  Some do this as early as 2-3 months.  It looks like it is taking E about 4 months to reach this.  Will adding supplementation to breast milk help?  As in my previous post, I think it is debatable.  I chose not to supplement and just wait it out.  E is sleeping longer now without supplementation so personally, I think this supports the theory that there is no need to add rice cereal or switch to formula to help baby sleep longer.  It just takes time.  We did however, start giving a bottle of pumped breast milk in the start of the night so we knew exactly how many oz he was getting.  We tried doing it in the middle of the night as well but that did not necessarily lengthen his sleep.  He still woke up 3 hours later to feed.  So I'm concluding that the general sleep pattern for babies is such:
  • Newborns:  sleep / feed cycle every 2-3 hours
  • By 2-3 months to about 6 months or so:  drop 1 feed so there is a 5-6 hr longest stretch then back to 2-3 hrs rest of day
  • Between 6 months to 12 months:  drop the other feed to get the 12 hours sleep at night
With that said, not every child will follow this.  I've had parents report their 2 or 3 year old still does not sleep through the night.  I recall a couple of parents telling me their eleven year old still crawls in bed with them in the middle of the night!  So of course temperament plays a role.  Some children are naturally great sleepers while others are not.  For the bad sleepers, parents will have a harder job of sleep training if they choose to or will have to just adjust and go with it if they don't mind it or don't believe in sleep training.  My personal opinion is that sleep training works... not necessarily the hard core "cry it out" Ferber method... but I'm just referring to gently training the child to self soothe and develop a healthy habit of sleep.

Even adults who want good sleep should follow good sleep hygiene skills (which I'm breaking right now blogging in the wee hours while sitting in my bed).  If more adults have good sleep hygiene, I'd be prescribing less ambien!

So I plan to record how we end up training E if we get there.  Since I've gone through this twice before and both kids now sleep through the night, I have more confidence that there is an end in sight and this kid will soon be sleeping through as well.  Let's see when!

Tuesday, November 1, 2011

Happy Halloween

So who else trick or treated with snow all over the ground?  My boss actually shifted my hours yesterday so I could get home to go trick or treating with my girls.  It was fun but a bit chilly.  We didn't take the baby out.  I just wore my doctor scrubs since I didn't have time to get a costume this year... let alone make a costume!  Kudos to all you moms out there who make cute costumes for your kids!  I wish I had the time and the talent.   It sure saves some money.  I heard on the news that stores did really well this year for Halloween despite the economy.  It is supposed to be the second biggest holiday shopping of the year.  That just sounds crazy to me.

Alright.. with Halloween out of the way I guess we're on to Thanksgiving... then Christmas!

Tuesday, October 25, 2011

Ready for Parenthood?

I love my Friday mornings when I get to attend MOPS.  It is nice to have a couple of hours to chat and hang with other mommies, munch on delicious food, get encouragement/useful tips/devotionals, do crafts etc ...and all this without the kids!  Every mom (especially of small children) should have some mommy support group.

This past Friday we listened to a hilarious list of things to do to "prepare for parenthood".  I laughed so hard I had tears in my eyes.  It was as much the presentation as the list itself!  I wanted to find the list to share with my husband, so I googled it and discovered that this was actually from a blog post from 2007 by The Lactivist, Jennifer Laycock.

I especially resonate with lesson #3!!

Lesson 1
1. Go to the grocery store. 
2. Arrange to have your salary paid directly to their head office.
3. Go home.
4. Pick up the paper.
5. Read it for the last time.

Lesson 2
Before you finally go ahead and have children, find a couple who already
are parents and berate them about their…

1. Methods of discipline.
2. Lack of patience.
3. Appallingly low tolerance levels.
4. Allowing their children to run wild.
5. Suggest ways in which they might improve their child’s breastfeeding, sleep habits, toilet training, table manners, and overall behavior. Enjoy it because it will be the last time in your life you will have all the answers.

Lesson 3
A really good way to discover how the nights might feel….
1. Get home from work and immediately begin walking around the living room from 5PM to 10PM carrying a wet bag weighing approximately 8-12 pounds, with a radio turned to static (or some other obnoxious sound) playing loudly. (Eat cold food with one hand for dinner)
2. At 10PM, put the bag gently down, set the alarm for midnight, and go to sleep.
3. Get up at 12 and walk around the living room again, with the bag, until 1AM.
4. Set the alarm for 3AM.
5. As you can’t get back to sleep, get up at 2AM and make a drink and watch an infomercial.
6. Go to bed at 2:45AM.
7. Get up at 3AM when the alarm goes off.
8. Sing songs quietly in the dark until 4AM.
9. Get up. Make breakfast. Get ready for work and go to work (work hard and be productive)
Repeat steps 1-9 each night. Keep this up for 3-5 years. Look cheerful and together.

Lesson 4
Can you stand the mess children make? To find out..
1. Smear peanut butter onto the sofa and jam onto the curtains.
2. Hide a piece of raw chicken behind the stereo and leave it there all summer.
3. Stick your fingers in the flower bed.
4. Then rub them on the clean walls.
5. Take your favorite book, photo album, etc. Wreck it.
6. Spill milk on your new pillows. Cover the stains with crayons. How does that look?

Lesson 5
Dressing small children is not as easy as it seems.
1. Buy an octopus and a small bag made out of loose mesh.
2. Attempt to put the octopus into the bag so that none of the arms hang out.
Time allowed for this – all morning.

Lesson 6
1. Take an egg carton. Using a pair of scissors and a jar of paint, turn it into an alligator.
2. Now take the tube from a roll of toilet paper. Using only Scotch tape and a piece of aluminum foil, turn it into an attractive Christmas candle.
3. Last, take a milk carton, a ping-pong ball, and an empty packet of Cocoa Puffs. Make an exact replica of the Eiffel Tower.

Lesson 7
Forget the BMW and buy a mini-van. And don’t think that you can leave it out in the driveway spotless and shining. Family cars don’t look like that.
1. Buy a chocolate ice cream cone and put it in the glove compartment.
Leave it there.

2. Get a dime. Stick it in the CD player.
3. Take a family size package of chocolate cookies. Mash them into the back seat. Sprinkle cheerios all over the floor, then smash them with your foot.
4. Run a garden rake along both sides of the car.

Lesson 8
1. Get ready to go out.
2. Sit on the floor of your bathroom reading picture books for half an hour.
3. Go out the front door.
4. Come in again. Go out.
5. Come back in.
6. Go out again.
7. Walk down the front path.
8. Walk back up it.
9. Walk down it again.
10. Walk very slowly down the sidewalk for five minutes.
11. Stop, inspect minutely, and ask at least 6 questions about every cigarette butt, piece of used chewing gum, dirty tissue, and dead insect along the way.
12. Retrace your steps.
13. Scream that you have had as much as you can stand until the neighbors come out and stare at you.
14. Give up and go back into the house.
You are now just about ready to try taking a small child for a walk.

Lesson 9
Repeat everything you have learned at least (if not more than) five times.

Lesson 10
Go to the local grocery store. Take with you the closest thing you can find to a pre-school child. (A full-grown goat is also excellent). If you intend to have more than one child, then definitely take more than one goat. Buy your week’s groceries without letting the goats out of your sight. Pay for everything the goat eats or destroys. Until you can easily accomplish this, do not even contemplate having children.

Lesson 11
1. Hollow out a melon.
2. Make a small hole in the side.
3. Suspend it from the ceiling and swing it from side to side.
4. Now get a bowl of soggy Cheerios and attempt to spoon them into the swaying melon by pretending to be an airplane.
5. Continue until half the Cheerios are gone.
6. Tip half into your lap. The other half, just throw up in the air.
You are now ready to feed a nine- month old baby.

Lesson 12
Learn the names of every character from Sesame Street, Barney, Disney, the Teletubbies, and Pokemon. Watch nothing else on TV but PBS, the Disney channel or Noggin for at least five years. (I know, you’re thinking What’s “Noggin”?) Exactly the point.

Lesson 13
Move to the tropics. Find or make a compost pile. Dig down about halfway
and stick your nose in it. Do this 3-5 times a day for at least two years.

Lesson 14
Make a recording of Fran Drescher saying “mommy” repeatedly.
(Important: no more than a four second delay between each “mommy”; occasional crescendo to the level of a supersonic jet is required). Play this tape in your car everywhere you go for the next four years.
You are now ready to take a long trip with a toddler.

Lesson 15
Start talking to an adult of your choice. Have someone else continually tug on your skirt hem, shirt- sleeve, or elbow while playing the “mommy” tape made from Lesson 14 above. You are now ready to have a conversation with an adult while there is a child in the room.

Sunday, October 23, 2011

How Contagious is Lice?

I was picking up my daughter from dance last week when I saw a sign on the door saying that there has been an outbreak of lice in the local elementary schools in the area as well as some of the kids at the gym.  Great.  I wonder if I'll be seeing some folks come into the office.  But now as a mommy of a preschooler, I'm checking her hair for any signs of lice... namely:
  • intense itching of the scalp
  • tiny red bumps scalp, neck, or shoulders (may become crusty)
  • tiny white specks that are hard to get off (lice eggs or nits)
So here is a short 101 on lice: 

What is it?   Tiny insects that live on the skin and depending on where you can have:
  • Head Lice
  • Body Lice
  • Pubic Lice
How do you get it?  It is very contagious!  You get it by:
  • close contact with someone who has it
  • touching clothing or bedding of someone who has it
  • sharing brushes, combs, hats, towels with someone who has it
How do you treat it?
  • lotions and shampoos either over the counter or if necessary prescription by your doctor
  • remove nits with metal comb
  • wash all clothing, bedsheets, etc in hot water with deteregent
  • vacuum and cover furniture for 2 weeks
  • need to notify schools/churches/gyms so other children can be examined otherwise infection may recur
Complications?  Sometimes you can a secondary infection from scratching too much.  You can use benadryl for itching.  Call your doctor if experience redness/pain at the skin sites and an antibiotic may get prescribed.

At the end of the day, it is harmless and it does not mean poor hygiene.  However, it is a bit of a pain to treat.  I'll be happy lice hunting for these next few days I suppose...

Tuesday, October 18, 2011

Flu Season

Long time no write!  It has been crazy busy at work.  Between that and trying to sleep at night when I can... I'm beat.

I just finished giving everyone in my family flu shots (not counting baby E since he is only 3 months).  Unlike last year, lots more crying this time around.  I also thought it hurt more this year.  Well.. it is better than getting the actual flu!

Like I said.. crazy busy at work and we are starting to see the flu... so get your flu shots!

I'll blog more tomorrow... maybe...

Wednesday, October 5, 2011

Dads are great!

Dads are great.  I don't know how single moms do it.  I do appreciate my husband's help with the kids and I definitely feel the difference when he is not around.  There are moments when I feel like I need to be the one "doing it all"... sentiments expressed in my previous "clone me" post... but overall I do have to admit that having dad around is more helpful than not.

I especially am thankful for the past two nights when he woke up for the 1am feed.  So this post is a "kudos to dads" post =)  I mean I had to shake him pretty hard to wake him and he was pretty disoriented... but he did it!  Of course, I was still awake listening to baby cry a little longer than usual... but he did it and it helped me sleep a little more.

So here are some pros and cons for me feeding vs dad feeding...

Pros to when I'm doing the feed
I usually go to the baby before he is even fully awake or crying.  I hear his little pre-crying grunts and basically stick a nipple in his mouth before he gets to an all-out scream.  Less disruptive for everyone in the house... less painful for baby... 

Cons to when I'm doing the feed
I often fall asleep in the middle of nursing and wake up unsure when baby fell asleep and how much he ate.. therefore no wonder if he wakes up an hour later hungry again!

Pros to when daddy does the feed...
He knows exactly how much baby is eating and can keep waking him until he finishes entire bottle.  Therefore, baby usually sleeps longer after the bottle feed.

Cons to when daddy does the feed...
Takes him a while to get to baby!  He first goes to the bathroom... then goes downstairs to heat up the water in the microwave... then gets the bottle out of the refrigerator... and finally heats up the bottle for a few minutes in the hot water.  By then baby is screaming pretty loudly and for quite a while.  He is now fully awake and has the potential to wake up his sleeping sisters...

After all is said and done, I'm still taking the help because I'm soooo tired.  Today I drove like fifteen minutes going the wrong direction on route 95 after picking up my mother in law from the airport.  It took me a while to figure out why my gps kept telling me to take the next exit for a u-turn... I know... scary.

One last thought about dads.  This happened a couple of weekends ago and I thought it was pretty funny... I think...

So we're at Sesame on a somewhat rainy cloudy day.  Those are the best days to go because there are absolutely no lines!  Oh and side note and money saving tip - I waited until Aug this year and got a season pass for 2012.  Means I can use it for the rest of 2011 and then all of 2012.  Then I'd prob not buy 2013 until Aug again and get the season pass for 2014.  This way I can get a pass for basically two years of use...

Anyways, I let daddy go on the rides with the girls while I waited around with E since daddy is usually at work during the week.  Well, before one of the rides he asks me if I'm sure A is old enough to ride these rides.  "Well, yes for the ones we are going on as long as accompanied by adult, " I answer.  "Why?"

"She fell right off onto the floor during teacup ride" he tells me.  

"Um.  The whole point of you riding the rides with them is so that that doesn't happen... you weren't holding her?"

"Well, after she fell on the floor, I set her back on the chair and braced her with my legs"  

So I wasn't sure how to respond to that but as you can see... I've been playing back this conversation in my head for a while and even now I just have to shake my head and conclude that dads and moms are just different... we think differently...  we parent differently... and our instincts and responses are different... but I do still appreciate the help...

Friday, September 30, 2011

Bedtime Routines

So in earlier sleep posts I mentioned the importance of schedule and routine for developing good sleep hygiene.  This actually goes for adults as well.  

Over the years our "routine" has changed here or there. The overall structure is the same and we do try to keep the times consistent.  I figure I'd outline our current routine as a memoir for later years...

Currently, hubby is on a business trip.  I do have my au pair around but I usually give her the weekends off.  So here's a typical night when it is just me putting all 3 to bed:

6pm - Dinner time!  ...or  "mum mum time" as my #2 likes to call it...

I march the two girls to the bathroom to wash their hands why bjorning my third.  If he is not fussing, I'd put him on a bouncy seat in the kitchen.  

Next... strapping down both kids on booster seats is key to keep them from running around and gives me more control.  Yep.. I even strap my preschooler... (though more recently I've allowed her to sit in a grown up chair but it depends on my mood and how much control I need at the moment)

Now I rummage through our fridge and usually there is enough leftovers for me to scrounge up dinner for the two as well as for myself.  (This is when I'm completely alone and don't feel like cooking at all).

While they are "eating"... I now can take #3 upstairs for his bath.

Putting down my 3 month old...
Depending on the night he can be either very easy or very hard.  Usually after I bathe him, I dress him in a onesie.  Right now I find he still sleeps better swaddled so his hands cannot flail all over the place.  I feed him and he usually gets pretty sleepy towards the end.  Sometimes I'd give a bottle of pumped milk instead of nursing so I know exactly how much he drinks.  Once sleepy, I either put in bed propped a little sideways or I put him on the swing with a pacifier... it depends on how fussy he is.  Eventually, we'll sleep train him so he'll be in his crib every night.  But right now, I'm still in survival mode... 

6:30pm - Finish up dinner...

I go back to examine the mess.  Usually what I'd find is #1 would have hardly touched her food and is distracted with some book or toy or other that she found on our messy kitchen table.  #2 has food all over her mouth, hair, hands. floor, wall etc. but usually does a pretty good job of eating what's given to her.

So I'd wolf down my own dinner while throwing food on the tray for my #2 and coaching my #1 to "take another bite"...  "take another bite and I'll answer that question"... "take another bite and I'll read the next page.."  Like other preschoolers her age, she is not a very good eater and often a source of great frustration.  Will blog more on picky eating in another post...

7pm - Bath time for #2

Usually at this point, #1 is just about done.  On a good day if she is done, I can give her an ice pop or ice cream (we're actually trying to fatten this one up)!  This keeps her busy and happy while I take #2 upstairs...  Sometimes I throw in a video as well although more recently I haven't had to and she just entertains herself somehow.

Putting down my 22 month old...
By far, she is my easiest child to put down.  She goes on the potty before her bath and actually has been going pretty consistently for the past month.  I bathe her and get her into her pj's.  We are still using a sleep sack with her so I put that over her pj's.  Next we go downstairs to grab a bottle of warmed up milk which she drinks while I read a few books to her.  She would keep pointing and wanting me to read more but depending on the time, I'd usually only read 1 or 2.  She actually really likes to just go through her ABC book and point and say all the pictures on there including the letters.  Right now she recognizes just about all 26 letters.  Here are some favorite bedtime stories we've been reading recently:
The Going to Bed Book
Goodnight, Goodnight, Sleepyhead
Good Morning, Good Night!

Other favorites and classics:
Goodnight Moon
Goodnight Gorilla
Shhhh!  Everybody's Sleeping

Reading is actually my favorite part of the whole bedtime routine.  Now, we put the bottle away.  Go to the bathroom to brush her teeth.  Then I shut out the lights.  Turn on the sound machine.  She has recently wanted me to sing "Jesus Loves Me" to her while holding her.  I love this part and often want to just hold and rock her.  Often I prolong it by singing the song twice or humming it a third time.  Finally, I ask her if she is ready for her "yellow blanket" and "wawa" (means doll in chinese).  She usually responds with "ya".  I lay her in her crib and giver her her blanket in one arm and doll in the other.  Then I tell her I love her and blow her a kiss.  She blows me a kiss back.  Then I leave and shut the door behind me and she is down for the rest of the night!

7:30pm - Bath time for #1
Getting her upstairs is tricky because she often will want to "just play a little more".  Lately, we've pulled out our kitchen timer to use in various scenarios.  Here is one where I'd set it to five minutes and tell her that once it beeps, we have to go upstairs.  While she is playing, I can then clean up the kitchen mess.  So if we do this right, there is no meltdown and fussing.  Otherwise, we get some stomping and crumpling to the floor bawling but since we've implemented the timer, things have been going more smoothly.

Putting down my almost 4 year old...
So by far, she is my hardest kid... ever since birth.  I start off by asking her to pinky promise me that she will not fuss later when I put her to bed.  This was a recent thing I started after having many difficult nights with her... and now has become a part of her bedtime routine.  We hook pinkies and shake.  Then I remind her to "sneak" when we go upstairs.  Otherwise, her loud stomping and talking would wake #2 up and cause a lot of crying.

I usher her into the bathroom as quickily as possible and shut the door.  If we turn on the hallway light or have the bathroom door wide open when the lights are on, #2 can see the light from her crib and will often cry.

While on the potty I ask her what she wants to wear to sleep (for if I choose the wrong outfit, we'd have another meltdown).  I get her clothes and help bathe her.  Changing into the nightwear, blow drying her hair, then brushing her teeth usually goes fairly smoothly but takes some prompting.  We get into her room and switch on the sound machine.  Maybe it is a false sense of security, but I hope it drowns out noise so to not wake or bother #2.

Now my preschooler picks out the clothes she wants to wear the next day (this helps the morning run smoother).  This process often takes some negotiating because sometimes the clothes she picks is just not practical for the weather.  I tell myself I need to clean out her closet and only have appropriate clothes out as a choice but have not found the time to do so yet.

Then it is time to get in bed and read a story!  Lately she has been picking a chapter from her chldren's Bible book.  It is short and simple and has a memory verse at the end.  At this point, I can turn on the night light and turn off her regular lights.

Now the tricky part is "tucking her in" correctly.  99% of our bedtime melt downs happen at this step.  I often get it wrong because she wants the blankets in a particular order and tucked under her in a certain way but needs to be tucked under the pillows too.  Whew!  She is also holding her baby doll who I have to help her swaddle in a blanket and have the doll's bottle and a toy cinderella cell phone by her side.  Little donut pillow also by her side for her baby doll to sometimes sleep on.  Can you tell that this daughter of mine is very particular?

Finally, with her all tucked in and with only the nightlight on, I get to make up a "princess story".  Sometimes I tell her about the "blue princess who likes to have everything blue"... or the "princess who talks too much"...  I just make up whatever comes to my mind and she is usually fairly entertained.  However, I always have to start with "once upon a time... " and I have to end with "the end".

Then prayer time...  The past few nights, she has asked me what my "prayer request" is.  I'd pray for her and she'd pray for me and we'd pray for whoever else comes to mind or needs prayer that day.  Her typical prayer these nights... 

"Dear Lord, please help E not cry so mommy can sleep."  or  "Dear Lord, please help me be good so mommy doesn't get mad".

Then... I sing her a song.  Sometimes she lets me pick but usually she has a song in mind.  Tonight it was the Awana Cubbies theme song.

Finally... I walk over to her ipod machine and turn on the music with 30min to "sleep".  Every night she listens to Hide 'Em in Your Heart and wants me to start with the song, When I Am Afraid.  Once the music starts, she wants me to "run out fast" but I have to "leave the door a little open".

I usually heave a huge sigh of relief if I get out of there with no crying/fussing/meltdown!   Depending on whether she napped that day, she will either pass out fairly soon... or more often she'd talk and sing to herself for sometimes a couple of hours before finally falling asleep.  Either way, I usually do not have to go back in the room once I leave her room.

Therefore most nights at around 830pm or 9pm I'm done and have time to myself!  Yay!  This is when I pull out my laptop and get a few emails in... or blog... or get caught reading random things on facebook...  when I really should be sleeping because #3 will probably wake up any minute now to feed!

So... goodnight...

Wednesday, September 28, 2011

Baby Constipation

Kid #3 is exactly 3 months old today!  We're planning on celebrating his 100 day birthday korean style.  Grandma C is coming to meet him for the first time and to plan the party.  Being chinese, I'm not that familiar with the korean traditions but one common theme across most asian cultures in general is that it involves food.

So this kid has been pooping every 4-7 days.  Constipation you say?  Well, actually for babies constipation is determined more by the consistency of the stool and not so much by the frequency.  Some breastfed babies can go 8-10 days without a bm because breastmilk is absorbed better than formula.  Formula fed babies usually go at least once a day.  As primary care physicians, we get calls all the time from distraught moms worried that their baby is constipated.  Depending on age and circumstance, sometimes a glycerin suppository is warranted... or the good 'ole rectal stimulation with a thermometer... but probably more times than not, baby is fine and not really constipated.

Common causes of constipation would be:
  • switching from breastmilk to formula
  • recently starting on solids
It is rare that mom's diet will actually affect baby to be constipated.  However, if getting the sense that certain foods make baby more fussy or break out in rashes... then common foods to avoid include:
  • milk (lactose) products
  • soy
  • wheat
  • corn
  • eggs
  • peanuts

So if you think baby is truly constipated, call your physician.  However, if baby seems fairly happy, not straining to poop, and poop is not really hard... then the timing may just be a variant of normal.  

Ofcourse it is always harder when it is your own kid.  After day 4 or 5 of no poop... there is usually much rejoicing when we get a stinky poopey diaper!

Monday, September 26, 2011

About Work and Sleep...

Here we go... the start of another week!

Last week, my boss came back from vacation so my hours went back to normal (which is about 25 hrs/week).  Kudos to you full time working moms!  I would totally burn out in less than one month if I had to work full-time.  I'm not sure about other jobs but as a family doc I feel like I'm trying to meet everyone's needs.  So when I was working extra shifts I felt like I was non-stop trying to meet need after need after need...  Even after work, my phone would ring and I'm pulled to give sound advice... call in scripts... all this with screaming children in the background.  The lack of sleep at night does not help things either.

So... with back to normal hours I feel better.  Now if I can only get E to sleep longer at night.. all I ask is a consistent 3 hr stretches... soon it will be time to sleep train...

It is funny when I read my previous posts about training my child #2.  She sleeps great ever since... 7p-7a!!  I truly believe that if we didn't try to train her, she'd still be waking up crying in the middle of the night or crawling in bed with us.  Child #1, too!!

So first child slept through the night at 15 months... second child at 12 months.. I'm hoping with this third child he'll be sleeping through by 6!  We'll see...

Monday, September 19, 2011

Clone Me!

So I've been thinking about this for some time now... need to make a sci fi movie about mommies who clone themselves in order to manage their households as well as hold jobs and find time to relax etc all at the same time!

I really longed for a clone while on our mini-vacation trip during Labor Day weekend.  Husband and au pair were both with me on this trip so adult child ratio was one to one.  Nevertheless, there were moments where I wished I could have been in 3 places at once!  Here is an example:

We all just got back from dinner and now is the time to get the kids down for the night.  We have been giving E a bottle of breastmilk before his sleep at night so we know exactly how much he drinks hoping this would help him sleep longer.  So daddy had that job.  Au pair was going to try to bathe both girls at the same time.  I had to pump, wash the pump stuff, then store the milk.  While pumping I can hear all the commotion going on outside my bedroom door.  E was crying very hard and having a hard time drinking his bottle for whatever reason.  The two girls were squealing and excited that they were going to sleep in the same room that night.  I went over to help hold E who quieted down right away.  Meanwhile, my milk is sitting out because I didn't get to put it away yet.. so I direct husband to go put it away for me.  Then I hear the girls acting out... S is screaming something and starting to have an attitude.  So when our au pair comes out of their room, I hand her E and go into the girls' room to assess the situation and calm them down.  

It is fuzzy in my memory now, but I think I went back and forth between baby and my girls for a while before baby finally passed out on the sofa bed.  I had to lay in the room with the girls until they fell asleep to keep them from talking and keeping each other up.  I actually didn't mind that part because I probably fell asleep before either of them did.

So yes, having other caregivers around is definitely more helpful than being alone by myself... but sometimes I feel like cloning myself would be the easiest and most efficient way to get all that needs to be done done!  Then I need that extra clone to just sleep for me.

Now that I think about it, this post is similar to another post I wrote about a year and a half ago!

Boy, I should be sleeping now... but one last thing...  I found this on the web while googling "mommy clones".  Heh.  This is a better for Christmas time but since on the subject I'll post it now.

So for all the moms out there... 

'Twas the night before Christmas, when all through the abode
Only one creature was stirring, and she was cleaning the commode.
The children were finally sleeping all snug in their beds,
while visions of Nintendo and Barbie flipped through their heads.
The dad was snoring in front of the TV,
With a half-constructed bicycle propped on his knee.
So only Mom heard the reindeer hooves clatter,
Which made her sigh, "Now what is the matter?"
With the toilet bowl brush still clutched in her hand,
She descended the stairs and saw the old man.
He was covered with ashes and soot, which fell with a shrug,
"Oh, great," muttered Mom, "now I have to clean the rug."
"Ho Ho Ho!" cried Santa, "I'm glad you're awake,
your gift was especially difficult to make."
"Thanks, Santa, but all I want is time alone."
"Exactly!" he chuckled, "So, I've made you a clone."
"A clone?" she muttered, "What good is that?"
"Run along, Santa, I've no time for chit chat."
Then out walked the clone - The Mother's twin;
Same hair, same eyes, same double chin.
"She'll cook, she'll dust, she'll mop every mess.
You'll relax, take it easy, watch The Young and The Restless."
"Fantastic!" the Mom cheered. "My dream has come true!"
"I'll shop, I'll read, I'll sleep a night through!"
From the room above, the youngest did fret.
"Mommy? Come quickly, I'm scared and I'm wet."
The clone replied, "I'm coming, sweetheart."
"Hey," the Mom smiled, "she sure knows her part."
The clone changed the small one and hummed her a tune,
as she bundled the child in a blanket cocoon.
"You're the best mommy ever.  I really love you."
The clone smiled and sighed, "And I love you, too."
The Mom frowned and said, "Sorry, Santa, no deal.
That's my child's love she is trying to steal."
Smiling wisely, Santa said, "To me it is clear,
Only one loving Mother is needed here."
The Mom kissed her child and tucked her in bed.
"Thank you, Santa, for clearing my head.
I sometimes forget, it won't be very long,
when they'll be too old for my cradle and song."
The clock on the mantle began to chime.
Santa whispered to the clone, "It works every time."
With the clone by his side, Santa said, "Good night.
Merry Christmas, dear Mom, you will be all right."
~ Author Unknown ~

So maybe I don't want a clone after all... but just  a little sleep would be nice.  G'night!

Monday, September 12, 2011

Head Injuries

It has been a crazy two weeks since my boss is on vacation and I'm working more than my usual number of shifts.  Today I come home for a lunch break and was about to sit down for some nourishment when I hear a loud BANG.  I look over and my preschooler and her chair are tipped over on the ground.  She probably kicked the table with her legs despite the many times we've warned her not to... and this time her chair tipped.  I rushed over to assess the situation.

No blood.  Not much swelling.  However, I did have a loudly crying child who was terribly shaken up.  I coax her to calm down as I move her to the refrigerator so I can grab some ice.  I also couldn't help but started lecturing her on how this is why she should obey when we tell her not to do things... how mommies and daddies are always looking out for her best interest... and how she should never disobey anything we say ever again!

My dad was helping me babysit today and he is a pretty anxious person on a good day.  So the loud commotion drew him to the scene in a panic.  The string of nervous comments that followed only heightened the situation and caused my child to cry louder and start coughing.  Once the coughing started, I knew what was going to come... all her lunch.  She threw up and threw up... got it all over the floor, herself, and my skirt.  When we thought she was done, she threw up some more.  During these moments, I never know whether to move her to the bathroom or just stay put.  We stayed put.  I figured a puddle of throw up was easier to clean than a long trail.  Finally, things did settle down.  S got a bath and I changed into scrubs.  I still needed to get back to work but thankfully (though unusual for Monday) the schedule was lighter and I was able to stay home to monitor S a little longer.

So when do you take a child to the ER after a head injury?  And when do you need a CT scan after a head injury?

Well, when in doubt, never hesitate to call your physician and ask.  But here are some general guidelines...

Get your child evaluated after any head injury but you can call to determine whether that means bringing him or her into the primary care office or going straight to the ER.  Physicians are not as quick to get a head CT on a child anymore due to the high exposure of radiation.  In a developing body, they are more prone to long term risks such as cancer.  So there was a study of 40,000 children treated for head trauma in 25 emergency room centers between 2004 and 2006.  They found that 4 to 6 hours of observation reduced the amount of CT scans ordered with comparable outcomes as those who ordered ct scans right away.

So some signs that would have caused me to take my preschooler to the ER today for a head ct include:
  • if her vomiting recurred or did not resolve
  • if she became confused
  • if she had slurred speech or started to say things that did not make sense
  • if she had any visual complaints
  • if she had any difficulty with balance or her coordination
  • if she continued to fuss and cry and be irritable