Wednesday, February 28, 2007

Great Service

Wow! Something happened with our ASTRO decoder about a week ago and after a short phone call, a polite man came to replace it - no questions asked. The same thing happened again today and again, the same polite man came to replace it - still asking no questions. This never happens in Malaysia.

I am starting to notice that the Indonesians are, in general, a much more polite people. Also much friendlier and love little children. The people in the markets are friendly, sales people in the malls are helpful without being pushy, everyone is friendly. That is what I like about Palembang.

Hang on...the police aren't all that chummy.....but we don't meet them all that often so its ok.

Saturday, February 24, 2007

I'm so NOT a Tai Tai

On the surface is seems that life here will be the 'Tai Tai Life'. Thats how Evelyn puts it anyway. Tai Tai is cantonese for 'Lady of Leisure'. Sure, we have a maid and a driver but its definitely not a leisurely life. Aaron is still not sitting up yet so we have to carry him most of the time. In this heat and humidity, one is quickly spiralled into a grumpy and impatient mood. Not exactly the best vibe to be sending out to the baby. So, to avoid the worst of the heat, we go out each afternoon to the malls or to the gym. That at least provides some respite from the boredom and heat.

So....do we like it here?

I don't know.

Wednesday, February 21, 2007

Breastfeeding: how can dad help?

Once again, this article is from the Bornew Bulletin Weekend but its only on their website for a week so I've copied it here.

Breastfeeding: how can dad help?
By Dr Hjh Norlila Dato Paduka Hj Abdul Jalil, Breastfeeding Trainer, Ministry of Health

Breastfeeding, what does it have to do with fathers? Most people would say that traditionally it is a taboo subject for men and is only discussed amongst mothers and midwives. This is because only women can breastfeed.

However, in modern day Brunei where both men and women are out in the workplace coupled with the aggressive campaigns by milk formula companies to promote their products, many mothers are giving milk formula to their babies rather than breast milk. This is despite knowing that breast milk is far superior to milk formula.

Why? This is because the greatest fear expressed by many Bruneian mothers is that their breast milk will not be enough to feed their babies so that they will have to supplement their milk with milk formula.

This doubt, if seeded, will slowly grow and definitely lead to their eventual failure to breastfeed. Unfortunately, this fear is totally groundless! With the right knowledge, support and attitude, the great majority of Bruneian mothers have the potential to successfully and exclusively breastfeed their babies. And for this fathers play a very important role.

Successful breastfeeding will result in a happy, healthy and intelligent baby, all that parents would wish for in their newborn child. Whether breastfeeding becomes a success or not, depends on various factors from the woman herself right to the kind of environment in which she is living in.

The first step towards successful breastfeeding is self-confidence, which means that the mother must believe that she can breastfeed. She must know that her milk is all that her baby needs and that her breasts, whatever their size or shape, will produce perfect milk in sufficient quantity. She should also be armed with the necessary knowledge not only about the techniques and advantages of breastfeeding, but also the normal changes expected in her body and the expected behaviour of a normal breastfed baby.

Meanwhile, the father being the closest person to her plays a pivotal role in helping the mother to achieve all this. However, he needs to understand this role and the associated responsibilities so that he can make a positive rather than negative contribution.

For the first few weeks after childbirth, a woman is more sensitive and emotional. This helps her to love her baby, but she also becomes upset more easily. She can easily doubt her ability to look after her baby, especially if it is her first child and can easily do what other people tell her to do.

If there is a difficulty, or if someone asks her: "Do you really have enough milk?" she may stop breastfeeding altogether. The first role of a father is to support his wife emotionally, especially when his wife is having postnatal blues. He should provide a comforting shoulder to cry on if she is particularly tearful and strengthen her with words of encouragement. If she should have any doubts whatsoever about breastfeeding, he should reassure her and help to dispel her fears.

The attitude of other people in the family is also important. If her family believes that breastfeeding is normal, natural and best for her baby, she is more likely to succeed. However, if those who are near and dear to her think of breastfeeding as being difficult, embarrassing, old fashioned or inconvenient, she is more likely to fail.

Therefore, a father plays another invaluable role of providing moral support. As the 'leader' and head of his family, he can encourage his wife and other relatives that he wants her to breastfeed and knows that her milk is the best food for their baby. He should be the first to motivate his wife to breastfeed, instil in her the confidence that she can breastfeed successfully and, if she is working, be supportive and encourage her to continue breastfeeding as long as she can.

Material support is another important role. The Holy al-Quran, in surah al-Baqarah verse 233 states: "The mothers shall breastfeed their children for two whole years, (that is) for those (parents) who desire to complete the term, but the father of the child shall bear the cost of the mother's food and clothing on a reasonable basis. No person shall have a burden laid on him greater than he can bear. No mother shall be treated unfairly on account of her child, nor father on account of his child....". Thus a father should provide adequate nutritious food for the mother to ensure the health and well-being of both mother and child. This is because a breastfeeding mother has an increased dietary requirement in terms of energy, proteins, vitamins and minerals compared to other women, including pregnant women.

A father should also provide support in other practical ways such as helping to do some of the housework and look after the other children, especially if they cannot afford to employ a housekeeper or if there is no other help available from their extended families. He must understand that a breastfeeding mother needs to have adequate sleep, rest and nutrition in order to maintain a sufficient milk supply.

When the baby is not breastfeeding or sleeping, the father can spend that precious time to bond with his new baby by holding and talking. He can even help with the feeding for example by giving the baby expressed breast milk himself, during the times that the mother is unable to breastfeed directly.

There are certain issues regarding breastfeeding, which may be of concern to fathers. Firstly, is the question whether breastfeeding will affect a woman's beauty and body shape? It should be reassuring for him to know that breastfeeding helps a woman to lose weight after delivery and helps her to keep in shape.

It also helps to prevent bleeding from the uterus after birth and prevents breast cancer. Therefore, it has health benefits for his wife. He may also be worried that matrimonial or sexual relationships will be affected by breastfeeding, however there is no evidence to support this.

On the contrary a happy, healthy mother and baby consolidates the marital harmony and strengthens family relationships. Some fathers have even reported how they like to watch their wives breastfeed their babies and the warm feelings they experience on witnessing such a personal and tender moment.

Such experiences help to create strong bonds between father-mother-baby, which the father can consolidate even more by playing a more active hands on role in his baby's everyday life as outlined previously.

In summary, fathers undeniably play a very important role in helping mothers to succeed in breastfeeding. Modern fathers should dispose of the old belief and attitude that breastfeeding is the sole responsibility of mothers. They should take the initiative to learn more about breastfeeding and become more actively involved for the future and well being of their children. - Ministry of Health Public Awareness Programme

Saturday, February 17, 2007

A New Life

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Whats all the excitement about? You're moving where??? Where is Palembang? The baby too??

We moved over here to Palembang, Indonesia from Klang, Malaysia on 3rd February. It used to be known as the Venice of the East but to me.....it just looks like a really big village with a few modern malls and more importantly, BROADBAND. Its on the island of Sumatra.....

Richard, Aaron and I are now Indonesian residents. That sounds strange....

I wonder how much time I will have to blog seeing that Aaron is a 24hr job with no lunch hour and no weekends. I'll try though.....to capture the time here and to share what its like to live in a not yet developed place.

Saturday, February 10, 2007

Breastfeeding: The first hour can save lives

I cut and paste the news article to my blog because the newspaper only kept it online for a week. Here it is.

By Dr Rohayati Taib of the Department of Paediatrics,
RIPAS Hospital

Breastfeeding helps to bring mother and baby closer.
Each year, a total of 10.9 million children under the age of five will die
worldwide. The majority of deaths occur below the age of one and 40 per cent
will occur in the newborn period. In total, it is estimated that four million
babies will die annually in the developing world, particularly in Sub-Saharan
Africa, before they reach the age of one.

Almost all of the four million newborn deaths are due to preventable causes. The
majority of them are attributable to infections such as diarrhoea, septicaemia,
meningitis and pneumonia. Most deaths occur at home. There is now clear evidence
that early initiation of breastfeeding would be protective and will have a
substantial impact in reducing this staggering statistic.

According to the World Health Organisation, in the Global Strategy for Infant
and Young Child Feeding, two-thirds of under-five deaths that occur in infancy
are most related to poor feeding practices. Breastfeeding is a key to child
survival. As many as 1.45 million lives are lost globally due to the sub-optimal
breastfeeding practices in cutting down childhood deaths worldwide was
recognised and published in the Lancet series on child and newborn survival in
2003 and 2004. The authors concluded that 13 per cent to 15 per cent of all
child deaths could be reduced if coverage levels of breastfeeding are increased
to near universal.

Breastfeeding in the first hour of live could save almost one million babies'
lives each year. Last year, Paediatrics published evidence proving that early
breastfeeding has an impact in reducing mortality in the newborn period. This
research was funded by the Department for International Development (DFID).
It showed that if mothers start breastfeeding within one hour of birth, 22 per
cent of babies who die in the first 28 days, the equivalent to almost one
million newborn each year, could be saved. If breastfeeding starts on the first
day then 16 per cent of lives could be saved. The likelihood of death increases
significantly each day the start of breastfeeding is further delayed.
Babies who were fed only breastmilk were four times less likely to die than
those who were also fed other milk or solids, confirming the health benefits of
exclusive breastfeeding in the first month.

This is the first study of its kind to assess the effect on newborn survival
rates of when mothers start to breastfeed. It was carried out by Kintampo Health
Research Centre in Ghana and the London School of Hygiene and Tropical Medicine
and was funded by DFID. The analysis was based on 10,947 breastfeeding babies
born between July 2003 and June 2004 in Ghana who survived to the the second
day.

The First Hour: Early Initiation of Breastfeeding

The first hour after birth is an exciting and exhilarating experience for both
mother and child. Early skin-to-skin contact and the opportunity to suckle
within the first hour are important. The baby who is in close contact with its
mother can suckle when there are signs of readiness such as the suckling
movements. Close contact in itself does not necessarily result in immediate
suckling. Mothers require support for both suckling and contact, both acts so
closely interrelated.

The suckling reflex of the newborn is at its strongest 20-30 minutes after
birth, which diminishes if the infant is not fed, only to reappear almost 40
hours later. This may be called 'the fourth stage of labour', which includes
putting the baby to breast after birth and ensuring the intake of colostrum by
the neonate. The ideal time for early initiation of breastfeeding has been
suggested right from birth in the delivery suite to within one hour after
delivery.

Mechanisms by which early breastfeeding can save newborn lives
There are several mechanisms by which early initiation of breastfeeding could
reduce the risk of death in the newborn infant:
- Early human milk (Colostrum) is rich in a variety of immune and non-immune
components that are important for early gut growth and resistance to infection
- Early feeding with non-human milk proteins (for example, animal milk) may
severely disrupt normal gut function
- Lack of feeding in the first hours or days of life may disrupt metabolic
functions and cause acid build-up (acidosis) and low glucose (hypoglycaemia)
- Mothers who suckle their babies shortly after birth have a greater chance of
successfully establishing and sustaining breastfeeding throughout infancy
- Promotion of warmth and protection may reduce the risk of death from
hypothermia

Other benefits
Early breastfeeding has a physiological effect on the uterus as well, causing it
to contract. This is due to a hormone called oxytocin, which is released when a
baby suckles or in response to hand stimulation by the baby, causing uterine
contraction as well as milk ejection. Oxytocin is known to play a role in
bonding and reduction in postpartum bleeding. Postpartum bleeding is a major
problem that jeopardises maternal health and its prevention can save a mother's
life through early breastfeeding.

World Breastfeeding Week 2007
World leaders at the United Nations Millennium Summit in September 2000 agreed
on a critical goal to reduce deaths of under-five children by two thirds, but
this may be unattainable without halving newborn deaths which now comprise 40
per cent of all under-five deaths. The promotion of early initiation of
breastfeeding has the potential to make a major contribution to tackling the
millennium development goal for child mortality. In global terms, over one
million lives would be saved if all newborns younger than one month were
breastfed within the first hour of life.
This year's World Breastfeeding Week (August 1-7) calls upon policy makers,
health workers, families and community members to ensure conducive conditions
for mothers and babies to start breastfeeding during the first hour of birth.
The evidence is clear and in abundance: Breastfeeding saves lives. It is a
solution that does not need costly medicine. - Courtesy of the Ministry of
Health Public Awareness Programme)