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Placebo Helps Everything

Shlomo has a very, very low-grade fever. As *the* paranoid mom, I am obviously freaking out. But that’s not the point right now, is it? No, it’s not.

At any rate, he is sitting on the toilet and complaining of a headache. Now, this headache could be from four things:

  • he’s pushing too hard
  • he’s cried and screamed enough to give himself a headache
  • he really does have a headache
  • he’s making up an excuse, to get attention or to get out of pooping (please, no “don’t make your kid poop” criticism – this is what it is, and there is good reason for it).

Yitzchak wanted to give him Akamoli (kiddie Tylenol). And I said NO. Big NO.

Why? For the simple reason that Akamoli will completely cover up his symptoms. And I need to see the symptoms in order to judge what he has and how urgently he needs to see a doctor. Until now, he hasn’t really complained enough to justify the Akamoli. I want to see if, after he’s off the toilet, he still has a headache or if it magically goes away.

Because it’s important.

Well, Shlomo didn’t like that I nixed his yummy Akamoli. He wanted medicine. It’s strawberry flavored, guys. And Tova has received a fair bit of it lately (teething, anyone?), so Shlomo wants some, too. I get him. I do.

That doesn’t change the facts.

So Yitzchak made Shlomo a new headache medicine. It’s *the* best medicine for headaches, and works terrifically well for many other things, too.

It’s called Placebo.

It tastes really good. It’s the same 5ml that we would’ve given him anyways. And it helps Shlomo feel better, while letting me observe his symptoms.

Placebo really is the greatest medicine in the world.

The only thing is, Yitzchak doesn’t have red Placebo. He only has it in clear.

Therefore, Shlomo is protesting. Will he take the medicine or not?

As of right now, he’s refusing. But his headache went away, anyways (bingo, Mom!), so it’s not too relevant. We’ll save his special Placebo medicine for later, just in case he needs it.

I wonder how many years it will be before Shlomo learns what “placebo” actually means. It’s a Hebrew-speaking country, so it may take a while.

In the meantime, Yitzchak is playing doula to Shlomo’s poop. Ugh. But it’s working, sooo . . . I guess it’s all good.

Update: As soon as he was off the toilet, Shlomo’s headache disappeared. Hmmm . . .

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Do You Love Nursing?

See peeps, here’s the thing:

I don’t love nursing. Never have, really.

Yes, there are times I enjoy nursing, and there are definitely times it’s convenient. I am always grateful that I have milk for my babies, and especially when they’re not feeling well. I am also extremely grateful that I have never had to feed my babies  powdered cows’ milk from a factory.

But . . . that doesn’t mean I love nursing.

I nurse for three simple reasons:

  1. It’s healthy. For mother and baby. Physically, emotionally, psychologically.
  2. It means my babies *don’t* get formula – which has its own set of risks, unrelated to how much a mother breastfeeds.
  3. I believe that parenting may not always be fun, but that does not mean that we don’t have to act responsibly. I believe that choosing not to breastfeed, even though you *can* (physically – meaning, you have milk available) and are healthy enough to do so (no bodily-fluid-transmitted diseases, no medicines that preclude breastfeeding) is choosing to take the easy way out. I believe that supplementing with processed cows’ milk powder is harmful unless it is medically necessary. I believe that choosing either of those options, because it’s easier, more convenient, or whatever other non-health reason, is irresponsible, after all the research that has been done.

So I breastfeed. My minimum is 1 year. Yitzchak thinks 2 is better. Shlomo hated breastfeeding. We stuck it out 14 months, 7 of them only because I gave him no other options. I said, “I don’t care if it makes him mad. When he grows up he will thank me.”

Tova happens to like nursing. She is now older than Shlomo was when he quit nursing. And she shows no sign of wanting to wean.

And me? I’m done. I’m sick of nursing. I am *so* over it. It was fun, kid. But come on, let’s move on with life.

But I won’t stop if she doesn’t want to, because the fact is that the WHO recommends breastfeeding until the age of two. So if she’s happy, we’ll stick it out.

She will have to learn not to stick her hands down my shirt, or pull my shirt up and stick her hands in my belly button. And she will have to learn that no, I will not nurse her if the last time she nursed was an hour (or two, or three, or five) ago. She dropped down to two nursings a day – morning and evening – and I am sticking with it.

And as much as I want to nurse tandem, I’m beginning to think that I should wean her before the next one comes along. Why should the next baby suffer because Mom has been nursed-out by an older sibling? Doesn’t seem fair to me.

In the meantime, however, we will stick it out. And we’ll just have to wait and see what happens next.

But no, people. I nurse because breastmilk is healthy and formula is a medicine that is meant to be given only under certain circumstances – no matter how much society and formula companies may brainwash you otherwise.

I nurse because as a parent. sometimes we all have to do things that are difficult, annoying, hurt, or just that we’d rather not do. Because that’s what being a parent is. Choosing your kid over your comfort.

Even if nursing is sometimes *very* uncomfortable. (I should know . . . 2.5 months of tongue tie, 6+ months with a cracked nipple, two months of tender nipples that don’t want to be touched, much less sucked on . . . yeah, I know. So?)

 

Tel Aviv is One of the Most Expensive Cities

So, Tel Aviv ranked as the 22nd most expensive city worldwide, and the most expensive city in the Middle East.

Honestly, neither of those facts surprise me. It’s known to be an expensive place to live, even more so than Jerusalem. But let’s look at the opening sentence, which has two parts.

  1. Tel Aviv is the world’s 22nd most expensive city. That means that 21 cities are more expensive. And hundreds of thousands are less expensive. Okay. Makes sense, at least kind of.
  2. Tel Aviv is the most expensive city in the Middle East. You can look at this in two ways. First, Tel Aviv is an expensive city to live in. Second, other cities in the Middle East are inexpensive to live in.

Tel Aviv is a bustling, modern city. It has hospitals, a long strip of beaches, malls, and an international airport (which actually belongs to Lod, but whatever). It’s full of markets, museums, and tourist attractions. It’s a port city, and it’s an old city, too. All of these factors added up mean that no matter how small or old your apartment is, the land that it’s sitting on costs a fortune.

So yes, it makes sense that Tel Aviv is expensive. So is New York. Fine.

The other side of the coin is that most of the Middle Eastern countries are still considered to be developing economies. Many of the governments are corrupt, and the lay people are poor. Between civil wars and terror groups fighting for power, it’s no surprise that less funds, jobs, and social benefits are available for the citizens.

That means that Israel (and I would put Jordan, too, and until recently, Egypt) is one of the most stable and developed countries in the Middle East. So, it’s no surprise that Israel’s most expensive city should be the region’s most expensive city. Is that something to be proud of? I think not. But, our economy definitely is.

And while we’re on the topic of how great Israel is – several of Israel’s hospitals ranked high on the global list. We’re talking about a list of the top 12,000 hospitals in the world. In this tiny country, 32 hospitals made the list; the highest ranking of them being #103 in the world. That’s pretty good, and I’m proud of it.

Enough With the Awful Weather!

I blinked.

I opened my eyes.

Suddenly, it’s September.

The awful weather we had in June turned milder, but still hot, in July.

We’ve had three heat waves, where the weather reached 40 degrees in some places. I feel like our average was 38, throughout the summer. (But I may be wrong.) One of those heat waves lasted a week. A WEEK.

Now there’s a dust storm, and I can’t even open the windows. I hate not being able to open the windows. It cuts out light and air. Even hot air is air. But to have no air, except what’s already in here? Ugh.

It’s a dust storm and a fourth heat wave. It started on Tuesday morning, and hasn’t let up yet. With the windows closed, there is still light, but much less. They’re thick, and translucent, instead of transparent.

How am I supposed to get work done when I can’t see the sun and sky, when there’s no breeze? I don’t have a choice. I have to work, even if I can’t work as well as usual.

Sheesh. I’ve spent the whole summer waiting for nicer weather. And now, the summer’s over – over – the school year has started, and there is no nice weather in sight.

Sunday night is Rosh Hashana. On Monday, we’re eating with friends who live fifteen minutes away from the shul. If this doesn’t let up, we may have to cancel – Tova can’t go out in this, and even though Shlomo has been going to gan, it’s not good for him to breathe this polluted Syrian-Iraqi dust, either.

In gan, they have an air conditioner, and he takes the bus. Yesterday, it looked like the dust was clearing, and the ganenet let the kids play in the yard. I think that was a mistake, and hope they weren’t allowed out, today.

In the meantime, this apartment is getting more and more stuffy and humid. I have a layer of grease over my entire body, and pimples that make me look sixteen. It’s gross. I want to open the windows, and I want an air conditioner. I want sun and I want air, and I want my laundry to dry in five hours instead of 30.

But as of last night, 600 people had been hospitalized for inhaling this polluted dust, and I just can’t take the chance. The health ministry has warned that the elderly, babies, young children, and pregnant women, shouldn’t be exposed to this stuff – and neither should anyone with asthma or pulmonary heart issues. They’ve warned everyone to stay inside and not to strenuous physical activity.

Yitzchak isn’t doing a good job of listening to that instruction, but he’s an adult, and he has things to do – he can’t stay home all day. I feel like we should be splitting the outings between us, but the fact is, it doesn’t make sense for him to come home and then for me to leave and make a separate trip. It’s easier for him to just run the errands that are on the way to wherever he’s going.

This dust is choking. It makes you cough and it makes your eyes burn. I don’t know if we were smart or stupid to send Shlomo to gan. But I do know that Tova has no business breathing in any of this stuff, and even though she’s going stir crazy wanting to get out of the house, we just can’t risk it.

I hope this polluted sandbox weather clears up soon. I’m not sure how much longer I can stay inside with the doors closed. Thankfully, it’s not winter. If we had gas or a heater on, there would be a serious carbon monoxide risk. Sheesh, even in the winter I air out the nearly every day. Sure, it takes more time for it to warm up again. But I can’t stand having no fresh air.

Dust, you’ve got twelve hours to get out of here. If you’re intent on causing harm, go to Iran. They need you a LOT more.

Mastitis

In honor of breastfeeding support week, I share my (hopefully finished) mastitis story.  Let it be known that in over a year of nursing Shlomo, I did not have one case of mastitis.  Even when I changed his feeding schedule from every 3.5 hours to every 6 hours, in one day.

However, Shlomo did not have tongue tie, and Tova’s tongue tie apparently still leaves its marks, even after we clipped her tongue.  On one side, she nurses too hard.  A few months ago, when we were going through a super-duper-stressful period, I had no energy to correct her latch, didn’t care about the pain (because I had much more important things to care about), and soon, instead of just reddish-purple lines, I had actual cuts in the nipple.  And they just got deeper.

No surprise, then, that a few weeks later, I ended up with my first case of mastitis (in the doctor’s words, the germs were having a discotek in my milk ducts).  At first I thought I was simply engorged, but then it didn’t get better, there was a red spot that changed size, disappeared, and came back, and I felt really sick.  When I couldn’t lift my left hand, and had a fever of 38.5, I took myself the next day to the doctor, who gave me a miracle drug: Augmentin.  Within twelve hours, I was feeling worlds better.  Within 24 hours, the pain was almost gone.  Within 48 hours, I was practically good as new.  This continued for two weeks, and then I ran out of antibiotics . . . but the deep cuts were still there.  Sure enough, about two weeks later, there I was back at the doctor, with my second bout of mastitis.  This time, the doctor didn’t believe it right away, because I had come too early, with not enough clear symptoms.

He sent me to a surgeon and told me to take Tylenol.  I managed to freak myself out about IBC, but the surgeon checked everything, including my shoulders and neck, and didn’t find anything (thank G-d!).  The next week, still suffering, I went to an after-hours clinic, where the doctor still didn’t think I had mastitis, and told me to see a breast surgeon, but gave me a week’s worth of antibiotics “because I said it was getting worse”.  Well, the Augmentin worked magic, again.  And I got really scared that a week wasn’t enough, and I was in for a third bout, as soon as the antibiotics had worn off.

Unfortunately, I was right.  However, thankfully, this time the red spot was huge (in a different spot, but same breast) and unmistakable.  I also got a different doctor, because it was my regular doctor’s day off.  This doctor was younger and more laid-back, and when I asked for three weeks of antibiotics so that the cut could close, he gave them to me, telling me that maybe I should take probiotics because three weeks is a long time.

I went home (I had to nurse), and Yitzchak ran out to the pharmacy to fill the prescription . . . except that he forgot the prescription at home.  The pharmacist told him to go into the clinic and ask another doctor to print it out.  Well, as it turns out, the last doctor of the day to leave was our amazing, much-loved pediatrician.  When she saw that I had been given three weeks worth of Augmentin, she was in shock.  Yitzchak says that her expression said, “This guy should be sued!”  She couldn’t touch the prescription that he had given me, so she gave me one herself: 10 days of Augmentin and a lanolin-based nipple cream called Rafael New Mother’s Ointment.  She said that after the ten days were up, there are ways to keep the mastitis at bay.  I guess some of those are natural remedies, but I didn’t look them up.

What I ended up doing was that two days after I finished the antibiotics, I fished out the old prescription and sent Yitzchak to fill it.  The pharmacist wrinkled her nose at a prescription for antibiotics that was nearly two weeks old, so Yitzchak explained it, and she gave me 11 more days of antibiotics (10+11=21).  Very soon, I was too stressed to remember to take them twice a day, and eventually settled on one a day, at night, with my vitamin.  So far, so good.  Except that my nipple is still not healed, and it’s been more than three weeks.  Hopefully, by the time I finish my one-a-day regimen, it will be healed enough that I don’t get mastitis again.  I actually thought it was getting better, but wouldn’t you know, in the past two days, Tova has managed to make it worse again.  I don’t think the cut is as deep as it used to be, though, so maybe, just maybe, there is hope.

Lessons:

  1. Don’t get lazy about proper latch.  Even when you’re super-duper stressed.
  2. Tongue tie, sore nipples, cracked nipples, and mastitis are all connected.
  3. Thank G-d, if antibiotics work, it means that there’s nothing more serious.

By the way: Every woman should have an annual breast examination by a qualified surgeon.  Some women should be examined every six months.  And yes, this applies even to twenty-year-olds.  Because, prevention is the best medicine.  You can do these examinations when you are pregnant or nursing; just inform the surgeon of the situation.

Individual Choices Impact Society

Is it draconian and wrong to make receiving child stipends dependent on immunizing your children?  That depends on how you look at it.

Let’s start with the fact that the state is not obligated to give us money each month just because we have kids.  We can continue with the fact that health care here costs peanuts, and the vaccines are free.  A vaccine only makes it into the health care “basket” with no co-pays if it is determined that funding the vaccine for everyone in Israel costs less than it would to hospitalize, and treat, the number of people who would become seriously ill with the disease.

If the vaccines cost money, you could say that the state can’t require you to put out so much money.  But the state is paying for the vaccines, paying for the healthcare, AND paying you 140 shekels a month, per kid.  So, why can’t the state say, “Hey, guys, listen up.  We don’t want to pay for the added healthcare that your kid is about to cost because he’s not vaccinated AND pay your child stipend.  Choose what’s more important to you.”  Honestly, the child stipend isn’t what will make true anti-vaxxers vaccinate their kids, nor will it break anyone’s bank account (despite complaints otherwise), but maybe it will make some extraordinarily low SES families (and therefore, by definition less-educated and probably at higher risk of contracting illnesses) give their kids vaccinations.  However, the state has a right to say this, I think.

If this were all there was to it, it would be pretty simple.  Do what you want, and leave others alone.  I read an opinion article on Kristen’s blog that asked basically, “Why are we allowed to question every aspect of parenting except vaccines?”  And the answer is this: Because if you want to formula feed your baby three days after he’s born, you are risking damage to YOUR baby’s gut.  If you want to buy a second-hand car seat, you are risking YOUR baby’s life.  True, it is everyone’s taxpayer money; true, it hurts everyone to see your kid suffer.  But the ones who are going to pay the highest consequences are you, your child, and your family.

HOWEVER, if you choose not to vaccinate your child, it goes beyond that.  Yes, you are costing us taxpayer money, because you are exposing your child to an illness likely to require lengthy hospitalization and/or rehabilitation.  BUT, the difference is this: You are forcing your choice on the rest of us.  Those with weakened immune systems, those pregnant, the elderly, those who cannot receive vaccinations, those who received the vaccines but are only partially immune, those too young to be fully or even partially vaccinated.  You are putting ALL OF US at risk for dangerous diseases that can be avoided and even eradicated, against our wishes, and without asking or informing us.  Your unvaccinated child is likely to begin or spread an epidemic, and that puts the rest of us at risk as well.

That is why it is different.  Cloth diaper or use disposables.  Feed your kid formula, breastmilk, cow milk, goat milk, or chocolate milk.  Feed your kid junk food, only meat, vegan with no vitamins.  Put your kid in the front seat, the back seat, the car seat, with or without an airbag.  Smoke beside your kid, but not around mine.  And do not expose my family to dangerous diseases, just because you think you are more educated than everyone else.  I don’t care how educated you are.  If you don’t want to vaccinate your kids, keep them away from my kids’ environments.  Period.  If your kid gets hurt by your choices, my heart will hurt, but there is nothing I can do about it.  They are your kids.  I will feel bad, I will be shocked, I will wish it didn’t have to happen.  But they are your kids, and you are in charge.  If you want to risk their lives, that’s your business.  BUT, I don’t allow you to take risks with my kids.  My kids are my responsibility, and I take that responsibility seriously.  If you don’t vaccinate, the least you can do is make sure to only hang around with like-minded individuals, and alert everyone else that you are a potential carrier of dangerous diseases.

Spanish Boy Suffers for Parents’ Stupid Decision

Or, perhaps, “The Obvious Has Happened: Unvaccinated Child Contracts Diphtheria.”

Or maybe, “Parents Who Don’t Vaccinate Are a Danger to Us All.”

Thirty years ago, Spain eradicated diphtheria.  Thirty.  Years.  Ago.  But of course, since then, parents have become smarter, braver, more educated, more independent, and in general, have a better understanding and grasp of the world, and think for themselves.  In other words, doctors are out to get us.  So are pharmacists, nurses, and anyone else who sells conventional medicine, with all those long leaflets covered in warnings.*  Obviously, a bunch of parents with a bone to pick, and a need to hang autism on something avoidable, are much smarter than everyone else.  And much safer, too.  After all, none of their kids are vaccinated, and none have contracted any of those diseases.  Until, of course, they do.

As I mentioned in my last post on the subject, pertussis is the most common problem, but measles and mumps sometimes pop up, as well.  This time, though, a kid is paying for his parents’ stupidity.  And if not for modern medical miracles, he’d have paid with his life, already.  A 6-year-old Spanish boy is being kept alive by 3 machines, after he contracted diphtheria.  No, he wasn’t vaccinated.

Worse yet, eight children – vaccinated children – who have been in contact with him, are being quarantined, because they tested positive for the disease.  They aren’t sick yet, and maybe they won’t get sick, but they are being quarantined as a preventive measure, to prevent an outbreak.  In other words, 8 children are suffering because of the stupid decision of this kid’s parents.  I don’t even want to think about any babies (too young to be vaccinated) who came in contact with him, or any pregnant women.  Let’s just not go there.

And we forgot the immunocompromised, didn’t we?

Parents, listen up, and listen good.

Choosing not to vaccinate your children means CHOOSING to endanger many, many other people.  CHOOSING to endanger other peoples’ children, sick people who have a compromised immune system, and tons of others.  It is not funny.  It is not nice.  It is not safe.  It is disgusting.  And anyone who dies or gets sick, is on your head.

We protect your kids, by being vaccinated and vaccinating our kids.  You endanger our kids’ lives, and our own lives, by not vaccinating, and not warning the rest of us that you are a potential disease carrier.

This kid’s parents feel, “terrible guilt,” as well they should.  They are guilty for their son’s condition.  And guilty for possibly spreading it to many other people, endangering them, as well.

They were not “hoodwinked,” or, “tricked,” by the anti-vaccination movement.  They chose to take a risk, a known risk, a deadly risk, without doing proper research and without thinking their decision through.

Because most parents who care will understand, that beside the risk of 0.0000000001% of the child reacting adversely to the vaccine, is a much higher risk of the child actually contracting the disease and being permanently disabled, if not killed, by it.  (Diphtheria has a mortality rate of 1 in 10.  Would these same anti-vaccine parents take an integrated NT scan with that number without doing amniocentesis?)  There is nothing in the vaccine, and no side effects in the vaccines, that are not found in, or caused by, the disease itself.  If the side effects of the vaccine scare you, think about how much worse it would be if your kid got the disease.  And then go beg for the vaccination, because it will maybe, maybe, maybe, give your kid a mild side effect, but it will very, very, very probably keep him from having to suffer from the actual disease.

And the parents whose kid “became” autistic right after the MMR vaccine?  Here I stand with MidlifeSingleMum; I believe that the kid showed signs of autism shortly afterwards.  But I have a few questions about whether the connection is causational, correlational, or nonexistent.  Possibly, the signs of autism were only noticed after the MMR vaccine, even though they were present long before; autism is tough to spot in tiny babies, unless you know what very specific signs to look for.  Possibly, the child would have become autistic anyways, and the vaccine sped the process up.  In any case, autism is not – or at least, has not been proven to be, after much research – a side effect of vaccines.  But it may be a side effect of untreated fevers during pregnancy.

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*(Note to self and readers: Alternative medicine is medicine without the lengthy research, without supervision, and without leaflets stating contraindications and warnings.  For some reason, I’d rather know what I’m getting into than take medication without knowing its possible side effects, especially concerning my kids.  I do use natural remedies, but only after researching them thoroughly.)

Flying During Pregnancy

Every once in a while, the subject comes up.  Would you, or would you not, fly during pregnancy?

When I was pregnant with Shlomo, my mother (who lives in Canada) wanted me to visit for Chanuka (just me – she didn’t have the money for both of us).  The flight would have been when I was 32 weeks pregnant, I think.  I flat-out refused, and my mother didn’t understand; they let you fly until 36 weeks.  I insisted that I was not going to fly while pregnant, and certainly without Yitzchak.  Why?  I don’t know.  I just didn’t feel comfortable doing it.  So, when Shlomo was a month old, we went to visit Yitzchak’s family, and when he was five months old, we went to visit my family.  (And we haven’t flown since.)

This past summer, Ari had a bar mitzva and Esther got married.  This past summer, I was pregnant with Tova.  At first, when Esther got engaged, she was planning a June wedding.  True, that would also have been flying while pregnant, but I felt like the risk at 15-18 weeks was one I was semi-willing, although very, very, very uneasy, to take.  It’s not the first trimester, when the risk of miscarriage is high; if G-d forbid something happened, I could easily hide it, because my stomach would not yet be too visibile; it’s not late enough in the second trimester to be a viability issue.  And still, I didn’t feel comfortable, precisely because the baby was yet viable and there was nothing I would be able to do.  I debated the subject and decided to ask three doctors first . . . and then G-d (or Esther) solved the dilemma for me, and the wedding got pushed to August.  The moment it got pushed to August, I knew there was no way I was going.  At all.  No matter what.  Unless they got married here in Israel, and I could take a bus and not a plane.  By that time, though, it was already obvious that there wasn’t enough money to pay the extraordinary sum needed to bring us in anyways, obvious that I would not travel alone, and the point was moot – so I didn’t explain to the entire family that I was not willing to travel while pregnant.

But why did I not want to travel?

First of all, when I still thought the wedding would be in June, I did extensive research on insurance policies for pregnant women and what they cover.  Specifically, what they don’t cover.  Also, I am technically a Canadian citizen, but since it is acquired citizenship and not by birth, I no longer am covered by the governmental insurance, unless I chose to live there for three consecutive months.

Second of all, the date was very borderline.  I would have been between 22 and 25 weeks pregnant, and those weeks are critical, when you are talking about preemies.  It’s not just a question of the birth, it’s a question of whether or not the baby survives; which hospital you go to can make a big difference, and besides for that, even if the baby is fine, it’s not something you want to be going through when you are thousands of kilometers away from home – especially since you don’t really know how long you’ll be spending in the hospital.  And, it’s not something that I would want to go through without Yitzchak, which, because of budget issues, was a question that was put to me muiltiple times.  I knew people would be mad and would be hurt; I also knew that if I risked my baby’s life, I would never, ever, ever. forgive myself – and I knew that no one would be dealing with the consequences of a premature baby, and the risks that severe prematurity entail, except for Yitzchak, Shlomo, and myself.  So I stayed.  Because my baby’s life – if you like, Tova’s life – is worth more than my sister’s wedding celebration (she’ll be married with or without me, and the proof is in the pudding), and worth more than my entire family’s wedding celebrations put together.  And I just wasn’t willing to risk it, even if the risk was teeny, teeny, tiny.  If the risk is too big for the insurance companies, it’s waaaaay too big for me. (Sorry guys!  When you have kids, you’ll know what I mean.)

Let’s get back to the insurance policy.  I looked at several policies; all of them have a few things in common:

1. They cover more before the end of the first trimester than they do after;

2. they state a set amount that they will pay if you have your baby abroad;

3. they do not cover you if you have any preexisting medical conditions, or

4. if there is any reason your pregnancy might be high risk (and for the record, this often includes ANY unexplained bleeding during the pregnancy, as well as multiple gestation and IVF);

5. most of what they cover is about the mother – the birth, the hospital stay, a miscarriage; and

6. very, very little, if any, is for the baby.

7. Many policies do not cover you past 32 weeks, some cover until 36 (partial coverage, obviously), and some put the limit at 26 or 28 weeks (i.e., if the baby has a good chance of surviving and not suffering from its prematurity too much, they don’t want any part of it);

8. weeks vary, but often, you need a letter from your doctor saying that s/he is taking responsibility for the fact that you are allowed to fly;

9. many doctors are willing to give you permission, but they are not willing to write a letter to that effect (because they don’t want the insurance companies suing them; doctors are not prophets).

True, the exact conditions, as well as the sum and specific weeks, vary from company to company.  True, the amount that they are willing to pay for the baby is five digits, and possibly you might (but it’s rare) find a six-digit amount.  But even though that amount looks large, when you are talking about a hospital stay, with oxygen, with the lights needed for a jaundiced baby, and quite a few weeks in the NICU (even if the baby is doing pretty well), along with any other interventions needed to ensure that the preemie survives – you are talking about so much money that the sum from the insurance company is only a small fraction of the total eventual costs, and does not save you from possibly lifelong debts.  Plus, as most people know, getting an insurance company to pay up is an incredibly difficult task.

A third problem with flying during pregnancy is that sometimes the flight will cause a premature birth.  It’s not definite, and it doesn’t always happen.  But when it happens, it’s not good.  And frankly, after not eating lox, not eating sunny-side up eggs, not drinking alcohol, not doing root canals or x-rays, taking huge vitamins, throwing up, and whatever else – why would anyone want to take the chance?

And therefore, friends, think twice, even three or four times, before deciding to travel while you are pregnant.

My family might have been upset, but they will get over it, and having Tova with us and healthy is more than worth it.  (Okay, I admit; I was bummed, very, very bummed, but [after a long while] I got over it and told myself that my first responsibility is to my kids, and I am doing the right thing, even if it’s not the easiest thing.)  And after reading Wendy Morrow’s story (she traveled at 32 weeks for her brother’s wedding), I know I did the right thing.

For those who read Hebrew, I have more comprehensive links, with policy specifications and explanations.  I did not see a point in looking them up and linking them, because my audience is almost completely English speaking,  (What can I do – policies here are generally worded in Hebrew, as is everything else.)

If any of you want real-life stories on the subject, Google, “travel insurance doesn’t cover premature birth.”

When is Baby Ready for Solid Foods?

When Shlomo was a baby, we decided to give him solid food only at 6 months.  Not 5 months and 2 weeks, but six months, to the day, or perhaps plus a day or two.  After all, nursing babies don’t need solid food before then; the range of 4-6 months is because, until recently, formula-fed babies were thought to need solids from 4 months, regardless of whether their digestive system was completely ready for it.  (Recently, the guidelines have changed, and the new guidelines say to start solids only at six months, regardless of whether the baby is breastfed or formula fed.)  And so six months it would be.

Honestly, four to six months is an estimate.  Just like not every baby smiles at six weeks exactly, not every baby is born on their due date, and not every baby crawls at the same time – so, too, not every baby’s digestive system is ready for solids at exactly the same time, either.  The 4-6 months for starting solids is a general guideline; even though, as a general rule, you won’t hurt your baby by giving them solids at five months and one week, it doesn’t mean that that’s what’s absolutely best for your specific baby.

If so, how will you know when to give your baby solids?

When Shlomo was five months old, we went to visit my family, in Canada.  When he fussed after a feeding, my mother, always wanting to get to the fun stuff, give advice, and catch a “first” before we went back home, told us that he needed solids.  He was five months and a few days, and we said no.  He might want it – in fact, he definitely wanted it – but he didn’t need it.

When Shlomo was five months and one week, my family went to visit a lakeside cottage; we had been invited to go with, but the technical details did not work out, and so we stayed behind, with my grandmother, cousins, and Esther, who also couldn’t go for technical reasons.  During the week that followed, Shlomo suddenly stopped sleeping as well as usual, stopped pooping during the day, and when he woke up at night and pooped, it was this weird poop (Yitzchak says it was “foamy”) that leaked all over.  After a few days of this, Yitzchak picked up the phone and called his mother (ahem, ahem).  She listened to the description and said, “Sounds like he’s ready for solids.  Try giving him banana first and then oatmeal; those are two foods that practically nobody reacts to.”

I was peeved.  I had wanted to wait until six months.  Helloo, the baby’s gut takes about six months to fully close.  But I told myself that evidently Shlomo’s gut was showing signs of readiness two weeks early, and five months, two weeks, was still pretty good.  We went out, bought some bananas, opened one partially, took a spoon, scraped some banana onto the spoon, and fed it to Shlomo (how I miss the banana-scraping days; oh, wait, we’ll soon be back there).

Abracadabra – that night, he went back to sleeping normally, pooping normally, and all was well.  My mother had her wish (kind of; I don’t think she was wishing that this would happen while she was away vacationing), and my best-mother complex had taken a slight, but not too serious, hit.  We took bananas with us on the plane home, and fed them to our five-months-two-and-a-half-week-old.  Shlomo’s first solid foods had been eaten not at home, but at his great-grandmother’s house.  (And he loved it, by the way.)

This, then, is the answer: Your baby’s gut is ready for solid food when they don’t poop on their regular schedule, their poop is weird foam, and they’re not sleeping well.

Lately, Tova has been pooping later and later in the day, and making only one or two poops, as opposed to her usual three or four.  They are also very liquidy, instead of the regular seedy.  Is this her version of foam?  Or should we wait?  For the moment, we are waiting.  We have time; there’s no rush.

Plus, there are three very nice advantages to breastmilk-only poop: 1. You don’t have to take her out of a synagogue, or stop praying, just because she made a poop.  2. Most (95%) of the poop that gets on her clothes doesn’t leave any kind of mark, even without stain treatment.  Of the remaining 5%, if I put stain remover onto it once, it comes out 99% of the time.  Which means that between two breastfed kids, I have maybe two or three garments that were stained, truly stained, by breastmilk poop. 3. Ditto for breastmilk spit-up – I don’t think I’ve had to use stain remover at all.

In other words, I really like the convenience of my baby’s bodily fluids not staining anything.  And I will miss that when we add solids.  On the other hand, after they start solids, the poop becomes more solidified and they spit up less.  So it kind of (but not quite) evens out . . . right?

To Vaccinate, Or Not To Vaccinate?

When I was growing up, everyone in my family knew that I was the only one who had been properly vaccinated.  Esther had been mostly-properly-vaccinated, and the younger kids had never had the pertussis vaccination.  This didn’t mean much to me, until I was in high school.

I don’t remember which grade I was in, maybe tenth, but at some point a note was sent home (that I never got), that everyone needed to take antibiotics, because someone in school (or someone in school’s sibling) had had whooping cough.  Probably, they still had whooping cough at that moment – it isn’t a cough that goes away quickly.

As mentioned, I didn’t get the notice.  I don’t remember how we found out that I hadn’t gotten the notice, but I do remember that my mother blamed me for bringing pertussis into the house and not taking precautions to make sure no one would get sick.  As I write this, the anger at being blamed for the family’s illness comes back to me.  I didn’t get the notice, I didn’t do it on purpose, and I certainly didn’t deserve to have all of my siblings blaming me for something that could have been prevented, if my parents had vaccinated them.

Obviously, as it usually goes, those who are not vaccinated suffer the most – and the younger you are, the worse it is.  I don’t remember if my parents had pertussis; I do remember that of my siblings, Noach and I had the lightest cases.  Noach was about 7, Shira was 4, and Ari was two, I think.  Esther was 12, maybe 13, but she had the worst case, because it was complicated by a preexisting heath condition (which, for privacy reasons, I will not name now).  Esther, by the way, always a copy of my mother, blamed me for the fact that she was sick and lost her summer job, a few times a day, for about a year.

At any rate, this is getting off topic.

People who don’t vaccinate make me mad.  Herd immunity is one of the major reasons that vaccinations work, and without herd immunity, even vaccinated people can sometimes get very sick.  This is because the vaccination does not work 100% on everyone.  Some people get the vaccination and are only 80% immunized.  If everyone around them is also vaccinated, the herd immunity protects everyone, and no one gets sick.  If enough people in the community aren’t vaccinated, an epidemic will break out, putting even the responsible, vaccinated population at risk.

In addition to this, no one is immunized until they finish the vaccination schedule, at about a year and a half (or age 6 for measles, mumps, and rubella).  This means that, especially for babies who don’t breastfeed (and therefore have no immunity at all for the first three or four months, and do not receive any helpful antibodies to aid their immune systems afterwards), those who are not vaccinated are a huge threat, not just to their health, but to their lives.  Even those who do breastfeed are at risk, especially if they were born prematurely, and even if they are still in the relative sterility of the NICU.  Tara Hills, in her article on how she went from being against vaccines to being absolutely in favor of them, says it beautifully: “But in the four highly contagious days before any symptoms show we easily could have passed on our infection to my sister’s toddlers or her 34-week-old son in the NICU.”

In other words, to put it very bluntly, if you choose not to vaccinate, you are putting many innocent lives at risk, not just your own kids’.

That’s a lot of responsibility; unfortunately, many anti-vaccine parents don’t see it that way, and refuse to see it that way.  Probably because it would burst their “better-and-more-natural-than-you” bubble.

From what I’m writing, most of you probably assume that I unblinkingly, unthinkingly, give my kids any vaccine out there, without asking questions.  This, I must say, is not true.  I do not completely trust the varicella vaccine, nor am I convinced that it is necessary for everyone.  I do agree, however, that for certain populations it is probably recommended.  And about the HPV vaccine – new, barely-tested, and a good part of the risks avoidable by teaching teens responsibility – let’s just say that each person can make their own decision, and as long as this does not become a required vaccine, I will keep my peace.  But there is a huge difference between the routine vaccinations – for diseases that literally spread like plagues, often with disastrous results – and the HPV vaccine, for a disease that in most cases (admittedly, not all) can be avoided by proper monitoring and taking responsibility . . . and is not spread through coughs, air, or random handshakes.

About a year and a half ago, there was a polio outbreak here in Israel (brought here, of course, by some Arab who came from the grossly unsanitary conditions present when the Muslims gathered in Mecca).  At some point, the Ministry of Health told everyone to get OPV – the oral polio vaccine, consisting of a live, but weakened, virus.  Even those who received IPV (the dead, or inactivated, polio vaccine) were supposed to get OPV.

When I did some research, I found out that the push to get OPV was not so that the person vaccinated would not get polio, but in order to ensure it could not be passed on.  As it turns out, polio, like group B streptococcus, can live in a [vaccinated] person’s gut without harming them; however, if it passed to someone who was not immunized, that person would get infected, and probably sick, as well.  If we had had an young baby at that time, I probably would have gone out and gotten all of us immunized with OPV.  However, we did not have a baby at that point, and I saw no reason to give my kid a live virus so that people who chose not to immunize their kids would not have to suffer.  At the end of the day, I reasoned, those who are the biggest threat to society’s health are not about to run out and give their kid IPV, much less OPV.  True, there are those with compromised immune systems, there are the elderly, there are the babies.  But we don’t have contact with too many of those people, and if the virus was passed on, it would be by someone else, not by us directly.  So, Shlomo did not get OPV.  Was I irresponsible and thoughtless?  Probably.  But a live vaccine is a big thing, and if everyone had had IPV, the OPV wouldn’t be necessary.  Even a dead, inactivated, vaccine can cause side effects, and if I am taking that risk, I don’t think that I need to take the live virus risk – not the risk of the actual disease because of a lack of herd immunity, and not to try to compensate for that lack of herd immunity.

When I asked one of my cousins if she was going to give her kid OPV, she said, “No, he doesn’t go to gan [hint: unlike your kid], and I don’t live in the south [hint: unlike you].”  Which just proved to me that she hadn’t done her homework – polio had been discovered in the sewage in the center of the country by that point, as well; and just playing with one friend’s dirty toys, or touching his dirty hands if they hadn’t been thoroughly washed after he pooped, was enough to infect him.  If that wasn’t enough, she was seven months pregnant – her new baby wasn’t about to be vaccinated any time soon, either.

As it turns out, thank G-d, the polio scare passed without too many problems, on both a personal and national level, thank G-d.  The OPV was largely understood to be a highly protective, preventive measure, and there was a question if it was truly necessary.

herd immunity, spreading infections, outbreaks, immunity, immunizations, vaccination, vaccinations, health, diseases, babies, mutual responsibility, those who dont immunize put everyone else at risk, anti-vax, anti-vax stupidity, education, responsibilityA few months after Shlomo was born, Esther said, “Did you give him the pertussis vaccine?”  I told her yes – since we were kids, the vaccine has changed.  Plus, no matter what, it’s better to get the vaccine than the disease – and pertussis is one of those very nasty diseases that still pops up quite a few times a year.  True, Esther’s health was negatively influenced by the pertussis vaccine (and it’s not certain if the vaccine was the cause, the trigger, or completely unrelated); but it is also true that she was never fully immunized, and that she ended up getting the actual disease – and suffering the consequences – in the end, anyways.  Isn’t it better to just get the vaccine?

By the way, as it turns out, people need a DTaP booster as adults, too.  Once, when we were in a clinic because Shlomo was throwing up, there was a kid next to us with a distinctive whooping cough.  I asked the mother if he had had his immunizations, and she said he had had all but one.  When I asked which one – she didn’t know.  We moved away from them, and later that week, Yitzchak and I went to get DTaP shots (Shlomo was about a year old at the time, and his shots were recent enough that he was protected).  As it turns out, this was helpful in more ways that just the obvious one: When I was pregnant with Tova, the nurse told me to get a pertussis shot.  Always wary of vaccinations during pregnancy, I asked Mom, who, at first, told me that I should get the vaccine; when I told her I’d had one in January 2012, she told me that it was recent enough to give Tova my IgG without having to get a vaccination while pregnant – and she also told me that she tried to get her vaccinations while not pregnant, for this exact reason.

What I did just realize is that when Esther has a baby, she probably will not vaccinate the kid against pertussis – which means that I don’t want my kids coming in contact with hers until they have been fully immunized and have had recent enough booster shots that I won’t have to worry.  Luckily, because Esther doesn’t live too close to me, this won’t be too much of a problem to pull off.  Hmmm . . . does that mean I don’t want any of my siblings near my kids, until I know my kids are fully vaccinated?  But maybe not, because they all got pertussis – not the shot, but the disease.  I guess it doesn’t matter, because it all amounts to the same thing: not to travel unless we are all up-to-date and not in need of booster shots.  Maybe this is why the concept of vaccinations before traveling exists?

vaccinations, peanut butter allergies, irresponsibility, plauges, outbreaks, infections, immunity, school, healthPlease, everyone, vaccinate your kids.  The entire time I was pregnant with Shlomo, I was worried about getting rubella.  At the beginning of the pregnancy, the blood tests showed that I wasn’t immune, even though my mother insisted that I got both doses (and even if I don’t always believe my mother, you can’t get into the school system where I was in first grade without being up-to-date).  At some point, there was a notice in my college (again, while I was pregnant with Shlomo) that everyone should check their vaccination records, because there had been a case or two of measles.  As soon as I could after having Shlomo, I went with him to one of his well-baby appointments and got myself an MMR vaccination.   Thankfully, since then, I have tested my levels twice, and each time, the IgG value went up a bit, so that now I am fully immunized.

I think that everyone who didn’t receive the necessary vaccinations needs to make sure that those around them know to keep away – especially pregnant (or potentially pregnant) women, young children, babies, and anyone with any kind of medical issue – even just a flu.  Outbreaks of infectious diseases happen every few years; for some diseases, every year.  And they always start in communities that have high numbers of people who are too good for the vaccine – white, richer, more skeptical of the “outside world”,you name it.  Let’s stop trying to convince ourselves that vaccines are the cause of so many of today’s ails, and accept the fact that they have very effectively prevented thousands, if not millions, of hospitalizations per year.