Tag Archive | families

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.”

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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?

Formula: Sometimes, Medically Necessary

When?

Well, once upon a time, the gene for not being able to produce breastmilk was pretty rare.  If a woman couldn’t produce enough milk, she needed a wet nurse.  Wet nurses were expensive, though.  So if she didn’t have the money, and didn’t have the milk – well, let’s just say the gene wasn’t passed on to the next generation.  Survival of the fittest, did we say?  Perhaps of the richest, who often used a wet nurse even when it wasn’t necessary, to spare Mom the “burden” of breastfeeding.

Over the centuries, many tried and failed to find a substitute for human milk.  The formula we have today is the grandchild of the earliest experiments at alternative feeding; usually these alternative methods resulted in infant mortality within the first year; some from the food itself and some from bad hygiene.  In other words, it is the grandchild of the first non-toxic formula.  Obviously, back then, no one gave formula unless the baby didn’t have a mother, or the mother had not a drop of milk and no one to nurse her baby.

Since the age of barely non-toxic formulas, we’ve come a long way.  We’ve come so far, in fact, that unless you know a person’s medical history, it’s hard to guess which kids were formula fed and which were breastfed.

In other words, formula does a pretty good job of enabling these babies to grow, develop normally, and have a great chance at a good life.

That doesn’t mean, though, that formula is for everybody.  Formula isn’t human milk, and because of that, it wasn’t made for human babies.  However terrific a job it does at compensating for the lack of breastmilk, it still isn’t the ideal baby food.  Formula is like medicine.  In many ways, it IS medicine.  It was made for certain situations, and in those situations, it literally saves thousands, if not millions, of lives.  But just like you don’t give your child penicillin if he doesn’t have an infection, you shouldn’t give your child formula if he doesn’t absolutely need it.  Giving either of them too frequently, and without just cause, can have unwanted results. But, that’s not the topic of this post.

With the advent of good infant formula, a lot of babies survive who wouldn’t have had a chance previously.  With the advent of successful fertility treatments, and good prenatal monitoring, a lot of babies are born who wouldn’t have had a chance to be otherwise.  Combine these factors together, including the fact that if a couple’s infertility is female-factor, the same hormones that made pregnancy difficult may make lactation impossible – and there you have it, growing numbers of mothers and babies who are simply unable to breastfeed.

And – that’s fine.  In fact, it’s great.  It is absolutely terrific that these mothers are able to have babies, and that these babies are able to survive.  It’s a modern-day miracle, and one that we all have to be thankful for.

Again, the problem isn’t formula.  The problem is the abuse of formula. Let’s take a look at some possible contraindications to breastfeeding:

– As usual, mother has no milk.  By no milk I mean that she tried supplements, she tried dietary adjustments, she went to lactation consultants, she nursed and pumped around the clock to raise supply – and no luck.  Nothing doing.  The mother who suffers from this often feels inferior, because she feels betrayed by her body and unable to give her baby its most basic necessity – food.

– The baby who cannot form a vacuum.  This is usually fixable by some surgical procedure (yes, even clipping a tongue is technically a surgical procedure, even more so fixing a cleft palate), and until then, the mother has to stick it out by pumping and/or nursing.  Many mothers, too many, give up prematurely.  (There, but for my research, go I.)

– The mother who is taking a medication that is incompatible with breastfeeding, and there is no breastfeeding-compatible medicine available for her.

– The baby who is lactose intolerant, including lactose from human milk.  Sometimes this is fixable by a change in the mother’s diet.  Sometimes, no matter what the mother eats or doesn’t eat, the baby reacts.

– The baby whose mother got pregnant only a few months postpartum.  While this doesn’t mean that you have to stop nursing, if the baby is less than nine months old, chances are high that supplements will be needed.  Sometimes, the baby will start eating more solids.  Sometimes, if the baby isn’t old enough for solids or refuses, formula will be necessary.  Here I want to add that for the first two or three months of pregnancy, the milk stays suitable for the older baby.  Around week 16-20, it begins to turn into colostrum, and possible supply will decrease.  Again, any breastfeeding is better than none, and even if supplements are necessary for a few months, when the baby is born, the mother can dump the supplements in the trash and nurse tandem.

– The baby whose mother chose a method of birth control that is incompatible with breastfeeding.

– The mother who is hospitalized without being given an opportunity to pump.

– The mother who was given bad advice by medical or lactation “professionals”.

– The baby who has no mother.

There are probably more, but these are the main, basic, categories that come to mind right now.

Let me ask a question: Why aren’t there more banks for human milk?  At the moment, at least in Israel, there is a government-supervised bank, but the milk goes mostly to preemies, gastro-intestinally compromised babies, or babies without a mother.  Why can’t a “normal” baby get donor milk?

Some of you will say that it’s gross.  Well, I have news: Birth is gross.  Changing diapers is gross.  For goodness’ sake, any bodily fluid is gross.  Well, except breastmilk, in my mind; it tastes okay and it’s good for you (I tried a drop of my milk so that I’d know the difference between good milk and sour milk).  What grosses most people out, I think, is the idea of sharing the breastmilk.  But think of it this way: When you need a blood transfusion, do you say, “Ewww, gross, that blood was in someone else’s body?”  Of course not.  So, why is it gross to use donor milk?  As long as the donor is healthy – and if she is willing to feed the milk to her own kid, I think that she can pretty much be trusted – there’s no reason why not.  The only difference between donor milk and the wet nurses of old is that donor milk can be fed to the baby by its parents, while a wet nurse took all the responsibility on herself.

So, now there are Facebook groups and community milk banks.  But they aren’t widely enough spread, they don’t have enough donors, and not enough recipients are aware of them, or willing to use them.  But if formula, in the mind of someone who tried to breastfeed and couldn’t, is a sign of failure, why is donor milk worse?  It’s better – no, you couldn’t breastfeed yourself, but you still made sure that your child got breastmilk.

I think society needs a change of mindset.

Formula is a legitimate choice for those mothers who cannot breastfeed, or whose babies are unable to breastfeed.  Formula is a very, very, good thing, as long as it is not abused.  Those mothers who use it without medical necessity ruin how society views formula for those who have a legitimate need to use it.

Those who need formula should not have to pay the inflated price formula companies ask.  It is not fair, it is not just, to force someone who has no other option to pay an outrageous fee, for that many containers a year.  Formula that is medically necessary should be hugely subsidized.  Formula that is not medically necessary should be off the shelves.

Breastmilk, even donated breastmilk, is better than formula.  Feeding someone else’s breastmilk to your baby is not a sign of failure but a sign of courage and dedication.

Breastfed babies are the norm, not the exception.  Breastfeeding needs to be accepted and encouraged, not something shameful and disgusting.  I am not for a woman exposing her entire front and side on a park bench.  I am for women being able to sit and nurse, modestly and decently (I don’t use a blanket, but between the blouse and the t-shirt underneath, no one sees anything), in public places.  Without worrying if they will be yelled at, without feeling that the whole world is staring at them, without worrying about a smoker coming to sit down next to them (and then they are either stuck second-hand smoking for half an hour, or they have to get up and move in the middle), and without having to walk ten minutes, with a screaming, hungry, baby, to find a place to nurse.

Pumping should be legitimate and supported, especially for working mothers.  It should not be easier for a mother to switch to formula when she goes back to work, especially since, in the long run, it costs us all money.

Society needs a change.  But it won’t happen if we play Ostrich.

 

 

“I Want My Mommy”

Well, maybe not exactly.

It’s not easy living far away from any kind of immediate family.  We have extended family in a few cities in Israel, second and third cousins of mine, and over the years, we developed family-like relationships with some other people.  But they are in Jerusalem . . . and we don’t live there anymore.  Which means that before I had Tova, we had a period of time when we didn’t know who would be able to watch Shlomo while we were in the hospital.  If we had still been in Jerusalem, or if I had had a guarantee that I would be in Jerusalem when I went into labor, we wouldn’t have had to think twice – we have people who we can ask.  But, from Jerusalem till here is at least two hours.  Luckily, some neighbors, whose kid is in gan with Shlomo, offered to watch him – even at 1am.  At first I was kind of uncomfortable about disturbing them, but in the end it worked out.

Living so far away also means that when we’re both sick, we have to manage on our own.  Usually, Yitzchak and I get sick in turns, one after the other.  Maybe we have a day of overlap, when the one who got sick first still feels sick, but feels decent enough to be able to manage.  This time, we were both sick the same day.

On Friday night, after the meal, I couldn’t fall asleep.  I tossed and turned, I was cold, nauseous and couldn’t get comfortable.  And then I jolted upright and asked Yitzchak for a bucket.  He brought me a basin from the bathroom and I filled it more than halfway with my supper and drinks.  It was more than I ever, ever, remember throwing up at once.  Then we went to sleep.

This morning, I woke up achy (as I have been for the past few days), and Yitzchak woke up “feeling queasy.” Over the course of the day, he threw up about six times.  I think.  Towards afternoon, we both were thinking that it was a shame that we didn’t have family close by, because we would’ve really liked if one of us could have gone over to ask for help.

To be fair, Shlomo was terrific.  He played nicely, quietly, by himself, for 80% of the day.  10% was spent playing with Tova (and annoying us a bit, because he was sitting beside one or the other of us, and kept accidentally sticking one of his limbs into a sore spot on one of us), 5% being difficult (he needed attention), and 5% eating or doing other things.  He peed a bit in his pants (I think because he forgot to go to the bathroom), changed himself, and then told us that he’d peed.  He let us sleep a couple hours in the morning, and then again in the afternoon.  And I think if Tova had been more willing to play or sleep, instead of demanding attention, we would’ve gotten even more sleep.  As it was, we stayed in bed the entire day.  I got up to pee and give Shlomo food.  Yitzchak got up to pee and puke.  We changed Tova’s diapers on the bed.  Every time we smelled her tush and mentioned changing her diaper, Shlomo ran to bring us a new diaper and spread out the changing pad.

The house is a disaster, it’s true.  But Shlomo was a big, big, big, boy.

And still . . . it would’ve been nice if there was someone to take care of Shlomo and Tova while we slept.  Or to help me with Shlomo, Tova, and the kitchen, after Shabbat, while Yitzchak slept.  Or to go buy Tylenol (we only have 1 left and don’t have a car, so it’s a looong trip, and longer when you’re this sick).

Yitzchak said, “If Mom lived around here, I’d crawl over to her house and ask her to come help us.”  I said, “I was thinking the same thing, it would be nice to have Mom around.  But don’t crawl.”

Yes, well . . . it would have been nice.  But we managed anyways, like we always do (thank G-d).

A Trip to the Consulate – Continued

The first section of this very interesting story of travel and bureaucracy can be found here.

Part Four: Going to the Consulate

I called Egged at 7:30; the call center wasn’t open yet.  I called again at 8:30, and was told that there was a bus at 8:45, and a bus at 9:45.  My appointment was at 10:30, and the bus ride was supposed to take 50 minutes.  Meaning, from 9:45 to 10:35.  If you remember that there is a line outside the consulate (so that you can prove that you have an appointment, receive a pass, and go through security), you will understand that arriving at 10:35 meant entering the consulate at about 10:45, 15 minutes after my scheduled appointment.  I got up and ran to the bus, calling Yitzchak on the way to bring me the money.

I felt bad about running so quickly, because my cousin had just asked me to watch her two youngest (she has a Shlomo-aged kid, a Tova-aged kid, a two-year old, and four older kids) while she took her Shlomo-aged kid to gan, but we both realized that there really wasn’t an option.  So I went.

I made the bus; Yitzchak missed it, and me, by 3 minutes.  I figured that there would be an ATM somewhere around the consulate; I figured wrong.  I got to the consulate 70 minutes early, because the bus had only taken 40 minutes, and discovered that I couldn’t go in until half an hour before my appointment.  I found a bench under some trees and finished nursing.

united states consulate, jerusalem consulate, american consulate

The oustide of the consulate.

Yitzchak ended up taking the 9:45 bus and arriving at 10:27 to hand me the money.  Of course, since Yitzchak couldn’t prove that he had an appointment, I needed to walk out of the consulate.  Because I had told the security guard, when I first went in, that my husband was bringing me the money, I was able to skip most of security and the guard told the inner security workers to let me through easily.  Therefore, I walked back into the actual consulate at 10:33, and they gave me a number with no problems.  It would have been smarter to take the number and then go out to meet Yitzchak, but I didn’t think of that at the time.

Obviously, in order to find out where Yitzchak was, I needed my phone, so I had to go through the cell phone security bogus.  But my phone was Yitzchak’s phone, and his was mine, so it made sense to switch them instead of just waiting for him to appear.  After Yitzchak had given me the money and I was waiting to go back inside, I saw that the person next to me was holding a passport issued by the Palestinian Authority.  Ha, I didn’t know they issued passports.  Is that kind of like a little girl pretending to serve tea to her friends?  It was actually kind of funny, and I said something to myself (or to Tova) and chuckled.

Finally, money in hand, diaper-and-clothes-changed (I had forgotten the diapers on the bed, and had to borrow a 4+ from another family; I told Tova not to poop in it because it was too big on her and would leak, and she actually listened until we were off the return bus and walking back), I had time to sit for a few minutes.

Part Five: The Catch

Then my number was called.  The lady at the window was very efficient, asked for all my documents, and I gave them to her; answered my questions about the social security cards; asked for Shlomo’s passport so that he could get his, and seemed surprised when I handed it to her; and sent me to pay.

She asked if I was still married to Tova’s father.  Yes, I am.  And in my head, I think that it’s a funny question to ask.  Can she have the marriage certificate?  I gave it to her.  She asked if I was going to pick up the report or if I wanted it sent to me.  I wasn’t sure I had enough to have it sent, and kicked myself for not asking Yitzchak for another twenty shekels when I had met him earlier.

I went to the shipping-and-number-giving desk, where I waited beside a guy with a thick accent who wanted to know where to go.  I tried to help him, until I heard his accent and saw his manner.  What does he need?  He wants to go to America. Does he need a visa?  Yes, he says.  Is he a citizen?  He doesn’t know what that means.  Where is he from?  “Palestine!”  Ha ha.  I laughed at that one.  The number-giving guy called for another guy and told the other guy to “help this gentleman”.  No one can tell me what the exchange rate is, and they are annoyed at me for asking and ‘being angry’, when I am not angry, just kind of frustrated at having to explain such a simple question over and over.

I go to the paying-desk, now that there is no line, and say, “Mah ha’shaar (what’s the exchange rate)?”  He thinks I said, “Mah hasha’a (what’s the time)?” looks at his watch, and tells me 10:45.  It took me a second to figure out what had happened, and then I repeated my question.  This time, he understood, and told me “4”.  I gave him the receipt from the lady who had handled my documents (and was waiting for my return) and gave him 400 shekels.

When I get back, the lady tells me that I can’t get a social security card for Tova because she doesn’t have a passport.  Huh?  I didn’t see that written anywhere.  As it turns out, it doesn’t have to be an American passport, but if we have never applied for any passport, from any country, for Tova, then she cannot get a social security card.  And she hands me back the form, apologetically.  Okay, fine.  At least Shlomo can get one.  She tells me to wait and that the consular officer will call me.  He will give back the documents.  If I want to apply for a passport, then my husband will have to accompany me.  Yep, don’t I know it.

I sit and wait for the consular officer.  While I wait, I see someone holding a credit card.  Hm, I think, can I pay for shipping with a credit card?  The shipping-girl isn’t at the desk, and while I wait for her to return, the consular officer calls our name.  We don’t usually use credit, even though our debit cards are really credit cards.  But sometimes, it’s a good option to have.  Although, we have been known to say that we don’t have an option for credit.  I suppose you could say it’s lying, but the truth is that it’s not usually an option, financially and budget-wise.

I ask the consular officer if I can still have the documents shipped to me, provided that shipping-girl will take a credit card (and I saw a machine for it on the desk).  He doesn’t know if she will take it, but says that it’s not a problem for me to get them shipped, even at this late stage.  Then he asks for Shlomo’s birth certificate.  I need proof that we are his parents asking for his social security card.  I don’t have the beautiful Report of Birth Abroad, nor do I have his Israeli birth certificate.  I thought the passport would be enough, and the consulate site didn’t say otherwise.  In fact, I thought the consulate site said a passport was enough.  And the lady didn’t say anything . . .  So, we can’t get a social security card for Shlomo, either.

Part Six: The “Solution”, or, Making the Most of An Aggravating Trip

However, Tova’s Report of Birth Abroad should be ready in a week and a half to two weeks.  I can drop off the social security forms at the same time as I pick up the Report of Birth Abroad, no appointment necessary.  I guess that’s what I’ll have to do; I don’t have a cell phone to ask Yitzchak his opinion (because, if you remember, it was taken when I came in), so I decide to make the trip to pick up the report and drop off the forms.  The consular officer is nice and makes sure every ‘t’ is crossed and every ‘i’ is dotted so that I will have an easy, fast, trip next time.  I appreciate it.  And I am frustrated that every trip to Jerusalem seems to leave loose ends that need to be tied up by another trip.  Another 80 shekels; another wasted day.  Arg.  We will not be able to get the social security cards by the 15th of June, but we can file for an extension.  Better yet, we can talk to a CPA and get him to help us out.

But, maybe we should get Tova an Israeli passport in the meantime, and then apply for both social security cards when we pick up the report of birth.  Hmm.  Sounds like it could work.

And that’s where we stand now.

I also didn’t get to buy what I wanted for myself when I was in Jerusalem.  Yitzchak said he’s going to check some places here and ask if they can order it in; if not, then I guess I will have another chance in two weeks.  Maybe we will plan it for a Friday that we are in Jerusalem.  But we are not pulling another stunt like this one; it was too difficult.

Part Seven: The Israeli Passport

We debated whether or not to get Tova an Israeli passport.  On the one hand, we aren’t planning on going anywhere.  On the other hand, we need it for a social security number, which could potentially save us, or give us, a lot of money, and the passport is good for five years.  Plus, it would be kind of funny to see two “baby” passports and compare the pictures.  We decided to get the passport.  From what I saw on the internet, it would cost between 125 and 140 shekels, which is not too bad.  Much, much, less than $105 (which right now is 420 shekels).  Plus, we probably wouldn’t have to wait in line.  Not too bad . . . so we went for it.

Tuesday morning, Yitzchak went to sell the chametz with the city’s rav, at the city’s commercial center.  At the same time, he took Tova to get passport photos taken, and parted with 25 shekel.  He went into the Ministry of Interior and asked for a passport application, only to be told that they don’t give them out, and we had to come in.

From what I had read on the internet, I knew that both of us needed to sign the application.  My plan had been for Yitzchak to pick up the application and sign it, and then I would fill it out, sign it, and take Tova in to the Ministry of Interior to apply.  Now, this plan got changed.  So, at 4:15, we all got on a bus and went to the commercial center, where they asked if we wanted a regular passport or a biometric passport (regular, thanks), and told us that since we’re married, only one of us has to sign the form.  The passport cost us 140 shekels.  Sigh.

On the bright side, they also said that the passport would be put in the mail either that day or the next morning, and we should have it within ten business days.  Sounds good to me.

And so, we now wait for Tova’s Israeli passport to arrive; hopefully before Pesach vacation ends and I have to go back to work.

Update: About an hour and a half before this post was published (I had scheduled it to post, ahead of time), we had a knock on the door: The passport had arrived, through registered mail, a day and a half after we applied for it.

A Trip to the Consulate

Part of being an expat is deciding if you want your kids to be registered as citizens of your birth country.  Sometimes you want the tax benefits; sometimes you think that it is better for the kid in the future; and sometimes you think that it is worthwhile, or necessary, of the present.

We never really debated the subject; it was just kind of obvious that since Yitzchak and I are both American, and we have family in the States, that we would register our kids as American citizens.  When Shlomo was born, and we realized the expense involved (admittedly a pittance in comparison to expats who are not married to other expats, or who did not spend any time actually in America), we thought about just getting him a visa for his Israeli passport whenever we wanted to travel.  Not only did this turn out to be against the rules, it wasn’t even worthwhile financially.  We spent about a thousand shekels on getting him a Report of Birth Abroad and an American passport, and then we still had to get him an Israeli passport (because we were planning to travel).  Now, we had to register Tova.  Having no immediate travel plans, we pushed it off and pushed it off and finally decided to get it over and done with, for the sake of taxes.

Here is the story, for those who are interested in life in Israel and life as an American expat.

Part One: Making the Appointment

There is a U.S. Embassy in Tel Aviv, and there is a U.S. Consulate in Jerusalem.  Because we used to live in Jerusalem, we went to the consulate to register Shlomo.  Because I hate Tel Aviv, and know where the consulate is (since I’ve been there before), I emailed the consulate and asked if we could still come to Jerusalem, even though technically the consulate is only for the residents of Jerusalem, Judea, and Samaria.  The response I got was that we could go to the consulate and did not have to go to Tel Aviv.

Throughout this narrative, I write, “I,” because while we weren’t sure if Yitzchak would end up coming, it was pretty obvious that I had to go, since I am nursing Tova, and was still on maternity leave.

Then, I had to make an appointment with the consulate.  There were a few issues with this:

1. It is, at minimum, a two and a half hour trip into Jerusalem, not including the bus that goes from the Jerusalem Central Bus Station to the consulate.  Two and a half hours, multiplied by two trips (there and back) is already five hours minimum.  From the Central Bus Station to the consulate is about an hour each way, by bus.  Taxi might be faster, but costs a lot – maybe 100 shekel, or more, per trip.  The taxi may not save us time, either, because Jerusalem has awful traffic jams.  So far, we have a seven hour trip at minimum – and that’s not even counting the time we would spend at the consulate, which is calculated to be about an hour and a half, on average.  Total amount of time to travel from home to the consulate and back: 8.5 hrs.  Or, in other words, an entire [work] day.

2. We needed to get Tova a Consular Report of Birth Abroad.  Let it be known that this is an absolutely gorgeous document.  We also wanted to get her, and Shlomo, social security numbers.  When Shlomo was a baby, I sent in an application for a social security card, but we never got the card.  I don’t know if the application was rejected or if the card never reached us.  At any rate, because we wanted their social security numbers for taxes, we wanted to make the appointments in enough time to send in the forms at least before the June 15th expat tax date.  Looking back, I realize that my calculation was foolish, since it can take up to six months to get the social security cards.  But no matter.  We need to do it, and the sooner the better.

We debated whether to get Tova a passport at the same time.

The pros: No need to worry or race if we end up traveling, or if we decide to move back for whatever reason.

The cons: An extra $105 (about 420 shekel), and it expires in 5 years; Yitzchak would need to waste an entire day so that both of us would be present, or we would have to waste money on a notarized consent form that he allows his child to get a passport when he is not physically present; if both Yitzchak and I are at the consulate, where is Shlomo?

Which leads us to #3:

3. Only the people who are absolutely necessary for the appointment are allowed into the consulate.  In other words, if you are applying for a Report of Birth Abroad, one parent accompanies the child.  If you are applying for a passport, both parents.  But – if you have another child who has nothing to do with the appointment – he will not be allowed into the consulate.  Hmmm . . .  I considered making a fake appointment for Shlomo (because, after all, he did need a social security card, even if I didn’t need a separate appointment for it), but Yitzchak reminded me that Shlomo coming with us meant Shlomo running laps in the consulate, for about an hour.  We decided to that it was worth trying to avoid having to discipine him.  After all, what’s wrong with running laps?  (Answer: Nothing.  It’s just that the consulate isn’t really the place to do it.)

4. We are always loath to part with such large sums of money.  The trip to Jerusalem is about 80 shekels round trip.  The Report of Birth Abroad is $100 (400 shekel).  That’s a LOT of money.  But we have no choice; we are required to file taxes and we want to be able to write down all exemptions possible, just in case, somehow, it may in some fashion look like we earn enough to actually owe something.  Plus, we probably qualify for $1000 a year, per child, in tax returns.  With Shlomo we were too lazy, and stingy, to get an accountant to deal with it, and we didn’t know how to file ourselves.  But things have changed since then (mostly expat tax laws), and it looks like, lazy or not, we need to file this year.  Which means, why not do it all at once?

5. The appointments are made online.  You can only make one appointment per child.  I cheated the system, not knowing which day I wanted to go, and wanting to make sure I had an appointment that worked for me.  The system allows you to make appointments only for the next three weeks or so, and they get taken very quickly, leaving only 8 or 8:30am appointments, and even then, only on one or two days out of the month.  You need to really keep on top of the appointment site in order to get one that works.  I made two appointments for Tova, and got past the system’s block by changing a letter in her name.

Part Two: The Stupid Rules

American security is infinitely stupider than Israeli security, for the simple reason that they do not know what they are doing.  One example is what I wrote above – only the people pertinent to the appointment are allowed entry.  Here are a few others:

– If you come more than half an hour early for your appointment, you may be denied entry and your appointment will be rescheduled.  Gee, it’s nice you wrote that on your website and not just on the window outside the consulate, for folks like me who are dependent on buses, live a few hours away, and called Egged, only to be told that the only bus that goes to the consulate leaves once an hour, at a quarter to the hour, and takes 50 minutes to get there.  It’s a shame I didn’t schedule my appointment differently.  On second thought, maybe I couldn’t have scheduled it so that it worked with the bus schedule.

– If you have a stroller, you need to leave it at the gate.  Oh, and they aren’t responsible if it gets taken.  Make sure you bring a sling, if you have a baby, or your arms will get exhausted.

– In order to be allowed entry, you first need to prove you have an appointment.  This you do by handing them the printout of your appointment details and the documents and forms that you brought with you.  The guy you proved it to gives you a pass.  Then, pass in hand, you go to the security guy, who asks you more questions, gives you a basket to put your phone and charger in, and asks if you have other electronics that need to be in the basket.  Basket in hand, you go through the doors, to pass through the metal detector and put your bag through the x-ray machine.  If, like me, you have forgotten about an electronic device that you happen to have in your bag (I forgot that I had the camera), they get very angry at you and treat you like you are a bigger threat than Iran.  The contents of the basket are put into a “cell” and you are given a card with the cell’s number, which you present in order to get your belongings back when you are done.  By the way, they are not responsible for any electronics put in the “cell”.

– Let’s say you need to make a phone call.  You go back to security, show your card, get your belongings (all of them), walk outside, make your phone call, and need to be readmitted by the guard.  Let’s say you need to get a document or whatever, and you walk out for a second.  Same deal.

– They take checks, written for the exact amount, according to that day’s exchange rate.  No credit cards.  They take cash, but do not give change.

– No one is allowed to wait outside the consulate.

– No sealed envelopes are allowed in.

For more stupid rules please see here.

Part Three: The Debate 

I had a Thursday appointment and a Friday appointment.

Advantages of Thursday:

– If only I go, and I am on vacation, it is just a waste of a day (and not a waste of two peoples’ days and double the money).

– It leaves me all of Friday to prepare for Shabbat.  Therefore, it is less stressful.

– I can also do some clothes shopping while I am there (I hate clothes shopping, but sometimes there is no choice); on Friday the stores close early and I probably won’t have time to shop.

Advantages of Friday:

– If we are not home for Shabbat, it is not a wasted trip.

– Yitzchak has books to pick up in Jerusalem; if we go as a family and are not home for Shabbat, we “kill” two birds with one stone.

– We do not want to be home for Shabbat anyways, since it is the Shabbat before Pesach.

– If I go on Friday by myself, I can meet my friend, who I haven’t seen in ages.

In the end, my cousin saved the day.  We went on Thursday afternoon to Jerusalem, I did some shopping, we stayed at my cousin’s overnight, and early in the morning I went to the consulate, and Yitzchak went to pick up his books.  Then, we all traveled to Kfar Chabad for Shabbat, and after Shabbat went home.  On Thursday night we changed the clocks, which meant an hour less of sleep for everyone, but more time to get things done.  It was tough, because we were exhausted from all the running around, but we made it.  My cousin was also traveling for Shabbat, so we helped them get out, as well.

Total time spent going to and from the consulate: 4 hours.  Not bad, considering that if we had traveled to Jerusalem just for the consulate, it would have taken an entire day.

Oh, and I forgot – Friday was our fifth anniversary.  And we spent it traveling.  To and from the consulate, from Jerusalem to Kfar Chabad.  We had thought to do something else, less for the anniversary than because it was an excuse to get a babysitter and take a breather.  But in the end, like every year, we forgot the date until afterwards.

Stay tuned for the next section of this riveting narrative . . .

Why Do Mothers Choose to Formula-Feed?

During my maternity leave, I went back to an old hobby of mine – reading about baby feeding, health, and development.  Probably, all of you know on which side of the breastfeeding – formula feeding divide I very firmly stand.  That said, it irks me a lot when people say, “The most important thing is a happy mother; if breastfeeding is too hard for you, it’s better to just give your baby formula and quit nursing, as long as you’re not stressed out.”  Which, by the way, is bunk.  Then there are those who say that mothers who choose, from the outset, to add formula, care just as much about their babies, and do not do it for convenience but for the baby’s sake.

I’ll let Alpha Parent say it; here’s a quote from her post comparing past and present in baby feeding:

Self-interest is still quoted as the prime reason for not breastfeeding. From the UK Department of Health Infant Feeding survey (which involves around 8000 mothers and is done every 5 years): “The most common reason for choosing to breastfeed was that breastfeeding was best for the baby’s health, followed by convenience. The most common reason for choosing to bottle-feed was that it allowed others to feed the baby, followed by a dislike of the “idea” of breastfeeding.”

And here’s some more, for those who claim that breastfeeding doesn’t allow you to sleep at night:

Breastfeeding mothers get more sleep and their sleep is of higher quality. A breastfed baby can eat as soon as he is hungry. If co sleeping, that means before the baby even starts to cry. A formula-fed baby has to wait for formula to be prepared and warmed, in the meantime getting more and more distressed and agitated as well as waking others in the household. When breastfeeding, even the mother does not need to wake up fully to nurse her baby. Furthermore, the hormones produced during nursing have a relaxing effect, and the mother is likely to sleep even better when she nurses her baby. Studies have shown that parents of infants who were breastfed in the evening and/or at night slept an average of 40-45 minutes more than parents of infants given formula (Doan et al). Parents of infants given formula at night had more sleep disturbance than parents of infants who were exclusively breast-fed at night.

And for those who think that Dad can feed the baby at night if you formula feed:

I’m sorry to burst SMA’s bubble but as Gabrielle Palmer (The Politics of Breastfeeding, 2009) has pointed out, “The reality is that few fathers actually do take the whole responsibility of infant care and most artificial feeding is still done by mothers”. Pauline Lim, author of the very useful book Teach Yourself Successful Breastfeeding, concurs that:

“In reality few partners actually share the night feeds, so don’t be tempted to stop breastfeeding for this reason. There might be an odd occasion when this happens but the novelty wears off very quickly, leaving you firmly back in charge of the night-feed. This is particularly true when your partner has to get up for work.”

Remember when we were dealing with tongue-tie?  I pumped and went to sleep, and Yitzchak fed her the pumped milk.  Or, sometimes, I just pumped while he fed Tova the previously pumped bottle.  However, this was for a very limited time, until Tova finally learned how to nurse while lying beside me in bed, and Yitzchak did it not because he ideologically believed it was better for him to share the nighttime burden (because there is no question that nursing is better than getting a bottle of pumped milk, no matter how fresh), but because I was so weak, out of it, and barely functioning that he basically had no choice.  It wasn’t easy for Yitzchak and I don’t think we would have been able to keep it up long-term.  Especially since I would wake up when Tova cried and then have to fall back asleep. During those early weeks, however, it was a lifesaver (and you know something is wrong when it’s easier to pump than it is to nurse).

Here’s a study that compares the health of formula fed, or mixed formula and breastmilk fed, babies with those exclusively breastfed for the first six months.  Obviously, any breastfeeding is better than none, but that does not mean that supplementing a breastfed baby with formula does not have any undesirable side effects.  Another thing that should be mentioned is that breastfed babies are not healthier than formula fed babies; rather, formula fed babies are sicker than breastfed babies.

Don’t worry, give me a few days and we will get back to the elections.  We are still waiting on the final 1% of votes to come in, and until they do, nothing is official and the only thing we can do is speculate.

 

The Best Purim

I think Purim was always the holiday I liked least, for the simple reason that too many people get drunk.  I will note here that despite what most people think, if you read the Shulchan Aruch, you will find that the vast majority of Ashkenazi poskim who commentate the book (rabbis who tell us what the halacha, or Jewish law, is) forbid getting drunk.  The Beit Yosef, a Sefardi rav and the author of the Shulchan Aruch, does not advocate getting drunk, either.  In the Shulchan Aruch, he writes the language of the Gemara, “a person is required ‘levisumei’ [ed: commonly translated as getting drunk, but it is not certain that that is the only understanding of the word] until he cannot differentiate [between ‘cursed is Haman; blessed is Mordechai’].”  In his commentary on the Shulchan Aruch, called the Beit Yosef, he opines very strongly against getting drunk.

In other words, people who get drunk on Purim should learn halacha.  Tipsy, maybe is okay, IF (according to Jewish law) you know that you will still be in charge of your faculties.  Drunk – absolutely not.  Most people do not know this; I am not sure why.  Probably for the same reason that most people don’t know that a baby’s gut doesn’t fully close until around six months, so anything they eat dribbles directly into the bloodstream.  We expect people to be educated and know the things that are important to proper living, and are basic to the values that they claim to hold dear.  In reality, it doesn’t work that way.

Israelis also have an odd habit of using firecrackers around Purim.  We will simply say that this is a nasty practice and Yitzchak and I both hate it.  Thankfully, where we live now, there are fewer firecrackers, and hardly any drunks.

Now that I have fully explained why other Purims were worse, let’s go back to the title of this post: Why was this Purim the best?

First of, all, we did all the shopping beforehand.  Second, the mishloach manot that we prepared were simple: yogurt, some cherry tomatoes and cucumber sticks, and a pita, placed in a disposable bowl and wrapped in cellophane.  We froze the pitot so that they would stay fresh, and the rest of it, including the bowl, I prepared the night before.

Third, and this is what made the biggest difference: Yitzchak went to shul, to daven maariv [the evening prayer] and hear the megilla.  I stayed home with Shlomo and Tova.  He arranged with a friend that he would borrow the friend’s megilla at 10:30pm and return in at 7am the next morning, when they met in shul.  Then, Yitzchak came home and read the megilla for me, while I nursed Tova.  After that, we went to bed, and set the alarm for 5:30.  At 5:30 we woke up, said the morning brachot (blessings), and at 5:45 Yitzchak read for me again, while I nursed Tova in bed.  Sometime towards the end, Shlomo woke up; when Yitzchak finished reading, we did some last-minute things, and he left for shul, with four mishloach manot in his hand.

That left Shlomo and I with six to deliver; Shlomo helped me wrap them up (he held the cellophane while I wrapped the ribbon), and then I gave Shlomo breakfast, nursed Tova again (while Shlomo ate) we got dressed, and we left.  It was a quarter to nine.  At eleven-thirty we were all back at home, with me doing the obvious (i.e., nursing Tova again, since three hours had passed), while we sat for a bit to rest and eat.  Then we had Shlomo take a nap.  It sounds strange, but the big boy had been a VERY big boy while walking and delivering mishloach manot for two hours (we had made some for bus drivers, and Shlomo insisted on waiting for buses instead of using the time logically to finish the rounds, and then meet the bus with no wait time; we had also gone to the store to get diapers).  He was exhausted.  So he went to sleep, Tova went to sleep, and I went into the kitchen to prepare the meal, which, because we had surprise company, had been set for 3pm.  Then Yitzchak got called off to read the megilla for someone else; by the time he was finished reading, an hour later, I was also finished cooking.  Then we cleaned up, talked, ate, and guess who went back to bed . . . and Purim was over, pain-free, drunk-free, and very calmly.

Honestly, it was the calmest, nicest, Purim I’ve ever had, and I would do it again – even though Purim is my least-favorite holiday – in a heartbeat.

Poopy-Training and Tzuk Eitan

Remember how, during Tzuk Eitan (Operation Protective Edge), we were potty-training Shlomo and a siren went off while he was on the potty?

Well, 6 months later, we are about back to where we were then.  How we did it, I don’t know.  I think by just making a direct reward, a direct consequence, and letting it be.  In other words, the direct reward and direct consequence are the only things that we associate with pooping.  It was just getting to be too much, and we felt like everything in his life, and ours, was connected to poopng . . . something we didn’t feel was healthy or beneficial.

Direct reward: He gets his pacifier from the moment he’s off the potty until he leaves for gan the next morning.  There is no connection between the pacifier and the potty, you say?  You’re right.  Except that the pacifier was the only thing he really seemed to care about on a long term basis.

No potty, no cookie?  No problem, I don’t need a cookie anyways.

Potty and half an hour of uninterrupted playtime with one of us, even on a busy day?  Well, that’s nice, but I get it enough anyways, and when I really want it I’ll poop in the potty.

No potty, no pasta (because pasta is constipating and he eats too many carbs)?  Who cares, I like vegetables and as long as I’m not hungry it doesn’t make that much of a difference.

No potty, no tablet? Meh, who cares.

Poop in pants and pick it up with a wipe?  Who cares?

Poop in pants and pick it up with my hands?  Ewwwwww.  But it’s not so bad, it gets a reaction, and the solution is simple: Don’t poop.

No potty, no pacifier?  But I waa-aa-aaa-annn-ttt.

Originally, I suggested trying poop-f0r-pacifier for a single week to see if it would work.  The idea was that at the end of the week, something would have changed.  Either he would give up the pacifier, he would poop in the potty, or possibly both.

In the end, what happened was none of the above; and all of the above.

He is much less dependent on the pacifier, and can sleep well without it.  (If Tova wakes him up, we give him the pacifier whether or not he’s pooped.  Tova waking him up is not something that he can control, plus it means that he won’t become resentful of her waking him or us up.  Win-win.)

And when he wants the pacifier, which is nearly every day, he sits and poops on the potty.

If he poops in his pants, he helps clean it up.  Just like he would clean up after himself if he spilled oatmeal.  We clean up our poops, he can help clean up his.  Because he is a clean freak, this is a very awful punishment – which is why, when it was done by itself, he held in his poop for a whole week and became seriously constipated.

Shlomo isn’t pooping every day yet, but we’re averaging about three times a week, which is pretty good.  Sometimes he holds in his poop so long that he gets poop smear stains on his underwear – poop that tried to come out but got pulled back in.  When that happens, he has two choices: Put a big poop in the toilet, or touch the poop in the underwear.  It’s been about a month since the last poop outside the potty, and we’ve only had a few big smears and a few little ones.  Tfu tfu tfu, may it continue to get better.

Also, at some point more than a month ago, we switched from potty to toilet seat.  We took the stool and the toilet seat and sat him on the big toilet.  At the beginning he was afraid and held Yitzchak’s shoulders, until he realized he wouldn’t fall.  Then he had a choice: No toys and potty, or toys and big toilet.  Guess which one he chose – the big toilet.  He poops with his tablet in hand.  And if that means that he only poops 6 days a week and doesn’t poop on holidays, so be it.  The maximum is three days, and even that is only once a year, and not every year.

The toilet seat has this lid in the front meant for making sure that the pee won’t spray all over the place.  He complains that it hurts his peepee.  Solution?  Stick a wad of toilet paper between the plastic and the peepee.

We are still working on peeing while sitting on the potty.  At present he insists on standing up to pee and then sitting back down to try pooping.  Eventually, I think he will get it.  In the meantime, he has peed on himself a few times when we told him to push down his peepee and pee into the toilet while sitting.

I write the bathroom-appropriate details because I assume that some of my readers are parents who are potty-training boys, and I assume it will be helpful.  If Shlomo reads my blog when he is older and protests my explicit instructions meant for potty-training parents, I will let him reword it.  Otherwise, I will save it for him and his wife when his son decides to pull the same stunts.

I take comfort in the fact that Tova, unlike Shlomo, does not like sitting in dirty diapers.  She will cry until you change her diaper, even if it only has pee in it.  Shlomo did not care if his diaper was wet or dirty, unless it got his clothes wet or dirty.  The biggest obstacle to his potty training was that he simply did not care.  For all that he is a neat freak, having a gross bottom was someone else’s issue and not worth the break from playing.  Hopefully, since Tova seems to dislike being wet or dirty, she will be happy to learn how to keep herself dry and clean by going to the potty.  She is also a girl, and supposedly girls train faster – but this we will see in due time.

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Update from after Shabbat, Feb. 28: Apparently, I need to stop posting poop-training updates.  Shortly after this was published we found poop in his underwear – or rather, slime in his underwear.  It was much more than just a little stain.  Then he pooped in the toilet.  The next day, we found another stain in his underwear.  And the day after that.  Sigh.  Today I told Shlomo that my contract includes washing poopy underwear for maximum eight months, and that it applies to one-, two-, and three-year olds, but not to four-year-olds.  Then I got a brilliant idea: My contract doesn’t include washing a 4-year-old’s poopy underwear, right?  And the extra loads are a waste of water and electricity; if I don’t do the extra loads I suffer from the stink and have to make sure nothing touches it.  Solution: He can hand wash his own poopy underwear.  Fair enough, no?  It takes the task of my hands, and saves electricity and water . . . and teaches him some responsibility.  We’ll see what happens now.

A Tongue-Tie Survival Story

Survival?  Well, I don’t know.  But it does sound catchy, and we did make it through with not a single drop of formula.

When the hospital’s pediatrician checked Tova he told Yitzchak, “Just so that you don’t sue me, she has tongue tie.  It shouldn’t cause a problem for nursing and in 90% of cases it doesn’t.”

When Yitzchak brought Tova back to me (note: in Hadassah Ein Karem they don’t separate you for a minute; in Soroka it took two and a half hours before she was brought back to me, during which time Yitzchak was with her for all except five minutes) he told me what the doctor had said.  Angry as I was at how the birth had gone, the birthing-factory treatment (they have 20 delivery rooms and no competing hospitals) and how I was being treated like an idiot (thanks, Soroka), I rolled my eyes, thought, “Oh, great; a nursing mother’s nightmare,” and asked why they hadn’t clipped it.  Yitzchak told me it shouldn’t be a problem, and I hoped that he was right, while reminding myself that he was the sane one at the moment (and I was the exhausted, hormonal one).

After a few days, we brought Tova to the pediatrician because we were concerned about her jaundice.  The jaundice, thank G-d, turned out to be fine, but the pediatrician asked to weigh her (fine by me, since I hadn’t taken her to the well-baby clinic to check her weight yet) and discovered that her weight was not fine; I think she had gained 50g.  We were to come back in three days.

Three days later she had gained only another 30g.

Three days after that, we came back again.  This time, she was already over a week and a half old and hadn’t yet regained her birth weight – and at the rate she was going, we weren’t sure when she would.

At two weeks, she still hadn’t.  I don’t remember when it was, but there was a week in there that Tova gained only 70g – slightly less than half of what she should have gained.

I remember that during this time my mother called and asked how we were doing.  I said we were fine and thank G-d everything was going pretty good.  And as I said it, I thought of how ironic it was.  Shlomo had bronchiolitis (or bronchitis, not sure which) and was on antibiotics.  Tova wasn’t gaining weight and the pediatrician, Dr. R.,  had sent us for a pee test and told me to pump, see how much I got, and then feed her the bottle to see how much she took, and had given us a referral for the ER just in case she did XYZ (don’t remember what).  I was sore, overwhelmed, and dealing with excruciating pain every time I nursed.  Yitzchak and I were barely sleeping, despite being blessed with a baby who, if left to her own devices, will give us a decent night’s sleep.  And with all this, I told my mother I was fine.

Then we did a nursing test.  I brought Tova in, she was weighed, Dr. R. put me in a private room to nurse, and then 40 minutes into the nursing session Tova was weighed again.  To our credit, she had gained 85g.  Not all would stay, obviously, but it meant that she had eaten quite a bit.  Don’t tell the pediatrician, but a good portion of it was squirted into her mouth, since she wasn’t nursing well.  Not that it mattered, of course: the point was to see how much she was getting, and it didn’t really matter which of us was doing the work, as long as it did the job.  To my dismay, the previous day’s “cheating” backfired: I had sent her to be weighed just after a meal, so that the scale would show more.  It wasn’t enough, obviously, and when she was weighed, hungry, the next day it looked like she had “lost” weight.  I didn’t tell Dr. R. why she had “lost” weight; it was enough that to see that she obviously could get enough and officially rule out milk supply as the issue (it wasn’t the issue and I knew that, but we had to prove it).

Several times along the way we were suggested formula – starting in the hospital.  Because even a single bottle of the stuff can do permanent damage to a baby’s gut, Yitzchak and I have started calling formula “medicine”.  It is lifesaving when medically necessary and potentially damaging in any other case. What parent gives their kid medicine when it’s not medically necessary?  And what parent will expose their kid to something even potentially damaging, if there is another option?  Thankfully, our pediatrician was as reluctant as we were to add formula and gave us other options.

The “other options” weren’t fun, though.  The next step was to see if she would gain weight if enough food was forced down.  So, Dr. R. told us to nurse every two hours, maximum every three at night, and come back in two days.  If she hadn’t gained at least 50g – well, let’s not think about that.

We did it.  And thank G-d, she gained 70g in those two days.  In other words, problem found, and it was a simple, easy-to-fix problem.  Tova wasn’t eating enough, and therefore wasn’t gaining enough.  Thank G-d, a million times over, that that was the problem.

However, since she was such a weak nurser, and didn’t want to be nursing so often, each feeding took about an hour.  Every five minutes, we were waking her up.  At one point, I was pumping in the evening, refrigerating the bottle, and Yitzchak was feeding her one of the late-night feedings so that I could sleep a bit.  (After all, I was only three weeks postpartum.)  Other times, Yitzchak gave the bottle I’d pumped earlier, while I pumped a new one.

You know that there’s something wrong when it’s easier to pump than it is to nurse.

Thankfully, I had a hospital-grade pump from Yad Sarah and could easily get 80-90 ml in about 20 minutes (from one side).  Let’s hope that when I go back to work and have to pump, I still have an easy time pumping the amount that she needs.

For a week, I nursed every two hours during the day and every three at night.  Ten feedings a day.

We asked the pediatrician – maybe it’s the tongue tie?  We were told to go to the ENT; the place where he does it, and he himself, will not clip a tongue before the baby is 8-10 months old.

Then it was every two hours during the day and every four at night – for another week.  Nine feedings a day, she said.

Then we got permission to let her sleep – no more than five hours – at night, but we still had to do every two hours during the day. Eight feedings a day; don’t do any less.

Then I realized that the usual postpartum breastfeeding pains had gone away, but Tova was STILL hurting me every time she had nursed.  I managed to keep her from making my nipples bleed, but the dark lines on the tops hadn’t gone away, and my nipples would often continue to hurt for an hour after each feeding – which in those days, meant that the side I had nursed on hurt pretty much until the next feeding.

It suddenly occurred to me that maybe her gassiness, my sore nipples, her difficulty gaining weight, and the long nursings, all had a common cause: TONGUE TIE.  I went online, asked if I was on the right track, and asked for referrals.  I was given two names: Dr. C., a surgeon in Be’er Sheva, and Dr. K., a surgeon in Ashkelon.  Be’er Sheva is closer, so Be’er Sheva it was.  I asked for a referral and Yitzchak took her in.  Dr. C., and all of Soroka, will only clip the tongue when the baby is at least a year; we should wait and see if it interferes with her speech development.  Yeah, and what about the nursing?

[Then Tova got a cough and we borrowed a nebulizer from Yad Sarah, bought a mask and saline solution, and “masked” her three times a day for five days.  Dr. R. wanted to see her again just to make sure that she was able to breathe okay.  And we got another list of things to watch for and another just-in-case ER referral.  Thank G-d, these referrals were never necessary.]

Then Dr. R. told us to go the Tipat Chalav (well-baby clinic, where nurses check development and give vaccinations) and that she was officially dismissing us.  Thank G-d.

I made an appointment with the surgeon in Ashkelon.  He, I had heard, would clip the tongue in the clinic, on the spot.  He was on vacation for a few weeks, so I took an appointment the first day he was back.

We went back to the pediatrician to get another referral.  Dr. R. doesn’t like surgeons; she prefers ENTs.  So she went to ask the ENT herself, partially to make sure that it was really impossible and partially because maybe if she asked the answer would be different.  It wasn’t, and she gave us the referral.

In addition, for the past month or so, Tova’s poop had been forest green.  Dr. R. said it could be because she had a cough, but sent us for a stool culture.  Thank G-d, it came back negative and the doctor said we didn’t really need to do it after the color changed back, even if it wasn’t perfect.  But we did it anyways.

So, we went to Ashkelon.  And I took Tova on a bus, by myself, to Ashkelon.  We left at 1:30pm and came back at 7:45pm.  She was two and a half months old, and still taking an hour to nurse.  Both buses were late, so I arrived 40 minutes late.  Thankfully, Dr. K. still took us, and even forgave us after I explained what had happened.  He asked some questions, including one that surprised me – if milk spilled out the side of her mouth while she ate (it did).  Then he checked her tongue, expressing surprise at how far the frenulum was tied, “It’s tied practically to the end.”  (Dr. C. had said it was “borderline”.)

Then he took out a sterile kit with scissors, a long q-tip, and asked me to hold her chin.  Using the q-tip to hold the tongue up, he showed me what he was about to cut, took the scissors, reassured me that the crying was okay and I shouldn’t worry, and clipped.  It took about two minutes.  There was a bit of blood, but after another two minutes it had all but stopped bleeding.  Tova, the sensitive baby that she is, cried hysterically for long after the bleeding stopped.  Dr. K. said that she would calm down when I started nursing – and she did.  I took her to a corner of the waiting room and nursed.

She latched easily.  She sucked fast.  It took 40 minutes, but not 40 minutes like the previous 40 minute nursings had.  Previously, when I stopped after 40 minutes, I felt like she hadn’t finished but didn’t have the energy to argue.  This time, I was pretty sure she’d eaten enough.  And – what had been sore still hurt.  But as any nursing mother knows, previous sore spots and new sore spots feel different.  There were no new sore spots.  And she didn’t leak milk.

I went to the wheelchair bathroom (that’s what you do with a stroller; this one happened to have a change table, too) and changed her diaper, which had leaked.  It had been full before the doctor clipped her tongue, but for obvious reasons, I nursed before changing her.  Since Yitzchak had forgotten to pack me wipes, and I had decided not to ask because obviously he hadn’t forgotten, I had to clean Tova in the sink.

We went home; Tova pooped on the first bus; I nursed her on the second bus, stopped just before I had to get off, and finished nursing her fifteen minutes later when we arrived home.

When we got home, a few things happened:

1. YItzchak changed her diaper – and her poop, which had been green when I changed her diaper in Ashkelon, had suddenly turned mustard yellow again.

2. She went back to nursing for an hour.  Luckily, this was temporary.  Now she nurses for twenty or thirty minutes; more than that happens, but not often.  She can eat every two and a half or three hours.  I am starting to trust Tova to tell me when she’s hungry. But I still want to weigh her again, just to make sure I’m not making a mistake by trusting her.  She still spills milk sometimes, but after she finishes nursing, not while she’s still attached.

3. Nursing didn’t hurt anymore.  After two and a half months of torture – it didn’t hurt anymore!  I’m still in shock, a few weeks later.

I have a life again.  When I was nursing an hour out of every two, this is how my day looked:

Nurse.

Pee and drink OR eat OR shower

Nurse

Sort laundry

Nurse

Poop and eat a bit

Nurse

Shower and get dressed

Nurse

Put in a load of laundry

Nurse

Get the point?

In three words: It Was Awful.

But we did it.  Without a single drop of formula to ruin our baby’s gut.  If I hadn’t read up on the subject of formula, nursing difficulties, and tongue tie, I wouldn’t have made it.

If Yitzchak hadn’t been so helpful and supportive, I wouldn’t have made it.

And next time they tell me in the hospital that my baby has tongue tie, or I see that my baby has tongue tie, I will wait a week to see if the weight gain is normal.  And if it’s not, or the baby isn’t latching well, I will make an appointment with Dr. K. in Ashkelon and take the baby to get its tongue clipped at three weeks instead of at two and a half months.

I tell this story for a few reasons:

1. It is therapeutic for me to write it.  Very therapeutic.  This post has taken me about two hours to write, and I feel so, so, so much better now.

2. If this post helps anyone else, I will have done a lot.

3. I believe that it is important. Important to write about nursing difficulties, important to know that they can be overcome, and important to be educated.

I do not tell this story because I want everyone to know that I, Chana of Little Duckies, gave birth to a tongue-tied baby and am a radical anti-formula mother who insisted that her baby will have no medicine that is not medically necessary.

I would rather be able to choose who I tell my story to and who I do not tell my story to; this choice vanishes the moment I write the story on the internet.

But it is important, it can be done, and if any of you are in Maccabi in the south of Israel, use the “contact me” page and I will try to help you out.  After all, it was another mother online who helped me.