Tuesday, September 16, 2014

How to feed your newborn.

Isn't this the most precious little face ever?

We didn't plan to have three kids. In fact, we were pretty done with two - I mean, it's been five years since we had a baby and we finally have two school-aged kids who are pretty independent.

We are thrilled for this new life, though, and he is pretty cute, so I guess we'll keep him. I mean, seriously, how cute is he?

Being pregnant had it's craziness, but having a newborn is just confusing as far as cultural norms go. I never know where I stand, and when I think that I'm doing things right, I get told that no, sorry, that's not the way to do it. I've mostly learned to turn off my ears when people start to give advice - not because I don't respect their opinions, but because in the end, we are the parents and we need to make the decisions that are right for us.

Amely's first day home.
And therein lies the rub. I am pretty well-saturated in information about what I believe. (Wow, that sounds pompous. It's not meant to be). I read a lot before making a decision. My husband is a crap-shoot. Sometimes he believes what the old-women say, and sometimes he gets on the internet and searches. So, one day he can be completely ¨Haha, so and so tried to get rid of hiccups by putting a thread on the forehead. Does that work?" And the next day, he'll be "OMG baby has hiccups, why didn't you put the thread on his forehead, that totally works. My grandmom told me."

I did get lucky in some respects - most Dominicans don't understand that exclusive breastfeeding is a real option for feeding a baby, but my in-laws are supporters of EBF mostly because it's all they've known. Their mom gave birth in a house with no electricity or running water and had no option but to breastfeed. The neighbor ladies divvied up the first 30 days of a baby's life and picked up the cloth diapers to wash in the river every day. No, I'm not joking.
Baby Samil

My two big kids were exclusively breastfed for one year and eighteen months (respectively). So far,
Adiel only knows the boob juice (well, except for the formula they forced on him in the clinic, but that's a story for another day).

The day I got home from the hospital, I started being force-fed malta with oatmeal, bacalao soup and chocolate de agua. I say force-fed, but the only really gross thing is the malta - it's got all the hops that beer has, but none of the delicious-ness of actual beer and none of the alcohol. Amalio put oatmeal in it which made it more drinkable, but still not enjoyable. Cod fish soup and hot chocolate made with water (not milk) are good. Not my favorite foods, but not terrible either. Milk production is serious business, and the food that is meant to help it along are all a mom is supposed to eat for the first few days.

I actually deal with the breastfeeding side-eye much better than I ever dealt with pregnancy advice (and MUCH MUCH better than I deal with other newborn advice), but it can get tiring. I imagine that the reason a lot of women don't even try to breastfeed here is because every five minutes someone is in your face with a new reason why breastmilk is terrible and how you're messing it up somehow.

My favorites:
+ You cannot eat or drink two hours before breastfeeding. The fat will leak into the breastmilk and cause baby to have green poop.
+ You can definitely NOT eat or drink WHILE breastfeeding because baby will probably die. (Or just get some crumbs on his head, but no big deal, right?)
+ You CAN drink alcohol while breastfeeding because beer helps production! Rum makes baby strong!
+ Baby cannot drink milk while laying down.
+ Baby cannot drink milk while sitting.
+ Baby can only be breastfed in traditional cuddle position.
+ If you are sad, angry, stressed, etc... your breastmilk will turn salty or sour and baby will not drink it.
+ If you are happy, breastmilk tastes delicious.
+ If you want to wean baby from breast, you need to express a cup of milk and throw it on the sidewalk so people can walk on it.
+ If you breastfeed at night, your baby will never.ever.sleep. (which might be true because Amely is still a terrible sleeper. Not Samil though. I guess it's a crap shoot).
+ Breastfed babies are bad sleepers in general.
+ Breastfeeding overheats babies. So, if it's hot outside when they are born, it is better to bottle feed to avoid death by overheating.
+ Only poor women breastfeed.
+ Women don't produce enough milk to exclusively breastfeed anymore because they work outside of the house. (I've also heard that women have more c-sections nowadays because they spend so much time sitting down).

A friend of ours came over today to visit. He claims he didn't know the baby was born yet, but we'll forgive him because at least he came. A friend of mine was over as well, and as we sat on the porch, he leaned over - all confidentially - and whisper-asked me if it was true that we don't buy milk. Like it was a big secret. I told him no, and his jaw dropped. "Women still do that? Well you all can keep having kids because they don't cost you anything!"
I found this image on google. It's a snap-shot
from a YouTube video of a baby
playing with his milk cans from his first year.

The idea that "milking" a baby has to be expensive is rampant here. A lot of newborn feeding decisions get made based on social-appearances more than anything. It is a status symbol to be able to feed your baby can after can of expensive formula. And pediatricians don't help as Nestle, one of the worst formula-pushers in the market, has most of the medical professionals in their pocket.

I've seen pictures taken at first birthday parties with the child and every single can of formula he drank in his first year. A pyramid of milk cans. And that's great, but where do you store all of those cans for a year?? It's also great if you can afford suffi
cient milk for your child, but the fact is that milk is expensive and most people don't make enough money to properly feed their child with formula. Add that to a contaminated water supply and it can get tricky.

So, I stick to my guns and do what I have to do. Adiel has already gained enough weight to feel heavy in my arms and grow longer. I drink my tea while he suckles (I kind of hate that word), and eat toast that drops crumbs on his precious little head and all of the neighbors stare and whisper. But, I figure, they're going to stare and whisper anyway, so I might as well give them something to talk about.



Sunday, September 14, 2014

PRegnant in the DR

My doctor encouraged me to exercise during pregnancy - walking as he referred to it, because you know, chubbies don¨t actually exercise. It was the first thing, besides him talking me off the ledge of ¨my blood pressure will kill me¨ (completely unreasonable fear, I have LOW blood pressure), that endeared me to him and made me go back to a second pre natal care appointment instead of finding a different doctor.

See, pregnancy is complicated in the DR. There is a list - much longer than the one I published here - of things that can and cannot be done for nine months. Exercise of any kind is usually on the list of cannots.

translation: Dominican man, eventhough your belly looks like
this, remember that this parking spot is for pregnant women! 
It takes a long time to really figure out how to manage the cultural taboos. In fact, usually by the time one figures it out, there is a newborn in the picture.

Alas, not all things are bad for pregnant women in the Dominican Republic. There are many lovely things that happen here that are so ingrained in the culture that I didnt even realize how much I appreciated them until I returned to the states this summer and those things were non-existent.

In any parking lot, there are spots reserved for pregnant women - spots that are different from the handicapped spots. Well, to be fair, some are shared sports, but mostly there are spots just for preggos. And it is serious. I have been yelled at for parking in the spot during a rain storm by the security guard. Those spots are sacred. Pregnant women should not have to walk a mile to do their shopping.

Pregnant women also never have to wait in line. And if said pregnant woman tries to wait in line, at least three people will point out that she should not be waiting in line. Basically, if you have a baby in your belly, you can cut in any line you want. This is especially helpful in Wendys at lunch time and the bank on pay day.

When I was dating Amalio, we went to the movies. I had no idea about this no-line-waiting policy as it does not really exist in the USA. We were waiting to see a really popular Dominican movie - which means the line went around the block - and a pregnant woman was in front of us in the line, with her baby-daddy. The usher came to pull her out of line and let her into the theater, but wanted to leave the baby-daddy behind. The uproar was insane. The no-line-waiting applies to everyone in the pregnant womans  party and everyone knows it.

There is no lifting involved in pregnancy. Strangers on the street will offer to help you carry a piece of paper if you are pregnant. While this can be pretty annoying, it is really helpful on grocery shopping day or any day there is a lot of stuff to be moved. I have spent the last seven months soaking up the help with every thing from my purse to groceries.

Our neighbors have brought us so much food it is a wonder that I didnt gain 60 pounds during pregnancy. Any time they cooked something special, we got a plate. Any time someone thought I was looking particularly tired, a plate. And forget about it if I even mentioned a craving. Some of our ¨boys¨ went all over Santiago looking for a specific type of fried something or other when I mentioned I was craving it. And my brother in law spent more time walking to the intersection in the midday sun to buy me cold coconut water and pineapple. We are still getting a ton of food dropped off and Im not really sure when this falls off, but Im enjoying it while it lasts.

The Dominican Republic labor law protects pregnant women as well with a three month paid maternity leave AND a maternity stipend for one year for employed women.

I was completely shocked when we got back to the States this summer and I was expected to wait in line like there was nothing special about me. I had to park at the back of the parking lot on numerous occasions and no strangers offered to help me with anything. And I was very very pregnant. (My mom recently got her knee replaced. So, when we went to Walmart (I know, I know, dont judge me), she got a motorized cart and believe me, I stole that and drove around like people of Walmart because my feet and back and head hurt from being SO pregnant.)

So, while the rules are strict and kind of bizarre, Id say pregnant women are, in general, treated with the respect they deserve - I mean come on, we are carrying around the generation in our bellies!

Thursday, September 11, 2014

Old wive's tales (or what not to do during pregnancy).

Photo courtesy of Rebecca Rousculp
I just had a baby. I just had my third child - all of whom were gestated and birthed in the Dominican Republic. You might think that I'd be used to everything that pregnancy entails. I'm not.

I worried about my blood pressure. Okay, I obsessed about my blood pressure. Some of that was physiological - I am overweight, a little over-stressed and (was) pregnant; but, mostly, I worried that there would be one comment, one sly little remark about how I was doing it all wrong that would throw me into a pre-eclamptic fit and I'd have to be rushed to the emergency room.

My doctor is amazing, though, and he assured me that my blood pressure was fine, that no, I was not diabetic and no, I was not going to be rushed to the ER because of someone's snark. (If you're in Santiago, I highly recommend Dr. Enrique Herrera for all of your gynecological needs. He's kind of dry and more than a bit weird, but he's dedicated and knowledgeable and just a good doctor. He also speaks enough English to consult, but not enough to fall into the "well, he's a good doctor because he speaks English category. He has an office in HOMS and one in Corominas). 

Pregnancy is a funny thing here in the DR. It is a rite of passage - a woman who does not want children is viewed as strange, and woman who cannot have children is pitied. It is an illness - pregnant women are supposed to adhere to a list of rules and regulations to guarantee a healthy baby that are archaic and often cruel. It is also empowering.

I did not know that I was pregnant until I was pretty far along - 12 weeks - and because of that, I was able to avoid some of the taboos. It was also because of that that some of my female friends were angry with me - they thought that I had purposely kept the information to myself for my first trimester to keep them out of the happiness loop. See, babies are a blessing and from day one of a missed period, people share their good news. The fact that I hadn't shared meant I was being stingy with the good stuff.

I was a *little* insane at the end of my pregnancy. I convinced
my brother to DRIVE with me and the kids from Chicago to
Philadelphia. That's 14 hours, folks. At seven.point.five
months pregnant. Here is a picture of me, the belly and
my amazing brother at the Bean. I broke *all* of the rules
on that trip - we must have walked one million miles.
I did, in fact, hold off a few weeks to tell people that I was pregnant because I was in shock. I also really wanted to go to the beach without the commentary. Like I said, there is a list of rules and regulations for pregnant women, and going to the beach is off-limits. The waves and the water and movement of the ocean will apparently cause miscarriage almost all of the time. All of those crazy gringoes at the beach on their baby moons are in for a terrible shock when they return to their homes.

Some of these rules and regulations are based on actual good advice, but they've been so that there is no real meaning left to them. Eating plantains is on the list of no-nos which is strange since plantains are a staple in the Dominican diet; however, plantains can cause constipation which is not something that you want to exacerbate during pregnancy. The rule makes sense, but when someone is yelling at you to stop eating plantains because OMG YOU'RE GOING TO HURT THE FETUS is just obnoxious and makes me want to eat more plantains.

I also teach (have taught?) pre-natal education classes - and while I really love doing that, sometimes I get so frustrated that I think my head might explode. There are DOCTORS telling (healthy, pregnant) women to refrain from normal, everyday activity because... well, I don't really know why.
I also went to the beach at about six months pregnant. I even
went in the water. No pictures of me in a bathing suit, but
these two cuties can make up for that.

Here is a (non-exhaustive) list of some of things I was told during my pregnancy.
*I'm marking with a star the things that are also old wive's tales that I've heard from North Americans as well. 
** A double star for things are based in fact

- You cannot swim in the ocean because the movement of the ocean can cause miscarriage.
- You cannot squat down (aplastarse in good Dominican-spanish) because the baby might fall out.
- You also should not bend over.
- You cannot exercise (aerobics or lifting) because it can harm baby


- You must not go out on "chilly" nights
- You must not carry anything over 2 pounds. **
- Foods to avoid: bananas and guanabana (soursop), will give (in-utero) baby "mucous" in lungs; plantains (cause constipation); fruits in general (will give mom  gestational diabetes); soda (will cause kidney problems** but coffee is okay)
- You need to give a pregnant woman all of her cravings or baby will be born with birthmark resembling said craving *
- Baby bellies are shaped differently depending on the sex of the baby *

It is interesting to note that in the United States, one of the beliefs for inducing labor is to go for a bumpy car ride. Here, it is not abnormal to see pregnant women on the backs of motorbikes until the very end of pregnancy (and motorbike rides are almost always bumpy!).

There are many, many benefits to being pregnant in the Dominican Republic (another post), but it's not for the faint of heart or the fast-tongued. It took me three pregnancies to learn to ignore snide comments on the street - and now, with a newborn I have to listen to a whole different stream of consciousness-baby-raising-advice.

What old wive's tales have you heard for pregnancy?

Tuesday, September 9, 2014

welcome.

It's been awhile since I last blogged.

This time I have a great excuse.

Presenting to you, blog readers,

ADIEL.
Our new son. Born 25 August 2014 at 8:35am.
Weighing in at a whopping 9 pounds and measuring 23 inches long.


There are plenty of pregnancy and newborn anecdotes to share. But we'll get to that soon. I am recuperating from a c-section and getting into a routine with two kids and a baby! I do have three months of maternity leave to enjoy this.

Thursday, July 10, 2014

break-bone fever, bent-back fever and malaria, oh-my!

When I first came to the DR ten years ago, I was given a course in tropical diseases - it was a general "going-overseas" course, so a lot of the diseases we learned about didn't even really apply to my part of the world, and really, THANK YOU WORLD. Some of those things - worms that bore through the heels of your feet and end up in your blood stream, scorpions that sting, snakes that bite - are enough to give the most seasoned outdoorsmen nightmares.

The Dominican Republic doesn't even have a malaria problem (though occasionally you'll hear of malaria in Haiti). As far as mosquito-borne illnesses go, malaria was the scariest for me. Afterall, I had recently read The Poisonwood Bible.

I have since learned that malaria is not nearly the most painful or even the most widespread of mosquito-borne illnesses. 

Dengue Fever - often referred to as break-bone fever - is common in the DR. It is transmitted by a special, of course, type of mosquito and everyone once in awhile the country's emergency rooms fill up with infected humans. It is marked by high fevers, diarrhea and vomitting and an intense pain in the joints and bones. There is no treatment, and is often deadly - especially for small children and the elderly. 

Doesn't sound terrible, right? Some fevers, dehydration, and in the end you (probably) live? Perfect.
Except you can't take pain killers stronger than tylenol, and the only other relief is simple re-hydration by IV. And the pain can last for days and days. 

Dengue hasn't reared it's ugly head recently - at least not in epidemic status.
No, in fact, I haven't heard one story of dengue for months, but mostly that's because a new disease arrived in town about two months ago.

Chikungunya Fever.
Lovingly referred to in Africa as bent-back fever because the pain is so strong it forces your back to hunch over. Bent-over. 

Same mosquito, different disease. Pleasant.
Not as deadly, apparently, as dengue fever, but far more uncomfortable - high fever, vomitting and diarrhea, intense pain in the joints and bones and, for added drama, a bright red rash that covers the body. 

We're not really sure if it's run through our house yet, but I'm going to bet on no. We all got some intense fevers, and I was pretty uncomfortable - but no rash, no intense bone pain. Amely, we think, had strep throat and so I'm sure that's also probably what Samil had. I probably just had pregnancy-whiny-ness. Katherine, Amalio's cousin, was down for the count for three days, but also didn't have the bone-pain. Amalio, of course, was left unscathed.

The gross-ness did make it's way through school - our attendance dove into the ground in June. I had parents in the office, waiting in line to tell me that their kid was sick. And our cook, our has-never-missed-a-day cook was out for three days because she literally could not put her feet on the ground to get out of bed. 

Earlier this week, a friend called to tell me that her two month old son had the chikungunya and could I recommend an ER? (Hi, Janet!) I recommended the ER I always use. I told her that I don't really buy into any of the pediatricians there, but we've always had a decent experience (with the exception of Amely's chicken-pox visit) with the doctors in this particular one - and as an added benefit, it's just busy enough to inspire confidence but not so busy to frustrate. 

I have never waited in this particular ER. ever.
I swung by on my way home from work, to check on her and the baby because medical care can be overwhelming here. I imagined she was on a bed, getting checked or waiting to get checked. She was standing in the triage area, with a thermometer under baby's arm because there was no where else to go. There were at least 25 people waiting in line - even pregnant women were waiting in line (unheard of for preggos to wait in ANY line in this country) because there were just so many people.

She was sent home with the indication to hydrate and continue acetometophen treatment. There's not really much else to do. 

I'm hoping to avoid being a statistic this time around - it's predicted the 85% of the island will be infected, and that it will be a worldwide epidemic, not limited to tropical regions. It's worse for newborns and the elderly. If you're traveling to the Caribbean, make sure to bring mosquito repellant and apply liberally to avoid bites. The specific "breed" of mosquito is more likely to bite during the day (instead of at dawn and dusk like "normal" mosquitos) and looks different than the mosquitos that most non-tropic-natives are used to (a little bigger, front legs are higher than hind legs, and are striped like a tiger). DO NOT take any pain medication except acetometophen (I don't know how to spell that), because Advil and others can make it worse. And, if you do get sick, hydrate, hydrate, hydrate!

Tuesday, July 8, 2014

never a dull moment.

On Sunday, I took the kids to the beach with our friends, The Rousculps.

The nearest beach is only about an hour from our house, and I'm very sad to tell you that we do not visit there often enough. It is a beautiful, Caribbean beach with waters as azul as the sky, and as warm as ocean water should be. The beach sand is white and soft. And.

And we can go there in January. Or March. Or really whenever.
But we don't.
Because we apparently do not know how to take advantage of what we've got.

Nevertheless, on Sunday, we went.

The water was beautiful, the sun was out. And, of course...

thank god it's not a baby! just a dead puffer-fish!
Josh wrestled with a barracuda. At first, he thought one of the kids had rammed into his leg, but when that "kid" bit into his trunks and tried to steal them, he put his hand down and felt a long, sleek fish that was pretty big.

Rebecca and I made friends with a sweet little girl, no older than 18 months who just wanted to eat our cookies.

And then! a dead puffer fish appeared in the water, and it was like a scene out of Dominican Baywatch -- you know, the slow motion of the entire beach running toward the lifeguards pulling a drowner out of the water onto the beach -- the entire population of the beach ran toward the brave swimmers carrying a dead fish out of the ocean, including a woman who dramatically dropped to her knees and praised God when she realized that it wasn't a drowned-child.

Overall, it was a great day. Just enough drama to keep it interesting and just enough energy to knock the kids out on the way home! (well, just the boys - Zora and Amely were all about their fantasy land).

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On the way home, we pulled over to a road-side fruit stand and Josh got 5 avocadoes and a bucket of mangoes for less than three dollars. And that bucket of mangoes has SIXTEEN mangoes in it.


Friday, July 4, 2014

on reading.

Volunteer Anne Pelsser read to students
three times a week for an entire semester.
We miss you Anne (and Pierre!)
I've said - quite frequently and to anyone who would listen - that most of the problems that we've dealt with in starting and running a school are not the problems that I foresaw. I expected irresponsibility with payments, lack of concern from parents and maybe some teacher truancy and attendance issues. There are some inherent problems due to the demographic that the school serves, but overall, I guess I expected some semblance of teacher preparation and training - after all, all but one of our teachers (the 3-year old class teacher) are trained, professional educators.

I've known that there is a deeply entrenched literacy poverty in the Dominican Republic - even among the upper class - that affects how our children think and learn. There are no public libraries and most schools - again, even in the fancy private school - are lacking books. Sure, there are text books, but there is a deficiency in any other type of text: few story books, few non-fiction books, few encyclopedias.

What comes with this lack of actual physical reading resources is a lack of understanding of the real, profound importance of teaching kids not just to sound out words, but how to actually read - to comprehend, to question, to analyze the words that are on the page. But, how does one even go about switching something so ingrained culturally?

Samil was in first grade this year. He fought learning to read - he dug his heels in and absolutely refused to practice. Homework was a dreaded task - for everyone involved. The "reading" that was happening was phonetic, and from what I could decipher consisted in sounding out long lists of words.

No sentences. No pictures to describe sentences. No stories.
Lists and lists of words.

As far as technical reading goes, the method works. The student learns basic phonetic combinations of consonants and vowels (ma, me, mi, mo, mu), and then combines those sounds into simple words, building upon the previous sounds learned.

What happens when the student has to not only decode words, but decipher meaning in sentences? Or read a story and figure out the meaning?
Learning the phonetic sounds using scoops of ice-cream!

It's tragic.

One of the first teachers who worked at school - teaching three year olds - told me that she didn't have time to read stories to her students. That she needed to be focusing on far more important skills, like making sure everyone was sitting at the right table. Another told me that, after reading one story book, she just didn't have time for something the students aren't interested in. She taught four year olds.

Loving reading is an acquired skill. Loving stories is, too.
Unfortunately, there just hasn't been an emphasis on reading as a means to better educational quality. It is so hard to incorporate simple reading into the curriculum because neither the parents nor the teachers understand the importance. Sadly, I don't think this is a Dominican Republic problem. I think we're taking the joy out of reading for most kids - be it for lack of exposure, or for forcing test-based-reading, or for just not providing quality texts.
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There are some awesome organizations on the island that are working hard to enhance the culture of reading for our kids. Check them out:

Amely loves reading story books!
FUNDEBIBO - is an organization that works to train librarians and other "resource-arians" and to promote literacy in the Dominican Republic. Based in Santo Domingo.

Lleva un libro en la maleta - is a grassroots movement to motivate people to bring a book, many books and/or school supplies with them in their suitcase when they visit the island and then donate them to schools that need them.

Fundacion Mahatma Gandhi  - is located in Las Terrenas - a beautiful beach town on the Samana peninsula and offers library services with more than 7000 books to the community.

Biblioteca Comunitaria Dr. William House is, of course, my favorite literacy program on the island. Located in San Francisco de Macoris, the library offers programs ranging from story time to English classes to art hour.