Tuesday, November 27, 2007

newborn vaccines #2

*05/16/08 UPDATE* I've since written several new posts about Thumper's vaccination schedule and well as new thoughts on what I want to get. Please see the newer posts if you want to see the final schedule I came up with.

I finally finished my research on vaccines. And here's what I found and what we might do. Will write up on what actually happens after our ped appointment today.

First, I highly recommend The Vaccine Book by Dr Bob Sears. He goes through all the vaccines one by one, tells you what each one treats, how prevalent it is, the ingredients, pros and cons of each vaccine, travel considerations, and lastly, his take on the vaccine. He also gives an alternative schedule, discusses all the concerns about the vaccine, and some Q&A.

My second source of info was the CDC Vaccination Schedule The nice thing about this site is that it gives the vaccination schedule for your whole life and also lists, on its footnotes, more detailed info about each vaccine like minimum age given.

Basically, for first 6 months, there are these vaccines:
  • Rotavirus
  • HIB
  • Pc
  • Polio
  • DTaP
  • Hep B
And the schedule as recommended by CDC is as follows:
  • Birth: Hep B
  • 1 month: Hep B
  • 2 months: Rota, DTaP, HIB, Pc, Polio
  • 4 months: Rota, DTaP, HIB, Pc, Polio
  • 6 months: Rota, DTaP, HIB, Pc, Hep B
The schedule after 6 months is kind of varied. It could be:
  • 12 months: MMR, chickenpox
  • 15 months: Pc, HIB, DTaP
  • 12 - 24 months: Hep A
Here's what I found out about vaccines
  • Some diseases (HIB, Pc, Rota) really only most commonly to kids under age 2, with most severe reactions under the age of 1. It can go up to age 5. But that's about it.
  • You're bound to catch the Rotavirus. It's a matter of when, not if
  • Your likelyhood of catching some of these diseases or have more severe forms of it is lower if you breastfeed for more than 1 year (Dr Sears recommended 2!), and you don't go to Daycare. I think this is especially true of Rota and Pc
  • You can stop a series and start it up again w/o redoing the whole series of shots.
  • You CAN delay shots, sometimes this means you don't have to get as many. You cannot do that with the Rotavirus vaccine though.
  • Vaccines have a bunch of weird stuff in it that some parents may be opposed to. The big ones are mercury, alumninum, and animal parts.
  • Polio, HIB aren't that prevalent any more.
  • These vaccines are really only good for childhood, where it'll cause the most problems. That's why you have to get booster shots as teenagers and adults.
  • DTaP, HIB, Hep B have multiple vendors, with aluminum levels ranging from 0 to pretty high.
  • If you delay vaccines, you could lower the number of shots you take! You would just have to weigh that against the time of likelihood occurance.
Since mercury is no longer in all vaccines, except for flu shots, Dr Sears didn't talk about it much. He spent a lot of time talking about aluminum. There is some evidence that aluminum causes neurological damage to premies. And the government limits aluminum to 25 micrograms in IVs. Part of the reason it's now showing up as a concern is that we now have more vaccinations. It used to be just DTaP that had aluminum. But we've since added the Hep B, Pc, HPV, and HIB vaccines.

Here's what I decided.

This is based on the fact that we'll be traveling next year, and we may travel to Taiwan in the future. Plus the fact that I'll breastfeed as long as I can and that Thumper won't be in daycare till she's 10 months at the earliest. My 3 goals were to delay shots if possible, get the ones w/ least aluminum, and only get the ones that are really necessary.

For sure we'll get DTaP & Polio today. We really don't need polio because it's considered wiped out but since it has no aluminum and who knows what weird countries we'll travel to when she's young, might as well get it. DTaP is important for the P part, which is whooping cough. It's still pretty prevalent, and you can't just get a single P shot, it's always a combination shot.

We will definitely get Hep B because Taiwan is endemic. Otherwise it's a disease that doesn't occur till teenage years in the US. (Since mostly sexually transmitted here). Though kids do bite and can transmit that. I will ask about getting a combo shot of Hep B + HIB since same amount of aluminum in the combo shot. So might as well get the HIB one, even if it's rare now. For this one, since I won't go to Taiwan for awhile, I'll ask about delaying the shots till past 6 months. This way she'll only need 3 HIB shots instead of 4!

When I asked my pediatrician about the Rotavirus, Pc, and HIB, I was told that Rotavirus is one of the newer ones and if there is one I want to skip, that would be the one. Rotavirus is pretty new. There was a problem w/ the last one a few years ago in causing your intestines to twist in weird ways.

It's important to note my peds have no problems w/ no vaccines. The pediatrician said she hasn't seen HIB ever since she practiced medicine though has seen Pc. Combined with the fact that Pc strains are more likely to be resistant to antibiotics AND those ones are coming out of Asia, where I will be traveling, I think I will be getting the Pc but passing on the Rotavirus. I don't want the baby to get Pc and then needing to go to hospital and having IVs and who knows what other medicine pumped into her.

I didn't even research the vaccines you get AFTER 1st year, like chickenpox and MMR. I'll leave that worrying for another day!

Tuesday, November 20, 2007

College Savings Funds

My friends and family laugh at me because I've already started lil' Thumper's college fund. There are basically a few ways you can save for college.

  • Coverdell
  • 529 College Savings Accounts
  • US Government Savings bonds
  • Regular investments
All the contributions are with after-tax money. The first 3 are all tax free if you use it for education.

The Coverdell has a limit of $2000 a year per child. You can use it for any type of education, including K-12 school. You open an account w/ a bank or brokerage that offers this type of account. You can then invest the money however you like.

The 529 College Savings accounts are only for college. They are offered and managed by individual states. There are bigger contribution limits. There are basically two types of 529 plans: College Savings and Prepaid Tuition. One good website I found for the 529 plan is My Money Blog. Do a search on 529 on his website. He talks about the different state offerings and what he chose.

If you have a US Savings Bond, such as an I Bond, you can cash it and use it toward tuition without paying taxes on the interest you earned on the bond.

Lastly, you can always just set up some sort of investment yourself and use it to pay for college. There are no contribution limits of course on having your own investments. You just don't get preferential tax treatment. There's also something called UTMA/UGMA, which allows you to "gift" money to your child and held it in his/her name. Though this probably isn't great because minor's is expected to contribute a bigger percentage of their asset to their college tuition.

Keep in mind also that each of these types of investments have different withdrawal penalties and rules.

I went with the Coverdell account for a few reasons:
1. I did not want to have someone manage my investments
2. I did not want to open up a Prepaid Tuition 529 account.
3. I liked the fact that I could foreseeably withdraw the money for private k-12 tuition if I ever decide to go that route.

Given the flexibility of Coverdell account, and the fact that I can only afford $2000/year contribution right now, I went with Coverdell. If I ever have more money to save, I'd probably open up a 529 account then.

Lastly, remember that you need to save for your own retirement first before you save for your kids' education. They're young, they can afford to be poor at that age, they can work, and there is always financial aid or scholarships. Since you can't count on your kids funding your retirement, you gotta do it yourself first.

Sunday, November 18, 2007

pregnancy books and classes

These are the books I read during my pregnancy. I found that taking classes (later in the post) was actually better because I could not remember half of what I read, and it was also hard finding time to read all these books in addition to leading a life! And in hindsight, I spent too much time reading pregnancy books and not enough on childcare books!

Many people do not like the What to Expect book because it's full of doom and gloom. I personally liked it as I'm a pragmatic worry wort and reading up on symptoms I have puts me at ease. Because I know, logically, that the 1/1000 chance of xxx happening to me is actually remote.

The Girlfriend's Guide isn't necessarily full of detailed information, but it's great for the emotional support.

I liked the Mayo Clinic book because it gives you baby's growth info week by week.

I also really liked Dr Sears Pregnancy book. It's written in a very clear and yet simple format. This is the book to read, not for the facts about baby developement, but for more detailed info on what to eat, what exercises to do, how to deal w/ labor, etc. Dr Sears leans towards natural childbirth. But the book listed some of the symptoms I was experiencing (esp last trimester) that I could not really find in the other books.

The Happiest Baby on the Block book is written by Harvey Karp, a pediatrician in LA. He teaches you about the 5 S's which will help shush your baby up. Definitely helpful for baby's first 3 months.


In terms of classes to take, I highly recommend the Childbirth class ($125) offered by your hospital. Of course, you may want to ask your OBGYN/midwife if they've heard good things about the class. Usually there are other places that offer childbirth classes as well. But I found that the great thing about hospital one is that you get an idea of how the hospital operates and how it will affect your birth.

In general, childbirth classes are good. There's something about receiving information from an instructor, and watching video, that beats just reading books. The visuals really help in remembering what you're supposed to know. We also had a really good instructor who gave me info that weren't in books. Another great reason to take this class is that you get to share your experiences with other expecting mothers.

I also took the Childcare class offered by my hospital ($90), which included breastfeeding info about 2 months before my due date. While it was hands on (we practiced burping and swaddling on a fake baby), I forgot all about what I learned after the baby was born! So unless you have a really great memory, you may want to skip this class and rely on the expertise of your relatives/nurses who are going to come and help you after you give birth. OR, take the class as late as you can. Maybe 1 month before your due date instead of 2, like I did. However, you may be taking your chances here because lots of people nowadays give birth before the 40th week.

The third class I took was Infant CPR. This is a non-certified CPR course that focused only on Infant CPR. I took it before the baby was born and of course I kind of forgot most of it already. But it'll probably be harder for you to take it after the baby is born because you'll be too busy.

Friday, November 16, 2007

newborn vaccines

It's almost time for Lil Thumper's first set of vaccines, which means a lot of hours in front of the computer researching vaccines. I'd heard w/ half a ear over the years about mercury in vaccines so I thought I'd read up on all the controversy.

Basically, there's one camp which believes that vaccines (and the mercury in them) is what causes autism. There's another camp (namely the government) which says that there is no link. Each one has studies and research to back up their claim as well as reasons why the other side's research is faulty.

I personally never quite believe it when there's controversy and the government says things are "safe". I think history is full of examples where we were told things are safe (e.g., DDT, some of the original birth control pills), only to discover they aren't years later. By then, the damage has been done and the general population was the guinea pig.

On the other hand, I'm not quite sure I believe the link between autism and vaccines either. Some people say that autism is usually diagnosed around the same time the MMR vaccine is given. Therefore it's coincidence. The good thing is that mercury is no longer in vaccines. But did you know that other preservatives such as aluminum and formaldehyde are?

After reading all about the different sides, I've concluded that I DON'T KNOW if mercury is bad, or even if aluminum is bad. So I've bought Dr Bob Sears
Vaccine book
, which just came out. I shall report dutifully as I learn more.

For now, I'm leaning towards limited vaccines, in single dosage if possible, with a delayed schedule. I don't have proof, but it doesn't sound too good to be bombarding your baby w/ these metals and preservatives when they're so young. The number of recommended vaccines is much more than when we were kids. And some of them may not be necessary. For example, did you know that Hep B is usually a sexually transmitted disease? And the vaccine may wear out by the time they're sexually active? Why get it so young then? (I'm getting that because we may travel to Asia and there's a high percentage of HepB there).

I'm also getting the feeling that the reason that the vaccine schedule is such is because they want the babies to be immune to these diseases as soon as possible. But, if your baby never goes to childcare, and doesn't really interact w/ other kids, then I don't think it's as important. I won't go the route of NO vaccine. I think it's good citizenship to make sure your child is vaccinated. But maybe not at such an intense schedule.

Just in case.

Thursday, November 15, 2007

baby shopping list.

There are a gazillion lists out there on what to get, but a lot of them did not have brand names or quantity. So here's my list. There were a few criteria before I really bought them:
  • If possible, get it as donation or as gifts. Other than car seats, most of the stuff you probably don't have to buy yourself.
  • Don't buy things that will last only a few months. A lot of the "stuff" will make your life easier. For example, a boppy pillow. But I didn't want to buy things that only lasts 3 months.
  • Don't buy things when existing products can be used as a substitute.
  • Wait to buy some of the stuff. Every baby is different. And some stuff you think you need, you probably won't end up needing. And other things you won't really know exactly what features you want till you have that baby.
  • If you're going to put off buying some of the things, be sure to do your research while pregnant and decide on what you want. The first few weeks are so hectic you're not going to have time to decide which brand/model is the best.

It was easy deciding on the big stuff, like car seat. But I was very confused on what I needed to get to dress thumper as well as all the little stuff. Then there is the "how many of xxx do I need to get?" My philosophy is less is better as then I don't have to pack when I move. On top of that, babies outgrow things so quickly. I'm willing to spend big money to get the best car seat for example, but a changing table or "My Breast Friend?", I didn't get those.

In any case, here's my list. Keep in mind that we are doing laundry about every 4-5 days, and we hand wash some of these things to keep up w/ demand.

What we got
1. Britax Marathon Car Seat. ($270)
Britax is supposedly the best brand for car seats. The other choice was their Decathelon model, which will be great for newborns as it has a little newborn insert. But my friend gave me her infant car seat. I'm glad that I'm not getting the Decathelon because even the infant car seat was too big and I ended up using blankets around the baby's head as padding.

2. 20 white bibs from Babies R Us.
Get the plain cotton ones as they absorb well. Forget the ones with cute raised figures on them. They're terrible at absorbing anything. We eventually got 3 Circo ones from grandma that was 100% cotton on the front w/. They had drawings but it was printed on so it soaked up well too. Not as well as the white ones though.

3. Gerber 6 triple ply clothe diapers from Target
These make great burp clothes. They doubled as bibs in the first 2 weeks.

4. Cotton balls & vaseline
Great for preventing diaper rashes.

5. 1 pack of size N diapers (pampers)
No need to get more than 1 pack unless you're REALLY sure of your baby's weight. Once you're sure, you can buy the jumbo pack. Babies supposedly poop and pee 6-8 times a day. Figure you'll use more than that because they will poop right after you changed them just to spite you.

Size N goes up to 10 pounds. Size 1 is 8-14 pounds. The difference is in absorbency as well as width.

We started w/ Pampers. In terms of pricing, I've heard that Pampers is the most expensive, followed by Huggies. After having to change diapers 3 times in 10 minutes, we switched to Target brand. Target brand is about 1/2 the cost of Pampers. Not as good absorption, but hey, if you're changing diapers constantly instead of letting it sit, then it really doesn't matter. I've never had a leak with our Target diapers. Costco also sells Huggies in huge packages. I've heard that the worst place to buy diapers are grocery stores.

6. 6 Swaddling blanket. (free!)
Take as many from the hospital as you can. They have lots at the delivery room (but not the recovery!) Or try to get the ones that are 36x36. The cheapy, cute, thin, flannel 30x30 ones in stores really aren't as good. Given the amount of spit-up you can get, we actually change them once a day.

7. Baby clothes.
Try and get donations. And you know that everyone will buy you something. I got really confused by all the terms. What is a layette? Or onesie? Or sleeper? Essentially, since the baby will be sleeping a lot, you really just need a one piece clothing (onesie) that covers their diaper , plus a whole body suit (sleeper). Get the ones where you DON'T have to pull over their head, it's SO much easier! If it's summer, you can get short sleeve onesies, long sleeve for winter.

I've seen lots of other babies since Thumper was born wearing lovely outfits. Whenever I see them, I kind of wish that I had dressed her in nice outfits. But really, they're so expensive and I'm such a lazy person, Thumper was basically in her sleeper the first 3 months. And we changed that about once every 2 days if she did not goop on them.

Assume you'll go through one set a day (onesie bottom, sleeper top), get as many as you think will last you till laundry day.

What about mittens? "Experts" recommend not covering them in mittens as it helps development for them to be able to touch and feel things. A lot of the long sleeve clothes also come with built-in mittens.

8. Ergo Baby Carrier ($100)
You can get the infant insert or else you can't use it till the baby is 15-25 pounds?

An alternative is the Baby Bjorn. Though I've heard that the Bjorn places a strain the baby's spine because of the way they sit. See here

9. Playpen with changing table but no music. ($85)
Get a solid color one if you can as babies get distracted by really colorful ones. The changing table definitely came in handy. The baby slept in it the first few weeks while I was recovering from c-section and couldn't bend down easily. (I don't see how SIDS can come in play here as she was all bundled and slept a lot in the beginning anyway) There's really no need for the music if you don't believe in putting baby to sleep w/ music anyway. This is acting as our crib for now so we don't have to buy a crib AND a bassinet.

In reality, the baby may end up sleeping in a stroller, or bouncy chair, or in your bed so there is no need to get really expensive stuff or getting the whole set in the beginning. You just don't know what will actually happen once he/she comes home. Most of the mothers in my mom's group said that their babies ended up sleeping w/ them in their bed, and that never used the crib they got.

Other options are: crib, snuggli (a little box which you put in your bed for baby to sleep in), bassinet, co-sleeping.

10. Madela breast shield & lanolin
You will go through the breast shields quickly. Get the higher priced Madela breast shield instead of Gerber. The Gerber one did not absorb at all. Lanolin is for your sore nipples.

11. 1-2 Wash clothes

12. Bathtub & little sitting stools.
I got a little tub that will fit into the bathtub, as well as 2 really short sitting stools. This way, I can sit in the tub and wash the baby. It's not necessarily comfortable in the first few months as you have to be the one holding the baby's head while you wash them. But they grow so fast I was not willing to buy those infant tubs that will last just a few months. This one will last a few years.

13. 3 8 oz Evenflo glass bottle. ($5-$6) and bottle brush.
Newborns drink 2-4 oz. Why bother getting the 4 oz when they will outgrow it? You are only supposed to feed them once every 24 hours in the first 2-4 weeks anyway in order to avoid nipple confusion. With all the scary news about plastic, I decided on glass bottles instead. It's pretty easy to heat up if you have a thermo. Pop the bottle into a ceramic cup filled 1/4 w/ hot water from the thermo and wait 5 minutes. Be sure to shake the bottle periodically so it'll warm up faster.

I've also seen bottles where the nipple and bottle is connected by a tube. This way, you don't have to hold the bottle in order to feed them. They can just suck on the nipple.

14. 2 changing table liner (cotton with vinyl insides) and a pack of chucks.
Chucks are these disposable pads that are used in the hospital. They're great when the baby decides to poop right when you're reaching for that new diaper! We use the changing pads normally and the chucks when the pads are in the laundry basket. You can get chucks in the adult diaper area in any drugstore.

15. Baby soap
We got a bunch of these as gifts but we actually havn't used any. Babies don't really need soap anyway, or daily baths for that matter. Just need their smelly grimy hands, face, and butt wiped if you don't give them baths.

16. Q-tips & nail clippers
Great for picking out snot. Babies have no nose hair and they seem to make boogers pretty fast. Though I've also used my fingers as they are quicker and do the job better sometimes.

17. Breastpump ($35-$200)
The Madela manual pump is pretty cheap. Great if you're planning to do only occasional pumping. Otherwise, you may want to invest in an electric pump. Here's a good article on which pump to get.

If you're concerned w/ BPA, then Madela's the brand for you as their products have no BPA in them.

18. Pacifier(s)
There are so many different kinds to choose from. We got one from the hospital, 2 donated new, and 2 long silicon kind from Target. Everyone says that you just have to find the ones that the baby will suck on. I found that the baby didn't like any of them (they're all different shapes) in the beginning. And still she'd only take it if she was about to fall asleep or was hungry. Even then, we had to semi-force it. But after 3-4 weeks, she will take any of them now.

One tip we learned was that instead of forcing the binkie, try inserting and then pretending to take it out. Their reflex will make them suck on it harder. However, this did not really work on the newborn. It works now that she's a few weeks old.

19. 7 Nursing bras
Around the 5th month, you may notice that you need new bras. You can get a bunch, or just a few like I did. Because around the last month or two, your breast will grow again. I hear that for some people, they go up a size after giving birth as well. So you may want to wait to buy a lot till later. They do sell these bra expanders for when you go up a size (not in cup but chest)

Thank goodness that did not happen to me. I did only buy 3 during my 5th month. Then after I gave birth, I determined that I wasn't going to get any bigger and then bought a whole bunch more of the same model. You will go through them quickly if you don't wear your breast shields. :D

There are lots of bras to choose from. As a lazy person who doesn't go out much, I got just the night nursing bras from Motherhood. Which are all cotton with no underwire. Motherhood has a no-return policy on bras, yet another reason I was careful w/ my purchase.

20. Boppy Noggin Nest pillow ($10)
Supposedly to prevent flat head. But because of SIDS, you actually can only put it in a stroller and maybe carseat? Basically surfaces that are semi-upright. On top of that, the baby likes to sleep w/ her head to the side and cried w/ the pillow under her as she couldn't turn. It was pretty useless.

What we didn't get
1. Stroller. (might buy a McLaren one later)

2. Changing table. It came already w/ the playpen. You can change the baby anywhere anyway as long as you have something underneath. As a lazy person, I've gradually moved on to changing the baby wherever she's laying, the floor, the bed, the playpen, wherever.

3. Thermometer & snot sucker. The hospital gives this to you.

Be smart and ask for things at the hospital. I got a tiny tube of lanolin from the hospital and didn't even finish using that one. Didn't open up the big tube I bought from Target at all. And if I'd known, I would have asked for a hospital grade breast pump. Those accessories for the pump are $50! I could have totally used them for my own breast pump.

4. Sling. ($50-$100)
If you believe in attachment parenting, or need to have a life other than baby the first 3 months, a sling is probably really useful. I didn't get it because I'm home all day w/ the baby and I don't run any errands personally. :D I just didn't feel like the cost was justified for a long piece of cloth!

Some of name brand slings I've heard about are: Moby Wrap and Maya Wrap

5. Boppy pillow. This is a pillow you put around your waist to help you breast feed. We use an existing firm pillow instead. You might also want a few firm throw pillows. They make great cushions for your arms when you're holding the baby upright.

What we bought but didn't need
1. dozen wash clothes.
I'm sure this will be useful later. But really, we only need 1 to wash the baby. And since no soap, no need to put it in the laundry except once a week.

Other things you may want (I didn't get)
1. Rocking chair
Good place for feeding. Though I much prefer our futon as there's more space to sprawl out.

2. Fisher Price Ocean Wonders Aquarium Swing. ($100)
You want the swing that swings side to side instead of front to back. They only last a few months though. Definitely helps putting the baby to sleep. Though Weissbluth of "Healthy Sleep Habits, Happy Child" cautions against leaving the swing on as he thinks motionless sleep is better sleep.

3. Breastfeeding covers.
They're usually called hooter hider. Great if you need to breastfeed outside. It's a piece of cloth w/ a round wire on top so that you can peek in and see how your baby is doing as you're feeding. I have no problems just hiking up my shirt and if really necessary using the pretty receiving blanket we got as a gift to cover myself, or a jacket....