Thursday 31 May 2012

Biting the Bullet on Vaccines

*Please note that this is no substitute for medical advice given by a board certified doctor of your particular case. This post is for informational purposes only.

My readings and my husband’s usually don’t mix.  So I was a tad surprised when he emailed me a link to The Economist.  The article talks about the trend away on vaccines and how some states in the US are now below the herd-immunity level, posing a risk to public health.  I have been meaning to write about vaccination for sometime now but honestly, I don’t know where to start.  Embarking on a discourse about it is a daunting task and entirely overwhelming.
It seems that there is a great divide between the conformist – those who religiously follow pediatrician recommended vaccines, and the nonconformist, or perceived ‘rebels’ who home-school their children so they can get away with mandated vaccines.  Both sides make convincing and valid points, which make it all the more difficult for parents like me who wish to make an informed decision.
The skepticism with vaccination has been around for awhile especially in the circles of naturalists to organic-yoga enthusiasts but it received international limelight when Jenny McCarthy guested in Oprah Show a few years back (which I have seen).  She vehemently claimed her once bubbly son suddenly withdrew and eventually developed autism, days after his MMR (measles, mumps and rubella) shot.  This claim is supported mainly from a study by Dr. Wakefield which was published in the British medical journal “The Lancet”.  However, this was entirely discredited and Dr. Wakefield censured.  Scientific studies consistently conclude otherwise and the medical community has since rallied against this unfounded link. 
On the other hand, I have read heartbreaking stories from parents whose babies changed dramatically after receiving the shots.  There is still that small percentage of a severe reaction, enough to make a parent think twice.  Furthermore, knowing what goes into these shots can make anyone totally against it.  Take for example vitamin K shot which is given immediately after birth.  It contains castor oil- Phenol (carbolic acid – a poisonous substance derived from coal tar), Benzyl alcohol (preservative), Propylene glycol (better known as antifreeze and a hydraulic in brake fluid), to name a few.  As an adult, I wouldn’t even want any of these inside my body!  
Looking back, I definitely regretted agreeing to vitamin K shot for both Ava and Ally, which was given right after birth. I was too focused on giving natural birth that I missed this one in my birth plan.  Same goes for Hepatitis B shot.  What are the chances that my newborns will get it when they were both exclusively breastfed and I don’t have Hepatitis B and neither anyone in our household.  That could have waited 6 months later or so.  The liver of a newborn does not begin to function until 3 or 4 days after birth. As a result, this little being has very limited to no ability to detoxify the large dose of synthetic vitamin K and all other dangerous ingredients in the injection buffet.
In any case, parents have to make the tough decision whether to forego or go for vaccination.  At the end of the day, if I had to pick my poison, I’d go for the one I can contend with.  As much as I feel guilty for allowing chemical junks inside their little bodies and gets all nervous every after shots, I am equally aware of the diseases that are debilitating and fatal.  It was only half a century ago that babies and children have been maimed or have died from polio, tetanus, diphtheria or measles.  The risk of getting the disease is still higher than a possible adverse effect from vaccines.  
Having said that, it is not a ‘take it or leave it’ approach.  I am very lucky that we have a pediatrician who understands and validates my concerns and is willing to work with me (I have heard stories of parents who have been shunned away after refusing vaccination for their kids).  We have taken steps to allay fears and risks.  
For the most part, I have delayed their shots from recommended timetable.  Although doctors see no difference in doing so and actually leave infants vulnerable to diseases longer, it makes complete common sense to me (as well as the psychological comfort it provides).  The older they get, livers function better and body mass bigger in accepting these foreign and potentially harmful substances.  
Secondly, we try to separate shots as much as possible.  Again, some doctors say combined shots contain weakened viruses at different incubation periods and will not invade the body at the same time.  However, I agree with the rationale that one never knows how the little body reacts to the vaccine.  If it doesn’t take it too well the first round, another wave of virus comes in, overwhelming the body.  Separate shots (taken at least a month apart as recommended by our pediatrician) is just gentler to the body.  It doesn’t need scientific evidence to make sense.
Lastly, we simply avoided vaccines that are truly unnecessary and not mandated to start with.  It was our pediatrician who suggested Ava can forego rotavirus (since he reckon we live in a first world country where food and sanitation are closely monitored) and because I was actively breastfeeding her (chances of severe diarrhea from happening is slim).  Rotavirus has been pulled out from the market before after a number of hospitalization cases for intussusception (one part of intestine slides inside the other).  
Also, we don’t get flu shots.  The flu shot is the only one of the many vaccines given to young children that has more than a trace amount of thimerosal, a preservative that contains mercury, which can be poisonous in high concentrations.  While there's a preservative-free version of the flu shot on the market, it's not widely available yet. Research indicates that an inhaled version of the flu shot, FluMist - which doesn't contain thimerosal, is safe for babies and may be more effective than the shot. However, the findings are so new that the US Food and Drug Administration hasn't yet approved FluMist for children under the age of 5.
Currently, I am still deliberating if I’d go for the varicella (chickenpox) shot for Ava.  It is one of those shots that I have requested to be separated - from the usual MMRV.  I have come across journals from American Academy of Pediatrics and even from Center for Disease Control that those who receive MMRV are twice as likely to have febrile seizures—fever and shaking—7 to 10 days after the vaccine than children who receive MMR and a separate varicella vaccine.  Recently, AAP stated that MMRV is generally preferred over MMR and varicella for first dose in children 48 months or older.  Anyway, with regards to varicella, we belong to the generation where it was normal to get it.  In fact, some countries like Germany, holds chickenpox kids party so everyone has them at the same time (albeit criticisms for morality issues).  The good news is, those who got it will be assured they won’t get it again versus vaccinated children who are not 100% out of the woods yet.
I have spent sleepless nights especially prior to every vaccine appointment, learning as much as I could.  I guess what I’m trying to drive at is - it really pays to know more.  As parents, we make decisions on behalf of our children and we owe it to them to make it an informed one.

Wednesday 23 May 2012

A Gift of Time

On this mother’s month of May, I salute my mom, my mother-in-law, and all the other full-time moms who have given so much of their time to make a house into a home.  They are called homemakers for a reason.  I also thank my husband who has worked so hard to give me this opportunity to stop work and be with our girls.  It’s the best gift I can receive on mother’s day. 

Making the decision to stop work and be a stay-at-home-mom was not a hard thing to do.  It definitely had its roots.  My mom was also a full-time homemaker.  She chose not to pursue of what could be a promising career - a corp commander and an honor student back in high school (while working part-time as radio deejay to support her studies) and a student body president graduating top of her class in college.  She put it all aside and instead concentrated on us growing up.  She truly gave us one of the greatest gifts - the gift of her time.
Now that I am officially a stay-at-home mom, a lot of friends have asked me how my life has been so far.  Technically speaking, being at home and taking care of the girls full time is not really new to me.  I have had 4 months of maternity leave doing just that - staying home, breastfeeding round the clock, changing diapers (round the clock too!), playing, reading, giving baths, the whole nine yards.  The only thing that is different now, in a very pleasant way is that I don’t dread the pressure-pack and rushed life of a working mom anymore.  
When you have been working like there was no tomorrow for more than 10 years, the sudden change of pace definitely need some getting used to.   I can still remember working on a masterplan project in China which almost brought me to a breaking point.  I was going home very late everyday, without weekends for almost a month.  It culminated on a 6-hour midnight flight to Shanghai arriving there at around 7am, going straight to office and working the whole day.  That night, we travelled a 4-hour road trip to Yangzhou and arrived at around 11pm only to continue finalizing the designs, which was to be discussed on a breakfast meeting at 7am the very next day!  Whew!  No wonder I was popping pills for migraine like they were vitamins!

In Shanghai office, after an overnight flight
In Yangzhou, still managed a smile after 2 days of no sleep.

So I am sure you’ll know what I mean when I say I am a lot happier now.  I am certain the girls feel that too, which is very important.  I believe having quality time with the kids without your mind wandering to work is one of the biggest challenges.  Now that work is out of the equation, we can truly take our time and genuinely enjoy the play at hand.   Our hours and imagination stretch, bringing characters to life beyond “they lived happily ever after”.  Our play is no longer interrupted by constant clock-checking and you-have-5-more-minutes-to-go warnings. On the flip side however, the bad news for Ava is - mommy also has unlimited time to enforce time-outs!
One time, Ava kept on bugging me to watch cartoons again.  I normally let her watch for a maximum of 30 minutes, just enough to get my sanity back.  The usual all-knowing parenting spiel would be (which of course I have inherited) “there is time for everything and now is the time to eat, or sleep, etc... After you have finished eating your vegetables (slide in delayed gratification too!) then you can watch”.  Depending on which side of the bed she woke up from, my reprimands were sometimes met with bouts of crying and squealing, worthy of a “terrific” two.  Since we have pretty much established who the boss is (I have all the time now remember?), she figured the cows are never coming home.
So as I was watching her eat, an inspiration suddenly lit.  There is indeed a time for everything.  If you look at life in its entirety, 3-5 years of being with our children at their tender and formative years is nothing when you live a life of, God-willing, 80 fruitful years.  And when you do in fact live that long, I’m pretty sure reliving those 3-5 years back will bring so much pleasure and contentment.  Yes, I am happy I made the time.  Work?  That can definitely wait.  My girls?  I don’t think so.

My thirsty cyclist.

Who couldn't resist staying at home with an adorable face like this!

Tuesday 1 May 2012

The Day I Decided to be a Stay-at-Home Mom

As my maternity leave was coming to an end, my husband and I came up with a game plan.  We would drop-off our firstborn, Ava, to childcare for half a day while I was at work and leave baby Ally at home with our ‘yaya’.   Then I will pick up Ava on the way home for lunch.  This sounded like a great idea.  So we narrowed down to two childcare/pre-schools that were closest to our house.  Since I sometimes get stuck on long meetings, it has to be a walkable distance so our ‘yaya’ can pick up Ava on the tandem stroller with baby Ally in tow.  We finally chose one over the other for the reason that they allow parents to sit in the class for the first few days.  This was very important to me. 

First of all, kindergarten is different from a child care.  The former normally has a duration of 2-3 hours whereas the latter ranges from 7:30am-12:30pm (half-day) to as much as 12 hours for whole day.  The childcare is meant to be a place where working parents can drop-off their children.  That means kids were having their breakfast, snacks, lunch, nap and showers in the center.  It literally becomes their second home.
A lot of childcares or pre-schools have the policy to leave the child behind on the first day.  The rationale behind is that if mommy stays, other kids will start to look for their mommies too.  I found this not necessarily true, after having sat down with Ava for almost a week on two different pre-schools.  The toddlers were happily busy with the play at hand to notice.  And it actually hinges more on how the teachers create a lively and exciting atmosphere, enough for them to be deeply involved or distracted.   
While in class observing the children, I could not help but feel a tug in my heart.  Seeing the toddlers (some as young as 18 months) comforting themselves with a favorite blanket or toy, feeding themselves with rice, lulling themselves to sleep - all seemed remarkable given the high level of independence at such a young age, but I was more surprised to feel a tinge of sadness. There was something unnatural about it.  
Probably because I practice ‘attachment parenting’ which encourages a strong early attachment and consistent parental responsiveness.   I strongly advocated natural birth for the reason that my baby and I will be alert and not drugged to initiate bonding, further sealed with breastfeeding, co-sleeping, babywearing and so on.  As a result, I became highly sensitive and attuned to Ava’s cues and behavioral patterns and she in turns, knew me so well too.  I felt I was breaking this mutual trust prematurely - at a very young age of 2.
In fact, theory on attachment and human bonding dates back to the 1900’s, pioneered by the British psychiatrist John Bowlby.  He suggested that a child would initially form only one attachment, which is normally the mother, acted as a secure base for exploring the world.  A child should receive this continuous care for approximately the first two years of life and at best should remain undisrupted until the age of 5.  The attachment relationship acts as a prototype for all future social relationships and disrupting it can affect long term cognitive, social and emotional development. 
Although these were discounted with subsequent studies which noted that by 18 months very few (13%) were attached to only one person, some had five or more attachments.  However, with a statutory requirement of 1:8 teacher-student ratio for playgroups (18-30 months) which significantly increases to 1:15 for nursery 1 (30months-3 years old), there is hardly time to form attachments with the caregiver.  It even takes awhile, if not unnoticed, to attend to the needs of every child.  Some end up wailing to get attention, others retreat into themselves and self-soothes, others become aggressive and some bear lonely faces and faraway gazes. It really made me question the whole thing.
It is not surprising that a few years ago, a massive research was conducted from the National Institute of Child Health and Human Development's Study of Early Child Care, which found that cognitive skills in pre-reading and math were strongest when children entered a center-based program from age 2 to 3.  But it also found that youngsters who spent more than 30 hours a week in center-based care had the weakest social skills - including diminished levels of cooperation, sharing and motivated engagement in classroom tasks, along with greater aggression - compared with similar children who remained at home with a parent. 
These studies validated my empirical observations.  I knew in my gut that I had to stop work and concentrate on my girls at their tender years.  The next question was, could we afford it?    Especially since we live in Singapore, one of the most expensive cities in the world.  It all boils down to finances - the quintessential predicament of the modern mother.  
We did our math.  I am lucky that we could still live on my hubby’s salary alone.  More importantly, he supports the idea of me stopping work, even if it could mean tightening our belts.  Affordability is relative.  It reminded me of Einstein on his theory of relativity when he said, “an hour sitting with a pretty girl on a park bench passes like a minute, but a minute sitting on a hot stove seems like an hour.  That is relativity.”  Indeed, I may have to curb some shopping and traveling for now but as the cliche goes, “when one door closes, another one opens”.  So here’s to exciting opportunities ahead and a crazy, fun-filled, tear-jerking, love and laughter abound with my girls!

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