twinutero

ICP is intrahepatic cholestasis of pregnancy. It’s a condition that can develop in the mother when bile flow within the liver is blocked. It usually occurs in the third trimester and the main symptom is intense itching. ICP is not dangerous for the mother but can be very dangerous, even fatal, for the baby. Early delivery is usually recommended. ICP occurs more frequently in multiple births, and is likely to recur in subsequent pregnancies.

I was diagnosed with ICP in my first pregnancy with Thomas. At about 35 weeks gestation, I started scratching. I would scratch my palms, lower legs and feet all day – and sometimes during the night to the point of bleeding. My doctor did not think there was a problem, but I (as patients do) researched online and made my own diagnosis of ICP. That was confirmed with blood tests.

As a result, Thomas was induced at 40 weeks. It was his “due date” but he was clearly not ready to greet the world. The induction was long – long – and very painful. I don’t think it was the best for Thomas or for me (or my husband who helped us through it). Failing to induce, however, could have been much, much worse.

Because ICP is recurrent and more likely in multiple pregnancies, I expected its return when carrying Alex and Jon. Sure enough, at the beginning of the third trimester, I started to itch and was diagnosed with early ICP. I was doing all I could to prevent pre-term delivery of the twins and I did not want ICP to result in another induction.

So I started drinking fresh lemon juice every morning. This is a naturopathic treatment for the liver in general. I figured it couldn’t hurt for ICP either. Every morning before eating or drinking anything else, I’d squeeze a full lemon into a glass and add about an inch of water, and down it. I’d wait an hour before eating.

There’s no medical evidence for this treatment (that I know of) but my weekly blood tests showed that my liver function had improved. In fact, my bile acid and liver enzyme levels returned to normal. The nurse commented that she never before seen such a reversal.

With all symptoms gone, I let up on the lemon juice. ICP returned. I went back on the lemon juice and managed to keep ICP in check until 38 and a half weeks when the twins were born.

To emphasize, I have no proof that lemon juice stalls ICP, and it is definitely not a substitute for medical attention. But as my nurse said, it can’t hurt and if it helps so much the better for you and your baby.

Check these links for more information.
Itchy Moms
Mayo Clinic

Easy….

Lock it. Hide it. Gate it. Plug it. Bar it. Just get rid of it.

There’s a school of parental thought that says childproofing is anxiety-driven and largely unnecessary. A recent article on Babble, for instance, argues that babyproofing is “overparenting”. Many of the comments agree.

I do too – in theory. I agree that children should be taught, through trial-and-error and through parenting, what is safe and what is not. I also agree with the larger movement to allow kids more freedom to roam, tinker and explore.

However, a laisser faire approach to childproofing with multiples simply doesn’t work. At best it’s chaos; at worst it’s dangerous.

Just last week, Thomas sent me on a scouting mission in the backyard. He had deposited a poo in some undisclosed location. I returned from this mission within minutes, object in hand. The house was strangely silent – and the fridge door was wide open. I then heard small noises in the living room. Alex and Jon were planted on the couch, sharing a liter bottle of blueberry juice and chatting like they were hanging at the local pub. Not a tragedy perhaps, but a real pain to clean up.

We’ve had many, more serious events.

In a flash, Alex climbed to standing on the kitchen counter, rummaged on top of the microwave, found the “panic button” for our security service and pressed it – holding the button down the required two seconds to send armed response racing to our house.

Ah yes, and Thomas carefully demonstrating to his younger brothers how to place one’s neck in the chord for the blinds and lean on a 45 degree angle. “I’m choking!” he says, to complete the lesson.

I could go on.

So we’ve put put a clasp on the refrigerator door, we wind up the blind chords every morning, and we’ve stored the panic buttons so high as to be completely useless.

We could teach the kids not to do these things. We do teach the kids not to do these things, one by one, and time after hundredth time. But the twins are two years old, and Thomas is three. They will do everything they’ve been told not to do, and they will work with astounding cooperation and synergy to achieve their desired mischief.

The days are too short – life is too short – to spend my time mopping up a liter of juice, placating the security company, or whisking the kids into emergency. So until we have as many watchful adults as roving children, we will continue to lock it, hide it, gate it….

[Cross-posted at Twin Pregnancy and Beyond]

Our children may be among the last to consume bisphenol A (BPA) with their milk and formula. Or so we hope.

Since I wrote on using Medela baby bottles, public pressure to ban BPA has heightened and the availability of BPA-free baby products has soared.

And then… one of the biggest producers of polycarbonate bottles and the strongest defender of BPA safety, Nalgene, launched a line of BPA-free drinking bottles. Read more commentary on Z Recommends.

And now… Health Canada has announced that it is “taking action” on BPA. The department has completed its risk assessment, which focused on infants and newborns, and is proposing a ban on polycarbonate baby bottles.

Here is the story according to the Globe and Mail.

Here is Health Canada’s offical news release of April 18. Make of it what you will.

Also see information on BPA from the Canadian Partnership for Children’s Health and Environment.

We recently traveled (moved actually) from Canada to South Africa with three children under four years old. Here are ten tidbits of wisdom I learned along the way:

1. Start paper work early. Everyone needs a passport now, from newborns up. That means getting passport quality photos and that means, realistically, several trips to the photographer. Small children don’t like to perch on a high stool and have a flash go off in their face. Getting photos that the passport office will accept is therefore a chore. We also needed visas – a different form, a different office and more photos. Get at least four copies of ID photos and leave plenty of time for the bureaucracy to do its work.

2. Get proof of custody. In Canada there are “long form” and “short form” birth certificates. Only the long forms include names of parents. We needed the long form to get visas – an extra step that took time and money. (Ontario guarantees delivery of a birth certificate within five business days if you pay $65 and choose their “premium online delivery” option. Otherwise, the process can take months.) On the topic of custody, you might also check the Government of Canada’s publication International Child Abductions. Just in case….

3. Get vaccinated – expect trauma. My GP was unable to tell us what vaccinations we needed to travel to Cape Town so we consulted a travel doctor. He advised Hepatitis A/B and rabies shots. Hep A/B is a series of three needles, as is rabies. That’s six needles per child, times three children – eighteen needles. It has not been fun. It has not been cheap either. Medical treatment for traveling purposes is not covered by our provincial medical plan. Rabies shots are particularly expensive, about $180 per needle. Also, Hepatitis vaccinations are given over a six month period, so plan ahead.

4. Get an international driver’s license. Foreign licenses may be valid for a time, but they eventually expire and getting your license renewed from abroad can be a real pain. I’ve also been advised by the Canadian consulate in South Africa that insurance companies aren’t partial to foreign licenses and might try to avoid payment if you’re in an accident without a local or international license.

5. Travel by night. We took two overnight flights: Halifax to London; then London to Cape Town. It was the most direct route we could find, but was still over thirty hours of travel. We left at midnight, with the kids in their PJs, hoping they’d act like any other night and sleep. That flight was brutal, I have to say. We got a day room at an airport hotel in London. While it was expensive, it allowed everyone to shower and sleep. It was worth it. The next flight, twelve hours long, was a breeze in comparison. The kids slept most of the way and arrived in South Africa ready to go. Based on other, shorter trips we have done, traveling by night was the right choice.

6. Sedate the children. Okay, I didn’t tell the whole story in #5. We gave Gravol to Alex and Thomas on the second flight. Just one shot – the recommended dose. I don’t know if it was necessary since Jon slept for nine straight hours without any meds and I’m reluctant to give sedation my wholesale recommendation. But this time, for us, it worked.

7. Travel light. Check your luggage all the way through to your destination, otherwise you’ll be traipsing through airports with cranky kids and toppling stacks of suitcases. Our carry-on bags were also as compact and simple as possible. The kids carried their own backpacks with their blankets, snacks and water. My carry-on was full of wipes, diapers, extra plastic bags, lollipops for take-off and landing, and a few surprise toys to distract when things got raucous. Best travel toys are silent and have few moving parts. We brought books, stickers, magnets (in a tin) and drawing boards. And we watched the in-flight movies – several times.

8. Get a good moving company. I’ve moved many times – and I’ve never found a moving company I like. This move was no exception. Their cost estimate was off by 50% and the shipping took a month longer than predicted. It seems impossible to avoid these little surprises, so I would now expect them. Expect to pay more and wait longer. That means finding an interim place to stay that will accommodate kids, and that kids will accommodate.

9. Share your plans. We started talking about our move as soon as it was confirmed. Thomas knew that we were going “to Africa” and that we’d take a plane to get there. He knew he wouldn’t see his toys for a while, and wouldn’t see his friends for a longer while. Jon and Alex were included in these conversations but were too young to respond. I still don’t know how much they understood, but each transition (house to hotel; hotel to airport etc) went smoothly, as if they knew what we were doing. In any case, it just seems fair to let your kids know if you’re going to travel across the world.

10. Don’t do it for fun. I wouldn’t include international travel with small children as part of a fun family holiday. It’s costly, it’s stressful, and it increases your ecological footprint by several sizes.

This question has been on my mind since I started reading mommy-blogs – more so since I started my own.

What is the difference between showing cute photos of your children to relatives, friends, or even acquaintances met on airplanes, and posting those same photos to a blog? In my mind, a big difference.

Sharing pictures and guess-what-my-kid-did-today stories with relatives deepens a personal and hopefully enduring connection. Same for friends. Sharing with strangers and acquaintances strengthens your connection with that person, but does little for your kids.

In all of those circumstances, though, you have control over who sees the photos and hears the stories, and more often than not you get direct feedback, so you know whether you want to continue sharing with this person.

Not so with a blog, of course. That photo of your baby breastfeeding, your toddler in diapers or your preschooler sleeping are out there for anyone with an internet connection to see.

Call me paranoid, Luddite, introverted (I may indeed be all of those) but I have a problem with posting intimate moments of my child’s life to the world. It is, after all, their life.

“Your children are not your children,” as Kahil Gibran famously wrote and Sweet Honey in the Rock beautifully sang.

That photo, now cataloged on the internet, is a fragment of a life that will expand in a million directions to form a complex adult with a very real and personal past. We’d think twice about posting a candid bedroom shot of our spouse or an entertaining faux pas of a sibling. I don’t think children are different.

Informed consent and benefit-sharing are two basic ethical principles drilled into every student of moral philosophy. It’s generally acknowledged that receiving informed consent from a young child is impossible. As for sharing benefits? Well, why do we blog? To share our “lessons learned” with a community of peers; to see our writing and photography published; to be heard; to gain a following; to earn money….

Few of these benefits go directly (if at all) to the main subjects of the blog, our children. Yet they carry a fair share of the risks, mainly loss of privacy although one could imagine worse.

So where do you draw the line? Have I already crossed it, despite attempts to respect my family’s privacy? Are all memoirs – and blogs are memoirs of a kind – exploitative? As with most ethical issues, debate is open and sometimes the best criterion is “I know it when I see it.”

I’ve seen plenty of insightful, respectful mommy- and daddy-blogs. I’ve also seen many where my sole thought is, “Are those kids going to be pissed….”