Category Archives: parenting

31 for 21 – Why is it so difficult to access services for my baby???

parenting, Trisomy 21

Today is Day 22 of 31 for 21, a blogging effort to promote awareness about Trisomy 21, also known as Down syndrome.

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After Yirmiyahu was born and I shared the news with people that he has Trisomy 21, I felt so encouraged to hear that there were significant resources in Israel to support his development.  Now that he’s three and a half months old, I’m feeling much less supported and encouraged.

I’ve been to plenty of doctors for Yirmiyahu – I’m not going to enumerate them because I think I have in the past!  I’ve also taken him to the Child Development Center, where he’s supposed to get supplemental therapies.  Before the holidays he had one physical therapy appointment, and I have another scheduled for next week.   While I appreciate that, I kept feeling that there should be a lot more early intervention happening.

I haven’t been passively waiting for outside help – I’ve been trying to put together a neurodevelopmental program for Yirmiyahu on my own.  I don’t mean to sound whiny, but I really don’t think I should be needing to reinvent the wheel and figure out everything myself- I’m not living in a third world country and Down sydrome is something there’s a lot of experience with.

I spent weeks trying to reach the national support organization for parents of children with T21 – no luck.  They never answered or called back in response to my repeated messages.  I tried to reach the clinic in Jerusalem that specializes in Down syndrome – no luck.  Again, no one answered or returned my calls.  Finally last week I went into the local health clinic to find out about getting services for Yirmiyahu, and was told I need to speak to his pediatrician (who I’ve seen a number of times already and never suggested anything).  I made an appointment for the next morning.

That night, I called someone in Jerusalem with an eleven year old son with T21 to find out what is normal – maybe my expectations were totally off?  She told me the norm is that from the time the baby is very little, he gets therapy at least three times a week – once speech therapy, once occupational therapy, once physical therapy.  I also learned that she was able to successfully breastfeed her baby exclusively thanks to the exercises the speech therapist gave her.  Nice.

Now armed with the knowledge that others in different parts of the country in the same situation as me are getting significantly more services, I went to see the pediatrician.  She told me that the Child Development Center here is perfectly fine and if they don’t offer more services, it’s because it’s not necessary.  Then she demanded, “What kind of occupational therapy are they going to do on a baby so young?” and without giving me a chance to answer, told me that there’s no such thing as occupational therapy for a three month old.

So I went to go see the doctor who is in charge of the Child Development Center.  She reminded me that I had already had an appointment in the beginning of September for physical therapy and that I had another one scheduled for the end of October.  Yes, but doesn’t once in seven weeks seem….well, pathetic?  Apparently not.

She told me that she will meet with me in a month to discuss this because she doesn’t want me to feel deprived or to think that I’m not getting services I should be getting.  Personally, I think she should worry less about my feelings and more about making sure my baby gets the support he needs.  When I told her that in other parts of Israel parents of babies with T21 are getting multiple therapies a week, she told me that a baby should only have one person working with him and that’s the physical therapist.

This was so frustrating.  Despite it being well-known how important it is to help babies with T21 very early on in their lives, somehow this isn’t happening here.  I felt like I was in the Twilight Zone when I was talking to both of these doctors.  My partial comfort is that I’m working with Yirmiyahu on a few developmental areas and I hope he’s not suffering for lack of support, but it would be nice to get some support from trained professionals.

Later that day I was happy to get a call from the Feuerstein Institute in Jerusalem, which specializes in brain development and rehabilitation, and they’ve had a lot of success working with children with Down syndrome.  I had been trying to reach them for several days and left a couple of messages, but due to my experience with not having my calls returned, I wasn’t expecting to hear from them.  It was so validating to speak to someone there who told me this is absolutely a critical time to start working with him.  She told me the person who works with babies will call me and we can schedule an evaluation – this is private, however, and I don’t know how long their waiting list is for infants.  (I’ve heard that it can be months for adults.)  Hopefully we can get him seen soon.

You know what the doctors seem to be most worried about?  His weight.  Although he’s gaining weight nicely now that he’s started supplemental bottles, he still remains under the average growth curve.  (I pointed out that on the T21 growth chart he’s in the fiftieth percentile but was told that’s not relevant.  Why is there a different growth chart for babies with Down syndrome if it’s not relevant??)  My Israeli friend laughed when I told her about this and told me this is what they tell most mothers in the country, that their babies need to gain weight.  I suppose that’s reassuring but what would be more reassuring is if I could actually get some meaningful assistance for my baby!

Avivah

31 for 21 – Benefits of using Haberman bottle

parenting, Trisomy 21

Today is Day 21 of the 31 for 21 blogging effort to increase awareness about Trisomy 21.

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(Edited to add: While the concept is great and it worked well, I can’t recommend it.  The silicon nipple lasts for just a month before cracking; I bought several bottles and used a number of the nipples included and this was my experience with every single one of them.  This is something that shouldn’t happen so fast and makes this bottle a frustrating and expensive option.  With our second baby with T21, I used the MAM bottle, which also encouraged a strong suck, helped the baby keep his tongue in his mouth,  just 40 shekels for the bottle (versus 160 shekels) and the nipple never cracked.) 

Every time I go out with Yirmiyahu and pull out his bottle, I get curious looks and if the person is close enough to me, they ask me about it.  Here’s why:


It looks a little bit different, doesn’t it?

After spending weeks working to get Yirmiyahu to be able to exclusively nurse, after a couple of weeks I saw that he didn’t seem to be getting enough.  I still don’t know why this is – maybe I didn’t have enough milk, but I think it’s something else.  Unfortunately I don’t have any professional feedback on this so I’m just guessing.  Anyway, since my efforts to remedy this on my own weren’t working, I agreed to the suggestion that we give supplemental bottles.

The bottles were great – I was able to see how much he was getting and that was reassuring, as was seeing the return of wet and dirty diapers.  But something more troubling also presented itself.  When I had taken him to the doctor as well as the physical therapist just three weeks before, they had both commented on how good his mouth closure was.  Since infants with Trisomy 21 have hypotonia, the lack of muscle tone can make it harder for them to keep their tongue in their mouth.  I credited Yirmiyahu’s good mouth closure to nursing.

However, within two weeks of a regular bottle, his tongue began sticking out a lot more frequently.  This isn’t a surprise, since sucking on a bottle requires a baby to thrust his tongue forward, and nursing requires him to pull his tongue inward.  But surprise or not, it was disturbing to me – was this the price I had to pay to help him gain weight?  I was feeling stuck between a rock and a hard place, when a friend suggested the Haberman feeder.

The Haberman feeder was created for babies with feeding difficulties, but I think it’s a good choice for all babies.  It’s the only bottle that a baby has to use his mouth in a similar way to breastfeeding.  There are a number of benefits to this, but the one that most interested me was that it would help Yirmiyahu build his oral motor strength, just like nursing.

Now, getting him to drink from this wasn’t so easy.  While he could finish a five ounce bottle in twenty minutes or so, it took him four hours to drink the same amount the first time we tried this bottle.   This was problematic because we needed to get his weight up, and for a few transitional days I gave him feedings from regular bottles as well as from the Haberman to be sure he was getting an adequate amount to eat, while giving him a chance to learn how to eat from this.

However, we got through that period and have been using just this bottle since then.  Just as quickly as we saw his tongue begin to stick out more, we’ve seen it go back to how it was before.  This would take a lot of speech therapy to overcome if we stuck to the regular bottle, so it’s a big savings in time and energy!

Another benefit is that excess air being gulped in along with the milk is eliminated due to the bottle design.  Yesterday I happened to sit down at the park bench next to the school nurse and she asked me why we didn’t burp Yirmiyahu a few minutes after he started drinking his bottle.  I hadn’t consciously thought not to burp him, it’s just that he didn’t need it.

Here’s a short clip of Mandy Haberman, the designer of this bottle, showing how it works:

The disadvantages to this bottle that I’ve experienced are:

– Cost – it’s not cheap!  We spent 160 shekels on this, which at the current exchange rate is over $40. Contrast that with bottles that are considered upgrades/higher quality and priced at 40 – 60 shekels.   (Updated to add: two nipples are included with the bottle.  Since the nipple lasts only for a month before cracking and becoming unusable, this dramatically adds to the cost of using this bottle.)

– No lid – when you travel with this bottle, there’s no lid to prevent spilling.  I haven’t found much leakage to be a problem as long as there’s no milk in the top part of the bottle, since it required suction to get it out.  But when there is milk in the top reservoir, I just wrap a cloth around it in the diaper bag to prevent any leaking and that seems to work fine.

Avivah

31 for 21 – Seeing the symptoms instead of the person

parenting, Trisomy 21

This month is National Down Syndrome Awareness month.  This year I’m joining in the 31 for 21 blogging effort to raise awareness about Trisomy 21.  Why 31 for 21?  There are 31 days in October, and in T21, the 21st chromosome is triplicated.  In the coming days I’ll be sharing about questions I’ve been asked about T21, as well as other topics not related to T21 at all.

This morning I took dd16 and dd11 to a community event for mothers and daughters.  A couple of minutes after I walked in, a staff member at one of the schools approached me and peered into the stroller.  (Yes, I do sometimes use a stroller rather than the wrap!).  She looked at Yirmiyahu and with surprise in her voice said, “He’s so cute!”  She had cornered me about a month ago when I was at the school to inquire about if the news she had heard that we had had a baby with special needs was true.  At that time I got the impression that she thought this was something hush hush that I should be feeling ashamed or sad about, which isn’t even a tiny bit true.  Today she seemed surprised that he was cute because she knew he had T21 and that’s not what she was expecting.  (I know, this is my cue to insert a current photo here but I don’t have one so you’ll have to scroll back to other posts that have pictures.:))

I said, “Of course he’s cute!”  I had picked him up and she looked at him close up and said, “He looks like a normal baby.”  I have an emotional trigger to the word ‘normal’ – does my baby having T21 mean he’s not normal?  I replied with a smile, “Yes, he is a normal baby but maybe a little cuter than usual.”  “But he doesn’t look like anything is wrong with him,” as she looked at me questioningly.  I could tell she was wondering if she was mixing me up with someone else, so I confirmed for her, “He has Down syndrome.”  “But he doesn’t look like it.  How can you tell?  There are five signs, right?  But I don’t see any signs of it.  Are you sure he has it?”

I wasn’t enjoying this conversation from the very first comment and was trying to remain polite.  What does she think, that I’m making it up?  I told her there are more than fifty possible signs of Down syndrome (maybe more than 100) and which signs people with T21 have vary from person to person.  She wanted to know which signs Yirmiyahu had but I thought that was none of her business so instead I assured her that we had done genetic testing and we were absolutely positive that he has T21.

I don’t tell most people that I see locally that Yirmiyahu has T21. Not because I’m embarrassed or because I want to keep it a secret – not at all.  I’m very comfortable speaking about it and Yirmiyahu is perfect just as he is.  But I know that most people have negative preconceptions about T21 (as I did before Yirmiyahu was born) and I want to give people a chance to appreciate him as a sweet baby without them looking for the ‘label’ when they first see him.  Once they have a chance to see him as a baby rather than as a syndrome, then at a later point I can share with them about his diagnosis and then there’s a place for more helpful dialogue.

Today the woman who was looking at him was looking for signs of his diagnosis rather than seeing him as a baby and that bothered me.  I know I can’t control people’s reactions and I’m sure there will be many interesting interactions in the future when I’ll be asked about this issue.  But I so much wish for now, and even more for the future as Yirmiyahu gets older and it becomes more obvious that he has T21, that people will be able to see him for himself.

Avivah

Our new crawling track – a developmental tool

parenting, Trisomy 21

Here’s our newest baby apparatus – a crawling track!

If you’re anything like me until about 2.5 months ago, you’ve never heard of a crawling track and can’t imagine why in the world anyone would want one!  I read about this when Yirmiyahu was two or three days old, and once I understood the benefits resolved that we would make one for him.

The idea of a crawling track is to provide a safe and comfortable environment in which your baby is encouraged to move from birth (if you have one at that point).   Why not the floor?  The narrowness of the track allows the baby to move forward, and the sides give him something to push off against.  A blanket on the floor would get rumpled and in the way, a mat on the floor doesn’t have anything for the baby to push against to keep him going straight.  Also, the track can be lifted on one side at different angles depending on the age of the baby, according to what is needed to help him make his way down the track (higher for very young infants, lower as they get older).  Once a child knows how to crawl, they don’t use a crawling track anymore – this provides a place for them to have lots of early opportunity to move and when they can crawl on the floor they won’t need this.  The recommendation to use a crawling track comes from the work of Glenn Doman, who has studied the development of healthy and brain damaged children for over fifty years and shares practical suggestions for parents based on his experiences.

What’s the point of encouraging them to move?  Very much in brief, there is a direct relationship between movement and learning.  Crawling on the belly and creeping on all fours is critical to integrating the primitive reflexes of the lower parts of the brain.  The lower parts of the brain  are organized in the first year of life through crawling on the belly and creeping on all fours.  The more organized movement there is, the better it is for the brain.  This is good for any baby, but for a baby with issues like T21 I think this is of even more value in enhancing their physical and cognitive development.

Yirmiyahu below on the track for the first time – one end was slightly raised so that he would be at an incline that would assist in his movements. Edited to add: It’s recommended that a baby go down the track ten times a day – so far Yirmiyahu only goes down it a few times daily but we’re working up to the recommended amount of times.

You can see below how he’s lifting his head and pushing one leg against the floor of the track to propel himself forward.

The next picture was taken just a couple of minutes later – notice how he’s moved forward on the track.  It helps to have brothers to cheer him along the way!

These can be purchased in the US for about $450 – not cheap!  I knew this was something we could make ourselves but it took a while to make it because I wanted to do it as frugally as possible, and that meant finding materials that I could recycle for this project. A couple of weeks ago, we found something that someone was giving away that looked like we could dissemble for the materials, and brought it home.  That was a great find, but the next day, ds10 found something even better, which is what we ended up using.  It was just the right width and length for the track and the sides, and was basically a board covered with a thin layer of foam and material (we took this apart so that it could be washed before using it).  The track is supposed to be six feet long, and the sides are between 6 – 8 inches high.  The foam wasn’t one inch thick, which is what was recommended, but it’s comfortable and firm so it works out just fine.

Though it’s recommended to use vinyl or naugahyde for the top layer, I preferred the soft and velvety material that I used – it’s smooth enough that it doesn’t impede movement, but there aren’t issues of offgassing that vinyl would have.  Then again, it won’t be as easy to clean as vinyl but to me that’s a small price to pay for something that is better for the baby’s health, not to mention more cozy.  Dh cut each side piece and then affixed them to the bottom piece with brackets.  The ten brackets were our only financial outlay for this project – a total cost of twenty shekels ($5).  Once he finished that, he left the rest of the project for me. While it took time, it wasn’t difficult, and I was very pleased with how it turned out.

We keep this in the living room and Yirmiyahu goes in as often as we can manage – people like to hold him a lot when he’s awake so this limits his track time.  Since babies move so much in their sleep, it’s recommended to put them in this rather than a crib to give them room to move, which we do for naps.  At night, he sleeps with me and his movement is limited to him squiggling himself as close to me as he can get.  Which I totally love.

Avivah

Babywearing – makes it so much easier to be out and about!

aliyah, parenting

Today I was on the bus to Tzfat (Safed) and was thinking – as I do almost every single time I have a lengthy trip somewhere and have to spend hours away from home – how glad I am to be able to wear Yirmiyahu in a wrap.

 

Me with Yirmiyahu in Tzfat – yes, it really is that beautiful!

I wrote about babywearing with a stretchy wrap when my ds3 was little, and at the time, I found it hugely helpful in freeing up my hands and taking care of things around the house while keeping the baby happy.  As useful as it was then, it’s even more helpful  now!  When we moved to Israel, I got rid of all of our baby stuff in our ruthless downsizing, with the exception of three things – one of them was the stretchy wrap, and one was a mei tai.  I knew that if we had another baby, it would be expensive to aquire these again and that I’d really regret not having them.  I’ve so many times thought how glad I am that we brought these along, because with all of the traveling in the city as well as outside of the city, it’s made my life so much easier.  Now that we don’t have a car, the helpfulness of a wrap has skyrocketed!

I started wearing Yirmiyahu when he was less than two weeks old, at our first post-hospital doctor visit.  Every time I needed to take a bus to another city for another appointment for him, I felt so grateful to have the stretchy wrap – the option would be taking a bulky stroller that I’d have to fold with one hand while holding him with the other, while simultaneously try to board the bus and pay without falling over!   Not a fun thought.  Like this, he’s securely held in place even when my hands are full or occupied, and I don’t have to drag extra baby paraphenalia around with me.

I also find it useful for when I need to get around locally, like trips to the store or for my daily walk to pick up ds5 from kindergarten.  He stays cozy snuggled against me while I get my errands done.  Today I tried a new way of wearing him, which I think is an improvement for him.  Since babies with T21 have more flexible joints, you’re supposed to keep their legs together as much as possible.  When I would put him in the wrap facing towards me, I always arranged his legs so they would be together, but now I’m wearing him facing sideways (similar to the cradle hold) and it’s easier to be sure his legs stay together the entire time.  Both positions are comfortable for me since my back is well-supported.  (See picture above.)

Not only is it practical, babywearing is helpful for a baby’s development in a number of ways.  Dr. Bill Sears says that babywearing stimulates the baby’s vestibular system, and that the stimulation “helps babies breathe and grow better, regulates their physiology, and improves motor development” (Sears and Sears 2001).  At the same time that babywearing offers the baby stimulation, it’s also calming for them.

I think that because he’s in the wrap versus a stroller that Yirmiyahu gets noticed alot, because he’s at chest level for people walking by so they don’t have to look down and into a stroller to see him.  That means lots of smiles and comments about how cute he is, as well as comments about the wrap itself.  Today the bus driver asked me as I was paying, if the baby was comfortable. I’ve had people tell me he’s too hot, too cold, too squished, too young to be out, his head isn’t supported enough,his head should be covered because of the sun or air conditioning, his legs should be hanging out, his legs shouldn’t be hanging out, he’s not secure enough – but since they usually tell me how cute he is at the same time, I don’t mind too much!  I think of it as a nice thing about living in Israel, that strangers care enough to tell you how to take care of your child.

I was fortunate to be given this wrap by an online friend (who is also a blog reader) when she finished using it with her son, and it’s gotten tons of use since then!  I’ve shared it with a friend in Michigan, who used it for months and then mailed it back to me when she finished with it.  Then I moved to Israel and I shared it with two different friends here.  And now I’m using it once again.  It’s gotten lots of mileage and I anticipate that it will get a lot more usage before I’m ready to move Yirmiyahu into the mei tai.

I’ve been asked by lots of people if I use this in the house, and the answer is, rarely.  It’s really useful but when the kids are home, there’s always someone (usually more than one someone) who is waiting to hold Yirmiyahu.  He’s rarely put down unless he’s sleeping, though sometimes someone will put him in the baby seat and rock him.  More often, when one person is finished holding him, they pass him to the next person waiting.  Now that the kids started school, I’m hearing daily complaints from several of them that they hardly get to hold him anymore.  Problems, problems.  🙂

Avivah

First day of school – what a difference!

aliyah, parenting

I started writing a post about preparing for school in Israel, and how you basically are given very little information that you need until the last minute or past the last minute.  I was going to share that to let people know this is normal so they don’t get frustrated, but I decided to delete it because it sounded negative and I don’t like to be negative, so instead I’ll share about the first day of school today.

Today was such a good day!   It was so dramatically different from when everyone began school last year – at that time none of us knew any of the teachers, administrators, kids in the classes.  We didn’t know what the school rules or schedules were, what supplies we needed; all of the kids except the high school girls were signed up for school after the school year officially began.  The kids didn’t speak Hebrew and hardly understood anything going on in the classes, and were extremely limited in communicating with their classmates.

And this year?   I know the teachers and principals at each school, and they know our children and their needs.  (I spoke with two principals yesterday to make sure they understand the kids will continue to need academic support throughout this year.) The kids now understand Hebrew (varying levels of this, but in every case it’s much, much better than last year) and most of them were going into familiar school situations.  Everyone left with backpacks filled with the requisite school supplies, with the appropriate uniforms – last year it took a week to buy what we needed for dd10 since they didn’t sell anything that fit the school requirements in the city (the school sells uniforms but only had clothes left for very little girls).  They all came home positive, basically saying how big a difference it was between this year and last year.

Yesterday ds6 participated in the orientation for first graders – the parents of the first graders and the first graders were invited to the school in the late afternoon, and the principal and teacher went over school rules and what the boys will be learning while the boys did an activity together.  This was the second meeting for incoming first graders; the first was several months ago and I was very pleased they did this.  It took away the unfamiliarity of a new situation and helped the kids become familiar with their teacher, classroom, and classmates, and ds6 had a great first day of school today.  I ‘ve been vacillating about where to put him in school and questioning the decision that I had made, as well as the reasons that I made the decision I did – it’s hard to send to a school that hardly anyone in the charedi community is sending to, and sometimes I doubt myself and wonder, if my reasons are so good, why doesn’t anyone else who shares my concerns make a similar choice?  But yesterday at the orientation I had a feeling of peace that it really was the right thing to do.

Ds4 (will be five in a week and a half) had the hardest time today.  I had been anticipating that it would be pretty smooth for him to begin kindergarten, since he was entering the class that ds6 was in last year, and he accompanied me every day to pick up ds6, so he was familiar with the teacher and the building.  But a few days ago I found out that they shuffled the teachers and class locations, so he now is in a building that he’s never been in, with teachers he’s never seen before.   One positive part is that he knows a number of the boys from last year, despite the shuffling of the boys in the classes into different groupings.  Another positive aspect is that thanks to the shuffling, his class size is now 22, down from 34 last year, which was overwhelming for him.  When I took him in to the kindergarten class, I was pleased that the atmosphere was so calm, since lots of noise and stimulation is hard for him.

I stayed with him for 45 minutes, then thought it was a good time to leave since he seemed comfortable and told him I would be back later to pick him up.  As I was walking out of the courtyard, he came running out presumably to say goodbye again, then burst into tears.  The teacher told me to leave him there, that he was crying because I was there and it would be easier for him if I left him, but that’s not my belief.  I understand why it seems to work better to leave children despite their crying and screaming, but when they do quiet down, what looks like their acceptance of a new situation is often them shutting down emotionally because they feel unsafe.  Resignation and acceptance are very different emotions that look quite similar from the outside.  I was reminded of Dr. Gordon Neufeld’s statement that peer oriented children look so much better than parent oriented children, because they seem more confident and look as if they’re doing better in new situations.  Looks can be deceiving.  To the teacher, I only said that everyone knows their own child and I didn’t think it would be a good idea for ds4 to leave him there against his will.  I took him home and we’ll give him a chance to adjust to kindergarten more slowly, so that when we leave him there, he feels comfortable with it.  Pushing him to stay there before he’s ready isn’t going to be beneficial to him.

I wasn’t looking forward to school starting – it feels like the summer went by too quickly and since it was the postpartum period for me, I didn’t spend the kind of time I wanted to with the kids.  Nonetheless, the kids had a nice summer and despite my reluctance for the summer to end, I’m glad that they all had such a positive start to this year.

Avivah

Balancing needs of new baby with needs of other children

parenting

>>I was wondering how this nursing around the clock is affecting your other children, especially the younger ones? I am not saying to ditch the nursing and switch to the bottle, but I wonder about the cumulative effect on the family.<<

This is a very reasonable question!

When the baby was born, I stayed with him in the hospital for the first four days.  A friend called to let me to know that the hospital had apartments that could be rented for a nominal sum so that I could stay with the baby over Shabbos after I was discharged, and I told her that I planned to go home.  She wanted to know what would happen with giving him my milk, since I was pumping and he was getting it through a feeding tube, but I couldn’t get ahead enough to leave him with enough until I would be able to come back on Sunday morning.  I told her that the staff would give him formula when the milk I left him ran out, and though it wasn’t ideal, my kids at home needed me, too.  She answered, “Oh”, and I thought that she was keeping her disapproval of my choice to herself, that I wasn’t devoted enough to my newborn baby.

The next day I got an email from her.  She wrote how much she admired me for being willing to give the baby formula even though it clearly wasn’t my preference in order to be there with my other children.  She shared her regret that when she had a very medically needy child several years before, she was so focused on being there for him that she wasn’t able to give her other little children what they needed – her presence.

A week or so later, another friend called.  About a year ago, she had a baby who was born with serious health issues; we had talked about this when we last chatted around the time we made a bar mitzva, and she wanted to let me know that an article about her and her baby had just been published in Binah a few days before to flesh out our conversation.  I filled her in on our news (she hadn’t yet heard we’d had a baby), and we got to discussing exactly this point, of how to find balance between the very real needs of a sick infant and all the children at home.  She told me that looking back, she regrets one particular choice because it took too much time that could have been spent with her children at home.

But the fact is, hindsight is always 20/20.  These women are both wonderful mothers who are very devoted to their families, and although they may be hard on themselves for what they could have done differently, I’m positive they made the best choice they could at the time.  I’m making what I think are the right choices based on what I can see in front of me right now.  I feel very strongly that nursing this baby is a priority right now, for the reasons I shared in my recent post.  It’s true that I’m more limited in time and energy than I would otherwise be.  But I’m trying to be available for the other kids, too.  When I’m nursing or pumping, it’s not like I fell off the face of the planet – I’m still at home, even if I’m spending much more time in my bedroom than the living room.  The door is open and the kids come in and out all the time, to talk or hold the baby or to read with me.  (I can’t read to the littles when I’m nursing, but I do read to them when I’m pumping.)  An advantage of giving Yirmiyahu a bottle is that feeding him isn’t limited to just me.  The kids take turns giving him bottles, and all them get to do this – including our three year old.  They all vie for the chance to hold him, and I make sure that they all get to do that – I think it’s important that they feel this is ‘our baby’, not “my baby’.  So I involve them as much as they want to be involved with his care.

Also, the littles get a lot of attention from their older siblings, especially now with it being summer vacation.  Though I’d like to be able to to more with them, they do have brothers and sisters who spend time with them.  Sometimes it’s something special, like ds19 taking ds6 for a two hour bike ride.  Sometimes it’s something ordinary, like dd11 or ds10 taking them to the park a couple of buildings away.  Whatever it is, they aren’t being neglected or ignored.

Balancing the needs of a new baby with other children is a challenge that most mothers face in the early postpartum period, even if there aren’t medical complications.  Actually, this isn’t limited to postpartum.  This is an ongoing parenting issue, of balancing the needs of all of your children, and sometimes one child will really need you more than the others.  Being fair doesn’t mean giving everyone the same thing, but giving each child what he needs.  Sometimes you do have to make compromises in order to help the one who needs it most.  But the reality is that a mother’s physical and emotional energies are limited; we simply can’t be everything to everyone all of the time, and we shouldn’t even have that expectation.  We have to be careful not to beat ourselves up for what we can’t do.    Hashem gave us these children and Hashem gives us the challenges that we need to grow, and part of that is learning to accept our limitations and love ourselves the same way we love our children with their imperfections.  In any given situation, we can only do our best, and ask Hashem to give us the wisdom to make good choices and the strength to follow through.

Avivah

Double birthday dinner cookout

aliyah, parenting

Our oldest son turned 19 two days after Yirmiyahu was born, so there wasn’t much of a celebration for him at home.  We wished him a ‘happy birthday’ and joked that the shalom zachor celebration was a party for him, too, since it was the evening of his birthday.  🙂

Exactly a month later, dd16 had a birthday.  Again, no celebration, though it’s not uncommon for us to delay parties somewhat with the hope to surprise the birthday celebrant.  Yesterday dd17 and dd11 took her to the beach in Akko (Acre) as a girls’ day out in honor of her birthday, but it wasn’t a family get together.  But plans were in the works for both dd16 and ds19.

Dd16 was at the forefront of plans for this birthday party for her brother, not knowing that a couple of her siblings were conspiring to surprise her at the same time.  She baked him a lovely cake decorated with a gemara (Talmud).  Ds10 baked a cake for dd16 a few days ago but the freezer was full and so it stayed wrapped on a pantry shelf – it was still pretty fresh but dd17 wanted to serve something nicer.  So she tried to get dd16 out of the house while ds13 prepared a chocolate brownie cake with a vanilla pudding layer and a chocolate pudding layer.  Yum!

Preparing for campfire

What they decided to do was to have a family cookout at a local forested area that is legally zoned for campfires, so we didn’t have to get permission to have it there.  It took a good bit of preparation to gather the wood, shlep all the food there, etc, but it was worth it.  Once the campfire was going, dd16 lit the candles on the cake for ds19 and we all started singing ‘Happy Birthday’ to him.  He was really surprised; at first he thought we were singing in honor of his sister’s birthday!

While he was admiring his cake and thanking everyone, dd17 was lighting the candles in the shape of a 16 on the second cake, and he had hardly finished thanking dd16 for the cake when we all started a second round of ‘Happy Birthday’, this time for dd16!  It was amazing that they were able to surprise dd16, but that’s why the cake was baked just an hour before the cookout; if they had done it further in advance she’d probably have gotten wind of it.

They both cut their cakes and served everyone a piece of each.  The other family in the campground area apparently heard us singing because a few minutes later, they brought over plates of bamba (a popular Israeli peanut corn puff snack) and popcorn.  A couple minutes later, they came with the next round, a plate of nuts and sunflower seeds and a plate of olives.  And a couple minutes after that, they brought us four containers of dips – eggplant, humous, techina, and red cabbage salad.  They were finishing their family party and hearing our party, wanted us to enjoy what they had rather than take it home – and they assured us that everything was store bought and had a badatz hechsher (kosher supervision).  Only in Israel!  It was really nice and their additions definitely added to the festive feeling.

While everyone was enjoying the cake, ds13 was grilling hot dogs and chicken wings, and checking the potatoes and onions that they had started roasting as soon as they had gotten there to set up.  We also brought a marinated kidney bean salad that dd11 prepared, so there was plenty to eat!

After we all ate, the kids built up the fire again.  As they were doing that, seven bicyclists with flashing red and blue lights headed straight for us.  Our backs were to them, so we didn’t realize until they spoke to us that they had come to check out what we were doing, and that they were policemen!  They were very pleasant and it seems they just wanted to check out what was happening.  After suggesting that we be careful and try not to set the forest on fire – we agreed that would be a good idea – we wished each other a good evening and off they rode.

After that, we sang together by the campfire.  When we’ve gone camping, one of the nicest parts is always the evening meal – building the fire, cooking the food over the grill, eating it, and then singing together.  I miss being able to go camping – without a car it’s not so simple to go to a campground.  The older kids were researching campgrounds last week because they wanted to have their own camping trip, but it was so costly and complicated because of travel that they opted not to pursue that.  Having this tonight was like having the best part of a camping trip, without having to go far from home.

Finally, what campfire would be complete without marshmallows to roast?  The little kids loved being able to do this by themselves, even ds3.  We brought along wafers and they sandwiched the roasted marshmallow between the wafers, our Israeli version of smores.

It was a wonderful evening that we all enjoyed, and it happened thanks to everyone getting involved and doing their part.  My family is growing up and I appreciate every opportunity that we have like this when all of us can be together.  I know it’s not going to stay like this forever, and I savor it while I have it.

Avivah

Private nursing rooms in public places – so, so helpful!

parenting

Today I took the baby to a pediatric cardiologist in Nahariya for a follow-up – the NICU doctors recommended we take him to different specialists for each of the concerns they had right after his birth. (The doctor said everything is normal and that there’s no reason to come back for another six months, when we’ll check everything again.)

Visits to the pediatrician and for blood work are easily taken care of locally.  But all of the specialists are located in different cities, and this adds a component of stress to the experience.  The night before I have a visit, I spend a lot of time figuring out which bus to take to whatever city I’m going to, then which intercity bus to take once there, and how to get from the bus stop to the office I need.

Then early in the morning, I wake up early in order to have time to pump so that I’ll be able to take a bottle with me, and also nurse the baby.  Until today I’ve taken the electric pump with me and have to find a place to use it so that I can prepare a second bottle while I’m out.

So a good bit of this pressure is related to needing to have bottles ready for when I go out. This is because we’re still at a transitional point with nursing; it’s going very well but where we’re at right now is more typical of a few days after birth than five weeks. That means that he needs a lot of help latching on and staying latched on, which is really hard to do discretely; this requires more privacy than generally is available in a public place and I can’t do it with a blanket thrown over my shoulder.  I’ve been dreading these appointments more and more since they are so wearying and take so much energy to prepare for, over six hours away from home due to using public transportation, and then I’m so tired when I get home that I have to rest.

Today I went to a part of Nahariya that I’ve never been to before, so there was the usual effort involved in trying to figure out how to get there. Once I arrived, I was over an hour early for my appointment, so I strolled through the mall where the office was located.  As I got to the third floor, opposite the cardiology clinic, I was surprised to see a room with a sign: “Nursing and changing room”. I pushed the door, expecting it to be locked (it looked dark and unoccupied) but was pleasantly surprised when it swung open.

Inside was a simple setup – a couple of padded chairs, a low table, and a sink. Nothing fancy. But it was quiet and it was private – and it was perfect! For the first time in all of the traveling I’ve been doing with the baby since he was born, I was able to nurse him somewhere except for at home. It was so, so relaxing. Sometimes you don’t realize how much tension you carry around with you until you don’t have it!

And for the first time since doing all of this traveling, I didn’t need to give the baby a bottle. He was content during the entire doctor visit, slept soundly for the next two and a half hours until we got home, and I didn’t need any bottles at all during the entire 6.5 hours we were out!  Having this room made such a huge difference to my day – I was so grateful and wished I knew who thought of the idea so that I could personally thank them.

Maybe these rooms are common – this is the first I’ve seen in Israel, but until very recently I wouldn’t have been looking! If so, it’s a trend that will hopefully catch on and become much more widespread.

Do you have nursing rooms in public areas near where you live? Are they common or hard to find?

Avivah

Building sense of responsibility, competence, confidence in children

homeschooling, parenting

I’m in the happy situation of currently reading aloud to my children two of my all-time favorite books – the Little House on the Prairie series, and Understood Betsy, by Dorothy Canfield.  A couple of days ago when I read one of the chapters, it struck me how similar some of the underlying messages of the books are.

Yesterday a reporter emailed me some questions to flesh out an interview for a magazine I had done with her about homeschooling, a week after Yirmiyahu was born.  Insightful and valuable as her questions are, I won’t have time to respond in detail to them, but they really underscore the same indirect underlying message of the two chapters that I wanted to share with you.  I don’t think it’s a coincidence that I received the questions that relate to the topic I was planning to post about today!  The questions were, how do you go about:

1) developing a sense of personal responsibility in children

2) developing a child’s natural curiosity and love of learning

3) instilling in the child a confidence in his unique abilities

In the second chapter of Understood Betsy, a young girl of nine is moving from her home where she has been extremely coddled and overprotected to living with her relatives who value independence and hard work.  In her very first interaction with them, she’s handed the reins to the horses and told to go ahead and drive home.  City girl that she is, she has no clue how to handle them.  But since her uncle who is with her is seemingly unaware of her inability to drive the wagon and busies himself with something else, she has no choice but to try.  And after a bit, she figures out what to do.

This happens again and again throughout the book, that she’s given opportunities to do age appropriate activities on her own or with strategic guidance from adults, and it’s fascinating to watch the transformation of an insecure, dependent, incompetent little girl into someone who thinks for herself and trusts in her ability to find solutions and get things done.

Similarly, in Farmer Boy (third book in Little House series), Almanzo is given a yoke for a calf for his tenth birthday.  His father leaves him with two young calves and tells him he’s sure he’ll figure out how to train them using his new yoke.  Initially, Almanzo is mystified about how to go about this but through trial and error, he figures it out.

Both children experience tremendous pride in themselves when they figure out on their own what they needed to do.  What was it that the adults around them did that led them to their discoveries, to building their sense of responsibility, competence, and confidence?

1) Firstly, loving adults in their lives knew what the task required and knew it was within the abilities of the children.  It’s important to give children opportunities to stretch themselves, but not to give them something so impossibly difficult that they’ll give up in despair.  And it’s also important not to give them something so easy that their abilities aren’t respected or recognized.  (To clarify, I’m talking about when giving over jobs for the sake of building character. Sometimes a job needs to be done and even if it’s boring or repetitive for a child – eg sweeping the floor, washing dishes – that’s okay.  But you wouldn’t want all of the tasks you give your child to fall into this category.)

2)  The tasks the children were given were real and meaningful.  No one finds busywork satisfying, and children can quickly recognize when they’re doing something of inherent value and when they’re having something fobbed off on them to keep them busy.  They got built-in feedback about what they were doing was working or not (the animals didn’t go where they were supposed to go or do what they were supposed to do).

3) Lastly, the adults didn’t hover around, giving suggestions or giving the message that they as adults knew what to do and how to do it.  They gave the children the clear message that they trusted them to figure out something new, and gave them plenty of time and space to work it out.  They didn’t within five or fifteen minutes return and start questioning if the children needed adult assistance or tell them the best way to get the job done.  They stayed out of the way.

This is a hard thing to do, particularly in this day and age.  We want so much to be helpful and encouraging that we easily co-opt the responsibility for the task by being overly involved.  The reality is, however, that only one person can accept responsibility for something at a time.  If your child knows that you’re still taking responsibility for the job you gave him, he’s not going to accept the responsibility for himself.  So sometimes we need to let go, to learn to sit on our hands or bite our lips or whatever we need to go to stay out of the way and let real life learning happen.

I think all of this is very relevant to modern day parents, though most of us don’t drive wagons or have farm animals that need training!  And it’s also very relevant to the questions I was asked above about homeschooling.  Whether it’s regarding day to day chores around the house, homeschooling, or any other area that we want to encourage our children to develop healthy independence, we need to give our children opportunities that will stretch them, the opportunities should be meaningful, and we need to let them have responsibility for the success of the experience.

This isn’t just for little children!  As a parent of children ranging up to age nineteen, I continue to remind myself of these principles and come back to them in a variety of different circumstances.

Avivah