My Labor Experience

It has been 20 days since I gave birth, and I finally found time to write about my experience. Since I am a doctor, I know the signs of labor already and know when to go to the hospital and when to stay put in the house. Should know anyway.

On the friday before I gave birth, I thought I had an episode of leaking bag of water but my contractions weren't regular. But upon check up, everything was fine and I was sent home, my IE or internal exam showed my cervix to be 1 cm, high which means it's a long way to go yet.

So in the meantime, I tried eating dates, walking around a lot, doing acupuncture and electroacupuncture on myself, and even tried to get some massage (and eyelash perming but not related to inducing labor) but wasn't allowed because they don't want to risk me going into labor (which is what I wanted anyway). I also tried the evening primrose oil, which I inserted vaginally.

On July 31, I had an episode of bloody show and knew this is one of the signs but my contractions still weren't regular. So I went for an ultrasound, a non stress test with amniotic fluid index. There was no problem with the NST but my amniotic fluid showed decrease amounts, also known as oligohydramnios. Complications of that include mecomium stained birth and fetal demise. So I went to Cardinal Santos Medical Hospital to be admitted.

My internal exam showed me to be still at 1 cm, good results in fetal monitoring via NST.  Since I wasn't in active labor yet, they just put me in my room, had my vital signs and fetal heart beat monitored, and inserted 6 caps initially then 4 caps of evening primrose oil intravaginally every 4 hrs, with internal examination monitoring also done.

In the morning, my IE was still 1 cm but it was soft and doesn't hurt as much as the previous. I was brought to the labor room after breakfast at around 8 to 9 am where I could be monitored via NST continuously.
I was given oxytocin at 10 am when they saw that my contractions weren't regular. Eventually I could feel the contractions closer every 2-3 minutes. And I could feel myself bleeding and gushing out during and after contractions.

At 2 pm, IE was done, where I was at 5 cm but my cervix was paper thin already. My doctor said I could suddenly fully dilate anytime. At this point where my previous IE were just 1-2 or 4 cm, I was thinking if I may eventually end up with a cesarean section. But that gave me hope. Anesthesia was then given because I was officially in active labor... And that the labor would progress quickly so I better have the anesthesia already in.

At this time, contractions were getting intense with my hip pain eventually at 7/10. At first, I can describe the hip pain as numb, which doesn't really hurt at all. Then it became tingling or feeling of "nangangawit." Eventually, it felt like I was being grounded (as in a small electric current). So I was a bit glad that the anesthesia is being prepped already.

I was put in a fetal position for the spinal anesthesia. They might had a bit hard time putting the needle in because I felt several pricks before it was successful. Yes, imagine doing a fetal position to extend the back, but I have a huge uterus in front that is contracting and giving me electric shocks to my hips! It was sooo hard to kept still but I had to because I also know the consequences if the needle hit anything else.

Eventually, it was inserted successfully and, I can feel the pain going away. I was even able to take a nap. But the medicine only lasted for 2 hours. So I may have to be given more if needed.

At 4 pm, IE was repeated and showed I was fully dilated. Yes! But... My doctor wasn't around yet. I was given anesthesia again 2x before I gave birth.

At 6 pm, I was wheeled to the delivery room. My legs were a bit like jelly and numb from the anesthesia. My hips were also numb. I couldn't feel the contraction anymore. I was a bit scared but anxious thinking, "this is it!" my whole 9 months has been preparing me for this ultimate moment!

My husband was called in because he was going to cut the umbilical cord hehe I was  bit anxious for him because he's scared of blood but well atleast he didn't faint hehe I cannot feel my contractions so I was just coached when should I take a deep breath etc. The anesthesiologist also did a fundal push. I felt like I was either going to vomit or cough. And I did. My OB suggested vacuum assisted so it would also be easier also. After 4 tries, at 6:11 pm, Maple was out and crying even though I have yet to see her it my abdomen yet.

When Maple was put in my abdomen, she had her eyes open and was looking at me, but she didn't want to breastfeed or atleast suck. She was just staring at me.

Honestly, I didn't feel like a mother at that instant. But it did feel weird and kind of incredible still that a little baby came out of me. It was a surreal experience, that's for sure!

Inducing Labor Naturally

So I've been ready to give birth for the last 2 weeks, and still... waiting.
I don't want to wait beyond August 1 that's for sure because of the complications that may arise when the baby stays too long in the womb. So I tried to find and did some research on natural induction methods. Some of which, I do wish I started earlier.

This are generally the requirements for a successful vaginal delivery: 1. regular labor contractions, 2. cervical dilatation and effacement, and for the 3. descent of the fetus to the vaginal canal. To induce labor contractions, one needs oxytocin while cervical softening requires prostaglandins. Descent of the baby usually is not a problem when there is no problem with the pelvic area (which causes cephalopelvic disproportion); this part cannot be helped much.

1. Exercise
There are a lots of exercises out there for pregnancy. Mind you, I did my "normal" walking (applicable with commuting) through out pregnancy. I even incorporated some yoga mornings and stretches to "open my hips" more (though those poses I already did prior to getting pregnant).

In pregnancy, the hormone elastin allows the pelvic bones to move in preparation for birth, enabling it to become wider... and supposedly this stretches are supposed to help.

What I should probably do is climb lots of stairs...

2. Dates
There's a research journal saying that this is effective if taken in 4 weeks before your estimated time of birth, taking a daily dose of 6-7 dates/day. My OB friend who is also working in the middle east, also swears by this based from the patients she'd seen. Eating dates are supposed to shorten the labor time and soften the cervix effectively.

3. Acupuncture and acupressure
Because I'm an acupuncturist, of course I would do this to induce myself into labor. The most effective points is LI4 and SP6, but I am also doing GB21 (just because I also love my shoulder massages), BL32 (back massage), BL 28 and BL 48 (butt massage), KI1, KI3 and BL 60 (foot massage).

I read that some are effective without the need for electrical stimulation, but if it doesn't work, I am going to apply TENS also to my needles.

4. Sex
Nipple stimulation causes oxytocin to be released (which is similar process to producing breast milk), prostaglandins from the semen, and reaching orgasm to stimulate contraction of the uterus are all said to help induce labor... but really, it's a bit of a challenge to do this when you're so big and you easily get shortness of breath with certain positions.

5. Evening primrose oil
My friend took this orally for several weeks before giving birth, and it wasn't very effective.  I tried to look it up in journals also but oral intake doesn't seem to be much effective.

My OB told me that on the day of induction, she will use 6 caps of evening primrose oil 4 hours before IE. Apparently, she was one of the authors in a study in PGH, where it was said to improve Bishop scoring (and cervical dilatation) to more than 4... Though in that study, only about 31% had successful vaginal deliveries and the rest had cesarean sections due to fetal distress (46%), intraamniotic infection (1%), and arrest in cervical dilatation (15%).

Because almost half the reason for cesarean section was due to fetal distress, I am contemplating on doing that the night before we get admitted, or just doing it in the hospital.

6. Malunggay capsules
One OB in a prenatal class I attended said that Malunggay capsules can also start contractions, that's why she recommends giving it when the patient is already term. When I asked my OB about it as a supplement in preparation for breastfeeding, she just told me that it's a supplement, so you have to establish breast milk first. And it may have constipation as a side effect.

Anyway, I started drinking 1 cap 500 mg since I was in 37 wks old, but I don't think it's very helpful.

7. Pray
Probably the best thing to do is also to pray. Pray for a safe and successful delivery to a healthy baby. I am constantly in anxiety over the possibilities of stillbirth and postnatal infection and complications, especially now that I'm getting past my ideal 38-39 weeks AOG.

Every night, I listed to my fetal heart tone... sometimes, twice! Especially if I don't feel her move as much. I noticed that there is less tendency for movement in my last month of pregnancy as compared to the 2nd and early 3rd trimesters. The reason for this is because the baby is accumulating fat and getting bigger, and the uterus is getting cramped.


Anyway, I will update on how my labor goes. I don't know else what to do when there's only less than 48 hours before my scheduled admission!

Where to give birth? Cardinal Medical Center VS St. Luke's QC

Yes, we are now officially term at 37 weeks AOG, and I can finally have my massage and whatnot! Hehe Anyway, just when the time is about to come, we realize that we better check out St. Luke's QC too as an option for giving birth, since our OB-Gyne is also affiliated here too. I will also post their recent packages and room price list if anyone is interested as of July 2018.

St. Luke's QC

Room Rates and Packages

Room Rates in SLMC QC

SLMC OB Packages

In case that the above picture is too small or can't be read, we just want to emphasize on the following rooms (price is per day):

Private Rooms

Executive private - 6,400

Deluxe private - 4,400

Regular private - 3,700

Small private - 2,800

Two-Bed Private rooms

Two-bed private with TV & Ref - 2,400

Two-bed private w/o TV & Ref - 2,000

Ward - 1,200

Birthing Room - 13,100

Birthing Room Rooming in charges (single baby) - 14,100

High Risk Pregnancy Unit (HRPU) - 5,400 (for 24 hrs)

Labor Room - 1000+

Rooming-in charges:

Suite Room/HRPU - 1000

Executive Private - 700

Deluxe/Regular/Small Private - 600

Two-Bed Private - 500

Ward - 400

I have highlighted our possible room choices.

Pros:

Location is nearer (about 1 km from our home)
I can call my acupuncture friends to do that technique with me, right? Because they aside from acupuncture, they also practice as Pedia, OB, and a medical acupuncturist in St. Luke's (though there might be a conflict because I haven't really told my OB-Gyne about this part)
More HRPU units as compared to 1 Lamaze room in Cardinal (where the husband can stay during labor)
Admissions staff was very friendly and even offered us an admission papers already

Cons:

Rooms are way smaller as compared to Cardinal
More expensive than Cardinal (?)

Others:

Admitting kit is already provided in the room, containing toothbrush, toothpaste, medicinal cup, kidney basin, etc
Newborn kit contains EVERYTHING daw according to the nurse, including 2 swaddles, 1 set of clothes and bonnet/socks/mittens, 2 pcs baby diaper, alcohol, etc



Cardinal Medical Center

Room Rates and Packages

Room Rates in Cardinal

OB Package in Cardinal

In case that the above picture is too small or can't be read, we just want to emphasize on the following rooms (price is per day):

Big private - 3,690

Regular private - 3,480

Small private - 3,160

Semi-Private - 1,930

Lamaze room - est. 2,200 (first 2 hours) + 229/every 30 min

Labor Room - free for first 8 hrs + 250/hr

Pros:

Rooms are bigger as compared to SLMC
May be cheaper than Cardinal (?)
My friend Karen gets to be my Pedia
NICU nurse, DR nurse, and admitting section were very prompt in replying to my email

Cons:

Only 1 Lamaze room (and they will give priority daw for those with certificates)
Location is farther... especially if school resumes for Xavier and ICA
Admission papers weren't given yet (a relative will come down for me to be admitted)

Others:

Admitting kit contains toothbrush, toothpaste, face towel, soap, spoon and fork, medicine cup and glass, 1 roll of bathroom tissue, 1 500 mL water, 1 pillow.
Newborn kit contains EVERYTHING I will need like white basin for bathing, kidney basic, cotton buds, cotton applicator, alcohol 70%, J&J top to to wash, diapers, digital thermometer, cotton, and 1 box of gloves. I will provide the swaddle and clothes when the baby is roomed in.
(Since I already have the swaddle, I am leaning towards Cardinal instead.)

*Not sure if all medications and supplies are required to be from the hospital, but from Mariel's inquiry with her chemo drugs, Cardinal is not as strict as SLMC.

Though I have posted their OB packages, a lot of nurses and staff don't think that they are economical because a lot of doctors prescribed medications and supplies that is not included in the package, so this would be a waste, and you have to pay extra for the excess. So one still has to consult with their OB-Gyne.

Conclusion

Our preference would still be for Cardinal Santos Medical Center mostly because of the bigger rooms... But if I feel that I can't make it because of traffic, etc.... Well, I guess St Luke's would still do because it's nearer. Or I was thinking, I should just have my IE in St. Luke's first and decide from there if I could still transfer to Cardinal Santos.

We weren't also sure about the Lamaze room. Though I did told myself, maybe depending on the IE? If I was dilated already, like more than 8cm dilated, perhaps I will just choose the Lamaze room. But if the contractions aren't closed enough yet, or I am less than 8 cm dilated, I know that it will take several hours of labor so I would just have to do with the labor room.

Regarding my anesthesia, I was wondering if I could have an epidural without having sedation? Or if I could only be administered once my VAS is more than 7 or 8?

Hospital List

Hooray, we are in the 8th month already! 6 more weeks to go before I popped out! Hehe
So now, it's time to prepare our hospital bag :) The goal is to have them ready and waiting in the car by 36 weeks AOG (or for some, 34 weeks).

I have read a lot of blogs and forums on what to prepare, but of course it really depends on the patient, right? Actually, I also think it depends on the hospital because their rules and package inclusions also vary.

So this is our hospital list. We are going to give birth on Cardinal Medical Santos, under the service of Dr. Angela Aguilar, and so far, NSD is still the plan. We have a prenatal check up scheduled on Monday, and we're going to try to go to the nursery, and ask if they have a list of things to buy or prepare for giving birth... or whatever is included if we're going to take the package? Like, for certain hospitals, they will charge you for the diapers, maternity pads, cotton, thermometer, wound cleaning solution, abdominal binder, etc. I am going to ask if we can prepare them in advance so they don't have to charge us.


Labor Bag

o   Paperwork:

o   Birth Plan

o   Admitting Order

o   Maternal Information Sheet

o   Philhealth contributions, MDR

o   Marriage contract

o   Government IDs

o   Medical Records/Lab Work-up

o   Apparel:

o   Socks

o   Slippers

o   Things to do:

o   Cellphone

o   Charger

o   Labor:*

o   Massage oil or lotion?

o   Heat pad

o   Gym ball?

o   TENS machine

o   Toiletries:

o   Eye glasses

o   Petroleum Jelly

o   Hair tie

o   Betadine vaginal wash

o   Cordlife Kit


*I know that Cardinal offers a Lamaze room for a really expensive price (more expensive than a suite) for those who plan to give birth naturally (meaning without epidural). I myself thought about it and wanted to try natural birth... but I also want to have the reassurance of an anesthesiologist because they say giving birth REALLY hurts. Second, we didn't really officially go to  Lamaze class and don't have a certificate (because I'm already a doctor, and my OB told me it's not necessary for me because I have already seen and birth other mothers).


So I am thinking if their Labor room would allow this stuff? And would allow me to attempt for natural pain relief? I myself know acupuncture, so I am planning to use the TENS machine when the time comes (actually, I am planning to induce myself with acupuncture haha)... Though I wonder if I could do it myself if I am in soooo much pain. I did wonder if I could give birth in St. Luke's QC (because my current OB also have visiting rights there), because I know another OB who also practices acupuncture, and I could call on him when I am in labor, right? He did help me with my morning sickness and my constipation back on my first trimester...


Recovery Bag

o   Postpartum recovery:

o   Adult diapers or maternity pads

o   Abdominal binder

o   Cutasept would cleaning solution? (I read in another blog from someone who gave birth on St. Lukes... I also know this was given to my sister in UST post-surgery)

o   Apparel:

o   Going-home outfit

o   Front-opening pajamas

o   Bathrobe

o   Bath towel

o   Disposable undies

o   Nursing:

o   Nursing bras

o   Nursing pads

o   Nursing cover? Or use the bathrobe?

o   Nipple cream?

o   Nursing pillow?

o   Breast pump

o   Toiletries – toothbrush, deodorant, contact lens


Partner’s Bag

o   Change of clothes

o   Toiletries - include tissue

o   Pillow and blanket

o   Things to do

o   Cash, credit card

Babies Bag

o   Health

o   Thermometer?

o   Cotton/Baby wipes

o   Alcohol?

o   Powder?

o   Toiletries

o   Hooded towel

o   Small cetaphil?

o   Diapers

o   Receiving blanket

o   Lampin

o   Clothes

o   Tie-sides

o   Swaddle

o   Going-home outfit

o   Bonnet, mittens, booties/socks

o   Baby book

o   Feeding bottle?


 So there... but I will update this list especially after our prenatal check up on Monday.

Update (7/7/18):

I sent an email to Cardinal Medical Center. The admitting section replied promptly, indicating the following in their admission kit (so i don't have to bring) :

1. Toothpaste (small)

2. Toothbrush

3. Face towel

4. Soap

5. Spoon and fork

6. Medicine cup and glass

7. 1 roll of bathroom tissue (one time charge only)

8. 1 500ml of bottled water (one time charge only)

9. 1 pillow 

For the nursery, they will provide everything in the kit such as: white basin for bathing, kidney basin where we place the cotton mix  with soft in there, cotton buds, cotton applicator, alcohol 70%, J & J top to toe wash, diaper, digital thermometer, cotton and 1 box of gloves. Other inclusions are Bcg, hepa b, vit.k, erythromycin, bld typing, newborn kit, newborn hearing, and baby diploma. They will just ask for the clothes and swaddle when the baby is roomed in.

When I asked about the DR rules, they told me that I cannot bring supplies or machines including cellphones in the Labor room and delivery room complex.

So I guess, I can remove a lot of the things I have on the list... Though the basis of this list is actually based on US websites. Though I am wondering how am I going to manage labor in the labor room without my ball, warm compress, cellphone to monitor my contractions. Will they let me do labor in my room? Haha

I remember the Labor room as a boring place to wait for the contractions and for the labor to progress.

I know that they have a Lamaze room but I find it expensive. It's like a birthing suite. And for practical reasons, I don't want to have to get that. Maybe i should just monitor my contractions at home then when they're like 3 to 4 minutes apart, I will go to the hospital then haha I don't know yet... A part of me wants an unmedicated chilbirth but I know that it's not a popular thought in the Philippines. And I am a doctor haha

My Ideas on How to Save on Baby Stuff

So... I have been going through these baby stuff for more than a month now, and I just want to share my thoughts on something. Once they add the word "Baby" to a regular item, it becomes more expensive. So... if you could, you can actually buy the normal/adult version because it can do the same process. I am going to share tips on what I think to save on baby stuff.

1. Feeding

They say this is one of the biggest expenses for babies. So the lesson: Breastfeed!
Aside that the milk is free, it also has more nutrients for the baby (and immunoglobulin), less side effects and constipation from the milk, good for the mommy who can lose weight and get back to their post-partum bodies faster, etc.

The equipment that you might need:

• Nursing Bra - well, your breasts are going to get bigger anyway, so why not buy the nursing kinds directly? I bought these online for less than 200 pesos only. But I am planning to invest on a really good pair after the baby is born. (I read about Marks and Spencer, and checked the price from Mothercare which cost less than 2000 for 2 pairs of nursing bra).
• Silicon manual breast pump - I bought a manual silicon pump, Haakaa style, because (1) the electric ones are too expensive (and I'm not yet sure if I might need them), (2) the manual ones have a less suction on them than the Hakaa-style manual pump, and (3) the Hakaa style is simpler and easier to clean because it only has 1 essential part and its lid. You can try the suctions themselves if you just go to an SM Department store (they don't have the Hakaa brand, but a cheaper similar silicon pump from Mom and Me was there only cost 300 pesos, which I compared with the Looney Tunes manual pump). If you want the original Hakaa brand, it's 950 pesos in Rustan's and The Parent Emporium (the lid is sold separately), but since I wasn't sure of a lot of things yet, I bought it online in Shoppee for only 100 pesos! It also comes with a lid, where I can even choose my preferred color :)
• Breast pads - actually, I just bought 1 or 2 washable pairs online because I wasn't sure yet  if I would have enough breast milk

Optional:

• Breast milk storage bottles/bag - optional actually especially if you're with your baby 24/7
• Nursing cover - actually, I didn't buy this because... I had a lot of sarongs and this wraparound multipurpose blanket from Headware, which I used during my camping and traveling days which I think would serve the same purpose
• Nipple cream - I haven't bought this actually since I wasn't sure yet if I will need it. They say to prevent those nursing pains, make sure I breastfeed correctly... And that I should just leave the residual milk which will be the ones to heal any nipple wounds.

My pediatrician friend told me that production of breast feeding is also about the mind and willpower of the mother. She told me to make sure to feed (or try) every 2 to 3 hours so the milk will just continue flowing. Don't wait until the baby is hungry but I should try and pump even while the baby is asleep just to keep the stimulation of breast milk continuous. (That and I was planning to take one of those seemingly-delicious lactation brownies and cookies that I've read about, and maybe those malunggay capsules which should be started on the 3rd trimester.)

But if I really can't.... then for bottle feeding, the essentials are:

• Bottles! - I have read about babies selecting their bottles and nipples, though I am not sure how common is that in the Philippines. Anyway, after reading a looooot of blogs, I decided on Philips Avent bottles. It's waaaay cheaper to buy them from the US (10 USD for 3 bottles as compared with 1800 per bottle here in SM) and fortunately, I had a friend who came from the US so I saved a fortune with those. Aside from Philips Avent, I also bought Tommee Tippee (because we liked how the nipple resembles a natural breast and Comotomo was still too expensive) and we were also thinking about Playtex (because it was just soooo cheap from the US but decided against it because I think we think we already have 10 haha). So if you could, do it like me, buy online from amazon, ship to someone you know in the US, and bring it back when your friend comes home hehe
• Bottle cleaner - this is actually pretty cheap since it's just basically sponge that can reach the bottoms of the bottle. We bought this online, though we also saw this available even in Daiso stores.
• Milk - now this is the expensive part. But I didn't buy any because well, sometimes the pediatrician is the one who will advise on the kind of milk. And... I am really pushing for breastfeeding.

Optional:

• Milk storage container - I wrote this under optional because you may just need this while traveling
• Bottle sterilizer - we weren't actually sure if we're gonna buy this because we think the old habit of "boil and dry" method works

Now, regardless if you're breastfeeding or bottle feeding, the baby will need this:

• Burp cloth - one of the most useful things for a baby, they say that you might need as many as 15! Good thing, a burp cloth can actually be a receiving blanket, a lampin, a towel, etc. They even say that the bigger the size, the better because sometimes the original burp cloth is not enough to catch all that spit. --> Personally, what we plan was use several lampin or microfiber towels to be used as burp cloth since they are bigger, more absorbent, and versatile
• Bib - we got the cute waterproof ones, and obviously this is to protect your baby's clothes from the spit and the milk so you won't have to keep changing their clothes. Though... what we did was bought a "Bib/Clip Holder", which means we can use any cloth actually as a bib as long as it was absorbent... so we bought wash cloth and microfiber towels instead which was cheaper. (Of course, these are also more versatile.)

Optional:

• Nursing pillow - we bought the U-shaped one which was what my friend advised me from PC Supermarket in Shaw for only 400 pesos (it was the only one left, not sure if they will restock)! Next to that, cheapest we've found was in Shopwise Cubao. Online and in baby stores, you can buy it for a whopping 1000 to 2000 pesos! So even though we weren't sure if we're gonna buy these, we bought one because it was really cheap compared to the baby stores haha

2. Diapers

Next of the bigger expenses are the diapers that a newborn baby can consume 12-15 per day because they say that a newborn has to be changed every 2-3 hours (about the same time frame that the breast needs to be stimulated for breastfeeding).

For me, in order to save bucks (and save the environment, plus also decrease the risk of diaper rash), I am going for cloth diaper. I already had a previous post on this topic, so I will just summarize my essentials:

• Lampin - they say gauze is more absorbent than bird's eye, though bird's eye is more durable and can be used as a burp cloth, bib, towel, cloth wipes, etc. Very much available in department stores, but cheaper in Baclaran (if you have the time and patience), and also available online.
• Cover-Type Cloth Diapers - our fave because if the baby only urinates, we can just change the insert and reuse the diaper. Unfortunately, I can only find this online in Shoppee and in Facebook
• Pocket-type Cloth Diapers - for night time use, so we can stack up inserts and increase absorbability. I found this cheaper online, but can also be found in department stores (usually with brands like Charlie Banana, Hush Tush, Next9, etc) 
• Microfiber diaper insert - actually, I wasn't a big fan of microfiber after reading that they will only last for a year and after which they lose their absorbancy. So... what we were planning to do (which I followed from certain blogs) was just use the regular microfiber towels, wrap them in lampin/cotton, and use them as inserts, which was cheaper and more versatile.
• Hemp diaper insert - my favorite so far because it's so thin! And it's one of the best in absorbing. However, it's a bit expensive, though there are only several online shops that sell this. I was thinking of making my own diaper insert, but the fabric seems to be not available in the Philippines.
• Cloth wipes - I was thinking about using disposable wipes (at least when we travel), but if we're doing cloth diaper, basically it's logical to also use cloth wipes because they can just be washed together. I've also read about several mixtures of oil or water to keep the baby's bum free from rash. I read that you can use just about anything (but preferably cotton) like old t-shirts, but we were also thinking of using the wash cloth or microfiber towels since we also bought them.
• Changing mat - for me... this is more essential than a changing table (which is more common in the US) because it's more portable. Also... I think this has the same purpose as a waterproof protector used in cribs.

Optional:

• Bamboo charcoal diaper insert - also not a fan, because I find them soooo thick and bulky, but we have them because they say this is better than microfiber inserts in absorbancy
• Bamboo cotton diaper insert - this is also a bit thick, but someone advised me that she would rather use this than microfiber for the absorbancy and duration of use
• Diaper clamps - if we're going to use lampin as is, without any cover, we would still need this
• Wet bag - used for traveling to store and separate clean and dirty diapers
• Diaper pail - common in the US, but for me... this is just similar to a hamper specifically for diapers, correct?
• Changing table - in the Philippines, this is not really common because you can just change the baby on the bed, right? Well, what we did to make it more convenient was just to buy the diaper caddy organizer (which can be stuffed with a changing mat, clean diaper, cloth wipes, powder, etc) which is also very portable.

3. Sleeping/Nursery

Essential:

• A place to sleep with a stiff and safe mattress - I didn't say crib or playpen because a lot of Filipinos co-sleep with their babies on the bed, and what we planned was use Baby Cuddle (which was a gift) on the bed with us. From what I read in several forums, cribs can be hardly used if the baby refused to sleep by themselves once they're co-slept. (We were thinking to just transfer the Baby Cuddle in the crib once the baby is asleep if we're not co-sleeping).
• Waterproof protector - protects the mattress from baby's accidents while sleeping
• Blanket/Swaddle - depends on the baby if she likes to be swaddled (because some swears on a wearable swaddle to keep the baby asleep), but my friend recommended Halo. Though I think a regular blanket for swaddling is also essentially the same thing.

Optional:

• Wooden crib - we were still deciding between a playpen and a wooden crib, when this was bought for us. Advantage would be a crib feels sturdier, but disadvantage with wood is that it's heavier. We were thinking of a playpen because we like its portability and multi-function use with the reversible napper and changer. Graco is so expensive here in the Philippines, and what we originally thought was to buy it online in Amazon (only 4000 pesos), then have it shipped here via sea (additional 2000 pesos) which is soooo much cheaper than the ones in bought in SM (14000 pesos). Anyway, the wooden crib was a gift and so... we will just save our money for future vaccines hehe
• Crib mattress - we had this customized in Mandaue Foam for only 900 pesos (Uratex costs more). Inquire about their mattress particularly for cribs, which was stiffer than the softer and more comfortable ones for adults. Their crib mattress has a warranty for 5 years (which is more than enough for a baby).
• Crib sheet set - since we had a crib size smaller than the usual size, we will just use one of the blankets as crib sheet (we bought 4 from Shopee just because it was so cheap, the equivalent of 1 muslin blanket from the mall)
• Baby monitor - common in the US because the parents room is usually separated from the nursery
• Night light - usually helpful at night for diaper changes. We already have two actually even before we got pregnant.
• Bassinet - Actually this is a gift... Though from the reviews of rocker napper, it can be used up to toddler months. This is actually one of the reasons why we weren't in a hurry to buy a crib or playpen because we know that the baby can sleep in this for at least 3 months. 
• Wooden Rocking Chair - We actually bought one because of my reflux during my third trimester, and I can hardly sleep sometimes because of that. And well, I realized we could use this while feeding the baby and rocking him to sleep. Online, there's ofix (physical shop was also located in Gilmore) selling it for 3000 pesos, but we wanted the old rocking chair type that our grandparents used because it feels more sturdy. It can be bought in Caloocan from 3500 to 5000 pesos.

Not really recommended

• Crib toys, pillows, bolsters, mobiles - they say this can promote SIDS. So... let's just minimize what's on the crib

4. Bathing and Health

This is one of the departments where putting "Baby" in front of the item becomes more expensive than their adult/ordinary counterparts.

Essentials:

• Wash Cloth - an alternate cheaper version to the baby version would be to just look for normal face towels
• Towel - I don't think it has to be hooded... but the hooded ones can be soooo cute!
• Shampoo and body wash - got a lot of free samples already
• Thermometer - I'm pretty sure the adult digital thermometer is similar to the pediatric one
• Nail filer/cutter - They say that the newborn nail cutter is different from the adult one...
• Nasal aspirator - imagine how hard it is to sleep with a stuffy nose as an adult, what more for a child who cannot express anything?

Optional:

• Bath tub - according to some american blogs, this is one of the things that you don't really have to invest in because you can just bathe the baby in your sink. Because... what happens when your baby outgrows your bath tub? It's just something bulky that can occupy space. So...  I had this idea to just use one of those big plastic storage boxes like the Megabox? They are made out of plastic just like the bath tub, but at least they can still be used when the baby is already big. But this is just in theory... We didn't really bought one, because apparently, my sister already bought us an inflatable baby bath tub! Hehe
• Bath net - my friend recommended this especially for newborns, who have no head support yet. The baby can just sit with his neck supported while you can easily bathe him even if you're by yourself... Though I was thinking that you can also use your arm (or maybe prop up some towels) to recline him? Anyway, after 3 months, the baby is supposed to have neck support already.
• Bath hat - honestly, I just bought these because I want to have free shipping on Shopee hehe but this is optional, though I guess could be helpful as I remember getting irritated as a child when the water would flow to my eyes and ears. What more for a baby who doesn't understand to close her eyes?
• Bath toys

5. Clothing

I reserved this last because personally, we haven't bought this since we were thinking if there was a baby shower, we would get a lot of this.

But personally, babies are small and they outgrow clothes very fast so I wouldn't really recommended the really expensive or branded ones. My friend even told me that I should just get second-hand ones because babies outgrow them very fast anyway.

Anyway, this is my list:

• Newborn set (3 sets of tie side sleeveless, short sleeves, long sleeves, shorts, and pajamas with 5 sets of bonnets, mittens and booties) - only 400 pesos from Shopee! Though I must admit I am not sure of the quality (because it's not Lucky CJ as they say)... but on the other hand, the baby will just use it for 3 months, so... Actually we weren't sure about the shorts and pajamas as well, because the baby will be in cloth diaper anyway, isn't that a cuter and better bottom for the baby? :) There are also blogs about bonnets not really that useful, and keeps on falling so they are also not a priority for me, but I've read that mittens will keep the baby from scratching themselves.
• Socks - I think socks are better than booties at keeping the feet warm and more secure
• Hooded long sleeves - we will also buy this hooded long sleeves just in case the bonnet keeps on falling off our baby's head (and also to reach the PhP 500 minimum for free shipping from Shopee hehe)
• Onesies - we are looking for those onesies with snap-ons on the side, and it was actually hard to find these in SM. If we do found one, they are usually long sleeves or long pants or frog suits, instead of the romper kind. Instead, we found 2 in Uniqlo for only 300 pesos! Haha

6. Travel

Optional: (until the baby is born because some say that you have to try these with the baby's approval)

• Carrier/Baby Sling - actually, they say that I should buy this when the baby is born because the baby may not want to be carried in a certain way. Anyway, we got this as a gift.
• Stroller - Did you know that there are many Japan Surplus selling strollers from Japan? While Aprica strollers are being sold online and in SM Department stores for more than PhP 17000, Japan Surplus stores like Mumsavers in FB sold them at only PhP 4500-5500 (depends on the model, but we are aiming for Aprica Karoon Plus High Seat because it's lightweight, one-hand operation, reversible handle). Actually Mumsavers also sells cribs, playpens, etc which are also cheap as compared to mall prices. Their physical shop is just in Gilmore area, so it's pretty near our place too.
• Car seat - actually, this is supposed to be required before bringing the baby home from the hospital, but is not very commonly done here in the Philippines. We are still thinking if we're going to buy this or not. Though if w did buy it, we will probably get it from Mumsavers too.
• Diaper bag - We prefer the backpack type because my back hurts if carrying heavy objects using only one shoulder. We got one from Shopee for only 300+ thanks to its coins and vouchers and promos haha 

Hmmm... I guess, that's all for now. This is what I think... as an expectant mother (but no experience yet) so I'm not sure what will hold true or not haha

Cloth Diapers

Babies mostly sleep, eat and urinate/poop generally.
This is one of the reasons why they can be so expensive, which is why I am planning on breastfeeding (versus 7K pesos per week), and using cloth diapers (which is also more environmental friendly and less prone to diaper rashes for the baby). Modern cloth diapers (versus the lampin) usually have cute designs (no need for the baby to wear separate shorts? Haha) with adjustable sizes (some even claim until 3 yrs old).

I have read on the different kinds of modern cloth diapers, but I have decided to focus on the following because I think this is where I will stick to. To read about the basics, you can click here, or here, or here, or just google it :)

1. Flats
Most Filipinos grow up with the concept of lampin (or flats).

Pros:
Cheap (1 dozen can only cost PhP 220)
Easy to wash and dry
Breathable (presko)
Easily adjusted based on size by using diaper clamps (I remember using pins when I was young, but clamps are safer)
Lampins are also versatile and can be used as burp pads, wipes, towels for the back, etc.


Cons:
Not waterproof - but can be remedied by using diaper covers
Can be hard to put on, especially when baby is makulit

2. Pocket Diapers
Pocket diapers consists of an outer waterproof layer, and an suede inner layer with an opening on the end, to serve as a pocket. Inside the pocket, you can add flats or inserts or combine them together (to be discussed later).

Pros:
Inserts/absorbancy can easily be adjusted
No need for diaper pins/clamps
Popular (these are what I usually find in department stores)

Cons:
Needs time to stuff the pocket with inserts
Harder to dry when cleaning
May also be more disgusting because you have to separate the insert from the pocket when washing

3. All in Twos
I think this is our favorite. But I have seen different variations. It usually has two components, an outer waterproof layer with a separate absorbable insert that can be snapped on to the waterproof layer. The outer layer (also known as the diaper cover) can either have a snap for the insert, or flaps on both side of the diaper where the insert can be inserted.

The other variation I've seen is a waterproof outer layer with a suede inner layer that can be used as a pocket, but it also has a snap that can be used with a removable snap-on insert.

Pros:
Reusable in between washing (if only the insert gets wet or dirty with urine)
No need for diaper pins/clamps
Easier to dry than All in Ones and Pockets
Can be combined with a disposable insert (well, this is actually available only from the US and can be expensive)

Cons:
Need time to stuff the insert
Inserts can shift when the baby moves


From all these, I figured we would use All in Twos a lot because they are reusable in between washings (we just need to buy and wash more inserts). We would also use the pocket, especially for night use where we could stuff the pockets with more inserts. I think it's pretty useful also if the baby is constantly moving, which might displace the inserts with All in Twos.


I've been talking about inserts a lot, and base from my research...
1. Flats - lampin; because this is pretty cheap and easy to dry
2. Microfiber - most common default insert
Pros:
2-3x more absorbent than flats
Cheaper than other modern inserts

Cons:
Cannot be directly put on the baby's bum
Can retain the stink
Absorbancy properties gets lost after about a year

3. Bamboo charcoal
Pros:
More absorbent than microfiber
Can be direct on the baby's bum

Cons:
Bulky
Also said to retain the sink
Harder to dry when washing

4. Hemp
Pros:
More absorbent than bamboo charcoal
So much thinner than bamboo charcoal
Natural fiber so can be next to baby's bum
Softer with every washing

Cons:
More expensive

Because of all this, I was thinking on just going for the hemp inserts, and probably the microfiber ones because it is the free default insert that comes with most cloth diapers. Though I did also buy some bamboo charcoal and zorb already just to try it out when the baby comes.

I must say that I'm really excited about trying on cloth diapers on my baby. (Though maybe it's also because I don't really wash the laundry hahaha) They did say 20-30 diapers is already enough. But since I was planning to use AI2s, I think I can just buy 30 inserts and just make do with 15 diaper covers? Though I read from another blog, that a newborn can go through 15 diapers per day! Or... maybe I should just stick with the flats with nappy clamps and pins, which is bought per dozen anyway.

Though I was so excited when I first read up on it that I already bought 10 diapers when I was just 5 months pregnant (they are a mixture of 6 pockets, 2 AI2, and 2 diaper covers that I bought online) with a mixture of different inserts (including "special" ones like pure bamboo booster (for night use), hemp jersey (stiffer than pure bamboo, but just as absorbent), bamboo cotton, zorb diamond cloth (one of the most expensive but most absorbent out there), coffee fleece (claims to have absorb the smell).

Sample of a diaper cover with hemp insert

Sample of a pocket diaper with bamboo charcoal lining

Aside from the cloth diapers from shopee, I also bought a pure bamboo booster, hemp jersey, and bamboo cotton insert

Sample of a diaper with fleece as outer lining (in contrast to the usual TPU and PUL)

Aside from my cloth diapers from shoppee, I also bought a Wazoodle Zorb insert, microfiber, and bamboo charcoal insert

This is my favorite set from a certain shop in Shopee. It comes with 1 Diaper Cover with 2 snap on stay-dry (includes microfiber) layer and 1 hemp insert. There's a specific snap so they all match perfectly (3 diapers in 1!)

I just wanted to demonstrate the different sizes of the diaper depending on the buttons

Some diapers only have 3 rows adjustable (from small, medium, and large), but this one has 4 (to include newborn size).

This is a sample of All-in-Two with a snap-on Bamboo Charcoal Lining. (Unfortunately the snap on from the other diaper did not exactly match with the snap on from this shop but can still be used if I don't use the snaps.)

Aside from the cloth diapers, I also ordered a coffee insert (which isn't really common but I've read is good for the smells)

When I received them, this is when I realized that the AI2s were my favorite, particularly the "diaper cover-type" because we can just wipe off the PUL cover then reuse it again with another insert! Yey! 

To organize my own baby shower or not?

I am soooo excited to buy things already for the baby. It's all I've been browsing and thinking about since we've reached 20 weeks and the baby has been kicking!

But... unfortunately, I can't yet. Because mom said I should wait before my baby shower before buying anything... Well, who was supposed to organize it anyway? They say it's usually a friend or relative of the mother-to-be... And I am in agreement, because it seems that we're scouting for gifts if I organized it haha

Regardless, they say the best time to do a shower is 4 to 6 weeks before the baby is due. Since we're due on August 1, that will be in mid-June, right? Hmmm... since my parents are going away after June 5, I prefer it to be June 3 which is a Sunday. I guess, there is still time for me to do online shopping then hehe Though when I counted, I am 31-32 wks AOG at the time.

But I am a bit confused on who should organize it? Should I let my sister take over or can I? Haha
Though... I was also thinking what is the purpose of the baby shower? To tell them that we're pregnant, and we're celebrating? To just meet up with my friends (especially those coming from the abroad)? To collect gifts? Haha

Okay, a part of me is saying... if I'm going to be the one to shell out a budget for this, then I guess let's just not give a baby shower and just use the money to buy our own baby stuff, right? But... if I do wait for my relatives to organize a shower for me... then... when should I start buying? Or... maybe I should just buy the essential stuff first that we'll be needing within the first month, right? That seems to be the safer answer.

What are the essentials again, especially for the first month:
Bathing - wash cloth, hooded towel, waterproof pad
Clothing - newborn set (side ties, bonnet, mittens, booties), onesies, receiving blanket, swaddle
Diaper - cloth diapers (we already have 10 pcs) and inserts
Feeding - manual breast pump, bottles, bibs and burp cloths, nursing stuff (nursing cover, pillow, pads, bra)
Nursery - we're planning on co-sleeping for the first few months, so the BabyCuddle should do

From the list above... actually, a lot of them can be easily bought online (since the diapers are local; we just need a week for delivery; and several days to have them washed first), Hello Baby Outlet (clothes), or department stores (wash cloth, towels). Since the swaddle is a bit expensive on department stores, my guess is that I could buy those online along with the manual breast pump. Even the usual lampin and basic newborn set is more expensive in SM as compared when bought outside.

IF hindi man kami mabigyan ng baby shower, ready na din naman kami mag shopping online especially for the Graco crib, which we plan to buy from the US (cause it's 3x cheaper) and just have it ship here via sea. Kahit 2 months siya aabutin, it's okay kasi maliit pa din naman si baby.

Second Trimester Preparations

Yey for second trimester!
Goodbye morning sickness and hello to appetite once again!

We are now 21 weeks, and we already have a baby bump!
I can also feel my baby move at times, which can be described as a very short intestinal borborygmi hehe Or as our nurse described it, like popcorn popping from the inside.
I can also sometimes here our baby's heartbeat with my stethoscope... Though sometimes it's hard and the sound is still very slight.

Anyway, I just want to say that I'm soooooo excited for the baby now that we're past the miscarriage stage (1st trimester). We only have half way to go.

We started looking at things to buy for a newborn. Like, what to look for in a crib? Or do I really need to buy a breast pump?

Most people tell me not to spend too much money on newborn clothes because they're easily outgrown... Which is true... it's the last thing for us to think about or put in the registry. Actually, I was thinking of just asking from my friends for this haha So... what do I really need to buy? Or at least... what do I need to research before buying?

1. Nursery Stuff

• Crib
• 1-2 waterproof mattress cover
• 2 Receiving blankets
• 1 Comforters and pillows - But I read somewhere that too much soft things can lead to SIDS. So we'll just probably buy 1 set?

Actually, we haven't really started looking at this but since we joined Cordlife, their freebie for the month includes a Tiny Love 3-in-1 Rocker Napper... We looked it up of course, which made us look into cribs and playpens haha

We are looking more into a playpen because they also have a bassinet and a changing table so it seems to be more convenient. Playpen costs PhP 4,000 to 12,000 which the child should be able to use until toddler stage, maybe 2 years old?

Anyway, we still think we have to time to think and research with this because it's just our second trimester. And since, we have the rocker napper and the BabyCuddle (which could be used for co-sleeping), she actually has a bed already.

UPDATE: We looked at cribs and playpens in SM department store (we were thinking of getting a registry, and it will probably come from there). It turns out that Graco is the only one that has lifetime warranty for service, in case any part gets stuck or whatever. Their service center is in Sta. Mesa. The other brands, though cheaper, only have 1 week store warranty.

2. Feeding

• Breast pump - manual breast pump for now, preferably Haakaa style (available online, Rustans Department Store, or The Parenting Emporium)
• Breastmilk reusable storage bottles or disposable storage bags - I am kind of looking for the disposable ones because I am still not sure how much breast milk I can use, nor do I know if I really need it because as of know, I am planning on breastfeeding fulltime
• Bottles and nipples
• Nursing bras and breast pads - Yeah, I already bought nursing bras and breast pads (because my breasts started to hurt from my 3rd month of pregnancy, so might as well get nursing bras already)
• nursing pillow - Is this worth it? Though Tin recommended it too, particularly the U-shaped one. Anyway, online and in department stores, it can costs so much, roughly up to 1000 for something that a normal pillow can also do, right? Though we did see it cheaper in Shopwise... haha
• nursing tops - I am still thinking if I want to buy nursing tops or I can just use a nursing cover which is more versatile
• 4 cotton bibs
• 12 burp cloths (bird’s eye, gauze or cotton) - They say burp pads are a bit small, so it's better to use bigger ones like event the hooded towel, receiving blankets, or the lampin
• Bottle/nipple brush

From this list, I am more concerned with the breast pump.
Do I need that? Electric or Manual? From what I read, Medela is usually the one being recommended... if we can afford it. Though at this point, I am looking into Ameda, which is from Switzerland, it's way cheaper and there's also a warranty for 1 year. I read some good reviews on it too. But do we really need it? Or... for now, we decided to prolong the decision until after the baby is born. Or.. for now, maybe I will just buy a manual one, preferably in the style of Hakaa which had good reviews, including better output than the electric ones.

As of now... I am more concerned with... what if I cannot produce enough breast milk? Does that mean that I need to buy bottles? Just in case. Well, I've read that they say bottles are trial and error. So we should just buy a few bottles of certain brands (brands recommended by friends and the internet), and see if it works for our baby.

So far, most popular in the Philippines is Philips Avent. Though from most US blogs, they say Playtex, Dr. Brown (soooo expensive), MAM are also good especially in preventing colic. We liked the shape of Tommee Tippee (which is cheaper than Comotomo), and we also liked NUK when we were in the department store. Therefore... we limited out bottle choices to Avent and Tommee Tippee and... well since the opportunity arises, Playtex are cheaper coming from the US, so we got those too hehe

3. Diapers

• 30 pcs of Cloth Diapers with inserts
• Diaper changing pads - we already bought one by mistake haha
• Baby wipes
• Cotton balls

Since we are aiming for cloth diapers, I read that we need 24 to 30 diapers because for a newborn, they change diapers every 2 to 3 hours, which is equivalent to 8 to 10 diaper changes per day.

My guess is I should also help with the laundry, particularly for this one because we need the diapers and it needs time to dry (especially with those microfiber and super absorbent inserts).

So far, (and in my excitement) I bought 10 already from Shopee haha We tried different brands, with different types of diapers (all in one, all in two, and pocket) with different features (single versus double gussets), with different inserts (microfiber, bamboo charcoal, hemp, coffee, zorb). Usually for newborns, they say that the microfiber is enough... unless the baby is really heavy wetter, then the hemp and zorb are better absorbers. I am quite excited to experiment which one works best, but since I don't have a baby yet, I may have to lend them to my other friends then tell me their verdict afterwards.

As of now, it seems that Jeff and I are aiming for the cover-type or the all in two diapers, which have snap ons at the end. If the baby pees, it seems that we can just change the insert and still use the same cover. I read that double gusset is important in keeping the poo inside the shell, so we also got those. But... really, it has to depend on the size of the baby and its fitting.

UPDATE: Most department stores only sell the pocket ones usually with microfiber inserts. There are so many better choices  online! So I would recommend to buy online instead. It seems to me that we have already settled for Babyland and Happy Flute cover diapers with hemp inserts coming from Shopee.

4. Clothes
They say that I should refrain from buying too much newborn clothes since they will outgrow them very fast. As I said before, I did think about just inheriting this from my family and friends haha

• 3-6 Tie-sides - best they said, especially for newborn babies who still has their umbilical stumps
• 3-6 Onesies - convenient especially for changing diapers
• 3-6 Mittens - prevent themselves from scratching themselves
• 3-6 Socks - no shoes needed since babies don't walk yet
• 3 Bonnets - prevent the cold from going in
• Burp pads/Lampin/Gauze eye - hmmm... I was just thinking if a microfiber towel serves the same purpose? Microfiber towels are cheaper from Shoppee than lampin!

So we're thinking if we're going to put this on the Baby Registry, because this seems to be the easiest. And there is the possibility that we would want to pick our own baby's clothes, right? (Like... even if we're having a girl, no very girly-girl stuff so much; we prefer it to be neutral)

So... our plan is to wait until after the baby shower to purchase this. Someone will probably give us this even if it's not on the registry. If not, we plan to go to this Hello Baby Outlet in Makati to get clothes in bulk, which is cheaper.

5. Bathing and Grooming Accessories

• 1 bath tub with hammock-like chair
• 1 bottle baby wash (Cetaphil or any brand recommended by the pedia)
• 1 bottle baby shampoo (optional. Baby wash can double as shampoo)
• 3 hooded towels
• 4-6 wash cloths - so isn't this the same as the burp pads above?
• 1 bottle alcohol
• 1 bottle baby oil

• 1 nail clipper or nail file
• 1 soft brush and comb
• 1 nasal aspirator
• 1 pack cotton buds
• 1 pack baby-safe laundry detergent
• 1 digital thermometer

We looked for the bath tubs in SM Department store. Bath tubs can cost from PhP 300 to 2000! Since we're practical people, we think the simple plastic one is already enough, though we are going to get this sort-of hammock-like chair (similar to this one) where the baby can sit because she's still an infant. (In Landmark, they already have a set with both bath tub and net which costs less than its counterpart in SM)

They have different hygiene sets in the Baby Company, so some of those are conveniently packed and ready to be bought as gifts haha Though... what I think we really need are the nasal aspirator and the nail clipper. It's not like the baby would have that much hair when born, right? And we already have a thermometer, as freebie from one of the baby seminars I've attended.

For the consumables,  like the baby wash, shampoo, alcohol, baby oil, cotton buds, detergent... We are not too concerned. We still have many freebies from the baby seminars. We also have to test which one is best for our baby. And... it's not like the baby can already take daily bath after she's born.

6. Travel

• 1 diaper bag
• 1 baby carrier (ring sling or baby wrap is recommended for newborns)
• 1 stroller (optional if you prefer to babywear)
• 1 car seat

From this list, Jeff just preferred a diaper bag that doesn't look like a diaper bag (because he's the one who's probably going to carry it), like this backpack. I prefer it to be one with many pockets and compartments. Bags in the department store costs up to 4k! Whoa! Okay, we have time to look into this and shop online haha Though in the end... we actually got one for free because Cordlife already gave one to us.

For the baby carrier, my sister already gave us one. I am not sure if we going to buy another 1 as an extra. But I guess it would be an investment because carrying a baby will probably hurt my back hehe Though that could also wait until after the baby is born hehe

For the stroller, Jeff preferred it to include a car seat already... Though I was thinking, car seats aren't really common in the Philippines because there's no law about it yet. Though for security purposes, a car seat is always nice. I just prefer the stroller to be lightweight. In the department store, the brand that will fit our expectations was Graco, for the whopping price of 15k! Haha That's the price of the crib already! So... we still have time to look for something else haha

So there you have it. My guess is that it's still too early to buy this but I'm too excited so I'm already on the lookout for sales and reading up on the different kinds! Haha The list is basically based on another blog and this one.

Though a thought came while we were in the department store... Do we really need those sterilizers that cost 15k? I just remember getting the bottles sterilized through boiling in water when I was young haha I guess I still have much to learn and read up on, but it's okay because I'm excited anyway hehe




Since I've been reading up on "essential" things for babies, I also read up on those things that are not really necessary (some of which, I agree). For example, there are a lot of things listed in the SM Department Store Gift Registry, which I don't think are necessary.
Clothes - as I said previously, they say don't buy a lot of newborn clothes, because babies tend to outgrow them very quickly (and they're rather cheaper to buy in bulk in Hello Baby Outlet in Belair, Makati)
Car seat - well, in the Philippines, they are not totally required, unless in the US and they're actually pretty expensive here
Sterilizer - as I said, we can just boil them right? Hehe But I guess it's a nice to have especially if it's a gift hehe
Air purifier/humidifier - really?
Changing table - actually... we are thinking of just a regular drawer... but we're not yet sure since we don't really have enough space for now. Or since we were hoping to get a playpen, they can come with changing tables.
Diaper pail/trash bin - having a separate bin for diapers? Well, I was thinking of a diaper bag because we have to wash this separately from the other clothes because we need it.
High chair - we think it's way tooo far to think about buying one... Actually, I don't really remember if we used one at home before.
Knee pads - I think babies need to crawl on their own and it would only strengthen if they don't have knee pads

Cordlife: Worth it or not?

So we are already on our 2nd trimester, and thinking about banking our child's cord cells upon birth. Since I am a doctor, cord cells is not a new concept for me. In fact, I was surprised that we can do it already here in the Philippines... And I guess that's where my doubt lies.

Let me tell you why we are interested in getting Cordlife.
1. Family history
We have a family history of cancer on my side of the family. That is enough of a risk factor for me.

2. Elderly primigravid
I am already almost 35 years old by the time I give birth, so that is already at risk for trisomies and other malformations.

3. Radiation and chemicals today
As compared to previous generation of raising children, a lot of women my age are having a hard time conceiving, and I believe that there is an increase in the congenital malformations. I think it's due to the radiation of technology today, and the chemicals that we eat everywhere! From canned goods to instant food, to even the pork, beef, chicken, and fish that are fed with chemicals and antibiotics to grow bigger and faster! I really think the likelihood of cancer will increase.

4. Cord Shield
Aside from banking our baby's stem cord, I am also aware that there isn't much health insurance that covers maternity (as far as I know, only Maxicare... and maybe Intellicare? Based on the patients that got admitted on the hospital that I work at). Even SSS doesn't cover maternity benefits if you applied for it too late.

With Cordlife, there is some sort of insurance in case there is fetal and maternal death and complications. Though as of now, there are only 7 types of maternal complications that they cover, which includes pre-eclampsia, DIC, postpartum hemorrhage, abruptio placentae, and fetal death. In the event that the baby also has congenital malformation like Down syndrome, diaphragmatic hernia, common heart defects (ASD, VSD), cerebral palsy, and hydrocephalus, they are also covered.

5. Cord Blood Network
They also offer to extend the use of cord blood to our baby's sibling, ourselves (the parents), and the grandparents.

This is an advantage, yes, but there seemed to be a lot of hang ups with this one (I will explain everything later, which is one of the reasons why we are still hesitant about it.)


Reasons Why We Are Still Hesitant:
1. Insufficient Quantity
The contract states that for the cord blood to be valid, they only require 15 mL... which is in international standards is very limited. (But the blood bag, according to the agent holds up to 250 mL).

Because of this other blog, I learned that even Cordlife themselves admit that their own units are limited to less than 40 kg patients... Meaning not adults. Heck, today, some children 12 years old and above are already more than 40 kg!

So... I was thinking maybe we could increase the quantity to at least 40 or 50 mL collection, before we can consider it sufficient quantity? I have to talk to my OB about it, because she is the one to collect the blood.
If the collection is insufficient or no blood was collected, Cordlife will give us a full refund.

2. Application in the Philippines
Just about... how many cases of umbilical cord transplant are there in the Philippines? Apparently, 3 have already been released. One of which is in Davao, Cerebral Palsy, where a team of doctors, including a doctor from Singapore Cordlife and a doctor from Manila, came to Davao to do the transfusion for the patient, and she improved.

So... am I safe to assume that the doctor will be provided by Cordlife in any hospital in the Philippines? Or if not... how do I know which doctor is "accredited" by Cordlife?

Either way, up to what part will Cordlife cover the cost of the actual procedure? According to their Cordlife Transplant Care Guarantee, they will give SGD 50,000 if the baby is the one that needs the procedure. So... does that cover everything already? But if it's not the baby herself, I assume that we will be the one to shoulder the procedure and the hospital bills... which will roughly cost millions?

But... what if the baby needs a transplant, but it's not her cord blood (it's not autogenic), but an allogenic transplant? So does that mean, Cordlife Transplant Care is not applicable anymore?

3. Cordlife Pledge
If my baby needs an autologous transplant, and we later found that the blood is not viable, Cordlife will find a suitable match OR SGD 50,000 lump payout.

But the question is... so if they found a match, are we going to pay for the unit, which the agent says costs millions? But since we're clients of Cordlife, they will sell it to us with a huge discount. This is what Jeff thinks, so we have to ask them about it.


So, we are going to UP Technohub tomorrow to check their lab (might as well), and talk again with our agent Edward to clarify our questions.

Here is the price list given to me by our agent last March in case you are interested:

They have two products which is the Umbilical Cord Blood and the Cord Lining Cells, but we opted to get both. For me, it seems the umbilical cord blood is more important for the baby, while the cord lining cells is more applicable for us adults hehe

They have 3 different payment schemes, which is Classical (only pay upfront, then you have to pay the annual fee very year), Premium (pay upfront and advance for 10 years), and Prestige (pay the whole upfront up to the 18 years).

Of the three, we think we will go for Premium payment scheme because:
1. I think the most crucial in the child's life is the first 10 years. This is where most childhood leukemia is diagnosed... As well as the other diseases listed treatable by umbilical cord blooding, like palsy and autism.
2. IF the theory on cord blood only works for patients less than 40 kg, then it probably won't cover until 18 years of the baby's life.
3. The Classical Plan doesn't have Cord Shield, which is the insurance part during pregnancy.



UPDATE:
We just got back from our site visit from UP Technohub. Princess was the one who explained to us the technical side of the processing of the samples, from the pre-processing to the storage to the withdrawal and use (as far as she knew).

So to answer our previous concerns:
1. Based from her experience, there are patients who is able to get more than 1M TNC from just 15 mL, so it's not necessarily insufficient quantity.
After their processing, they are going to tell the parents if the count is less than 1M TNC. If it's less than that, we have the option for a partial refund (we only pay the 35k). In the case that we want to store it, we sign a waiver.

IF in the future, we need the sample and our transplant doctor deems it insufficient, we have the option of doing a STEM CELL Expansion to increase the number of cells. Unfortunately, this is done in Singapore and there's going to be a fee, which they don't know yet because it hasn't been done. But at least our question was answered.

2. Princess told us that in case we need the blood, our transplant doctor (whoever and where ever we might be) will coordinate with Cordlife's Medical Director. Cordlife will provide a team consisting of the Philippine Cordlife Medical Director and even the Singapore Cordlife Medical Director, which will be shouldered by Cordlife. The Philippine Cordlife Medical Doctor is a pathologist who is also part of the Stem Cell Division in St. Luke's and teaches pathology in PGH and other medical schools.

So they will be the one to assist the parents how to go about it. If the baby is the patient, lucky for them, processing, matching will be done by Cordlife, and they will also give a SGD 50,000 to cover the transplant. In case, another relative will be the patient, processing, matching, and hospitalization will be shouldered by the client.

3. Cordlife Pledge
Yes, we have to pay for the unit but since we're Cordlife clients they're going to give a HUGE discount. (A unit of cordlife costs 5M, according to the agent? Not really sure because it hasn't really been done in the Philippines yet.)

Here's an interesting thought that I learned today. In case that we decided to terminate our contract with Cordlife, we can decide to discard the unit (which is a waste), or sell the sample. I didn't know we could do that! But in the Philippines, since we only have private cord blood banking, there is an option to sell our cord blood to other family who might need it.

Basically, a lot of questions remained unanswered because Cordlife is sooo new here in the Philippines, that there only has been 3 cases where it was used. So... they are also not sure about our other questions because they haven't experienced it first-hand.


So... OUR VERDICT: Yes

And we're... pregnant! (First Trimester Woes)

I didn't think it would be this quick, but we are already pregnant. And may I just say that this is not fun as it sounded like from my mom, who had no symptoms when she was carrying all 6 of us. I am currently on my 13th week of pregnancy already, almost at the end of my first trimester. And I am really hoping the symptoms would start to abate and I could enjoy this pregnancy.

I first learned that I was pregnant on the 2nd week of December. I was feeling nauseous for several days since we came back from Tokyo. I thought it was just some sort of travel-related bug or whatever, but it didn't go away for 3 days. And since I was delayed (I was supposed to have my period when I was in Tokyo), I took a pregnancy test. And it was positive!

I thought it would be easy, because I was a doctor. I should already know things, right?

For a few weeks, I didn't announce it much because I know how pregnancy could go wrong, and the risk of spontaneous abortion was still high. I just told people at work, because I don't want to risk maternal infections. To (supposedly) lessen the anxiety, we had our ultrasound at 8 wks so I can be "sure" that there is a heartbeat.

Unfortunately, I also found a bit of subchorionic hemorrhage on ultrasound even if I was asymptomatic. Since I was a bit paranoid, I told myself to do bed rest and stop work for the next 2 weeks. Unfortunately, this was also the holiday season, so clinic schedules are not regular for a lot of doctors and I cannot consult an OB. Instead I sent a message to my OB friends (who were abroad), who told me to also take Duphaston (which made me my nausea worse).

Being the doctor that I am, I just repeated the ultrasound after one week to find out that it has regressed spontaneously. I therefore conclude that I could attend my cousin's wedding where I was a bridesmaid haha Though another OB friend told me to take Heragest instead if I cannot take Duphaston orally.

I thought my nausea and dizziness was already starting to resolve itself, because during my cousin's wedding, I was fine for the whole day! But... tada... the next day was New Year's Eve, and that's where I felt my nausea the worst, almost vomiting in Friday's at the time. So while everyone was watching the show at Eastwood and enjoying, I wished I was at home, curled in bed and trying to sleep off the nausea.

The term "morning sickness" is actually deceiving, especially for me whose nausea is even worse at night. I cannot drink water, cannot smell Japanese or Chinese food, cannot eat chicken -- these things made my nausea really bad. I really miss the water though. I wasn't much of a juice person before I got pregnant. But now... the water tastes metallic and weird. Though I find it more tolerable if it's cold. I used to love Japanese food and chicken before I got pregnant too... but I guess what do they say when you're pregnant? You abhor your previous favorites and start to eat other new things that you usually don't eat, right?

I am sooo thirsty right now as I'm writing this, because sugary drinks also make me thirsty. But if I drink cold water, it makes me nauseous and bloated and uncomfortable in my stomach.

Good news is... it seems the morning sickness is starting to let up. I was able to drink water in my parents' home, even if it was warm just last weekend!! I was so happy! Unfortunately, when I got home, I still taste the metal in the water. Argh.... I wish I could just stay in my parents' home in the meantime... Or at least get myself some water from our purifier there.

And just when the morning sickness was starting to let up, I had an episode of spotting! I thought I was more or less safe because the last ultrasound only showed minimal hemorrhage, and my Heragest was actually discontinued (for 5 days). And also, because I am near the end of the first trimester already. I basically panicked when I saw the piso-sized brown blood on my underwear when I woke up! (Well, I had a dream the other night before that I bled... profusely while I was panicking trying to find my Heragest and a napkin.)

It was a good thing our doctor had a clinic schedule for that day. Ultrasound was done, which showed low-lying placenta for me... And I was advised 2 weeks bed rest again :( I am so depressed.

And now, I am being emotional and crying yesterday, feeling sorry for myself. I really hope the next two weeks pass by quickly...